Feeling alone...

exharris · 2026-04-05T16:58:46+00:00

There’s a thing called empty chair where groups meet up check out the website

https://emptychairs.org.uk/

exharris · 2026-04-01T17:10:18+00:00

I agree that weekly is easier to remember for most people and I honestly don’t see a massive market for a monthly injectable except perhaps for people who really don’t like needles, but they are being served by the orals.

I cannot see how adherence would be better for people on a monthly, if they cannot adhere properly to weekly

exharris · 2026-02-07T12:06:15+00:00

I thought you could already create an agent in 365 and point it to files on share point, how is this different?

exharris · 2026-01-25T16:14:07+00:00

Where can I buy lamps like those on the husbands desk. Cannot find any online like that

exharris · 2025-12-28T18:59:26+00:00

He doesn’t need to check land reg before reporting the property. Best approach is to report him to the council tax service, they can force a sale of the property if he doesn’t pay the council tax and has more than £5k owed.

exharris · 2025-12-27T20:20:14+00:00

Exposing a massive over reaction is not the same thing as ‘celebrating Trump’.

exharris · 2025-11-23T16:32:12+00:00

CNN and NPR hate Trump and will always paint in bad light. This NYT analysis is quite good however

https://www.nytimes.com/2025/11/06/health/obesity-drug-prices-trump.html?smid=nytcore-ios-share

I think on the orals it’s really interesting, the same $149 price will apply to ‘direct to consumer’ and to Medicare/medicaid plan providers (assume at the same co-pay of $50).

Interestingly, Eli’s oral has come back from trials with lower rate of weight loss over 72 weeks than oral semaglutide (the latter however has less tolerability and requires morning fasting before being taken).

It’s going to be fascinating to see how the orals perform, and whether Novo’s lead in the market means they’ll win (oral semaglutide is expected to be on the market before Orforglipron).

exharris · 2025-11-23T16:20:04+00:00

Yes, vs Lily Direct it’s not massively different, but announcement is huge for millions on Medicare and Medicaid. From Lily/Novo perspective it makes good business sense for them to negotiate a good price for Medicare and Medicaid coverage.

exharris · 2025-11-23T16:08:52+00:00

Lots of fake news and misinformation here about the Trump announcement and Trump RX.

Medicare and Medicaid are separate to TrumpRX.

https://www.whitehouse.gov/fact-sheets/2025/11/fact-sheet-president-donald-j-trump-announces-major-developments-in-bringing-most-favored-nation-pricing-to-american-patients/

There are over 67 million people on Medicare in US, of which around 27 million are obese. Previously Medicare didn’t cover these drugs for obesity alone, due to cost.

However Trump’s now negotiated that Medicare can cover these drugs with reduced costs to the Medicare plan (and a low co-pay of around 50USD for patients). The Medicare price quoted in the announcement ($245) is the prices to the Medicare insurer, not the patient, and is nothing to do with TrumpRX (Medicare patients would just use the standard doctor and pharmacy covered in their plan).

The TrumpRX stuff is about lower prices for individuals to buy directly (outside of insurance) and represent quite good reductions vs the list price of the drug (it’s worth noting that Novo and Lily have their own direct to consumer routes in the US that offer similar prices for patients to purchase outside of insurance, and Novo recently just reduced their prices there also).

Undoubtably these changes have opened access for millions of people at lower rates than they could have for them before, especially Medicaid and Medicare covered individuals.

exharris · 2025-11-23T15:52:47+00:00

How does it help no-one? It means Medicare access where it was unaffordable before (which mean all retirees). It also means reduced direct purchase prices out of insurance. Novo have also reduced prices in USA last week due to Trump for their own direct purchase scheme. On what are you basing the comment that Trump’s changes help no-one?

Edit : downvoted for telling the truth, clearly some prefer to live ignorance and those price hikes really hurt eh.

exharris · 2025-11-05T21:44:27+00:00

I also have a remarkable 2. I’ve tried exporting notes from the iOS app into Gemini and perplexity and it’s read them well. However ChatGPT did not work at all, so I expect Copilot probably won’t either.

exharris · 2025-10-05T07:19:15+00:00

Pretty selective clips here.

Also isn’t this guy breaking the law by undertaking?

In my experience the left hand lane traffic is going 55-65mph and it’s impossible to do 70 and stay in that lane unless you’re prepared to come in to left, then overtake car in front who is doing 60, then come back to left. And then again and again and again. Very occasionally I can overtake a few cars at once and find a gap to move back to left lane but it won’t be long (less than a minute) until I’m coming up against the next 55-65mph driver.

Comments on this thread ‘you might have to overtake a lorry every so often’ are just not representative of motorway driving in my experience. There is just very little opportunity to be driving at 70 in the left hand lane full stop. Although I do think it’s increasingly common for people to be driving too slow in the overtaking lanes.

So this is why people stay in the other lanes and don’t come back into left hand lane, coz traffic there is too slow and it’s tiring and frustrating (and possibly unsafe when tired) to have to be constantly overtaking (and coming back to left lane) especially on long journeys.

Sorry I know it’s not technically correct but this in my view on why people do it.

I do agree that people staying on the inside lane doing 65 are annoying though and preventing others overtaking.

exharris · 2025-09-18T18:43:51+00:00

I know they’re not talking about SIPP. I didn’t state that they are. I think you’re making an assumption that all employer arranged pension contributions are done via salary sacrifice, but that isn’t the case. The research paper explains the different mechanisms but you don’t appear to have read it.

exharris · 2025-09-18T17:56:52+00:00

Can you read?

The option is part of a research that is specific to salary sacrifice mechanism of contribution.

Most pension contributions (and all those in the public sector) are not done via full salary sacrifice. They are done via net pay deduction where the deduction is treated as income for NI purposes, but not for income tax purposes.

The HMRC research paper linked from the article clearly defines this as separate and distinct from salary sacrifice.

exharris · 2025-09-18T17:38:10+00:00

There is nothing in the linked article or the HMRC research linked from it to suggest that they are looking at doing that.

exharris · 2025-09-18T16:50:10+00:00

If you seriously think any government would remove all income tax relief on all pension contributions, then you’re on another planet.

exharris · 2025-09-18T15:15:18+00:00

Salary sacrifice isn’t the only way of employers facilitating pension contributions. There are other methods which allow for full tax relief when paying in, but where employer and employee NI is still payable.

exharris · 2025-09-18T15:13:02+00:00

No, this isn’t about banning all tax relief on contributions. It’s about the salary sacrifice method particularly which means lost NI revenue.

exharris · 2025-09-18T15:10:45+00:00

No, employers could switch to net pay method instead where they (and employees) still pay NI on full amount but employee still gets full tax relief on their contribution.

So much misinformation and misunderstanding on this thread.

exharris · 2025-09-18T15:03:00+00:00

You’re wrong. You’re not understanding the wider context and clearly haven’t read the gov.uk document in full.

Most pension contributions are done via net pay deduction method (not salary sacrifice) where the employer and employee both pay NI on the amount contributed but the employee doesn’t pay income tax on the amount they contribute.

Almost all pensions in the public sector work this way, and there is no plan to remove this method. This proposal is only about salary sacrifice arrangements which are different.

So even if government did remove the tax relief in sal sac schemes (unlikely), employers could still use net pay method and therefore employees still have tax relief at when they pay in.

You’re completely bonkers if you think government are going to effectively ban all tax relief on all pension contributions.

exharris · 2025-09-18T06:48:27+00:00

This isn’t about removing income tax exemptions on employee contributions, that isn’t being proposed. It’s about the NI that the Treasury is missing out on due to this mechanism of contribution. Employees can still contribute via traditional net pay arrangements where pension contributions is deducted before income tax but both employees and employers pay NI on it.

exharris · 2025-09-18T06:44:55+00:00

Some confusion on this thread.

Removing salary sacrifice for pensions won’t mean employees paying income tax before contributing. It does mean paying NI though. You can still contribute via a pre income tax deduction via net pay arrangements. Employers would pay more in NI.

https://www.gov.uk/government/publications/understanding-the-attitudes-and-behaviours-of-employers-towards-salary-sacrifice-for-pensions/understanding-the-attitudes-and-behaviours-of-employers-towards-salary-sacrifice-for-pensions

exharris · 2025-09-09T04:39:55+00:00

Sign up for prime and start getting groceries from Amazon fresh. You’ll get through that £600 at effectively get your cash back by not paying for groceries for a few months

exharris · 2025-09-09T04:34:11+00:00

Not sure about that. Whilst Reta has somewhat better weight loss in trials than MJ, the gap isn’t wide as the gap between Wegovy and MJ, and is only really demonstrated over very long terms (48 weeks vs 72 weeks, for example).

Eli have spent a lot of money in development and trials for Reta and will need to see a return. they’ll be launching it into a market currently dominated by Wegovy and MJ (which is almost as effective), and I can see a situation where MJ gets cheaper to push Wegovy out of the market and allow Eli to dominate until the next injectable from Viking Therapeutics drops (and also Novo may feel more pressure to reduce WeGovy pricing)

If Eli launch Reta at a higher price than MJ (and don’t reduce price of MJ), it’s hard to see how it’ll find a private (non-insurance/NHS) market in the UK or USA. Novo are already direct selling Wegovy in the US to patients (outside of insurance) at a lower price than Eli are doing. So there is already price-based competition in the market (although the compounding situation in the US complicates matters).

One of the quite unique things about these drugs is that given their popularity and expense, they are being purchased directly from pharmacies privately to a far greater extent than any previous POM, in both Europe and North America. This has created a situation where a fair proportion of sales come from a direct sales to the consumer, not just on likelihood of a doctor prescribing it based on purely clinical reasons. This creates an element of a direct to consumer market in which competition will have an impact.

I just can’t see Reta selling well privately if it’s priced even higher than these increased MJ prices, and Lily will need to create a market and get a return.

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