Nay 17, 1967

Hone Gaylord Nelson
United States Senate
washington 25, D.C.

Dear Gaylord~

As I am sure you know without my repeating it, I have been a longterm
admirer of yours since before paur election as Governor of Wisconsin. On
that premise, I may be too presumptuous in writing this comment, but I
hope you will not misunderstand my motives.

what perturbs me is the muckraking flavor of your current investigation
of drug ppices. There are, of course, plenty of abuses in the short run
picture, and I have no criticism of their re-exposure. But a rerun of the
Kefauver hearings seems such a stole thing to do. If I heave a serious cri-
ticiem, it is not what your committee seems to be doing; I am disappointed
in what it is apperw@mtily not doing: an honest investigation to discover
new facts and constructive policies (as opposed to an expose of old ones)
that can reconcile the conflicting motives and interests involved in the
drug in@ustry. To rake it over the coals for ite prices provides maximum
pressure on just one protuberance of a very complex problem, end I am afraid
will have the most paradoxical effects in the long run.

I would urge you then to take on a much broader approach to the whole
problem. There are important elements of the drug industry no lese disturbed
than you and I are about the hucksterism that makes up a growing part of
ite total activies, and together with academic and government interests
could work with you on a much more constructive cooperation. The point that
concerns me the most is how to provide the incentive for much more research
investment in new drug development, and disincentives for the misleading
and odious promotional practices that dominate the industry's budgets. We
heave to attend to pricing too, but I must say I have to put that oat an even
lower priority than these considerations. The most expensive drugs there
ever can be are the ones that are not developed; and I am equally concerned
about the non- and mis-education of the medical profession about new drug
development. ‘To half-socialize the industry seems to me a self-detructive
blunder, and we have to come to some clarity whether we are going to moti-
vate research investment by some (reasonably rezulatec) profit incentive or
by direet subsidy. It is indubitsble that the profit incentive nourishes a
lot more than research, but if we could meet that problem head on, we might
get a lot more efficient and competitive a system than a subsidy-bereaucreacy
could manage. If ‘exorbitakbhtprofits from high drug prices' really were fed
back into research, would that be such an odious system?

These remarks are personal, but I am enclosing some more public ones
for whatever use you wish to make of then. Best personal regards,

Joshua Lederberg

N°s74N