u/5u114

Just wondering what people's experiences are on the biosimilars for Stelara / Ustekinumab ... specifically Wezlana or Pyzchiva.

I often see people have a bad time moving from the original biologic to the biosimilar. Sometimes I wonder if it's the switching over itself, rather then the biosimilar specifically, which causes the poor performance.

Like I wonder if you started on the biosimilar would you have a better experience than starting on the original and then switching. I wonder this because I have also seen some people report that they were fine on the original, moved to a biosimilar and had a bad time - but stuck it out and after several months ended up back in the same good place they were at with the original.

Anyway, I digress, I'm just curious who is using these biosimilars and what your experience has been - as I am likely to start on Wezlana or Pyzchiva in a couple months or so. I am not currently on Stelara. I started my first biologic, Entyvio, recently. Two infusions but had a bad reaction to it so I will be switching biologic.

Just wondering what people's experiences are on the biosimilars for Stelara / Ustekinumab ... specifically Wezlana or Pyzchiva.

I often see people have a bad time moving from the original biologic to the biosimilar. Sometimes I wonder if it's the switching over itself, rather then the biosimilar specifically, which causes the poor performance.

Like I wonder if you started on the biosimilar would you have a better experience than starting on the original and then switching. I wonder this because I have also seen some people report that they were fine on the original, moved to a biosimilar and had a bad time - but stuck it out and after several months ended up back in the same good place they were at with the original.

Anyway, I digress, I'm just curious who is using these biosimilars and what your experience has been - as I am likely to start on Wezlana or Pyzchiva in a couple months or so. I am not currently on Stelara. I started my first biologic, Entyvio, recently. Two infusions but had a bad reaction to it so I will be switching biologic.

The main argument I have heard against Valve subsidising the Steam Machine, and I think (if memory isn't playing tricks on me) Valve staff may have even made this argument directly around the launch announcement media appearances, is that because the Steam Machine is essentially a PC - they can't subsidise it because someone could buy it (or many of them) and never actually buy any Steam games. They could use it as a PC, or simply use it to play games bought elsewhere, or previously owned games. Etc.

OK.

However, it's not like Valve don't have an obvious way of getting around this.

All Valve would have to do, to counter this specific concern, is to subsidise the Steam Machine through an up-front expense on the consumer end which is leveraged/'refunded'/'rebated' against future discounts on Steam game purchases, which Valve would then use their revenue share to finance.

For example, let's say they *have to* sell the Steam Machine for $1,000 (just to pick a simple figure) ... but what would really be more palatable to their target consumer base is $800 (another simple figure, and also my personal limit for the 2tb SKU) - All Valve would have to do is offer $200 worth of Steam discounts, by simply discounting part or all of their revenue share (30% in most cases) per Steam game purchase. Until $200 has been 'refunded'/'rebated' to the consumer.

It wouldn't even matter if this stacked on sale prices, since it's going to amount to the same revenue expense on their end either way - but they could insist that the discount/'refund'/'rebate' would only apply to full price purchases - which would be a boost to the developer's selling games on their platform. But I digress.

Yes, this means Valve are subsidising the console. But it completely addresses the argument against subsidising which is based on the idea that someone could just buy the subsidised hardware and not buy any games. Anyone doing that would be paying full price for the hardware, and Valve wouldn't be subsidising them.

The idea could be tweaked here and there to make it even more certain that the people being subsidised are genuinely Steam gamers, or that Valve are still making money through the process of issuing the 'refund'/'rebate' (partial revenue share rather than the whole 30%)

So if Valve don't want to subsidise the Steam Machine, fair enough - but don't tell me it's because they can't be sure the buyer isn't just going to use it as a PC and not buy any games.

What am I missing here ?

No previous history of arthritis, inflammatory or psoriatic.

Waiting for rheumatology to investigate before proceeding with further Entyvio doses.

May not turn out to be psoriatic arthritis, but the symptoms are the same. Could be reactive arthritis, isolated enthesitis ... but for all intents & purposes, the symptoms are the same as psoriatic arthritis. In my knee.

Fuck this. I hate that I was worried about biologics, specifically adverse reactions and side effects, and it turns out I was right to be worried.