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PRC and Peppy: Agreed 100% that US healthcare needs a shakeup so that outcomes are the reimbursement multiplier rather than episodes of service. I'm not sure that RFKJr is the one I feel most comfortable to do it, but they are not asking my opinion. The basic issue with the cost of delivery in the US is the burden of administrative costs and the expectation of profit (notwithstanding the moral and ethical problems) because a heart attack victim cannot shop around, so there is not the truly competitive marketplace required in free market capitalism. Marketing costs also drive up the cost of care and drugs. Professional sports on television are bombarded with direct-to-consumer pharmaceutical ads. We using the drugs are paying for those.

One comment that needs to be clarified for the record concerns Canada. Canada spends less than half (about 42%) for health care and covers all of its citizens, achieving better outcomes in infant mortality, preventable illnesses, and life expectancy. It should not be described as having socialized medicine, however (any more than Medicare and Medicaid are socialized in the US). Canada rather has a single-payer healthcare insurance system, which works like private insurance in the US but is funded by the federal and provincial governments. The providers work for chartered hospitals or are in private practices and clinics that the government does NOT operate. When I lived there, in each province, a resident was given a provincial care card that functioned like a Blue Cross/Blue shield card in the US. Regardless of the provincial issuer, that card was good throughout the country. Their national publicly funded system is called Medicare, and no co-pays or out-of-pocket expenses apply for essential (versus elective) healthcare services. For elective services, Canadians can opt for private insurance to help cover any costs and co-pays for elective care and pharmaceuticals.

When the system was first developed at a conference in Saskatoon, Saskatchewan in 1957, there was considerable public opposition to the idea. Now, like Medicare and Social Security in the USA, Canadians would fight like hell if anyone suggested taking it away (despite the exaggerated tales of long waits and dissatisfaction promulgated in the US- primarily by the health insurance industry).

Just wanted to double check, LQDA is dead in the water until at least summer 2025 or is there a chance for that decision to be overruled?

The problem is the money. Who is willing to pay? Afrezza is expensive.

Ofev (nintedanib) revenues $3.8 billion ....... if we can build a better mouse trap.

FDA-approved Drugs for IPF
Currently, two drugs are FDA-approved for treatment of idiopathic pulmonary fibrosis (IPF), which is the most common form of PF. These include nintedanib (Ofev®) and pirfenidone (Esbriet®). These medications are called anti-fibrotic agents, meaning that they have shown in clinical trials to slow down the rate of fibrosis or scarring in the lungs. These drugs are approved for patients with mild, moderate and severe IPF.

OFEV® (nintedanib capsules), for oral use
 Gastrointestinal disorders: Diarrhea, nausea, and vomiting have occurred with OFEV. Treat patients at first signs with adequate hydration and antidiarrheal medicine (e.g., loperamide) or anti-emetics. Discontinue OFEV if severe diarrhea, nausea, or vomiting persists despite symptomatic treatment. (5.3)

Gastrointestinal perforation has been reported. Use OFEV with caution when treating patients with recent abdominal surgery, previous history of diverticular disease or receiving concomitant corticosteroids or NSAIDs. Discontinue OFEV in patients who develop gastrointestinal perforation. Only use OFEV in patients with known risk of gastrointestinal perforation if the anticipated benefit outweighs the potential risk. (5.7)

content.boehringer-ingelheim.com/DAM/b5d67da8-329b-4fa4-a732-af1e011fc0a5/ofev-us-pi.pdf