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How to be treated in the US and get paid for it

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Life hacking for those who want to earn and for those who have expensive insurance

It's no secret how much private medical insurance costs, what you need to get medicaid and what mental jungle has to be overcome in order to understand where and what the insurance covers, and where it is necessary to pay.

And while we are healthy, we are not interested in it, and when we are sick, there is no time to go into details.

One of the ways, I want to emphasize, is only “one of the ways to use the existing system to your advantage and in no way a panacea for everything that can and cannot be cured, research that involves volunteer patients for work.

You do not check either the status or the insurance card. You do not require money. Moreover, pay here - you.

Although, of course, in society, the subtext “use us” is popular, not without it.

We are talking about testing drugs in humans. Immediately comes to mind a bunch of associative material. Myths that those who aspire to world domination are eager to change a person at the genetic level in order to easily and easily conquer him. A lot of films about how harmful clinical research is and how healthy they make patients.

No, there will be no advertising for research and there will not be a single positive or negative epithet addressed to them. There will be bare information about how such studies really go, what they give to science, and that to their immediate participants.

FAQ

What it is?

Pharmaceutical research has been conducted all over the world for more than half a century and during this time has undergone a lot of technical, ethical and legal corrections in favor of the patient, but what remained unchanged - yes, in the course of these studies, drugs are actually being tested in humans.

If they had not been tested in public, humanity would have received far more unpleasant surprises than it had already received. The people who are tested for the clinical picture or the effect of the drug can be roughly called “guinea pigs”, or you can be volunteers who help science and extract financial compensation from their activities.

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Who is doing this?

Great variety of both public and private clinics. The lion's share of such studies is carried out in hospitals. The larger the organization, the more research it can conduct and the higher the level of diversity of such research. And the cooler equipment.

Who needs it?

Pharmaceutical companies interested in developing new drugs. Consumers of pharmaceutical companies, for demand creates supply. Wait, this is not the whole list. This is also needed by patients who have been prescribed “not that” for many years, who have tried all possible medications and realized that their illness does not help anything (migraine is especially famous for the lack of a way out), who have nothing to lose and participate in testing the drug for them. - the last hope to get at least something that works.

You - me, I - you

This principle in research works to its fullest. You provide your blood, urine, saliva for tests, answer questions about your state of health a very large number of times, your body may (and it’s not a fact that it really happens) have to suffer the side effects of a new medicine. This is what you give. What they give you: the possible cure of your illness, medical support in the event of a side effect, and ... material compensation.

Why is it paid?

Because you spend your time on this in the first place. And a resource. Your ability to be a human unit, expressing an opinion on which, among others, drug developers will be guided, is a resource. This is a common practice, as is done everywhere.

Sometimes, in order to take part in a study, a person is forced to skip the work day, and sometimes he, according to the terms of the study itself, requires an accompanying person or taxi. All this clinic compensates, and the patient signs the “received money”.

Who pays it?

Those who sponsor certain studies. In different clinics they are different people. The cost of participation in the study of each patient is initially budgeted.

How is it paid?

Also in different ways. Participation in a depression research program is, for example, $ 50 per session. A session lasts an hour and you do not use anything. In fact, a number of other studies are accompanied by taking the drug. In tablets or intravenously.

Who will know that you participated in these studies?

No one. Under the terms of a completely formal contract that you sign, this action is absolutely anonymous. Even in a telephone survey, you will be called your personal code, because the respondents do not know and should not know your name.

Risks

Changing the health for the worse and side effects of the drug.

Nobody hides this from anyone; a person is always warned about what could theoretically happen to him and is asked in detail about the sensations during the procedure.

It is for the identification of side effects (among other things) that research is being carried out.

Are there any such cases?

There are. The medical staff is first interested to bring you around if this happens. The clinic is responsible for everything that happens inside it. If you do not take drugs under the terms of research, then the side effects are not talking.

“What if I am put on drugs?”

The FDA controls the entire synthesis process of all approved drugs. Without its green light, research will not begin and the drug will not be available at pharmacies.

That is, I can come here just like that, and they will just take me to participate in the study?

Not. You will be taken to participate in the study of a certain disease only if you are already sick by it - and in order to find out, you will be examined beforehand (interviewed, examined). Sometimes, your own doctor recommends taking part in a study.

How does this happen? The patient complains that he is not helped by anything, the doctor offers another option - to determine whether the latest developments help him, by experience. Participation in the study, of course, only voluntary.

Who is involved in such research?

Most of the volunteers are people from 50 years. However, for the study of migraine, for example, people are allowed to 18 years - this disease is characteristic of all ages, unfortunately.

For different studies need different people, in hospitals there are also pediatric studies. Pediatric oncology, autism, hearing impairment - all this is investigated, and through the participation of volunteers as well. Parents give consent if the child is minor.

How it is done

Svetlana Netrebchuk, coordinator of a research clinic, describes the situation as follows: “In Brooklyn, I also know 3 clinics that conduct research - and many hospitals. Hospitals are conducting studies of the cardiovascular system, operative surgery - they have decent equipment, they can conduct research during surgery, develop a new approach technique, for example. These are studies with severe patients, the severity of which is determined only by preliminary examination.

Svetlana Netrebchuk, clinic coordinator. Photo by Nata Potemkin

Svetlana Netrebchuk, clinic coordinator. Photo by Nata Potemkin

We do not take very heavy patients, our profile is diabetes, Alzheimer's disease, depression and migraines. There is a study for severe diabetics who are not helped by anything and need to switch to insulin. We provide everything to everyone - with needles, alcohol pads, everything you need. Patient 24 hours under our supervision through Wi-Fi - he is at home, and we in computers see what happens to him, we see blood counts. There is another study for those who have kidney problems as a result of diabetes. Controlled diabetic studies are mostly uninteresting.

I never ask the documents - but there is a requirement on some (not all) studies picture ID - any document with a photo so that I can see that this is the same person who filled out the questionnaire.

And if you think that you need or would like to take part in such studies, then there is a centralized government brokerwhich is used to search for both the disease and your place of residence. There you will be told the nearest clinic that deals with exactly your problem. In any country, here, in Europe, in Australia, Japan - wherever you are gathered, research is conducted all over the world. It is not necessary to come to us or to the hospital - the choice is unlimited. You can also go to the website of any individual clinic and ask everything that interests you.

On any front desk, you can say that you are interested. clinical Trials - and you will be answered whether such studies are conducted, and in what area. You may not have medical insurance (no), you may be in the status of a tourist - however, provided that you participate in research, this will not be a problem.

We financially encourage participation in research and call patients volunteers not because we personally want it, but because research sponsors are interested in it. This is compensation for the journey (some volunteers travel to us from the Bronx, for example), during research, we sometimes need snacks, snacks, a car service ... We have to pay for all this, and we do it. This is not our idea and our pocket - it is an inviolable protocol. Each study lays a different budget. For example, cognitive studies of Alzheimer's disease require an 5-6-hour stay in the clinic — and compensation is appropriate there. Sometimes you need to do an MRI or scan - you need to go and do it all, and many of our patients do not move well. But in the study of depression, for example, visits are short, and payment is less. "

What happens next

The decision on whether the drug will not be released to the market is made by the FDA. All information about the study sponsors send to Food and Drugs Administration before the research begins. Sponsors make a detailed report on what they expect from this medication, what they expect during the study, what requirements they impose on the composition, etc. The FDA may or may not allow these studies. And only after that the pharmaceutical company is looking for a clinic to implement the research. After the study is completed, all data is also sent to FDA for processing. This is a huge amount of information, a complete database of all possible side effects, data and state of health, and only if all of them are within the normal range - the administration decides to release the drug on the market.

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Side effects

Svetlana Netrebchuk, coordinator of one of the research clinics, says that side effects are quite common, and this is not surprising: “First, it is discussed at the first visit, at the screening, we provide the patient with full information in his language (usually it is in English, but if a person does not read English, we always provide it in his native), we always talk about the side effects of this drug. This is negotiated immediately, and the person must agree. In the starting information for the patient, everything is painted - and what we are going to do at each visit, and the side effects of this medication. If a person does not give his consent on the first visit, we stop working with him. We do not deceive anyone and do not hide anything from anyone. Our duty is to tell about negative moments first of all.

If a person has nausea, vomiting, headache, fever, individual intolerance of some component - the patient is obliged to either call us and tell about what happened as soon as possible, or we ourselves see that something is wrong.

In addition, not every person is suitable for research - we are in the strict framework of the criteria of age, gender of the patient, previous diseases.

Allergies are included in this list. And if a person does not fit these criteria or there is the slightest risk of harm to him - we will not even take him. We will never endanger a person consciously. We will most likely refuse him on the first visit. But usually, as a side effect, we still have a headache or some parallel ailments that are not related to taking the drug - a cold, for example, accidentally caught up, or an accident ... But if this is definitely a side effect of the drug, we discuss the expediency of further participation of the patient in the study and direct him to a narrower specialist who is able to analyze the situation. "

Personal experience

Galina, asked not to mention her last name, 39 years, New York. Undergoing research in the 2017 year: "At the moment I am participating in the study of drugs for depression, and this is how it happens. On the first day, they took a blood test (completely free), urine and saliva for serious illnesses: diabetes, cirrhosis of the liver, etc. I asked if they would tell me if they found something that I should know about? They promised to say and really said (that everything is in order), but not immediately, not on the second visit, but a little later. Every time I answer the questions of a person whom I do not know - they are different people all the time, and every time I come to the next stage of research, I speak on the phone about my condition. I am being interviewed in such detail that I often find it difficult to answer precisely because it is very detailed. More details than I think about myself. I can give or not give permission to record our dialogue - and I give it. I also answer the questionnaire about my current state in writing. The study includes a mandatory conversation with a doctor who observes me and prescribes treatment - and I do not need an insurance card or ID - nothing. For each session of research, I get $ 50 in my hands - this is the lowest paid research.

I have never seen a single person who would take part in research in the same way as me. Researches are completely anonymous, and their schedule is designed so that patients do not overlap with each other.

I need to drink drugs for depression - however, these drugs were prescribed to me by my doctor even before I decided to participate in the study. That is, from a chemical point of view, nothing has changed in my life.

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George, asked not to mention his last name, 46 years, passed a very long list of studies in 2003-2007 years: "I participated in such studies in Canada and in England, in 2003-2007, in the USA did not participate. I, among other people, was planning to test a drug for the treatment of asthma. I donated blood, urine, they checked my height and weight, I filled out a questionnaire. Under the terms of the study, the person testing the drug should be from 18 to 45 years, and should not be overweight. Cardiogram and pressure. I was there several times for several hours, the longest time I spent there - 8 hours per visit - it was a preliminary examination, screening. As a result, I got into the reserve - that is, my data was taken in case someone leaves the distance in this study, then I will be a substitute.

At the moment I am alive and well, but I would like to say about other research participants. I had a feeling that people come there for material compensation and it is important for them not so much to help science as to earn. There are real volunteers, but their percentage is low.

Most of the emigrants participated. Students People sitting on the velfer. Ethnic minorities. Parents of large families of poor families. Native people practically did not come across.

From $ 700 to $ 1000, patients earned such studies in Canada. If you take a few studies, you could save money for starting your own business or for a car - and very often my patient colleagues did just that.

More than 4 thousand pounds such research was then worth in England.

As a result, postoperative healing studies - I was tested on the effect of some kind of healing drug - lost the sensitivity of the oral mucosa and external skin for a while.

Once for a few seconds lost consciousness. But I was immediately brought a stroller, cared for me. In study I donated a total of 700 with over a milligram of blood.

There, people are divided into those who take a placebo and those who receive a real drug. Who will receive what - medical secrecy.

And those who take a placebo, definitely do not get any harm to health. And the one who takes the real drug may feel something.

The legislation is very different in these countries: Canada between the study of the same person should take place around a month (28 days), but in England - at least 56 days.

There are some characters who contrive and participate immediately in 2 research: at that time there was no shared computer in the clinics. But that was a long time ago; I think the situation has changed since then. With this, the patient makes worse both himself and the study.

How do I personally feel about this kind of research? If it is voluntary - why not? Everyone is responsible for their decisions. We can, for example, donate organs after death in an accident. Why not something? I participated in a lot of such studies, and now you are talking to me, right? Research conditions, by the way, have always been good. As in the sanatorium there was about. "

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