2013年5月15日星期三

Joseph E. Stiglitz: Lives versus Profits / 生命與金錢之博弈




This illustration is by Paul Lachine and comes from <a href="http://www.newsart.com">NewsArt.com</a>, and is the property of the NewsArt organization and of its artist. Reproducing this image is a violation of copyright law.NEW YORK – The United States Supreme Court recently began deliberations in a case that highlights a deeply problematic issue concerning intellectual-property rights. The Court must answer the following question: Can human genes – your genes – be patented? Put another way, should someone essentially be permitted to own the right, say, to test whether you have a set of genes that imply a higher than 50% probability of developing breast cancer?

To those outside the arcane world of intellectual-property rights, the answer seems obvious: No. You own your genes. A company might own, at most, the intellectual property underlying its genetic test; and, because the research and development needed to develop the test may have cost a considerable amount, the firm might rightly charge for administering it.

But a Utah-based company, Myriad Genetics, claims more than that. It claims to own the rights to any test for the presence of the two critical genes associated with breast cancer – and has ruthlessly enforced that right, though their test is inferior to one that Yale University was willing to provide at much lower cost. The consequences have been tragic: Thorough, affordable testing that identifies high-risk patients saves lives. Blocking such testing costs lives. Myriad is a true example of an American corporation for which profit trumps all other values, including the value of human life itself.

This a particularly poignant case. Normally, economists talk about trade-offs: weaker intellectual-property rights, it is argued, would undermine incentives to innovate. The irony here is that Myriad’s discovery would have been made in any case, owing to a publicly funded, international effort to decode the entire human genome that was a singular achievement of modern science. The social benefits of Myriad’s slightly earlier discovery have been dwarfed by the costs that its callous pursuit of profit has imposed.

More broadly, there is increasing recognition that the patent system, as currently designed, not only imposes untold social costs, but also fails to maximize innovation – as Myriad’s gene patents demonstrate. After all, Myriad did not invent the technologies used to analyze the genes. If these technologies had been patented, Myriad might not have made its discoveries. And its tight control of the use of its patents has inhibited the development by others of better and more accurate tests for the presence of the gene. The point is a simple one: All research is based on prior research. A poorly designed patent system – like the one we have now – can inhibit follow-on research.

That is why we do not allow patents for basic insights in mathematics. And it is why research shows that patenting genes actually reduces the production of new knowledge about genes: the most important input in the production of new knowledge is prior knowledge, to which patents inhibit access.

Fortunately, what motivates most significant advances in knowledge is not profit, but the pursuit of knowledge itself. This has been true of all of the transformative discoveries and innovations – DNA, transistors, lasers, the Internet, and so on.
A separate US legal case has underscored one of the main dangers of patent-driven monopoly power: corruption. With prices far in excess of the cost of production, there are, for example, huge profits to be gained by persuading pharmacies, hospitals, or doctors to shift sales to your products.

The US Attorney for the Southern District of New York recently accused the Swiss pharmaceutical giant Novartis of doing exactly this by providing illegal kickbacks, honoraria, and other benefits to doctors – exactly what it promised not to do when it settled a similar case three years earlier. Indeed, Public Citizen, a US consumer advocacy group, has calculated that, in the US alone, the pharmaceutical industry has paid out billions of dollars as a result of court judgments and financial settlements between pharmaceutical manufacturers and federal and state governments.

Sadly, the US and other advanced countries have been pressing for stronger intellectual-property regimes around the world. Such regimes would limit poor countries’ access to the knowledge that they need for their development – and would deny life-saving generic drugs to the hundreds of millions of people who cannot afford the drug companies’ monopoly prices.

The issue is coming to a head in ongoing World Trade Organization negotiations. The WTO’s intellectual-property agreement, called TRIPS, originally foresaw the extension of “flexibilities” to the 48 least-developed countries, where average annual per capita income is below $800. The original agreement seems remarkably clear: the WTO shall extend these “flexibilities” upon the request of the least-developed countries. While these countries have now made such a request, the US and Europe appear hesitant to oblige.

Intellectual-property rights are rules that we create – and that are supposedto improve social well-being. But unbalanced intellectual-property regimes result in inefficiencies – including monopoly profits and a failure to maximize the use of knowledge – that impede the pace of innovation. And, as the Myriad case shows, they can even result in unnecessary loss of life.
America’s intellectual-property regime – and the regime that the US has helped to foist upon the rest of the world through the TRIPS agreement – is unbalanced. We should all hope that, with its decision in the Myriad case, the Supreme Court will contribute to the creation of a more sensible and humane framework.


Joseph E. Stiglitz, a Nobel laureate in economics and University Professor at Columbia University, was Chairman of President Bill Clinton’s Council of Economic Advisers and served as Senior Vice President and Chief Economist of the World Bank. His most recent book is The Price of Inequality: How Today’s Divided Society Endangers our Future.



生命與金錢之博弈

紐約——美國最高法院最近開始審議一宗案件——該案件突顯出了知識產權引發起的深層次問題。最高法院必須對以下面問題提供答案:就是你我都有的基因——能否被人列為專利呢?換句話說,法律是否容許某人有權決定你可不可以接受一個檢查,驗出是否擁有一對令你有超個百分之五十罹患乳癌的基因。

對那些不曉知識產權的人來說,當然是不可以。你固然擁有自己的基因,一間公司極其量是擁有測試基因的知識產權﹔因為公司所費不菲來研究及發展該測試,公司亦當收取合理檢驗費用。

但美國猶他州的麥利亞德基因公司(Myriad Genetics)不止於此,它稱擁有與乳腺癌兩個關鍵基因所有測驗的專利,並且毫不留情地行使這權利,儘管其測試不及由耶魯大學所提供較便宜的檢驗。其後果是可悲的:對高危病人提供徹底且可負擔的檢可以挽救生命。不準許這種檢查會賠上生命。麥利亞德是唯利是圖的典型美國企業,甚至罔顧人命。

這是一個尤其觸目的事件。通常,經濟學家慣常談及得與失:他們認為較小保護知識產權會減小推陳出新的動力。最諷刺是就算沒有麥利亞德公司,它的研究最終都會出由政府資助及國際間的努力去發現人類整套基因排列,一項現代科學的非凡成就。麥利亞德公司稍早的發現帶給社會的好處遠不如它不惜一切圖利為社會換來的悪果。

更多人越來越覺得現有的專利制度不獨令社會付上沉重 的代價,更如麥利亞德公司的這基因專利般未能擴大創新。何況分析基因的技術不是麥利亞德公司發明,如果那些技術都有專利權,麥利亞德公司就不能有所發現了。而它對其專利權的緊密控制已經阻礙了發展更好更準確基因測試研究。其實很簡單 , 所有的研究都是建基於已往的相關研究。像目前這個設計糟糕的專利權制度會阻礙往後的研究。

這就是為什麼我們不允許專利權出現於數學的基本知識之原因。這也是為什麼基因專利權實際上會減少關於基因的新知識:新知識最重要以往的研究成果,然而這些研究成果卻因專利權而被禁止使用。

所幸的是知識重要的演進是由於求知慾而不是利潤,革命性的發現和創新如DNA、晶體管、激光、互聯網皆如此。

一宗美國法院案件突顯了靠專利權而壟斷會帶出一嚴重危險:貪腐敗。由於專利產品價格遠遠高於其生產成本,因此經藥房、醫院或醫生推銷產品就可以謀取暴利。

紐約南區的聯邦檢察官最近就指控告瑞士巨型制藥廠諾華(Novartis)正正如此,藥廠向醫生提供非法回扣、酬金和其他好處, 該公司三年前在一宗訴訟和解中應承不會如此做。確實,美國消費者權益組織【公民】就計算過,僅僅是在美國醫藥行業就因與聯邦及州政府的法庭裁決和金錢和解都支付了數以億計美元。

可哀的是,美國和其他發達國家一直 催逼加強全球知識產權管制。這種制度會限制貧窮國家得到發展所需的知識——並且會讓數以億計支付不起藥物公司壟斷而生的高價藥物而無法得到用來救命的非專利藥物 (genric drugs)

這事在正在進行的世界貿易組織(WTO)談判中會達到高潮。世貿的知識產權協議,簡稱TRIPS,原本是向全球48個最不發達的國家,即是國家人均收入每年在800美元以下,彈性處理。原本協議非常清晰:WTO應該這些最不發達國家彈性處理。然而當這些最不發達國家正式請求時,美國和歐洲卻對履行承諾踟躕不進。

知識產權是我們造出來的規矩,改善社會本是原意,但不公平的知識產權制度造就低效率,包括壟斷利潤及不能善用知識,阻礙了創新步伐。而且如麥利亞德案例,這些知識產權規則會引致無謂的生命損失。

美國的知識產權制度是美國借助TRIPS協議強推到世界各地,是一個不公平的制度。我們均希望美國最高法院藉著對麥利亞德案例的裁決,締造一個更合理和更人道的架構。