FungalDoc: moved to bluesky

ID at @washuID obsessed with fungal infections. Section Chief, Transplant ID. #fungus #TxID #IDTwitter Head of @WU_Mycoses. Deputy Editor-OFID. He/Him

[FungalDoc: moved to bluesky @FungalDoc]

@DrToddLee @ABsteward @BradSpellberg I can make a study of 15 patients have a beta of 80. Assumptions are all that matters.

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@PaulSaxMD I would happily give 5 uncompensated talks where I don't have to do paperwork than 1 well paid one where I do.

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@DrToddLee @ABsteward @BradSpellberg This is fundamentally broken. In superiority studies, alpha is what we look at, but for NI, we need beta to be strong. And physicians are just not well trained to understand beta.

This study is non-informative.

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I just had the saddest conversation of my career.

My patient told me that if the next insurance appeal with Sav-Rx, sponsored by @UFCW @UFCWRx is denied that she will pull out her PICC line and choose to die.

Let that sink in. We can cure her, but profit matters more to some.

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@ASP_PharmD @AstellasUS They cannot give drug for outside of FDA indication.

Trust me I tried.

[FungalDoc: moved to bluesky @FungalDoc]

I just had the saddest conversation of my career.

My patient told me that if the next insurance appeal with Sav-Rx, sponsored by @UFCW @UFCWRx is denied that she will pull out her PICC line and choose to die.

Let that sink in. We can cure her, but profit matters more to some.

[FungalDoc: moved to bluesky @FungalDoc]

@cavecane @UFCW @UFCWRx Frankly, it shouldn't have to be like this.

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@cavecane @UFCW @UFCWRx What is the access to the drug like? A lot of physicians I have worked with have trouble getting Isa in many countries.

Looks like the lowest price internationally is about 41 dollars per capsule. So 82 dollars a day. Cheaper, but still not something a person can afford.

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@cavecane @UFCW @UFCWRx For lifetime isavuconazole?

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Ultimately, I am terrified that I will watch a patient die because we don't have the will to spend some money.

The lowest point of my career.

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She even attempted to talk to her congressman, @BobOnderMO. We have had luck with other congressional representatives helping us.

We were told that they don't get involved in those kinds of situations.

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@IdVilchez @AliSMV7 @DrNeilStone 1. It is better than we think.
2. It is becoming resistant to azoles. It's just that in some places it is happening faster than others.

[FungalDoc: moved to bluesky @FungalDoc]

@MRodgersRodgM @IdVilchez @DrNeilStone @ClancyNeil @DrToddLee @BradSpellberg @dralicehan @ApuAkkad1 @BJegorovic No. Itra is a negative inotrope.

[FungalDoc: moved to bluesky @FungalDoc]

@IdVilchez @serotavirus @DrNeilStone @ClancyNeil @DrToddLee @BradSpellberg @dralicehan @ApuAkkad1 @BJegorovic X reminds me of an old joke.

"What do you call a bar that has one Nazi in it?

A Nazi bar."

[FungalDoc: moved to bluesky @FungalDoc]

@serotavirus @IdVilchez @DrNeilStone @ClancyNeil @DrToddLee @BradSpellberg @dralicehan @ApuAkkad1 @BJegorovic LOL. My cult is growing!

[FungalDoc: moved to bluesky @FungalDoc]

@DrToddLee @IdVilchez @DrNeilStone @ClancyNeil @BradSpellberg @dralicehan @ApuAkkad1 @BJegorovic Lots. A paper coming this year too.

Isa is a good choice.

[FungalDoc: moved to bluesky @FungalDoc]

@IdVilchez @ApuAkkad1 @serotavirus @dralicehan There are certainly chronic invasive forms. And they are often tragic disasters.