Medicine and business: allies or enemies?

An interesting movie from 2015, “The Big Short” (known as “The Big Bet” in Spanish), illustrates the case of the bursting of the real estate bubble between 2007 and 2010 in the United States and in various parts of the world due to the same mortgage system “subprime”, with real data and characters. The story focuses on Michael Burry, an investor specialized in discovering overvalued assets and betting on their decline, hence the English title of the film “The Big Short”, since that system of buying and selling at different amounts, minors of course, is known as shorts in stock market jargon.
The question is what will Burry, Christian Bale, the actor who plays him, famous among others for the Batman saga, have to do with a note in the health section?
Let’s start with some connections: a retinoblastoma is a tumor, as its name indicates, of cells of the retina and that in some cases requires the removal of the eyeball. Burry has an ocular prosthesis for having suffered from this pathology in his childhood, but not only does that bring him closer to the field of health, but he also self-diagnosed Asperger’s syndrome (some attribute to this in the fictionalized drama-documentary the reason of their particular perception in finances), when studying the pathology diagnosed in one of their children and finding similarities. But perhaps the most striking coincidence is that, academically, he is a neurologist who graduated from Vanderbilt University and is actively licensed in California, despite not actively practicing.
However, the real coincidence with what concerns us is that his financial specialty is finding overvalued financial assets with potential loss of value. This type of operation, the assets in “shorts”was strangely cited in recent weeks in scientific journals such as Nature or especially in Science, the reason? Matthew Schrag, a researcher in Neuroscience at Vanderbilt University, the same as Burry, had published articles questioning the validity of the data regarding a drug, Aducanumab marketed as Aduhelm (which is still being questioned and under review), an antiprotein Beta amyloid.
The accumulation of this protein is a strong hypothesis in Alzheimer’s disease, but it is not definitive that its accumulation is the cause or consequence of the pathology. Due to his questioning, Schrag was contacted by a lawyer representing two investors who suspected that a drug under experimentation, Simufilam, which would block the deposits of this protein (AB * 56), could fail if the hypotheses were true. of Schrag. In such a case, the shares would fall and they would make millions according to the model in which Dr. Burry prevails, the famous “short”.
Following an almost fictional plot, the United States National Institutes of Health (NIH) invested 1,600 million dollars in projects on the amyloid protein, only in the last fiscal year. And, finally, in case there were missing elements to the plot, that the two investors are neuroscience researchers.
But what was Schrag’s job that sparked the interest of the lawyer’s clients who called him? The work commissioned was to review the images published by the laboratory to request the authorization of Simufilam and that supported the amyloid hypothesis and he had already expressed doubts about them. Specifically, he found images that he said would be duplicates and some even constructed from different images. Schrag accepted the job and that led him to pull a thread that took him much further, to other jobs, specifically the jobs that gave impetus to the amyloid protein hypothesis, the one announced by Lesné in his 2006 paper in, Yes: Nature.
The amyloid protein hypothesis is the dominant one regarding Alzheimer’s disease. However, starting with a 2006 study in which it was shown that an amyloid protein, AB*56, would act on memory, it became the benchmark from which a number of clinical and research studies began. The work was spearheaded by a brilliant former graduate of the University of Caen in France, Sylvain Lesné, at the time of Karen Ashe’s team at the University of Minnesota. The latter, a world reference since it had collaborated in the work that led to studies on prions, proteins related to diseases of the nervous system, such as Jakob-Creutzfeldt and which gave the Nobel Prize to Stanley Prusiner in 1997.
The finding that questioned the images is to some extent to simplify and perhaps trivialize it since much has been written about it, as if someone found real and verifiable scientific evidence (not conspiracy and delusional) that the images of the man on the moon have been , how do you rate Science regarding the hypothesis that Schrag questions, an “elaborate mirage”.
The subject is incredibly complex, encompassing highly respected universities and researchers, countless subsequent papers (estimated to be more than 20,000 with their corresponding grants), more than 15 years of scientific research into what could be an orchestrated hoax or , at least, a red herring if proven.
Consequence of this, the same publications in particular the original, Nature 2006, have put a note of caution to those who read the references to date, since they say, the controversy is already being investigated, that is, it is not ruled out, despite all that its questioning would imply. The huge investments, the effort, in time and money, multimillionaire, could mean a profound rethinking. From a medical point of view, it is to reconsider a theory that has been the most cited in a pathology that affects millions of people. In any case, the subject is far from being closed, it is only the beginning.
However, whatever the case may be, it forces us to rethink the paradigms regarding research, medicine, the ethics of both, and somehow accept that economic factors and power groups of all kinds play a role every day. increasingly important in health and this interrelation of factors and the interests at stake cannot be ignored. Clinging to dogmatic or ideological positions would be the worst strategy since, ultimately, for example in this case, all of this would be about finding a solution or at least relief for those who suffer from this devastating disease and for their families.
At the same time, and at a time when medical research overrode some basic limits, due to exceptionality, understanding that the attempt to separate economy and health is no longer possible. It is not only what the material aspect represents for the support of the health system, but the need to include and observe that parameter, the economy, very carefully, accepting reality. Research is necessary and very expensive, but guided predominantly by the profits of the “shares or stock holders”, the shareholders, may not represent an interest for health, balance and ethics, added to the common good. Any partiality will cause harmful imbalances.
The profits made by successful companies in the vaccine boom have been unique. Interestingly, sometimes part of the investigation into something considered alien, like money, points the way.
The evolution of short sales by groups related to experts or global laboratories, or their CEOs, depending on the output of a report in one direction or another, was also very significant.
The media have been filled with characters presented as experts but who in reality do not clearly state their interests or which ones they directly or indirectly represent.
Let us remember that our rulers used to say that they had to choose between health and the economy, and even in a slip of the tongue, someone said “we chose the economy”, and indeed sometimes it seems that way.
It is not about rebelling but about accepting that medicine and the economy are inseparable variables, but for that very reason immense care in the way they interact, that is the dilemma of current medicine and health in general.
In history, but also in individuals, there are relationships of inevitable mutual convenience. Perhaps it is worth exploring this topic before reaching the “therapy” of a couple that is sometimes dysfunctional, with serious consequences for the family.


#Medicine #business #allies #enemies

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