VeracityMD

I think you mean “amenities” rather than “enmities.”

Let me correct a few of these, as well as add why some of these are some really fantastic choices. These are all fairly expensive medications, but many of them are common first line and best choices for the relatively common things they treat. And while this is only for medicare directly, almost everything to do with medicare rolls downhill to private insurance. This will save many many many people a lot of money, or allow people to have the right medicines that would not otherwise be able to afford them.

Eliquis/Xarelto: Blood thinners. Tons of people on these, and they are safer and more convenient to take than the warfarin they replaced.

Jardiance/farxiga: Blood sugar medicines, but not just for diabetes type 2, also usable in type 1 as an adjunct to insulin. Also showing a lot of value in both subclasses of heart failure, even in people without diabetes. The data is so good that these are being prescribed for pretty much all heart failure patients as long as they can afford them.

Entresto: Not for blood pressure, although it does lower blood pressure. Another heart failure drug, far superior to the ACE inhibitors and Angiotensin receptor blockers it replaces as far as heart failure outcomes. Again, prescribed for pretty much all CHF patients that can afford it (and can tolerate the blood pressure lowering effect).

Fiasp/Novolog: Does not affect speed of insulin, is actually insulin. Short acting formulation, some of the more common ones. Not sure why Humalog/Admelog didn’t also make the cut. Probably next round. I’m sure you’ve all heard on here and reddit the cost of insulin being a major problem for diabetics.

Januvia: Blood sugar control, but only for type 2, not indicated for type 1. No other benefits. There’s other drugs I think we’d benefit from having on this list over januvia, but I wont’ complain too much.

Stelara/enbrel I have less familiarity with, not terrible choices from what I know. Quite expensive as all monoclonal antibodies are, and those who benefit from them, REALLY benefit from them.

Imbruvica I can’t speak to much too.

Overall this is a list of some of the most useful medicines in general adult medicine the use of which are frequently limited by cost.

Sometimes you do not have the luxury of waiting to treat until you have all information. In general a short course of steroids is extremely safe. Additionally, steroids are correct to give in CNS helminth infections anyways, although usually it is dexamethasone, not prednisolone. More likely the mycophenolate was the immunosuppressant that let it get into the brain not the steroid.

More importantly, they did quite a bit of workup, including bronchoscopy with BAL, which indicated she likely had a form of eosinophilic pneumonia, probably Churg-Strauss syndrome. Steroids and immunosuppressants are the standard of care for this, and it is a severe disease if not treated.

This is something that has never occured before in known medicine, so to expect them to have figured it out entirely before initiating a treatment is unreasonable. Her initial symptoms were in January of 2021, final diagnosis was made mid 2022. Would you expect your doctor to hold off on any treatment for a year and a half?

Actual case report here: https://wwwnc.cdc.gov/eid/article/29/9/23-0351_article

Wiki on Churg-Strauss: https://en.wikipedia.org/wiki/Eosinophilic_granulomatosis_with_polyangiitis