I'm in the US, and there are a couple of wrinkles to this: insurance typically won't cover off label use, so patients end up paying the full cost of the medication, and if there is a big enough market, I believe companies can patent the new use even if the patents for the original use have run out.
Doctors here are allowed to prescribe them though.
Insurance will have prior authorization rules for certain drugs that are expensive that require the doctor to submit documentation of the condition, but in most cases the common medication is simply covered if prescribed. The insurance company does not receive documentation of every condition for every prescription to determine if the prescription is on label or off label.
Insurance companies can and do also support some off label treatments that are commonly used under their prior auth requirements.
I don’t know why there are so many comments in this thread making confident assertions that off label prescribing or insurance or so uncommon. This happens all day long at doctors offices and pharmacies.
Agreeing. There is a ton of blatant misinformation being shared in this thread by people who seem utterly confident despite their apparently complete ignorance.
"COM claims can be difficult to gain for repurposed compounds, as the patentee must somehow differentiate their patent claims over what is in the public domain and present data that the drug is a credible candidate for the new indication [41, 42]."
I would guess this is a consequence of people following orders. There's many people that should have refused the work along the way, but only the planner gets the blame, while I'd bet the planner was only following orders also.
People need to be able to think for themselves. I once stayed in an apartment house where I noticed a door 1.5 m up in the air on the outside of the building. When opening the door there was a small bathroom with a toilet. With no way of accessing it from the inside. Just that normal inside door on the outside wall up in the air. 100% someone in the chain made a mistake and said the door should be on the wrong wall. But no one that actually built the house stopped and say ”eh are you sure?”
Rogan is obviously pro psychedelics, and was even featured in the oval office during the recent Ibogaine approval signing. I think it's worth noting if this N=1 "study" has any association with such an obviously biased and influential individual.
I mean.. I've seen the preliminary studies on treatment resistent PTSD so I'm also pro psychedelics, because I'm anti suicide.
Dismissing this "study" (really a case file) because of the N=1 and the shady journal seems like a stronger position than bringing in Rogan. Talking about Rogan just looks like partisan posturing.
What does "the effects were very short lived" mean in this context? If it's hours then it seems useless, but if it's months that is short for us normies that expect to live decades more, but for someone who is 90+ that's a pretty nice percentage that is absolutely acceptable if it just means repeating the treatment.
I've used Claude a TON to build this, I freely admit. It started out as an experiment on how good Claude was at porting the C++ codebase for TurboVision to Mojo (fairly good), and then if I could build a simple editor, then I sort of got carried away and wondered if I could replace my daily driver PyCharm.
I'm now on ~4 days of using this as my daily driver, so it's going well. For Django development I did have to make my own LSP with Django special features too: https://github.com/boxed/iommi_lsp
It's obviously hard to say how accurate these numbers[1] are, but it looks like Twitter has doubled their workforce from its lowest following their mass layoffs. It might be stable again now because they hired the workforce required to actually keep it running.
Seconded. Coming from MySQL this is a huge regression that makes Postgres look like something from the 80s. I still wonder why this isn't seen as the absolutely highest priority.
I have not ran MySQL for some years but it at least used to have exactly the same issue. Upgrading a database with MySQL can take a long time if you have many tables. The main difference is only really that PostgreSQL does it with a separate tool, pg_upgrade, while MySQL does it as part of the main binary.
For both MySQL and PostgreSQL you will need to use some kind of logical upgrades if you want no downtime.
No, the main difference is that MySQL bundles the code needed to interact with the old db version in the newer server binaries (effectively by not changing the on-disk binary format!) while pg_upgrade requires you to have both old and new installs living side-by-side to reuse logic/code from old binaries. It is a more bulletproof method and less susceptible to bugs and (upstream) developer errors, but is (or at least can be) harder for the sysadmin+dbadmin.
(For example, ports under FreeBSD doesn’t let you install multiple Postgres versions as they are marked as conflicting packages so installing one necessarily uninstalls the other. The saving grace here is that most (virtually all) FreeBSD installations have root on ZFS and you can employ ZFS snapshots (via the hidden .zfs folder) to access the old binaries after upgrading to the new postgres version, but not many people know this trick!)
MySQL has advocated for decades spinning up a replica with the upgraded version, waiting for it to catch up to master before promoting it to the new master. You can do the same thing with Postgres.
Exactly, MySQL and PostgreSQL are the same here. Maybe one is a bit faster than the other at doing major version upgrades but the behaviours are quite similar.
Even when MySQL development velocity was more rapid, they maintained binary table format compatibility across major version upgrades the vast majority of the time. Literally the only exception I can think of, which necessitated a table rebuild, was the fractional timestamp storage change when going from MySQL 5.5 (2010) to 5.6 (2013).
It is also a bit tricky tradeoff. You do not want to be stuck with the same data format forever. So databases like MySQL and PostgreSQL need a downtime when doing a major version upgrade. They both try to keep it short, usually seconds, but minutes can happen in either database.
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