{"id":295,"date":"2004-07-09T10:19:27","date_gmt":"2004-07-09T14:19:27","guid":{"rendered":"http:\/\/chimeraobscura.com\/vmalt\/?p=295"},"modified":"2006-05-01T09:00:11","modified_gmt":"2006-05-01T14:00:11","slug":"who-knew-2","status":"publish","type":"post","link":"http:\/\/chimeraobscura.com\/vm\/who-knew-2","title":{"rendered":"Who Knew?"},"content":{"rendered":"

My From the Editor page in the July\/August issue of my day job<\/a>:<\/p>\n

Who Knew?<\/strong>
Cancer drug prices explained! (and the Gell-Mann Amnesia effect, to boot!)<\/em><\/p>\n

In June 2004, Robert Bazell, the chief science correspondent for NBC News, wrote an article called Strange Medicine<\/a> on Slate.com<\/a>. I’ve read Slate, which is owned by Microsoft, for a few years now. It has its partisan turns, which can drive me to distraction, but I find its articles pretty informative, in general.<\/p>\n

In his article Mr. Bazell attempts to explain why cancer drugs are so expensive. He writes, \u00c3\u00af\u00c2\u00bf\u00c2\u00bd[T]he simplest answer is that drug companies can charge whatever price they want.\u00c3\u00af\u00c2\u00bf\u00c2\u00bd Who knew it was that simple? I certainly didn’t, so I kept reading, to find out why Pharma doesn’t charge $1 million per dose of every drug (a prospect which surely would’ve made this year’s Top 20 Pharma Companies Report<\/em> even more entertaining).<\/p>\n

Well, I discovered, it’s because Medicare has failed to rein in costs by setting fees for treatment. Since private insurers follow Medicare’s lead (until they don’t, in Mr. Bazell’s world), new MAbs for cancer like Erbitux and Avastin are ridiculously expensive because drug companies want to charge lots of money for them. He writes, “Like all pharmaceutical companies, [Bristol-Myers Squibb] and Genentech cite research costs and the huge risks involved in drug development (many drugs fail; clinical trials are expensive . . . but haven’t we heard it all?) as explanations for the high prices of their drugs. But the real reason is that market forces do not apply to drugs.” Who knew? Perhaps the $2 billion that B-MS committed to ImClone to co-market Erbitux simply grew on a tree, too.<\/p>\n

Referring to manufacturing those same drugs, he writes, “True, these antibodies are more expensive to produce than most pills, but only slightly–the technology can be replicated in any college biology lab. Production costs amount to few dollars a dose at most.” (You can go back and read those lines again; I’ll wait.)<\/p>\n

Again, who knew? All this time, I was under the impression that my readers and advertisers were manufacturing and purifying multi-step chemical and biological processes under cGMPs at large scale, then storing, packaging and distributing them, while educating doctors and other prescribers about the uses and benefits of their products (e-mail<\/a> me to let me know what additional steps I missed, like formulation and validation). Now I realize that a bunch of college kids could make Erbitux to treat the 106,000 annual colon cancer diagnoses that Mr. Bazell cites, and there wouldn’t be any problems at all!<\/p>\n

At this point I rapidly concluded that my AppleCare warranty likely wouldn’t cover damage to my nifty new laptop caused by hefting it across the room. Then I was reminded of something I read a few months ago. At the risk of turning this space into the \u00c3\u00af\u00c2\u00bf\u00c2\u00bdMichael Crichton page,\u00c3\u00af\u00c2\u00bf\u00c2\u00bd I’d like to A) note that I’ve never read a book of his, and B) cite another of the writer\u00c3\u00af\u00c2\u00bf\u00c2\u00bds speeches<\/a> (to the International Leadership Forum, in April 2002):<\/p>\n

[T]he Gell-Mann Amnesia effect is as follows. You open the newspaper to an article on some subject you know well. <\/p>\n[. . .] You read the article and see the journalist has absolutely no understanding of either the facts or the issues. Often, the article is so wrong it actually presents the story backward–reversing cause and effect. I call these the “wet streets cause rain” stories. The paper\u00c3\u00af\u00c2\u00bf\u00c2\u00bds full of them. <\/p>\n[. . . .Y]ou read with exasperation or amusement the multiple errors in a story, and then turn the page to national or international affairs, and read as if the rest of the newspaper was somehow more accurate about Palestine than the baloney you just read [about your field]. You turn the page, and forget what you know.<\/p>\n

That is the Gell-Mann Amnesia effect. [. . . I]t does not operate in other arenas of life. In ordinary life, if somebody consistently exaggerates or lies to you, you soon discount everything they say. In court, there is the legal doctrine of falsus in uno, falsus in omnibus, which means untruthful in one part, untruthful in all. But when it comes to the media, we believe against evidence that it is probably worth our time to read other parts of the paper. When, in fact, it almost certainly isn’t. The only possible explanation for our behavior is amnesia.<\/p><\/blockquote>\n

Smart guy, this Crichton. If he applies himself, he may just amount to something in this world.<\/p>\n

Gil Roth<\/a>
Editor<\/p>\n","protected":false},"excerpt":{"rendered":"

My From the Editor page in the July\/August issue of my day job: Who Knew?Cancer drug prices explained! (and the Gell-Mann Amnesia effect, to boot!) In June 2004, Robert Bazell, the chief science correspondent for NBC News, wrote an article called Strange Medicine on Slate.com. I’ve read Slate, which is owned by Microsoft, for a … <\/p>\n

Continue reading “Who Knew?”<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[12],"tags":[],"class_list":["post-295","post","type-post","status-publish","format-standard","hentry","category-pharmaceuticals"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p4C7K-4L","jetpack_likes_enabled":true,"jetpack-related-posts":[{"id":334,"url":"http:\/\/chimeraobscura.com\/vm\/phase-0","url_meta":{"origin":295,"position":0},"title":"Phase 0","author":"Gil","date":"August 4, 2004","format":false,"excerpt":"Neat article in today's NYTimes about changes in preclinical drug testing. That subject matter may not interest you too much, but it's part of my day job, and I have a vested interest in seeing the pharma\/biopharma industry come up with better methods of drug discovery & development.The best part\u2026","rel":"","context":"In "Pharmaceuticals"","block_context":{"text":"Pharmaceuticals","link":"http:\/\/chimeraobscura.com\/vm\/category\/big-business\/pharmaceuticals"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":96,"url":"http:\/\/chimeraobscura.com\/vm\/the-day-job","url_meta":{"origin":295,"position":1},"title":"The Day Job","author":"Gil","date":"November 4, 2003","format":false,"excerpt":"Here's the editorial for the new issue of the magazine I edit for my day-job. Enjoy:You, Too?In the Pharma business, there's no shame in coming in second. Or thirdHardly seems like four years, but that's how long it's been since we launched Contract Pharma. We started with a November\/December issue\u2026","rel":"","context":"Similar post","block_context":{"text":"Similar post","link":""},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":254,"url":"http:\/\/chimeraobscura.com\/vm\/velixollogy-day","url_meta":{"origin":295,"position":2},"title":"Velixollogy Day","author":"Gil","date":"June 23, 2004","format":false,"excerpt":"Wow. I come across this take on the Iraqi flag during breakfast this morning, then I get an e-mail from new VM reader Nancy with a great link critiquing flags from all over the world (Angola: Machete on flag nicely depicted but not wise idea).Enjoy.PS: Cut me some slack, okay?\u2026","rel":"","context":"In "Pharmaceuticals"","block_context":{"text":"Pharmaceuticals","link":"http:\/\/chimeraobscura.com\/vm\/category\/big-business\/pharmaceuticals"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":17,"url":"http:\/\/chimeraobscura.com\/vm\/drug-deal","url_meta":{"origin":295,"position":3},"title":"Drug Deal","author":"Gil","date":"April 28, 2003","format":false,"excerpt":"I'm on a press trip in Puerto Rico this week, as mentioned earlier, and it's been sorta tough to get any blogging done. The perfect sunlight tends to, um, make too much glare on the laptop's screen. Yeah, that's it.Anyway, this morning, before heading out to the beach from my\u2026","rel":"","context":"Similar post","block_context":{"text":"Similar post","link":""},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":388,"url":"http:\/\/chimeraobscura.com\/vm","url_meta":{"origin":295,"position":4},"title":"Pharma BluesGood post by Jane\u2026","author":"Gil","date":"October 11, 2004","format":false,"excerpt":"Pharma BluesGood post by Jane Galt (with TONS of great comments) about the problems with drug pricing in the U.S.In my magazine this month, I posed the following question to my Editorial Advisory Board members for the \"Ask the Board\" feature: \"How do you explain U.S. drug pricing to the\u2026","rel":"","context":"Similar post","block_context":{"text":"Similar post","link":""},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":1539,"url":"http:\/\/chimeraobscura.com\/vm\/utilitarianism","url_meta":{"origin":295,"position":5},"title":"Utilitarianism","author":"Gil","date":"June 6, 2007","format":false,"excerpt":"Every summer, when we get rolling on the annual Top 20 Pharma \/ Top 10 Biopharma report, my trusty associate editor compiles pipeline information for the past year. While I suss out sales figures and try to parse the arcana of accounting, she puts together lists of new drugs that\u2026","rel":"","context":"In "Big Business"","block_context":{"text":"Big Business","link":"http:\/\/chimeraobscura.com\/vm\/category\/big-business"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]}],"_links":{"self":[{"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/posts\/295","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/comments?post=295"}],"version-history":[{"count":0,"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/posts\/295\/revisions"}],"wp:attachment":[{"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/media?parent=295"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/categories?post=295"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/chimeraobscura.com\/vm\/wp-json\/wp\/v2\/tags?post=295"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}