An anarchist takes on the drug industry by teaching patients to make their own meds
via Stat News
ENLO PARK, Calif. — The anarchist grew animated as he explained his plan to subvert a pillar of global capitalism by teaching the poor to make their own medicines — pharmaceutical industry patents be damned.
Swaggering, charismatic, and complex, Michael Laufer has become a fixture in the growing biohacker movement ever since he published plans last year for a do-it-yourself EpiPencil — a $35 alternative to the pricey EpiPen.
It’s not clear whether anyone has actually ever used a homemade EpiPencil to prevent anaphylactic shock. But that seems almost an afterthought to Laufer’s bigger goal — trying to build a DIY movement to attack high pharma pricing and empower patients.
The de facto leader behind the leaderless collective Four Thieves Vinegar, Laufer is now on to his next project: He’s developing a desktop lab and a recipe book meant to equip patients to cook up a range of medicines, including a homemade version of the expensive hepatitis C drug Sovaldi, on their kitchen counters.
Health professionals have strenuously warned against DIY pharmaceuticals, but Laufer sees his work as a moral crusade against the patent laws and market forces that let drug companies price vital remedies out of reach for many patients.
“To deny someone access to a lifesaving medication is murder,” he said. And “an act of theft [of intellectual property] to prevent an act of murder is morally acceptable.”
The trade group PhRMA has so far ignored Laufer and declined to comment on his work. Regulators at the Food and Drug Administration haven’t bothered him, either. But in an era when a year’s worth of medicine can cost U.S. patients $750,000, Laufer believes his message is starting to resonate. And even some who call his approach irresponsible and dangerous acknowledge that it’s hard to dismiss Laufer outright.
“Desperate times call for desperate measures,” said Dr. Vinay Prasad, a professor at Oregon Health and Science University.
Prasad is no friend of the drug industry, but he considers it foolhardy for patients to try to make their own medicines. Still, he says the emergence of Laufer, or someone like him, was inevitable: “He’s another symptom of the disease, and the disease is drug pricing.”
A decade ago, while he was volunteering with aid workers in El Salvador, Laufer said a nurse at a remote health outpost told him she’d run out of antibiotics and birth control pills — cheap, generic medicines that even her suppliers couldn’t immediately replenish. “This is ridiculous. They should be able to build their own simple lab” to make the pills, he recalled thinking at the time.
The moment haunted him.
So, two years ago, Laufer began to work in earnest on his plans to help disenfranchised patients develop a modicum of self sufficiency when it came to essential medicines.
The 38-year-old wears his confidence like the jet black suit and purple paisley vest — and antifa lapel pin — he favors when he’s at his day job teaching math at Menlo College, a private business school in Atherton, home of the wealthiest zip code in the nation. (Among biohackers, he dons jeans and a leather or camouflage jacket — “my peasant clothes,” he quipped.)
“To deny someone access to a lifesaving medication is murder. And an act of theft to prevent an act of murder is morally acceptable.” - Michael Laufer
A slight, shaved-headed, bushy-bearded son of journalists, Laufer makes no pretense of modesty.
He studied particle physics as an undergrad and says he reads 18 or 19 languages, modern and ancient, east and west. As a graduate student, “I actually had to learn French in a day,” he said. “I managed to absorb enough that I was able to translate a math paper.”
In English, Laufer’s speech tilts to the highfalutin — “antecedent structure” for what happened, “procure” for get.
When he’s among the biohacker crowd, he spells his name “Mixæl,” mashing up the Euro-variant for “ae” and a Coptic “x,” pronounced “ck.” He says he got the idea after studying Coptic lettering on the Rosetta Stone and learning about the Coptic archangel Michael.
Asked to name a role model, Laufer picks Gandhi, for his 1930 march to the Arabian Sea to protest colonial salt taxes. Laufer compares that historic moment to his own battle against monopoly drug pricing, which he calls “criminal — ‘unjust,’ to use Gandhi’s word.”
Laufer said he hates to be typecast by popular notions of what an anarchist must be like. He dresses up in a “dandy” suit for teaching “to show students that I take what I do seriously,” with the hope that they will too, he said. “But I wouldn’t wear it to prison,” he added, referring to his weekly math lesson to inmates at San Quentin State Prison in nearby Marin County. He wears his leathers up there, necessary for the motorcycle trip up.
“I grew up in a lot of different worlds,” including Europe, where his parents were working, Laufer said.“I learned to code-shift in a lot of different ways.”
But beneath his flamboyant idealism and messianic allusions, Laufer exudes a crusader’s thoughtful determination to “transcend the cult of the expert” as a way to fight what he sees as unconscionable corporate profiteering by drug makers.
Adapting the DIY approach of meth labs
The EpiPencil was meant to address a single, life-and-death challenge at a time when the price of the auto-injector had soared past $600 for a two-pack. Now Laufer has turned his attention to publishing plans for the “Apothecary MicroLab,” — a general purpose chemical reactor built from materials purchased online for about $100. He also plans to publish free recipes for using the desktop lab to manufacture certain medicines.
Assembly, he said, “shouldn’t be harder than Ikea furniture.”
To demonstrate, he dumped the contents of a cardboard box onto the desk of his cramped office, crammed with leftist books, espresso accessories, and an antique Tesla radio set, which he said needed some work. Prototype parts — wires, canning jars, a printed circuit board, and cooling and heating tubes — landed in a jumble next to a Rubik’s Cube.
Laufer launched a work-in-progress program on his computer; it stepped through what it would be like to cook a batch of Sovaldi — Gilead Science’s cure for hepatitis C, which has a list price of $84,000. He said his recipe would show how to make the drug for $800 or less. Gilead declined to comment.
Laufer regards his off-the-shelf approach to lab design and chemical synthesis as unique, with the possible exception of illicit meth labs. “Unfortunately,” he said, “their interest is so niche, it’s not really generalized chemical knowledge.” (He hasn’t picked up any tips from “Breaking Bad” for that reason — and because he doesn’t own a TV.)
Instead, Four Thieves found inspiration and its logo from a bubonic plague episode in the Middle Ages. As Laufer tells the possibly apocryphal tale, thieves who made a habit of looting plague-ridden areas protected themselves from infection by using masks containing vinegar and herbs with antimicrobial properties. Eventually, they were captured, then freed after agreeing to reveal their formula — which was made public, saving many lives.
The story perfectly illustrates Laufer’s model: “an emancipation of knowledge.”
“Desperate times call for desperate measures. He’s another symptom of the disease, and the disease is drug pricing.” - Dr. Vinay Prasad
He said his collective includes several technical experts, such as medical doctors who help him identify life-saving, costly drugs that can (at least theoretically) be recreated in a canning-jar reactor. It was impossible to verify that physicians are helping him; none agreed to talk with a reporter.
Repeatedly pressed to provide introductions to his collective members, Laufer was either unwilling or unable to do so. He said most members haven’t met each other due to “different levels of paranoia” about lawsuits or harassment. Even Laufer doesn’t know all his colleagues by name, “for my safety and theirs,” he said.
“An anarchist collective is by definition a little disorganized,” Laufer conceded. But the micro-lab plans will be out in beta this year, he promised.
Recipes that few have the nerve to try
Creating the homemade equivalent of an EpiPen or Sovaldi involves deadly perils — contamination, overdose, and underdose — that even compounding pharmacies sometimes struggle with. The margins for error are very small.
That means the logical person to use a Four Thieves plan would be a cash-poor, uninsured patient who desperately needs an expensive drug — and who is also a sophisticated and supremely competent tinkerer. Needless to say, that’s a small market.
When might Laufer’s plans be ready for the masses? “I don’t think ever,” said Josiah Zayner, CEO of The Odin, a company advised by iconoclastic Harvard professor and CRISPR celebrity George Church that sells do-it-yourself kits to amateur scientists who want to tinker with genetic engineering.
Zayner called Laufer’s work so far “proof of concept stuff … usually the first step in innovation,” adding: “I’m not sure Michael’s really going to change the world, [but] he’s a symbolic force.”
“I’m not sure Michael’s really going to change the world, [but] he’s a symbolic force.” - Josiah Zayner
Laufer agrees that not many people would have the nerve to make their own medicines using his blueprints. “There’s no one for whom the medical infrastructure is working who would instead chose to manufacture the drug at home” — except perhaps himself, he said.
Despite having health insurance, he added, “I might actually reach for my tool first, being who I am.”
Laufer doesn’t track who has used his EpiPencil design and couldn’t cite a single example. No one has bragged on social media about having assembled and used one, although the popular NurdRage channel on YouTube built one and pointed out a couple of design weaknesses, and another video shows an alternate DIY design.
But for Laufer, market size isn’t the point. He says his goal is simply to empower those patients who have no alternatives.
Four Thieves shies away from selling any products; it offers only free advice and encouragement, giving the group a kind of legal protection, according to Laufer.
Patricia J. Zettler, a law professor at Georgia State University and a former FDA attorney, agreed that such an approach gives the FDA little reason to intervene. “There is no product,” she said, “and FDA doesn’t regulate what people say about a drug.”