Spot Price

The Seller’s condition, multiple sclerosis (MS), is diagnosed by identifying and analyzing the white spots—signs of damage to the nervous system. As such, the spots have come to play a central role in the Seller’s life. Yet the Seller only recently learned that, beyond marking the “attacks” that characterize the early stage of MS, the spots have proven to be a source of immense, hidden value: an entire economy is based on visualizing, counting, and measuring them in the development of drugs. When the first “disease-modifying treatment” for MS, Betaseron, was made available in the United States in 1993, the government’s approval was based on the drug decreasing the number and size of the spots on patients’ scans, not on the clinical benefits. In other words, the image became the disease. And the conflation of the two unlocked an extraordinary market for pharmaceuticals.

With each treatment, the Seller got scans to measure its effectiveness. The drugs became more and more successful in treating the white spots, but not in addressing the most critical consequence of the disease: the onset of permanent disability. Nevertheless, the value of the market for treatments has surpassed $20 billion per year. Remarkably, even the price of the earliest drugs has gone up, despite their patents expiring and new treatments appearing: Betaseron has gotten nearly ten times as expensive since 1993, and increases in the cost of drugs taken by the Seller, such as Gilenya and Tysabri, have been similarly steep.

Given the inexorable rise in prices and the decisive role of the white spots in validating drugs, the spots pictured in Spot Price (2023) may be the Seller’s most valuable asset. The series includes three sets of five MRIs, with each set consisting of scans that were created when the Seller was prescribed the drug named in the title; the value of each work is fixed to the current price for a one-month supply of the drug. Spot Price offers a peek inside the Seller’s head as well as an investment in the economy built on the white spots, which is sure to thrive for as long as the image is seen as the disease.

Further reading: “Regions of Interest”.