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The new contract says:

• A biologic isn’t successful if it’s only temporary.
• Immunogenicity is not a side effect—it’s a design
flaw.
• Patients should not just survive therapy—they
should stop fearing it.

And it demands mutual accountability:

• From industry: To prioritize immune-cooperative
designs and delivery platforms that reduce rejection
risk.
• From regulators: To define success in terms of
long-term patient benefit—not short-term lab
results.
• From payers: To fund what lasts, not what
launches.
• From researchers: To pursue immune literacy with
the same rigor as molecular efficacy.
• From patients and advocates: To challenge the
norms that treat biologic failure as routine.

This is not just about science—it’s about dignity. A system
that asks patients to cycle endlessly through failing drugs is
not just inefficient. It’s inhumane.

What It Looks Like in Practice

Imagine a world where:

• A 10-year-old with Crohn’s starts on an edible anti-
TNF biologic—and never needs to switch.

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