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    How NADAC, WAC, and ASP Shape Drug Costs

    How NADAC, WAC, and ASP Shape Drug Costs

    April 20, 2026
    The Hidden Costs Employers Don’t See in Traditional Health Plans

    The Hidden Costs Employers Don’t See in Traditional Health Plans

    March 22, 2026
    The Impact of COVID-19 on Patient Trust

    The Impact of COVID-19 on Patient Trust

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    Understanding of Clinical Evidence in Peptide and Hormone Use

    March 30, 2026

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    Can you tell when your provider does not trust you?

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Home Perspectives

Giving Thanks

Dr. Leap reminds us about the importance of gratitude, even for the mundane.

Edwin Leap by Edwin Leap
November 20, 2022
in Perspectives
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Giving Thanks

Abdallah, Creative Commons

How many ordinary, boring days do you have? How many days so unremarkable that you can barely remember anything about them? When I ask my confused patients if they know the date, I’m looking down at my watch. I forget too.

Life slips by like that and we find ourselves at successive days, not marked by outstanding or memorable moments. Some researchers posit that we really don’t remember our lives like a movie with a running strip of film, but as a series of moments that stand out. The rest, it seems, is rather a blur.

The blurry days aren’t necessarily bad; just unremarkable. They may include waking the children, making breakfast, feeding the dogs and cats, kissing everyone goodbye for the day, going to work, cooking again, helping with homework and getting everyone off to bed.

The blurry days are days of office work or study, days when we wish for vacations, or outstanding breaks from monotony. They are the days described by Dr. Seuss in the book, ‘My Many Colored Days,’ where he says ‘Gray day, everything is gray. I watch but nothing moves today.’

They are days when we are sometimes beset by ‘first world problems.’ I learned this phrase from my kids, who make it their mission to ensure that I know the latest funny concepts to emerge in culture. A ‘first world problem,’ for instance, is this: ‘my nice car isn’t as nice as my friends’. Or ‘when I go to work, I only have an hour long lunch.’ Or as one child suggested, ‘the Wi-Fi doesn’t reach my favorite bathroom.’

I imagine that on our ‘blurry days,’ when life just is, we may anchor on those first world problems for a little something to mark the time. A little stimulus, if only in frustration. A shot of adrenaline to feel alive. But it’s deceiving; our little complaints, even our numbness, blind us to an important perspective, especially at Thanksgiving.

The hard truth is that many people in the world would dearly love one of our blurry days, our gray days, our first world problems. Everywhere in the world, men and women would weep with joy for the safe boredom, the predictable monotony of our wonderful lives in our wonderful land.  They would gladly surrender religious oppression or violent conflict, untreated disease or slavery for a dull day in the office, a magnificent day of messy children and cooking over a warm stove, a delightful afternoon of study in a place with clean water and good medicine and just laws. Their days are marked alright; marked by loss and by tragedy and with memories of things that this life will not likely be able to purge from their minds’ eyes. They dream of our boredom.

But it can get even more personal than that. How many times in each of our lives have we hoped and cried and prayed for the day we were currently experiencing to be different? To be average and forgettable – even uninspiring? Or to be thrilling or wonderful, or anything other than what it was; painful and miserable.

Many years ago, my son Seth, then five, was diagnosed with diabetes. I worried about his future. I wondered if he would escape complications and reach his manhood. I hoped for a regular day. And now, embarking on his own journey of adulthood, he is the very vision of a powerful young man. I’ll take any regular day with him.

Twelve years ago my wife was diagnosed with a stage four malignancy. At every point in her diagnosis, treatment and recovery, I longed for her to have normal days, days free of drugs and radiation, pain and fear. I ached for average, common, mundane days of work and joy and meals and health. I see every day differently now with her by my side. We arrived at normality, at days of blessed, glorious simplicity.

This Thanksgiving, consider for a moment a time when you wished you could hurl yourself away from trouble and forward to the future. And give thanks for where you are right now, a place and time you probably once wished for with all your might.

For those of you still hoping and still hurting, may your gray, boring day of thanks come swiftly. It may seem far away, but it will arrive at just the right time and leave you forever grateful for common things.

Happy Thanksgiving!

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Edwin Leap

Edwin Leap

Edwin Leap, MD, is an emergency physician and writer. He was born and grew up in West Virginia, where his mother was a nurse and his father a pastor. He met his wife Jan during his undergraduate work at Marshall University. He graduated from the West Virginia University School of Medicine and then completed his emergency medicine residency at Methodist Hospital of Indiana in Indianapolis. He has lived and worked for most of his career in South Carolina, where he and Jan raised four children. After 20 years in a private emergency medicine group, he embarked on locums work and has worked in many small, rural hospitals over the last ten years. Dr. Leap is especially passionate about the plight of those underserved facilities and their struggling populations. Beginning college as a journalism major, he changed directions to enter the medical profession. However, he rediscovered his passion for writing and has been a columnist for assorted publications since submitting his first op-ed to the Greenville News in 1995; a publication where he had a regular column for decades. Along the way he has also written for Emergency Medicine News, MedPage Today, the Huffington Post blog, Physician Magazine, the SC Baptist Courier, the Atlantic and others. He continues to practice emergency medicine for West Virginia University Hospitals in Princeton, WV and hopes to one day write a novel of staggering brilliance which will change the literary landscape. Or at least sell a hundred or so copies, whichever comes first.

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Videos

summary

An in-depth exploration of drug pricing, including key databases like NADAC, WAC, and ASP, and how they influence the pharmaceutical supply chain, policy, and patient advocacy. The episode also introduces MedPricer's innovative pricing intelligence platform, offering valuable insights for healthcare professionals, policymakers, and patients.

Chapters

00:00 Understanding Drug Pricing Dynamics
03:52 Exploring the Drug Pricing Database
10:07 Patient Advocacy and Drug Pricing
13:56 Market Intelligence in Drug Pricing
How NADAC, WAC, and ASP Shape Drug CostsDaily Remedy
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Policy Shift in Peptide Regulation

Clinical Reads

FDA Evaluation of Certain Bulk Drug Substances in Compounding: Clinical Interpretation

FDA Evaluation of Certain Bulk Drug Substances in Compounding: Clinical Interpretation

by Daily Remedy
April 19, 2026
0

Clinicians increasingly encounter patients using or requesting peptide-based therapies sourced through compounding pharmacies. The U.S. Food and Drug Administration has identified a subset of bulk drug substances, including certain peptides, that may present significant safety risks when used in compounded formulations. The clinical question is whether these regulatory signals reflect meaningful patient-level risk and how they should influence prescribing behavior. This matters because compounded peptides often sit outside traditional approval pathways, creating uncertainty around quality, dosing consistency, and safety. Understanding...

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