Tagged Health Industry

Rural Hospitals Closing At Dangerous Rate For Pregnant Women Stuck Hundreds Of Miles From Care

Researchers estimate that fewer than half of the country’s rural counties still have a hospital that offers obstetric care. “We can’t keep a hospital. What is our community coming to?” Kela Abernathy said. In other women’s health news, a judge rules in favor of the Trump administration over its proposed funding rules for the family-planning program, and many women treated for early-stage breast cancer aren’t getting the recommended follow-up care.

Must-Reads Of The Week From Brianna Labuskes

On this Friday the 13th, we’re wrapping up another week dominated by the upcoming battle over the next Supreme Court justice and the administration’s scramble to reunite separated families — not to mention new efforts to chip away at the health law.

Don’t feel overwhelmed. Here are some of the best stories on all that news and more.

The battle brewing over Supreme Court nominee Brett Kavanaugh highlights the political complexities of the upcoming midterms. In the Senate, where the battleground favors conservatives, the vote is an albatross around vulnerable red-state Democrats’ necks. But in the lower chamber, the fights are being waged in swing suburban districts around the country, giving Democrats the chance to appeal to independents and moderate Republicans.

The New York Times: Who Might the Court Fight Help in the Midterms? Democrats. and Republicans.

However, Democrats — in what even they say is a classic problem with the party — can’t seem to focus their message. Yes, they’re talking health care (threats to not only abortion but the health law itself). But they’re also focusing on presidential power and unions and LGBTQ rights and … the list goes on.

Politico: Dems Pitch Mixed Messages in Supreme Court Fight

(On that note, my favorite quote of the week comes from Politico’s coverage of Senate Minority Leader Chuck Schumer trying to get his people in line: “I’ll be 71 years old in August, you’re going to whip me? Kiss my you know what,” said Sen. Joe Manchin (D-W.Va.) when asked if Schumer can influence his vote.)

States are also scrambling to make sure they don’t have any centuries-old laws on the books banning abortions … just in case.

The Associated Press: States Brace for Abortion Fights After Kavanaugh Nomination

Even though the government missed the court-ordered deadline, officials have announced that all “eligible” children under age 5 have been reunited with their families. That still leaves 46 “ineligible” kids, plus thousands of older ones still in custody.

The New York Times: U.S. Says It Has Reunited Half of All Migrants Under 5, With Rest ‘Ineligible’

And somehow Health and Human Services Secretary Alex Azar has become the public face (and punching bag) of this crisis.

Politico: How the New Face of the Migrant Crisis Got Stuck With the Job

The health law absorbed a one-two blow this week. Not only did the administration slash funding for navigators (counselors who help people sign up for coverage), but it also froze a program that provides billions of dollars to insurers to help stabilize the marketplace. The reaction to both was fairly tempered, though. (Which might be a sign that upheaval and uncertainty has become the new norm.)

Politico: Latest Obamacare Shake-Up Could Fuel Rate Hikes

Modern Healthcare: CMS Risk-Adjustment Payment Freeze to Hit High-Cost Insurers Hardest

Pfizer’s agreement to roll back its price hikes earned the company flashy headlines. Looking more closely, the move doesn’t really translate to savings for consumers.

Stat: What Pfizer, Trump, and Consumers Got Out of a Surprising Deal

Be sure to check out this deep dive on the CEO who, while having a knack for turning a profit, is described as tone-deaf to the current outrage on drug prices.

Stat: How Pfizer’s CEO Kept on Raising Prices — Until Trump’s Tweet

If all that wasn’t enough news for you, here’s my miscellaneous file for the week: A startling report finds that drug distributors shipped the equivalent of about 260 opioid pills for every person in Missouri in a six-year period; despite New York’s abundance of world-class hospitals and surgeons, thousands of patients needing transplants are languishing on lists because New Yorkers donate organs at a lower rate than anywhere else in the country; and the administration tried to water down a global resolution on breastfeeding, resorting to trade threats and backing off only when Russia stepped in to introduce the measure.

The Washington Post: Companies Shipped 1.6 Billion Opioids to Missouri From 2012 to 2017, Report Says

The New York Times: New York Has World-Class Hospitals. Why Is It So Bad for People in Need of Transplants?

The New York Times: U.S. Opposition to Breast-Feeding Resolution Stuns World Health Officials

And just when we were getting over the romaine lettuce outbreak, we have not one but two more food-related illnesses popping up.

Have a great weekend!

Facebook Live: The Marketing Plan That Fueled An Addiction Epidemic

Files from Fred’s basement: KHN senior correspondent Fred Schulte talks about a cache of files detailing Purdue Pharma’s early OxyContin marketing plan. These documents, which are more than 15 years old but still relevant now, offer insights into how these strategies contributed to the nation’s current opioid addiction epidemic.

Here’s the recent story he wrote on the topic. Click here to view the files.

For more in-depth conversations with KHN reporters, check out our Facebook video archive.

KHN’s coverage related to aging and improving care of older adults is supported in part by The John A. Hartford Foundation.

Initiative Targeting Synthetic Opioids Will Hyper-Focus On Counties To Try To Eradicate Every Instance Of Drugs

Attorney General Jeff Sessions announced the project, which is based on a successful model in Manatee County, Florida. The program will provide a new assistant U.S. attorney to districts in New Hampshire, California, Kentucky, Maine, Ohio, Pennsylvania, Tennessee and West Virginia.

FDA Wants To Be Granted Expanded Authority To Intervene In Drug Shortages

While the number of drugs in shortage is down from a peak several years ago, many supply interruptions are lasting much longer — sometimes well over a year. Right now, there’s not much the agency can do, but FDA Commissioner Scott Gottlieb says he wants to get more aggressive in protecting patients from the shortfalls.

Pfizer CEO Has Knack For Making A Profit, But He Misplayed The Optics Of Raising Prices In Current Atmosphere

Like clockwork, Pfizer has been raising prices every six months, flying under the radar because most pharma companies were doing the same. But then the company caught the attention of President Donald Trump, and everything changed. In other pharmaceutical news: Novartis ditches antibiotics research; a patient advocacy group highlights a New Jersey candidate’s ties to high prices; and an experimental epilepsy drug moves forward toward approval.

Retooled Vaccine Raises Hopes As A Lower-Cost Treatment For Type 1 Diabetes

For Hodalis Gaytan, 20, living with Type 1 diabetes means depending on an assortment of expensive medicines and devices to stay healthy. Test strips. Needles. A glucose meter. Insulin.

The increasing cost of Type 1 diabetes, one of the most common serious chronic diseases, has created heavy financial burdens for families and generated controversy, with insulin prices more than doubling in the past decade.

Without her parent’s insurance, “I would not be alive,” said Gaytan, a student at the University of Maryland.

The burden of treatment is why a small study that shows promise for a simpler, cheaper alternative treatment to Type 1 diabetes is being met with hope — but also with caution and skepticism.

The research, published June 21 in the journal Nature Partner Journal Vaccines, showed that an older generic vaccine may help lower the blood sugar level of patients with Type 1 diabetes, decreasing their need for insulin. The vaccine, BCG, is used in a number of countries to prevent tuberculosis and has long been known to stimulate the immune system as well. That vaccine is relatively cheap, costing about $157 per dose in the United States, according to the health care technology company Connecture.

In the study, participants with long-standing Type 1 diabetes were injected with two doses of Bacillus Calmette-Guerin tuberculosis vaccine — known as BCG — four weeks apart. Three of the patients were observed for eight years. Nine participants were followed for five years.

The blood sugar levels — known as A1c — of those followed for eight years dropped by more than 10 percent three years after the injection and were sustained for five more years.

While the trial involved a tiny number of patients, the researchers — led by Dr. Denise Faustman, director of the Immunobiology Laboratory at Massachusetts General Hospital — are conducting a much larger Phase 2 trial of BCG to treat diabetes to see if the results hold up.

JDRF, a leading nonprofit organization that provides funding for research on Type 1 diabetes, and the American Diabetes Association issued a joint statement shortly after the new study was released, cautioning against misinterpreting the findings and stating that they “do not provide enough clinical evidence to support any recommended change in therapy at this time.” Both groups have partnered with drug manufacturers and device makers in the industry.

Still, Dr. Camillo Ricordi, director of the Diabetes Research Institute at the University of Miami, said he is “cautiously optimistic” about the findings, noting the “incredibly high price tag” for patients with diabetes. But he warned against generating “too much hype” among families before the treatment is proven to be effective.

Dr. Joseph Bellanti, professor emeritus of pediatrics and microbiology and immunology at Georgetown University Medical Center in Washington, D.C., was also encouraged by the studies’ findings. While he acknowledged the skepticism surrounding Faustman’s research, scrutiny is a necessary part of the scientific process, he said.

“We’re seeking the truth, and we want to make sure that the results and the interpretations are correct, Bellanti said, “and that requires healthy debate.”

Hodalis Gaytan was diagnosed with Type 1 diabetes six years ago after a routine physical. Without health insurance to pay for the expensive, lifesaving medicines, she says, she believes she would have died. (Courtesy of Hodalis Gaytan)

Faustman said her findings are important because they suggest that the vaccine could have positive effects in the treatment of diabetes, similar to what has been seen in previous research on other autoimmune diseases, like multiple sclerosis, that involve an immune system reaction against normal tissue.

“It also opens up a host of new possible treatment avenues,” Faustman said, adding that it could help in developing interventions for other groups suffering from chronic illnesses.

Type 1 diabetes, which typically is diagnosed in childhood, occurs when the immune system destroys the cells that produce insulin. People with Type 2 diabetes produce normal levels of this vital hormone, but their bodies don’t respond appropriately.

These findings surface as the country grapples with soaring insulin prices — a rise so significant it has prompted attorneys general in several states and at least one federal prosecutor to launch investigations targeting insulin makers Eli Lilly, Novo Nordisk, Sanofi and pharmacy benefit managers.

The United States already pays a steep price for its diabetes burden. According to the American Diabetes Association, the 24.7 million Americans living with the diagnosis last year spent $237 billion in direct medical costs.

For patients like Gaytan, the prospect of new medications to simplify and reduce the costs of her treatment is tantalizing. She injects herself with insulin and checks her blood sugar level about five times a day. And she attends therapy to help deal with the burden of living with a chronic condition, and worries about how she’ll afford it in the future.

“I know diabetics [whose] families pay for everything,” she said, adding they “just can’t afford it.”

According to Connecture, the list price for Apidra SoloStar — an injectable insulin product that Gaytan uses several times per day — increased from $33.24 per pen in early 2009 to $104.28 per pen in early 2018.

Faustman said her research has documented the mechanism by which the old vaccine reduces blood sugar levels. In the Phase 2 trial, she will attempt to replicate her findings by following 150 participants with the disease for five years. It will be at least another four years until results are published.

Ultimately, if BCG works to treat Type 1 diabetes, its current cheap price could rise, said Gerard Anderson, professor of health policy and management and medicine at Johns Hopkins University in Baltimore, who, like Kaiser Health News, receives money from the Laura and John Arnold Foundation. Though BCG is generic, pharmaceutical companies can raise the price by altering the drug and issuing a new patent.

Drugmakers are expert at retooling old drugs to treat new conditions, he said, adding: “It could result in no cost savings at all — and, in fact, a higher price.”

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.