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While exact figures are elusive, the combination of high
individual drug costs, the prevalence of tolerization, and the
expenses associated with switching therapies carry a heavy
burden. This underscores the need for strategies to mitigate
immunogenic responses and improve the longevity and
efficacy of biologic treatments.

1.4 – Why It Matters (To Patients
and Payers Alike)

Tolerization isn’t just a scientific curiosity. It’s a human
problem with economic consequences. When a biologic
drug fails due to immune rejection, it reverberates across
the healthcare system—starting with the patient, radiating
outward to physicians, payers, and the broader
infrastructure that sustains high-cost specialty medicine. No
one escapes untouched.

The Patient Pays First

For the patient, tolerization is devastating—not because it’s
dramatic, but because it’s demoralizing. There is no
explosion, no dramatic crash. The drug just stops working.
Sometimes the failure is slow—a creeping return of
symptoms. Other times it’s sudden—a full inflammatory
relapse or a resurgence of disease markers.

What follows is a cascade of consequences:

• Pain returns.

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