Reverse engineering the EpiPen There are certainly other costs like getting approval, but this is a very simple and cheap device and the current price is out of line. Bad regulations, waste in the system and, above all, greed.
It is well established that equating calories burned from exercise with those taken in doesn’t work .. basically we can’t measure the input numbers well enough and calculate a personal metabolism accurately enough to make a meaninful call. In fact evidence suggests fitness trackers are a bit worse than no tracker if weight loss is the goal (over time means > one year).
A new study has a twist .. lifestyle intervention plus a fitness tracker . The wearable was only doing the exercise component. What is interesting is the people who used the fitness trackers did significantly worse than those who didn’t use one.
The caution is human metabolism and the measurement of interventions is very very tricky and it is easy for biases to creep in. Perhaps devices will get smart enough to do expert coaching, but our understanding of our social and psychological nature is probably more primitive than that of metabolism.
I still like the idea of devices for people who want one .. weight management is *much* less important than physical conditioning. It has been shown that motivated people tend to increase their level of conditioning independent of device .. but if one fits your personality, then it probably should be considered a necessary device. I’ve seen successful exercises swear by and at fitness trackers and I’ve seen the same from people who have failed.
Against a growing outcry over the surging price of EpiPens, a chorus of prominent voices has emerged with a smart-sounding solution: Add the EpiPen, the lifesaving allergy treatment, to a federal list of preventive medical services, a move that would eliminate the out-of-pocket costs of the product for millions of families — and mute the protests.
Dr. Leonard Fromer, a clinical professor of family medicine at the University of California, Los Angeles, just promoted the idea in the prestigious American Journal of Medicine. A handful of groups are preparing a formal request to the government. And Tonya Winders, who runs a patient advocacy nonprofit organization, reached out late last month to crucial lawmakers on Capitol Hill.
“We can save lives by ensuring access to these medications,” said Ms. Winders, chief executive of the Allergy and Asthma Network.
A point not mentioned by these advocates is that a big potential beneficiary of the campaign is Mylan, the pharmaceutical giant behind EpiPens. The company would be able to continue charging high prices for the product without patients complaining about the cost.
An examination of the campaign by The New York Times, including a review of documents and interviews with more than a dozen people, shows that Mylan is well aware of that benefit and, in fact, has been helping orchestrate and pay for the effort.
The journal article says it was “drafted and revised” by a medical writing consulting firm paid by Mylan, in consultation with Dr. Fromer. And Dr. Fromer himself has served in the last year as a paid Mylan consultant — which he discloses as part of the journal article. The company has also contributed money to many other groups behind the effort, and it has met with them — and Ms. Winders’s organization in particular — to coordinate its strategy, the participants said.
Global warming could bring a dramatic increase in ragweed (another other pollen borne) allergies to Europe. A paper appearing in Environmental Health Perspectives(pdf and not paywalled)
(a tip of the hat to Andrew)
Climate Change and Future Pollen Allergy in Europe
Iain R. Lake,1 Natalia R. Jones,1 Maureen Agnew,1 Clare M. Goodess,1 Filippo Giorgi,2 Lynda Hamaoui-Laguel,3,4 Mikhail A. Semenov,5 Fabien Solomon,2 Jonathan Storkey,5 Robert Vautard,3,4 and Michelle M. Epstein6
1School of Environmental Sciences, University of East Anglia, Norwich, UK; 2Earth System Physics Section, International Centre for Theoretical Physics, Trieste, Italy; 3Laboratoire des Sciences du Climat et de l’Environnement, IPSL, CEA-CNRS-UVSQ, UMR8212, Gif sur Yvette, France; 4Institut National de l’Environnement Industriel et des Risques, Parc technologique ALATA, Verneuil en Halatte, France; 5Rothamsted Research, Harpenden, Hertfordshire, UK; 6Department of Dermatology, Division of Immunology, Allergy and Infectious Disease, Experimental Allergy, Medical University of Vienna, Vienna, Austria
Background: Globally pollen allergy is a major public health problem, but a fundamental unknown is the likely impact of climate change. To our knowledge, this is the first study to quantify the consequences of climate change upon pollen allergy in humans.
Objectives: To produce quantitative estimates of the potential impact of climate change upon pollen allergy in humans, focusing upon common ragweed (Ambrosia artemisiifolia) in Europe.
Methods: A process-based model estimated the change in ragweed’s range under climate change. A second model simulated current and future ragweed pollen levels. These were translated into health burdens using a dose-response curve generated from a systematic review and current and future population data. Models considered two different suites of regional climate/pollen models, two greenhouse gas emissions scenarios (RCP4.5 and 8.5), and three different plant invasion scenarios.
Results: Our primary estimates indicate that sensitization to ragweed will more than double in Europe, from 33 to 77 million people, by 2041-2060. According to our projections, while sensitization will increase in countries with an existing ragweed problem (e.g. Hungary, the Balkans), the greatest proportional increases will occur where sensitization is uncommon (e.g. Germany, Poland, France). Higher pollen concentrations and a longer pollen season may also increase the severity of symptoms. Our model projections are driven predominantly by changes in climate (66%), but also are influenced by current trends in the spread of this invasive plant species. Assumptions about the rate at which ragweed spreads throughout Europe have a large influence upon the results.
Conclusions: Our quantitative estimates indicate that ragweed pollen allergy will become a common health problem across Europe, expanding into areas where it is currently uncommon. Control of ragweed spread may be an important adaptation strategy in response to climate change.