This card requires a re-evaluation now that [[Cyberdex Sandbox]] is a thing. Before, it was a hate-card first and foremost. Now, it is a powerful economic tool that is arguably the most extreme example of Code Gates Rez-to-Break ratios. Macrophage is positional, Macrophage is phenomenal.
Assume you play glacier, and the runner has spent 8-ish credits breaking two pieces of ice in front of it, they now sit opposite of an ice that costs either 5+ credits to break with a powerful breaker like Engolo, or will encounter two pivotal traces - Trace 4, or the corp gains 0-12 credits, and Trace 1, or the Corp ends the run. Sine the first sub will often feed into the 2nd, runners can't expect to be able to get away with paying low sums.
[[Thimblerig]] helps move Macrophage to the innermost position of each server, and that's where it should be - after all, the subs are most punishing post breakage of other subs.
One way to counter this power a little bit is to understand that [[Cyberdex Sandbox]] only gives money the first time the corp purges viruses. This means that repeat fires of the first sub don't do much beyond removing virus counters.
There's also the problem of the Sandbox score being a requirement to turn Macrophage "on". This means that the ice is particularly suited to AGinfusion builds, that have a relative ice flexbility meaning that if not yet active, Macrophage can be used as a boop too.
Given the relatively prevalence of the NWE's new Maxx build, Macropage stock can be expected to rise up and up.