Not mentioned in this article, Enbrel modifies your immune system in a way that increases risk of infection. Curious why not noted, as it would also help explain trade offs decision.

Between that and Alzheimers I'd roll the dice on infection.

yeah till someone dies due to a disease acquired due to a weakened immune system and their family sues for $500 million and wins.

There are a lot of medications that have the side effect of weakening the immune system, and it seems that there has been an uptick in such medications in the last few years. There are also medications that deliberately weaken the immune system. Sure, a weak immune system is a serious issue, but if the disease being treated is worse then it's less of a decision point for most people.

This medication tends to be used in a population where one of the top three causes of death is immune failure at the care facility (hospital, subacute care, etc.)

It’s not just a serious issue, it’s a top killer.

One thing mentioned in the article is the lack of patent incentives for Enbrel that don't affect the other medication with the funky Xanjy name that appears to have longer patent legs. If true the patent system is sick and twisted and needs to be turned 180 degrees to where the invention owner incurs disincentives - say loss of 1/4 of the exclusivity period - for each failure to share material research surrounding patented formulations.