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Biotechnol Healthc. 2010 Fall; 7(3): 1.
PMCID: PMC2957733


In Christopher Nolan’s smash-hit movie Inception, the main character is a top expert in the art of dream extraction — stealing secrets that reside in a person’s subconscious when that person is asleep. If thoughts can be stolen, he reasons, might they also be implanted, and goes on to show us that, yes, they certainly can. Of course, the movie is another take on corporate espionage, but it got me thinking. Suppose that a pharmaceutical company could implant a thought in a medical director’s subconscious? Like, “Pay for Drug A,” or “Remove utilization requirements,” or…. Well, you get the idea.

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We could play quite a game with Nolan’s basic assumption. And the reality is that the architecture of the human mind has been under considerable study for some time as psychologists, neurologists, and experts in artificial intelligence, among others, probe how it works. Eye trackers, for example, can determine the limits of what a person notices, and thereby determine what is present in the mind.

What has this got to do with biologics and how to pay for them? Well, patients to a good extent depend on their perceptions rather than hard facts when deciding whether to accept and stick with a particular therapy. The persuasion of direct-to-consumer ads, for example, is a phenomenon that payers are all too conscious about. And patient perception usually leads to the demand for what is perceived to be a better, but usually more expensive, drug.

With cancer, it gets even trickier, because the extension of life is at stake. But cancer costs are un-sustainable, a point that each article in this issue of Biotechnology Healthcare makes. Would implanting factual information about what a cancer drug can and cannot do in patients’ collective subconscious help ?

Lola Butcher writes about the success of clinical pathways in tamping down cancer costs, but not without caveats. And her extended sidebar on how therapeutic vaccines will affect pathways gives payers another dilemma to ponder. Senior Contributing Editor Bob Carlson, in an excellent report on how payers are rethinking the management of molecular diagnostics, makes the salient point that prior authorization is costly — which adds to overall treatment costs. Getting oncology diagnostics to market is going to get trickier, says Sarah Collins, and the viewpoint expressed by Shannon Doyle, an undergrad Public Health student, reminds us that biologics have now been mainstreamed.

Inception is also about my beginning as Managing Editor of this very informative publication. I encourage our readers to let me know what it is you want to know about biologics —what ideas do you want implanted? You can reach me at «moc.erachtlaehygolonhcetoib@srotide».

Articles from Biotechnology Healthcare are provided here courtesy of MediMedia, USA