A clue might lie in the words buried at the very end of the British journal article (entitled, tellingly, “Tamoxifen: An Enduring Star”.) The authors write, “We admit a naive awareness that medical practice is increasingly influenced by external, namely financial, pressures, including shareholders’ concerns and legal issues;nevertheless, tamoxifen is a telling example of an effective agent with an unprecedented body of clinical evidence that has thus far had little appeal in the prevention setting mainly because of its poor commercial interest (the drug is cheap and off patent).” In other words, tamoxifen is losing its popularity because no one’s making enough money off it. The article concludes with this rather poignant warning: “We urge the community of scientists and clinicians to rethink its priorities and move toward choices driven more by public health concerns than by market interests. Unless we envision medical care exclusively for an elite, the resulting escalation of health care costs will become unaffordable.”

AIs are massively more expensive than tamoxifen. A quick online check shows 100 Arimidex tablets going for justunder $750 at costco.com, while the same number of generic tamoxifen pills are $34.99. Hmmmm… might the authors of that British article have a valid point? Are tamoxifen’s fall and the rise of AIs being driven, at least in part, by the almighty dollar?