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Intropin via Wikimedia Commons // CC BY 3.0
Intropin via Wikimedia Commons // CC BY 3.0

Another EpiPen Competitor Is on Its Way

Intropin via Wikimedia Commons // CC BY 3.0
Intropin via Wikimedia Commons // CC BY 3.0

The makers of the EpiPen competitor Auvi-Q have announced plans to bring their product back to pharmacy shelves in February—at a jaw-droppingly high sticker price. They claim, however, that the high cost won't be shouldered by consumers.

Auto-injectors like the EpiPen and Auvi-Q are often the only thing standing between people with severe allergies and death. The devices deliver a fast-acting dose of epinephrine that can prevent someone from going into, or dying from, anaphylactic shock. In other words, they’re not optional. But they are very, very expensive.

The price of EpiPens has increased more than 450 percent in the last decade or so, and a two-pack will cost the consumer about $600—even if they have health insurance. The new government-mandated generic version costs $300.

CVS drugstores recently threw their hat into the ring with a truly generic version that retails for $109.99. The chain plans to offer a prescription discount program for low-income households that will bring the price for some customers down to just $10.

Now comes the Auvi-Q, which was recalled in 2015 due to its potential for delivering inaccurate dosages. At the time, its price was comparable with the EpiPen’s. When it returns on February 14, manufacturer Kaleo has set the price of two auto-injectors at $4500—a hefty price hike, to say the least.

Kaleo CEO Spencer Williamson told CNBC that there was a method to the Auvi-Q’s mind-boggling cost. He noted that the actual price to consumers would be much lower: free for those with commercial insurance and uninsured households earning less than $100,000, and $360 for those without insurance above that income cap.

Insurers, however, have to be on board for the pricing structure to work, and whether they will be remains to be seen. "We believe the most important price is the price to the patient," Williamson said. "No epinephrine auto-injector, branded or even generic, will cost a commercially insured patient less out of pocket than Auvi-Q."

Time will tell.

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Karen Bleier, AFP/Getty Images
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Medicine
Bill and Melinda Gates Will Repay Nigeria's $76 Million Polio-Fighting Loan
Karen Bleier, AFP/Getty Images
Karen Bleier, AFP/Getty Images

Not long after announcing a $100 million donation to find a cure for Alzheimer's disease, Bill and Melinda Gates have agreed to pay off Japan's $76 million loan to Nigeria to stamp out polio, Quartz reports.

Polio has been eradicated in most countries around the world, but it's still present in Nigeria, as well as in Afghanistan and Pakistan. In 2008, according to The Conversation, Nigeria accounted for 86 percent of all polio cases in Africa. This high number was thanks in part to low immunization rates and calls from extremists to boycott polio vaccinations out of fear that they were tainted with anti-fertility steroids.

National and international campaigns were launched to lower polio rates in Nigeria, and in 2014 the nation received the loan from Japan to boost disease-fighting efforts. Progress has been made since then, with no new cases of polio reported in Nigeria in 2017. Two children had contracted polio in 2016, two years after Nigeria's last known case.

Nigeria's loan repayments to Japan were slated to begin in 2018. The Bill & Melinda Gates Foundation agreed to cover the costs after Nigeria met its goal of "achieving more than 80 percent vaccination coverage in at least one round each year in very high risk areas across 80 percent of the country's local government areas," Quartz reports. The loan will be repaid over the next 20 years.

While the Gates Foundation is lending a hand to Nigeria, the Associated Press reports that health officials in Pakistan's eastern Punjab province recently launched a new chapter in the nation's ongoing struggle against the disease. Health workers will engage in a week-long, door-to-door vaccination campaign, though efforts like this are risky due to threats from the Taliban and other militant groups, who view vaccinations as a Western conspiracy and believe they sterilize children. Anti-polio efforts in Pakistan also suffered after the CIA used vaccinations as a cover to get DNA samples from the Bin Laden compound.

[h/t Quartz]

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George Mayerle, U.S. National Library of Medicine // Public Domain
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Design
This 1907 Vision Test Was Designed for People of All Nationalities
George Mayerle, U.S. National Library of Medicine // Public Domain
George Mayerle, U.S. National Library of Medicine // Public Domain

At the turn of the 20th century, San Francisco was a diverse place. In fact, Angel Island Immigration Station, located on an island in the San Francisco Bay, was known as the “Ellis Island of the West,” processing some 300,000 people coming to the U.S. in the early 1900s. George Mayerle, a German optometrist working in the city at the time, encountered this diversity of languages and cultures every day in his practice. So in the 1890s, Mayerle created what was billed as “the only [eye] chart published that can be used by people of any nationality,” as The Public Domain Review alerts us.

Anticipating the difficulty immigrants, like those from China or Russia, would face when trying to read a vision test made solely with Roman letters for English-speaking readers, he designed a test that included multiple scripts. For his patients that were illiterate, he included symbols. It features two different styles of Roman scripts for English-speaking and European readers, and characters in Cyrillic, Hebrew, Japanese, and Chinese scripts as well as drawings of dogs, cats, and eyes designed to test the vision of children and others who couldn't read.

The chart, published in 1907 and measuring 22 inches by 28 inches, was double-sided, featuring black text on a white background on one side and white text on a black background on the other. According to Stephen P. Rice, an American studies professor at Ramapo College of New Jersey, there are other facets of the chart designed to test for a wide range of vision issues, including astigmatism and color vision.

As he explains in the 2012 history of the National Library of Medicine’s collections, Hidden Treasure [PDF], the worldly angle was partly a marketing strategy on Mayerle’s part. (He told fellow optometrists that the design “makes a good impression and convinces the patient of your professional expertness.”)

But that doesn’t make it a less valuable historical object. As Rice writes, “the ‘international’ chart is an artifact of an immigrant nation—produced by a German optician in a polyglot city where West met East (and which was then undergoing massive rebuilding after the 1906 earthquake)—and of a globalizing economy.”

These days, you probably won’t find a doctor who still uses Mayerle’s chart. But some century-old vision tests are still in use today. Shinobu Ishihara’s design for a visual test for colorblindness—those familiar circles filled with colored dots that form numbers in the center—were first sold internationally in 1917, and they remain the most popular way to identify deficiencies in color vision.

[h/t The Public Domain Review]

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