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clinical benefit. This mismatch between economic gain and
biological sustainability highlights the urgent need for more
durable, immune-compatible biologic therapies.

The Silence Is Strategic

Tolerization isn’t a bigger story because it undermines a
powerful narrative: that biologics are the future of
medicine.

Acknowledging that future is fragile—vulnerable to the
very immune systems it seeks to influence—is more than
inconvenient. It’s threatening.

So for now, the silence persists.
But in that silence, patients are suffering. Payers are
overspending. Clinicians are improvising. And science is
being restrained by economics.

This book breaks that silence.

Because naming the problem is the first step to solving it.

1.7 – Setting the Stage for a Solution

The failure of biologics due to tolerization is not a mystery.
It’s not unpredictable. And it’s not unfixable. It is, in fact,
one of the most solvable—and neglected—crises in modern
medicine. Not because the science is out of reach, but
because the system hasn’t demanded we solve it. We've
optimized biologics for mass production, regulatory

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