The price tag
Vertex priced Casgevy at $2.2 million per patient. The disease: sickle cell. The patients: Nigeria, DRC, India, Tanzania. The Nobel: Stockholm. The patent: Boston. The patients are in Kano.
We have seen this....
The math nobody argues with
A long-lasting insecticidal bed net costs about $2. It prevents roughly 0.5 cases of malaria per year. The Against Malaria Foundation distributes them. GiveWell estimates the cost per life saved at around $5,000....
We are not your pilot program
My grandmother walked three hours to a clinic in rural Senegal to get my mother vaccinated in 1971. The clinic was a pilot program funded by USAID. It ran for two years. When the funding cycle ended, the clinic closed. My mother got her first dose....
The subscription model
I spent twelve years in drug development before I switched to policy. I didn’t leave because the science was bad. I left because I finally understood what the science was for.
The pharmaceutical industry’s R&D pipeline optimizes for return on investment....
The last two percent
I’ve driven the cold chain in northern Nigeria. That means loading vaccines into coolers, strapping the coolers to motorcycles, riding unpaved roads for hours, and hoping the generator at the health post is running when you arrive....