Myeloma Drug Costs per month:
Bortezomib $6000
Elotuzumab $10500
Ixazomib $11000
Panobinostat $12000
Isatuximab $13500
Daratumumab SQ $15000
Lenalidomide $16000
Carfilzomib $16000
Pomalidomide $20000
Selinexor $22000
Belantamab $24000

Patients need 2-3 of these in combination.
I'll be watching and posting the cost of Melflufen and CAR-T

Myeloma treatment is often continuous. Myeloma patients even with insurance can have substantial co-pays. Middle class patients who don't qualify for very low income assistance programs are affected a lot.
For more on the high cost of prescription drugs, especially cancer drugs and what we need to do about it, please check out this article. nature.com/articles/s4140…
There are very few allies in the struggle to lower prescription drug costs. Everyone in the system benefits from high costs except patients.
This story is not unique to myeloma. I could a similar list for just about every cancer. Every cancer drug approved in the 5 years is >$100,000 per year.

Unsustainable.
Some new cancer drugs work very well. However many new drug approvals are for drugs with marginal or modest benefit: few months extra in survival. Some even less, or not at all.
Regardless of whether a drug improves lifespan by a day or a week or a month or not at all, the price can be set to whatever the drug company wants. Whatever.

Therein lies the broken system. Unregulated monopoly.
Regardless of whether a drug improves lifespan by a day or a week or not at all, the price of a drug can be increased at an time over and over again, whenever and to whatever level the drug company wants.

Therein lies the broken system.
Not just cancer drugs. This can happen with any drug. Even insulin.

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More from @VincentRK

28 Feb
Progress towards herd immunity in the US:

~30 million have had COVID
~50 million have received at least 1 dose of vaccine
~70 million are children; not eligible for vaccine.

After considering some overlap in 3 groups: ~140 million to go to get 80% of eligible population immune
With J & J approval, this goal is achievable within 3-4 months.

Things then will be remarkably good considering how good the vaccines are in preventing deaths & hospitalizations. It will relieve the huge stress many frontline health care workers have endured for the last year.
Here is information on vaccines by state. @Forbes forbes.com/sites/joewalsh…
Read 4 tweets
26 Feb
In randomized trials with 6 different COVID vaccines involving ~175000 persons:

0 hospitalizations for COVID in persons who received the recommended schedule of vaccine.

That is ZERO.
Astra Zeneca Oxford
Pfizer
Moderna
Novovax
Sputnik V
J & J
Source: I read each FDA guidance document for Pfizer, Moderna, and J & J. The @TheLancet papers for Astra Zeneca (most recent) and Sputnik V. And press release for Novovax interim analysis.
Read 5 tweets
25 Feb
If you had any doubts about the efficacy of vaccines: Marked reduction in deaths in vaccinated persons in nursing homes than in overall US population. #VaccinesSaveLives @nytimes @mathisonian @smervosh @danielle_ivory
If you don't believe this, and the data from randomized trials and other real world data we already have, then your aren't gonna believe.
This is why I'm confident that vaccines will get us back to normalcy.

This is why I don't this March will be terrible.

This is why I think we can be near normal by summer as proportion of people who have been vaccinated and those with prior COVID inches close to herd immunity
Read 7 tweets
25 Feb
Mutants or not this is what's happening. Update. #COVID

What we can control: Vaccines
What we can't control: Mutants
(Except through Vaccines).
Same story in Israel where more than half the country has received at least 1 dose of vaccine. And real world data show marked protection from vaccines.
This is pretty good sustained reduction since my earlier tweet from over 2 weeks ago.
Read 4 tweets
24 Feb
COVID Deaths. ft.com/content/a2901c…
You can hardly see India on here now.

While relaxations on masks & lockdowns led to increased deaths in Europe & USA, we don't see this in India even though I think similar relaxations occurred. Next month is critical.
There is worry about new cases increasing in Maharashtra. Hope this is controlled with some changes to policy and by expanding vaccinations quickly.
Deaths may lag behind the rise in cases and that's why I think we will need another month to assess the severity of the recent increase in cases over the last 10 days. news.google.com/articles/CAIiE…
Read 4 tweets
24 Feb
Breaking. FDA Guidance document on J & J vaccine efficacy. Overall efficacy 67%. Efficacy to prevent severe COVID 77%.
Severe COVID efficacy analysis.
Efficacy maintained in older patients.
Link to FDA guidance document. fda.gov/media/146217/d…
Read 6 tweets

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