Aduhelm Approval and Infrastructure Companion Package

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Earlier in my career I worked in health care. The Foundation for Shared Medical Decision-Making was my employer. They created video programs to assist patients who had been diagnosed with certain conditions for which the patient had decision options for treatment. The goal was to actively involve the patient in the decision making process because research said that the more actively involved the patient is in the decision making in regard to treatment, the more satisfied the patient is with the outcome, regardless of a good or bad outcome. One of the big lessons for me during this work experience is that patients think that medicine has all the answers, using 80% science and 20% art. What I learned is that medicine is actually the opposite, 20% science and 80% art. Patients are frustrated when physicians fail to diagnose their medical problem.

We approach medical treatment with a set of expectations for answers and successful treatment. That brings me to the recent FDA approval of a drug to treat the symptoms of Alzheimer’s called Aduhelm. The drug was approved with much controversy and a very expensive cost- $56,000/year. Because of the desperation and lack of treatment for Alzheimer’s, and the marketing of pharmaceutical companies, the drug will add to the deficits of Medicare. The approval was controversial because the trials didn’t demonstrate sufficient efficacy to the outside scientific advisory board. Several members of the board resigned after the approval, concerned that the science was not up to the standards of the rigorous FDA process. Alzheimer’s is a terrible illness with no current treatment and only token help for the symptoms. The suffering of patients takes a big toll on loved ones and society. Little progress has been made in research leading to the desperation reflected partly in the approval of this expensive and questionably efficacious drug. The 80% science expectations might have, in part, driven approval. The FDA has the highest scientific standards in the world, and some are concerned that approval of this drug is a slippery slope for future drug approvals that are made with politics in mind.


Infrastructure Plan

Democrats on the Senate Budget committee have agreed in principle to approve a $3.5T infrastructure package as a companion to the bipartisan Senate proposal for a $1T bill to fund traditional infrastructure. The $3.5T proposal does not specify funding, although the news is referring to Biden’s tax increase for Americans earning over $400k. But the Democratic proposal includes non-traditional infrastructure including social, health and environmental initiatives originally included in the $6T proposal early in the Biden administration. All legislation faces challenges, but any passage of infrastructure will provide stimulus to the economy. Is that reflected in market levels currently? We shall see.


Path(s) Forward Post Lockdown

Much of what was accepted to be a part of “normal life” pre-pandemic is being evaluated and challenged. This article provides some interesting perspective on the weight work and our careers play out in our life.

There is a suggestion on viewing work as a piece within our life portfolio. It’s easy for lines between work and homelife to be blurred, especially in a work from home dynamic. This is a more freeing framework to hold space for everything that matters to us, without work encroaching too much on other pieces of our life ‘portfolio.’


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