Wealth Paper

ATLANTA (AP) - More than half of U.S. adults with diabetes also have arthritis, raising a serious obstacle for diabetic patients urged to exercise, according to a government study.
The survey of nearly 800,000 people is the first extensive look at the overlap between the two conditions, said Dr. John Klippel, president of the Arthritis Foundation.
And its findings highlight a significant challenge: Most diabetics are told exercise is important to their health, but experts say many of them don’t do it.
People with diabetes who exercise have better control of their blood sugar and a much lower risk of heart disease complications. But the new research suggests many diabetics see themselves as unable to exercise because of arthritis, said Julia Simard, a Harvard School of Public Health researcher who has studied rheumatoid arthritis and diabetes.
“If you have this perception of ill health, it may affect your willingness to be active,” said Simard, who was not involved in the new research.
More than 46 million Americans have some form of arthritis, and nearly 21 million have diabetes. Other research indicates exercise is important in managing both conditions.
The study found that 52 percent of diabetics said they also had arthritis. The conditions and the overlap were most common in Americans 65 and older.
The analysis was based on telephone surveys in the years 2005 and 2007 by the Centers for Disease Control and Prevention. Researchers relied on what people said about their health, and did not verify diagnoses.
The researchers also asked about exercise and physical activity. People with both diabetes and arthritis were 30 to 40 percent more likely to be physically inactive than those who had diabetes alone.
“If we’re ever going to successfully control a disease like diabetes, we’re going to have to pay a lot of attention to arthritis,” Klippel said.
Exercise that put less stress on joints, such as walking, biking and aquatics, are recommended for people with arthritis, said Dr. Chad Helmick, a CDC epidemiologist who co-authored the study.
On the Net:
The CDC publication: http://www.cdc.gov/mmwr
The Arthritis Foundation: http://www.arthritis.org

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CHICAGO - People with diabetes are twice as likely to have arthritis, putting them in a double bind as the pain in their joints keeps them from getting the exercise they need to keep both diseases at bay, the U.S. Centers for Disease Control and Prevention said on Thursday.

They found that more than half of U.S. adults diagnosed with diabetes also have arthritis, a condition that makes them far less likely to exercise.

The association was independent of age, gender or body mass index (BMI), a measure of obesity.

“The prevalence of arthritis in a diabetic population is astoundingly high,” said Dr. John Klippel, president of the Arthritis Foundation in a telephone interview.

“Over half the people with diabetes have arthritis. If in fact you have both conditions, you are quite unlikely to be physically active,” he said.

According to the report, nearly 30 percent of diabetics with arthritis are likely to be physically inactive, compared with 21 percent of diabetics who do not have arthritis.

That compares with 17.3 percent of adults with arthritis alone who are inactive, and 10.9 percent of adults with neither condition who are inactive.

Nationwide, the CDC found 46.4 million adults have arthritis and 20.6 million have diabetes.

The CDC said the study suggests the pain of arthritis presents a barrier to physical activity — the very thing that might offer people some relief.

“For people with diabetes, physical activity helps control blood glucose and risk factors for complications. For people with arthritis, physical activity reduces pain and improves function,” said Janet Collins, director of the CDC’s National Center for Chronic Disease Prevention and Health Promotion.

JOINT-SAFE EXERCISE

Klippel thinks two things stand in the way.

“Because arthritis affects the joints and is associated with pain, people with arthritis, when they begin to exercise, experience more pain,” he said.

“The other thing is there is a common misconception that exercise is bad for arthritis and it will damage joints.”

He said many forms of exercise are in fact “joint-safe,” including walking, swimming and biking.

“If people walked 30 minutes a day it would have a profound effect on reducing their pain and improving their symptoms,” he said.

Given the scope of the problem, Klippel said the finding will likely affect the way doctors and policymakers go about encouraging their patients to exercise.

“Public health programs that are directed at controlling diabetes are going to need to pay a lot more attention to arthritis if they hope to get people to be physically active,” he said.

The report is based on data gathered from a random telephone survey in 2005 and 2007. People were asked if they had ever been diagnosed with arthritis or diabetes.

It does not say what type of arthritis people had — osteoarthritis, rheumatoid arthritis or another form. Nor does it say if people had type 2 diabetes, the most common kind that is associated with obesity and lack of exercise.

Type 1 diabetes is an autoimmune disease often diagnosed at an early age.

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LITTLE ROCK, Ark. (AP) - Wal-Mart Stores Inc., the world’s largest retailer, announced Monday it would expand its discounted prescription drug program to offer 90-day supplies for $10 and add several women’s medications at a discount. It also said it would lower the price of more than 1,000 over-the-counter drugs.
The move marks the third phase of a company program that began in 2006 to provide a 30-day supply of generic prescription drugs for $4. Wal-Mart said the program has saved customers more than $1 billion.
With the expansion, the company began filling prescriptions Monday for up to 350 generic medications at $10 for a 90-day supply at Wal-Mart, Neighborhood Market and Sam’s Club pharmacies in the U.S. Almost all the prescription generics in the company’s $4 program were included in the expanded $10 offer, said Wal-Mart senior vice president John Agwunobi.
In addition, the company will add several women’s medications to its list of prescriptions available for $9, including drugs to treat breast cancer and hormone deficiency.
For instance, alendronate, the generic version of osteoporosis medication Fosamax, will be added to the list. Company pharmacies will fill 30-day prescriptions of alendronate for $9 and a 90-day supply for $24 at a comparison of $54 and $102, respectively, that women previously paid for the same amounts, the company said.
Tamoxifen, used to treat breast cancer, will be offered for $9 for a 30-day supply, as well as combination estrogen/methyltestosterone tablets, prescribed for menopause and hormone deficiency.
Wal-Mart also will lower the prices of more than 1,000 over-the-counter medications to $4 or less in its pharmacies, company officials said. Those price rollbacks represent about one-third of the retailer’s over-the-counter medicines. They include Wal-Mart’s Equate versions of popular drugs, including Zantac, Pepcid and Claritin, and Wal-Mart’s Spring Valley prenatal vitamins.
Since 2006, Wal-Mart’s $4 generic drug program has expanded to every state, except North Dakota, where Wal-Mart has no in-store pharmacies. And many company competitors have followed the retailer’s lead.
While stressing that the expansion was designed to help customers at a time of exorbitant health-care costs and difficult economic times, Agwunobi said the program has worked in everyone’s favor.
“This is the time for us now to begin building capacity,” he said. “It offers (customers’) employers potential savings. It offers the customers significant savings. It also offers us the ability to add capacity to our pharmacies without adding people.”
Agwunobi expects the 90-day discount will increase the company’s market share of mail-order and online prescriptions as customers realize the value of the company offer.
Wal-Mart Chief Operating Officer Bill Simon said the results in each phase of the program have been strong and prescription volume has increased, “exceeding our expectations.” He said the company would not, however, offer free generic drugs at its in-store clinics as some competitors have.
“We’re in business to make money,” Simon said. “Free is a price that is not a long-term sustainable proposition.”
Shares of Wal-Mart fell 31 cents to $57.18 in midday trading Monday.

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By Nicole Maestri

NEW YORK (Reuters) - Wal-Mart Stores Inc is expanding its low-priced drug program, saying on Monday that it now offers more than 1,000 over-the-counter items for $4 or less, and it will sell certain 90-day generic prescriptions for

$10.

“With the state of the economy in flux and health care costs still on the rise, many families are struggling to afford their medications, to afford their access to health care,” said John Agwunobi, president of health and wellness for Wal-Mart’s U.S. stores, in the announcement of the expanded low-price drug program.

In 2006, Wal-Mart began selling some generic drugs for $4 per monthly prescription in Florida, but it quickly extended the program to all its U.S. pharmacies.

Last year, it added more medicines to the program and said in September that $4 prescriptions accounted for nearly 40 percent of all prescriptions filled in its Wal-Mart, Sam’s Club and Neighborhood Market pharmacies.

The world’s largest retailer said pharmacies at its U.S. discount stores, Neighborhood Markets and Sam’s Club warehouse locations will fill prescriptions for up to 350 generic medications, like diabetes drug metformin and asthma drug albuterol, for $10 for a 90-day supply.

OTC ITEMS

It also said its Wal-Mart Stores and Neighborhood Markets will sell more than 1,000 over-the-counter items for $4 or less without a prescription — including Wal-Mart’s own Equate brand of Zantac, Pepcid and Claritin.

Deisha Galberth, a Wal-Mart spokeswoman, said Wal-Mart previously sold some of these items for $4 or below, but the number of over-the-counter items being offered at those prices has increased.

Wal-Mart has been working to expand its health and wellness services, which are seen as a way to drive shoppers into its stores more frequently and boost sales.

Other retailers have responded to Wal-Mart’s move to offer cheaper drugs. Target Corp offers certain generic drugs for $4 for a 30-day supply, while Kmart, a division of Sears Holdings Corp , offers certain generic drugs for $15 for a 90-day supply.

Last year, Publix Super Markets, a privately held U.S. grocer, and Meijer, a privately-held retailer with stores in the U.S. Midwest, started giving away some generic antibiotics most often taken for childhood ailments such as strep throat.

But Wal-Mart said it had no plans to offer drugs for free.

“We’re in business to make money,” said Bill Simon, the chief operating officer of Wal-Mart’s U.S. stores. “Free is a price that is not a long-term sustainable proposition.”

Agwunobi said Wal-Mart is continually looking for ways to its expand its low-priced drug program and cut prices on branded drugs.

“This is one more step in that journey,” Agwunobi said. “It’s not the last step, it’s just the next.”

Wal-Mart shares were down 30 cents at $57.20 in midday trading.

(Reporting by Nicole Maestri; Editing by Brian Moss and Steve Orlofsky)

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RIO DE JANEIRO, Brazil (AP) - Brazil announced a new malaria treatment Thursday that scientists say offers a potentially cheap and effective way to attack a disease that largely afflicts the world’s poor.
The treatment, developed by the Brazilian government in conjunction with the Drugs for Neglected Diseases Initiative, combines existing malaria drugs artesunate and mefloquine into a single, fixed-dose tablet and reduces the cost of treatment.
A key benefit is that it reduces the number of tablets patients must remember to swallow.
“Now they only need take one to two tablets a day for three days,” said Bernard Pecoul, executive director of the Drugs for Neglected Diseases Initiative, an international alliance of seven health organizations.
“The fixed dose combination will probably mean greater adherence to the treatment program,” said Keith Carter, regional adviser on malaria at the Pan American Health Organization, who was not involved with the treatment’s development.
Carter said he had not seen the result of the Brazilian study and could not comment on it. But he noted that the World Health Organization has recommended similar combination treatments for several years and said development of a single, fixed-dose medication should make treatment easier and more effective.
Another single-dose combination is available to fight malaria, but Pecoul said this combination was more effective.
Pecoul said developers would not try to patent the new treatment because they are trying to reduce the cost of attacking a disease that mainly affects the poor.
The Brazilian government will distribute the medication, known as ASMQ, free of charge and will transfer the technology to India for production and distribution in Southeast Asia, where a full course of treatment should cost around US$2.50 (1.58).
A field study involving 17,000 patients in Brazil’s Amazon state of Acre showed that the incidence of malaria dropped by 70 percent over a year, Pecoul said. A similar study in the Peruvian Amazon where the two drugs were used in separate doses only showed a drop of 50 percent.
Carlos Morel, one of the drug’s developers and director of Brazil’s Center for Developing Medical Technology at Fiocruz/Farmanginhos, said the number of patients hospitalized with malaria in the Brazilian region dropped from 2,500 to only 500 over the course of the year.
Malaria is a mosquito-borne disease caused by a parasite. The less time each person spends infected, the less likely it is to spread.
“This is really good news in a field where there hasn’t been much good news lately,” Morel said.

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LONDON - Brazil launched a new treatment for malaria on Thursday, marking the latest step in a global program to make cheap two-in-one pills available to millions at risk from the mosquito-borne killer.

The country’s state-run drugmaker Farmanguinhos is working with the Drugs for Neglected Diseases Initiative (DNDi), a non-profit group based in Geneva, to bring the medicine to market at a target price of $2.50 for a full adult treatment.

The Brazilian market is just the first stop.

The fixed-dose combination, known as ASMQ, will be made available to children and adults throughout Latin America and southeast Asia over the course of 2008 and 2009, with India’s Cipla Ltd supplying the Asian market.

The drug is not protected by any patents and will be sold at cost by the suppliers, both of which have a track record of bringing cheap generic AIDS medicines to market.

Jean Rene Kiechel, the project’s manager, told Reuters the medicine would be cheaper and more effective than existing therapy. He estimated it could treat between 2 million and 3 million patients in the next three years.

ASMQ belongs to a new generation of artemisinin-based combination therapies, or ACT drugs, which are recommended by the World Health Organization because of growing resistance to older treatments such as chloroquine.

Malaria, caused by a parasite carried by mosquitoes, kills more than 1 million people a year worldwide, with Africa the continent hardest hit.

DNDi, working with Sanofi-Aventis SA, launched its first combination treatment for Africa last year but that medicine is ill-suited to fighting malaria in Latin America and Southeast Asia, where there are different resistance problems.

ASMQ combines artesunate, a derivative of artemisinin, with another antimalarial drug, mefloquine.

These drugs are already given widely to treat cases of malaria in Latin America and southeast Asia but the combined price of buying them separately is between $4 and $7.

“This will be much better in terms of cost,” Kiechel said.

It also simplifies treatment, with patients taking a single daily dose of one or two tablets for three days, depending on their age, which ensures the two component drugs are taken together and in the correct proportion.

ASMQ will not be as cheap as the combination drug used in Africa, which mixes artesunate and amodiaquine and sells for around $1. Kiechel said this reflected the particularly complex production process for mefloquine.

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You’ve just been diagnosed with cancer, and the doctor is discussing treatment options. Should the cost be a deciding factor? Chemotherapy costs are rising so dramatically that later this year, oncologists will get their first guidelines on how to have a straight talk with patients about the affordability of treatment choices, a topic too often sidestepped.
“These are awkward discussions,” says Dr. Allen Lichter of the American Society of Cliniple, has revolutionized care for a type of leukemia - and the prices reflect manufacturers’ years of research and development investment.
Also, drug companies do donate a certain amount of medication to prescription-assistance programs that provide them for free to patients who otherwise couldn’t pay. Since 2005, nearly 5 million people - cancer patients and people with other diseases - have been matched to such programs through the drug industry’s “Partnership for Prescription Assistance.”
But few patients get a Gleevec-style home run, and there’s very little research that directly compares competing treatments to guide cancer patients on which might offer the best shot at survival for the money.
“As long as a therapy provides a benefit, it will tend to be offered to patients. Whether it’s a small benefit or a moderate benefit, it may be offered with the same level of enthusiasm,” says Dr. Neal J. Meropol of Philadelphia’s Fox Chase Cancer Center, who is leading the panel writing ASCO’s new guideline on how to weigh treatment costs.
The idea: treat cost essentially as another side effect to weigh in choosing a therapy. Meropol has watched patients do those calculations on their own, like the colon cancer patient who asked to switch from oral chemo to cheaper but more laborious intravenous chemo, or the woman who refused a pricey anti-nausea drug that would make her chemo more bearable.
Even if doctors want to discuss cost, they may not know it - it’s not included in treatment standards. At a meeting of the standard-setting National Comprehensive Care Network earlier this month, Sloan-Kettering’s Saltz and other doctors urged adding chemo prices to those treatment guidelines.
“If there’s a need to spend it, let’s talk about it. If we can do it just as well less expensively, I think doctors should know that and be able to make a decision,” Saltz says.
Even the well-insured are feeling the bite as patients are having to shoulder a higher portion of the bill.
When Medicare began its Part D prescription coverage, retiree Helen Geiger of Whiting, N.J., paid for a premium plan and put it to good use when she was diagnosed with multiple myeloma, a blood cancer. She said the plan listed the cost of her dose of Thalomid at $5,500 a month but her copay was $60 a month.
In renewing the prescription plan last year, the 71-year-old Geiger didn’t notice that Thalomid coverage had been changed. It now was classified a specialty drug, costing a $1,051 monthly copay that she couldn’t afford. She went several months without the anti-cancer pills, as her doctors at Philadelphia’s Fox Chase Cancer Center and her family appealed to the insurer and then scoured charities in hopes of finding her free or cheaper drug.
“You don’t need this kind of stress when you’re sick,” says Geiger, who finally stumbled onto a prescription assistance program that provided her free medicine.
EDITOR’S NOTE - Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
On the Net:
Prescription assistance programs: http://www.pparx.org

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WASHINGTON - You ve just been diagnosed with cancer, and the doctor is discussing treatment options. Should the cost be a deciding factor?

Chemotherapy costs are rising so dramatically that later this year, oncologists will get their first guidelines on how to have a straight talk with patients about the affordability of treatment choices, a topic too often sidestepped.

These are awkward discussions, says Dr. Allen Lichter of the American Society of Clinical Oncology, which is writing the guidelines. At least we can bring this out in the open.

It s a particular issue for patients whose cancer can t be cured but who are seeking both the longest possible survival and the best quality of life and may be acutely aware that gaining precious months could mean bankrupting their families.

The prices can be staggering. Consider: There are two equally effective options to battle metastatic colon cancer, the kind spreading through the body but one costs $60,000 more than the other, says Dr. Leonard Saltz of Memorial Sloan-Kettering Cancer Center.

What s the difference? The cheaper one, irinotecan, causes hair loss that makes it impossible for people trying to keep a job to hide their cancer treatment, he explains. The pricier oxaliplatin can cause nerve damage in hands and feet that might make it a worse option for, say, a musician or computer worker.

Saltz offers a tougher example: A drug for pancreatic cancer an especially deadly cancer with few treatment options can cost $4,000 a month. Yet while Tarceva has offered some people remarkable help, research suggests that extra survival on average is a few weeks.

Is it a good investment, a high-risk investment, or buying a lottery ticket? is how Saltz puts these choices.

Drug prices are a growing issue for every disease, especially for people who are uninsured. But cancer sticker shock is hitting hard now, as a list of more advanced biotech drugs have made treatment rounds costing $100,000, or even more, no longer a rarity. Also, patients are living longer, good news but meaning they need treatment for longer periods. The cost of cancer care is rising 15 percent a year, Lichter notes.

Make no mistake: Some of these newer drugs have greatly helped some patients Gleevec, for example, has revolutionized care for a type of leukemia and the prices reflect manufacturers years of research and development investment.

Also, drug companies do donate a certain amount of medication to prescription-assistance programs that provide them for free to patients who otherwise couldn t pay. Since 2005, nearly 5 million people cancer patients and people with other diseases have been matched to such programs through the drug industry s Partnership for Prescription Assistance.

But few patients get a Gleevec-style home run, and there s very little research that directly compares competing treatments to guide cancer patients on which might offer the best shot at survival for the money.

As long as a therapy provides a benefit, it will tend to be offered to patients. Whether it s a small benefit or a moderate benefit, it may be offered with the same level of enthusiasm, says Dr. Neal J. Meropol of Philadelphia s Fox Chase Cancer Center, who is leading the panel writing ASCO s new guideline on how to weigh treatment costs.

The idea: treat cost essentially as another side effect to weigh in choosing a therapy. Meropol has watched patients do those calculations on their own, like the colon cancer patient who asked to switch from oral chemo to cheaper but more laborious intravenous chemo, or the woman who refused a pricey anti-nausea drug that would make her chemo more bearable.

Even if doctors want to discuss cost, they may not know it it s not included in treatment standards. At a meeting of the standard-setting National Comprehensive Care Network earlier this month, Sloan-Kettering s Saltz and other doctors urged adding chemo prices to those treatment guidelines.

If there s a need to spend it, let s talk about it. If we can do it just as well less expensively, I think doctors should know that and be able to make a decision, Saltz says.

Even the well-insured are feeling the bite as patients are having to shoulder a higher portion of the bill.

Click for related content Obese women less likely to have cancer testsTest tracks down source of mystery cancers Doctor removes 6 organs to carve out tumor

When Medicare began its Part D prescription coverage, retiree Helen Geiger of Whiting, N.J., paid for a premium plan and put it to good use when she was diagnosed with multiple myeloma, a blood cancer. She said the plan listed the cost of her dose of Thalomid at $5,500 a month but her copay was $60 a month.

In renewing the prescription plan last year, the 71-year-old Geiger didn t notice that Thalomid coverage had been changed. It now was classified a specialty drug, costing a $1,051 monthly copay that she couldn t afford. She went several months without the anti-cancer pills, as her doctors at Philadelphia s Fox Chase Cancer Center and her family appealed to the insurer and then scoured charities in hopes of finding her free or cheaper drug.

You don t need this kind of stress when you re sick, says Geiger, who finally stumbled onto a prescription assistance program that provided her free medicine.

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Patches containing the prescription painkiller fentanyl were recalled for the second time in a week Monday, because of a flaw that could cause patients or caregivers to overdose on the potent drug inside.
Sold in the United States by Actavis South Atlantic LLC, the newly recalled patches have both this name and the company’s former name, Abrika Pharmaceuticals Inc., on their packaging. The old name is on the pouches that contain the patches and the new name is on the outer carton.
Last Tuesday PriCara, a division of Johnson & Johnson, announced a recall of fentanyl patches manufactured by its affiliate ALZA Corp.
Monday’s recall includes 25-microgram-per-hour, 50-microgram-per-hour, 75 microgram-per-hour and 100 microgram-per-hour patches with expiration dates of May through August 2009.
Some of the patches may have a defect that can cause them to leak, putting patients and caregivers at risk of coming into direct contact with the powerful “opioid” drug inside. This could result in difficulty breathing and a potentially fatal overdose.
The company has not received any reports of injuries related to this defect.
Damaged patches should be flushed down the toilet and not handled. Skin that has been exposed to the gel should be thoroughly rinsed with water, but not washed with soap.
The recalled patches were manufactured for Actavis Inc. by Corium International Inc. Activis Inc. is a division of Actavis Group hf.

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WASHINGTON - Patches containing the prescription painkiller fentanyl were recalled Tuesday, because of a flaw that could cause patients or caregivers to overdose on the potent drug inside.

Sold in the United States under the brand name Duragesic by PriCara and generically by Sandoz Inc., the recall includes all 25-microgram-per-hour patches with expiration dates on or before December 2009.

Some of the patches may have a cut in the lining of the internal reservoir where the drug is stored in gel form. If the fentanyl gel leaks into the drug’s packaging, it could cause a patient or caregiver to come into direct contact with this powerful “opioid” drug. This could result in difficulty breathing and a potentially fatal overdose.

If this reservoir is cut, it can be seen when the foil pouch containing an individual patch is opened. Damaged patches should be flushed down the toilet and not handled. Skin that has been exposed to the gel should be thoroughly rinsed with water, but not washed with soap.

In December, the FDA put out its second warning in two years about the dangers of misusing the powerful drug.

The drug is intended for chronic pain in people used to narcotics, such as cancer patients, and can cause trouble breathing in people not used to this family of painkillers. Yet the FDA found cases where doctors prescribed it for headaches or post-surgical pain.

Click for related contentIcy Hot patches recalled after burns

PriCara estimates that two patches out of every million included in the recall have the defect that causes the leak.

For details on Duragesic patches sold by PriCara, call 800-547-6446. For details on generic fentanyl patches sold by Sandoz, call 800-901-7236.

The recalled patches were also sold in Canada under the Duragesic brand by Janssen-Ortho Inc. and generically by Ranbaxy Laboratories Ltd.

All of the patches were manufactured by PriCara affiliate ALZA Corp. PriCara is a division of Ortho-McNeil-Janssen Pharmaceuticals, Inc.

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CHICAGO (AP) - U.S. syphilis cases climbed for the seventh straight year in 2007, and increases in the disease among gay men and blacks largely contributed, government researchers reported Wednesday.
The trend can be partly blamed on too few gay men getting recommended annual screenings for syphilis and other sexually transmitted diseases, the federal Centers for Disease Control and Prevention said, citing studies released at an STD conference in Chicago.
While the number of cases still is relatively low - 11,181 last year - the trend worries public health officials, who say better awareness and screening is needed.
About 60 percent of syphilis cases last year occurred in gay men, compared with just 5 percent in 1999, according to preliminary CDC data presented at the conference.
The main symptom is painless sores at the site where the syphilis bacteria entered the body. It is easily treated with antibiotics if caught early; if not, complications can include blindness and organ damage. Syphilis also increases susceptibility to AIDS infections, and can be fatal to infants who get it from infected mothers during pregnancy.
The data show the syphilis rate increased about 12 percent between 2006 and 2007, to about 3.7 cases per 100,000. That’s a jump from 9,756 cases in 2006 to 11,181 last year, CDC researchers reported.
It’s also a 76 percent increase since 2000, when the rate was 2.1 per 100,000.
Among black men, rates jumped 25 percent to almost 22 cases per 100,000. Among black women, there was a 12 percent increase, to about 5 cases per 100,000.
On the Net:
CDC: http://www.cdc.gov
AP-NY-03-12-rs to meet the needed reductions, and areas with the worst pollution are likely to have as long as a decade to comply.
Ozone is a product of nitrogen oxides and other organic chemical compounds from motor vehicles, power plants, manufacturing and industrial plants. As it comes into contact with the sun’s rays it is seen as the smog that hangs in much of the nation’s air, aggravating respiratory problems for tens of millions of people.
An estimated 85 counties of the more than 700 that have monitoring stations exceed the current 80 parts per billion concentration, according to the latest EPA calculations. More than 320 counties exceed the tighter 75 parts per billion standard.
Health experts say smog under the current ozone regulation - even in areas where the limit is being met - causes hundreds of premature deaths among the elderly and health problems for thousands of young children and people with asthma and other respiratory illnesses.
An independent EPA advisory group of scientists last year said an ozone standard of 60 to 70 parts per billion is needed to provide an adequate margin of protection for the millions of people susceptible to respiratory problems. A similar conclusion was reached by a second advisory board on children’s health.
In December, 111 health scientists, in a letter to Johnson, urged the EPA to adopt the science panels’ findings.
Clean air advocates called the latest EPA reduction a move in the right direction - but also a political compromise that does not go far enough.
“It’s disheartening that once again EPA has missed a critical opportunity to protect public health and welfare by ignoring the unanimous recommendations of its independent science advisers,” said William Becker, executive director of the National Association of Clean Air Agencies, whose members will be developing programs to meet the federal air quality requirement.
Becker acknowledged that the tighter the standard the more difficult it will be to meet, but he said: “The public deserves the right to know whether the air they breathe is healthy.”
In recent weeks, some of the most powerful industry groups in Washington have waged an intense lobbying campaign at the White House, urging the administration to keep the current standard.
Electric utilities, the oil and chemical industries and manufacturing groups argued that lowering the standard would require states and local officials to impose new pollution controls, harming economic growth, when the science has yet to determine the health benefits conclusively. The 80 parts per billion standard was enacted by the EPA in 1997, but its implementation was delayed for several years because of court challenges by industry groups.
“Hundreds of counties haven’t been able to meet the current standard set a decade ago,” said John Kinsman, senior director for environment at the Edison Electric Institute, which represents most of the country’s power companies. “Moving the goalpost again will inflict economic hardship on those areas without speeding air quality improvements.”
The EPA has said, based on various studies, cutting smog from 80 to 75 parts per billion would prevent between 900 and 1,100 premature deaths a year and mean 1,400 fewer nonfatal heart attacks and 5,600 fewer hospital or emergency room visits. A separate study suggests that tightening the standard to 70 parts per billion could avoid as many s 3,800 premature deaths nationwide.
The EPA by law is not supposed to consider economic cost in establishing the federal health standard for air quality. The agency has estimated that new pollution control efforts to comply with a 75 parts per billion standard would cost as much as $8.8 billion a year, although it acknowledged that does not take into account reductions in health care costs that could be even greater.
On the Net:
Environmental Protection Agency: http://www.epa.gov

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WASHINGTON - The U.S. syphilis rate rose for the seventh straight year in 2007, driven by a continued surge in cases among homosexual and bisexual men, the U.S. Centers for Disease Control and Prevention said on Wednesday.

Since 2000, when the national syphilis rate sank to a low of 2.1 per 100,000 people after a decade of progress in the 1990s, the rate has soared by 76 percent, the CDC reported.

Homosexual and bisexual men accounted for 64 percent of syphilis cases in 2007, up from about 5 percent in 1999.

CDC officials expressed concern not only because the recent increases in this bacterial sexually transmitted disease follows years of declines, but also because syphilis can elevate a person’s risk of being infected with the AIDS virus and the odds of giving it to someone else.

They also called rises among women and blacks troubling.

The overall national rate of syphilis rose by 12 percent in 2007 from 2006, reaching 3.7 cases per 100,000 people, based on preliminary CDC data released at a meeting in Chicago.

The rate for men was 6.4 per 100,000, a 14 percent rise from 2006.

The number of syphilis cases nationwide jumped to 11,181 in 2007 from 9,756 in 2006, with men accounting for six times as many cases as women. Rates for men and women had been roughly equivalent a decade ago.

Syphilis hit the black community very hard, with rates six times higher for men and 13 times higher for women than among whites, the CDC said. The rate for black men, 21.5 cases per 100,000, has risen 99 percent since 2003.

Syphilis rates have been surging in homosexual and bisexual men in the past decade, particularly among those who are highly sexually active with multiple sex partners.

RISKY BEHAVIOR

“Having multiple sex partners and other high-risk behaviors like not using condoms do put you at higher risk for HIV and syphilis,” CDC epidemiologist Dr. Hillard Weinstock said in a telephone interview.

“Syphilis can increase the likelihood of HIV transmission two to fivefold. And CDC recommends that sexually active men who have sex with men get tested for syphilis, HIV and other STDs at least annually,” Weinstock added.

“It is imperative that we make STD screening and treatment a central part of the medical care for gay and bisexual men,” while also finding ways to avoid these infections including HIV in the first place, said Dr. Kevin Fenton, who heads the CDC’s STD, AIDS, tuberculosis and viral hepatitis prevention effort.

Weinstock said despite the increases of this decade, syphilis rates remain lower than in the past.

After reaching 50,000 cases and a rate of 20.3 cases per 100,000 people in 1990 — the highest rate since 1949 — public health efforts helped drive down the rate to 2.1 per 100,000 people in 2000.

“We are concerned that the increases that we’re seeing now could continue,” Weinstock said.

Syphilis is passed person-to-person through direct contact with a syphilis sore. Transmission of the organism occurs during vaginal, anal or oral sex. Pregnant women with syphilis can pass it to their babies.

via MSN

SPRINGFIELD, Ill. (AP) - A group of pharmacists asked the Illinois Supreme Court on Tuesday to throw out a rule that forces them to dispense emergency contraception despite moral objections, claiming it amounts to illegal coercion.
Gov. Rod Blagojevich issued the rule in 2005, prohibiting pharmacies from turning away women seeking emergency contraception. The medicine is a higher dosage of typical hormonal contraception, and if taken within three days of having sex it greatly reduces the chance of pregnancy.
Pharmacists who do not want to dispense the drug say it is tantamount to abortion. The closely watched case mirrors concerns raised in other states.
The druggists argued that Illinois law protects them from choosing between violating their consciences and losing their licenses, and that they shouldn’t have to wait until they’re out of jobs to seek justice.
A lawyer for Blagojevich argued that the pharmacies in the lawsuit don’t have standing to sue because they have suffered no repercussions. Laura Wunder, an assistant state attorney general, also said those pharmacies don’t even stock so-called “morning-after” medication, so it’s unlikely they would violate the rule.
In oral arguments, however, justices bluntly pointed out to Wunder that the pharmacies must get the drug if requested - and that their licenses would be at risk if they failed to comply.
Wunder countered that the pharmacies have been unable to show that they’re in jeopardy of state penalties because it’s unlikely that a customer would ask a drug store to order a medicine that is needed right away.
The pharmacists’ lawyer, Mark Rienzi, said his clients should be able to sue even if they haven’t suffered repercussions.
Rienzi argued they are protected by two state laws: one that prohibits forcing health care decisions over moral objections, and one insulating citizens from religious interference.
“They are designed to protect people from coercion and burden,” Rienzi said. “They are not only designed to protect people after the ax has fallen, after your license is taken away, after your career is ruined.”
Since the pharmacists sued in 2005, a pharmacy owned by one plaintiff closed because no pharmacist would work there under the state’s threat of license revocation.
Rienzi said outside of court that generally, customers who are denied the drug have accepted that they had to go elsewhere for it, although they could have complained and forced state sanctions on the stores.
A federal judge suspended a similar requirement in Washington state in November but said pharmacists who refuse to dispense the morning-after pill must refer the customer to another nearby source. That case is on appeal.
The Illinois rule led to several lawsuits, including one in federal court that was settled by a compromise in which objecting pharmacists wouldn’t have to participate in filling the prescription. In such cases, a pharmacy employee would contact a pharmacist at another location, then follow his or her directions for dispensing the morning-after pill.
That rule needs approval from the legislative Joint Committee on Administrative Rules, which could d
PDVSA decided to demand payment in euros as a means of protecting the company from the falling value of the dollar.
The euro hit an all-time high of $1.59 on Monday, but fell slightly on Tuesday to $1.57 after the U.S. Federal Reserve cut its benchmark interest rate.

via AOL

SPRINGFIELD, Ill. - Pharmacists asked the Illinois Supreme Court Tuesday to overturn a rule forcing them to dispense emergency contraception over their religious convictions.

Gov. Rod Blagojevich’s three-year-old edict requires pharmacists to fill orders for the so-called “morning-after pill.” Taken within days of having sex, the pill can interfere with conception, which some pharmacists argue is the equivalent of abortion.

A lawyer for Blagojevich said the pharmacies don’t stock the drug and the chances of them violating the rule are slim. But justices peppered the lawyer with questions about a provision requiring that pharmacies order the drug upon a patient’s request.

When Blagojevich introduced the rule, he said pharmacists had an obligation to fill all prescriptions despite any personal qualms. Someone in need of emergency contraception should always be able to get it, “No delays. No hassles. No lectures,” he said then.

Circuit and appellate courts have ruled the group of pharmacists has no standing to file a lawsuit because the druggists have not lost their jobs or suffered other repercussions because of it.

The pharmacists counter that they should be able challenge the rule before they either violate their consciences by filling prescriptions or break the law by refusing to.

The pharmacists’ attorney, Mark Rienzi of Washington, told the court it should consider evidence collected since the lawsuit was filed in fall 2005. That includes statements from the pharmacists that they have had requests to fill the prescriptions, although the patients have accepted the explanation that they must go elsewhere.

But any of those patients could have complained to the state and triggered the revocation of a pharmacy’s license, Rienzi said.

via MSN

Sen. John McCain, the presumptive Republican Party nominee for president, arrived in Baghdad on Sunday for an unexpected visit with Iraqi and American leaders, a U.S. official said.
The details of McCain’s visit were kept secret for security reasons.
“Senator McCain is in Iraq and will be meeting with Iraqi and U.S. officials,” said Mirembe Nantongo, spokesperson for the U.S. Embassy in Baghdad.

via AOL

WASHINGTON - Like no other candidate, John McCain has linked his campaign for president to an unpopular war _ and to a lifelong focus on foreign issues that many voters ignore.

McCain was born in the Panama Canal Zone, became famous as a Vietnam prisoner of war and has spent his long Senate career traveling to more foreign countries than most people could even name.

He makes his eighth trip to Iraq this weekend, a visit sure to get a lot of attention. But his weeklong overseas trip also includes Israel, Britain and France _ all countries where he’s made many visits.

A defiant supporter of the 2003 invasion and President Bush’s troop increase last year, McCain is likely to focus in Iraq on the drop in sectarian violence and U.S. and civilian casualties since last summer.

His own situation has changed strikingly, too, since then. Now he’s the Republican presidential nominee-in-waiting.

Last April, as McCain’s chances for winning the nomination seemed uncertain, the four-term Arizona senator toured a Baghdad marketplace, hailing the progress even though he was protected by three Black Hawk helicopters, two Apache gunships and 100 U.S. troops.

He was widely ridiculed as being out of touch.

As he returns, a new Pentagon study shows sectarian violence down 90 percent and U.S. and civilian casualties down 70 percent since last July.

Last December, nearly two-thirds of Americans said they opposed the war, including nearly a third of Republicans and nearly all Democrats, according to an Associated Press-Yahoo News poll. Opinions on the war have remained basically steady.

However, a poll released Friday by NBC News and The Wall Street Journal said about 35 percent of those questioned think McCain has the right approach for Iraq, compared with 30 percent for Hillary Rodham Clinton and 27 percent for Barack Obama.

McCain calls the fight against Islamic extremism the “transcendent challenge of the 21st century.”

He suggested on Friday that terrorists in Iraq don’t want to see him in the White House. Asked at a campaign stop in Pennsylvania whether al-Qaida might step up its attacks to hurt his chances, he said, “Yes, I worry about it. And I know they pay attention, because of the intercepts we have of their communications.”

As for any effect his Iraq war stance might have on his candidacy, he said this week in New Hampshire, “I’ve made it abundantly clear that I would much rather lose a campaign than a war.”

The one may be tied to the other.

Says Michael O’Hanlon, a foreign policy analyst at the Brookings Institution: “I have a hard time seeing how he wins if Iraq falls apart between now and November, and I have a hard time seeing how the Democrats use Iraq against him over that time if things continue to improve.”

As Democrats Clinton and Obama fight over which of them has the credentials to be the next commander in chief, McCain offers a much lengthier foreign policy and military resume.

Now 71, he was born in the Canal Zone, where his father, a naval officer, was stationed. A graduate of the Naval Academy, McCain flew in Vietnam and was a prisoner of war for more than five years. In the Senate, he is the senior Republican on the Armed Services Committee.

He has visited every region of the world, including Antarctica and the Arctic Circle, and frequently meets with leaders of the countries to which he’s traveled, both when he visits their countries and when they visit the United States.

McCain has been across the world so many times that aides named off the tops of their heads some 69 countries he’s visited _ including Azerbaijan, Estonia, Laos and Palau _ and warned the list was far from exhaustive.

Aides say he keeps up to speed on the politics and policies of many nations _ a passion he regularly displays to reporters traveling with him _ and understands the long-term ramifications of having well-established personal relationships with foreign leaders.

He makes it a point to meet with up-and-comers, too. Aides say he met Angela Merkel at a Munich conference several years ago before she became German chancellor. In summer 2004, McCain met at a restaurant with Viktor Yushchenko before the Orange Revolution when he was elected Ukrainian president.

Next week, McCain is expected to meet with British Prime Minister Gordon Brown for the first time, and French President Nicolas Sarkozy for the third time. He met and corresponded with Sarkozy both before and after he was elected. The two last saw each other last summer.

McCain has relationships with every leader in Israel he plans to see, including Prime Minister Ehud Olmert, Foreign Minister Tzipi Livni, Defense Minister Ehud Barak and hawkish opposition leader Benjamin Netanyahu.

The senator last met with Iraqi Prime Minister Nouri al-Maliki last Thanksgiving, and he’s also gotten to know other members of the Iraqi government.

He returns with two of his chief presidential supporters, Sens. Joe Lieberman of Connecticut and Lindsey Graham of South Carolina, but he insists it is a fact-finding venture, not a campaign photo opportunity.

“There’s nothing like being on the ground,” he said. Mentioning a mountainous area in northwestern Pakistan, he added, “I went to Waziristan once and it gave me a much better understanding of how difficult it is to get Osama bin Laden.”

O’Hanlon, the Brookings analyst who says he’s a Democrat, says McCain has shown a more realistic vision than Bush about the number of troops needed to succeed in Iraq, as well as the problems that were likely to be encountered after the invasion.

“What that tells me in terms of future policy is McCain may be willing to stay the course, so to speak, in terms of future difficulties, but also assess if the strategy is really working or not,” O’Hanlon said.

Jon Alterman, a former Bush administration aide who now runs the Middle East program at the Center for Strategic and International Studies, notes that Bush’s father spoke of “the vision thing.”

“This president has always been strong on the vision thing, even when the implementation is lacking. I don’t think John McCain is enamored with the vision thing. He talks about the task and focuses on the task. It’s just a different orientation,” Alterman said.

“The straight talk express is not often associated with diplomacy,” he said. “But the advantage of it is you know what you’re getting. And it may be that he’s able to form quite valuable relationships precisely because of his bluntness.”

___

Associated Press Writers Liz Sidoti and Libby Quaid contributed to this report.

via MSN

China and the United States are working together to investigate the blood-thinner heparin, which has been linked to 19 American deaths, China’s food and drug administration said Sunday.
The U.S. Food and Drug Administration has been widening its investigation into the hundreds of adverse reactions - including difficulty breathing, nausea and falling blood pressure - linked to U.S. health care company Baxter International’s heparin injections.
Heparin is derived from pig intestines, and China is the world’s leading supplier.
U.S. and Chinese officials have been investigating heparin samples but have reached no conclusions, Wu Zhen, the deputy commissioner of China’s State Food and Drug Administration, said Sunday.
“China’s State Food and Drug Administration and America’s FDA are working closely together on the heparin investigation, and American investigators came to China to investigate and we supported them,” Wu said at a news conference.
“The most important thing now is that the scientists of both sides launch an in-depth investigation into the details,” he said. “We can’t take effective measures until we find the cause.”
The U.S. FDA found a contaminant in 20 of 28 samples of raw heparin from Baxter’s main supplier, Scientific Protein Laboratories of the United States, which gets the bulk of its heparin from a joint venture in China’s east Jiangsu province.
Scientists don’t yet know exactly what the contaminant is, except that it mimics heparin so closely that standard drug-purity tests will not catch it. Nor is it certain that the contaminant is to blame for the allergic reactions, although it is the prime suspect.
Wu said it was still unclear at what stage the heparin had been contaminated because the production process was long and complicated. He said Scientific Protein Laboratories got its raw material from Kaipu Biochemical Co. in Changzhou, also known as Changzhou SPL.
Wu said the heparin could have been contaminated after production or when the drug was exported overseas.
A different brand of heparin has also been recalled in Germany after 80 patients there became sick, and the German manufacturer said it was narrowing down the source of contamination to another Chinese supplier.
The mayor of Changzhou, Wang Weicheng, said Friday that the city government had cooperated with the investigation and was seriously monitoring the companies in the city. He said it was the first time a problem had been reported.
The city shut down 800 chemical companies last year for violating environmental standards, he said.

via AOL

WASHINGTON - U.S. health officials have ordered all imports of the blood thinner heparin, and its raw ingredient, stopped at the border for testing to detect a contaminant linked to 19 deaths.

The Food and Drug Administration announced the move Friday, the latest step in its widening investigation of hundreds of allergic-type reactions linked to Baxter International’s heparin injections.

The FDA found the contaminant in 20 of 28 samples of raw heparin that the agency tested from Baxter’s main supplier, a Chinese factory owned by Scientific Protein Laboratories.

A different brand of heparin also has been recalled in Germany after 80 patients there got sick, and the German manufacturer said Friday that it was narrowing down the source of contamination to another Chinese supplier.

FDA announced some good news Friday, saying it had learned of no additional deaths and just two more allergic reactions since Baxter recalled the last of the suspect heparin late last month.

Scientists do not yet know exactly what the contaminant is, except that it mimics heparin so closely that standard drug-purity tests won’t catch it. Nor is it certain that the contaminant is to blame for the allergic reactions, although it is the prime suspect.

Click for related contentNew approach to CPR saves more livesPatients in Germany sickened by heparin

But the FDA is “very close” to identifying the substance, a step that should help tell if the contaminant got into heparin by accident or by fraud, said FDA drug chief Dr. Janet Woodcock.

Heparin is derived from pig intestines, and China is the world’s leading supplier. Tiny family-run workshops near slaughterhouses send batches of raw ingredients to larger middlemen before they reach factories like SPL’s in Changzhou. The FDA has not yet inspected those workshops, saying that was something under discussion with Chinese officials.

Two weeks ago, the FDA urged all remaining U.S. heparin manufacturers to start using more sophisticated tests to be sure their products were contaminant-free. Friday, the agency said worldwide testing had begun.

The added hurdle for imports “will improve our safety net,” Woodcock said. “We will get a much better picture of whether there’s any contaminant existing, and we can trace it back” to its source.

Most of the actual import testing will be done by five of the nation’s leading heparin manufacturers, which will be cleared to sell their products once the FDA receives those test results.

The FDA itself will test any remaining shipments that arrive from abroad.

The FDA wouldn’t name the five companies that will do their own testing, and acknowledged it has no plans to do spot checks of the quality of those companies’ tests.

via MSN

Leigh Bradshaw could be mistaken for a drug-company sales rep as she pulls out charts and leaflets to tell Dr. Ernest Josef about the costs and benefits of various cholesterol-lowering drugs.
But notably absent during her visit to his family practice is the swag typical of a pharmaceutical marketing arsenal - the free pill samples, the logo-emblazoned pads and pens, the free lunch for doctor and staff.
That’s because Bradshaw, a registered nurse, isn’t trying to pitch a product for a drug manufacturer. She works for Pennsylvania taxpayers.
In a David vs. Goliath battle, Pennsylvania is among a handful of states trying - with modest results at best - to counter the pharmaceutical industry’s multibillion-dollar marketing and cut costs for prescription-aid programs for senior citizens, who are bombarded with “ask your doctor” advertising.
“The more times they see it on TV, they feel that implies it is a better drug, which might not necessarily be the case,” Josef said.
Josef, who is 45 and has been practicing medicine for 16 years, said he had already begun prescribing more generic cholesterol drugs in response to patient cost concerns, but that Bradshaw’s presentation gave him more information to back up his recommendations.
State officials here say they are trying to ensure that patients get the most effective treatment. But driving the outreach is an effort to hold down expenses - in some cases by steering doctors to generics, in others by showing how lifestyle changes can sometimes be preferable to medication.
Pennsylvania is not the first state to try what is known as an “unsales” strategy, but its program, begun in late 2005, is considered the most extensive. The state spends $1 million a year on its “unsales” force - 11 consultants, including some former pharmaceutical salespeople, assigned to the 28 counties with the highest concentrations of seniors enrolled in discount drug programs.
West Virginia ran a similar program in two cities from 2003 to 2005. Vermont has a program focusing on rural medical practices and South Carolina began one last fall, focusing on mental-health prescriptions.
In visits with doctors, Pennsylvania’s consultants share findings such as:
The cost of a 20-milligram daily dose of various cholesterol drugs can range from 13 cents for generics to $4.53 for one of the more expensive brand names.
A 30-day supply of some popular brand-name heartburn drugs can cost anywhere from $111 to $124, compared with just $1 to $2 for an equivalent supply of over-the-counter antacids.
With generic drugs already accounting for two-thirds of all prescriptions, the pharmaceutical industry’s main trade group questions the value of the “unsales” programs.
The group said care could suffer if steering patients to generics is the primary objective - which the programs deny. It also maintained that state consultants are not held to the same strict standards as drug company reps in their presentations.
“A less expensive treatment may be more costly in the long run if it is not the best therapy for the patient,” Ken Johnson, spokesman for The Pharmaceutical Research and Manufacturers of America, said in a written statement to The Associated Press.
Bradshaw said generics are not pushed “unless the generic is the better choice,” noting there are cases where brand-name products are deemed the most effective.
States are clearly outgunned.
The industry spends more than $7 billion a year on direct marketing to doctors and employs about 90,000 salespeople - one for every five doctors, according to the Prescription Project, a campaign funded by The Pew Charitable Trusts to challenge pharmaceutical marketing practices.
Still, Pennsylvania reports some slight cost-control success in its assistance programs, which last year enrolled 360,000 people 65 and older and cost the state $325 million, up more than 30 percent in the last decade.
For patients of nearly 300 participating doctors, average monthly spending on some pain relievers dropped from $400 to $340 per doctor within six months after a state consultant visit, a preliminary analysis found.
Another analysis found that the program saved Pennsylvania about $572,000 a year alone on heartburn drugs.
In both instances, the state took into consideration other factors influencing doctors’ prescriptions - such as publicity about dangerous side effects and a strong push for generic drugs by insurance companies, said Thomas Snedden, director of Pennsylvania’s prescription drug discount programs. The evaluations included control groups of doctors who either did not participate in the program or practiced in counties where it is not offered.
To develop Pennsylvania’s program, state officials consulted with Dr. Jerry Avorn, a Harvard Medical School professor who pioneered the practice in the late 1970s.
He determined that the best way to combat industry marketing was to try to beat them at their own game - by using the industry’s basic tools to tell medical professionals about a broader base of medical research in a more engaging style than the pedantic lectures he endured as a medical-school student.
But states have found it hard to staff their programs, let alone measure the results.
West Virginia used pharmacists to educate doctors but because it could not pay enough, the state had difficulty recruiting enough consultants to expand beyond Morgantown and Charleston, said S. Suresh Madhavan, a professor at West Virginia University’s pharmacy school, which collaborated on the initiative.
Vermont relies on a two-person staff and a $50,000 annual budget which leaves little room for extensive evaluation, said Amanda Pinckney, a co-director of the program. The state is now considering partnering with Maine and New Hampshire.
In her recent visit with Josef, Bradshaw presented data compiled by Harvard researchers, including a cholesterol chart showing when lifestyle changes should be pursued as opposed to medication, and a price comparison of various brand-name and generic drugs.
Josef said he was initially skeptical about the value of an “unsales” pitch but now appreciates getting a broader view of research into various classes of drugs.
“It makes me feel more comfortable that I have some data to back up that the generic drugs are just as efficacious,” he said. “It saves me time from having to do a lot of the research.”
He said patients do not put up much resistance to switching once he can assure them a generic is just as effective.
The state uses data it keeps on the number of prescriptions doctors write for certain drugs covered by the prescription-discount programs to identify potential participants, and passes it along to the consultants so they can set up visits, Snedden said.
Participation in the program is voluntary, and doctors can earn continuing medical education credits from Harvard for doing so.
“I think the physicians are very receptive to these calls, in large measure because it is the state calling,” Snedden said. “Physicians have a good deal of respect for the (prescription drug-assistance) program.”
To no one’s surprise, Bradshaw said she often runs into drug industry reps when she’s out in the field.
She said they are relieved when she tells them she works for the state, and not a competitor.
On the Net:
Independent Drug Information Service: http://www.rxfacts.org
The Prescription Project: http://www.prescriptionproject.org
Pharmaceutical Research and Manufacturers of America: http://www.phrma.org

by AOL

CONTROLLING COSTS: A handful of states are trying to counter the prescription drug industry’s multibillion-dollar marketing to doctors and hold down drug costs for state-subsidized programs.

HOW DOES IT WORK?: Doctors are given summaries of medical research and pricing information comparing generic drugs to their brand-name counterparts, plus information about some alternatives to medication, like lifestyle changes.

ANY SUCCESS?: Pennsylvania reports some slight savings in its program, but officials acknowledge it’s an uphill battle.

by MSN