The Canadian Rheumatology Association (CRA) would like to provide an update on the current situation concerning ACTEMRA IV in Canada. The CRA has been monitoring stock levels with the help of our healthcare and industry stakeholders and have noticed an increased demand due to its off-label use in COVID-19 patients.
Hoffmann-La Roche estimates approximately 1400 hospitalized patients per month can be treated with ACTEMRA IV for COVID-19-related pneumonia while still maintaining adequate supply for rheumatology patients.
In an effort to help address increased demand during this pandemic, the CRA recommends that, where appropriate, rheumatologists consider switching or starting patients on the subcutaneous ACTEMRA SC formulation. This will help protect the supply for rheumatology patients as well as provide for those with severe COVID-19-related pneumonia.
Further estimates provided to us indicate that if 100 out of approximately 1,700 rheumatology patients currently on ACTEMRA IV switched to ACTEMRA SC this month, ICUs in Canada would be able to treat at least an additional 65 COVID-19 patients per month (over 780 per year).
The CRA will continue to monitor stock levels of ACTEMRA IV and advise members as the situation continues to evolve. We also ask all members to remain vigilant for any disruption in access and report any concerns to firstname.lastname@example.org.
Special thanks to Carter Thorne for his continued advocacy on this […]
This is a decision that needs to be decided before you open your practice, as you will probably be signing leases for office space, possibly leasing equipment, trying to obtain loans, and hiring staff.
Typical decision making on this is potential tax savings and legal separation from you and the practice. You should have a discussion with your accountant and lawyer early on in your decision-making process.
As mentioned above, assuming you have incorporated, the lease would be negotiated and signed by the corporation to keep the liability within the corporation.
Consideration should be given to length of lease and space requirements for growth, based around your vision of the practice for the medium- to long-term. Negotiations with the landlord will include such things as what the landlord is willing to pay for up front regarding improvements to the space, and a potential rent-free period.
This is a question that I am asked quite a bit, especially from higher income professionals (doctors, lawyers, etc.).
Unfortunately, my usual answer is: It depends…
Assuming you are treated as a contractor, not an employee, you have the options of being self-employed or to create a professional corporation (assuming you live in a jurisdiction where your professional body allows you to incorporate).
The initial test to incorporate or not is to determine whether you require all the income you earn to pay for your lifestyle. If the answer is yes, then, generally speaking, there is not a lot of tax savings in incorporating, as all the income going through your corporation flows out to you. There may be some minor savings by splitting your income between salary and dividend, but the savings are not significant.
Typically, the expenses you can claim through a corporation are the same expenses you can claim as a self-employed professional (automobile, phone, office, salaries to other people, membership dues, etc.)
Where the majority of the tax savings are created, are when you do not require all the income earned by your corporation and you can leave some of the income in the corporation to be taxed at the small business tax rate […]
The situation with COVID-19 is changing rapidly and there is still a paucity of evidence surrounding this emerging condition. The CRA, in addition to endorsing the ACR statement on this subject, would like to direct your attention to the EULAR and PReS statements (links below).
We have provided a few important points from these statements to help guide you through this uncertainty. We will continue to monitor the situation and provide updates as new evidence emerges or if expert consensus changes. It is also important that you continue to familiarize yourself with your own local and provincial recommendations.
Besides social distancing and hand hygiene recommendations:
Patients with rheumatic diseases should continue their medications.
Patients with rheumatic diseases in isolation or in quarantine (without infectious symptoms) should continue their medications.
In patients with rheumatic diseases on corticosteroids, these should NOT be stopped and may require adjustment in the face of an infection.
If the immunocompromised rheumatic disease patient should develop fever, cough, or shortness of breath, they should seek medical attention and advise them to mention that they are immunocompromised.It is understood that physicians have their own threshold for the interruption of therapy during an infection balancing the risk of disease flare and serious […]
At this time, and given the paucity of evidence surrounding this emerging condition, the CRA is endorsing the ACR statement on this subject. We will continue to monitor the situation and provide updates as required. It is also important that you familiarize yourself with your own local and provincial recommendations.