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[I]n medical school, they never teach us how to tell our patients or their grieving family members that an “inability to afford medications” is a possible — if not common — cause of death. Neither does the Maryland Department of Health allow us to list “inability to pay” as a cause of death on death certificates. Yet, in this patient’s case, there was no truer underlying cause of death than the blatant unaffordability of her prescription medications. She had been admitted to a different hospital exactly one week before I met her. (Nicky J. Mehtani, 6/4)

The first question often asked when learning someone has cancer is, “What kind of cancer is it?” In the era of immunotherapy, our view of cancer is changing. Today, the patient’s immune system is as important as the type of cancer when treating the tumor. We no longer treat patients using a one-size-fits-all approach that subjects them to physically and financially debilitating treatments that may not work. Modern clinicians attempt to optimize the treatment for the patient using tumor-based biomarkers. This approach is called precision medicine (PM). Even when a PM approach is used, there can be failures. (Raymond J. Tesi, 6/4)

President Trump’s plan to lower prescription drug costs uses a surgeon’s scalpel to address a range of issues, offering nearly 30 policy recommendations to modernize payment policies, weed out counter-productive regulations, improve price transparency, and expand competitive price negotiations. The plan reflects the complexity of the industry and the regulatory system that governs government approval and payment for prescription drugs. While it has some barbs, the blueprint respects the need to provide incentives for companies to continue to invest in research, to protect intellectual property rights, and provide the greater transparency and lower costs consumers are demanding. (Grace-Marie Turner, 6/4)

Don't say I didn’t warn you. Shares of Nektar Therapeutics Inc. plunged some 40 percent Monday morning after a disappointing weekend data update on a combination trial of its lead medicine with Bristol-Myers Squibb & Co.’s immune-boosting cancer drug Opdivo. This is just the latest in a series of roadbumps for such combo cancer treatments, which, as I have pointed out, offer as much risk and uncertainty at this stage as they do promise. (Max Nisen, 6/4)

Have you heard the oft-repeated “fact” that it takes at least 10 years from initial discovery for a new drug to enter the marketplace? Take it with a grain of salt. The drug development journey is closer to 30 years. I’ve experienced the lag time between discovery and commercial success as the co-founder of a biotech startup, and now I study it at the Center for Integration of Science and Industry at Bentley University. (Fred D. Ledley, 6/6)