[fnordpiglet]

Didn’t see any pricing information? Sadly all incentives are to not make it less expensive and to simply extort the institutions on the payment side and give rebates to everyone who doesn’t have an institution to back them. Much of medicine is intentionally expensive to prop up revenues (and indirectly profits while maintaining a defensible percent of revenues margin).

But maybe not here - Moderna got a lot of experience with mass scale production in the pandemic. If they orient it here we could see biopsy based / pre surgical vaccination of cancer at mass scales which would require scaled out pricing.

[s1artibartfast]

Current personalized cancer "vaccines" arent really comparable. They typically cost millions and require the a team of scientists to harvest your cells and create tailored biologics to treat you.

Even if you strip out the profit motive, you still have huge amounts of skilled human labor

[fnordpiglet]

Yes, but that’s the beauty of industrialization. As scales grow, manual skilled processes become automated. I’m not asserting todays mRNA based on a sequence of a single virus genome is comparable - but that the process of industrializing as a skill is in fact a skill in an enterprise that once perfected can be applied to more complex domains.

The profit motive is reflected more in terms of keeping high revenue producing processes inefficient to justify higher profits with the same margin. Medicine is replete with examples of processes that can be dramatically more efficient and widely available, but are not optimized because it reduces profits by reducing gross revenues. High margins invite scrutiny, high revenues invite investment.

[s1artibartfast]

I agree with the march of progress and the hopeful commodification of new technologies. I also agree that there are a number of counterproductive incentives driving up the cost of healthcare. Regulatory capture and lack of payment controls means efficiency is not rewarded.

It is similar to the California energy market, where electric providers are fixed, and rates are set by the sate on a cost plus basis. It should be no surprise that electricity production costs are multiple times higher than other states if manufacturer profit is capped at 8%.

[gattr]

Hopefully, in a few decades: got cancer? Go for a biopsy, wait a week for a personalized vaccine. Even if some cells survive, mutate and start growing again, just repeat the procedure. Cancer becomes a somewhat annoying chronic illness.

[DiscourseFan]

Well, let's hope that repeatedly injecting people with mRNA over the course of a lifetime doesn't create other problems--I guess if the alternative is death, then there's nothing else one can do anyway

[bawolff]

Is there any reason to think it would? mRNA is naturally present in the body, and also gets broken down pretty quickly.

[bawolff]

industrialization usually requires making the same product for everyone. E.g. back in the day everyone had custom fitted shoes, now we choose from pre-made sizes.

Its not entirely clear such tailored processes can be easily automated.

[fnordpiglet]

Programmable automation absolutely allows for industrialization of personalized stuff. It depends greatly on can the production of the actual mRNA be programmed flexibly enough to allow the last mile work non tailored but programmable. However the entire pipeline of collection, sequencing, and the planning of the mRNA can absolutely be fully automated. The last stages that may be manual can be industrialized in the sense there’s a repeatable process that can be compartmentalized into functional roles ala assembly lines.

I don’t know it needs to be industrialized to the extent producing ibuprofen is, but I’m not as bearish that individualized medicine can’t be industrialized and done at scale - especially if aspects of the tailoring can be programmable. Even if it’s not now - as scale increases, maybe technology meets that?

By the way you can in fact get tailored clothes produced through automation. Shoes, pants, shirts. There are products that will scan your body shape and an automated process produces a custom fit for you. They’re slightly more expensive, but I think the sales process is cumbersome and they never took off vs big box of throw away ill fitting garbage to cover our body with and throw away. That’s more a sad statement of modern culture than a limitation of our ability to automate and industrialize.