Xtandi’s Public-Science Tollbooth

The Xtandi money trail starts, in the account at issue, with publicly supported UCLA research, including support attributed to the NIH and the Department of Defense, and leads to a medicine associated with Astellas and Pfizer. The stated annual price is $180,000—not a claim that every patient pays that amount out of pocket. That is quite a trip for a public contribution: it leaves the lab as civic support and arrives at the pharmacy wearing a velvet-rope wristband.

I follow the invoice, not just the discovery. Public research deserves support, but public support should count for more than a polite thank-you while patients face a private price tag. Taxpayers get acknowledged in the fine print; patients get handed the bill. If the public helps with the groundwork, it should not be treated like a stranger at the counter.