Thoughts on Dallas Buyers Club

* The movie is brutal; it’s easy for someone who didn’t live through the 1980s to forget or not know how frightening AIDS was when no one knew anything about the disease.

* Like most movies Dallas Buyers Club is too long, by at least 20 minutes and probably 30. Still, many scenes were delightfully under-elaborated, letting watchers fill in gaps.

* Darshak Sanghavi’s article The Pills of Last Resort: How Dying Patients Get Access to Experimental Drugs is out today and covers similar ground from a clinical / abstract perspective; Alex Tabarrok’s argument about the F.D.A.’s slowness, from Launching the Innovation Renaissance, gets a narrative boost from Dallas Buyers Club. Sanghavi observes that Thalidomide launched the modern F.D.A. drug trial rules, but drugs for a minor issue (nausea during pregnancy) and drugs for major issues (imminent death) should have different rules and different standards for safety. The reaction to the Thalidomide story has resulted in a situation that may be worse than the original problem.

* Compare how doctors and bureaucrats are portrayed in Contagion versus Dallas Buyers Club.

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