Just not enough sick people

Eli Lilly considers testing weight-loss drugs on people who are not overweight

Eli Lilly is considering testing its blockbuster weight-loss drugs in people who are not overweight but are at risk of weight gain, in an early sign that the drugmaker may look to broaden the rollout of the medications beyond obese patients.

Dave Ricks, Eli Lilly’s chief executive, told the Financial Times that the drugmaker behind Mounjaro and Zepbound was drawing up plans to study its anti-obesity medications among people with a body mass index (BMI) that does not classify as overweight.

He said: “Maybe the cut-off point of [a BMI of] 27 we use in northern Europe and the US for entry into the studies isn’t appropriate. Maybe we should use [a BMI of] 25. Long term, should we look at health maintenance? Maybe we will.”

This is the standard pharma playbook. You have to treat the well as the pool of sick people is not large enough for quarterly earnings reports. Interesting to see if they will fund the studies with hard endpoints (i.e death) over several decades — when the patents have long expired. Of course not.

Money for nothing

John Lanchester · For Every Winner a Loser: What is finance for?

In his indispensable guide to the current condition of the financial industry, Other People’s Money, published in 2015, John Kay talks about the state of the UK banking sector, whose assets then were about £7 trillion, four times the aggregate income of everyone in the country. But the assets of British banks ‘mostly consist of claims on other banks. Their liabilities are mainly obligations to other financial institutions. Lending to firms and individuals engaged in the production of goods and services – which most people would imagine was the principal business of a bank – amounts to about 3 per cent of that total.’

That’s finance. The total value of all the economic activity in the world is estimated at $105 trillion. That’s the mangoes. The value of the financial derivatives which arise from this activity – that’s the subsequent trading – is $667 trillion. That makes it the biggest business in the world. And in terms of the things it produces, that business is useless. It does nothing and adds no value. It is just one speculator betting against another and for every winner, on every single transaction, there is an exactly equivalent loser.

The point bears repeating. There are other ways of getting rich, and in our society the classic three ways of making a fortune still apply: inherit it, marry it, or steal it. But for an ordinary citizen who wants to become rich through working at a salaried job, finance is by an enormous margin the most likely path. And yet, the thing they’re doing in finance is useless. I mean that in a strong sense: this activity produces nothing and creates no benefit for society in aggregate, because every gain is matched by an identical loss. It all sums to zero. The only benefit to wider society is the tax paid by the winners; though we need to remember that the losers will have their losses offset against tax, so the net tax benefit is not as clear as it might at first seem.

The sad state of UK higher education

The next five years will be worse for English universities than the past five years have been. And the five after that could be worse still. 

The above is a quote from Alison Wolf (Baroness Wolf of Dulwich) writing in the Times Higher Education in 2015. The title was revealing: Can higher education’s golden age of plenty continue? For me 2015 did not seem an age of plenty. I took up a permanent post in 1990 in Newcastle, and over the successive decades became inured to year-on-year reductions in funding that directly supported student teaching. Research relied on external grant money without any funds for pilot or left field ideas. Core academic infrastructure was stripped, and less money flowed to the shop floor. Class sizes went up, and universities became increasingly impersonal — not just for students but for staff. Clinical academics felt like unwanted guests in the wider university and few now would recommend anybody following in their footsteps unless they had private incomes or they were both extraordinary and lucky. Fibs became more and more common.

University academic leasers have been dealt a poor hand by successive governments, but with notable exceptions — think Louise Richardson at St Andrews and then Oxford— they have been a dull bunch who have played fast and loose with the categorical imperative that for many of us provided the fundamental justification for publicly funded higher education.

So not a fair test then?

John Lanchester · For Every Winner a Loser: What is finance for?

Digression: a highly satisfying, bizarre and under-reported finding published on arxiv.org last year showed that this is exactly the same probability you get from tossing a coin. You may have been brought up to think that the probability of a coin landing heads or tails is exactly equal with every toss. That, amazingly, turns out not to be true. A coin flipped energetically and caught in mid-air is 2 per cent more likely to land on the side that was facing upwards the last time. The principles at work appear to be aerodynamic: airflow around the tossed coin makes it by a fine margin more likely to repeat the previous toss than to contradict it. By their own admission some of the richest people on the planet earned their fortunes on the basis of the same odds you get by tossing a coin.

The rest of article is brilliant, too. Worth the annual subscription to the LRB.

Why do penguins struggle with modernist architecture?

from The Economist

Short answer: because the clients were not consulted.

Set between the llamas and the Land of the Lions, the penguin pool in London Zoo is a mini-modernist masterpiece. Built in 1934 and designed by Berthold Lubetkin, it is sleek, swooshy and perfectly proportioned; its cantilevered concrete ramps, slender as apple peelings, were revolutionary… There was just one problem with this piece of modernist perfection. The penguins didn’t like it.

The refurbished concrete hurt their feet. The elegantly shallow pool was too shallow. The minimalist white walls were too white, and hurt their eyes. London Zoo’s keepers do not like to talk about penguins being “happy” or “unhappy” (it is anthropomorphising). But, says Jessica Fryer, team leader of penguins and flying birds at the zoo, some of the penguins’ feet became “so sore”. They developed a foot disease that, in its severest form, can lead to penguins being put down. It may not be possible to say whether penguins are “happy” or “unhappy”. But “dead” is definitely worse than “alive”.

Then the killer line

The penguin pool has become a white elephant.

From pineapple on the pizza to freedom of worship

Andrew O’Hagan writing in the London Review of Books

Andrew O’Hagan · Push Me Pull You: Creating the Beckhams

The Beckhams are British in a new way, a way that wealthy people who live most of the time in places like Dubai and Miami are British, loving the royal family and hating income tax while deploring the press they relentlessly deploy. They fill their days topping up their self-pity and complaining that they haven’t yet got the knighthood they so clearly deserve.

Let’s be clear about Beckham. He likes pineapple on his pizza. He can’t get enough of The Lion King. He admits that he has never read a book in his life, almost certainly including the ones he wrote himself. (He didn’t make it all the way through Posh’s either.) It is said he once posed wearing an Adolf Eichmann T-shirt and carrying a bottle of Moët, without realising who the guy on the T-shirt was, though he recognised the champagne. In his best moments, he’s a reverse Dorothy Parker, curving another déclaration folle into the back of the net. ‘We’re definitely going to get Brooklyn christened,’ he said, ‘but we don’t know into which religion.’

Left-behind Britain

From a review of Paul Collier’s latest book (Left Behind: A New Economics for Neglected Places) in the New Statesman

Were this not infuriating enough, Collier describes the devastation wrought by the Treasury’s preference for economic theory over accounting reality. The department’s “hermetic paranoia against expertise” allowed it to be easily outmatched by multinational oil companies, for example, which have for decades paid about three times as much tax on Norway’s oil as they do on the same resource taken from beneath Britain’s part of the North Sea. Norway’s finance ministry is far smaller, but it was prepared to hire 40 accountants rather than thousands of PPE graduates. In administering taxes on Norway’s oil properly, these accountants have helped to build the largest sovereign wealth fund in the world.

It would be nice to think things might change after Starmer’s landslide. There is infinite hope, but is any of it for us?

The dismal science

Industrial Policy Is a Nostalgic Pipe Dream by James K. Galbraith – Project Syndicate

As I have written before, a consensus of economists – even well-meaning progressives – is a dangerous thing. Consensus, by its nature, is the enemy of consistency and logic

I would add: no truly intelligent system should be 100% consistent

Integrity as an unnecessary business expense

Post Office scandal: how did Paula Vennells, an ordained priest, fall so far and so fast from grace? | Post Office Horizon scandal | The Guardian

In meeting notes about Crichton’s departure, Vennells wrote that the lawyer had “put her integrity as a lawyer above the interests of the business”. (emphasis added)

Two years earlier, the inquiry has heard, in the evidence of the Post Office’s then senior in-house lawyer, Chris Aujard, it was Vennells who insisted that prosecutions of subpostmasters continue, despite contrary evidence raised in Second Sight’s interim report. Susan Crichton, Aujard’s predecessor as general counsel, had resigned after being excluded from a meeting about that report after, she said refusing to “manage or manipulate the [information] in the way that Alice Perkins [former chair of the board] was expecting me to.” In meeting notes about Crichton’s departure, Vennells wrote that the lawyer had “put her integrity as a lawyer above the interests of the business”.

A particular dominant negative mutation in capitalism will destroy much we once held dear. Capitalism, the nation state, or democracy: you only get to choose two of the three options. There remains the Hell option for the chosen few.

God & mammon

God™: an ageing product outperforms expectations

from The Economist

Hard facts on the economics of the Almighty are hard to come by. But the Mormon church is reportedly one of the largest private landowners in America. One study found that in 2016 American faith-based organisations (non-profits with a religious bent) had revenues of $378bn. This was more than the revenues of Apple and Microsoft combined. Better yet, churches usually pay no tax. God may be great; His full-year results are greater.