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What are the reasons behind such prohibitive cost? Rare expertise, advanced factories, amount of time required, lack of economy-of-scale, monopoly, something else?

If the cure is proven, the society will likely be able to mobilize much more resources, particularly to scale up operations.

Special expertise can be trained to other biologists (the underemployment problem would be mitigated as well). More biologists could be trained. Likewise for factories, materials, etc. Monopolies can be broken.

What factors cannot be scaled up with such an approach? (Honest question. I do not know anything about antibody production.)



> What are the reasons behind such prohibitive cost? Rare expertise, advanced factories, amount of time required, lack of economy-of-scale, monopoly, something else?

The first 3. Monopoly doesn't help I'm sure, but this drug class in inherently very expensive to produce, there's a reason there is little outcry over the prices charged.

It's extremely labor intensive, and very hard to scale up. They are also inherently dangerous, so there is a need for extreme purity. (See: https://en.wikipedia.org/wiki/TGN1412 for what a monoclonal antibody can do, you would not want that to happen by accident.)

As of right now this drug class remains the most expensive of all drugs, I would assume if it were possible to make it cheaper they would have.

But we'll only really know once the first generics enter the market.




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