Medicare Pays Too Much for New Generics

According to this article on The Wall Street Journal Blog when the price of generic drugs plunges, Medicare is slow to reflect that price change.

A report published by the Health and Human Services’ inspector general looks at irinotecan, which is a cancer that went generic in February of this year. The average price of the drug factoring in sales of the branded version was $52. During the current quarter, Medicare was paying about $75 for irinotecan, which is still far above the average price.

Read the full report here.

We're getting ready to launch a new blog that looks at the broader issues of Medicare, update your RSS feed now as we get it ready for our official launch: http://medicareadvantagecongress.blogspot.com.

Numbers of uninsured dropped

In a recent report released by the census bureau, they state that the number of uninsured has decreased 3.2% to 45.7 million, which is 15.3% of the population. According to this article here at Modern Healthcare, authorities state that the reasons why uninsured numbers have decreased is still unknown. The number of uninsured children has dropped as well to 8.1 million, down from 8.7 million in 2007 which is a 6.9% drop.

Oversight in Medicare Drug Fraud

As reported in this Wall Street Journal article, the Government Accountability Office released a report stating that some insurers do not have “in place all the fraud controls they’re supposed to.” This means that some of them have not “met the requirements for employee training and internal monitoring and auditing. The GAO also stated that this oversight “risks significant misuse of funds in this $39 billion program.” Acting administrator for Medicare, Kerry Weems, has stated that he disagrees, however, has admitted the funding cap for the Medicare Integrity Program has, “seriously degraded [Medicare’s] ability to meet its responsibilities in combating fraud abuse.”A copy of the full report can be found here.

New Drug to Help Blood Clotting is Approved

The NY Times reports regulators have approved Amgen’s new drug called Nplate, which treats a rare blood clotting disorder that affects about 140,000 people. The disorder causes the body to attack platelets, which are tiny components that help with blood clotting. The drug will encourage platelet production by stimulating patient’s bone marrow.

There are some risks to taking the drug so regulators will require all patients to enroll in a long-term safety study. Some patients who have enrolled in the study have developed leukemia due to bone-marrow abnormalities. More studies will need to be done though to determine whether the development of leukemia may relate to the use of Nplate.

Measles outbreaks are at alarming levels

According to a news report at ABC, measles infections are at their highest level in a decade. So far there have been 131 cases this year in the United States as opposed to 42 cases throughout the entire last year. Over half of those infected are children who did not receive the vaccine. Also alarming is the number of outbreaks, in a normal year there is one in the United States. This year, as of July 30, there have been seven outbreaks. The reason for the rising number of children not receiving the shots is because of the fear that the immunization leads to autism in some children.

Miracle Baby

According to this Reuters report, a baby that was pronounced stillborn in an Israeli hospital, “came back to life” after spending about 5 hours in a refrigerated storage unit at the hospital. The mother had, had to have an emergency abortion because of internal bleeding. Upon birth, at 23 weeks, the baby weighed 600 grams which is approximately 1.32 pounds. Hospital deputy director Moshe Daniel had this to say:

"We don't know how to explain this, so when we don't know how to explain things in the medical world we call it a miracle, and this is probably what happened”

One explanation that was supplied, by Motti Ravid a professor of internal medicine, was that the lower temperatures slowed down the metabolism of the baby, which might have helped her to survive. Currently the baby is a neonatal intensive care unit. The doctors are still unsure of her prognosis, and do not know if she will be able to survive.

Fruit Juice Can Reduce Effectiveness of Drugs

BBC News reports findings discussed in a recent US event suggest that fruit juice could reduce the effectiveness of some medicines, including anti-allergy drugs. Grapefruit, orange, and apple juice are said to contain ingredients that interfere with the effectiveness of medication.

Researchers discovered that grapefruit juice especially had a reverse effect to fexofenadine, which is an antihistamine drug, thereby making it less potent. Researchers used volunteers to take the medication with water and with the juice. When taken with the juice, only half of the drug was absorbed. So far, these juices have been found to affect the oral absorption of etoposide, a chemotherapy drug, some beta-blocker drugs used to treat high blood pressure, and cyclosporine, taken by transplant patients to prevent rejection of their new organs. The study author Dr David Bailey mentions:

"This is just the tip of the iceberg - I'm sure we'll find more and more drugs that are affected this way."

Road rage in the operation room

In a recent article at the Boston Globe, they report on a serious matter when it comes to doctors in operation rooms. In some hospitals, there are frequent outbursts from doctors that include fits of swearing, yelling and throwing objects in the emergency room. The Globe paralleled this behavior to road rage. According to a study done at Vanderbilt, 4 to 6% of doctors have frequent outbursts in the operation room. The study found that the more outbursts doctors have, the more likely the hospital is to be sued due to the fact that bad behavior in the surgery room is often connected to medical errors.

So some hospitals are stepping up and solving the problem. The Joint Commission is mandating that all hospitals and nursing homes adopt a zero tolerance policy by January 1 that will include rules and processes on: including codes of conduct, ways to encourage staff to report bad behavior, and a process for helping and, if necessary, disciplining offenders.

Turning Blue

I came across this article in ABC health news about a little known medical syndrome called argyria, also known as silver poisoning. This syndrome results in skin discolorations caused by silver that entered through the blood stream, and deposits on the skin as brown particles. The result however, is that skin looks gray/blue. Many who have been diagnosed with this system had been ingesting colloidal silver as a remedy for various elements. Many mainstream doctors have argued about the effectiveness of silver as a treatment, however, as the article points out, Paul Karason, a person affected by argyria is a proponent. He maintains that it has helped with various problems. As he states

"The acid reflux problem I'd been having just went away completely. I had arthritis in my shoulders so bad I couldn't pull a T-shirt off. And the next thing I knew, it was just gone."

Floridashealth.com posted this image of a man suffering from this syndrome and cautions individuals to consult with physicians before ingesting any silver.

Exercise is Key for Cancer Patients

This article in the NY Times discusses how fitness can be beneficial to hasten the recovery of cancer patients as well as fighting the effects of cancer such as the fatigue from chemotherapy, the loss of muscle tone, and the swelling of lymphedema.

Programs are opening up everywhere including the a new partnership between the Y.M.C.A. and the Lance Armstrong Foundation which will offer cancer fitness classes at more than 12 Y’s in 10 states. Cancer survivors are organizing their own classes at Curves International has created new routines for overweight-breast-cancer patients.

Data and research conducted by the National Cancer Institute within the past decade show that cancer patients who exercise regularly have less fatigue, better aerobic capacity, and greater strength than those who do not exercise. There are times though when patients will not be able to perform such strenuous activities, and all exercise plans should be discussed with their oncologists.

Debate raging over infant organ donation

An approach to infant organ donation is causing debate. Some doctors are removing infants organs before they are considered brain dead. Instead, doctors are removing the organs after the babies are declared dead cardiocirculatory (after the heart stops). This article at ABC News explores both sides of organ harvests, whether the infants give up their organs before or after they are brain dead.

Doctors believe that there is a greater chance at saving more babies if their organs are harvested after their heart stops and the parents choose not to resuscitate the child. This situation could lead to a dramatic increase in the number of infants that become organ donors, which in turn saves more lives. Doctors for this method see two problems solved by obtaining the organs after the baby’s heart has stopped: fewer infants die while they are waiting on transplants, and there will be more parents who will have the opportunity to donate their children’s organs.

There is a fear that doctors will look over the dying children, and instead focus on the ones they can save. However, each child’s life is precious, and many doctors will focus on saving their patients. What do you believe is the best approach for infant organ donation?

Marry For Health Reasons? Maybe Not Necessary

One common conception that scientists in the past have validated is that for your health, it is better to be married. A new study as reported in BusinessWeek, however, is suggesting otherwise.

Hui Liu, study’s lead author from Michigan State University stated

"One of the most-often documented facts is that married people are healthier than non-married people, but the difference between married and unmarried people has changed over the past few decades."

As the article further reports:

- the self-reported health status of never-married adults increased significantly over time

- self-reported health status of married women also increased

- the gap between married and never-married women's health stayed about the same

- never-married men narrowed the health gap between themselves and married men

Some of the speculated reasons for the results of the study include that with the mores in society changing, it is no longer imperative to have a spouse for social status and acceptance. In addition, currently there are more support systems in place for those who are unmarried that may help them to not experience the negative side effects that in the past have been associated with being single.

Living Near Highways Can Increase Risk of Low-Birth Weight

The NY Times reports that a recent Canadian study shows that mothers who live near highways are more likely to give birth to low-weight and preterm babies. The study, which was published in Journal of Epidemiology and Community Health, looked at medical records of nearly 100,000 births in Montreal from 1997 to 2001. Researchers measured distances to the nearest highways and determined socioeconomic and education levels from census data.

Researchers found that compared to wealthy neighborhoods, mothers who lived within 220 yards of a highway were linked to a 58 percent chance of preterm birth, and a 81 percent chance of increased risk of low-birth weight.

Dr. Mélissa Généreux, a resident physician at the University of Montreal mentions:

“Low-income mothers are exposed to more risk factors — smoking, poor nutrition, poor access to prenatal care, domestic violence. More advantaged mothers are protected from these risk factors, so they might be more affected by the addition of a single new risk factor, pollution from highways.”

FDA Drug Approvals low in 2008

At the end of June, only nine drugs had been approved by the FDA. According to this article at CNN Money, this slow pace could result in the lowest drug approval year since 2003. Some of this has to do with the FDA’s harsher rules that have the safety of the public in mind. The FDA cites faltering research as a reason for fewer approvals. However there have been 18 molecular entities approved that have not yet been used in an FDA approved drug.

Prescription drugs increasing in price

According to this article at the USA Today, drug companies are quietly but dramatically increasing the price of certain prescription drugs. Hikes have been seen anywhere from 100% to 1000% over the past year on a small number of prescription drugs. The number of drugs that have increased in price by 100% has nearly doubled this year. The majority of drugs affected by the price increase are typically older drugs that treat rare conditions. An example of this is Acthar, which treats spasms in babies. One bottle used to cost $1,650, but how has risen to the cost of $23,000 per bottle. Consumers are indirectly affected by the dramatic increase. Hospitals, the majority using these drugs to treat patients, pass of the cost to the insurers, which in turn increase insurance premiums for their customers.

Alzheimer’s Breakthrough

TauRX recently announced data on their drug remberTM has shown that in 81% of users, there is been a slow down in the cognitive decline in patients with Alzheimer’s. As Fierce Biotech reported this disease has been especially difficult for researchers to find a cure. Professor Claude Wischik offers some hope saying that

"This is an unprecedented result in the treatment of Alzheimer's disease. We have demonstrated for the first time that it may be possible to arrest progression of the disease by targeting the tangles which are highly correlated with the disease."

This news comes on the heels of the announcement from Myriad Genetics who announced that they are abandoning their over $60 million effort on Flurizan which had failed in late stage trials.

Broccoli Reduces Heart Damage Caused by Diabetes

BBC News reports that a study conducted by the University of Warwick suggests that a compound found in broccoli called sulforaphane encourages production of enzymes which protect the blood vessel. People with diabetes are five times as likely to develop cardiovascular diseases such as strokes and heart attacks, and both of these are directly linked to damaged blood vessels.

The team at Warwick tested the effects of sulforaphane on damaged blood vessels and they recorded a 73% reduction Reactive Oxygen Series (SOS), which can damage human cells. Researchers also noted that sulforaphane activated a protein called nfr2, which protects cells and tissue from damages.

New Study: Men over 75 shouldn’t be tested for Prostate Cancer

According to a recent study by the US Preventative Task Force, detailed here at the WSJ Health Blog, says it’s not healthy for men over the age of 75 to be tested for prostate cancer. Unless the man is showing signs that he is suffering from the disease, it’s not necessary to test for the disease due to the risks and stress that the test can cause. It’s far more likely at that point that the men will die of a non-prostate cancer related cause.

Getting Healthy While at Work

Dr. Jim Levine had conducted a study two years ago where the results shocked him. He found that 90% of overweight individuals were sitting 2.5 hours longer per day than individuals who were not considered obese. ABC Health reports that after seeing these results

“It was so staggering that Levine hasn't stopped walking since and even does his work while walking at a low speed on a treadmill.”

The concept behind this, is to introduce low intensity activity into an individuals everyday activities in order to help combat activity. In Levine’s own words

"I spend my entire work day at one mile an hour," he said. "I work at my computer at one mile an hour. I have my meetings at one mile an hour."

This past September he started on a 6 month study to determine if a “treadmill desks at work” would help with obesity. He used the SALO office as his lab, and the office staff who were interested as his subjects. His results show that “low-level activity is crucial to fighting chronic obesity.” Over the course of the 6 months, the staff lost a combined total of over 200 pounds. Levine says that individuals who have the highest success rate are those

“making a commitment to a lot of small adjustments. It's almost a matter of saying, I'm going to change my chair-based life to a dynamic and sort of more exciting life."

The “Exercise” Pill

According to this article in the NY Times researchers at the Salk Institute in San Diego reported that they have engineered two pills that trick the muscles into thinking that they have been working out furiously. For now, testing has been only done on lab mice. These drugs have shown up to 75% increase in endurance in mice, and the results will likely apply to people as well since muscle tone from human and mice are similar.

Dr. Ronald M. Evans, leader of the Salk group, mentions:

“It’s a little bit like a free lunch without the calories.”

The pills should be able to help people who are too frail to exercise, and those who suffer from diabetes and obesity. Diet and exercise are crucial to the treatment of diabetic patients, so there is a possibility that this drug could become widely used if it passes FDA guidelines. More testing and research is still needed in order to finalize the drug before it reaches consumers.