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鈴木雅明《フーガの技法》@紀尾井ホール。今日のコンサートに来られたあなたを正真正銘のバッハファンとして表彰しますと雅明さんに観客は褒められた！音楽というよりは建物を鑑賞したり水晶の結晶(主題)がどこにあるかと探すように楽しんでください、と冒頭ミニレクチャーから始まる。続
#BCJ
#BCJ
「もう1人のチェンバリストを呼びます」と鈴木優人さんが加わって、後半は鏡のフーガから。鏡のように反転させて成り立つ、対になった曲…を分析的に聴くのは諦めて、純粋鑑賞モードに切り替えると、まるで川の流れや木々のざわめきのような音が耳に飛び込んできた。続
#BCJ
#BCJ
美しい自然からそこにある法則を見出していった科学者たちの逆回転を、バッハは行ったのだなあ。対位法の極みで緻密な法則のもとで造られたフーガは、複雑さを離れ昇華するように自然の美を生み出す。化学の実験ですごく綺麗な色の何かが出てきてびっくりするみたいな。続
#BCJ
#BCJ
Three articles in the last few days in Blood Cancer Journal #BCJ showing reduced immune responses to COVID vaccines in patients with blood cancers.
1) Myeloma: especially patients on daratumumab and belantamab. nature.com/articles/s4140…
1) Myeloma: especially patients on daratumumab and belantamab. nature.com/articles/s4140…
Chronic lymphocytic leukemia. Especially patients on BTK inhibitors (Eg., ibrutinib)nature.com/articles/s4140…
Reduced immune responses in hematologic malignancies. Only half the patients appear to generate sufficient immune protection. Especially if on B cell targeting treatments. #BCJ @BloodCancerJnl @Mohty_EBMT nature.com/articles/s4140…
A friend just got a prescription of the diabetes medicine, Ozempic® (semaglutide) injection. 3 syringes: $2200. Fully insured, so out of pocket only $150.
Here the problem:
1/ High price means new medicines like this are only for well off people with good insurance
Thread
Here the problem:
1/ High price means new medicines like this are only for well off people with good insurance
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2/ And secondly, don't think for a minute that the insurance company is paying the remaining $2050. Due to rebates they may pay $1000 or less.
So the only people who pay the full list price will be unsuspecting uninsured paying cash, who think the list price is the real price.
So the only people who pay the full list price will be unsuspecting uninsured paying cash, who think the list price is the real price.
3/ The exact same thing happens with insulin. One vial of analog insulin costs >$300. Insured people will probably get it with a copay of <$30. The insurance company has to pay only $100 or less due to rebates.
Only people paying $300 are vulnerable diabetics without insurance.
Only people paying $300 are vulnerable diabetics without insurance.
2020 was rough from an academic standpoint. We couldn’t get clinical or lab research done as planned. I did get some work done. Here are some I feel good about.
1. RCT in Newly diagnosed myeloma of VRd vs KRd. ENDURANCE @myelomaMD @eaonc @TheLancetOncol thelancet.com/journals/lanon…
1. RCT in Newly diagnosed myeloma of VRd vs KRd. ENDURANCE @myelomaMD @eaonc @TheLancetOncol thelancet.com/journals/lanon…
2. RCT of Len vs Observation in Smoldering myeloma. @SagarLonialMD @eaonc @ASCO_pubs ascopubs.org/doi/full/10.12…
3. RCT of Ixa-Rd vs Rd in Newly diagnosed myeloma. TOURMALINE MM-2 @MayoMyeloma @ASH_hematology #ASH20 ash.confex.com/ash/2020/webpr…
Our study shows that approximately 10% of patients undergoing auto transplant for myeloma have an exceptional response (PFS > 8 years without maintenance therapy). Median survival ~20 years; 25% never achieved CR. #BCJ @MayoCancerCare @MorieGertz @Rfonsi1 nature.com/articles/s4140…
This doesn’t mean we don’t recommend maintenance. We do for all patients. But an attempt to determine the baseline proportion of patients who achieve extraordinary outcome with just induction and transplant. It’s hard to predict who they will be. Almost all had standard risk MM.
It also shows the incredible value of high dose melphalan in myeloma therapy.
1. @PhRMA files lawsuit against Minnesota’s Alec Smith Insulin Affordability Act that provides emergency insulin access. Diabetics dying due to lack of affordable insulin is a uniquely American problem. Pharma greed in display
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2. Gilead prices remdesivir at >$3000 per course for a treatment that has not been proven to reduce mortality. It exposes what’s wrong with prescription drug pricing in America, and how unregulated monopolies will charge what monopolies want. @peterbachmd google.com/amp/s/www.nbcn…
3. Novartis @Novartis bribed doctors and clinics in Greece and Vietnam to buy and prescribe its products, violating the Foreign Corrupt Practices Act. Will pay $112.8 million in fines. nytimes.com/reuters/2020/0…
My paper on the high cost of prescription drugs and possible solutions is out. I go into how US policies (or lack thereof) affect prices in other countries. #BCJ
#OpenAccess #CostVR #insulin4all @MayoClinic nature.com/articles/s4140…
#OpenAccess #CostVR #insulin4all @MayoClinic nature.com/articles/s4140…
There are no easy answers because the factors contributing to high prices are myriad, and come from all different directions. There are factors unique to the US, which are not operational elsewhere. We need many policy changes in order to have an impact. nature.com/articles/s4140…
Looks like a laundry list of things going on, because a laundry list of things is going on. Everything I mention plays an active role in high prices. We cannot control prices without looking at this 360°
There are things individual docs can do. So don’t wait for policy changes.
There are things individual docs can do. So don’t wait for policy changes.
