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According to the nominator, the manufacturing process is labor-intensive, requiring 520 staff hours to manually extract venom from 130,000 insects per batch, along with substantial equipment investment

Nat Rev Neurosci 12(12):723738

Response: We decline to adopt commenters' suggestions to forgo finalization of our proposal to exclude ACOs that fall below 5,000 assigned beneficiaries in any benchmark year from being eligible to benefit from the policies at 425.605(h) that provide certain low revenue ACOs participating in the BASIC track with additional opportunities to share in savings

Mercury and Amalgam Fillings Concern has been raised about the possibility of alpha-lipoic acid increasing exposure to mercury from amalgam dental fillings