Medicare Part D covers >3500 prescription drugs. Over 2400 of these are made by only one manufacturer (monopolies).

The prescription drug plan to let Medicare negotiate covers 10 drugs starting 2025. 20 drugs per year after.

Yet Pharma protests. Let's keep things in context.
New drugs are protected for 9 years from time on market from negotiation. Biologics for 12 years. Price increases capped to inflation.

Which means expect Pharma to "front load" prices. That means make the launch price much higher to cover all of this loss of revenue. @DavidP4AD
Out of pocket for seniors capped. Good. Important.

But it also means someone still pays Pharma. That's Medicare. Which is back to us, the public. So it's not like Pharma is losing money that way either.
We have a long long way to go for value based prescription drug pricing, unlike every other developed country.

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More from @VincentRK

1 Nov
COVID vaccines greatly reduce severe disease and deaths.

6 countries with delta waves. In each instance despite a rise in cases, deaths have stayed low this time around thanks to vaccines.
Note that even in countries like UK and Israel, one third of the population is not fully vaccinated. In absolute terms the numbers are high and allows virus to circulate.

Some vaccinated people are unable to mount an immune response due advanced age or cancer or other illnesses
To overcome these problems we need higher vaccination rates, booster doses at least for those at high risk, and continuation of preventive measures (masks and distancing) for some more time.
Read 4 tweets
31 Oct
Headlines about a study in @TheLancetInfDis stating that vaccinated people are just as likely to spread Covid as unvaccinated are misleading. Here's why.

1) Vaccination has lower risk of transmission even in this study (see table) & severe disease.
2) This study is primarily on household contacts. Household contacts live with each other. So the exposure is prolonged and sustained. So differences between vaccinated and unvaccinated groups will narrow in household settings.
3) What the study shows is that transmission from vaccinated people to household contacts can occur but at lower rate than unvaccinated. It also basically explains why the delta wave has occurred in even in some well vaccinated countries.
Read 10 tweets
29 Oct
Vaccines protect better against COVID than prior infection. Let this please end the "natural immunity" talk. #GetVaccinated nytimes.com/2021/10/29/hea…
Infection with Covid does give some protection. But getting vaccinated after will augment that protection and make it more durable.

For more read my prior thread on why it's important to get vaccinated whether or not you have had COVID.
It really doesn't matter whether vaccines protect 5 times more than prior Covid, to the same level, or even a lesser degree than prior infection. Vaccines are a far safer way to get immunity if you haven't had Covid. And if you already had Covid, vaccines augment that protection.
Read 5 tweets
26 Oct
As close to herd immunity as we can get so far:
5 countries have ~80% or more of their population fully vaccinated.

1) Deaths at or below 0.2 per 100K for >6 months.

2) UK at 68% fully vaccinated has kept deaths low at similar level despite sharp rise in cases. Vaccines work.
To get to 80% or more of total population is not easy when kids <12 are not yet able to get vaccinated.

These 5 countries vaccinated almost 90% or more of eligible population to get here. Kudos!
Since COVID infections seem to occur to some extent even after vaccinations, although much lower and milder that in absence of vaccinations, only time will tell whether we can get to long term herd immunity — with or without further boosters.
Read 4 tweets
25 Oct
On Jan 24, 2020 @DrEricDing posted a massive warning about the impending pandemic: The Holy Mother of God thread.

"We are now faced with the most virulent virus 🦠 epidemic the world has ever seen," Eric wrote.

As I read his thread again today, all of it has sadly come true
1/
He wrote:

"possibly an unchecked pandemic that the world has not seen since the 1918 Spanish Influenza. Let’s hope it doesn’t reach that level but we now live in the modern world 🌎 with faster ✈️+ 🚞 than 1918. @WHO and @CDCgov needs to declare public health emergency ASAP!"
2/
People quarreled with the R0 that was in @DrEricDing's thread, but most epidemiologists and leaders and organizations missed the forest for the trees.

We know what happened since:

240 million cases worldwide
5 million deaths

46 million cases in the US
>750,000 deaths

3/
Read 6 tweets
24 Oct
Alabama has lost more lives due to COVID in 2021 than other US states. More than 200 deaths per 100K population.

Vaccination rate in Alabama is 47th of 50 states. Only 44% of the population are fully vaccinated.
>400,000 cases this year. >10,000 deaths.
Some other states that have lost an high rate of lives this year:
Read 6 tweets

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