General Medical issues thread

[whatmeworry]

Geez the PBS is weird. You can't get some drugs if you haven't done chemo first which can be hard if the patient is too frail to take chemo.

Once I see the Oncologist with Dad, I want to see if we can have Zoladex added to his Bicalutamide and whether Zytiga with Presnisone is a better alternative to Bicalutamide.

Hopefully I can also get the doc to prescribe a Immunotherapy like Keystrada or Opvido.

 

[Pushka]

There's a protocol for everything PBS I guess. There's some treatment I can't get until earlier treatment has failed. Usually cost driven.

 

[TheRealTMA]

There's a protocol for everything PBS I guess. There's some treatment I can't get until earlier treatment has failed. Usually cost driven.

Dermatologist rang authority script people to confirm what script to write for Aldara for a superficial BCC. They clearly said ONE pump and ONE repeat.

Went to pharmac_ and was told, "No! That's the wrong script. It will be cheaper for you to pay for this privately $37 vs $49 on PBS. "

Go figure!

 

[Milboo]

Geez that's cheap - my Aldara was 2 pumps and was $120.

 

[TheRealTMA]

Geez that's cheap - my Aldara was 2 pumps and was $120.

Another badly written script? pharmac_ said a 2 pump script on PBS would have been much cheaper, but... dunno

 

[straitman]

Geez that's cheap - my Aldara was 2 pumps and was $120.

I'm glad DVA paid for mine so my cost was (I think) $6.30.

 

[whatmeworry]

There's a protocol for everything PBS I guess. There's some treatment I can't get until earlier treatment has failed. Usually cost driven.

It is quite stark reading when a certain drug can only be given on how well or how badly you are doing.

 

[rogerkambah]

The PBS has been my bedtime reading for a while now.

Unfortunately while the immunotherapy group of drugs to which Keytruda and Opdivo belong, would at first appear to be a broad spectrum panacea they have only been trialed and approved for use in a small number of cancers. As such their use is very specific in Australia under PBS subsidies.

While Wikipedia states "In May 2017 it was approved for any unresectable or metastatic solid tumor with certain genetic qualities without regard to the tissue type or site of the tumor, a first for the FDA."

However this only relates to the US FDA.

Keytruda and Opdivo aren't PBS approved for treatment of prostate cancer, although there are some refs to early trials in the US for this use. In Australia their usage appears to be restricted to treatment of melanomas, non small cell lung cancers and some others. I am not a medical practitioner, but my interest in cancer has been raised recently.

The list of side effects for Keytruda look rather ghastly to me.

Geez the PBS is weird. You can't get some drugs if you haven't done chemo first which can be hard if the patient is too frail to take chemo.

Once I see the Oncologist with Dad, I want to see if we can have Zoladex added to his Bicalutamide and whether Zytiga with Presnisone is a better alternative to Bicalutamide.

Hopefully I can also get the doc to prescribe a Immunotherapy like Keystrada or Opvido.

 

[Renato1]

Pollen season has come early I think because of El Nino and maybe because of them naughty NSW stealing water from the Murray-Darling Basin. I think it might be a bad season for hayfever. If we get a wet Spring, heaven help our noses.

Melbourne Pollen Index | Herald Sun

Thanks, I hadn't seen that link before.

The Doctor back then with my circumstance thought it was a case of dumb luck whether one was affected by pollen in August.

Firstly, there aren't that many north wind days in August when pollen gets funnelled down to Melbourne through the gap in the Great Dividing Range.

But secondly, when those few north wind days do eventually occur, the pollen that is driven down may be from grasses that we typically don't get later on into Spring and Summer - so that individuals more sensitive to them may react badly, even if the pollen count may not be as high as later on in next season (or words to that effect - I can't remember his precise wording).
Regards,
Renato

 

[whatmeworry]

The PBS has been my bedtime reading for a while now.

Unfortunately while the immunotherapy group of drugs to which Keytruda and Opdivo belong, would at first appear to be a broad spectrum panacea they have only been trialed and approved for use in a small number of cancers. As such their use is very specific in Australia under PBS subsidies.

While Wikipedia states "In May 2017 it was approved for any unresectable or metastatic solid tumor with certain genetic qualities without regard to the tissue type or site of the tumor, a first for the FDA" this only relates to the US FDA.

Keytruda and opdivo aren't PBS approved for treatment of prostate cancer, nor can I find any refs to any trials for this use. Their usage appears to be restricted to treatment of melanomas, non small cell lung cancers and some others. I am not a medical practitioner, but my interest in cancer has been raised recently.

The list of side effects for Keytruda look rather ghastly to me.

Yeah I worried my Dad won't be eligible for Keytruda and opdivo but maybe available for a trial. Keystruda in one literature paper was 30% remarkable for Prostate Cancer. Keystruda might be in a Monash trial.

Even Zoladex has some bad side effects like memory loss.

My plan is to keep him alive till he can get something potential better.

 

[rogerkambah]

Yes, WMW I understand your position. Good Luck.

 

[Quickstatus]

The PBS seeks to make medicines available to Australians at the most cost effective price. Setting aside the cost imperative, the PBS indication for a drug is tightly related to the drug trial outcomes which have by nature a very narrow focus. So generally, if a drug has been trialled in circumstances A, it will not be approved for PBS listing in circumstances B where it has not been trialled. Similarly if Chemo drug A has only been trialled in combo with drugs B and C, in cancers X,Y it will generally not be approved for use in cancers Z and combos C,D.

 

[Pushka]

Which makes sense. But those trials take forever when you or family are the ones dealing with a medical issue right now and early data shows promise for your situation.

 

[drron]

Many an early trial sounds promising but later turns out to be a false promise.And yes people can insist on being treated especially if money is no object as it was for one high profile Australian who then died of the complications of treatment.

 

[Pushka]

Many an early trial sounds promising but later turns out to be a false promise.And yes people can insist on being treated especially if money is no object as it was for one high profile Australian who then died of the complications of treatment.

And then there's the thalidomide story. I was told one treatment for psoriasis was over $100k a year but required I guess, almost body coverage for PBS. Body coverage would be unbearable.

 

[whatmeworry]

Funny how even thalidomide has been investigated for Prostate Cancer and other conditions.

 

[Pushka]

Funny how even thalidomide has been investigated for Prostate Cancer and other conditions.

Its quite effective for some conditions. Just not for pregnant women where it's toxic to the foetus.

 

[Renato1]

I was watching Dr Manny on Fox News Extra a month back, and he had something interesting to say about prescription and non-prescription medicines. He related how a recent Department of Defense study had found that 90% of medicines were perfectly fine and nearly 100% effective 15 years after their Expiry Date - providing they had been kept in a cool, dry environment. He said the Expiry Date wasn't really the day the medicine expired, but rather the Date to which the manufacturer guaranteed the medicine would be 100% effective.

This didn't apply to stuff like Insulin, nitroglycerine and liquid antibiotics.

So I then came across a packet of Tramadol with an expiry date of nine years ago, and used it. It worked fine in terms of pain relief - just like the new stuff.

I'm now wondering how much perfectly good and pretty expensive medicines I've thrown out over the decades.
How much have you thrown out?
Regards,
Renato

 

[JohnK]

I'm now wondering how much perfectly good and pretty expensive medicines I've thrown out over the decades.
How much have you thrown out?

People have probably thrown out heaps of medication.

Use by/expiry dates don't have too much meaning to me. I'm reluctant to throw out old(er) medicines but only make a decision after inspecting the packaging. If looks ok I will continue. I believe the main thing to worry about regarding used/expired medicines is that it may no longer have the desired effect.

 

[Renato1]

People have probably thrown out heaps of medication.

Use by/expiry dates don't have too much meaning to me. I'm reluctant to throw out old(er) medicines but only make a decision after inspecting the packaging. If looks ok I will continue. I believe the main thing to worry about regarding used/expired medicines is that it may no longer have the desired effect.

Thanks. I did recently throw out Vitamin pills where the outer casing of the long pills started splitting and half stripping off.
I'm sure they still had vitamins and especially minerals in them, but I couldn't bring myself to swallow them.
Regards,
Renato