&gt;  I don&#x27;t think the people that got cured from metastatic cancer would agree that they would be better of without Merck and their PD-L1 antibodies.<p>Of course they wouldn&#x27;t; its the relatives of all those who could not afford the drug and died who would be all-in for this!<p>And you seem to believe that the Free Hand of Market does magically fix every problem. Not so. It is just a Hand after all, with no eyes and no brain.<p>Big companies have their own share of inefficiencies. Maybe is not as bad as in the public sector, but they are far from working at full capacity. And whatever advantage private sector has you have to offset against the potential for corporate malfeasance. With corrupt public officials at least you know they limit themselves to trying to get rich and providing good paying jobs for their friends. In the private sector you give executives the chance to do the same thing legally, and then they go on to weaponize the patent system and actively block any progress (in house <i>AND</i> from external competitors) that is perceived to threaten a revenue stream.<p>Ultimately the people that count, the intellectual powerhouses that carry the weight of everybody else, are the same ones that you&#x27;ve dismissed as hobbyist. They are the only ones that care about the drugs themselves, and they care enough to do it even if nobody pays them, as long as they are not busy trying not to starve to dead. They usually don&#x27;t care where their paycheck comes from (grants, profits, venture capital, etc), and as long as all their needs and reasonable wants are provided for they continue to perform their magic.