The paper “Should governments buy the drug patents?” published 13 years ago in this same journal [1] reflected on aspects that have become relevant again, both for good and bad reasons. The last 60 years have seen huge advances in many of the scientific, technological, and managerial factors that raises the efficiency of commercial medicines research and development (R&D). Yet the number of new medicines approved per US billion dollars spent on R&D has halved roughly every nine years since 1950, falling around 80-fold in inflation-adjusted terms…