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November 19, 2009

Seniors Struggle With Drug Costs While Congress Debates Medicare ‘Doughnut Hole”

Filed under: Health News — Senior Helping Senior @ 6:58 pm

Minnesota Public Radio reports: “Since 2006, senior citizens have been able to choose plans for Medicare prescription drug coverage, but that coverage contains a gap known as the ‘doughnut hole,’ a gap that health care reform plans being debated in Congress would address.”

“Under the House health care bill, Medicare would eliminate the gap within a decade. The House bill would also require the Health and Human Services Secretary to negotiate prices directly with drug companies. There are no such provisions in the Senate proposals but a final Senate bill isn’t written yet. … Researchers at the University of Pittsburgh found about 15 percent of senior citizens who fell into the gap stopped taking their medicines, particularly if they were name-brand drugs. The study’s lead researcher Yuting Zhang said once seniors hit the gap, they hardly ever get out” (Stawicki, 11/18).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

Health-care spending in Canada to hit $183 billion

Filed under: Health News — Senior Helping Senior @ 6:55 pm

Canadian health-care spending is expected to reach $183.1 billion in 2009 or $5,452 per Canadian, according to figures released Thursday by the Canadian Institute for Health Information.

 

The estimate represents a $9.5 billion increase from 2008, when health-care spending was estimated to be $172 billion.

 

As a proportion of the gross domestic product, health expenditures represent 11.9 per cent, an all-time high, says the CIHI report. In 2008, it was 10.8 per cent.

 

The jump in health-care spending as a proportion of the GDP can be attributed to a slowdown in the economy, said the organization’s CEO and interim president Anne McFarlane.

 

“The reason for that increase is not particularly because of the growth in health-care expenditure . . . but because of the decline in the size of the economy because of the recession,” she said.

 

“If everything had remained constant, if the recession hadn’t happened, we would have projected that the GDP ratio for 2009 would be basically what it was for 2008.”

 

Taking into account inflation and population growth, health-care spending is estimated to increase by 2.5 per cent, the report says, down from 4.2 per cent in 2008.

 

“Every year, health-care expenditure basically does outpace inflation and population growth, it’s just the question is by how much,” McFarlane said.

 

Hospitals are expected to account for the largest proportion of health-care spending in Canada this year, at 27.8 per cent, or $51 billion, although hospitals in previous years have accounted for a higher share of the spending.

 

In 1975, hospitals accounted for 44.7 per of total spending.

 

Next in line are drugs, which are estimated to account for 16.4 per cent, or $30 billion of the $183.1 billion total. The report takes into account both prescribed and non-prescribed medications.

 

Fourteen per cent of total spending goes to physician payments in this year’s estimate, who account for the third largest proportion of the expenditure.

 

Governments account for 70 per cent of total health-care spending while the private sector accounts for 30 per cent.

 

Included expenses in the private sector spending are dental care, prescribed drugs and private insurance, McFarlane said.

 

Alberta grabbed the top spot among the provinces in the report for having the highest expected spending per person, at $6,072.

 

At $4,891, Quebec had the lowest.

 

Comparing the per capita spending in each provinces “allows jurisdictions to look at each other and learn from each other,” McFarlane said. “Other provinces will look at why others are spending so much more or less money.”

 

CIHI is an independent body that collects and analyzes data on health-care spending, services and population health.

November 17, 2009

Consumers In Search Of Saving Money Should Reconsider Prescription Drug Choices

Filed under: Pharmacy — Senior Helping Senior @ 8:54 pm

Americans are increasingly scrutinizing their drug choices to find ones that work but don’t break the bank. The Associated Press reports: “Last year pharmaceutical companies spent more than $4 billion urging patients like you to ‘ask your doctor’ about their drugs. But if you want a prescription that won’t empty your wallet, while still keeping you well, you might start asking your doctor about drugs you don’t see on TV. As unemployment continues to rise, experts estimate that 50 million Americans are without health care coverage, forcing many to bear the full cost of their prescriptions. Compounding the problem are steadily rising drug costs. The senior advocacy group AARP reports that prices for the most popular drugs rose 8.7 percent on average last year, more than twice the rate of inflation. Fortunately there are cheaper alternatives to many of these pills.” The AP also includes several important points to consider when choosing drugs (Perrone, 11/4).

This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery atkaiserhealthnews.org.

© Henry J. Kaiser Family Foundation. All rights reserved.

November 16, 2009

Drug Companies Hike Prices On Brand-Name Medicines

Filed under: Pharmacy — Senior Helping Senior @ 7:03 pm

Just as the pharmaceutical industry agreed to start cutting $8 billion a year from drug costs under a health overhaul, makers of drugs raised their wholesale prices by 9 percent, a $10 billion increase in the last year, the New York Times reports.

The Times cites work by University of Minnesota pharmacist Dr. Stephen Schondelmeyer for AARP. “When we have major legislation anticipated, we see a run-up in price increases,” he told the Times.

By comparison, prices of other products and services, as measured by the Consumer Price Index, fell 1.3 percent, not adjusted for seasonal variations, over the 12 months ending in September.

The increase ahead of political action is a familiar gambit in the Big Pharma playbook. As the presidential campaign heated up in 2007, the drug industry raised prices by almost 8 percent, theWall Street Journal reported last year. Many drugmakers have also raised prices on older brand-name drugs in recent years to encourage people to switch to newer versions ahead of generic competition.

One caveat, an old adage in the drug industry is that the average wholesale price, abbreviated AWP, really stands for “ain’t what’s paid.” Rebates and discounts offered to big buyers, such as the government and drug benefit mangers, can take a significant bite out of listed price increases. Still, the wholesale prices serve as a starting point for price negotiations.

For its part, the drug industry disputed the AARP analysis. Ken Johnson, senior vice president of the trade group the PhRMA told the Times, the AARP report was politically motivated and didn’t reflect the health-care savings medicines can bring.

November 12, 2009

Antibiotic overuse threatens modern medicine

Filed under: Health News, Pharmacy — Senior Helping Senior @ 7:47 pm

Overuse of antibiotics in Europe is building widespread resistance and threatening to halt vital medical treatments such as hip replacements, intensive care for premature babies and cancer therapies, health experts say.

Dominique Monnet of the European Center for Disease Prevention and Control’s (ECDC) scientific advice unit said the “whole span of modern medicine” is under threat because bugs are become resistant to antibiotics, rendering the drugs useless.

“If this wave of antibiotic resistance gets over us, we will not be able to do organ transplants, hip replacements, cancer chemotherapy, intensive care and neonatal care for premature babies,” he told reporters at a briefing.

Antibiotics are needed in all these treatments to prevent bacterial infection. But drug-resistant bacteria are a growing problem in hospitals worldwide, marked by the rise of superbugs such as methicillin-resistant Staphyloccus aureus (MRSA).

Such infections kill about 25,000 people a year in Europe and around 19,000 in the United States

On top of the risks to future treatments, Monnet said the costs of antibiotic resistance were already hurting — and may hit healthcare budgets across the European Union yet harder if the problem is not addressed.

The six most common multi-drug-resistant bacteria — often referred to as superbugs — cause around 400,000 infections a year in Europe, killing around 25,000 people and using 2.5 million hospital days a year.

The ECDC, which monitors and advises on disease in EU, calculates that with a hospital day costing an average of 366 euros ($548), superbug infections are already sucking up 900 million euros a year in extra hospital costs, and a further 600 million euros a year in lost productivity.

“Across the European Union the number of patients infected by resistant bacteria is increasing and that antibiotic resistance is a major threat to public health,” the ECDC said.

Britain’s government was criticized by a parliamentary committee on Tuesday for failing to tackle the majority of hospital-acquired infections by narrowing its focus to two high profile ones — MRSA and Clostridium difficult.

The ECDC is planning an “antibiotic awareness” campaign on November 18 to urge doctors to stop overprescribing antibiotics.

Patients demanding antibiotics for viral infections often are not aware that they will not work, it said, but doctors are and should stop giving in to pressure.

Sarah Earnshaw of the ECDC’s communications unit, pointed to a 2002 survey that showed 60 percent of patients do not know that antibiotics do not work against viruses like flu and colds.

“Patients often demand antibiotics,” she said. And doctors often think, she said, that giving in is a quicker way to deal with a demanding patients than persuading them otherwise.

Lack of health care killed 2,266 U.S. veterans in 2008: Study

Filed under: Health News — Senior Helping Senior @ 7:35 pm

The number of U.S. veterans who died in 2008 because they lacked health insurance was 14 times higher than the U.S. military death toll in Afghanistan that year, according to a new study.

The analysis produced by two Harvard medical researchers estimates that 2,266 U.S. military veterans under the age of 65 died in 2008 because they lacked health coverage and had reduced access to medical care.

That figure is more than 14 times higher than the 155 U.S. troop deaths in Afghanistan in 2008, the study says.

Released as the United States commemorates fallen soldiers on Veterans Day, the study warns that even health care provided by the Veterans Health Administration (VA) leaves many veterans without coverage.

The analysis uses census data to isolate the number of U.S. veterans who lack both private health coverage and care offered by the VA.

“That’s a group that’s about 1.5 million people,” said David Himmelstein, an associate professor of medicine at Harvard Medical School and co-founder of Physicians for a National Health Program who co-authored the study.

Himmelstein and co-author Stephanie Woolhandler, also a Harvard medical professor, overlaid that figure with another study examining the mortality rate associated with lack of health insurance.

“The uninsured have about a 40 per cent higher risk of dying each year than otherwise comparable insured individuals,” Himmelstein told AFP.

“Putting that all together you get an estimate of almost 2,300 — 2,266 veterans who die each year from lack of health insurance.”

Only some U.S. veterans have access to medical care through the VA and coverage is apportioned on the basis of eight “priority groups.”

“They range from things like people who were prisoners of war, who have coverage for life, or who have battle injuries and therefore have coverage for their injuries for life,” said Himmelstein.

Veterans who fall below an income threshold that is determined on a county-by-county basis can qualify for care, but many veterans are “working poor” and fall just above the bracket.

“The priority eight group, the lowest priority, are veterans above the very poor group who have no other reason to be eligible and that group is essentially shut out of the VA,” according to Himmelstein.

The study comes as the U.S. Senate weighs health care reform legislation and whether to offer government health insurance.

Himmelstein warns that congressional proposals could still leave veterans uncovered and favors a national health care program similar to those in Britain and Canada.

November 10, 2009

Will Tamiflu Shortage Drive U.S. To India’s Version?

Filed under: Health News, Pharmacy — Senior Helping Senior @ 6:30 pm

With demand for the swine flu vaccine outpacing supply, the Centers for Disease Control and Prevention says it is open to considering importing a generic flu drug from India. There’s just one problem: Tamiflu, the brand-name drug, is still under U.S. patent.

Flu-related hospitalizations and deaths are still on the rise in the United States. But there’s a shortage of Tamiflu, the anti-viral medication that can protect against complications caused by the illness.

To deal with the shortage, the CDC has ordered more Tamiflu from Roche, its Swiss manufacturer — but it is not expected to arrive until January.

Antiflu, a generic version of Tamiflu, is made by the Indian company Cipla — despite the fact that Tamiflu’s patent is protected under U.S. law until 2016. The Cipla version costs 20 to 30 percent less than the brand-name drug.

Dr. Yusuf Hamied, chairman of Cipla, says he is eager to provide the U.S. market with his generic version of the drug.

“We would keep our factories open night and day, because this is an emergency,” he told NPR’s Steve Inskeep.

“We would certainly cooperate in whatever way possible.”

The U.S. government has already released its last 200,000-some doses of the oral liquid version of Tamiflu for children. The highest hospitalization rate for swine flu is in children age 4 and under.

A recent poll from the Harvard School of Public Health found that only about a third of adults who have tried to get a swine flu vaccine have been able to get it.

Hamied says Antiflu is an exact clone of Tamiflu. It has been approved by the World Health Organization and is already for sale in India.

In 2001, Cipla tried to import its generic version of the antibiotic Cipro — which was stockpiled after the anthrax attacks in 2001.

“The drug was covered under patent,” Hamied said.

“And I think what happened — the American government stockpiled Ciprofloxacin and probably made a deal with Bayer [the manufacturer] at a much lower price than what was the prevailing market price at the time.”

Hamied said his new plan to export Cipla’s version of Tamiflu to the United States faces similar problems.

To import Antiflu before 2016, the U.S. government would have to override patent law, which it would likely only do in a real emergency. And Cipla’s drug does not yet have Food and Drug Administration approval.

India is the largest and fastest-growing producer of generic medicines; Hamied’s company has a long history of producing generic drugs to sell at cheap prices in the developing world.

The most famous of these is Cipla’s generic anti-retroviral drug. It is considered to be lifesaving for HIV-positive people in Africa, because it is available for a fraction of the cost of brand-name anti-retrovirals.

In developed countries, anti-retrovirals cost around $6,000 per patient per year; the Indian generic version is available in the developing world for $800.

All of this has not made Cipla — or Hamied — popular among pharmaceutical companies.

In the interview, Inskeep mentioned that the head of the pharmaceutical giant GlaxoSmithKline has called Hamied a “pirate” and described the quality of Indian generic drugs as “iffy”.

“You know what I replied to that, Steven?” Hamied said. “I said, ‘We do not break any laws. We live by the laws of the land.’ And then I sometimes add that even Robin Hood was regarded as a pirate.”

November 3, 2009

Over 7 Million UK Adults May Be Gambling Their Lives With Fake Medicine, UK

Filed under: Pharmacy — Senior Helping Senior @ 6:23 pm

More than one in seven British adults surveyed (15%)1 admitted to bypassing the healthcare system to get hold of prescription only medicine without a prescription, a practice which 78% of GPs surveyed say is putting people’s health and potentially lives at risk3, as some of the medicines obtained in this way may be counterfeit.

New research indicating the scale of the counterfeit medicine culture was released today as part of a hard-hitting campaign to educate the public of the risks involved in purchasing fake medicines from unregulated websites. The Get Real, Get A Prescription public awareness campaign is being launched in a partnership between Pfizer, the Medicines and Healthcare products Regulatory Agency (MHRA), the Royal Pharmaceutical Society of Great Britain (RPSGB), The Patients Association and HEART UK.

Without recognising the dangers associated with counterfeit medicine, UK adults are putting too much trust in illicit websites that are potentially selling them. Research suggests that the majority (60%) of adults agree that they’re more trusting of all purchases they make online today compared to five years ago1. In addition, alarmingly almost a fifth (18%) of UK adults believe people who sell prescription only medicine without a prescription, are providing a service to the general public – offering cheaper medicines to those that need it1. A third (33%) simply think what’s being sold is real thing, sourced from legitimate places and sold on1.

David Pruce from the Royal Pharmaceutical Society of Great Britain said: “Pharmacists are very concerned about the increase in fake or counterfeit medicines. As expert professionals in medicines and medicines use, we know only too well that fake medication does not work and that it can cause harm. Stay safe by ensuring that you always get your prescriptions dispensed at a registered UK pharmacy. If you want to buy medicines online, always check that you are dealing with a genuine pharmacy. Don’t go on face value – some of the illegal sites look very professional but supply dangerous fakes. Check our website for a list of sites that have been awarded the RPSGB’s internet pharmacy logo so that you can be sure that you are dealing with a UK registered pharmacy supplying genuine medicines. This campaign is important. We want the UK to be the safest place to obtain medicines.”

Steve Poulton, Pfizer UK Commercial Director and Business Unit Head, said: “We are thrilled to be partnering the Royal Pharmaceutical Society of Great Britain in this deliberately hard-hitting campaign, aiming to push the counterfeit medicines issue up the agenda and discourage consumers from by-passing the health system. Pharmacists play a key role in delivering healthcare services and enhancing the patient experience, something Pfizer supports through a range of activities such as this campaign.” Pfizer, the RPSGB, and the other campaign partners have been working with pharmacists across the UK to help them leverage public interest in this issue, as a patient education opportunity.

A hard-hitting TV advertisement, which is considered so shocking that it can only be shown after 11pm, will kick-off the campaign on Tuesday 3rd November. A national billboard poster campaign will also run nationwide in November, with a consumer roadshow touring seven cities over the next week. Consumers can go tohttp://www.realdanger.co.uk for more information and advice.

Notes

– The Get Real, Get A Prescription campaign is supported by Pfizer, the MHRA, RPSGB (the professional and regulatory body for pharmacy), The Patients Association and HEART UK.

– It is estimated that between 50 -90%4,5 of medicines now purchased over the internet are counterfeit, with global sales in fake medicines expected to reach $75 billion by 20106. Here in the UK, two thirds of GPs surveyed (67%) have seen patients who have obtained medicines from illicit sources3.

– Fake medicines can contain harmful ingredients such as rat poison, boric acid and lead paint7,8. They’re often produced by people with no appropriate qualifications9 and can include too much, too little or none of the active ingredient they should include6. Fake medicines can cause harm to patients, which can sometimes lead to death6.

– If you have been offered what you suspect to be counterfeit medicines, or have seen them for sale, or have bought them, we would like you to tell us. The Medicines and Healthcare products Regulatory Agency (MHRA) is the medicines safety watchdog and has a dedicated 24 hour hotline: 020 7084 2701, E-mail: counterfeit@mhra.gsi.gov.uk or write to: Counterfeits, The Intelligence Unit, MHRA, Market Towers, 1 Nine Elms Lane, London, SW8 5NQ.

– If you think a medicine or herbal medicine has caused an unwanted side effect (an adverse drug reaction), please report the problem to the MHRA’s Yellow Card scheme http://yellowcard.mhra.gov.uk/. The Yellow Card scheme has been used for over 40 years to collect information on suspected side effects from all types of medicines. These include prescription medicines, medicines you can buy without a prescription, and herbal and other complementary medicines.

– The RPSGB provides a list of legitimate, approved online pharmacies on its website for people to check before they buy from an online source:http://www.rpsgb.org.uk

About the Royal Pharmaceutical Society of Great Britain

The Royal Pharmaceutical Society of Great Britain (RPSGB) is the professional body for pharmacists and the regulatory body for pharmacists and pharmacy technicians in England, Scotland and Wales. The primary objectives of the Society are to lead, regulate, develop and represent the profession of pharmacy. The RPSGB leads and supports the development of the profession within the context of the public benefit. This includes the advancement of science, practice, education and knowledge in pharmacy. In addition, it promotes the profession’s policies and views to a range of external stakeholders in a number of different forums.

Following the publication in 2007 of the Government White Paper Trust, Assurance and Safety – The Regulation of Health Professionals in the 21st Century, the Society is working towards the demerger of its regulatory and professional roles. This will see the establishment of a new General Pharmaceutical Council and a new professional body for pharmacy in 2010.

About Pfizer

Pfizer Inc, founded in 1849, is dedicated to better health and greater access to healthcare for people and their valued animals. Every day, colleagues in more than 150 countries work to discover, develop, manufacture and deliver quality, clinically effective prescription medicines to patients. In the UK, Pfizer has its European R&D headquarters at Sandwich and its UK business headquarters in Surrey, and is the major supplier of medicines to the NHS. Pfizer invested over £5.4 billion worldwide (£104 million per week) in R&D in 2008.

About a healthy partnershipTM

a healthy partnership was launched by Pfizer in 2008 as a new approach to support the increasingly important role of community pharmacy in the delivery of healthcare and new services being offered to patients. It covers three areas highlighted as being important by pharmacists: Supporting professional development, enhancing the patient experience and delivering commercial value.

References

1. YouGov Plc data, September 2009. Participants: 2076 adults.

2. 7.1 million calculated using Office National Statistics Census 2007. 15% of UK adults aged 18 and over = 7,179,660

3. Medix UK plc (2009) Market Research Report: Counterfeit Drug Study. Participants: 205

4. WHO and IMPACT factsheet. Counterfeit drugs kill! Last accessed on 13.10.09 from here.

5. In-PharmaTechnologist News. Last accessed 08.10.08 from here.

6. WHO factsheet. Counterfeit medicines. Last revised 14 November 2006http://www.who.int/medicines/services/counterfeit/impact/ImpactF_S/en/ lastaccessed 10 October 2009

7. Soloman, S. BC Woman killed by fake drugs bought online. National Review of Medicine, 2007. 4:13.

8. Pfizer data on file

9. European Alliance for Access to Safe Medicines. The Counterfeiting Superhighway, 2008 Medicom

Source
Royal Pharmaceutical Society of Great Britain

October 26, 2009

Study: No Benefit to Costly Arthritis Drugs

Filed under: Pharmacy — Senior Helping Senior @ 5:09 pm

For many people with rheumatoid arthritis, the traditional, and much cheaper, disease-modifying antirheumatic drugs (DMARDs) appear to work just as well as newer TNF blockers that target the underlying disease process, a large study shows.

The findings also suggest that a step-up approach in which patients are started on methotrexate alone, with additional drugs added only if needed, may be preferable to immediate combination treatment, says Larry W. Moreland, MD, chief of rheumatology at University of Pittsburgh.

Moreland and colleagues studied 755 patients, mostly white women. All had early rheumatoid arthritis, with an average of less than four months since diagnosis, and had not yet received disease-modifying antirheumatic drugs (DMARDs).

The study was designed to compare the older and the newer drugs and to look at the benefit of starting with combination therapy compared to step-up therapy.

The patients were divided into four groups. Two groups began with immediate combination therapy: either methotrexate combined with sulfasalazine and hydroxychloroquine (the traditional DMARDs) or methotrexate and the TNF blocker Enbrel.

The other two groups began with methotrexate alone, with step-up treatment adding either sulfasalazine/hydroxychloroquine or Enbrel only if they had persistent disease activity at six months.

Arthritis Drugs: No Difference between DMARDs, TNF Blockers

Two years later, there was no significant difference in disease activity between patients taking triple DMARD therapy or methotrexate + Enbrel. This held true whether they received immediate combination treatment or step-up therapy.

“What this means in real clinical practice is that patients should be started on methotrexate alone, with other drugs added only if they don’t respond,” Moreland says.

“You always want to try to expose the patient to as few drugs as possible,” he says.

Although the traditional DMARDs worked just as well in the study as the TNF blocker, Moreland isn’t ready to conclude that holds true for all patients.

“While the results may show that, overall, both treatments have similar outcomes, we still are not certain how to best treat individual patients,” he says.

Moreland tells WebMD that X-ray images, taken during the study, may show whether one strategy is better at halting disease progression. But those images aren’t available yet.

“We clearly need better predictors of who will benefit from which treatment,” says Mayo Clinic rheumatologist John Davis, MD. He moderated a news conference to discuss the new studies at the annual meeting of the American College of Rheumatology.

In the meantime, Davis tells WebMD he tries to prescribe the least aggressive treatment that works. “I have patients that do very well on methotrexate alone,” he says.

SOURCES:

American College of Rheumatology Annual Meeting, Philadelphia, Oct. 17-21, 2009.

Larry W. Moreland, MD, chief of rheumatology, University of Pittsburgh.

John Davis, MD, assistant professor of medicine, division of rheumatology, Mayo Clinic, Rochester, Minn.

© 2009 WebMD, LLC. All rights reserved.

October 19, 2009

Watch Out For Bogus Swine Flu Remedies Online

Filed under: Uncategorized — Senior Helping Senior @ 7:06 pm

If you’re worried about swine flu, resist the temptation to stock up on dubious medicines being hawked online.

The Food and Drug Administration ordered a bunch of stuff on the Web recently that was supposed to fight or prevent the flu and doesn’t recommend you do the same.

One package from India that should have contained the flu-fighter Tamiflu, or oseltamivir, instead had some plain, white tablets that turned out to be a mixture of talc and acetaminophen. The Web site where the meds were offered “disappeared” shortly after the FDA placed its order, the agency said.

Other shipments included products that contained some oseltamivir but they weren’t approved for sale in the US.

The FDA has come up with a neat little widget (check it out on the right) to help people separate the impostors from the real deals when it comes to H1N1 products.

The proliferation of scams doesn’t exactly surprise us. A few months back the cosmopolitan cops at Interpol blew the whistle on swine flu spam, saying as much as 4 percent of spammy email at the time was about swine flu.

Add the swine flu stuff to that folder where you keep the Nigerian get-rich-quick schemes. “By responding to spam swine flu emails or attempting to order medication online through illegal and unregulated websites, people are risking their well-being and their money,” Interpol’s Jean-Michel Louboutin said in a statement in May.

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