<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>PragmaticPulp</author><text>If this was simply a matter of making the drug available for informed consumers willing and able to pay for it out of pocket, I wouldn&amp;#x27;t be as concerned.&lt;p&gt;If we&amp;#x27;re going to have Medicare and private insurance companies pay $56K&amp;#x2F;year per patient for a drug that may not have positive effects that outweigh the risk of side effects, that&amp;#x27;s a major problem.&lt;p&gt;Limiting access to experimental drugs is a difficult question. I know someone who has a different poorly-understood disease (not Alzheimer&amp;#x27;s, I&amp;#x27;m being deliberately vague to avoid debates) who managed to get enrolled in a clinical trial for an experimental treatment. She responded fantastically well to the drug, as did a small number of other patients in the study. On average, however, the response to the drug was poor.&lt;p&gt;She and several other responders have now found each other online and are trying multiple avenues to get back on the drug. They&amp;#x27;re getting desperate enough that they&amp;#x27;re pooling funds to order a custom synthesis from another country and have it analyzed for purity by a 3rd party lab. I&amp;#x27;m terrified to think of the risks they&amp;#x27;re incurring, but they&amp;#x27;re so desperate to return to remission that they&amp;#x27;d rather take the risks than continue to suffer. It must feel unthinkably unfair to be given a glimpse of remission, only to be forbidden to continue to buy the drug because it didn&amp;#x27;t work on a majority of patients.&lt;p&gt;In their case, it&amp;#x27;s likely that the disease has multiple causative factors and the drug in question only treats one specific cause. Without stratifying trials by these yet to be determined different causes, it&amp;#x27;s difficult for trials to show efficacy on large populations. I wonder if Alzheimer&amp;#x27;s disease could be similar, in that certain subsets of patients respond to the drug but the average patient will not.</text><parent_chain></parent_chain></comment><story><title>The Aducanumab Approval</title><url>https://blogs.sciencemag.org/pipeline/archives/2021/06/08/the-aducanumab-approval</url></story>
<instructions>Your goal is to analyze the following comment and estimate how highly it will be upvoted by the Hacker News community.</instructions><comment><author>sparsely</author><text>An absolutely shocking decision, which will have immense negative consequences for healthcare and healthcare costs far into the future. A license to turn false hope into profit margins and commissions for snake oil salesmen.&lt;p&gt;List price is $56,000 per year if you&amp;#x27;re curious.</text><parent_chain></parent_chain></comment><story><title>The Aducanumab Approval</title><url>https://blogs.sciencemag.org/pipeline/archives/2021/06/08/the-aducanumab-approval</url></story>