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Mar 11 • 6 tweets • 4 min read
Pay or Die.
Premieres today @sxsw

@PayorDieFilm
The high cost of Insulin in America. #Insulin4all
@scottaruderman @SarahKSilverman @NSmithholt12
The story behind @PayorDieFilm

payordiefilm.com/directors-stat…
The film is powerful.
Pay or Die is produced by award winning producers @scottaruderman and
Rachael Dyer and Oscar winning producer Yael Melamede.
Review from @THR
@aholdenj I am sure you will like this film. Hope you can watch it when it’s released.

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More from @VincentRK

Vincent Rajkumar Profile picture
Mar 9
Paradigm Changes in Myeloma.
#MedTwitter

1. End organ damage is no longer needed to diagnose myeloma.
@TheLancetOncol linkinghub.elsevier.com/retrieve/pii/S…
2/ Smoldering myeloma (SMM) is no longer considered an intermediate biological state between MGUS and myeloma.

It’s heterogenous. 2/3 of patients with SMM have MGUS. 1/3 have myeloma. @BloodCancerJnl @SagarLonialMD @mvmateos @myelomaMD nature.com/articles/s4140…
3/ Screening for myeloma should be considered in ultra high risk groups. @Nature nature.com/articles/d4158…
Read 11 tweets
Vincent Rajkumar Profile picture
Mar 8
Great discussion on insulin prices on @1a with @JWhitePubRadio

@aaronjkowalski, @UREssien, Rachael Dyer @PayorDieFilm

I welcome @LillyPad lowering insulin prices. Helps millions. Need major reforms to lower cost of other prescription drugs. the1a.org/segments/the-i…
Insulin prices are a symptom of a larger prescription drug pricing problem in the US. mayoclinicproceedings.org/article/S0025-… Image
See more in thread below.
Read 5 tweets
Vincent Rajkumar Profile picture
Mar 1
Wow. This is huge. This is the real @LillyPad

Eli Lilly cuts insulin price to $35. An issue many of us have been advocating so hard for. #insulin4all nbcnews.com/news/amp/rcna7…
The cap automatically applies to patients on private insurance.

The Inflation Reduction Already capped out of pocket cost to $35 for Medicare Part D recipients.

Huge: People without insurance will pay $35 if they sign up for Eli Lilly’s copay assistance program.
I hope all other insulin manufacturers especially @SanofiUS and @novonordiskus do the same.

This is just in time for @PayorDieFilm premiering March 11 and will shine a light on the huge amount of suffering patients have endured for years due to the cost of insulin.
Read 10 tweets
Vincent Rajkumar Profile picture
Feb 24
Why is hard to do anything about prescription drug prices?

It’s like a car with multiple broken parts: engine, battery, tires, transmission, seats, doors, and more.

You can’t fix just one. But fixing all at the same time is also difficult. #MedTwitter nature.com/articles/s4140…
You try to fix one, they point to the other broken parts and say it’s not going to work because so much else is broken.

You can’t fix it all because the opposition to change will naturally now come from all quarters.

It’s just very difficult. And needs enormous will.
If insulin can be expensive then you know it can happen to any drug old or new. If we understand why insulin is expensive you also understand many of the factors involved.

So what can be done? @MayoProceedings mayoclinicproceedings.org/article/S0025-…
Read 9 tweets
Vincent Rajkumar Profile picture
Feb 16
Updated mSMART recommendations for treatment of myeloma posted on mSMART.org #MedTwitter

1/ New for relapsed myeloma, clear recommendations based on type of Triple-Class refractory. We define 3 types. @Rfonsi1 @myelomaMD @MorieGertz
2/ New for Relapsed Myeloma - Approach to first relapse based on refractoriness to Len and Anti-CD38.
3/ We feel that bispecific and CAR-T approvals be based on refractoriness to specific drugs and drug classes and not be restricted by lines of therapy because myeloma can be refractory to all major drugs even within 2 lines.

Link to Relapsed Myeloma recs static1.squarespace.com/static/5b44f08…
Read 5 tweets
Vincent Rajkumar Profile picture
Feb 8
I hope we are moving away from “maximum tolerated dose” in oncology. #MedTwitter

Of the studies I’ve led, the one I am most proud of is the trial that showed that LOWER dose of steroids led to better survival & lower toxicity. @TheLancetOncol
#Myeloma thelancet.com/journals/lanon…
Maximum tolerated dose was an idea used with conventional cytotoxic agents. It’s time has passed.

We should now strive for minimum effective dose or optimal effective dose.
Even with targeted therapies and biologic therapies we have found years after drug approval that the original approved dose was too high and caused unnecessary toxicity.
Read 10 tweets

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