STAT readers reply to a viral essay on animal wellness
First Opinion is STAT’s platform for fascinating, illuminating, and provocative articles in regards to the life sciences writ giant, written by biotech insiders, well being care staff, researchers, and others.
To encourage sturdy, good-faith dialogue about points raised in First Opinion essays, STAT publishes chosen Letters to the Editor obtained in response to them. You possibly can submit a Letter to the Editor right here, or discover the submission kind on the finish of any First Opinion essay.
The story
“Philanthropy might help create a more healthy biotech ecosystem,” Brian Stanley and Michael Nguyen-Mason
The response
Brian Stanley and Michael Nguyen-Mason make the weird declare that patents are bankrupting biotech startups. That’s like blaming life jackets for drownings. Patents don’t sink firms; they preserve them afloat. Early-stage biotechs depend on patents as key belongings to draw traders. With out IP, there’s no capital. With out capital, there’s no innovation. This isn’t a controversial view contained in the business — it’s foundational.
The authors go on to assert that as a result of many startups hope to be acquired, they’re incentivized to develop “low-value and duplicative therapies.” That misunderstands how acquisitions work. Buyers and acquirers don’t reward redundancy. They search for differentiation, sturdy knowledge, and technical benefit. No firm is acquired for producing ineffective science. That merely isn’t how worth is created, or how offers are made, on this area.
The article additionally argues that the federal government could have to intervene extra aggressively to realign incentives, underwriting areas with “broader social and system advantages.” It additional proposes that philanthropy ought to step in to fund medical trials and steer biotech towards much less commercially enticing, however socially beneficial, improvements. This utterly overlooks what’s already occurring. Business is investing closely in areas like long-acting HIV prevention, antimicrobial resistance, and uncommon ailments. These aren’t anomalies; they present how public well being objectives and business incentives typically align. Philanthropy performs a crucial function in supporting analysis, however scalable innovation is determined by personal funding — and that funding is determined by patents.
Most perplexing is their suggestion that america ought to contemplate “scrapping the patent system” completely. That’s not reform. That’s the abandonment of a framework that has powered many years of biomedical progress. We’ve seen the implications of weakening that system. The 2022 Inflation Discount Act shortened the income timelines for a lot of modern medication. Because of this, traders are redirecting capital, firms are pausing applications, and builders are stepping again from promising analysis areas. Patents don’t stand in the way in which of biotech innovation. They fairly actually make it potential.
— Hans Sauer, deputy basic counsel, VP for IP, Biotechnology Business Group
The story
“The wellness business is killing animals, spreading illness, and fueling the subsequent pandemic,” by Andrea Love
The response
We run a pointing canine coaching kennel in Maine. Fifteen years in the past, somebody gifted us a now standard (then new) uncooked meals for Christmas. We had six canines and we supplied it as a snack at first. Solely a day later each canine had come down with C. diff. All six canines recovered, as a result of they have been younger and in prime situation. However when your canine needs to drink water and it will probably’t preserve it down, and it’s a must to bleach/sterilize a complete kennel, you recognize you’ll by no means be tempted with uncooked meals once more.
— T. Scot Rhys
The response
This text is 100% correct and I’d wish to distribute it to each pet proprietor within the U.S.! Simply final week I needed to refute the recommendation of one more ignorant canine breeder who touts the supposed well being advantages of feeding uncooked goat milk to canines. And don’t neglect all of the individuals who fall for the “pure” heartworm, flea, and tick preventives, and people who keep away from vaccinating their canine due to the “potent hurt” vaccines trigger. Simply final week I additionally needed to euthanize a canine who was dying of kidney failure, and checks confirmed he had contracted Lyme illness. I turned a veterinarian to assist sick pets, sure, however half of my schooling concerned studying about preventive care. It’s unhappy to see pets die of one thing simply preventable. It’s even worse realizing that the proprietor was misinformed or misled in how you can defend the well being of that pet.
— Ellen Harrison, Calvert Animal Hospital
The response
Pet dad and mom are on the lookout for alternate options to the pet meals business, which treats companion animals the identical manner they deal with cattle, with the identical substances and informal corner-cutting. When impartial lab-tested standard grocery retailer pet meals manufacturers come up yr after yr with traces of the drug vets use to euthanize animals, it’s no shock that businessmen noticed a gap and took it and, within the course of, turned their reply to the issue proper again into the identical drawback: greed and limitless income earlier than ethics and repair. The truths in regards to the pet meals business are true. The truths in regards to the alternate options are simply as dangerous. And either side are an enormous boon for the vet business.
Not all of the alternate options are dangerous. Many will not be uncooked, and plenty of be certain their meals is continually exterior lab-tested for security. The answer is to not maintain up the massive pet meals business as the nice guys wrongly accused. They’re nonetheless the dangerous guys and themselves refuse to alter their formulations. Even advocate pet dad and mom who know the science and what their pets have to thrive have a tough time discovering it and infrequently take to supplementation out of desperation.
The underside line is to not assault the alternate options, however to spotlight the enterprise fashions driving the business. Smaller is healthier, human-grade substances are higher, impartial testing is healthier. Know the science behind what your animal wants. And if they’re family members, your furry children, perhaps you have to be as concerned of their meals as you’re along with your precise children. Finger-pointing is quite a bit much less helpful than what we ought to be doing: demanding constructive methods to repair the issues in each industries.
— Karen Koole
The response
It’s disappointing that Dr. Love made no point out of high-pressure pasteurization remedy within the uncooked pet meals business. Whereas I agree that the science-denial is a critical subject, leaving out the truth that some throughout the business make use of confirmed strategies of pathogenic remediation does a disservice to the science group. This kind of science communication can serve to additional drive a wedge of mistrust between the science group and people who are suspicious of science.
— Wes Janzen
The story
“Medicare drug value negotiations want one thing new: a ground,” by Darius Lakdawalla
The response
Darius Lakdawalla requires a ground value to be set for every drug present process value negotiation by the Middle for Medicare and Medicaid Providers Drug Value Negotiation Program (DPNP). Lakdawalla contends that the present price-setting from the federal government lacks transparency and runs the danger of damaging future improvements by arbitrarily reducing the price of present improvements thus damaging wage potential for researchers. Lakdawalla finishes by calling for the usage of a floor-setting method that precisely captures the worth of the profit supplied to the affected person by the drug. As such, the ground will likely be increased for lifesaving therapies and decrease for much less beneficial therapies.
Whereas I agree that innovation should be rewarded and that value-based approaches to drug pricing have proven success in different nations, I query the implications of setting a floor-price for medication listed in Medicare’s DPNP. One of many main functions of the DPNP is to decrease out-of-pocket prices for beneficiaries. A method that assigns the next ground value for a therapeutic based mostly on the worth supplied to a affected person’s well being may unintentionally increase prices for sufferers and their households, which might be counterproductive to the objectives of the DPNP.
Moreover, analysis has constantly proven that sufferers taking a number of medicines exhibit increased ranges of noncompliance due to cost-related considerations. Sufferers requiring lifesaving therapies are sometimes prescribed a number of medicines and thus, the proposed pricing construction may disproportionately burden the very sufferers the DPNP seeks to help, elevating critical moral considerations. You will need to consider as researchers that innovation with out entry is innovation that fails to meet its promise.
I appreciated studying Lakdawalla’s perspective and agree that continued dialogue amongst the science, coverage, and regulation communities is important to crafting a drug pricing system that adequately rewards and incentivizes innovation whereas additionally defending affected person entry. On the similar time, we should maintain authorities applications to a excessive normal of transparency and be certain that pricing isn’t arbitrary and as an alternative displays each fiscal and human issues.
— Francis Bateman, UNC Chapel Hill Eshelman Faculty of Pharmacy
The story
“Dismantling the one U.S. company targeted on older adults, individuals with disabilities is startlingly inefficient,” by Alison Barkoff, Kathy Greenlee, Sharon Lewis, and Henry Claypool
The response
My spouse and I’ve been State Well being Insurance coverage Help Program counselors for the previous two years. We spent 20+ hours per week counseling, conducting in-person shows, and finding out to remain up-to-date with Medicare matters and particulars. We additionally help Medicare Enchancment for Sufferers and Suppliers Act monetary help and Senior Medicare Patrol fraud and abuse prevention applications. The advantages of those applications can’t be underestimated to the beneficiaries but in addition the Medicare program. We assist new and present beneficiaries perceive the system and choices out there to them. We assist beneficiaries perceive Medicare fraud and how you can stop, detect, and report abuse that reduces the system losses. Our Getting old and Incapacity Useful resource Middle has over 50 volunteers offering companies to elders of all financial backgrounds. Our state has 500 volunteers offering help, all for no prices to anybody, together with Medicare. Who will help the beneficiaries with ADRCs and SHIP applications gone? Who will present sources and help seniors who’ve labored laborious to succeed in their “golden years” and based mostly choices on authorities sources and help applications to help their wants? Our elders deserve higher from the federal government officers that have been elected to serve residents. Disgrace on elected politicians which have forgotten who they serve and reduce elder companies to fund billionaires with tax cuts. A tragic time on this nation.
— Steve MacDonough, State Well being Insurance coverage Help Program
The story
“Trump’s psychological well being and habit drawback,” by Paolo del Vecchio
The response
Thanks a lot for publishing the opinion piece in regards to the dismantling of SAMHSA. I work for a group psychological well being company that gives companies for individuals with critical psychological sicknesses. SAMHSA supplies crucial steerage, high-quality instructional supplies, and data that we usually reference to offer the very best look after these people of their restoration in order that they will reside extra independently. The lack of SAMHSA will likely be devastating as I do know it should result in a rise in homelessness, overdoses, and suicides throughout the nation. I imagine that if extra individuals change into conscious of simply how a lot SAMHSA does, they may communicate out in opposition to the lack of their help.
— Andrew Hannigan
