Patent

You may argue the hypothetical situation that I put up yesterday would never happen, and I’m too mean to patients with orphan diseases.

Very true. The flaw of my argument is obvious: Not all treatments of various orphan diseases appear on the market simultaneously. At any one time, only a few of them have effective but expensive treatments.  New drugs (with an astronomical price) for other rare diseases may appear one by one years later, but existing treatments would become less expensive during the same period because they lose their patent.

But, hold on. Would they lose their patent that easily? Not that much as you think. It is naive to believe a new drug applies for one patent – there are dozens if not hundreds or thousands. In fact, for many drug companies, the main duty of the R&D department is to explore modifications (usually in the manufacture and packaging) of an existing patented product so that new patents could be applied and the monopoly of that drug could be everlasting.

And, even if the patents are all expired, would there be a competitor to make a generic product? The incentive is not that high for a rare disease, simply because the market is small. (Readers with some knowledge in infectious disease could certainly cite a handful of examples that are used for treatment of uncommon infections.)