Big news in The Netherlands: a dispensing chemist in The Hague is challenging a pharmaceutical company by starting a pharmaceutical production line in the back of his shop rather than being forced to wholesale some really expensive medicine (NOS News). The pharma bro's are Vertex, the product is Orkambi, the disease is cystic fibrosis and the excessive price is over 100 thousand euro's per year for a treatment. The footage accompanying the article is confusing, with a production line you would expect all sort of reactors but on film we have only a line of rota-vapors (containing a brown goo), tiny filtration setup and a tablet press. How to deconstruct the story? Orkambi is a mixture of two compounds: lumacaftor and ivacaftor, so the process going on is probably just the mixing of the two. Still a respectable venture but somewhat less spectacular. The chemist has suppliers in China and expects to be able to serve 750 patients for one fifth of the Vertex price. In the meanwhile all the Dutch government can do is negotiate with Vertex for a better deal. How well they are at that is difficult to tell as these negotiations are strictly confidential.