The article is mostly about the difficulties of government run public health systems in smaller countries being strained under the costs of the most expensive medicine on the market (pembrolizumab).

I got curious as to why the medicine was so expensive. Its a deep rabbit hole. In short, some of the high expense is justified because not only was it crazy expensive to develop and test, but even after that production is not easy. Its a monoclonal antibody product.

The good news is the primary patents expire in Europe in 2028, and there are already five companies working “biosimilars” .

There’s absolutely some predatory behavior from the drug maker Merck. This includes trying to reformulate to extend patent protection. A new behavior I hadn’t heard of was Merck has patented the dosage instructions of what is effective so to access that information you’d have to ask Merck for each patient. One clinical trial in India found they got similar pretty good patient outcomes by using a 2mg does instead of the perscribed 200mg dose.

So all of this suggests much more cost effective ways to create and administer the treatment in the next couple of years.

“keytruda” sounds like a random hacking tool you found in a sub menu of Kali