At the end of his paper, Sismondo suggests nationalizing clinical trial planning and funding in order to avoid the issues which come about as a result of industry funded research. I think this is an interesting suggestion and opens up a variety of further talking points. Firstly, is it likely that the money spent by corporations could be matched by the government? Drug companies spend roughly 30 billion dollars a year on advertising and marketing, a figure which the government may not be willing to match.
Furthermore, drug companies are multinational, operating and servicing many countries; if research is nationalized it seems possible this could lead to national divisions in terms of the sharing of knowledge. Perhaps those countries most in need of new drugs will be unable to access them, or the empirical knowledge concerning them, as a result of the constant political conflict which occurs globally.
I certainly share Sismondo’s sentiments concerning innovation; (perhaps a little idealistically) I believe scientists are not mainly motivated by money. The Nobel Prize is a good example of this, for many scientists it is a dream and driving force that they might someday be directly or indirectly awarded in this manner. However, I think an argument might certainly be made that putting this power in the hands of governments is also a dangerous thing to do.
Nationalization can create too much centralized power and allows the government to exploit said power; while this is unlikely in most transparent democracies, it remains a concern in some.
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