Disease costs humanity three hundred ninety-seven point four trillion dollars annually.
That's more than global G.D.P. (one hundred and one trillion dollars).
The number sounds wrong because economists spent centuries measuring productivity without accounting for the people who
stopped being productive on account of being dead. The missing piece is disability-adjusted life years, or D.A.L.Y.s: healthy
years deleted by disease. Die at 40 instead of 80? That's 40 D.A.L.Y.s.
Spend 10 years severely depressed? That's 5 D.A.L.Y.s. Globally: 2.55 billion D.A.L.Y.s annually.
At three times G.D.P. per capita (one hundred fifty thousand dollars per year), that's three hundred eighty-two point five
trillion dollars in lost human potential, plus eight point two trillion dollars in direct medical costs and six point seven
trillion dollars in lost productivity. That's the bill. Here's the receipt for the fix: Your D.F.D.A.
(a decentralized F.D.A.) costs forty million dollars per year to run.
It saves fifty-eight point six billion dollars per year in clinical trial waste.
That's six hundred thirty-seven to one returns on R. and D.
savings alone. Total societal benefit (including lives saved): eighty-four point eight million to one.
I know. Those numbers look like someone fell asleep on the keyboard.
They didn't. Here's the breakdown. The Math: From forty-one thousand dollars to five hundred dollars.
Traditional Phase Three trials cost forty-one thousand dollars per patient.
That's a Tesla. Per person. To find out if a pill works. The pill costs 37 cents to make.
The paperwork weighs more than the patient. Then the Oxford RECOVERY trial proved you can do the same thing for five hundred
dollars. During a pandemic. While panicking. They tested COVID treatments on forty thousand plus patients by: Using existing
hospital staff (revolutionary concept: doctors treating patients).
Collecting data electronically (instead of sacrificing forests to the paperwork gods).
Focusing on what actually matters: does the patient live or die?
(not "did they complete form 27-B in triplicate?"). Your D.F.D.A.
takes this model global. eighty to one hundred sixty times cost reduction.
Same data quality. Better real-world applicability. It turns out you don't need 17 committees to answer the question "did
the medicine work?". Where the fifty-eight point six billion dollars Comes From.
Global clinical trial spending: sixty billion dollars per year (and growing, because apparently inefficiency scales beautifully).
Baseline estimate: ninety-seven point seven percent efficiency gains across the market (based on RECOVERY trial's actual
per-patient cost ratio). Ninety-seven point seven percent of sixty billion dollars equals fifty-eight point six billion
dollars saved annually. What fifty-eight point six billion dollars Buys You.
Each new drug approval is worth an average of one point six two billion dollars in market value.
The F.D.A. approves roughly fifty drugs per year per year. That is the speed at which a species with nuclear weapons and
artificial intelligence has chosen to cure itself. Staggering.
With twelve point three times more trial capacity, you could test far more treatments at once.
With the money saved every year, you could: Fund ten thousand new pragmatic clinical trials (at five million dollars each,
which is still luxurious by RECOVERY standards). Test treatments for seven thousand rare diseases currently ignored (because
orphan diseases aren't profitable enough for your orphan-making economic system).
Cut drug development time from seventeen years to three to five years (most terminal patients don't have seventeen years;
this has not occurred to anyone in charge). Make medicines affordable by eliminating two point six billion dollars in development
costs (roughly ninety percent of which is lawyers arguing about commas).
Daily Opportunity Cost. Every day without this system costs one hundred sixty-one million dollars in wasted trial spending
alone. Delayed treatments cost seven point nine four billion disability-adjusted life years, or D.A.L.Y.s, each year.
All because of the regulatory lag period. The lag period is not a safety feature.
It is a waiting room where people die. You just gave the waiting room a nicer name.
See Daily Opportunity Cost of Inaction for calculations. What It Costs to Run.
Your D.F.D.A. costs forty million dollars a year to operate.
Servers, engineers, compliance, global integration. The boring stuff that saves billions.
One-time build cost is similar. For context, this is roughly what your species spends annually on Halloween costumes for
dogs. I need you to sit with that for a moment. Less than one fighter jet.
Less than one yacht. Less than what FIFA spends on "hospitality."
See D.F.D.A. Cost-Benefit Analysis for detailed costs. R.O.I.
Scenarios. In the conservative scenario, the R.O.I. is six hundred thirty-seven to one, counting R and D savings only (N.P.V.
over ten years). In the recommended scenario, the R.O.I. is eighty-four point eight million to one, counting R and D savings
plus post-safety efficacy lag elimination. In the worst case scenario, the R.O.I.
is sixty-six to one, based on higher costs and lower adoption.
Even the worst case (everything goes wrong, adoption is terrible, the engineers quit and the servers catch fire) returns
sixty-six to one. That beats every military investment in human history.
Your worst medical outcome is still better than your best military one.
Let that sink in while you're approving next year's defense budget.