National Academy of Sciences Paper Warns Scientific “Fraud Is Growing Exponentially”

In previous blog entries I have cited evidence that top medical scientists have committed fraud in the areas of Alzheimer’s and cancer research. The research discussed in the passages quoted below reports a related but broader problem. In these accounts the fraud consisted mainly of doctored data and images, but did not mainly consist also of wholly fabricated text, which apparently what new evidence reveals is being increasingly cranked out by paper mills. The journals accepting these papers are presumably mainly the lower level, and less-cited, journals, and so this fraud arguably may be less damaging to the ongoing progress of science than the more sophisticated fraud carried out by top scientists and published in top journals. This argument assumes that scientists build on work published in the top journals. A problem with this argument is that many times, truly pathbreaking innovations are at first rejected by “top” journals and are only accepted by “lower” level journals. (For instance Krebs’s paper on what is now known as the “Krebs cycle” that must be memorized by all aspiring doctors, was rejected by the prestigious Nature and published by the much less prestigious Enzymologia (Lane 2022, p. 55).)

The newly revealed fraud reduces even further the credibility of those on the left who order ordinary citizens to “follow the science” rather than follow their own eyes and their own judgement.

(BTW, Dr. Elisabeth Bik who is quoted in a couple of passages quoted below, is also a prominent source in Charles Piller’s Doctored, that documented widespread high-level fraud in the Alzheimer’s research community.)

(p. D1) For years, whistle-blowers have warned that fake results are sneaking into the scientific literature at an increasing pace. A new statistical analysis backs up the concern.

A team of researchers found evidence of shady organizations churning out fake or low-quality studies on an industrial scale. And their output is rising fast, threatening the integrity of many fields.

“If these trends are not stopped, science is going to be destroyed,” said Luís A. Nunes Amaral, a data scientist at Northwestern University and an author of the study, which was published in the Proceedings of the National Academy of Sciences on Monday [Aug. 4, 2025].

. . .

“Science relies on trusting what others did, so you do not have to repeat everything,” Dr. Amaral said.

By the 2010s, journal editors and watchdog organizations were warning that this trust was under threat. They flagged a growing number of papers with fabricated data and doctored images. In the years that followed, the factors driving this increase grew more intense.

As more graduate students were trained in labs, the competition for a limited number of research jobs sharpened. High-profile papers became essential for success, not just for landing a job, but also for getting promotions and grants.

Academic publishers have responded to the demand by opening thousands of new scientific journals every year. “All of the incentives are for publishers to publish more and more,” said Dr. Ivan Oransky, the executive director of the Center for Scientific Integrity.

. . .

(p. D3) Elisabeth Bik, a California-based expert on scientific fraud who was not involved in the study, said that it confirmed her early suspicions. “It’s fantastic to see all the work we’ve done now solidified into a much higher-level analysis,” she said.

Dr. Amaral and his colleagues warn that fraud is growing exponentially. In their new study, they calculated that the number of suspicious new papers appearing each year was doubling every 1.5 years. That’s far faster than the increase of scientific papers overall, which is doubling every 15 years.

. . .

In an executive order in May on “gold-standard science,” President Trump drew attention to the problem of scientific fraud. “The falsification of data by leading researchers has led to high-profile retractions of federally funded research,” the order stated.

. . .

Dr. Bik proposed that scientific publishers dedicate more of their profits to monitoring manuscripts for fraud, similar to how credit card companies check for suspicious purchases.

. . .

Dr. Oransky said that the way scientists are rewarded for their work would have to change as well. “To paraphrase James Carville, it’s the incentives, stupid,” he said. “We need to stop making it profitable to game the system.”

For the full story see:

Carl Zimmer. “Fake Papers Found to Be Churned Out At Fast Pace.” The New York Times (Tues., August 5, 2025): D1 & D3.

(Note: ellipses, and bracketed date and year, added.)

(Note: the online version of the story has the date Aug. 4, 2025, and has the title “Fraudulent Scientific Papers Are Rapidly Increasing, Study Finds.” Where there was a minor difference in the wording between the online and print versions, the passages quoted above follow the online version.)

The academic paper documenting the substantial increase in scientific fraud is:

Richardson, Reese A. K., Spencer S. Hong, Jennifer A. Byrne, Thomas Stoeger, and Luís A. Nunes Amaral. “The Entities Enabling Scientific Fraud at Scale Are Large, Resilient, and Growing Rapidly.” Proceedings of the National Academy of Sciences 122, no. 32 (2025): e2420092122.

Nick Lane’s book, cited in my introductory comments, is:

Lane, Nick. Transformer: The Deep Chemistry of Life and Death. New York: W. W. Norton & Company, 2022.

“One Man’s Poison Is Another Man’s Cure”*

*The title “One Man’s Poison Is Another Man’s Cure” is a proverb that is widely attributed to the poet Lucretius. (I have not found a documented source.)

My commentary was posted on the Foundation for Economic Education (FEE) web site on Mon., Aug. 18, 2025.

Below are notes on sources supporting claims I make in the commentary.

https://www.1daysooner.org/ [website of group defending human challenge trials]

Attia, Peter. Outlive: The Science and Art of Longevity. New York: Harmony, 2023, pp. 78 & 84-86. [source of Attia’s views of rapamycin]

Bailey, Clifford J., and Caroline Day. “Metformin: Its Botanical Background.” Practical Diabetes International 21, no. 3 (April 2004): 115-17. [source on metformin]

Freeberg, Ernest. The Age of Edison: Electric Light and the Invention of Modern America, Penguin History American Life. New York: The Penguin Press, 2013, pp. 87 & 200-201. [source on electrification of New York faster than London]

Glanville, Jacob, Mark Bellin, Sergei Pletnev, Baoshan Zhang, Joel Christian Andrade, Sangil Kim, David Tsao, Raffaello Verardi, Rishi Bedi, Sindy Liao, Raymond Newland, Nicholas L. Bayless, Sawsan Youssef, Ena S. Tully, Tatsiana Bylund, Sujeong Kim, Hannah Hirou, Tracy Liu, and Peter D. Kwong. “Snake Venom Protection by a Cocktail of Varespladib and Broadly Neutralizing Human Antibodies.” Cell 188 (2025): 1-18. https://www.cell.com/cell/abstract/S0092-8674(25)00402-7

Harrison, David E., Randy Strong, Zelton Dave Sharp, James F. Nelson, Clinton M. Astle, Kevin Flurkey, Nancy L. Nadon, J. Erby Wilkinson, Krystyna Frenkel, Christy S. Carter, Marco Pahor, Martin A. Javors, Elizabeth Fernandez, and Richard A. Miller. “Rapamycin Fed Late in Life Extends Lifespan in Genetically Heterogeneous Mice.” Nature 460, no. 7253 (July 16, 2009): 392-95. https://www.nature.com/articles/nature08221

Ineichen, Benjamin V., Eva Furrer, Servan L. Grüninger, Wolfgang E. Zürrer, and Malcolm R. Macleod. “Analysis of Animal-to-Human Translation Shows That Only 5% of Animal-Tested Therapeutic Interventions Obtain Regulatory Approval for Human Applications.” PLOS Biology 22, no. 6 (2024): e3002667. [The title is misleading because the main message of the article is that “Notably, our meta-analysis showed an 86% concordance between positive results in animal and clinical studies.” The authors further explain: “We conclude that, contrary to widespread assertions, the rate of successful animal-to-human translation may be higher than previously reported. Nonetheless, the low rate of final approval indicates potential deficiencies in the design of both animal studies and early clinical trials.” (The quotations are both from the Abstract on p. 1) (See also: “How can we make sense of the fact that animal studies and early clinical trials seem to show promise, yet there is very limited official approval for these therapies? There are 2 possible explanations: One scenario is that the strict requirements of RCTs and regulatory approval are causing many potentially valuable treatments to be left behind. The other scenario is that both animal studies and early clinical trials may have limitations in their design, such as a lack of proper randomization and blinding, which affects their internal validity [45].” p. 12 https://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.3002667)]

Jewett, Christina. “Charlatans’ No Reason to Curb Untested Drugs, Kennedy Says.” The New York Times (Fri., June 6, 2025): A1 & A11. https://www.nytimes.com/2025/06/05/health/kennedy-stem-cells-experimental-treatments.html?searchResultPosition=1

Kinch, Michael. Between Hope and Fear: A History of Vaccines and Human Immunity. New York: Pegasus Books, 2018, pp. 33-34. [one source on Jesty]

Mandavilli, Apoorva. “Man of 200 Snake Bites May Be the Antivenom.” The New York Times (Sat., May 3, 2025): A1 & A19. https://www.nytimes.com/2025/05/02/health/snakes-universal-antivenom-tim-friede.html?searchResultPosition=1

Mannick, Joan B., Giuseppe Del Giudice, Maria Lattanzi, Nicholas M. Valiante, Jens Praestgaard, Baisong Huang, Michael A. Lonetto, Holden T. Maecker, John Kovarik, Simon Carson, David J. Glass, and Lloyd B. Klickstein. “mTOR Inhibition Improves Immune Function in the Elderly.” Science Translational Medicine 6, no. 268 (2014): doi:10.1126/scitranslmed.3009892. https://www.science.org/doi/abs/10.1126/scitranslmed.3009892?__hsfp=1773666937&__hstc=12316075.81f04695664b9dc054b5f524eb53b5a4.1525132803174.1525132803175.1525132803176.1&__hssc=12316075.1.1525132803177

Morgan, Kate. “Vaccine Protesters Find Winning Slogan: ‘Health Freedom.” The New York Times (Weds., Jan. 1, 2025): A11. https://www.nytimes.com/2024/12/28/well/health-freedom-medical-freedom-covid.html?searchResultPosition=1

Smith, Dana G. “Is the Secret to a Longer Life Hidden in a Transplant Drug?” The New York Times (Weds., Sept. 25, 2024): A1 & ?. https://www.nytimes.com/2024/09/24/well/live/rapamycin-aging-longevity-benefits-risks.html

Subbaraman, Nidhi. “A Universal Antivenom, from a Man Bitten by Snakes 200 Times.” The Wall Street Journal (Sat., June 14, 2025): C5. https://www.wsj.com/science/biology/snake-bite-blood-universal-antivenom-6de30fda?mod=Searchresults_pos1&page=1

Whiteman, Noah. Online notes to accompany Most Delicious Poison: The Story of Nature’s Toxins―from Spices to Vices. New York: Little, Brown Spark, 2023. [source of claim that 40% of drugs come from traditional medicine]

Zuckerman, Gregory. A Shot to Save the World: The inside Story of the Life-or-Death Race for a Covid-19 Vaccine. New York: Portfolio/Penguin, 2021, pp. 5-6. [one source on Jesty]

Brigham and Epstein Have the Guts to Nudge the Overton Window

The Overton Window is the range of “officially acceptable” or “politically correct” policy views. The left has been successful at shifting the window in their direction, for instance, in cancelling those who question any aspect of the global warming ideology for being outside polite discourse. In the face of cancel culture it takes courage to challenge the current Overton Window. Brigham and Epstein (see below) have that courage. Their views should be considered.

(p. B12) Exxon Mobil, Occidental Petroleum and other oil giants are expected to receive billions of dollars of incentives to collect and bury carbon emissions. Texas oil billionaire Ben “Bud” Brigham and pro-fossil-fuels activist Alex Epstein want to turn off the tap.

Brigham, a serial entrepreneur and libertarian from Austin, is urging President Trump and the Republicans who are considering slashing a host of energy incentives to go further and nix tax credits for carbon capture.

. . .

Brigham says he doubts carbon capture can be profitable without public funding and that it is a distraction from firms’ core mission of finding oil and gas. He says that the subsidies distort markets and encourage cronyism.

A geophysicist by training, Brigham made his fortune building and selling two oil companies for a total of about $7 billion. He is an Ayn Rand fan who has produced two movies based on the philosopher’s work. He was also a major backer of what is now the Civitas Institute, a conservative center that launched in 2022 at the University of Texas at Austin.

Brigham first met Epstein, another Rand fan, about a decade ago. The two men bonded over a common belief in the importance of free markets and fossil fuels. Epstein is the author of “The Moral Case for Fossil Fuels,” a book saying that the imperative to fuel societies flourishing with oil and gas outweighs climate-change risks. It has given Republicans ammunition to counter the left’s climate push, oil lobbyists say.

For the full story, see:

Benoît Morenne. “Oil Tycoon, Philosopher Fight Carbon-Capture Goals.” The Wall Street Journal (Tues., July 1, 2025): B12.

(Note: ellipsis added.)

(Note: the online version of the story has the date June 28, 2025, and has the title “The Oil Tycoon and the Philosopher Threatening Big Oil’s Bet on Carbon Capture.”)

Epstein’s book, mentioned above, is:

Epstein, Alex. The Moral Case for Fossil Fuels. New York: Portfolio, 2014.

Lucian L. Leape Was Willing to Take the Ill-Will

In an earlier entry I presented Charlie Munger’s story where a hospital administrator had to be willing to absorb the ill-will, if he was to take the actions necessary to fix a badly malfunctioning department of the hospital. Another person willing to absorb the ill-will in order to reform medicine was Lucian L. Leape whose story is sketched in the passages quoted below.

(p. B21) Lucian L. Leape, a surgeon whose insights into medical mistakes in the 1990s gave rise to the field of patient safety, rankling much of the health care establishment in the process, died on Monday at his home in Lexington, Mass. He was 94.

. . .

In 1986, at age 56, Dr. Leape grew interested in health policy and spent a year at the RAND Corporation on a midcareer fellowship studying epidemiology, statistics and health policy.

Following his stint at RAND, he joined the team at Harvard conducting the Medical Practice Study. When Dr. Howard Hiatt, then the dean of the Harvard School of Public Health (now the Harvard T.H. Chan School of Public Health), offered Dr. Leape the opportunity to work on the study, “I accepted,” Dr. Leape wrote in his 2021 book, “Making Healthcare Safe: The Story of the Patient Safety Movement,” “not suspecting it would change my life.”

The most significant finding, Dr. Leape said in the 2015 interview, was that two-thirds of the injuries to patients were caused by errors that appeared to be preventable. “The implications were profound,” he said.

In 1994, Dr. Leape submitted a paper to The New England Journal of Medicine, laying out the extent to which preventable medical injury occurred and arguing for a shift of focus away from individuals and toward systems. But the paper was rejected. “I was told it didn’t meet their standards,” he recalled.

Dr. Leape sent the paper out again, this time to The Journal of the American Medical Association. Dr. George Lundberg, then the editor of JAMA, immediately recognized the importance of the topic, Dr. Leape said. “But he also knew it could offend many doctors. We didn’t talk about mistakes.”

Dr. Donald M. Berwick, president emeritus at the Institute for Healthcare Improvement in Boston and a longtime colleague of Dr. Leape’s, agreed. “To talk about error in medicine back then was considered rude,” he said in an interview in 2020. “Errors were what we call normalized. Bad things happen, and that’s just the way it is.”

“But then you had Lucian,” he added, “this quite different voice in the room saying, ‘No, this isn’t normal. And we can do something about it.’”

Dr. Leape’s paper, “Error in Medicine,” was the first major article on the topic in the general medical literature. The timing of publication, just before Christmas in 1994, Dr. Leape wrote in his 2021 book, was intentional. Dr. Lundberg knew it would receive little attention and therefore wouldn’t upset colleagues.

On Dec. 3, 1994, however, three weeks before the JAMA piece appeared, Betsy Lehman, a 39-year-old health care reporter for The Boston Globe, died after mistakenly receiving a fatal overdose of chemotherapy at the Dana-Farber Cancer Institute in Boston.

“Betsy’s death was a watershed event,” Dr. Leape said in a 2020 interview for a short documentary about Ms. Lehman.

The case drew national attention. An investigation into the death revealed that it wasn’t caused by one individual clinician, but by a series of errors involving multiple physicians and nurses who had misinterpreted a four-day regimen as a single dose, administering quadruple the prescribed amount.

The case made Dr. Leape’s point with tragic clarity: Ms. Lehman’s death, like so many others, resulted from a system that lacked sufficient safeguards to prevent the error.

. . .

Dr. Gawande said he believed it was the confidence Dr. Leape had acquired as a surgeon that girded him in the face of strong resistance from medical colleagues.

“He had enough arrogance to believe in himself and in what he was saying,” Dr. Gawande said. “He knew he was onto something important, and that he could bring the profession along, partly by goading the profession as much as anything.”

For the full obituary, see:

Katie Hafner. “Lucian L. Leape, 94, Who Put Patient Safety at Forefront, Is Dead.” The New York Times (Thursday, July 3, 2025): B21.

(Note: ellipses added.)

(Note: the online version of the obituary has the date July 1, 2025, and has the title “Lucian Leape, Whose Work Spurred Patient Safety in Medicine, Dies at 94.”)

Dr. Leape’s history of his efforts to increase healthcare safety can be found in:

Leape, Lucian L. Making Healthcare Safe: The Story of the Patient Safety Movement. Cham, Switzerland: Springer, 2021.

Was Schumpeter Mean to Hayek?

I have sometimes been surprised by the level of hostility of some Austrian economists toward Joseph Schumpeter. I once asked a distinguished Austrian economist why so much hostility? His answer was: ‘Schumpeter was mean to Hayek.’ Of course, Schumpeter and F.A. Hayek disagreed on some issues of method and theory, but so did other Austrians, such as Murray Rothbard and Hayek. I have read a few biographies of Schumpeter and have never read that Schumpeter was ever personally mean to Hayek. To the contrary, when I spent a day in the Schumpeter archives at Harvard, I ran across a carbon-copy of a letter that Schumpeter wrote to Stephen P. Duggan, co-founder and president of the Institute of International Education. Schumpeter wrote that Hayek wanted to give a lecture tour of the United States in March and April and asked if Duggan “would undertake the management of the trip.” Schumpeter wrote that “very many economists in this country would like an exchange of ideas with so outstanding a man.” (The letter was dated “January 16,” with a typo in the year, but with a jotted correction indicating, I think, “1940”—Hayek did visit the United States in 1940.)

Skimming Schumpeter’s letters in the archive leaves the impression that Schumpeter was almost always gracious to everybody almost all of the time, Hayek included.

Healthcare Industry Now Top Employer in Most States

Source: the NYT article quoted and cited below.

Some argued that Obamacare would reduce the costs of healthcare in the U.S., but that has not happened. The government has failed us in multiple ways, by tolerating rampant fraud, by mandating voluminous red tape, and by reducing competition.

(p. A18) For years, the United States labor market has been undergoing a structural transformation. As jobs in manufacturing have receded, slowly but steadily, the health care industry has more than replaced them.

. . .

The nation’s corps of nurses, oncologists, lab technicians, anesthesiologists and other health-related workers has been growing steadily, through recession after recession, going from 9 percent of the total workforce in 2000 to 13 percent today.

. . .

. . . 20 percent or so of health care employment . . . is administrative.  . . .

David Cutler, a health care economist at Harvard University, cautions that while more people will be needed to deliver care in the future, the industry shouldn’t be seen as a jobs program. Costs have been rising for decades, placing a larger and larger burden on taxpayers and businesses — and to the extent possible, those resources should be redirected to other parts of the economy.

“Any person who’s employed in health care who we don’t need to be employed in health care, that’s a waste,” Dr. Cutler said. “That’s money in health care that costs people money when they’re sick, and that’s a person who could be doing a job somewhere else.”

For the full story see:

DePillis, Lydia, and Christine Zhang. “Health Care Industry Jobs Are Taking Over.” The New York Times (Sat., July 12, 2025): A18.

(Note: ellipses added.)

(Note: the online version of the story has the date July 3, 2025, and has the title “How Health Care Remade the U.S. Economy.”)

“Nothing Is Incontrovertible in Science”

Somewhere we should start a Hall of Fame for those who had the courage to take the ill will from the enforcers of the “new religion” of global warming. Among its honorees would be Michael Crichton, Freeman Dyson, and (see below) Ivar Giaever. Science is not a body of doctrine; science is a process of inquiry.

(p. B12) Ivar Giaever might not have won the Nobel Prize in Physics if a job recruiter at General Electric had known the difference between the educational grading systems of the United States and Norway.

It was 1956, and he was applying for a position at the General Electric Research Laboratory in Schenectady, N.Y. The interviewer looked at his grades, from the Norwegian Institute of Technology in Trondheim, where Dr. Giaever had studied mechanical engineering, and was impressed: The young applicant had scored 4.0 marks in math and physics. The recruiter congratulated him.

But what the recruiter didn’t know was that in Norway, the best grade was a 1.0, not a 4.0, the top grade in American schools. In fact, a 4.0 in Norway was barely passing — something like a D on American report cards. In reality, his academic record in Norway had been anything but impressive.

He did not want to be dishonest, Dr. Giaever (pronounced JAY-ver) would say in recounting the episode with some amusement over the years, but he also did not correct the interviewer. He got the job.

He proceeded to spend the next 32 years at the laboratory, along the way developing an experiment that provided proof of a central idea in quantum physics — that subatomic particles can behave like powerful waves.

. . .

Though Dr. Giaever later earned a doctorate in theoretical physics, in 1964, from Rensselaer Polytechnic Institute in Troy, N.Y., he had not yet completed that degree when he came up with the experiment that would earn him his share of the Nobel. Indeed, as he admitted in his Nobel lecture, he did not fully understand the ideas behind the experiment when he first started working on it. He was, after all, a mechanical engineer, steeped in how things work in classical physics, which deals with real-world objects. Quantum physics, on the other hand, predicts what happens in the weird subatomic world.

. . .

Dr. Giaever prided himself on his common-sense approach to science, but not all his ideas were welcomed by his peers. He became a prominent denier of climate change, referring to the science around it as a “new religion.” (“I would say that, basically, global warming is a nonproblem,” he said in a 2015 speech.) He based his opposition, in part, on his belief that it is impossible to track changes in the Earth’s temperature and that, even if it could be done, the temperature changes would be insignificant.

When the American Physical Society announced in 2011 that the evidence for climate change and global warming was incontrovertible, he resigned from the society in disgust, saying: “‘Incontrovertible’ is not a scientific word. Nothing is incontrovertible in science.”

For the full obituary, see:

Dylan Loeb McClain. “Ivar Giaever, 96, ‘D’ Student Who Won Nobel Prize.” The New York Times (Thursday, July 10, 2025): B12.

(Note: ellipses added.)

(Note: the online version of the obituary was updated July 9, 2025, and has the title “Ivar Giaever, Nobel Winner in Quantum Physics, Dies at 96.”)

artdiamondblog.com Is 20 Years Old Today and Will Now Switch to Weekly Entries (on Mondays)

On October 16, 2024 I announced some changes in my artdiamondblog.com web log. For instance, I was going to focus more entries on my next book project: Less Costs, More Cures: Unbinding Medical Entrepreneurs, and I was to include some brief entries on my memories of important economists such as George Stigler and Gary Becker. I implemented both changes, though more of the former than the latter.

One other change that I have made, especially in the last few months, is to precede almost all entries with (sometimes detailed) introductory commentary.

I believe that these changes have improved the average quality of my entries, but may have narrowed the audience who will find them of interest. My blog entries in the last several months may be of increased interest to those who are willing to follow me into the weeds of healthcare policy, but may be of decreased interest to those who care more about the broader set of issues that I dealt with in my Openness to Creative Destruction book.

Personally, I have mixed feelings about the changes to my blog. On the one hand I feel some pride and satisfaction on the higher quality of entries, and have some hope that many of the entries will end up being useful early notes toward my bigger project. On the other hand, the changes have not reduced the overall time I invest in the blog, as I had hoped they would.

The bottom line is that I have been spending too much time on the blog, and too little time on my writing and research projects. Or as an economist might say, the opportunity cost of marginal time spent on the blog is too high. So I have decided to implement another change. Starting on July 15, 2025, I will commit to running a new entry on Monday of each week, but will not post on the other days of the week unless something big comes up.

I want to see how this change works–it may be permanent, or after the end of the summer, I may switch back to daily posts.

I make this change with some twinge of sadness and regret, since I take some pride in having run a daily post on almost all days from July 15, 2005 through July 15, 2025.

On July 15 of every year Aaron Brown sends me happy blog birthday greetings. (I continue to be grateful to Aaron for his thoughtful comments on blog entries, and for letting me know when an entry is missing or when something in an entry is amiss.)

This year on July 15 my blog will be 20 years old.

Perseverance is sometimes praiseworthy; pivoting is sometimes praiseworthy too. I hope I am right to pivot.

Father Spends 20 Years Researching to Cure His Children’s Type 1 Diabetes

The development of a new drug to cure Type 1 diabetes is big news, a triumph of medicine. The process of developing the medicine and bringing it to market interests me for several reasons. One is that Doug Melton spent 20 years of effort on it. His passion was due to having skin in the game: he has two children with the disease. Another is that it took so many years “of painstaking, repetitive, frustrating work.” I emphasize the common importance of trial-and-error in many major medical discoveries. Another is that the trial-and-error was to develop a “chemical cocktail to turn stem cells into islet cells.” Several major medical advances have required nimble and persistent trial-and-error to adjust drug cocktails, in terms of components and doses. Examples include HIV, Hodgkin’s lymphoma, and childhood leukemia.

A final reason I am interested in the case is that Melton selected the Vertex company to bring the drug to market. Vertex is an interesting case of a large firm struggling to keep the innovative culture of its startup roots. I read a book about its struggles called The Antidote. I intend to read an earlier book about its early years called The Billion Dollar Molecule.

(p. 17) A single infusion of a stem cell-based treatment may have cured 10 out of 12 people with the most severe form of type 1 diabetes. One year later, these 10 patients no longer need insulin. The other two patients need much lower doses.

The experimental treatment, called zimislecel and made by Vertex Pharmaceuticals of Boston, involves stem cells that scientists prodded to turn into pancreatic islet cells, which regulate blood glucose levels. The new islet cells were infused and reached the liver, where they took up residence.

The study was presented Friday evening [June 20, 2025] at the annual meeting of the American Diabetes Association and published online by The New England Journal of Medicine.

“It’s trailblazing work,” said Dr. Mark Anderson, professor and director of the diabetes center at the University of California in San Francisco. “Being free of insulin is life changing,” added Dr. Anderson, who was not involved in the study.

. . .

The treatment is the culmination of work that began more than 25 years ago when a Harvard researcher, Doug Melton, vowed to find a cure for type 1 diabetes. His 6-month-old baby boy developed the disease and, then, so did his adolescent daughter. His passion was to find a way to help them and other patients.

He began, he said, with an “unwavering belief that science can solve the most difficult problems.”

It took 20 years of painstaking, repetitive, frustrating work by Dr. Melton and a team of about 15 people to find the right chemical cocktail to turn stem cells into islet cells. He estimated that Harvard and others spent $50 million on the research.

Dr. Peter Butler, a professor of medicine at the University of California, Los Angeles and a consultant to Vertex, said he was awed by the achievement of the Harvard team.

“The fact that it worked at all is just freaking amazing to me,” he said. “I can guarantee there were a thousand negative experiments for every positive one.”

When Dr. Melton finally succeeded, he needed a company to take the discovery into the clinic. He joined Vertex, which took up the challenge.

For the full story see:

Gina Kolata. “People With Severe Diabetes May Have Been Cured in a Small Trial of a New Drug.” The New York Times, First Section (Sun., June 22, 2025): 17.

(Note: ellipsis, and bracketed date, added.)

(Note: the online version of the story was updated June 21, 2025, and has the title “People With Severe Diabetes Are Cured in Small Trial of New Drug.” The online version says that the article appeared on page 24 of the New York edition of the print version. But the article appeared on page 17 of my National edition.)

The NEJM academic article co-authored by Melton and mentioned above is:

Reichman, Trevor W., James F. Markmann, Jon Odorico, Piotr Witkowski, John J. Fung, Martin Wijkstrom, Fouad Kandeel, Eelco J.P. de Koning, Anne L. Peters, Chantal Mathieu, Leslie S. Kean, Bote G. Bruinsma, Chenkun Wang, Molly Mascia, Bastiano Sanna, Gautham Marigowda, Felicia Pagliuca, Doug Melton, Camillo Ricordi, and Michael R. Rickels. “Stem Cell–Derived, Fully Differentiated Islets for Type 1 Diabetes.” The New England Journal of Medicine (published online on June 20, 2025), DOI: 10.1056/NEJMoa2506549.

The books that I mentioned about Vertex are:

Werth, Barry. The Antidote: Inside the World of New Pharma. New York: Simon & Schuster, 2014.

Werth, Barry. The Billion-Dollar Molecule: One Company’s Quest for the Perfect Drug. New York: Simon & Schuster, 1994.

Jarvik’s Father’s Heart Disease Drove Him to Persist in Developing First Permanent Artificial Heart

Robert Jarvik had skin in the game, had a sense of urgency, with his father suffering from severe heart disease. And he understood that the usual path toward an eventual breakthrough, is to keep “working it through so it can be better.”

(p. B10) Dr. Robert K. Jarvik, the principal designer of the first permanent artificial heart implanted in a human — a procedure that became a subject of great public fascination and fierce debate about medical ethics — died on Monday [May 26, 2025] at his home in Manhattan. He was 79.

. . .

In a 1989 interview with Syracuse University Magazine, Dr. Jarvik admitted that his belief that the Jarvik-7 was advanced enough to be used widely on a permanent basis was “probably the biggest mistake I have ever made.”

Still, he defended his work. Of the five recipients of the permanent Jarvik-7, he told the magazine, “These were people who I view as having had their lives prolonged,” adding that they survived nine months on average when some had been expected to live “no more than a week.”

“I don’t think that kind of thing makes a person in medicine want to stop,” he said. “It just makes you all the more interested in working it through so it can be better.”

. . .

From an early age, Robert was a tinkerer. As a teenager, he made his own hockey mask and began developing a surgical stapler. He attended Syracuse University from 1964 until 1968, intending to study architecture, but his interest turned to medicine after his father survived an aortic aneurysm, and he received a degree in zoology. Dr. Norman Jarvik died in 1976 after a second aneurysm.

“I knew that my father was going to die of heart disease, and I was trying to make a heart for him,” Robert Jarvik once said. “I was too late.”

. . .

According to a 2023 study of the artificial heart market, a descendant of the original Jarvik-7, now owned by another company, is called the SynCardia Total Artificial Heart. It is designed primarily for temporary use in patients who face imminent death while awaiting transplants. The study found that the device had been implanted in more than 1,700 patients worldwide.

For the full obituary, see:

Jeré Longman. “Robert Jarvik, a Designer of the First Artificial Heart, Is Dead at 79.” The New York Times (Friday, May 30, 2025): B10.

(Note: ellipses, and bracketed date, added.)

(Note: the online version of the obituary has the date May 29, 2025, and has the title “Robert Jarvik, 79, Dies; a Designer of the First Permanent Artificial Heart.”)