Category Archives: Biotechnology

Insurers hesitant to cover many proton beam treatments

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Comparison_of_dose_distributions_between_IMPT_(right)_and_IMRT_(left)By Michelle Andrews
KHN

Everyone seems to agree that proton beam therapy–a type of radiation that can attack cancerous tumors while generally sparing the surrounding tissue–is an exciting technology with a lot of potential.

But some insurers and disease experts say that, until there’s better evidence that proton therapy is more effective at treating various cancers than traditional types of less expensive radiation, coverage shouldn’t be routine.

That approach doesn’t sit well with proponents, some of whom say that insurance coverage is critical for necessary research of the controversial therapy’s uses.

Critics assert that the rush to build the centers is putting a very large cart before the horse.

Meanwhile, the number of proton therapy centers — huge structures that can cost more than $200 million — continues to increase.

Fourteen are in operation in the United States and a dozen more under development, according to Leonard Arzt, executive director of the National Association for Proton Therapy.

Critics assert that the rush to build the centers is putting a very large cart before the horse. Continue reading

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Quantifying the ‘Angelina Jolie effect’

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Actress’ impact on genetic testing for breast, ovarian cancer is ‘global and long lasting’

Angelina Jolie - Photo courtesy of the UK Foreign and Commonwealth Office

Angelina Jolie – Photo courtesy of the UK Foreign and Commonwealth Office

By Mary Engel / Fred Hutch News Service

Sept. 18, 2014

The so-called Angelina Jolie effect not only is real but has been “global and long lasting,” leading to a twofold increase in the number of women getting genetic testing to help determine their risk for hereditary breast cancer, according to new studies from the United Kingdom and Canada.

The number of women found to have a genetic mutation that increased their risk also has doubled.

And contrary to concerns that women at low risk for hereditary breast cancer would flood testing centers, researchers said that those being tested are women like Jolie who have a family history of breast cancer or who have personal risk factors such as ethnicity.

Certain ethnic groups, including Ashkenazi Jews, have a higher prevalence of BCRA mutations, which significantly increase breast cancer risk.

Women got the correct message

“What surprised us was that we didn’t get the worried well,” said Dr. Andrea Eisen, head of preventive oncology for breast cancer care at the Sunnybrook Odette Cancer Centre in Toronto and an author of the Canadian study, in a phone interview.  “We got women who got the correct message. That was gratifying.”

Jolie disclosed in a May 2013 op-ed in The New York Times that she had undergone a preventive double mastectomy after finding that she carries the rare BRCA1 gene mutation, which dramatically raises her risk of breast and ovarian cancers. Continue reading

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County receives $6m grant to improve hepatitis C care

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Hepatitis C by the numbersKing County has received a four-year, $6 million grant to improve testing, treatment and cure rates of people with chronic HCV infection.

Hepatitis C virus (HCV) affects large numbers of people in King County, but it often goes unnoticed until it’s too late.

“Thousands of people in King County have chronic HCV, but many don’t know they have it,” said Dr. Jeff Duchin, Chief of Communicable Disease & Epidemiology at Public Health – Seattle & King County. “This grant will allow us to make sure that patients with chronic HCV are not just identified, but also seen by a provider, receive follow-up testing, and get the care they need.”

The grant will fund the Hepatitis C Test & Cure Project, which will provide training for clinicians on the diagnosis, evaluation, and treatment of HCV and connect them to specialists. Continue reading

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Infertility patients finding creative financing help

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IVF egg thumbBy Michelle Andrews
KHN

Infertility treatment is a numbers game in some respects: How many treatments will it take to conceive a child? And how much can you afford?

Even as insurance plans are modestly improving their coverage of such treatments, clinics and others are coming up with creative ways to cover the costs to help would-be parents reduce their risk  for procedures that can run tens of thousands of dollars.

Some even offer a money-back guarantee if patients don’t conceive. Continue reading

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NIH to test Ebola vaccine in humans

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From the US National Institutes of Health

Trial will evaluate vaccine’s safety

Initial human testing of an investigational vaccine to prevent Ebola virus disease will begin next week by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

ebola

The early-stage trial will begin initial human testing of a vaccine co-developed by NIAID and GlaxoSmithKline (GSK) and will evaluate the experimental vaccine’s safety and ability to generate an immune system response in healthy adults.

The pace of human safety testing for experimental Ebola vaccines has been expedited in response to the ongoing Ebola virus outbreak in West Africa.

Testing will take place at the NIH Clinical Center in Bethesda, Maryland.

The study is the first of several Phase 1 clinical trials that will examine the investigational NIAID/GSK Ebola vaccine and an experimental Ebola vaccine developed by the Public Health Agency of Canada and licensed to NewLink Genetics Corp.

The others are to launch in the fall. These trials are conducted in healthy adults who are not infected with Ebola virus to determine if the vaccine is safe and induces an adequate immune response. Continue reading

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Are your medical records vulnerable to theft?

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This KHN story also ran in .

A decade ago almost all doctors kept paper charts on every patient. That is changing quickly as laptops become as common as stethoscopes in exam rooms. Recent hacking attacks have raised questions about how safe that data may be.

Here are some frequently asked questions about this evolution underway in American medicine and the government programs sparking the change.

Are my medical records stored electronically? Continue reading

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Variation in hospital charges for blood tests called ‘irrational’

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RedBloodCellsBy Roni Caryn Rabin
KHN

One California hospital charged $10 for a blood cholesterol test, while another hospital that ran the same test charged $10,169 — over 1,000 times more.

For another common blood test called a basic metabolic panel, the average hospital charge was $371, but prices ranged from a low of $35 to a high of $7,303, more than 200 times more.

The wide disparity in hospitals’ listed charges for routine blood tests at California hospitals was revealed in a study published in the August issue of BMJ Open. The study examined the listed charges for routine blood tests performed in 2011. Continue reading

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Cut the Crapshoot | RAND

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From the RAND Corporation:

U.S. policymakers need to counteract the perverse financial incentives that induce inventors and investors to bet big on new medical technologies that offer the highest payouts without substantially improving health.

Dice pair

Costly new technology is a primary driver of health care spending. This should come as no surprise, because all players in the dicey U.S. market for new medical technologies — inventors, investors, payers, providers, and patients — face long odds if they want to put money on products that could curb health spending while also boosting health.

The rules of the game need to change.

via Cut the Crapshoot | RAND.

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If you have a stroke, better it should be in Paris

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Frank Browning (Photo by Christophe Sevault)

Frank Browning. (Photo by Christophe Sevault)

Frank Browning writes from Paris
KHN

I had a stroke last month, oh boy.

It’s just that I didn’t know it. Here’s what happened:

Only after three days of flashing, floating visual squiggles — commonly known as ocular migraines that usually last 20 minutes — do I email my old friend Dr. John Krakauer, who helps run stroke recovery at Johns Hopkins Hospital in Baltimore.

After a few questions he told me to get an MRI scan as soon as possible.

In the U.S. that could involve the emergency room (with its hours-long wait) or a complicated process of getting the referral — and then finding a radiologist who would take my coverage.

Here in France, it is so much simpler. Continue reading

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Cord Blood: What You Need to Know – FDA

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Consumer Update from the US Food and Drug Administration

RedBloodCellsCord blood is found in the blood vessels of the placenta and the umbilical cord, cord blood is collected after a baby is born and after the umbilical cord is cut—an important point.

“Because cord blood is typically collected after the baby is delivered and the cord is cut, the procedure is generally safe for the mother and baby,” explains Keith Wonnacott, Ph.D., Chief of the Cellular Therapies Branch in FDA’s Office of Cellular, Tissue, and Gene Therapies. Continue reading

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‘Telepsychiatry’ helps bring mental health care to rural areas

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telepsych

Ed Spencer, director of South Carolina’s telepsychiatry program, (seated) and Ralph Strickland, program coordinator, (on screen) conduct a simulation of a typical emergency room telepsychiatry consultation at their offices in Columbia.

By Christine Vestal
Stateline

When emergency room patients are deemed “a danger to themselves or others,” every state requires hospitals to hold them until a psychiatrist conducts a face-to-face evaluation to decide whether it is safe to let them leave. In rural hospitals across the country, it can take days for a psychiatrist to show up and perform the exam.

Five years ago, rural hospitals in South Carolina illustrated the problem. On a typical morning, more than 60 people were waiting in the state’s emergency rooms for psychiatric exams so they could either be discharged or admitted for treatment.

Today the scene is quite different, thanks to a “telepsychiatry” program that allows psychiatrists to examine South Carolina patients through videoconferencing, reducing the average wait time from four days to less than 10 hours.

In 2010, North Carolina began rolling out a similar program, and a dozen other states, including Alabama, Kentucky and Wisconsin, plan to follow suit. Continue reading

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Bionic pancreas outperforms insulin pump in adults, youth – NIH

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Diabetes pump

From right, researcher Dr. Steven Russell of Massachusetts General Hospital stands with Frank Spesia and Colby Clarizia, two participants in a type 1 diabetes trial testing an electronic device called a bionic pancreas – the cellphone-sized device shown – which replaces their traditional fingerstick tests and manual insulin pumps. Photo courtesy of Adam Brown,

From the National Institutes of Health

People with type 1 diabetes who used a bionic pancreas instead of manually monitoring glucose using fingerstick tests and delivering insulin using a pump were more likely to have blood glucose levels consistently within the normal range, with fewer dangerous lows or highs.

The report was published online by the New England Journal of Medicine

TThe researchers — at Boston University and Massachusetts General Hospital — say the process of blood glucose control could improve dramatically with the bionic pancreas. Currently, people with type 1 diabetes walk an endless tightrope.

Because their pancreas doesn’t make the hormone insulin, their blood glucose levels can veer dangerously high and low.

Several times a day they must use fingerstick tests to monitor their blood glucose levels and manually take insulin by injection or from a pump.

In two scenarios, the researchers tested a bihormonal bionic pancreas, which uses a removable tiny sensor located in a thin needle inserted under the skin that automatically monitors real time glucose levels in tissue fluid and provides insulin and its counteracting hormone, glucagon, via two automatic pumps. Continue reading

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When doctors need advice, it might not come from a human

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Computer Circuit Board

This story was produced in collaboration with 

Long Island dermatologist Kavita Mariwalla knows well how to treat acne, burns and rashes. But when a patient came in with a potentially disfiguring case of bullous pemphigoid—a rare skin condition that causes large, watery blisters—she was stumped.

The medication doctors usually prescribe for the autoimmune disorder wasn’t available. So she logged in to Modernizing Medicine, a Web-based repository of medical information and insights, for help.

Within seconds, she had the name of another drug that had worked in comparable cases.

“It gives you access to data, and data is king,” she said of Modernizing Medicine. “It’s been very helpful especially in clinically challenging situations.” Continue reading

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There’s a life-saving hepatitis C drug. But you may not be able to afford it.

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Sovaldi logoBy Julie Appleby
KHN Staff Writer

MAR 03, 2014

This KHN story was produced in collaboration with 

There’s a new drug regimen being touted as a potential cure for a dangerous liver virus that causes hepatitis C.  But it costs $84,000 — or $1,000 a pill.

And that price tag is prompting outrage from some consumers and a scramble by insurers to figure out which patients should get the drug —and who pays for it.

Called Sovaldi, the drug is made by California-based Gilead Sciences Inc. and is the latest in handful of new treatments for hepatitis C, a chronic infection that afflicts at least 3 million Americans and is a leading cause of liver failure. It was approved by the U.S. Food & Drug Administration in December. Continue reading

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