Maybe the cost of Zingo compared to the lidocaine creams currently being used. I've been a nurse for too many years to admit and have stuck countless patients with needles of all gages. The cream used most commonly at my hospital is EMLA. It's a lidocaine/procaine local anesthetic. Our pharmacy cost is about 8 bucks. If Zingo comes out at close to double that, then there will be a problem. Being a nurse I would vote to use it simply because of the time saving property it has. It's a real pain in the butt to plaster some cream on the site,cover it with a patch and wait 20-30 min. Also I would scream loud and clear that saving all that time is money. But, I've been on some pharmacy and therapeutic meetings discussing yes or no on what goes in the formulary and believe me the cost of the product speaks for its self. Every director in every department is looking at the here and now and how they can cut costs. The sales team will have it's work cut out for them. At this time I don't think Anesiva will make much off Zingo for some time. I agree with a recent post that Adlea will be the product to watch. It will be a godsend to post op ortho patients and to the nurses caring for them. I think of the big hit the opiate market will take. Will be nice. Just my simple take on this issue. Have a great day.