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Paul Chambers
Hope is on the horizon if you don't look back.
Hope is on the horizon if you don't look back.
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Liquid Medication Syringes and other supplies including replacement feeding tube Don't forget to ask your feeding tube formula and supply supplier for 10ml oral medication syringes WITH caps each month when you reorder your supplies

They are part of the standard supply kit but you must ask for them.

A pill crusher syringe is also part of your kit but you must ask. This is like a 60ml flushing syringe but it is grooved and design to pulverize pills into a powder.

My regular monthly order is formula, 2x2 split gauze, 60ml flushing syringes, silk tape (Not paper), 10ml oral syringes with caps, feeding bags and pill crusher.

Every 3 months I order a replacement feeding tube and we replace them at home when needed. I put a video up on Youtube changing a tube at

Feel free to share your thoughts, comments, tips

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Update on post where Google Plus is failing to install on my Android 4.4 tablet.
Attempted install in terminal and came back with a missing shared library.

Any ideals? +Google+ +Google Play +Google Developers

+Keith Petersen

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I have Android KitKat 4.4.2 and +Google Play won't let me install +Google+
I tried to side load it and it won't let me either. What up?

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This spam email reminds of the time my doctor's office accidentally clicked the "F" instead of the "M" on a claim form to my insurance and for years I got post cards from my doctors office reminding me to get my pap smear and breast exam. 

Eventually my insurance populated it because of the claim forms and got confused too.

Over ten years later and I still get reminders from my insurance company every year.

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New FDA advisory regarding GBCA contrast agents in MRI's

New concerns for persons who have had four or more contrast MRI's.

After being administered, GBCAs are mostly eliminated from the body through the kidneys. However, trace amounts of gadolinium may stay in the body long-term. Recent studies conducted in people and animals have confirmed that gadolinium can remain in the brain, even in individuals with normal kidney function. Available information does not identify any adverse health effects.

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FYI: Circle me and when I circle you back you will see my freshest and most latest posts. I rarely post to public to avoid trolls.

Skyrocketing MS Drug Costs in US 'Alarming'

A new study documents what researchers are calling an "alarming" rise in costs for multiple sclerosis (MS) disease-modifying therapies (DMTs) in the United States and not just for newer oral medications.

"While we would expect that legitimate advances, such as the development of oral DMTs, might garner higher prices, the escalation in costs for first-generation agents that have been available for up to two decades is puzzling," Daniel M. Hartung, PharmD, MPH, and colleagues from Oregon Health & Science University, Portland, note in their article in the May 26 issue of Neurology.

"The issue of cost for DMT for MS is an increasing concern," Dr Hartung commented in a Neurology podcast.

"A flourishing pharmaceutical industry provides invaluable benefit to society by developing new drugs to combat disease and alleviate suffering," the authors write. "The success of the pharmaceutical industry in bringing new therapies to market for the treatment of MS has improved the care of people with MS.

"However, the unbridled rise in the cost of MS drugs has resulted in large profit margins and the creation of an industry 'too big to fail,'" they conclude. "It is time for neurologists to begin a national conversation about unsustainable and suffocating drug costs for people with MS — otherwise we are failing our patients and society."

Access Problems

The researchers examined about 20 years (1993–2013) of drug pricing data for nine MS DMTs, starting with the initially approved injectable medications — interferon β-1b (Betaseron, Bayer), interferon β-1a IM (Avonex, Biogen), and glatiramer acetate (Copaxone, Teva Pharm) — up to the newest oral agents — fingolimod (Gilenya, Novartis), teriflunomide (Aubagio, Genzyme/Sanofi), and dimethyl fumarate (Tecfidera, Biogen).

Their analysis showed that the first-generation DMTs, originally costing $8000 to $11,000 annually, now cost roughly $60,000 per year. The price of these older agents has increased annually at rates five to seven times higher than general prescription drug inflation. The newer oral agents commonly hit the US market with a cost 25% to 60% higher than existing MS DMTs, the authors note.

"The rising cost of many of the agents, in particular the three oldest agents — Betaseron, Avonex, and Copaxone — has not been uniform and seems actually from our data to be accelerated by approval of some of the newer agents," Dr Hartung commented.

He noted that significant increases in the cost trajectory of the first-generation DMTs occurred following the US Food and Drug Administration (FDA) approval in 2002 of interferon β-1a SC (Rebif, Merck Serono) and natalizumab (Tysabri, Biogen; reintroduced in 2006) and remained high following introduction of fingolimod in 2010.

The cost of MS DMTs in the United States is currently two to three times higher than in other similar countries, including the United Kingdom, Australia, and Canada, the authors note. The increases over the years in MS DMTs are not consistent with other prescription drug inflation metrics, Dr Hartung noted. In fact, they are "way out of line" in relation to a variety of comparisons.

The high cost of these agents is causing "real substantial access problems for patients," Dr Hartung warned. "Many insurance companies have been forced to use increasingly restrictive policies to manage cost and make people fail certain therapies before perhaps getting one of the oral agents," he noted.

"Because therapy for MS is very individualized, these types of regimented policies are not ideal for this disease state. While neurologists may become angry or frustrated over these increasing barriers that are put in place by payers, it is important to realize that the core reason for these restrictions is this escalation in cost, which is caused by the pharmaceutical industry," Dr Hartung said.

Holly Campbell, communications director, Pharmaceutical Manufacturers Association, told Medscape Medical News this study "doesn't tell the whole story because it does not take into account the competitive biopharmaceutical market that exists in the US, which helps to control costs while encouraging the development of new therapies for multiple sclerosis.

"The report only looks at the list prices of medicines, which typically do not reflect the substantial discounts negotiated by insurers," she said. "Similar price negotiation also happens in the successful Medicare Part D program. Focusing on list prices for a small group of medicines results in a misleading impression about the overall spending on medicines trend, which is just 10% of total US health care spending."

"Defies Common Sense"

In the Neurology podcast, David E. Jones, MD, from the MS Clinic at the University of Virginia, Charlottesville, who wasn't involved in the study, noted that MS neurologists have been "concerned for years" about the rapidly increasing price of MS DMTs, "but it seems like little has been written or done about this." Dr Hartung and colleagues have tackled "an area that needed to be addressed," Dr Jones said.

The coauthors of an editorial in Neurology, T. Jock Murray, MD, and Murray G. Brown, PhD, from Dalhousie University, Nova Scotia, Canada, say what has happened with MS DMT costs in the United States "defies common sense, logic, and the expected rules of the marketplace." After approval of the newer oral agents, the "skyward escalation" in prices of all DMTs was not expected.

"These price increases, and emerging evidence that long-term outcomes are less than anticipated, undermine the cost-effectiveness of MS DMTs. These counterintuitive increases suggest the possibility of collusion among the manufacturers, but the authors say they do not have evidence," Dr Murray and Dr Brown note.

Dr Hartung and colleagues say there is "an urgent need" for clinicians, payers, and manufacturers in the United States to confront the "soaring" costs of DMTs.

Dr Hartung encourages neurologists through their professional organizations, including the American Academy of Neurology and the National MS Society, to "take a strong stand against the aggressive pricing increases that have occurred."

"When you look at other fields, such as oncology and hepatitis C, there is a lot of public outcry against the pricing practices and it has allowed some concessions in terms of the prices for some of the new hepatitis C drugs as well as some cancer agents," he noted. "The publicity and acknowledgment of this pricing phenomenon I think will go a long way to hopefully stabilizing the cost of some of these agents."

Dr Murray and Dr Brown agree action is needed. "The ethics of medical professionalism requires physicians to be advocates for their patients. Hartung et al. ask that neurologists become concerned and initiate a national conversation on this issue, which is relevant also to conditions other than MS, such as cancer and hepatitis C. We cannot just be concerned — our professional ethic requires us to act," they write.

MS Society "Deeply" Concerned

Reached for comment on the study, Timothy Coetzee, PhD, chief advocacy, services and research officer at the National MS Society, said, "Access to affordable, high-quality healthcare is essential for people with multiple sclerosis to live their best lives. The evidence tells us that early and ongoing treatment with an MS disease-modifying therapy is vitally important to controlling disease activity, delaying the accumulation of disability, and protecting the quality of life for people with multiple sclerosis. However, today's healthcare reality is that the high cost of these important therapies prevents full access to them.

"The Society is deeply concerned by the rising costs of the MS therapies and the negative impact that this has on individuals being able to access these treatments," Dr Coetzee told Medscape Medical News. "People with MS must have full access to affordable health care. The Society is committed to bringing together all the stakeholders in this issue to find viable solutions to lower the overall costs of MS care and expand the medication formularies available to people with MS."

"While work proceeds on the public policy side, the Society focuses on helping to ensure that people with MS have access to the therapies they need by assisting them to tap into available options and assistance programs. Our work is grounded in our Access to High Quality MS Healthcare Principles, which are the foundation for all of our actions," Dr Coetzee said.

The study had no targeted funding. Dr Hartung, Dr. Murray, and Dr Brown have disclosed no relevant financial relationships. A full list of author disclosures is available at

Megan Brooks

Neurology. 2015;84:2105-2106, 2185-2192. Abstract Editorial

Medscape Medical News © 2015  WebMD, LLC
Send comments and news tips to

Cite this article: Skyrocketing MS Drug Costs in US 'Alarming'. Medscape. May 27, 2015.

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Bankruptcy Count sells Aereo's customer list to TIVo. Sales email ensues. Great, next Radio Shack +Senator Elizabeth Warren+Senator Bernie Sanders

TiVo OTA is not the same as #aereo. If you live in a OTA dead zone like me all you get is a $150 cancelation fee for months 1-12 and $75 for months 13-24.


Depression and Parkinsonism goes hand and hand. Disgusted at so called media and news outlets, esp the ones with health sections, having stories that reports depression as a surprise or new development. 
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