godfather of surgery

Chapter 1293 The Special Patient's Speech
Rigoyan has completed three courses of K therapy and is now preparing to be discharged from the hospital.

Compared to before treatment, the tumor has shrunk by 30%, all symptoms have disappeared, and the treatment effect is very gratifying. Moreover, the tumor will continue to shrink for a long time after the end of the K therapy. This is how Sisi was cured.

Twenty-four days had passed since his arrival. Twenty-four days ago, he was practically carried in on a stretcher, barely clinging to life with the help of a ventilator; now, he leans on a custom-made cane, his steps slow but steady. The tumor hadn't completely disappeared, but it had been brought under control and put into a dormant state, like a sleeping volcano. And this small volcano would continue to shrink, perhaps even disappear altogether.

The hospital conference room was packed with reporters from all over the world, their cameras and microphones aimed at this special patient, waiting for him to speak. He was the first American to receive K therapy, a patient with advanced and complex cases, and the CEO of a multinational pharmaceutical giant.

Rolf wanted to prepare a speech for him, but Rikoyan refused.

He stood in front of the makeshift podium. In the camera's view, he was thin but had clear eyes. People who have experienced the brink of life and death have a special kind of calmness.

“Twenty-four days ago, when I arrived here, I was prepared to die.” His voice came through the microphone, a little hoarse but clear. “Today, I can stand here, first of all, thanks to Professor Yang Ping and his team. They not only gave me a second life, but more importantly, they showed me what medicine should be like—never giving up on any life, even if there is only one percent hope.”

The flashes were intense.

“But I don’t want to talk about myself today.” Li Gaoyang changed the subject. “During my treatment, there were several patients in the same hospital receiving the same treatment. Some of them were entrepreneurs, some were teachers, some were farmers, and some were children. They paid in different ways, some paid out of pocket like me, some through insurance, and some through the universal framework’s aid fund, but the treatment they received was the same.”

He paused for a moment to let the translator catch up.

“For the past two decades, the BG Group, which I led, like other pharmaceutical companies, believed in market pricing and value-based healthcare. We believed that the price of a drug should reflect its research and development costs and clinical value. This is not wrong, but we overlooked one thing: when price becomes a barrier, even the best drug cannot save those who are excluded.”

The scene quieted down, with only the sound of camera shutters clicking.

"While in my hospital bed, I read through all of Professor Yang Ping's papers and studied Ruixing's inclusive framework. I realized that this is not charity, but a more sustainable business logic: expanding the market by increasing accessibility and creating value by reducing costs. While more patients receive treatment, we can also recover research and development costs and obtain reasonable profits." Li Gaoyang raised his head, his gaze sweeping over the international media present. "So today, I'm announcing three things."

Reporters immediately raised their recording equipment.

"First, BG Group will fully accept and support the Inclusive Framework. We will not only promote K therapy in North America, but also push this framework to become an industry standard."

"Secondly, I will personally donate $500 million to establish the Global Equitable Healthcare Foundation, which will be dedicated to supporting patients who cannot afford treatment. At the same time, BG Group will contribute 10% of its profits in the oncology drug field over the next three years to this foundation."

“Third—” he took a deep breath, “I urge all pharmaceutical companies to rethink their pricing models. The ultimate goal of medical progress is not profit maximization, but life maximization. What is the point of progress if our technology cannot benefit those who need it most?”

"Finally, I would like to tell you that my remarks today are not just personal opinions, but have been approved by the board of directors."

The scene erupted in uproar. This was no longer just a patient's testimonial; it was a declaration of war against the entire industry.

Dr. Johannesson listened from the crowd, his expression complex. As one of America's top medical experts, he knew the weight of these words. Li Gaoyang was not only thanking his savior, but also publicly supporting a model that would overturn the fundamental logic of the global pharmaceutical industry.

After the press conference, Li Gaoyang did not leave immediately. He returned to the research institute and met Li Xiaoyun, who was about to be discharged, in the general ward area.

"Congratulations, Teacher Li," Li Gaoyang said in his newly learned Chinese, his pronunciation stiff but sincere.

Li Xiaoyun felt a little awkward. She knew the identity of the foreigner in front of her from the news: the former CEO of one of the world's largest pharmaceutical companies.

“Congratulations to you too…” she said softly.

Wang Jianjun stood beside his wife, hesitated for a moment, and then reached out his hand: "Thank you for what you just said. For ordinary families like ours, the inclusive financial framework is our only hope."

Li Gaoyang grasped his hand: "No, I should be thanking you. Your successful treatment proves that the inclusive framework is not just an ideal, but a feasible reality."

Two men, one a former pricing power holder in the pharmaceutical industry and the other an engineer who almost gave up treatment because of the price, now held hands tightly together.

Yang Ping stood at the end of the corridor, watching this scene without saying a word. Song Ziming said softly, "Professor, it seems we really have changed something."

“It’s not that we’ve changed anything,” Yang Ping said, “it’s that medicine has been rediscovered as it should be.”

Forty-eight hours after Rigoyan was discharged from the hospital, news came from Brussels.

After ten days of intense negotiations, the European Medicines Agency (EMA) conditionally accepted Ruixing's data security framework proposal. The key concession was allowing real-time synchronization of all EU patient treatment data between the main data center in China and the mirror center in Frankfurt.

The newly established "China-EU Medical Data Security Oversight Committee" will have dual veto power—either party can suspend the cross-border flow of relevant data if it believes that data access may endanger patient privacy or national security.

"This is a solution that is unsatisfactory to all parties but acceptable to all of them," Huang Jiacai commented at an internal meeting. "The EMA has preserved its regulatory authority, we have preserved our market, and the European giants have gained the right to continue negotiations."

"And the cost?" one of the directors asked.

"The construction and operation costs of the Frankfurt data center are approximately 80 million euros per year, with a portion borne by Ruixing and another portion by several other European giants. In addition, the list of Chinese experts on the oversight committee needs to be reviewed by the European side—which means a transfer of some personnel authority."

Someone in the meeting room frowned: "This isn't fair."

“Commercial negotiations are never absolutely fair, only relatively balanced,” Huang Jiacai said calmly. “More importantly, this plan breaks down the barriers to entry in the European market. Once the K therapy is approved in the EU, other countries will face much less resistance in following suit.”

He pulled up a global regulatory map: "Currently, fifteen countries, including the UK, Switzerland, Australia, and Canada, have explicitly stated that they will refer to the EMA's decision. If Europe approves it, the approval process in these countries could be shortened by at least six months."

As they were talking, the encrypted line received a video call request from Schneider. Once connected, the German's face appeared on the screen, with the background showing the office at the Frankfurt headquarters.

“Mr. Huang, congratulations.” Schneider’s smile became more sincere. “The EMA’s position paper will be officially released this afternoon. I can say that without our full efforts, this result would not have been achieved so quickly.”

“I noticed some changes in the proposal,” Huang Jiacai said. “In particular, the clause regarding the EU’s priority purchasing rights was not within the scope of our initial discussion.”

Schneider's smile faded: "This is a political reality. The European Commission wants to ensure that European companies have priority in working with the company if the conditions are equal. Of course, this is based on equal conditions."

"This will affect the fairness principle of the inclusive framework."

“But we can guarantee that the European market will be open to K therapy.” Schneider leaned forward. “Mr. Huang, business requires compromise. We have already helped you break down the biggest regulatory barriers, which is a sign of our sincerity. Now, we need to see your sincerity in our place in the upcoming list of European partners.”

Huang Jiacai paused for a few seconds: "The evaluation is still in progress, but I can promise you: if your overall score is in the top three, you will become one of the first partners in Europe."

“Top three?” Schneider frowned. “We need a more definite commitment, after all, our influence in the EMA is something other competitors don’t have.”

“Influence should be reflected in the assessment score.” Huang Jiacai remained unmoved. “Regulatory communication ability is one of the scoring items, accounting for 15%. If you can get more EU member states to quickly adopt the EMA’s approval conclusions, this score will naturally be higher.”

After hanging up the phone, one director asked with concern, "If they really push for expedited approvals in other countries, should we keep our promise?"

“If their scores do indeed rank in the top three, they must deliver on their promises,” Huang Jiacai said. “The core of the inclusive framework is transparency and fairness, not charity or punishment. What we need to do is ensure that the scoring criteria themselves are fair, and then strictly enforce them.”

He glanced at the time: "Notify the evaluation committee that the final round of on-site inspections of all applicant companies will begin tomorrow. I will personally participate in the section for European companies."

While the political and business maneuvering continues in Europe, in an industrial park in the provincial capital of Nandu, the first standardized production line for K therapy has entered its final debugging stage.

This production line originally belonged to a bankrupt biopharmaceutical company, but was completely transformed after being acquired by Ruixing. According to Yang Ping's design, it was not intended to achieve traditional mass production, but rather flexible and customized production. On the same production line, it could produce both standard vectors targeting common mutations and customized vectors targeting rare mutations in small batches.

"The aseptic standards in the cell culture area have been met." Song Ziming, wearing a protective mask, checked the parameters of the incubator. "However, the recovery rate of the virus purification process is only 68%, which is lower than the design target of 75%."

Chen Xiao was the engineer in charge of the production line, and Yang Ping gave him this new task.

“Professor Yang, Dr. Song, we’ve been investigating this problem for three days.” Dr. Chen pointed to the control interface of the purification equipment. “The problem lies with the packing material in the chromatography column. There are batch-to-batch differences in the packing material supplied by the vendor, which leads to unstable purification efficiency.”

"Change suppliers," Yang Ping said simply.

"But this is the best filler on the market right now, and there is no substitute."

“Then let’s develop it ourselves.” Yang Ping walked out of the workshop and began to draw molecular structures on the whiteboard in the corridor. “Look, the ligand of the existing filler is nickel ion, which is adsorbed by histidine tag, but our carrier surface has special glycosylation modification, so the adsorption efficiency is not high.”

He drew a new molecular structure: "If we replace the ligand with cobalt ions and modify the purification tag of the carrier, the adsorption specificity can be increased by more than three times."

Dr. Chen was stunned: "This requires redesigning the vector's gene sequence..."

"So we need to make changes," Yang Ping said. "Our platform is already a third-generation design, and it's meant to be iterated upon. Discovering problems now is an opportunity for improvement, and we need to iterate actively and quickly."

"But the production line is scheduled to start trial production next week, and redesigning it means all the verifications have to be redone, which will delay it by at least three months!"

“If the products produced are substandard, speed is meaningless.” Yang Ping’s tone was flat. “The first principle for medical products is quality, not speed.”

Song Ziming added from the side, "Dr. Chen, the professor is right. K therapy is injected directly into the human body. Any imperfection in purification could cause an uncontrollable and fatal immune response. We cannot take that risk."

Dr. Chen remained silent for a few minutes before finally nodding: "I understand. I will immediately organize the team to redesign the purification process. But Professor Yang, you need to provide a new vector sequence."

"I'll give it to you tonight." Yang Ping glanced at his watch. "Also, notify the quality control team to re-evaluate all raw material suppliers. If any batch is found to be unstable, immediately activate the alternative plan."

After hearing Yang Ping's revised decision, Huang Jia did not question it, but only asked, "How much impact will a three-month delay have on global supply?"

“There are currently about three thousand patients waiting for treatment.” Chen Xiao pulled up the data. “Based on the current production capacity, about 1,500 doses can be produced in three months. The delay means that half of these three thousand people will have to wait another three months.”

"mortality rate?"

"Depending on the severity of the illness, the natural mortality rate is between 5% and 10% per month."

Huang Jiacai closed his eyes, pressing his fingers to his temples. This was a cruel math problem—insisting on quality meant that some patients might not get treatment; compromising on quality, on the other hand, could put patients who received treatment at risk.

“What if we split it into two batches?” He opened his eyes. “The first batch will be produced as planned, but only for the most critically ill patients, while informing them of the risks. The second batch will be produced after the new process is validated, and will be used for patients whose conditions are relatively stable.”

Yang Ping shook his head: "This violates medical ethics. We can't classify patients into different levels, and we can't tell some people that your medicine might be of poor quality, but anyway, you're going to die soon. Moreover, the potential side effects caused by substandard medicine will shake the confidence we've built up. This is very detrimental to the promotion of K therapy, and the number of patients treated will decrease. So either all of them are up to standard, or none of them are up to standard."

“Then let’s postpone it,” Huang Jiacai said, immediately instructing those around him, “We need to disclose the reasons for the postponement and the new timetable, and accept supervision; establish an emergency channel so that the most critical patients can apply for the use of experimental batches, but they must have full informed consent and additional safety monitoring; and speed up the construction of the second production line to make up for the loss of production capacity.”

Huang Jiacai couldn't help but admire Professor Yang's calmness and rationality. He never approached problems from a subjective perspective, but rather offered scientific analysis. Sometimes, even Huang Jiacai couldn't understand Professor Yang; was he driven by compassion or by cold rationality?