December 15, 2023

Theory and practice, drug cost edition

You know the one about theory and practice? That in theory there is no difference between the two, but in practice there is. Yesterday’s post from the economist Alex Tabarrok about better drugs costing more is a great example. Per Tabarrok:

Consider two lightbulbs, one lasts for 2 years the other lasts for 1 year. Which lightbulb is more profitable to sell? Any sensible analysis must begin with the following simple point: A lightbulb that lasts for 2 years is worth about twice as much as a lightbulb that lasts one year. Thus, assuming for the moment that costs of production are negligible, there is no secret profit to be had from selling two 1-year lightbulbs compared to selling one 2-year lightbulb. The firm that sells 1-year lightbulbs hasn’t hit on a secret profit-sauce because its customers must come back for more. If it did it could sell really profitable 1-month bulbs!

The same thing is true for pharmaceuticals. A treatment that lasts for 10 years is worth about ten times as much as an annual treatment. Or, to put it the other way, a treatment that lasts for 10 years is worth about the same as 10 annual treatments producing the same result. (n.b. yes, discounting, but discounting by both consumers and firms means that nothing fundamental changes.)

Too bad that drugs aren’t lightbulbs, hospitals aren’t hardware stores, and that treating people isn’t the same as selling tchotchkes. Well, maybe they are the same in theory, but we looked at actual cancer drugs, and their actual cost, and how much the cost per year correlates with actual improvements in survival, and the answer was: not at all. Novelty of the mechanism of action doesn’t have much to do with the cost either. We didn’t go into what affected the cost, but as I’ve written before, President Biden made a good guess.

So yes, lightbulbs. Cute story, professor Tabarrok, but true only in theory.

December 14, 2023

Here are Mr. and Mrs. Phillip Wase, as seen at the Smithsonian American Art Museum.

Painting of an elderly man and woman sitting in their parlour.

The odd and disengaged looks they both have aside, does Mrs. Wase look like she has a medical condition? Here is a hint.

Close-up of Mrs. Wase's hands holding a book. Fingers look swollen and misshapen in places.

This looks like textbook swan neck deformity, so Mrs. Wase probably had rheumatoid arthritis.

I wish there was a way to see what a post would look like in the micro.blog timeline when posting from MarsEdit. The Title field popping up is a hint that the post may or may not be truncated, but it’s not fool-proof. My first post for today was an example of a fool messing it up!

And while we are at it: being able to see the word count ± choose categories in the MarsEdit micropost window would be wonderful. This very post, which started in the micropost window, is the case study for why.

December 13, 2023

If you think yourself a scientist or physician-scientist, please stop what you are doing and dedicate 5 minutes to reading Darren Dahly’s tip for recording data in a spreadsheet. Your future self, your statistician, and the general scientific community will thank you.

December 12, 2023

Adam Mastroianni is out with another long essay about science and how statistics are not the be-all and end-all of finding the truth, because:

… the whole ritual of “run study, apply statistical test, report significance” is only about 100 years old, and the people who invented it were probably drunk.

So a bunch of drunks built modern statistics on the foundations of probability theory created by a bunch of gamblers. Sweet.

December 11, 2023

📺 Continuing my write-about-it-before-you’re-done-watching series, I would like to turn everyone’s attention to Scavengers Reign. Six of 12 episodes in, and it’s the best thing on TV so far this year. Between that and Across the Spider-Verse, 2023 has been stellar for animation.

Last year we showed that “better” cancer drugs don’t necessarily cost more. In a follow-up analysis just out in JAMA Network Open, it looks like novelty doesn’t have much to do with the price either. Then what does? To paraphrase № 46: drugs cost whatever the market will bear.

December 10, 2023

📺 Three episodes in, the third season of Slow Horses is the best one yet, and also the best live-action series I’ve seen this year (with a nod to Only Murders…). Fun fact: that theme song which sounds awfully lot like it was sung by Mick Jagger was sung by — Mick Jagger!

For Malaysia Airlines, 2014 was a devastating year. I remember flight MH17, which was shot down on July 17 while flying over eastern Ukraine. But months before, another flight — MH370 — disappeared from the radar never to be seen again (well, not intact). A friend directed me to this video, and the story is as engrossing as anything you’ll see on the big screen, only done with flight simulator software and stock footage. Make sure you can spare the full hour before you start watching!

Side note: it’s a good documentary, but Good lord how I hate YouTube’s aesthetics of catchy titles and eye-grabbing thumbnail videos. At least they’ve fixed the comments.

December 9, 2023

If you’ve haven’t heard of Big Biology until today, well, welcome to the club. It’s a podcast, and it describes itself thusly:

Scientists talking to scientists, but accessible to anyone. We are living in a golden age of biology research. Big Biology is a podcast that tells the stories of scientists tackling some of the biggest unanswered questions in biology.

Right up my alley! I started with the latest episode, on invasive species, and the intro seems a bit too scripted, but the focus is on the interviews, and those delivered. It’s already on my Overcast list of regulars. (ᔥRobin Sloan)