A recent episode of the very fine podcast EconTalk reminded me of one of the more remarkable episodes during my time here at the Acton Institute involving our internship program. The EconTalk episode is about the price of cancer drugs, and the various factors that go into the often astronomical prices of the latest cancer-fighting drugs. These can run up to an in excess of $300,000 per year.
A question implicit in the discussion is whether such high costs are just. That’s also the question that animates a highly-cited article from the Journal of Clinical Oncology, “Cancer Drugs in the United States: Justum Pretium—The Just Price,” by Hagop M. Kantarjian, Tito Fojo, Michael Mathisen, and Leonard A. Zwelling. This is where John Shannon, who was serving as an editorial assistant for the Journal of Markets & Morality and a research intern at the Acton Institute at the time (and now a graduate student at the LSE), comes in.
Shannon read the article, and discovered some curious claims. These include: “Aristotle is credited to be the first to discuss the relationship between price and worth in his book Justum Pretium—the just price.” As you might imagine, Shannon was amazed to discover an previously unknown book by Aristotle on the just price. After doing some digging, however, Shannon was disappointed: “An article in a medical journal justifies its title with a claim that Aristotle wrote a book that he didn’t write in a language that he didn’t speak.”
Check out Shannon’s comprehensive and devastating interaction with this journal article here, “Doing Injustice to the Just Price.”
Retraction Watch summarizes the fallout, which includes an erratum to the article, which unfortunately “only notes the missing reference, with no adjustment to the assertion that Aristotle wrote a long-lost book called Justum Pretium.”
Unfortunately one of the other consequences of this kind of scholarship is that attention is easily moved from a very important question (what is the just price of cancer drugs?) to something else (did Aristotle write a book on the just price in Latin?). As Shannon rightly puts it, “A judicious application of just price theory to the current cancer drug market would need to examine any cases of price discrimination or taking advantage of emergency situations in light of over a thousand years of scholarly discussion. Such a treatment is the stuff of which peer-reviewed articles ought to be made, but regrettably can’t be found in the Journal of Clinical Oncology piece.” Thankfully we have the EconTalk episode featuring Vincent Rajkumar of the Mayo Clinic, and the associated resources, to help sort through the complicated factors involved.
Let me also recommend a couple of other resources on the just price (beyond those that Shannon highlights and refers to in his own piece).
First, as so much of moral reflection actually boils down to, the just price can be considered what a just person would or should charge. See Jude Chua Soo Meng, “What Profits for a Man to Gain: Just (the) Price (of the Soul),” Journal of Markets & Morality 8, no. 1 (Spring 2005): 7-26. Our consciences need to be well-formed and informed, but in the end justice begins with each one of us living up to the standards of justice as they apply in our own situations.
And if I were ever to teach a seminar or have a course that involved the just price, I would have my students watch and wrestle with the issues raised in this episode of the classic TV western Bonanza, “The Price of Salt.”