This is a video from Lysefjord in Norway, hiking Kjerag, Kjeragbolten and Kjerag Falls, in the fall of 2020. “The 1,110-metre (3,640 ft) tall mountain sits on the southern shore of Lysefjorden, just southwest of the village of Lysebotn. Its northern side is a massive cliff, plunging 984 metres (3,228 ft) almost straight down to fjord, a sight which attracts many visitors each year. Another tourist attraction, the Kjeragbolten, a 5-cubic-metre (180 cu ft) stone wedged between two rocks is located on the mountain. The Kjeragfossen waterfall plunges off the mountain down to the fjord. It is one of the tallest waterfalls in the world”.
To soar over Stratford-upon-Avon in Warwickshire is to be transported back in time to the age of William Shakespeare; a man born in humble circumstances who would go on to become the most celebrated writer of all time.
There may be few issues that unite Americans ahead of the 2020 election as do their concerns about the cost of prescription drugs.
A clear majority — 75% — of respondents to a July survey said the cost of prescription medicines would be among the factors likely to influence their votes this year, according to a report from Gallup and the nonprofit West Health. Gallup reported on results from 1,007 interviews conducted with adults between July 1 and July 24.
1. What are the 2020 presidential candidates saying they will do to lower drug prices?
Both President Donald Trump, a Republican, and former Vice President Joe Biden, a Democrat, have highlighted insulin costs in their discussions of the need to lower drug prices.
In a January interview with the New York Times editorial board, Biden noted the widespread discontent among Americans about sticker shock often experienced at pharmacies. He spoke of a need for the federal government to act to make medicines more affordable.
“This is a place where I find, whether you’re Republican or Democrat, you think you’re getting screwed on drug prices. And you are, in terms of everything from insulin to inhalers and a whole range of other things,” Biden said. “So, again, can I guarantee that it gets done? No, but I can tell you what, if anybody can get it done, I can, and I think there’s a consensus for it.”
2. Why doesn’t Medicare, the biggest U.S. purchaser of drugs, directly negotiate on drug prices?
Congress has taken different approaches in designing the terms under which the two largest federal health programs, Medicaid and Medicare, buy drugs.
Medicaid is a program run by states with federal contributions and oversight. It covers people with low incomes and disabilities. Almost 67 million people were enrolled in Medicaid as of May 2020, including about 29 million children. In 1990 Congress decided that drugmakers who want to have their products covered by Medicaid must give rebates to the government. The initial rebate is equal to 23.1% of the average manufacturer price (AMP) for most drugs, or the AMP minus the best price provided to most other private-sector payers, whichever is greater. An additional rebate kicks in when prices rise faster than general inflation.
3. What’s the deal with rebates and discounts?
There’s widespread frustration among lawmakers and policy analysts about the lack of clarity about the role of middlemen in the supply chain for medicines. Known as pharmacy benefit managers (PBMs), these businesses describe the aim of their business as making drugs more affordable for consumers. Insurers like Cigna and UnitedHealth operate some of the nation’s largest PBMs, as does pharmacy giant CVS Health, which also owns insurer Aetna.
“They will tell you their mission is to lower drug costs,” said Rep. Earl L. “Buddy” Carter, a Georgia Republican, a pharmacist and a critic of PBMs, in a speech on the House floor last year. “My question to you would be: How is that working out?”
4. What is the “distinctly American” phenomenon of specialty drugs?
In this Perspective article, Kesselheim and Naci look at how the “specialty” designation morphed from its origin in the 1970s. It then referred to a need for extra steps for preparation and delivery of new injectable and infusion products.
5. How much does it cost to bring a new drug to market anyway?
The median cost for a medicine developed in recent years was $985 million, according to a study published in JAMA in March 2020, “Estimated Research and Development Investment Needed to Bring a New Medicine to Market, 2009-2018.”
“Rising drug prices have attracted public debate in the United States and abroad on fairness of drug pricing and revenues,” write the study’s authors: Olivier J. Wouters of the London School of Economics; Martin McKee of the London School of Hygiene and Tropical Medicine; and Jeroen Luyten of Leuven Institute for Healthcare Policy, KU Leuven, Belgium. “Central to this debate is the scale of research and development investment by companies that is required to bring new medicines to market.”
Aerial Cinematography: Anson Fogel Edit by: [yes our intern] Daniel Martin Song : LUX by Ryan Taubert
Special Shout Out to: Curtis Morgan – who’s work has and continues to inspire our team.
Five years ago, during the end of a particularly cold Nepali winter, we traveled to the high Himalaya to explore the limits of high altitude aerial cinematography. It was one of the most ‘extreme’ film projects we had embarked on as a team, but as we watched the images come through the monitors, there was nothing but giant smiles and the stress of the journey was gone. Maybe it was the lack of oxygen, but damn Mt Everest looks sexy in 8k 🙂
All that took a dramatic turn a month after we returned. One of the most devastating earthquakes of the last century hit the very villages we had spent time exploring. The buildings, and even some of the people we had spent time with were gone. We learned later that our close friend had family members perish in the landslides that were a result of the earthquake. We were in shock.
Out of respect for the communities that were devastated and because of the sheer struggle we all had of celebrating a place in the midst of crisis; a large portion of the footage was shelved. The dreams of creating something ‘bigger’ left for a later time.
And then 2020 happened.
Looking to challenge ourselves in the midst of the pandemic and with a brand new intern bouncing in his virtual ‘Zoom Call’ chair; we decided to dust off some of that Nepal footage and see if we couldn’t make something that would make us all smile.
So with that, I present to you… Nepal at Night. A journey into the high Himalaya after the sun goes down. When the electric sea of stars, and even brighter moon rise over the roof of the world. Part fact, part fiction. 100% a reflection of the dreams our Camp4 Crew are having right now.
In 2013 a special transport over water left from Rotterdam to Amsterdam. A timelapse camera was installed at 30 mtrs high. The resulting film gives a unique and stunning view of the old Dutch waterways, in 4K. Images were shot with a Canon 550d at an interval of 3 seconds, totalling around 30.000 pictures taken. In 2013 the film couldn’t be published right away due to restrictions. After a few years it was forgotten. Till now.
Music: Dvorak – Symphony no. 9 (From the New World) – second movement
Vice President Mike Pence and Calif. Sen. Kamala Harris faced off in the first and only vice presidential debate, touching on issues ranging from the Trump administration’s handling of the coronavirus to Joe Biden’s position on fracking. NPR’s Scott Detrow has the highlights. •