A serious, impassioned, and informed call for change.




In this authoritative survey of the biopharmaceutical industry, a scientist and investor diagnoses current problems and prescribes solutions.

Kolchinsky initially trained as a virologist, but he joined the biotechnology industry later on, and ever since, he says, he’s been on the “receiving end of a fire hose of knowledge.” He sees his current work as a biotech investor as providing a valuable contribution, but part of his book’s agenda is to state a mea culpa: “For too long my utopian view of the biotechnology industry omitted the perspective of patients who couldn’t afford their medications.” He then articulates what he calls the “Biotech Social Contract,” describing the relationship between the pharmaceutical industry and society. This contract would have the drug industry strive to make affordable versions of drugs (as generics) and have a health insurance industry providing universal coverage to keep costs down for patients. The author then enumerates the ways in which the contract has been breached by looking at the cryptic world of drug patents; how health insurance has the overburdened sick subsidize the more fortunate healthy; and the predatory practices of pharmacy benefit managers, who, according to the author, run “a complex shell game.” His main point is that although the biotech industry gets a bad rap for hunting big profits, it’s the insurance industry that’s the real problem; “drug companies must charge temporarily high prices for new drugs,” he argues, as long as their drugs go generic in a timely manner—but insurers, not patients, should bear that cost.

This meticulously organized and extensively supported book offers a thorough introduction to the factors and politics of drug pricing. In clear, deliberate prose, the author engages with and explains a range of concepts to lay readers. Even when Kolchinsky details rather elementary principles—one subsection is titled “How Insurance Is Supposed to Work”—he never strikes a condescending or pedantic tone. It’s hard not to share his ire toward insurance companies, although many readers may see his transfer of blame from the biotech industry and pharmaceutical companies to insurance providers as a self-serving maneuver. Still, his frustration with a dysfunctional system that allows patients to slip through a “patchwork of gaps” is unquestionably warranted. In the final chapter, he calls upon the biotech industry to continue linking revenue to innovation. This lacks the righteous punch of simply stating, “Let’s be ethical actors,” but the writer clearly knows that his industry has to uphold its end of the bargain. Kolchinsky stocks his pages with evidence, explanatory sidebars, and clarifications in regular footnotes. Sometimes, the most interesting point gets buried in the fine print. For instance, in one footnote, the author addresses a hot-button issue of the feasibility of a single-payer system. In the main text, he states that the single-payer model is “beyond the scope of this book,” but he expresses a firmer opinion in the footnote: “Basically, for a country the size of America, a single-payer system is likely only appealing in theory…but would be a tragedy of human incompetence in practice.”

A serious, impassioned, and informed call for change.

Pub Date: Jan. 17, 2020

ISBN: 978-1-73305-891-9

Page Count: 292

Publisher: Evelexa Press

Review Posted Online: March 16, 2020

Kirkus Reviews Issue: April 15, 2020

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Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and...


A dense, absorbing investigation into the medical community's exploitation of a dying woman and her family's struggle to salvage truth and dignity decades later.

In a well-paced, vibrant narrative, Popular Science contributor and Culture Dish blogger Skloot (Creative Writing/Univ. of Memphis) demonstrates that for every human cell put under a microscope, a complex life story is inexorably attached, to which doctors, researchers and laboratories have often been woefully insensitive and unaccountable. In 1951, Henrietta Lacks, an African-American mother of five, was diagnosed with what proved to be a fatal form of cervical cancer. At Johns Hopkins, the doctors harvested cells from her cervix without her permission and distributed them to labs around the globe, where they were multiplied and used for a diverse array of treatments. Known as HeLa cells, they became one of the world's most ubiquitous sources for medical research of everything from hormones, steroids and vitamins to gene mapping, in vitro fertilization, even the polio vaccine—all without the knowledge, must less consent, of the Lacks family. Skloot spent a decade interviewing every relative of Lacks she could find, excavating difficult memories and long-simmering outrage that had lay dormant since their loved one's sorrowful demise. Equal parts intimate biography and brutal clinical reportage, Skloot's graceful narrative adeptly navigates the wrenching Lack family recollections and the sobering, overarching realities of poverty and pre–civil-rights racism. The author's style is matched by a methodical scientific rigor and manifest expertise in the field.

Skloot's meticulous, riveting account strikes a humanistic balance between sociological history, venerable portraiture and Petri dish politics.

Pub Date: Feb. 9, 2010

ISBN: 978-1-4000-5217-2

Page Count: 320

Publisher: Crown

Review Posted Online: Dec. 22, 2010

Kirkus Reviews Issue: Jan. 1, 2010

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Loads of good explaining, with reminders, time and again, of how much remains unknown, neatly putting the death of science...


Bryson (I'm a Stranger Here Myself, 1999, etc.), a man who knows how to track down an explanation and make it confess, asks the hard questions of science—e.g., how did things get to be the way they are?—and, when possible, provides answers.

As he once went about making English intelligible, Bryson now attempts the same with the great moments of science, both the ideas themselves and their genesis, to resounding success. Piqued by his own ignorance on these matters, he’s egged on even more so by the people who’ve figured out—or think they’ve figured out—such things as what is in the center of the Earth. So he goes exploring, in the library and in company with scientists at work today, to get a grip on a range of topics from subatomic particles to cosmology. The aim is to deliver reports on these subjects in terms anyone can understand, and for the most part, it works. The most difficult is the nonintuitive material—time as part of space, say, or proteins inventing themselves spontaneously, without direction—and the quantum leaps unusual minds have made: as J.B.S. Haldane once put it, “The universe is not only queerer than we suppose; it is queerer than we can suppose.” Mostly, though, Bryson renders clear the evolution of continental drift, atomic structure, singularity, the extinction of the dinosaur, and a mighty host of other subjects in self-contained chapters that can be taken at a bite, rather than read wholesale. He delivers the human-interest angle on the scientists, and he keeps the reader laughing and willing to forge ahead, even over their heads: the human body, for instance, harboring enough energy “to explode with the force of thirty very large hydrogen bombs, assuming you knew how to liberate it and really wished to make a point.”

Loads of good explaining, with reminders, time and again, of how much remains unknown, neatly putting the death of science into perspective.

Pub Date: May 6, 2003

ISBN: 0-7679-0817-1

Page Count: 304

Publisher: Broadway

Review Posted Online: May 20, 2010

Kirkus Reviews Issue: April 1, 2003

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