Estimating the Environmental Impact of Certain Prostate Cancer Procedures < Urology

“Yale-led study examines the potential environmental benefits of more carefully selecting patients for prostate biopsy in a way that can also spare low-yield and potentially harmful procedures.

Yale School of Medicine Associate Professor of Urology Michael Leapman, MD, MHS, and coauthors across seven other U.S. institutions estimated the environmental impacts of prostate magnetic resonance imaging [MRI] and prostate biopsy, procedures that are part of the diagnostic process for patients with known or suspected prostate cancer. Overall, they estimate that performing both an MRI and biopsy is similar to going on a “round-trip flight from London to Paris,” in terms of energy used, staff travel, and supply production. Their research, using cradle-to-grave life cycle assessment methodology, was published in the January issue of the journal European Urology.

Study investigators say the overarching message is that sustainability efforts should be aligned with patient interests and evidence-based care. “We continue to see many medical and diagnostic procedures being used more often than recommended by clinical guidelines – increasing health care costs and in some cases, directly harming patients,” says Leapman. “A dimension that has been less well studied is the environmental impact of care that is already considered low-value or unnecessary. In this analysis, we estimate the carbon footprint of a prostate biopsy, then extrapolate the potential environmental benefits of adopting various evidence-based approaches,” continues Leapman, who specializes in the treatment of patients with prostate and genitourinary cancers and serves as clinical leader of the Prostate & Urologic Cancers Program at Yale Cancer Center and Smilow Cancer Hospital.”

Source: Estimating the Environmental Impact of Certain Prostate Cancer Procedures < Urology

Eli Lilly Says It Will Cut the Price of Insulin – The New York Times

By Christine Hauser

March 1, 2023Updated 9:17 a.m. ET

1 MIN READ

“Eli Lilly and Company said on Wednesday that it would reduce the price of its most commonly prescribed insulins and expand a program that caps monthly out-of-pocket costs for patients at $35 or less.”

David Lindsay Jr.

Hamden, CT  NYT Comment:

Good article, thank you. Finally. One commenter says it is only $7 in Australia. I’d like more information on what it costs around the world, how much it costs to produce, and what should it cost here. Maybe a lot less than $35 a month? InconvenientNews.net

How a Drug Company AbbVie Made $114 Billion by Gaming the U.S. Patent System – The New York Times

By Rebecca Robbins

• • Jan. 28, 2023

7 MIN READ

In 2016, a blockbuster drug called Humira was poised to become a lot less valuable.

“The key patent on the best-selling anti-inflammatory medication, used to treat conditions like arthritis, was expiring at the end of the year. Regulators had blessed a rival version of the drug, and more copycats were close behind. The onset of competition seemed likely to push down the medication’s $50,000-a-year list price.

Instead, the opposite happened.

Through its savvy but legal exploitation of the U.S. patent system, Humira’s manufacturer, AbbVie, blocked competitors from entering the market. For the next six years, the drug’s price kept rising. Today, Humira is the most lucrative franchise in pharmaceutical history.

Next week, the curtain is expected to come down on a monopoly that has generated $114 billion in revenue for AbbVie just since the end of 2016. The knockoff drug that regulators authorized more than six years ago, Amgen’s Amjevita, will come to market in the United States, and as many as nine more Humira competitors will follow this year from pharmaceutical giants including Pfizer. Prices are likely to tumble.

The reason that it has taken so long to get to this point is a case study in how drug companies artificially prop up prices on their best-selling drugs.”

David Lindsay: Excellenet article, but upsetting. It appears that there are many solutions, such as passing a law that says all additional patents to a new drug have to use the same start date as the original patent.

Dr. Herbert Benson, Who Saw the Mind as Medicinal, Dies at 86 – The New York Times

By Clay Risen

Published Feb. 17, 2022Updated Feb. 18, 2022

“Herbert Benson, a Harvard-trained cardiologist whose research showing the power of mind over body helped move meditation into the mainstream, died on Feb. 3 at a hospital in Boston. He was 86.

His wife, Marilyn Benson, said the cause was heart disease and kidney failure.

Dr. Benson did not set out to champion meditation; in fact, even after his first pioneering studies, he remained a skeptic, picking up the practice himself only decades later.

He was, however, open to the possibility that state of mind could affect a person’s health — common sense today, but a radical, even heretical idea when he began researching it in the mid-1960s.

During a stint working for the U.S. Public Health Service in Puerto Rico, he noticed that island residents often had significantly lower blood pressure than their mainland counterparts, all else being equal. He began to wonder if part of the cause lay outside the usual explanations of diet and exercise — a question he took up when he returned to Harvard as a researcher in 1965.”

‘It Felt Like Deception’: An Elite NYC Hospital Charges Huge Virus Test Fees – The New York Times

By Sarah Kliff

Published March 30, 2021Updated March 31, 2021, 12:22 a.m. ET

The Lenox Hill Greenwich Village emergency department, where patients have been charged extraordinarily high prices for coronavirus tests. This photo was taken in mid-March; the blue parts of the signs advertising Covid testing have since been removed.Credit…Steven Molina Contreras for The New York Times

“Lenox Hill Hospital in Manhattan advertised its “Covid-19 Testing” on a large blue and white banner outside its Greenwich Village division’s emergency room. The banner said nothing about cost.

But cost turned out to be the testing’s most noteworthy feature. Lenox Hill, one of the city’s oldest and best-known hospitals, repeatedly billed patients more than $3,000 for the routine nasal swab test, about 30 times the test’s typical cost.

“It was shocking to see a number like that, when I’ve gotten tested before for about $135,” said Ana Roa, who was billed $3,358 for a test at Lenox Hill last month.

Ms. Roa’s coronavirus test bill is among 16 that The New York Times reviewed from the site. They show that Lenox Hill arrives at its unusually high prices by charging a large fee for the test itself — about six times the typical charge — and by billing the encounter as a “moderately complex” emergency room visit.” . . .

David Lindsay Jr.

Hamden, CT | NYT Comment:

Horrible, terrible and upsetting. Thank you Sarah Kliff for disturbing my “wa,” or inner peace. You wrote, “Doctors and hospitals that bill higher prices for testing can rely on new federal protections to ensure they are paid. Congress passed a law last year that requires insurers to fully cover coronavirus testing costs and not apply any patient co-payments or other fees to the service.” Please write soon about what can we do about this Augean stable of greed. Would it be, in the short term, as simple as rewriting the law mentioned above, with strict parameters that empowers the insurance companies to respond with reasonable reimbursement rates? Is life ever as easy as I think it should be?

David Lindsay Jr is the author of the Tay Son Rebellion about 18th century Vietnam, and blogs at InconvenientNews.Net. He is currently writing a book about climate change and the sixth extinction, but he probably should be writing a book called, What the heck is wrong with Connecticut.

Rich Countries Signed Away a Chance to Vaccinate the World – The New York Times

By Selam Gebrekidan and Matt Apuzzo

• March 21, 2021

In the coming days, a patent will finally be issued on a five-year-old invention, a feat of molecular engineering that is at the heart of at least five major Covid-19 vaccines. And the United States government will control that patent.

The new patent presents an opportunity — and some argue the last best chance — to exact leverage over the drug companies producing the vaccines and pressure them to expand access to less affluent countries.

The question is whether the government will do anything at all.

The rapid development of Covid-19 vaccines, achieved at record speed and financed by massive public funding in the United States, the European Union and Britain, represents a great triumph of the pandemic. Governments partnered with drugmakers, pouring in billions of dollars to procure raw materials, finance clinical trials and retrofit factories. Billions more were committed to buy the finished product.

But this Western success has created stark inequity. Residents of wealthy and middle-income countries have received about 90 percent of the nearly 400 million vaccines delivered so far. Under current projections, many of the rest will have to wait years.”

This is a good article, and the subject is more complicated than some might think.  There is a lot to sort out. My quick take, the Gates Foundation language should have been included in the contracts, to protect the public from getting gauged.

5 Childhood Conditions That Don’t Require a Trip to the E.R. – By Jacob E. Osterhout – NYT Parenting

Even the most squeamish parents can treat these common ailments without ever needing to leave the house.

By Jacob E. Osterhout

• Oct. 3, 2019
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“My 4-year-old son has a particularly active imagination. On any given day, he’ll regale us with fantastical tales about dragons and superheroes and rocket ships. But no matter how implausible his stories are, they always maintain some connection to reality.

So when my wife, who is a pediatric anesthesiologist, came home one day and my son announced that there was a rock in his nose, she believed him even though she couldn’t see it. And when he said that a space alien had put it in his left nostril, she still believed him even though he is clearly not friends with any martians. And when our nanny said that she thought the rock was just a “hard booger,” my wife still believed my son even though we have pulled some rock-hard boogers out of those nostrils.

Had I, an average parent (at best) with no formal medical training, been the one to arrive home first during this medical crisis, we would have headed straight to the emergency room, where a doctor probably would have sedated my son and used forceps to pull out the offending rock in an uncomfortable, time-consuming and expensive procedure.

But my wife, and her 13 years of medical training, walked through that door and knew exactly what to do. She remembered a technique from medical school for removing a foreign object from a child’s nose called “the mother’s kiss.”

In essence, you plug the unaffected nostril and blow into the child’s mouth, hoping to force the foreign object to pop out — as illustrated in this video.

“By blowing in the mouth, which is connected to the nasal passage through the back of the throat, the air should force the bead or stone to come out the nostril,” said Dr. Lawrence Rosen, M.D., a pediatrician and founder of the Whole Child Center, an integrative private pediatric practice in Oradell, N.J. “It’s a lot gentler and more pleasant than going to the E.R. and having an instrument stuck up their nose.”

Of course, said Dr. Michael Patrick, M.D., a pediatric emergency medicine physician at Nationwide Children’s Hospital and assistant professor of clinical pediatrics at Ohio State University, any at-home medical procedure — including this one — can come with certain risks. “All the child has to do is potentially take a deep breath in and the rock could be sucked down into the lungs,” he said. “This could happen if they’re crying.” “

Source: 5 Childhood Conditions That Don’t Require a Trip to the E.R. – NYT Parenting