Saturday, 8 April 2017

Devils Advocate

If you look at comments Yestersday in Dropping ProgG.s marbels.  We came up with a term LAL to describe some neurologists


May I suggest an alternative subliminal reason not to use alemtuzumab not because of high cost but because of high maintainence as people taken alemtuzmab have to be managed and have blood tests every month and urines every few month.

This will add to the costs and the neurologists will have to deal with the 50% secondary autoimmunities that may appear

Maybe it is they are simply being Lazy........Again:-)

Fear Not, I suspect an alternative that requires little monitoring is coming soon. 

Achtung alle fauler Neurologen.
Kladribin wird bald ankommen 
Es ist Deutsch. Prima!

Worried about Cost-Go Generic

CoI None (Apologies for Bad German, DrK corrections Bitte)

5 comments:

  1. Hi Prof.

    Let's start with your translation. I'd propose: "Alle faulen Neuros aufgepasst: bald gibt's das gute Cladribin aus Darmstadt!"
    That said, I don't think you're catching the German Neurology "Zeitgeist" that well. There may be some reluctance amoung practicioners to take up new therapies. On the other hand, I think this mentality reflects in no small part a highly conservative attitude of MS Patients towards desease management. Independent Patient Organisations abound in Germany who don't mince words when reviewing the Therapy pipeline. Prices are generally irrelevant since everything is fully covered here. Rather, the (potential) impact of side-effects - no matter what the probability observed in studies - needs to be independently verified in the first years of common usage before considering a therapy. It's no coincidence that the global reference for PML cases under Tysabri is maintained by a German Blogger. I fear that Cladribin will get the same reception.

    That said, I'd like to differ with your opinion on the popularity of Alemtuzumab. Many can't even get it since it's provided with tight monitoring by select Hospitals. As a result, several centers are booked out through early 2018.

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    Replies
    1. PML after Clad I suspect will not be high because it does not deplete CD8 that much and it is gone within a few hours, but the past history may haunt it.

      Thanks of info on alem wonder what happens now

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  2. Plus alemtuzumab doesn't have such a 'liberal' profile as in the UK, where it can be the first DMT. In many countries, it is a 2nd or even 3rd line drug and it's supposed to be the last reserve if everything else fails.

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  3. Its 3 lane here on spain, it shames me a little admitting I was able to get it without failing another DMT because I'm a medic and my opinion was taken into account because of it.

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