One in every five Americans skips prescription doses because they can’t afford them. Drug prices spike overnight, and people with diabetes have had to turn to GoFundMe by the thousands, begging for the insulin they need to survive. Meanwhile, pharmaceutical companies are raking in profits at more than double the rate of other Fortune 500 companies. Even President Donald Trump has criticized the industry, saying in his first press conference after the 2016 election that Big Pharma is “getting away with murder.”

Yet the basic system that keeps drug prices and profits so high remains undisturbed. Trump’s suggestions for reforms—reducing some out-of-pocket costs for seniors and taking small steps toward negotiating drug prices directly with their manufacturers—have, at least thus far, been timid. (On Friday, he’s expected to deliver a speech laying out those proposals in more detail.) More ambitious congressional bills have not moved forward. And while some state legislatures have been making progress, a recent U.S. appellate court decision struck down Maryland’s new statute against prescription price-gouging, adding fuel to the pharmaceutical industry’s argument that only the federal government has the power to regulate drug prices meaningfully.

For Americans struggling to pay for their prescriptions, the prospects can seem bleak. But the foundation for a dramatic and permanent lowering of drug pricing is already in place: The federal government can and should assert control over the tasks of developing and distributing the medicines Americans rely on every day. That may sound like a revolutionary transition, but it would be far simpler than you may think. The United States already has a model: the defense and space industries. If the government emulated how those are structured, it would be able to deploy taxpayer dollars to ensure affordable medicines while eliminating the breathtaking inefficiencies in the current system. And for Democrats, who are currently looking at ways to fix America’s broken healthcare system, from Medicare for All to individual mandates at the state level, a NASA for drug research is worth considering.



Broadly speaking, a prescription drug in the United States goes through three main stages of development: On the front end, researchers make a scientific breakthrough in their labs, discovering the building blocks of a new drug. Then it goes through the second stage, which includes the often-costly process of clinical research and trials. Last, once the FDA has reviewed and approved it, the drug goes on the mass market, sold at drugstores and doctor’s offices.

The United States is already involved in the earliest stages of drug development. It’s the top funder of basic science research in this country through the National Institutes of Health, which has an annual budget of $37 billion, more than what the federal government pays for Head Start and Pell Grants combined. Most agree that this is money well spent: Every one of the 210 new drugs approved between 2006 and 2010 trace their origins back to government funding.