Page 31 - Binder2

This isn’t precision medicine. It’s managed uncertainty,
built atop an unspoken truth: we don’t have true control
over the immune compatibility of the drugs we give. So we
perform the ritual of control—adjusting parameters,
tweaking schedules, layering interventions—all while the
underlying problem remains untouched.

And until we address that root incompatibility—until we
design biologics that work with the immune system rather
than trying to evade it—we’re not solving anything.
We’re just delaying the collapse.
We’re buying time on a clock that’s already run out.

Because no matter how sophisticated the surface appears, a
system that tolerates tolerization as standard practice is
a system running on borrowed time.

1.6 – Why Isn’t This a Bigger Story?

If biologic drugs are failing at meaningful rates due to
tolerization, and if the consequences are both deeply
personal and economically enormous, then a natural
question follows:

Why isn’t this a bigger story?

Why don’t patients hear about it more? Why aren’t
clinicians shouting from the rooftops? Why don’t pharma
earnings reports warn of it? Why don’t regulatory agencies
track and flag it as a central performance metric?

The answer is as unsettling as it is clear: because it’s
inconvenient.

29