First Opinion is STAT’s platform for interesting, illuminating, and provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others.
To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT publishes selected Letters to the Editor received in response to them. You can submit a Letter to the Editor here, or find the submission form at the end of any First Opinion essay.
The story
“Philanthropy can help create a healthier biotech ecosystem,” Brian Stanley and Michael Nguyen-Mason
The response
Brian Stanley and Michael Nguyen-Mason make the bizarre claim that patents are bankrupting biotech startups. That’s like blaming life jackets for drownings. Patents don’t sink companies; they keep them afloat. Early-stage biotechs rely on patents as key assets to attract investors. Without IP, there’s no capital. Without capital, there’s no innovation. This isn’t a controversial view inside the industry — it’s foundational.
The authors go on to claim that because many startups hope to be acquired, they are incentivized to develop “low-value and duplicative treatments.” That misunderstands how acquisitions work. Investors and acquirers don’t reward redundancy. They look for differentiation, strong data, and technical advantage. No company is acquired for producing useless science. That simply isn’t how value is created, or how deals are made, in this space.
The article also argues that the government may need to intervene more aggressively to realign incentives, underwriting areas with “broader social and system benefits.” It further proposes that philanthropy should step in to fund clinical trials and steer biotech toward less commercially attractive, but socially valuable, innovations. This completely overlooks what’s already happening. Industry is investing heavily in areas like long-acting HIV prevention, antimicrobial resistance, and rare diseases. These aren’t anomalies; they show how public health goals and commercial incentives often align. Philanthropy plays a critical role in supporting research, but scalable innovation depends on private investment — and that investment depends on patents.
Most perplexing is their suggestion that the United States should consider “scrapping the patent system” entirely. That’s not reform. That’s the abandonment of a framework that has powered decades of biomedical progress. We’ve seen the consequences of weakening that system. The 2022 Inflation Reduction Act shortened the revenue timelines for many innovative drugs. As a result, investors are redirecting capital, companies are pausing programs, and developers are stepping back from promising research areas. Patents don’t stand in the way of biotech innovation. They quite literally make it possible.
— Hans Sauer, deputy general counsel, VP for IP, Biotechnology Industry Organization
The story
“The wellness industry is killing animals, spreading disease, and fueling the next pandemic,” by Andrea Love
The response
We run a pointing dog training kennel in Maine. Fifteen years ago, someone gifted us a now popular (then new) raw food for Christmas. We had six dogs and we offered it as a snack at first. Only a day later every dog had come down with C. diff. All six dogs recovered, because they were young and in top condition. But when your dog wants to drink water and it can’t keep it down, and you have to bleach/sterilize an entire kennel, you know you’ll never be tempted with raw food again.
— T. Scot Rhys
The response
This article is 100% accurate and I’d like to distribute it to every pet owner in the U.S.! Just last week I had to refute the advice of yet another ignorant dog breeder who touts the supposed health benefits of feeding raw goat milk to dogs. And don’t forget all the people who fall for the “natural” heartworm, flea, and tick preventives, and those who avoid vaccinating their dog because of the “potent harm” vaccines cause. Just last week I also had to euthanize a dog who was dying of kidney failure, and tests showed he had contracted Lyme disease. I became a veterinarian to help sick pets, yes, but half of my education involved learning about preventive care. It is sad to see pets die of something easily preventable. It’s even worse knowing that the owner was misinformed or misled in how to protect the health of that pet.
— Ellen Harrison, Calvert Animal Hospital
The response
Pet parents are looking for alternatives to the pet food industry, which treats companion animals the same way they treat cattle, with the same ingredients and casual corner-cutting. When independent lab-tested popular grocery store pet food brands come up year after year with traces of the drug vets use to euthanize animals, it’s no surprise that businessmen saw an opening and took it and, in the process, turned their answer to the problem right back into the same problem: greed and limitless profits before ethics and service. The truths about the pet food industry are true. The truths about the alternatives are just as bad. And both sides are a big boon for the vet industry.
Not all the alternatives are bad. Many are not raw, and many make sure their food is constantly outside lab-tested for safety. The solution is not to hold up the big pet food industry as the good guys wrongly accused. They are still the bad guys and themselves refuse to change their formulations. Even advocate pet parents who know the science and what their pets need to thrive have a hard time finding it and often take to supplementation out of desperation.
The bottom line is not to attack the alternatives, but to highlight the business models driving the industry. Smaller is better, human-grade ingredients are better, independent testing is better. Know the science behind what your animal needs. And if they are members of the family, your furry kids, maybe you should be as involved in their food as you are with your actual kids. Finger-pointing is a lot less useful than what we should be doing: demanding constructive ways to fix the problems in both industries.
— Karen Koole
The response
It’s disappointing that Dr. Love made no mention of high-pressure pasteurization treatment in the raw pet food industry. While I agree that the science-denial is a serious issue, leaving out the fact that some within the industry employ proven methods of pathogenic remediation does a disservice to the science community. This type of science communication can serve to further drive a wedge of distrust between the science community and those who are suspicious of science.
— Wes Janzen
The story
“Medicare drug price negotiations need something new: a floor,” by Darius Lakdawalla
The response
Darius Lakdawalla calls for a floor price to be set for each drug undergoing price negotiation through the Center for Medicare and Medicaid Services Drug Price Negotiation Program (DPNP). Lakdawalla contends that the current price-setting from the government lacks transparency and runs the risk of damaging future innovations by arbitrarily lowering the cost of current innovations thus damaging salary potential for researchers. Lakdawalla finishes by calling for the use of a floor-setting formula that accurately captures the value of the benefit offered to the patient by the drug. As such, the floor will be higher for lifesaving therapies and lower for less valuable therapies.
While I agree that innovation must be rewarded and that value-based approaches to drug pricing have shown success in other nations, I question the implications of setting a floor-price for drugs listed in Medicare’s DPNP. One of the primary purposes of the DPNP is to lower out-of-pocket costs for beneficiaries. A formula that assigns a higher floor price for a therapeutic based on the value provided to a patient’s health could unintentionally raise costs for patients and their families, which would be counterproductive to the goals of the DPNP.
Furthermore, research has consistently shown that patients taking multiple medications exhibit higher levels of noncompliance because of cost-related concerns. Patients requiring lifesaving therapies are often prescribed multiple medications and thus, the proposed pricing structure could disproportionately burden the very patients the DPNP seeks to assist, raising serious ethical concerns. It is important to keep in mind as researchers that innovation without access is innovation that fails to fulfill its promise.
I appreciated reading Lakdawalla’s perspective and agree that continued dialogue amongst the science, policy, and law communities is essential to crafting a drug pricing system that adequately rewards and incentivizes innovation while also protecting patient access. At the same time, we must hold government programs to a high standard of transparency and ensure that pricing is not arbitrary and instead reflects both fiscal and human considerations.
— Francis Bateman, UNC Chapel Hill Eshelman School of Pharmacy
The story
“Dismantling the one U.S. agency focused on older adults, people with disabilities is startlingly inefficient,” by Alison Barkoff, Kathy Greenlee, Sharon Lewis, and Henry Claypool
The response
My wife and I have been State Health Insurance Assistance Program counselors for the past two years. We spent 20+ hours per week counseling, conducting in-person presentations, and studying to stay up-to-date with Medicare topics and details. We also support Medicare Improvement for Patients and Providers Act financial assistance and Senior Medicare Patrol fraud and abuse prevention programs. The benefits of these programs cannot be underestimated to the beneficiaries but also the Medicare program. We help new and existing beneficiaries understand the system and options available to them. We help beneficiaries understand Medicare fraud and how to prevent, detect, and report abuse that reduces the system losses. Our Aging and Disability Resource Center has over 50 volunteers providing services to elders of all economic backgrounds. Our state has 500 volunteers providing assistance, all for no costs to anyone, including Medicare. Who will assist the beneficiaries with ADRCs and SHIP programs gone? Who will provide resources and assistance seniors who have worked hard to reach their “golden years” and based decisions on government resources and assistance programs to support their needs? Our elders deserve better from the government officials that were elected to serve citizens. Shame on elected politicians that have forgotten who they serve and cut elder services to fund billionaires with tax cuts. A sad time in this country.
— Steve MacDonough, State Health Insurance Assistance Program
The story
“Trump’s mental health and addiction problem,” by Paolo del Vecchio
The response
Thank you so much for publishing the opinion piece about the dismantling of SAMHSA. I work for a community mental health agency that provides services for people with serious mental illnesses. SAMHSA provides critical guidance, high-quality educational materials, and information that we regularly reference to provide the best care for these individuals in their recovery so that they can live more independently. The loss of SAMHSA will be devastating as I know it will lead to an increase in homelessness, overdoses, and suicides across the country. I believe that if more people become aware of just how much SAMHSA does, they will speak out against the loss of their support.
— Andrew Hannigan
