Category Archives: Drugs & Medicines

More states adopting law allowing terminal patients to try experimental treatments

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One dye showing 2By Michelle Andrews
KHN

Earlier this month, Arizona voters approved a referendum that allows terminally ill patients to receive experimental drugs and devices. It’s the fifth state to approve a “right-to-try” law this year.

Supporters say the laws give dying patients faster access to potentially life-saving therapies than the Food and Drug Administration’s existing “expanded-access” program, often referred to as “compassionate use.”

Supporters say the laws give dying patients faster access to potentially life-saving therapies. Critics charge such ‘right-to-try” acts are  feel-good laws that don’t address some of the real reasons patients may not receive experimental treatments.

But critics charge they’re feel-good laws that don’t address some of the real reasons patients may not receive experimental treatments.

The legislatures in Colorado, Louisiana, Michigan and Missouri also passed right-to-try laws this year as part of a nationwide effort spearheaded by the conservative Goldwater Institute, which hopes to get right-to-try laws on the books in all 50 states.

The measures generally permit a patient to get access to an experimental drug after it’s passed through phase 1 of a clinical trial, the initial testing in which a drug is given to a small group of people to evaluate its safety and side effects. Continue reading

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Naloxone kits for overdoses now available in Snohomish County

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Snohomish CountyNaloxone kits for treating opioid overdoses are now available at a number of pharmacies in Snohomish County.

These kits are available just by asking the pharmacists, there is no need to see a doctor to obtain a prescription.The cost of the kits is around $125.

Pharmacists will provide education to those being given a Naloxone kit on how to use it and when to use it.

In 2013 there were 86 opioid drug overdoses in Snohomish County, and 580 within Washington State.

The availability of naloxone (sold under the brand name Narcan) could potentially cut down on deaths due to heroin and prescription opioid drugs (morphine, oxycodone/OxyContin, methadone, hydrocodone/Vicodin, and codeine).  Continue reading

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Vaccination is the most effective flu prevention for seniors

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Flu shot todayBy Dr. Kory B. Fowler
Medical Director, Intermountain Region
Humana

The influenza virus– commonly known as the flu – affects up to 20 percent of Americans annually, leaving more than 200,000 people hospitalized from complications each year, according to the Centers for Disease Control and Prevention (CDC).

The flu is particularly dangerous for Washington seniors, who often have pre-existing chronic health conditions, such as diabetes or heart disease.

Last year the flu vaccine prevented 6.6 million illnesses, 3.2 million doctor visits and at least 79,000 hospitalizations.

There are many ways to reduce the risk of catching the virus, such as washing your hands often, but an annual flu shot is the most effective way to prevent the flu and reduce the risk of complications. Continue reading

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Hepatitis C patients may not qualify for pricey drugs unless illness is advanced

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Twenty-dollar bill in a pill bottleBy Michelle Andrews
KHN / October 28, 2014

In the past year, new hepatitis C drugs that promise higher cure rates and fewer side effects have given hope to millions who are living with the disease.

But many patients whose livers aren’t yet significantly damaged by the viral infection face a vexing reality: They’re not sick enough to qualify for the drugs that could prevent them from getting sicker.

An estimated 3 million people have hepatitis C. Faced with a cost per patient of roughly $95,000 or more for a 12-week course of treatment, many public and private insurers are restricting access to those who already have serious liver damage.

Many baby boomers who have hepatitis C contracted it years ago from blood transfusions at a time when blood was not screened for the virus.

Other strategies that limit access include restricting who can prescribe the drugs or requiring early proof the drug is working before continuing with treatment.

In addition, many state Medicaid programs require that patients be drug and alcohol free for a period of months before they can get the hepatitis C drugs. Continue reading

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Global Health News – October 24th

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Globe floating in air

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Get your flu shot now, state health officials say

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Flu virus - courtesy of NAIAD

Flu virus – courtesy of NAIAD

Flu can be serious and deadly; get vaccinated now before people are sick

 Flu season is upon us and although state health officials don’t know exactly when the flu will strike, how serious it will be or how long the season will last, they do know that it spreads every year and now is the time to get vaccinated against this serious, sometimes deadly virus.

 “The first and most important thing you can do to protect yourself from flu is to get vaccinated every year,” says State Health Officer Dr. Kathy Lofy. “Flu vaccine is available now in most provider offices and pharmacies across the state and getting it now will provide protection throughout the season. It’s not too early.” Continue reading

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California Prop. 46, inspired by tragedy, pits doctors against lawyers

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Bob and Carmen Pack with their children Troy and Alana, who were killed by an impaired driver.

Bob and Carmen Pack with their children Troy and Alana, who were killed by an impaired driver.

This story is part of a partnership that includes KQEDNPR and Kaiser Health News.

Troy and Alana Pack had spent the day at their neighborhood Halloween party in Danville.

Ten-year-old Troy went as a baseball player, and 7-year-old Alana was a good witch.

In the afternoon, they changed out of their costumes and set out for a walk with their mother. Destination: Baskin Robbins 31 Flavors.

“Alana, she liked anything with chocolate,” says their father, Bob Pack. “Troy, for sure, bubble gum ice cream, ’cause he liked counting the bubble gums that he would get.”

Bob Pack stayed home. His family made it only half a mile down the road before his phone rang: “I received a call from a neighbor screaming there’d been an accident. And I raced down there.”

An impaired driver had veered off the road and hit Troy and Alana head-on. Pack was doing CPR on Troy when the paramedics arrived.

“I remember telling them I love them, and hang on. Just praying that they could hang on,” he says

I needed to take action for justice.

Troy and Alana were pronounced dead at the hospital. In the months after their death, Pack’s wife, Carmen, retreated into her Catholic faith. Bob Pack was angry.

“I think, for me to get through, I needed action,” he says, “and I needed to take action for justice for Troy and Alana, and also for doing something that I thought maybe I could change to benefit others in the future.” Continue reading

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Vaccination rates lower among US adults born abroad

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Vaccine SquareBy Milly Dawson
Health Behavior News Service

Nationality at birth appears to play a significant role in whether or not adults in the United States are routinely vaccinated for preventable diseases, a new study in the American Journal of Preventive Medicine finds, reflecting a risky medical lapse for more than one in ten people nationwide.

Foreign-born adult U.S. residents, who make up about 13 percent of the population, receive vaccinations at significantly lower rates than U.S.-born adults.

Foreign-born adult U.S. residents make up about 13 percent of the population.

This gap poses special risks for certain groups of people who are vulnerable to many serious and sometimes deadly diseases that vaccines can prevent.

The study’s lead author, Peng-Jun Lu, MD, PhD, a researcher at the Center for Disease Control and Prevention, noted the rise in the foreign-born population in the United States, which stood at only five percent in 1970.

“As their numbers continue to rise, it will become increasingly important to consider this group in our efforts to increase vaccination and eliminate coverage disparities,” he said. Continue reading

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Got insurance? You still may pay a steep price for prescriptions

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This KHN story also ran in .

Sandra Grooms recently got a call from her oncologist’s office. The chemotherapy drugs he wanted to use on her metastatic breast cancer were covered by her health plan, with one catch: Her share of the cost would be $976 for each 14-day supply of the two pills.

“I said, ‘I can’t afford it,’ ” said Grooms, 52, who is insured through her job as a general manager at a janitorial supply company in Augusta, Ga. “I was very upset.”

Insurers and employers shifting more of the cost of high-priced pharmaceuticals to the patients who take them.

.Even with insurance, some patients are struggling to pay for prescription drugs for conditions such as cancer, arthritis, multiple sclerosis or HIV/AIDS, as insurers and employers shift more of the cost of high-priced pharmaceuticals to the patients who take them.

Increasingly, health plans – even those offered to people with job-based coverage–require hefty payments by patients like Grooms.

In some plans, patients must pay 20 to 40 percent or more of the total cost of medications that insurers deem to be specialty drugs and place in the highest tiers of patient cost sharing. Continue reading

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Medicaid ADHD treatment under scrutiny

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pills-spill-out-of-bottle

Amid national concerns that too many children are being medicated for Attention Deficit Hyperactivity Disorder (ADHD), some state Medicaid programs are stepping up oversight of diagnoses and treatments.

By Christine Vestal
Stateline

ATLANTA – Attention Deficit Hyperactivity Disorder, or ADHD, affects one in every seven school-aged children in the U.S., and between 2003 and 2011 the number of children diagnosed with the condition rose by more than 40 percent.

Doctors have considerable leeway in deciding the best course of treatment for a child with the condition, no matter who is paying the bill.

But children covered by Medicaid, the joint federal-state health care program for the poor, are at least 50 percent more likely to be diagnosed with the disorder.

Children covered by Medicaid are at least 50 percent more likely to be diagnosed with the disorder.

Georgia alone spends $28 million to $33 million annually on these treatments out of its $2.5 billion Medicaid budget, according to the Barton Child Law and Policy Center here at Emory University.

That is partly because of the toll poverty takes on kids and a lack of resources in poorer schools. But some states believe there are other factors at work.

Several have begun to investigate whether doctors and mental health providers who bill Medicaid for ADHD are rigorously using evidence-based guidelines when diagnosing and treating it.

ADD by state

In Georgia, state Medicaid officials are working with the Centers for Disease Control and Prevention to improve the accuracy of diagnoses and the efficacy of treatments for the ailment.

Missouri and Vermont have also sought the CDC’s help in analyzing Medicaid claims data to determine how best to improve care for what has become the most commonly diagnosed childhood behavioral disorder. Continue reading

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States negotiate for better drug prices

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Because of skyrocketing prescription drug prices, some state Medicaid programs and prison systems are limiting certain drugs to only the sickest patients. Some states are negotiating better pricing.

By Michael Ollove
Stateline

Twenty-dollar bill in medicine bottleThe new hepatitis C drug Sovaldi promises a cure rate of well over 90 percent, compared to 45 percent (at best) for older drugs. But when Sovaldi went on the market earlier this year for as much as $84,000 for a single course of treatment, critics blasted the cost as “exorbitant” and “gouging.”

It is estimated that between 3.2 million and 5.2 million Americans have hepatitis C, an infectious illness that can eventually compromise the liver.

The disease falls disproportionately on the poor and the incarcerated, which makes it a particular challenge for Medicaid, the federal-state health plan for the poor, and for state prison systems.

One study by Express Scripts, a drug benefits management company, estimated it would cost states $55 billion to provide Sovaldi to all prisoners and Medicaid beneficiaries with hepatitis C.

Because of its high cost, some state Medicaid programs and prison systems are refusing to provide Sovaldi to any but the sickest patients. Most recently, Oregon last month threatened to limit access to the drug unless it can get Sovaldi at a deeply discounted price.

“Sovaldi is a seminal event,” said Matt Salo, executive director of the National Association of Medicaid Directors. “It’s clear that states are not equipped to handle this. They simply do not have the tools to maintain control.”

But Sovaldi is only the beginning. Expensive new treatments for certain cancers, rheumatoid arthritis and other conditions also have rattled Medicaid officials, patients and health care providers.

What can states do to hold down drug costs? Drug pricing is a complicated and opaque process. Here are some of the basics.

Question: Is each state Medicaid program on its own when it comes to drug pricing?

Answer: Not completely. The federal Omnibus Budget Reconciliation Act of 1990 mandates that drug makers give all Medicaid programs a 23 percent rebate off the Average Manufacturers Price (AMP) for all prescription drugs purchased, or the difference between the AMP and the best price given to a private payer. (Prisons aren’t covered by this discount provision and have to negotiate drug prices as any retailer does.)

In return for the rebates, Medicaid programs must carry all drugs approved by the U.S. Food and Drug Administration on their “formularies,” which is the list of the medications each health plan will pay for.  That guarantee means that the drug makers get access to substantial markets in all 50 states and the District of Columbia. Continue reading

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Low-cost, long-acting contraceptives cut teen pregnancy, abortion rates

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A diagram showing a hormonal IUD in the uterusBy Lisa Gillespie
KHN / OCTOBER 1ST, 2014

Teenage girls who are given access to long-acting contraceptives such as IUDs or hormonal implants at no cost are less likely to become pregnant, according to a study in the New England Journal of Medicine released Wednesday.

The findings come just two days after the American Academy of Pediatrics recommended that health providers should consider IUDs and implants first when discussing contraception choices with teen girls.

Young women with access to these methods at no cost were almost five times less likely to get pregnant, five times less likely to give birth and four times less likely to have an abortion.

Although there are not as many teenage pregnancies as there once were — rates have been cut by more than half since 1991 — they still pose serious public health issues because of the costs associated with child birth and public assistance for young mothers.

These pregnancies can also stunt education and income opportunities for teenage moms.

Each year, 750,000 teenage girls become pregnant, and 80 percent of those pregnancies are unintended. Continue reading

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ProPublica’s ‘first dive’ into the Open Payments website

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The government’s data on payments to doctors and hospitals by drug and device makers is incomplete and hard to penetrate – but here’s a first look.


Screen Shot 2014-10-01 at 10.26.19 AMBy Charles Ornstein
ProPublica

The federal government unveiled data Tuesday detailing 4.4 million payments made to doctors and teaching hospitals by pharmaceutical and medical device companies.

The launch of the so-called Open Payments website, mandated under a provision of the Affordable Care Act, was far from glitch-free: Some users encountered long delays and sometimes error messages trying to access its seven data tables.

Also, the site didn’t provide consumers with an easy-to-use lookup tool, a single place to search for a doctor’s name and see all results across data files.

It will take a while to dig deeply into this new trove of data, which covers the period of August to December 2013 and includes general and research payments, as well as payments to companies’ physician investors.

All told, according to officials from the Centers for Medicare and Medicaid Services, companies spent a total of $3.5 billion during that period on 546,000 individual physicians and almost 1,360 teaching hospitals.

So what’s interesting at first glance? With the caveats we’ll detail, here’s a few nuggets: Continue reading

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What to be wary of in the government’s new site detailing industry payments to docs

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The government’s new website on drug and device company ties to doctors will be incomplete and may be misleading — for now.

Twenty-dollar bill in medicine bottleBy Charles Ornstein
ProPublica, Sep. 30, 2014, 10 a.m.

The government’s release today of a trove of data detailing drug and device companies’ payments to doctors has been widely hailed as a milestone for transparency.

But it is also something else: a very limited window into the billions in industry spending. Before you dive in and search your doctor, here are five caveats to keep in mind.

Tracking the Money

* The data only covers a fraction of payments

The Physician Payment Sunshine Act, part of the 2010 Affordable Care Act, called for the first public release of this data 18 months ago.

But because of delays writing detailed rules implementing the law, the first release of data will happen today and it will only cover payments for a few months, from August to December 2013.

So if you search for your doctor and you do not find him or her, it doesn’t mean that he or she didn’t receive a payment. Continue reading

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Medicare open enrollment fast approaching — What we know so far

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Calendar

By Michelle Andrew
KHN / September 30th

Medicare beneficiaries who want to make changes to their prescription drug plans or Medicare Advantage coverage can do so starting Oct. 15 during the Medicare’s program’s annual open enrollment period.

There will be somewhat fewer plans to pick from this year, but in general people will have plenty of options, experts say.

And although premiums aren’t expected to rise markedly overall in 2015—and in some cases may actually decline—some individual plans have signaled significantly higher rates.

The annual open enrollment period is also a once-a-year opportunity to switch to a private Medicare Advantage plan from the traditional Medicare fee-for-service plan or vice versa.

.Rather than rely on the sticker price of a plan alone, it’s critical that beneficiaries compare the available options in their area to make sure they’re in the plan that covers the drugs and doctors they need at the best price.

The annual open enrollment period is also a once-a-year opportunity to switch to a private Medicare Advantage plan from the traditional Medicare fee-for-service plan or vice versa. Open enrollment ends Dec. 7.

Although the Centers for Medicare and Medicaid Services has released some specifics about 2015 premiums and plans, many details about provider networks, drug formularies and the like won’t be available until later this fall. Here’s what we know so far: Continue reading

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