Eat Shit and Prosper
Correction: The $20k pricetag quoted in this piece was an estimate based on word of mouth from industry sources before Rebyota was actually available. As of May 2023, the price is $9487, according to Drugs.com. This is not the outrageous part.
Two weeks ago, on November 30th, the FDA approved Rebyota—the first-ever microbiome “drug”. You’d think I would be over the moon, but the truth is that I’m furious.
I put the word “drug” in scare-quotes because Rebyota isn’t really a drug in the typical sense. It is, for all intents and purposes, a bag of shit. And it is expected to cost somewhere in the neighborhood of $20,000 before insurance.
Before we get to that, a little context. Rebyota is supposed to treat gut infections caused by Clostridioides difficile, or “C. diff”—basically a lethal case of diarrhea. It’s a pathogen that’s resistant to most antibiotics, which is how it becomes a problem and why it’s so hard to treat. Pretty much the only way to cure it is to burn a person’s entire microbiome to the ground with the heaviest of heavy-duty antibiotics, then import a whole new microbiome from a healthy person to cover over the ashes.
Fortunately, there’s no overall shortage of healthy human gut bacteria; your average person has them, quite literally, out the wazoo: Feces is roughly 60% bacteria by dry weight, and—provided it comes from a healthy person and is handled properly—it typically contains a representative sample of all the species necessary for human health.
