Summer Reading List 2017: Even More Tales to Inform and Amuse You


It’s time once again for my annual roundup of some of the best books I've read this year. As usual, my focus is on non-fiction tales from the world of science, medicine, and technology. A master list of all books that I recommend can be found here, and you can also check out my previous book recommendations from 2016 and 2015. Here's my latest list:
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So What Did the March for Science Accomplish?


In the words of a wise former colleague, “don’t know, can’t say.”

With this historic event only a week behind us, it’s going to take time to figure out if the March for Science accomplished anything significant. Part of this is due to the fact that its stated goals were rather
diffuse. Data, of course, needs to be collected, sorted, and analyzed, which will happen because the March was studied by a slew of sociologists. Turnouts at the more than 600 marches worldwide were high, with enthusiastic crowds displaying a diverse cornucopia of signs and slogans not usually paraded about in public. As far as I can tell, the marches were uniformly peaceful affairs, with no counter protesters demonstrating in favor of “alternative facts.” I also saw a number of people sharing religious points of view, happily conveying their opinions that one can believe in both God and science. There was even a group of Satanists marching; I didn’t know until visiting their website that they, too, take a pro-science stance.
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Why I’m Joining in the March for Science


If you haven’t heard yet, there's going to be a nationwide
March for Science on Earth Day, April 22nd. This includes a primary March in Washington, DC, as well as “sister” marches around the globe (at least 320 cities have already signed up). I’m planning on marching here in Seattle, and I’m writing this to encourage others to participate in whichever March is most convenient for you to attend. The March for Science is being supported by a number of prominent organizations, including the American Association for the Advancement of Science, the Union of Concerned Scientists, and the NY Academy of Sciences. Not all scientists think the March will be helpful (and some have voiced that it could even be harmful), but I’m not in that camp for the reasons I’ve outlined below.
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BioPharma and Hollywood: Land of the Blockbusters


When you hear the word “blockbuster”, what’s the first thing that comes to your mind?
a) A movie that earns hundreds of millions of dollars at the box office
b) A prescription drug that brings in more than $1 billion a year in sales
c) A bankrupt chain of video stores
d) A large bomb capable of destroying an entire city block

All four of these choices are valid answers, but the focus of this article is on the first two. The parallels between biopharma and Hollywood are strong. Both industries invest huge amounts of money in a large number of projects with the hope that some will turn out to be blockbusters i.e. massive money making machines. Sometimes it works out, but the failure rate is high, with most drugs (and many movies) never recouping their development costs. Both groups also love to develop sequels, which is a simpler strategy than developing riskier independent products that their fickle public may, or may not, embrace.There are many aspects of their businesses that are shared by the pharmaceutical and movie industries. Let’s see how they compare:
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Hollywood and BioPharma: Differentiated by Unique Economic Models


In my previous post, I detailed numerous similarities between the pharmaceutical and film industries. Now it’s time to point out the substantial differences between these two businesses that illustrate their different economic consumption and pricing models.

Production Costs - Big Barriers to Entry in Pharma, but Not Film
Nobody’s producing drugs in their basement that are going to earn them a ton of money. Okay, let me rephrase that. Nobody’s producing legal pharmaceuticals in their basement that are going to earn them big bucks. Creating prescription drugs is a very expensive enterprise. The cost of bringing a new drug to market has been estimated by the Tufts Center for the Study of Drug Development to be about $2.6 billion. That’s a huge hurdle to making money. There’s no getting around extensive research, filing multiple patents, complicated manufacturing steps, expensive clinical trials, and detailed regulatory and FDA filing requirements. How long might it take just to recoup those costs? Let’s return to my previously cited example of a very poor selling drug. Seattle’s CTI BioPharma sold only $3.47 M of their non-Hodgkin disease/B-cell lymphoma drug Pixuvri worldwide in 2015 (all sales were in Europe). If it cost the company the current industry “average” of $2.6 billion to develop it (which it didn’t), it would take about 749 years just to recoup that money, based on 2015 revenues. And that’s without showing a profit. It’s a pretty safe bet this drug will never recapture its development costs no matter what they were.
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Would Government Buyouts of Pharma Companies Really Be A Good Way To Lower Drug Prices?


Here’s a novel way to lower health care costs: make the US government a purveyor of drugs. In a recent
article in Forbes, Peter Bach and Mark Trusheim suggested that the US government could reduce drug costs by buying Gilead and distributing its hepatitis C medicines at a greatly discounted price. The idea, on the face of it, is an interesting one to consider. In their scenario, the government buys Gilead for a 30 percent premium on its current stock price, spending $156 billion. The government would then sell off the R&D operations as well as a strong franchise of HIV drugs, reducing the “net cost” down to $77 billion. Other financial adjustments reduce the price further, lowering the cost to treat each patient down to $15,733 from what they claim is the current cost of $42,000. This represents a pretty nice cost savings when spread out over a patient population of 3.2 million people (including about one out of every three people in prison). Gilead’s hepatitis drugs certainly rank at or near the very top of innovative medicines coming out of biopharma in the last 25 years. However, the Forbes article did not delve into some of the far-reaching ramifications of what government buyouts might mean to other players. Let’s take a deeper look below the surface to see what such a buyout might portend.
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