Presented at the Society for the Social Studies of Science (4S) meeting, Buenos Aires, Argentina, August 2014
Abstract: In 2014, three pharmaceutical companies are set to bring new allergy immunotherapy products to market, a veritable revolution for a the slow-moving field of allergy and immunology. New treatments must walk a fine line between offering clinicians the flexibility to tailor treatment to individual patients – a hallmark of existing immunotherapy methods – and designing a product that can win FDA approval. Recent scholarship in STS has highlighted a tension between the ability of medical diagnostics to pinpoint individual risk factors and variation with ever-increasing precision and the need for pharmaceutical companies to develop drugs that appeal to the largest possible markets. Based on my ethnographic research with a medical products start-up company in New York City, I will show how this contradiction takes form in the area of allergy immunotherapy. FDA approval serves as an obligatory passage point for the future profitability of this company’s immunotherapy product, since new delivery methods of the already-approved active ingredients can only be marketed to a wide audience with their blessing. Clinical trials both generate the raw data needed for approval and generate buzz about the coming treatment revolution. The stakes of designing successful trials is even higher for a small company than for a multinational pharmaceutical corporation. This paper ends by engaging with research that examines how market logics touch down in medical care via regulatory policies that prioritize quick fixes and private-sector profitability over healing more intractable health problems with lower promised returns.