It’s time to have the conversation

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Even if you’re young and healthy, anyone can face a sudden illness or injury. That’s why it’s so important to have a conversation with your loved ones and care providers about your end-of-life goals and preferences now—before a crisis.

This conversation shouldn’t be a one-time event. Instead, it should happen at key points throughout your life, as your values, goals for care and preferences change.

Learn more about the IOM report and find resources about having the conversation at www.iom.edu/theconversation.

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The Cost of a Cure: Medicare Spent $4.5 Billion on New Hepatitis C Drugs Last Year

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Twenty-dollar bill in a pill bottleBy Charles Ornstein
ProPublica.

This story was co-published with the Washington Post.

Medicare spent $4.5 billion last year on new, pricey medications that cure the liver disease hepatitis C 2014 more than 15 times what it spent the year before on older treatments for the disease, previously undisclosed federal data shows.

The extraordinary outlays for these breakthrough drugs, which can cost $1,000 a day or more, will be borne largely by federal taxpayers, who pay for most of Medicare’s prescription drug program.

The most-discussed of the new drugs, Sovaldi, which costs $84,000 for a 12-week course of treatment, accounted for more than $3 billion of the spending.

But the expenditures will also mean higher deductibles and maximum out-of-pocket costs for many of the program’s 39 million seniors and disabled enrollees, who pay a smaller share of its cost, experts and federal officials said.

The spending dwarfs the approximately $286 million that the program, known as Part D, spent on earlier-generation hepatitis C drugs in 2013, said Sean Cavanugh, director of Medicare and deputy administrator at the Centers for Medicare and Medicaid Services (CMS).

The most-discussed of the new drugs, Sovaldi, which costs $84,000 for a 12-week course of treatment, accounted for more than $3 billion of the spending. Spending on another drug, Harvoni, hit $670 million even though it only came on the market only in October. Bills for a third drug, Olysio, often taken in conjunction with Sovaldi, reached $821 million.

Medicare also spent $157 million on older hepatitis C drugs in 2014, bringing the total spending for the category to more than $4.7 billion.

The spending surge is unlike anything Part D has seen. The nine-year-old program has benefited in recent years from a slowdown in prescription drug costs as several blockbusters, including the cholesterol-lowering drug Lipitor and the blood thinner Plavix, have lost patent protection and have faced competition from generics. Continue reading

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More states demand notification of use of biosimilars

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Three red-and-white capsulesBy Michael Ollove
Stateline

Without the medicine Rachelle Crow takes for her rheumatoid arthritis, the 29-year-old Michigan woman’s face would frequently feel as if it were engulfed in flames. She would barely be able to crawl out of bed. She would have trouble opening or closing her fists or lifting her 3-year-old daughter.

Crow can do all those things thanks to Cimzia, one of a highly complex, usually expensive class of drugs known as biologics that derive from living organisms. Cimzia is recommended for women, like Crow, who are trying to get pregnant.

Notification laws require that patients and doctors are told whenever “biosimilar” imitations are substituted for brand-name biologics

.What keeps her up at night is a fear that a pharmacy could substitute a cheaper, not-quite identical drug for Cimzia without her or her doctor’s knowledge. It’s not only a return of her worst symptoms that she worries about. “If another medicine were substituted without telling me or my doctor, it could put my pregnancy at risk,” she said.

Fears like Crow’s have helped propel legislative attempts in many states this year to make sure that patients and doctors are notified whenever imitations deemed “interchangeable” by the US Food and Drug Administration (FDA) are substituted for brand-name biologics.

biosimilars

 

Already, Colorado has passed a notification law, and Utah has revised its earlier law. More than a dozen states are considering comparable measures.

Notification bills began popping up in states two years ago, but most were defeated in the face of opposition from manufacturers of biologic copies, which are called biosimilars, and from organizations representing pharmacists, who objected to the extra workload notification requirements might entail.  Continue reading

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Distracted teens at the wheel

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Video analysis finds that distraction was a factor in nearly 6 out of 10 moderate-to-severe teen crashes, which is four times as many as official estimates based on police reports. Some of that footage is included in this video. (Video courtesy AAA Foundation for Traffic Safety)

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Our plan to combat and prevent antibiotic-resistant bacteria

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TuberculosisOp-Ed: By Secretary of the Department of Health and Human Services Sylvia Mathews, Secretary of the Department of Agriculture Tom Vilsack, and  Secretary of the Department of Defense Ash Carter

Antibiotics save millions of lives every year. Today, however, the emergence of drug resistance in bacteria is undermining the effectiveness of current antibiotics and our ability to treat and prevent disease.

The Centers for Disease Control and Prevention (CDC) estimates that drug-resistant bacteria cause two million illnesses and approximately 23,000 deaths each year in the United States alone.

Antibiotic resistance also limits our ability to perform a range of modern medical procedures, such as chemotherapy, surgery, and organ transplants. That’s why fighting antibiotic resistance is a national priority.

Combating and preventing antibiotic resistance, however, will be a long-term effort. That’s why, today, the Administration is releasing the National Action Plan for Combating Antibiotic Resistant Bacteria (NAP).

The NAP outlines a whole-of-government approach over the next five years targeted at addressing this threat:

1. Slow the emergence of resistant bacteria and prevent the spread of resistant infections 

The judicious use of antibiotics in health care and agriculture settings is essential to combating the rise in antibiotic resistance. We can help slow the emergence of resistant bacteria by being smarter about prescribing practices across all human and animal health care settings, and by continuing to eliminate the use of medically-important antibiotics for growth promotion in animals. Continue reading

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Many entitled to hefty insurance subsidies still opt out

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turn-money-back-570By Michelle Andrews
KHN

The good news: Three-quarters of people who were eligible for the most generous financial subsidies on the federal health insurance exchange this year signed up for coverage, according to a new analysis by Avalere Health.

The puzzler: Enrollment dropped off substantially for people with only slightly higher incomes who would also have qualified for significant subsidies.

Stiffer penalties for not having coverage and redoubled efforts to reach out and educate people about the health law and their obligations may be keys to increasing enrollment for people in these income groups, says Caroline Pearson, a senior vice president at Avalere Health.

Subsidies alone aren’t enough, she says.

“The carrots as a standalone don’t work,” Pearson says, referring to subsidies that are available to make coverage more affordable for people with incomes between 100 and 400 percent of the federal poverty level. “You have to make people aware of the mandate, and as the mandate penalties increase that will strengthen the effect.”

Unless they qualify for an exemption, most people are required by the law to have health insurance or face fines. The penalty for not having health insurance in 2014 was the greater of $95 or 1 percent of annual income.

This year, the penalty increases to $325 or 2 percent of income, and in 2016 rises to $695 or 2.5 percent of income. Continue reading

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The health insurance industry looks…well, healthy | Marketplace.org

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Twenty-dollar bill in a pill bottleOn Thursday, a new report out from the Commonwealth Fund finds the health insurance industry is doing just fine, thank you very much.

That’s contrary to the deep-seated fears of some as the Affordable Care Act launched back in 2010. But with three years’ worth of data on the books now, and insurers’ stock prices soaring, those fears have faded.

via The health insurance industry looks…well, healthy | Marketplace.org.

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Gingrich: GOP really doesn’t want to repeal Obamacare

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Newt_Gingrich_by_Gage_Skidmore_7Former House Speaker Newt Gingrich doesn’t think Obamacare should be repealed, and congressional Republicans who say they want to repeal it really don’t want to either, he told a Washington, D.C. health conference Wednesday.

Instead, he thinks more minor parts of the law that aren’t working will be addressed because the core parts of the law have broader support than is often acknowledged.

PHOTO: Courtesy of Gage Skidmore

via Gingrich: GOP really doesn’t want to repeal Obamacare.

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Kirkland woman claims she caught ‘superbug’ at Harborview from tainted scope | The Seattle Times

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HarborviewA Kirkland woman who says she developed a ‘superbug’ infection after a treatment at Harborview Medical Center is suing the maker of the scopes. Harborview officials say they have no record of infections tied to the devices.

via Kirkland woman claims she caught ‘superbug’ at Harborview from tainted scope | The Seattle Times.

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Olympus issues urgent steps for cleaning device linked to superbugs | Reuters

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creOlympus Corp, the largest maker of a medical device at the center of recent U.S. superbug outbreaks, issued new cleaning instructions for its equipment on Thursday, urging health providers to adopt them “as soon as possible.”

Olympus said in a 13-page letter that a small-bristle brush required for the new procedures to clean potentially deadly bacteria from the devices would be shipped “no later than May 8.”

via Olympus issues urgent steps for cleaning device linked to superbugs | Reuters.

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No evidence Ebola in West Africa is becoming more deadly, study

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Ebola virusFrom the National Institutes of Health

The Ebola virus circulating in humans in West Africa is undergoing relatively few mutations, none of which suggest that it is becoming more severe or transmissible, according to a National Institutes of Health study in the journal Science.

The study compares virus sequencing data from samples taken from patients in Guinea (March 2014), Sierra Leone (June 2014) and Mali (November 2014).

Ebola virus, isolated in November 2014 from patient blood samples obtained in Mali. The virus was isolated on Vero cells in a BSL-4 suite at Rocky Mountain Laboratories.

“The Ebola virus in the ongoing West African outbreak appears to be stable—that is, it does not appear to be mutating more rapidly than viruses in previous Ebola outbreaks, and that is reassuring,” said Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID), part of NIH. “We look forward to additional information to validate this finding, because understanding and tracking Ebola virus evolution are critical to ensuring that our scientific and public health response keeps pace.” Continue reading

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Congresswoman McMorris Rodgers asked her Facebook followers for their Obamacare nightmare stories. She did not get the response she was expecting.

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like-thumb-facebookTo mark the 5th anniversary of the signing of the Affordable Care Act, Washington State Congresswoman Cathy McMorris Rodgers, a Republican, asked her Facebook followers to share with her their Obamacare nightmare stories.

She didn’t get the response she was expecting. Most responders are giving it a big “thumbs up.”

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High-deductible plans bring down costs now, but will they bring pricey problems later?

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Twenty-dollar bill in medicine bottleBy Jay Hancock
KHN

Got a high-deductible health plan? The kind that doesn’t pay most medical bills until they exceed several thousand dollars? You’re a foot soldier who’s been drafted in the war against high health costs.

Companies that switch workers into high-deductible plans can reap enormous savings, consultants will tell you — and not just by making employees pay more.

Total costs paid by everybody — employer, employee and insurance company — tend to fall in the first year or rise more slowly when consumers have more at stake at the health-care checkout counter whether or not they’re making medically wise choices.

Consumers with high deductibles sometimes skip procedures, think harder about getting treatment and shop for lower prices when they do seek care.

What nobody knows is whether low-cost, high-deductible plans will backfire, resulting in higher costs later on.

What nobody knows is whether such plans, also sold to individuals and families through the health law’s online exchanges, will backfire. If people choose not to have important preventive care and end up needing an expensive hospital stay years later as a result, everybody is worse off.

A new study delivers cautiously optimistic results for employers and policymakers, if not for consumers paying a higher share of their own health care costs. Continue reading

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Want to quit smoking? There’s an app for that!

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quit

QuitGuide is a free smartphone app that can help you:

  • track your cravings and moods,
  • monitor your progress toward achieving smokefree milestones,
  • identify your reasons for quitting,
  • identify smoking triggers and develop strategies to deal with them,
  • provide guidance on quitting smoking, and a variety of other strategies to help you successfully become and stay smokefree.

QuitGuide is a product of Smokefree.gov (SfG)—a smoking cessation resource created by the Tobacco Control Research Branch at the National Cancer Institute in collaboration with tobacco control professionals and smoking cessation experts and with input from ex-smokers.

QuitGuide provides tips to use during cravings. Use these tips to help you manage your mood and stay smokefree. To get more tips and support, you can also visit the smokefree.gov website.

 

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