T4 for treatment resistant depression

[P A]

@Lolie

Interesting. That actually sounds like a remarkably efficient system, especially when compared to the one I've grown up with in the States. If you don't have damn good insurance around here, you're basically fucked if any significant health concerns (or general needs for pharmacotherapy) arise.

Many, many drugs are subsidised for off-label uses but getting new off-label uses approved for subsidy without significant research to back up such use is difficult. And drug companies don't want to run expensive trials to validate an off-label use for a relatively small market. Essentially they need to prove that their drug is both more effective and has less side effects than existing drugs which are subsidised for the same indication.

But many such drugs/indications - like thyroid hormone treatment in depressives - are decently well-backed by literally decades of research. And despite their comparatively sparse resources, independent research centers/hospitals do a good bulk of the research into 'off-label' indications, especially for those drugs whose profitable patents have expired in the U. S. and abroad (does the Commonwealth's system allow for patents, or is that system replaced in lieu by these 'subsidies?'). As such, I don't see what the drug companies have to do with it, since once a sufficient degree of patent protection is lost (in some statistically significant portion of paying countries), other drug companies sweep in to produce the generic counterparts. Or does that have no relevance to Australia's system?

I'm similarly confused as to how there could be such a thing as a brand label if the notion of a chemical patent is moot. This raises the question of how much relative profit a drug company could hope to incur in the first place by marketing drugs to what I assume is your federal government. In other words, what incentive could they possibly have? Much more money is to be made by marketing and selling newly developed medications to countries that allow market-cornering patents and direct purchase by sick consumers. Or does the government buy the drugs at some jacked-up 'patent' sum, then begin purchasing them at typical generic price at some specified year in the future? Are drug costs always the same for you, regardless of patent status abroad?

Confusing...

 

[Middleway]

Pharmaceutical benefits listed in the Schedule fall into three broad categories:

Unrestricted benefits - have no restrictions on their therapeutic uses;

Restricted benefits - can only be prescribed for specific therapeutic uses (noted as Restricted benefit); and

Authority required benefits - Authority required benefits fall into two categories:

•Authority required benefitsare restricted benefits that require prior approval from Medicare Australia or the DVA (noted as Authority required)
•Authority required (STREAMLINED) benefitsare restricted benefits that do not require prior approval from Medicare Australia or the DVA but require the recording of a streamlined authority code (noted as Authority required (STREAMLINED)).
http://www.pbs.gov.au/info/healthpro/explanatory-notes/section1/Section_1_2_Explanatory_Notes

"I'm similarly confused as to how there could be such a thing as a brand label if the notion of a chemical patent is moot. "

It is not moot, a patent expires after 7 years.

"This raises the question of how much relative profit a drug company could hope to incur in the first place by marketing drugs to what I assume is your federal government."

The drug companies hate the scheme and have put huge pressure on the government to abolish it. Nazi Fuck Ex prime Minister John Howard weakened it, but if they tried to take it away they would be exterminated in the next election.
An individual buying drugs from a drug company as in the US situation has no leverage to negociate on price.
The government buying for 22 million people does. We have a system to determine what should be a fair price by calculating the drug development and production costs as well as many other variables. If the drug company wont play ball and want us to pay through the nose they basically get told to fuck off.

"Are drug costs always the same for you, regardless of patent status abroad?"

You mean if we get sick overseas? Australia has reciprical health care agreements with

New Zealand
The United Kingdom
The Republic of Ireland
Sweden
The Netherlands
Finland
Italy
Belgium
Malta
Norway


Essentially they cover our sick citizens while overseas and we cover theirs.

http://www.medicareaustralia.gov.au/public/migrants/travelling/index.jsp


Basically all of your commonly used drugs can be perscribed under the benifet for any purpose deemed fit by your medical practiciner.

Restricted Benifets are often used for drugs that the patent period of 7 years has not yet expired and are thus much more expensive. Medicare will only allow you to have access to these drugs for approved indications. A good example being lamictal, approved as a second line drug for epilepsy but not covered at all for bipolar.

Authority Scripts for all intensive purposes are for access to specialised drugs or drugs of abuse. Gabapentin or lamictal for example require the doctor to make a phone call to a central body to confirm that the patient has been trialed on the first line (and cheap) drugs for epilepsy ie sodium valproate or tegretol and they have been ineffective and the patient needs these other drugs.

It all works really well. Basically we get a months supply of any one drug for about $30. An hours wages more or less.

Everyone is covered, we pay 2% of our yearly before tax income to the scheme if we dont have private health insurance, 1% if we do. And everyone is covered. If you get sick or injured you are not going to lose your house.

It is so disgusting the situation in the US and the lengths the pharmacetical industry went to to stop reform. I feel sorry for you guys.


http://www.pbs.gov.au/info/about-the-pbs

 

[Middleway]

Pharmaceutical benefits listed in the Schedule fall into three broad categories:

Unrestricted benefits - have no restrictions on their therapeutic uses;

Restricted benefits - can only be prescribed for specific therapeutic uses (noted as Restricted benefit); and

Authority required benefits - Authority required benefits fall into two categories:

•Authority required benefitsare restricted benefits that require prior approval from Medicare Australia or the DVA (noted as Authority required)
•Authority required (STREAMLINED) benefitsare restricted benefits that do not require prior approval from Medicare Australia or the DVA but require the recording of a streamlined authority code (noted as Authority required (STREAMLINED)).
http://www.pbs.gov.au/info/healthpro/explanatory-notes/section1/Section_1_2_Explanatory_Notes

"I'm similarly confused as to how there could be such a thing as a brand label if the notion of a chemical patent is moot. "

It is not moot, a patent expires after 7 years.

"This raises the question of how much relative profit a drug company could hope to incur in the first place by marketing drugs to what I assume is your federal government."

The drug companies hate the scheme and have put huge pressure on the government to abolish it. Nazi Fuck Ex prime Minister John Howard weakened it, but if they tried to take it away they would be exterminated in the next election.
An individual buying drugs from a drug company as in the US situation has no leverage to negociate on price.
The government buying for 22 million people does. We have a system to determine what should be a fair price by calculating the drug development and production costs as well as many other variables. If the drug company wont play ball and want us to pay through the nose they basically get told to fuck off.

"Are drug costs always the same for you, regardless of patent status abroad?"

You mean if we get sick overseas? Australia has reciprical health care agreements with

New Zealand
The United Kingdom
The Republic of Ireland
Sweden
The Netherlands
Finland
Italy
Belgium
Malta
Norway


Essentially they cover our sick citizens while overseas and we cover theirs.

http://www.medicareaustralia.gov.au/public/migrants/travelling/index.jsp


Basically all of your commonly used drugs can be perscribed under the benifet for any purpose deemed fit by your medical practiciner.

Restricted Benifets are often used for drugs that the patent period of 7 years has not yet expired and are thus much more expensive. Medicare will only allow you to have access to these drugs for approved indications. A good example being lamictal, approved as a second line drug for epilepsy but not covered at all for bipolar.

Authority Scripts for all intensive purposes are for access to specialised drugs or drugs of abuse. Gabapentin or lamictal for example require the doctor to make a phone call to a central body to confirm that the patient has been trialed on the first line (and cheap) drugs for epilepsy ie sodium valproate or tegretol and they have been ineffective and the patient needs these other drugs.

It all works really well. Basically we get a months supply of any one drug for about $30. An hours wages more or less.

Everyone is covered, we pay 2% of our yearly before tax income to the scheme if we dont have private health insurance, 1% if we do. And everyone is covered. If you get sick or injured you are not going to lose your house.

It is so disgusting the situation in the US and the lengths the pharmacetical industry went to to stop reform. I feel sorry for you guys.


http://www.pbs.gov.au/info/about-the-pbs

 

[Hodor]

As some already said:
If Tianeptine is available in your country, get it.
Works faster and more reliably than any other AD on the market.
Yeah, so tolerance builds after a few months, but when you're depressed, even a few months of relief are a godsend. Especially if your depression is season-dependent and you can just discontinue the drug in spring to reverse the tolerance.

Although now that some mention dizziness, yeah, that would explain why I'm constantly feeling woozy after half an hour of walking (though not after intense exercise), despite normal BP. Didn't associate it with my meds because it feels markedly different from the discontinuation symptoms of SSRIs/SNRIs (i.e. just like "normal" light-headedness rather than having your brain mounted in a free-floating gyroscope).

Still very a much a fair trade-off for effective depression relief.

As for Aurorix - my PDoc eventually put me up to twice the recommended maximum dosage, i.e. 1.2 GRAMS a day, and it didn't help in the slightest. You'd figure that with that kind of MAO-A inhibition, you'd be oozing more tryptamines out of your pores than a hallucinogenic toad :D. You'd also figure that would make a guy realize that not everyone's depression is serotonergic.
...
Wait, I actually think it did, and he thus decided to put me on Edronax next - which, unfortunately, was only later revealed to be the single least effective, most side-effect-laden antidepressant on the market.