Links to read the Root Room and The Informed online.

By Justin Yamashita, MSc. Benchtop, site, CRO. Three levels of basic and clinical research, explained without spin.

Last week in the Root Room, we ended on one number and left it sitting there. Debby the Denier typed Gleevec’s launch price into the Lab and added nothing after it. Sam the Skeptic said it belonged to this issue. The science arc is finished. The money story starts here.

Here’s a rule that defies logic when it’s broken. When something gets easier to make, the price falls. Phones. Flat screens. Solar panels. More volume, lower cost. Every single time, right?

Well, Gleevec broke the rule.

The leukemia drug that took 41 years of science and a 72 day FDA review launched in 2001 at about $26,000 a year. It didn’t get harder to make. Far more people started taking it, because it works so well that patients with this leukemia now live close to a normal lifespan. More demand. Same manufacturing.

So the price came down, right?

By 2012 the US price had climbed to roughly $92,000 a year. By 2014 it was about $132,000, and it kept climbing past $140,000 even as the first generic arrived. More people, easier to make, and the price more than quintupled. Rule broken.

If your car got cheaper to build every year and the dealer quietly charged you five times more, you would want a word with someone. Cancer patients did not get that word. So someone else spoke up, and it was the last group you would expect, because, you know, “Doctors are in Big Pharma’s pocket” as they say.

You’ve seen the argument online. Doctors are just a sales arm for pharma. They push the priciest drugs because somebody is paying them to.

In 2013, more than 100 of the world’s leading leukemia doctors answered that argument, probably without meaning to. They published a paper in Blood, one of the most respected journals in their field, and they used it to attack the price of the very drug that made their careers. Their own miracle drug. They called the prices of these cancer drugs unsustainable and tied it to a blunt question: what should a single year of a human life be allowed to cost?

These were not activists. They were the exact specialists who prescribe this drug every day, from more than a dozen countries, signing their real names to a public document that cut against the financial interest people assume they have.

Sit with what that means. If doctors were really just pharma’s salesforce, this paper does not exist. You don’t attack the hand that supposedly feeds you, in print, in your own field’s flagship journal, in front of everyone you work with.

They did it because the reason they went into medicine, to help patients, was colliding with a price their patients could not pay.

This is one of the most corrosive myths in health, because it tells you to stop trusting the one person in the room who spent a decade training to help you.

There is a real grain in it, and we will name it, because the Skeptic’s Toolkit means holding both sides. Financial relationships between drug companies and doctors do exist. Some are disclosed, some are small, some genuinely nudge prescribing at the margins. The Sunshine Act exists precisely so you can look those payments up yourself. That is worth watching.

But the leap from “some financial ties exist” to “doctors want your drugs to be expensive” does not survive contact with the evidence. The 2013 revolt is one data point against it. You can see others in any exam room. Doctors are the ones who fight insurance denials for you. They switch you to the cheap generic the moment it works as well. They are the ones who notice when a patient is rationing pills to stretch a prescription, and remember it.

A drug being expensive is not the doctor’s win. It is the doctor’s problem, handed to them across a desk, set by people far above their pay grade.

One more thing, because being right is not the same as being useful. When you see the ‘doctors are bought’ post in your feed, do not argue with it. Arguing feeds it: the algorithm reads your outrage as interest and shows it to more people. STARVE it instead, and put that energy into amplifying someone who gets the science right. That is the move I break down on social media this week. Last week we presented the opposite card. The REACH card. When good science is being spread, you can help expand its REACH by Liking, Sharing, Commenting, Saving, and Following. You have the power to combat the disinformation, by cutting off the fuel to the misinformation fear mongering fire.

A character from the Root Room track, Vera Santiago, the clinical trial participant many of you have followed into her own clinical trial, is in month 6 now. She had advantages most patients never get. She lives near a major medical center. Her clinical research coordinator, Nurse Nani, answered every question on consent day. She had been reading this newsletter for months, so she already knew what a data safety monitoring board was. And she found the Root to Rx Facebook Lab group, the same way 1,106 strangers found each other before the IRIS trial and told one another it was worth doing.

Now the uncomfortable question. How many people never get a chance like Vera’s?

Here is a number that belongs on a wall in every cancer center. Only about 7% of adult cancer patients in the United States ever join a treatment trial. More than 90% never take part.

Every drug in the pipeline, including the next Gleevec such as Daraxonrasib that’s in the news for huge impacts on pancreatic cancer, currently is in this situation for other types of RAS type cancers, and it and other medications wait on that thin sliver of people. When they cannot find a trial, or live too far from one, or were told trials are only for patients with nothing left to lose, the trial slows. A slower trial is a later answer. A later answer is a patient downstream who waits.

Access is not only about the price at the pharmacy counter. It starts much further upstream, at whether you ever got into the room at all.

Q9: What do independent experts with no stake in the outcome say?

This is the question the doctors’ revolt answers cold. When the people who would profit from a high price are the ones publicly arguing it is too high, that is the strongest kind of evidence there is. A witness testifying against their own interest. Weigh that more, not less.

Q4: Who funded this, and do they have a stake in the answer?

Run it in every direction. Yes, ask it of the doctor and the drug company. Then ask it of the loud account telling you every doctor is bought. Who are they, and what do they want to sell you once you stop trusting your physician?

You can look all of it up this week. The launch price. The climb into six figures. The doctors’ paper. The patient assistance program Novartis runs. The generic that arrived in 2016, though the early savings were smaller than people hoped.

You can hold two true things at once, which is the whole skill we have been building for 11 issues. It cost a staggering amount to create this drug. 41 years, a global trial, a whole system of independent checks. And $120,000 a year is a sentence for a patient without coverage. Both true.

Then you can see if you can do the part that may be new for you. Don’t post and contribute to the outrage. Send the access information, the assistance program and the generic, to people who actually need it.

That is the difference between being right online and being useful to someone you love. That’s the way to increase the REACH of helpful information and STARVE the disinformation.

More than 9 in 10 cancer patients never join a trial. One reason is a distrust of the whole system we have spent 11 issues rebuilding with you. That distrust does not float in a vacuum. It lives next to something. Something in the supplement aisle, something at gas stations you can buy miles away from the nearest pharmacist. We go there next week.

One thing, then go. Know someone rationing a prescription, scared of a price, or convinced a trial is only for people with nothing left to lose? Forward this newsletter to them. That is the whole point of it.

Then reply or leave a comment with one line: what question did this issue answer for you, and what are you still sitting with? Every reply shapes the next issues, and the readers who go looking for the flaw before they share end are part of the #SkepticalRevolution.

Everything you just read has a face in The Root Room, our story track, published the day before this issue. This week’s principle, holding two true things at once, is exactly what Debby does: she finds the doctors’ paper, and instead of posting the outrage she sends the help to the one person in her life who needs it. It is the clearest picture yet of the skill in practice.

If you have followed Debby from Denier to curious Skeptic, this is the week her arc pays off. If you are new, the catch-up links are at the top of the Root Room. Keep up with these characters as they grow, because that is how the ideas stop being advice you nod at and start being something you actually do. Vera also reflects on why she said yes to her trial, and Nurse Nani closes with the one sentence that says what Root to Rx is for.

Read The Root Room first, then The Informed for the full evidence.

New here? Foundation issues: 003b (the Skeptic’s Toolkit), 001 (why your distrust is rational), 004 (how a drug gets built and approved).

Citations verified June 2026. Peer-reviewed and primary sources confirmed via PubMed and publisher records.

[1] The expert critique of CML drug prices and the price trajectory: Experts in Chronic Myeloid Leukemia. The price of drugs for chronic myeloid leukemia (CML) is a reflection of the unsustainable prices of cancer drugs. Blood. 2013;121(22):4439-4442. https://doi.org/10.1182/blood-2013-03-490003

[2] Gleevec 2001 launch price (about $26,400 per year, roughly $2,200 per month): Washington Post, March 9, 2016.

[3] US arrival of generic imatinib in 2016 and the modest initial savings: ASCO Post, May 25, 2016, and NPR, February 1, 2016.

[4] Adult cancer treatment-trial participation about 7.1% (Commission on Cancer data, 2013 to 2017): National Estimates of the Participation of Patients With Cancer in Clinical Research Studies. J Clin Oncol. 2024. https://doi.org/10.1200/JCO.23.01030

Disclosure: Root to Rx is an independent publication of Open Label Media, LLC · openlabelmedia.com. Views expressed are personal views of Justin Yamashita and do not represent his employer or any affiliated organization. No employer resources or proprietary information are used. Every claim is sourced from publicly available materials.

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