Excited to arrive in a few days! Thank you for the warm welcome!

Lilly's goodwill move on Insulin probably easier to stomach as they have possibly the largest blockbuster drug in history on deck in tirzepatide for obesity

wsj.com/articles/eli-l…

Price of mavenclad (cladribine) highlighted in this article is particularly galling as it had been available for decades as a generic injection and only recently repurosed as oral tabs for $$$$

The Medicine Is a Miracle, but Only if You Can Afford It nyti.ms/3l4X6NC

One of best things about fall in pnw

I celebrated my bday with a five gallon bucket of dehydrated food and energy bars I won't eat. | Find me with inReach➜inreachlink.com/TLTPGJR

I'm starting my trip. Follow along at my MapShare site! | Find me with inReach➜inreachlink.com/OFBFFZZ

Our new paper finds large increase in barriers for opioids commonly used for cancer pain in part d.

Disease modifying therapies account for more than half of all direct medical spending.

What the Opioid Crisis Took From People in Pain (by Maia Szalavitz)
Stefan Kertesz, MD, MSc Jonah Geddes Gillian Leichtling @KorthuisTodd Dan hartung Alicia Agnoli Anthony Jerant @fenton_jj Allyson Varley, PhD
nytimes.com/2022/03/07/opi…

In addition to facing high out-of-pocket costs, individuals with ms and their neurologists often have to deal with utilization management policies (i.e. prior auth) that can compromise care. I was happy to chat about this issue, which was the focus of a recent paper in ncp.

Similar prevalence of Acthar conflicted nephrologists and neurologists (80% to 90%). pubmed.ncbi.nlm.nih.gov/30646086/
In the absence of credible evidence for much of anything, acthar requires the hard sell. pubmed.ncbi.nlm.nih.gov/34902005/

Good thing a teaspoon costs $39K

Kff brief (kff.org/medicare/issue…) indicates potential part d and b drugs that could be negotiated by Medicare if bbba implemented in 2022. Acthar (#13) should be a slam dunk for cms. Costs $39k per teaspoon and very weak evidence supporting use (jamanetwork.com/journals/jamai…)

Pharmacies and pharmacists, which have been leaned on heavily during pandemic, are in crisis, especially under resourced areas. While many factors in play, there is an urgent need to reform how pharmacies are reimbursed that acknowledges their import public health function

Can risk be presented as odds please

Buprenorphine saves lives. It is difficult to square the idea that the federal government has both advanced policies to broaden bup access AND actively undermines its availability by raiding pharmacies who dispense too much!?

bonkers! Can't wait until he publishes his synthesis of the 500 pages of evidence he reviewed.