Is $2.1 million too much for a drug? For affected parents, there is no debate First Opinion‘Anchoring’ was at work in setting the price of Novartis’ new gene therapy Peter B. Bach About the Author Reprints @peterbachmd Kahneman and Tversky asked two groups of students what percentage of countries in the United Nations were located on the African continent. Given an over/under anchor of 10%, their guesses averaged 25%. With an over/under anchor of 65%, the average answer was 45%. The effect of anchoring is largest when the guesser has no other frame of reference. Related: By Peter B. Bach June 4, 2019 Reprints After all, Zolgensma is different from other drugs. It is given just once and appears to reverse the loss of motor neurons that leads to severe and rapid decline and death in infants. What it has done for some children would warm the coldest, darkest critic’s heart. It has no logical point of reference.A few years ago, I started noticing drug corporations and their trade associations begin anchoring by proposing prices for drugs to come. Industry speakers started referring to “million dollar gene therapies” even though there was no such therapy actually on the market.There were criticism and opinion columns arguing that we need new ways to finance million dollar gene therapies. Blaming the health care system, not the manufacturer that wants to charge the highest possible price, is risible, but it falls nicely into the narrative that the U.S. health care system is broken.Yet while there is an actual number of ping pong balls that King Kong’s favorite hangout could soak up — about 23 billion — prices of drugs are not immutable. They are a product of what markets will allow. Hence lower prices in Europe than in the U.S. for the same drug.Over the past few months, Novartis CEO Dr. Vasant Narasimhan tossed out a bunch of price anchors for Zolgensma that ranged from $1.5 million to $5 million. Just before the big reveal, he told reporters the price would be well shy of $5 million, and it was.We all got anchored, then we got a discount, and now there actually is a gene therapy on the market with a multimillion-dollar price tag.Peter B. Bach, M.D., is the director of the Drug Pricing Lab at Memorial Sloan Kettering Cancer Center in New York City. Related: I remember the 1990s. A clot-busting drug came on the market that was deemed a threat to health insurance sustainability. It cost around $1,000. In the aughts, I witnessed a cancer drug be scrutinized heavily by Medicare because it cost around $80,000.Yet Zolgensma, at more than $2 million, has inspired merely a “meh”?The usual pricing justifications do not apply. Manufacturing a dose of Zolgensma may cost a lot but it doesn’t cost millions. Its research costs tally to a few hundred million at most, money Novartis will earn back in a handful of months as peak sales should reach $2.6 billion a year.The drug’s value today is around $900,000, according to the independent nonprofit Institute for Clinical and Economic Review. That is based on being willing to pay $150,000 per high-quality year of life for the treatment when used in already symptomatic type 1 patients, the most common clinical presentation.Most drugs today are not priced based on any of these parameters but are instead based on the prevailing price in the market for similar drugs — what economists call the price the market will bear.But Zolgensma is a gene therapy, and when Novartis set out to determine how much of society’s money it could transfer to its shareholders through Zolgensma’s sales, it saw an anchoring type of ping pong ball moment. Adobe If the Empire State Building happened to be hollow, could you fill it with 1 billion ping pong balls? Would that number fall short, or would you have leftovers? How many ping pong balls do you think it would take exactly?I know, it’s a hard question. It’s hard to know even where to start.A half a century ago, Nobel laureate Daniel Kahneman and his lifelong colleague Amos Tversky described what they called anchoring. When offered a number about an intuitively unknowable quantity, like how many ping pong balls could fill the Empire State Building, the guesser is pulled toward that number.advertisement I raise the issue of anchoring in light of the announcement last week from Novartis that its gene therapy called Zolgensma for spinal muscular atrophy, a rare disease, had an unimaginably high price: $2.125 million per treatment, payable in five annual installments.advertisement I have spinal muscular atrophy. Critics of the $2 million new gene therapy are missing the point Tags drug pricingrare disease
Canadian Government needs to Plan for Progressive Resumption of Air Connectivity Montreal – The International Air Transport Association (IATA) recognizes that the immediate focus of the Government of Canada is limiting the spread of COVID-19. This includes extraordinary measures aimed at stopping all but essential travel, along with strict testing and quarantine protocols, to eliminate the importation of new COIVD-19 variants.These policy actions to restrict the freedom of movement are taking a severe toll on people, businesses and the economy. To limit these effects, it is critical that the Government of Canada is prepared to progressively reconnect the country to the world when objective criteria give the decision makers the confidence that the epidemiological situation can safely permit this.A collaborative dialogue between industry and government will help this process in several key areas:Efficiently implementing policy measures, including global guidance of expert organizations such as the International Civil Aviation OrganizationUnderstanding and monitoring the benchmarks that the government is setting to eventually resume connectivityEnsuring that measures can be implemented in the international context with minimal inconvenience to travelers.“We are eager to support the leadership of the Honorable Omar Alghabra, Minister of Transport for Canada. This means implementing the measures needed to safely manage through the pandemic. But we must also ensure that there is a plan in place to energize the eventual recovery by restoring the freedom of movement and reconnecting the people and businesses of Canada, both internally and with the world,” said Nick Careen, IATA’s Senior Vice President for Airport, Passenger, Cargo & Security. /Public Release. This material comes from the originating organization and may be of a point-in-time nature, edited for clarity, style and length. View in full here. Why?Well, unlike many news organisations, we have no sponsors, no corporate or ideological interests. We don’t put up a paywall – we believe in free access to information of public interest. Media ownership in Australia is one of the most concentrated in the world (Learn more). Since the trend of consolidation is and has historically been upward, fewer and fewer individuals or organizations control increasing shares of the mass media in our country. According to independent assessment, about 98% of the media sector is held by three conglomerates. This tendency is not only totally unacceptable, but also to a degree frightening). Learn more hereWe endeavour to provide the community with real-time access to true unfiltered news firsthand from primary sources. It is a bumpy road with all sorties of difficulties. We can only achieve this goal together. Our website is open to any citizen journalists and organizations who want to contribute, publish high-quality insights or send media releases to improve public access to impartial information. You and we have the right to know, learn, read, hear what and how we deem appropriate.Your support is greatly appreciated. All donations are kept completely private and confidential.Thank you in advance!Tags:Air transport, Aviation, Canada, civil aviation, covid-19, dialogue, Government, IATA, industry, leadership, Minister, pandemic, President, quarantine, security, Transport
George Mason University has a strong institutional commitment tothe achievement of excellence and diversity among its faculty andstaff, and strongly encourages candidates to apply who will enrichMason’s academic and culturally inclusive environment. Required Qualifications:Doctorate in Music;Evidence of successful orchestra conducting, teaching, andrecruiting at the university level. Special Instructions to Applicants For full consideration,applicants must apply for position number F9212Zat https://jobs.gmu.edu/;complete and submit the online application; and submit thefollowing materials: (1) a detailed letter of application, (2) afull curriculum vitae, (3) names, email addresses, and phonenumbers of three professional references, (4) links to videos oforchestral performances and rehearsals—preferably with a universityorchestra, and (5) a personal statement that demonstrates thecandidate’s goals, experiences, and commitment to promotingdiversity and inclusion in artistic programming and teaching. Director of Orchestral Studies Responsibilities:Duties includeconducting the Mason Symphony Orchestra, Mason Opera/Musicals(semesterly rotation), and recruitment activities. Additionally,responsibilities include advising and teaching graduate-levelorchestral conducting students and related academic classes. Thesuccessful candidate will mentor future music educators,performers, and conductors and engage fully in the academic andartistic life of the Dewberry School, the College of Visual andPerforming Arts (CVPA), the University, and the community. The Dewberry School of Music of George Mason University, one ofthe most diverse institutions in American higher education, seeks adynamic Assistant or Associate Professor to serve as Director ofOrchestral Studies, starting August 2021. This is a full-timetenure-track 9-month position. Salary is commensurate withexperience. Full benefits package provided. Appointment beginsAugust 16, 2021. George Mason University is an equal opportunity/affirmativeaction employer, committed to promoting inclusion and equity in itscommunity. All qualified applicants will receive consideration foremployment without regard to race, color, religion, sex, sexualorientation, gender identity, national origin, age, disability orveteran status, or any characteristic protected by law. Preferred Qualifications:Exceptional artist-teacher with demonstrated experience workingwith strings. Diversity Commitment: George Mason University is fully committedto achieving the goal of a diverse and inclusive academic communityof faculty, staff and students. We seek individuals who arecommitted to this goal and our core campus values in the spirit ofMason’s university-wide initiative, Anti-Racism and InclusiveExcellence.
AddThis Sharing ButtonsShare to FacebookFacebookFacebookShare to TwitterTwitterTwitterShare to EmailEmailEmailShare to RedditRedditRedditShare to MoreAddThisMore25 years later and the iconic baby who blessed one of the most famed 90’s album covers of all time has skipped past his teen spirit phase and into young adulthood.Grunge rock band Nirvana released Nevermind in 1991 containing such hits as “Come As You Are”, “In Bloom”, and “Smells Like Teen Spirit”.The baby in the swimming pool named Spencer Elden, decided to honor his musical roots and recreate the historic photo a quarter of a century later.RELATED: The Couple From Woodstock LP Cover is Still Married 46 Years After ConcertAfter paying the photographer $200 – which happened to be the sum that his parents were paid for the use of his photogenic infant face 25 years ago – Spencer paid homage to the beloved band.The photographer talked Spencer out of doing the shoot naked like the original, but even with the lights out, the resemblance is still entertaining.You Don’t Have To Stay Away From Sharing This Story With Your Friends – Photo by Spencer Elden This Bizarre Photo Caused Mayhem, Try Not to Gasp when You See Why HealthCrash x Sponsored by RevcontentFind Out More >81,412AddThis Sharing ButtonsShare to FacebookFacebookFacebookShare to TwitterTwitterTwitterShare to EmailEmailEmailShare to RedditRedditRedditShare to MoreAddThisMore
Technique errors: Improper technique also can take its toll on your body. If you use poor form as you do a set of strength training exercises, swing a golf club or throw a baseball, for example, you may overload certain muscles and cause an overuse injury.Although an overuse injury can happen to anyone, you may be more prone to this type of injury if you have certain medical conditions. Overuse injuries are also more likely to occur as you get older — especially if you don’t recognize the impact aging can have on your body and modify your routine accordingly. Always speak with your doctor first before starting a new activity or ramping up your current routine.To prevent an overuse injury: Thinking of starting a new physical activity program or ramping up your current training routine? If so, you may be at risk of an overuse injury — which could ultimately cause more harm than good and sideline you from your fitness program.An overuse injury is any type of muscle or joint injury, such as tendinitis or a stress fracture, that’s caused by repetitive trauma. An overuse injury typically stems from:Training errors: Training errors can occur when you take on too much physical activity too quickly. Going too fast, exercising for too long or simply doing too much of one type of activity can strain your muscles and lead to an overuse injury. Use proper form and gear. Spending a little on a personal trainer can save you a lot on medical bills. These people are trained to teach you the best methods for your personal needs. Replace your shoes at least twice a year or more often depending on how often you work out.Pace yourself. If you’re starting a new fitness program, avoid becoming a weekend warrior. Compressing your physical activity for the week into two days can lead to an overuse injury. Aim for at least 30 minutes of moderate physical activity a day.If you don’t have time for a full 30 minutes, you can break it down into three 10-minute blocks. It’s also a good idea to take time to warm up before physical activity and cool down afterward. Avoid stretching until your muscles are warmed up.Gradually increase your activity level. When changing the intensity or duration of a physical activity, do so gradually. Mix up your routine with cross training. Instead of focusing on one type of exercise, build variety into your fitness program. Doing a variety of low-impact activities — such as walking, biking, swimming and water jogging — can help prevent overuse injuries by allowing your body to use different muscle groups and not overload any one particular group. And be sure to include strength training for the major muscle groups in your arms, legs and core at least twice a week.Remember the old saying, “Slow and steady wins the race”? Take it easy, build your fitness routine and you will enjoy the results of a better you. Stay healthy, my friends.Jody Holton writes about health for Port Arthur Newsmedia. She can be reached at [email protected]