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These terms suggest randomness, not pattern. But make no
mistake: the pattern is there. We just haven’t given it the
diagnostic attention it deserves.

Without consistent diagnostics, tolerization becomes a
kind of invisible failure—noticed, but unspoken. It
registers in the patient’s frustration, the doctor’s
uncertainty, and the insurer’s cost line. But it doesn’t show
up in the chart. It doesn’t trigger an alert. It doesn’t change
the treatment algorithm.

And that silence—that absence of diagnostic clarity—is
part of why tolerization persists. If we can’t name it, we
can’t track it. If we can’t track it, we can’t prove it’s
happening. And if we can’t prove it’s happening, the
system has no reason to change.

Too Risky to Spotlight

For pharmaceutical companies, tolerization isn’t just a
scientific problem—it’s a public relations hazard. These
are the drugs that headline investor calls and medical
conferences. They are marketed as game-changers,
precision therapies, cures in all but name. And many of
them carry price tags well above six figures per year. The
messaging is built on confidence, permanence, and
scientific mastery.

So, what happens when that promise unravels in 12 to 24
months?

Publicizing the prevalence of tolerization introduces a
cascade of uncomfortable questions—questions that reach
far beyond the clinic:

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