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    First looking at weather patterns, it appears that if there is nuclear fallout, where could you want to be? Remember weather patterns start in the West or North West and move across the country and change throughout the year, but always for the most part blow from East to West. So if you live East of the West Coast you could be in trouble if a Western city gets nuked. Then there are the East Winds in CA, which are called the Sant
    According to USFDA, a combination product is one composed of any combination of a drug and device; biological product and device; drug and biological product
    a Ana Winds which are hot, fast moving and dry, the worst possible conditions for fires. As we see every few years in the Southern CA mountains.

    So then perhaps you might wish to live on the West Coast, fairly good weather all year and the wind blows the other way. But you would want to live far from any major city on the West Coast. Not in LA, Not near the Nuclear Power plants, Not near the Military bases of Pt Mugu, Camp Pendl
    ; or drug, device, and biological product and fixed dose combination would include two or more combinations of drug.

    Examples of combination products may in
    ton or Vandenburg AFB. So where? Probably on the coast between Humbolt, CA and mid state OR. But alas there are huge faults along the West Coast and the OR Coastline is riddled with issues from liquefaction to offshore Tsunami generating Earthquake faults.

    San Francisco gets huge Earthquakes as we know and LA is not immune either and neither is the central valley of CA with it’s issues after proof in the Coalinga Fault. Living b
    lude drug-coated devices, drugs packaged with delivery devices in medical kits, and drugs and devices packaged separately but intended to be used together.

    etween the Russian River and OR Coastline near the coast would be okay even with these issues. Also you would not be down wind from any fallout and you are not a target. Safe in that you have fish for food and lumber for heat and no need for much of anything like power, surrounded by capable woods people.

    You would have lots of rain and no water that would be polluted running off from areas of fallout. Of course from an attack b
    here is enormous increase in the number of combination products entering the market in the recent years. Combination products have proven advantages but fixe
    sea from the Pacific side in the case of invasion, you would not be in the best spot, we are not expecting any wars, yet 20 years from now will China be our biggest trading partner or will 2 billion of them like this piece of real estate? If we were attacked for some reason you would have air support from all the Navy and Air guard Bases along the Pacific Coast. Where are other good spots? If Seattle was not hit by a weapon of m
    d dose combinations are still in the process of convincing regulatory authority on their advantages over the single ingredient formulations.

    Combination pro
    ass destruction then you still have Earthquakes and remember MT. Saint Helen. There are some cities inland on the I-5 freeway surrounded by mountains, but they are close to volcanoes too?

    Where else would be good? Well not Phoenix, not Las Vegas and Reno is over the hill from CA and gets all it’s left over weather. Boise has issues too. Although there are other cities in ID worthy of mention. Salt Lake is on a huge Earthquake fa
    ucts have become life saving products for the pharmaceutical companies who doesn’t have many innovative molecules in their product pipeline and have been inc
    lt. How about Helena MT, drought plagued and fire issues. Kellogg ID, superfund area. Billings out of water, Bozeman? Well too close to the State Park and there are issues with the volcanoes there too. Butte, MT also too close. Casper WY out of water and down wind in case of Volcanic Activity from Yellow Stone. Also think if Portland, SF or LA are not hit with nukes then we like, Four Corners, Elko NV, Battle MT (armpit) are doab
    easingly used in the product life cycle management. Even the companies having product patents are trying to extend their product life cycle through the combi
    le with large underground water supply but it has arsenic in it. Winnamucka NV many not be safe either, but has thermal activity for power. ND and SD seem safe too, but winter weather is tough. Ogalla underground aquifer is being drained fast and could cause Earthquake from collapse. Western NE, not good, Denver either in case of water supply issues in future or fallout from volcano in Yellow Stone. How about in the Northern Sect
    nation products and maximize the revenues. But the companies involved in this practice are overlooking that they are burdening the patients both economically
    on of AZ? Flagstaff has harsh weather, fire season. Winslow AZ is okay, with rail and FWY, but isolated. Of course these are only a few western states really and well we have identified several great locations with everything you need to survive.

    Having studied the FEMA reports and the regional issues of each area and state and the disaster plans, we are well served by such data, but it falls short and a comprehensive plan of at
    and physically. They need to rightly judge the benefits of the combination products and they have to even look at the risks involved when combining the produ
    tack needs to be considered, because many people living in a region will need supplies, such as we see after major Hurricanes. Which by the way leaves us to wonder if there are in fact any safe cities on the entire Eastern Seaboard, Gulf Coast or West FL coastlines. As we saw in the black out of 2003, the Hurricanes and loss of power, the many fires in drought areas of CA, AZ, NV, MT, ID, OR, NM these are all big issues.

    When mu
    ts. Some of the combination products were well accepted by physicians while others suffered. Companies involved in development of combination products are fi
    tiple disasters hit, and transportation is down, power is out, water turned off, dams broken, bridges out, etc. Then what? Well, for some it will be their demise, others have adequately planned. Some of the safest cities are sitting near large underground water supplies and generate their own power or have co-generation plants, which are co-ops near by. Those mid western cities near large rivers are not safe due to the issues wit
    ding difficulty in defining their combination products and facing various challenges from selecting a combination to marketing it.

    Following aspects would a
    flooding, as we have seen and continue to see every three to five years some town gets it. The water is fresh and clean in those areas and very soft, but when it floods, it is a disaster and very dangerous too.

    Some would say it is probably unnecessary to have a major disaster plan, however it is a good exercise anyway, in planning. Things of importance are fresh water supply uncontaminated, food supply, encapsulated market, no
    dd to the challenges in developing combination products:

    Which markets to tap where the combination products can do fairly well?
    Which combination prod
    t over populated, no problems with contaminated air from normal weather patterns know and comparable to the last 200 years, out side of a fire zone and a defendable location. Also of secondary importance out side the risk of major seismic activity, travel from major highways causing and influx of others trying to get away thus bringing in diseases or viruses or using up local natural resources. Worst places to be D.C., state capi
    cts are meaningful and rational?
    Which therapeutic categories to select?
    Which Combinations can address unmet needs of the patients?
    Do combin
    al cities with lots of military bases close by, cities on major freeways with bridges and no other ways around for over 40 miles or passes on mountain ranges.

    The cities which do not make the safest cities are Denver, Dallas, Mobile, Biloxi, Seattle, Chicago, NYC, Orlando, Tampa, Las Vegas, Salt Lake, LA, etc. Cities with no way to get out the population quickly are of problem, for instance DC with it’s daily grid lock or Los An
    tions increase the patient compliance?
    What would be the developing cost?
    How to tackle the risks encountered during combination product developmen
    geles, Atlanta, SF, etc. Cities, which rely on outside sources to get in important stuff are bad. Not to mention you are more likely to die from an auto wreck, although on the plus side they have the cleanest and best filtrated water supplies. That of course a trade off from the polluted air around you which could also kill you before your average life expectancy figure.

    Port cities and cities with big major airports, which are
    t?

    As combination products don't fit into the traditional categories of drugs, medical devices, or biological products, the USFDA is in the process of devel
    ubs for major airlines are bad too. Cities that are big but do not have fed banks are one click down on the list too. Think of the logistics by train too. Cities which are down river close to major railroad bridges, which handle lots of interstate trains are bad too. Port cities get an extra bad deal. Cities which are close to port cities which are over 2 million population are dangerous too. Large cities near borders of Mexico a
    ping new procedures for reviewing their safety, efficacy and quality.

    Professional from academic institutions, pharmaceutical industries, health care indust
    re dangerous if they have over 2 million populations.

    San Diego County, San Antonio, Phoenix, Austin TX, Houston, even throw in Tucson, El Paso, Yuma all bad. Already at a fresh water problem time due to droughts and over populations. Santa Monica is bad and LAX is a bad area to be near. A problem at the sewer treatment plant near LAX could be devastating with chlorine gas and weather patterns, with a weapon of mass destruction.
    y and representatives from various regulatory agencies are working out to design the regulatory requirements for manufacture and sale of combination products
    Worrisome also to our scenario of possibilities is the major computer brain areas. Like Silicon Valley, Seattle, VA and other Internet hubs, which would also include Boston.

    I would like to see a comprehensive plan to save American lives if an attack or Mother Nature event occurs, one which encompasses the entire country. Perhaps this is a good job for our war planners at the Pentagon, to try a reverse order plan, it would help
    .

    As there is an increasing trend of the combination products companies manufacturing such products should be able to tackle the problems involved in the de
    them learn where best to minimize vulnerabilities and an action plan against International Terrorists or Catastrophic Mother Nature Events.

    I have been to every city in the United States over 10,000 population. Where have you lived? Have you lived thru a natural disaster? Many of us have. The Hurricanes alone last year alone added 40 more million people to that list, it was a costly year for FEMA, but we made it through and show
    elopment. They need to be wiser in analyzing the market trends and the regulatory requirements.

    Companies that provide selfless information through particip
    d resilience. So where are you safe? The answer might be nowhere or everywhere and preparation and quality of first reponders may hold that key. What were your concerns, and immediate needs during that period in your life when you faced such uncertainty? What would you tell others who plan to protect the property and lives of America, too the first responders, planners and those entrusted to protect humanity in the times of need


    tion in industry events and feedback to regulatory authorities would be able to face the challenges and will be successful in developing combination products

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