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KHN First Edition: June 21, 2016


First Edition

Tuesday, June 21, 2016
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: Office Chatter: Your Doctor Will See You In This Telemedicine Kiosk
Kaiser Health News staff writer Phil Galewitz reports: "On the day abdominal pain and nausea struck Jessica Christianson at the office, she discovered how far telemedicine has come. Rushing to a large kiosk in the lobby of the Palm Beach County School District’s administrative building where she works, Christianson, 29, consulted a nurse practitioner in Miami via two-way video. The nurse examined her remotely, using a stethoscope and other instruments connected to the computer station. Then, she recommended Christianson seek an ultrasound elsewhere to check for a possible liver problem stemming from an intestinal infection. The cost: $15. She might have paid $50 at an urgent care center." (Galewitz, 6/21)

Kaiser Health News: Health Effects Of Egg Donation Not Well Studied
Sandra G. Boodman, for Kaiser Health News, reports: "Studies of the long-term impact of egg donation on donors have never been done, even though the practice dates back more than 30 years. Despite sporadic reports of subsequent infertility and a variety of cancers, some fatal, it isn't known whether these problems are linked to the process or are simply the result of chance. Fertility specialists say that egg donation is safe and involves the same process as in vitro fertilization, which uses drugs to stimulate and regulate egg production. A 2013 meta-analysis of 25 studies seeking to evaluate the risks between ovarian cancer and the use of fertility drugs found "no convincing evidence" of an increase in the risk of invasive ovarian cancer. ... But others say the matter remains unsettled because donors haven't been studied." (Boodman, 6/21)

Kaiser Health News: As Childhood Diabetes Rates Rise, So Do Costs — And Families Feel The Pinch: Study
Kaiser Health News' Carmen Heredia Rodriguez reports: "Childhood diabetes rates are on the rise, and a report released Monday pointed to the impact that the cost of their care could have on families -- even those who have employer-sponsored health insurance. The study, conducted by the Health Care Cost Institute (HCCI), found that children as old as 18 with diabetes who were insured through an employer-sponsored plan racked up $2,173 per capita in out-of-pocket health care costs in 2014. That spending level was nearly five times higher than that of kids without the illness. (Heredia Rodriguez, 6/20)

The Wall Street Journal: Senate Rejects Four Gun-Control Proposals
The Senate on Monday night rejected four proposals to tighten the nation’s gun laws, as familiar partisan battle lines left lawmakers unable for now to respond to this month’s mass shooting in Orlando, Fla. ... Two measures focused on the background-checks system also stalled Monday night. The Democratic bill would have expanded the use of background checks beyond only federally licensed dealers to include private gun sellers and all sales online. A competing measure from Sen. Chuck Grassley (R., Iowa) that would encourage states to submit relevant mental-health records to the nation’s background-check system was blocked. It would also have changed certain mental-health terminology in a way that Democrats said would make it easier for those with mental illness to procure guns. (son and Hughes, 6/20)

The Washington Post: From Columbine To Orlando, Medics Grapple With How Best To Stop The Bleeding
In the 17 years of mass shootings and stalled debates about gun control that separate Columbine from the recent massacre in Orlando, another debate has evolved among medical professionals and first responders about how to prevent deaths like Sanders’s. It hovers over the decision in Orlando to wait three hours after Omar Mateen began shooting before breaching the Pulse nightclub where he was holding hostages and where unknown numbers were wounded. And it is an increasingly urgent focus for emergency responders, because one of the few comments experts make with confidence about these unpredictable mass attacks is that they are sure to happen again. “Scoop and run” — the idea of moving victims to a trauma hospital as quickly as possible — is a mantra of modern U.S. emergency care. Internal hemorrhage can be handled only in an operating room. But stanching bleeding from arms and legs often needs to happen even sooner. (Stead Sellers, 6/20)

The Washington Post: How A Simple Sandwich Could Be Driving Up Drug Prices
Doctors who ate a single meal on a drug company's tab had a higher likelihood of writing a prescription for the name-brand drug that was being promoted instead of equivalent drugs that were cheaper, according to a new study. And the more meals — or the more expensive the meals — the greater the rate of prescribing the pitched drug. The study, published in JAMA Internal Medicine, can't show that dinner or doughnuts with the pharmaceutical company caused physicians to preferentially prescribe a particular drug, but it revealed a striking correlation between breaking bread with a sales representative who is pushing a particular drug and doctors who are prescribing it. Overall, the meals received were modest, with an average cost of less than $20. (Johnson, 6/20)

The Associated Press: Rx Pizza: 1 Free Meal Can Sway Doctor Prescribing
As little as one free meal from a drug company can influence which medicines doctors prescribe for Medicare patients, according to a study using Medicare records and recently released data from the health care law's Open Payments program. The study highlights the subtle ways doctors may feel inclined to prescribe a drug after receiving just a small gift, even if the drug is more costly for patients and their insurance plans, the study authors said. (6/20)

The Wall Street Journal: Even Cheap Meals Influence Doctors’ Drug Prescriptions, Study Suggests
The industry association, Pharmaceutical Research and Manufacturers of America, said that the study “cherry-picks physician prescribing data for a subset of medicines to advance a false narrative” and that drugmakers interact with doctors to share drug safety and efficacy information. Critics say drugmakers’ payments and gifts to doctors can improperly influence medical decisions and inflate drug costs by steering doctors to pricey brand-name drugs. (Loftus, 6/20)

The Associated Press: NIH Won't Cut Price Of Taxpayer-Funded Prostate Cancer Drug
The federal government has declined a petition to lower the price of a drug for advanced prostate cancer developed with taxpayer money. The public interest group Knowledge Ecology International petitioned the National Institutes of Health in January to reduce the $129,000-a year list price of Xtandi, made by the Japanese drugmaker Astellas Pharma. (6/20)

The Wall Street Journal: Supreme Court Upholds Rules That Have Been Friendly To Patent Challenges
The Supreme Court on Monday blessed new government procedures for challenging patents, a win for companies that argued the fledgling process was a better, more cost-effective way to weed weak patents out of the system. The ruling is a blow for companies that favor strong patent protections, such as those in the pharmaceutical and biotechnology industry. ... The case focused on Patent Office regulations that implemented part of a 2011 congressional overhaul of the nation’s patent system. Many supporters of the law argued there were too many questionable patents in the U.S. and it was too slow and expensive to challenge them in court. ... The Patent Office process has also become popular with generic drug companies, as well as some hedge funds, which have sought to challenge patents held by brand-name drug markers, said Brian Pandya, a lawyer with Wiley Rein LLP. (Kendall, 6/20)

The Associated Press: Experimental Zika Vaccine To Begin Human Testing
An experimental vaccine for the Zika virus is due to begin human testing in coming weeks, after getting the green light from U.S. health officials. Inovio Pharmaceuticals said Monday it received clearance from the Food and Drug Administration to begin early-stage safety tests of its DNA-based vaccine against the mosquito-borne virus. That puts the company ahead of researchers at the National Institutes of Health, who have said they expect to begin testing their own DNA-based Zika vaccine by early fall. (6/20)

The Washington Post: Scientists Announce Important Zika Milestone: First Vaccine Ready For Human Trials
Pennsylvania vaccine maker Inovio Pharmaceuticals and South Korea’s GeneOne Life Sciences said Monday that they had received approval from U.S. regulators to start testing a DNA vaccine, known as GLS-5700, on humans. The early-stage study will include 40 healthy subjects. It is primarily designed to assess the safety of the vaccine but will also measure the immune response generated by the injection. Zika, part of the flavivirus family of viruses that includes West Nile, dengue and yellow fever, is believed to be responsible for causing thousands of babies to be born with shrunken heads in Brazil and elsewhere. The Centers for Disease Control and Prevention recently detailed the cases of six babies born with the condition in the United States. (Cha, 6/20)

The Associated Press: Experts Only Beginning To Grasp The Damage From Zika Virus
Even though the explosive spread of the Zika virus has been met with a new level of international response, thanks to lessons learned from the Ebola crisis, experts warn they are only beginning to grasp the damage the mosquito-borne virus can do. Doctors speaking at a U.N. meeting on Global Health Crises said Monday that the Zika virus has already affected 60 countries on four continents, and a major outbreak on the Atlantic Ocean island nation of Cape Verde suggests the disease is now poised to enter continental Africa. Zika has already become epidemic in Latin America and the Caribbean. (6/20)

NPR: Zika And Children: What Parents Need To Know
By now we know that Zika is dangerous for pregnant women and their future babies. The virus can cause devastating birth defects. But what about for infections after babies are born? Or in older children? Is Zika a danger for them? So far, all the evidence suggests probably not. But there are a few caveats. (Doucleff, 6/20)

The New York Times: Conflicting Concerns At A Boston Hospital: Crowding, Costs And A Placid Garden
At a public hearing this year, a nursing director from Boston Children’s Hospital made a painfully detailed case for why the hospital needs to expand. In the crowded neonatal intensive care unit, she said, doctors sometimes have to perform emergency surgery at an infant’s bedside, “within feet of other critically ill children and their anxious parents.” The open layout means that only a curtain separates a family preparing to take its baby home from parents who just took theirs off life support, she added, their sobbing heard by all. ... But what might seem an undeniable need for Boston Children’s — a new 11-story building that would house a bigger N.I.C.U. and heart surgery center, and private patient rooms instead of doubles — is instead bogged down in controversy. (Goodnough, 6/20)

Politico: Scope Of Practice: How Can We Expand Access To Care?
Scope of practice — who can practice what kind of medicine, in what settings and under what type of physician supervision, if any — is an issue that has preoccupied state legislatures and the courts for years. The disputes involve physicians, nurse practitioners, chiropractors, pharmacists, dental hygienists, respiratory therapists, podiatrists, pharmacists, midwives — and just about everyone else in medicine. It has taken on renewed importance in the past few years given the coverage expansion of the Affordable Care Act, the shortage of primary care physicians and mental health practitioners in sections of the country, the needs of an aging population, and the pressures to find ways of providing care less expensively without harming quality. (6/20)

The Associated Press: Aetna-Humana Merger Gets California Regulator's Approval
A California regulator is approving Aetna Inc.'s proposed acquisition of rival health insurer Humana Inc. Shelley Rouillard, director of the California Department of Managed Health Care, announced her decision Monday. As a condition of the approval, Aetna agreed to limit premium increases in the small group market and to allow greater state oversight of its rates. The company will also have to keep certain decision-making functions in California and must invest in various health initiatives. (6/20)

The Associated Press: North Carolina Opens Access To Overdose Reversal Drug
North Carolina becomes the third state to provide unlimited access to a prescription drug that’s already saved more than 2,000 people statewide who were overdosing on heroin, OxyContin or other opium-based drugs. Gov. Pat McCrory signed a law Monday that creates a statewide standing order at all pharmacies to prescribe naloxone to anyone. (6/20)

The Washington Post: Marijuana’s Biggest Adversary On Capitol Hill Is Sponsoring A Bill To Research … Marijuana
Rep. Andy Harris (R-Md.) is Congress's most vocal opponent of legal marijuana, having single-handedly spearheaded a provision blocking legal pot shops in the District of Columbia in 2014. Rep. Earl Blumenauer (D-Ore.), on the other hand, was recently named Congress's "top legal pot advocate" by Rolling Stone. The two lawmakers couldn't be farther apart on marijuana policy, but they're teaming up this week to introduce a significant overhaul of federal marijuana policy that would make it much easier for scientists to conduct research into the medical uses of marijuana. (Ingraham, 6/20)

The Wall Street Journal: Researchers Study New Ways To Treat Suicide Risk
Scientists are developing new ways to directly target the suicidal thoughts and behaviors of people at risk. Researchers are finding that certain medications, like ketamine, clozapine and lithium, may alleviate suicidal thinking. Scientists are also tweaking existing psychological treatments, like cognitive behavioral therapy, and coming up with new ones to combat the desire for self-harm. (sen, 6/20)

The Washington Post: ‘We Had No Hope’: The Amazing Story Of The Baby Born With His Brain Outside His Skull
Right on schedule, Sierra Yoder went into labor. It was Halloween night, and she was wearing an orange T-shirt with a pumpkin covering her belly. It was embellished with her new son’s name and his expected birth date: “Bentley. Due 10/31/15.” Yoder and her husband, Dustin Yoder, hopped into the car and headed for the hospital — but without any bottles, without any diapers, without a car seat in which to bring their newborn home. They had packed one onesie — light blue with stars — and matching pants and warm, fuzzy socks. The couple expected to bury their son in it very soon. (Bever, 6/20)

The Washington Post: I Didn’t Like It, But This Was The Death She Chose
I hover expectantly over Ellen, and she looks up from her iPad, her eyes shiny. The device is a birthday present she asked my husband, Harry, and me to get for her six months earlier, and I’m glad we did so that she can now distract herself with old “M*A*S*H” episodes. “I’m lucky you were my mother-in-law,” I blurt. She doesn’t blanch at my referring to her in the past tense; we both know that, in light of her imminent kidney failure, she won’t be my mother-in-law much longer. “My children all picked wonderful life partners,” she replies evenly, and smiles. It’s a nice sentiment, though after nearly 30 years of being her daughter-in-law, I want to hear something more personal, a reminder of what we meant to each other that I can play over in my mind when she’s gone. But it’s crowded in my third-floor guest room, with Harry and Jennifer, Ellen’s home health aide, looking on, and it feels too awkward to prompt her any further. From her perspective, this is not the time to get mired in sentimentality. Things are working out according to her plans. (Schweich Handler, 6/20)

The Wall Street Journal: Study Finds Drinking Alcohol Associated With Heart-Rhythm Disorder
A study comparing hospital admissions in “wet” versus “dry” counties in Texas offers a surprising new perspective on how alcohol consumption may affect the health of your heart. The analysis found that people living in dry counties, where sales of alcoholic beverages are prohibited, had a higher risk of being hospitalized for a heart attack or congestive heart failure than people living in wet counties, where such sales are allowed. But residents of wet counties were at elevated risk for a heart rhythm disorder called atrial fibrillation. (Winslow, 6/20)

Kaiser Health News is an editorially independent operating program of the Kaiser Family Foundation. (c) 2016 Kaiser Health News. All rights reserved.

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