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KHN First Edition: September 1, 2016


First Edition

Thursday, September 01, 2016
Check Kaiser Health News online for the latest headlines

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

Kaiser Health News: Mylan’s Generic EpiPen — A Price Break Or Marketing Maneuver?
Kaiser Health News staff writer Julie Appleby reports: Following weeks of criticism over dramatic price increases on its EpiPen, Mylan said Monday it will offer a generic version of the life-saving allergy treatment. The generic, which the company says will be identical to the brand product, will sell for $300 for a two-pack, which is half the cost of Mylan’s brand name EpiPens. The news did little to dim the ongoing outcry over the price, for which there are no other competitors on the market. Some called it a marketing ploy. ... KHN offers answers to some key questions related to Mylan’s generic and breaks down what this development could mean for consumers and the marketplace. (Appleby, 9/1)

Kaiser Health News: How To Fight For Yourself At The Hospital — And Avoid Readmission
Kaiser Health News columnist Judith Graham writes: "Everything initially went well with Barbara Charnes’ surgery to fix a troublesome ankle. But after leaving the hospital, the 83-year-old soon found herself in a bad way. Dazed by a bad response to anesthesia, the Denver resident stopped eating and drinking. Within days, she was dangerously weak, almost entirely immobile and alarmingly apathetic. “I didn’t see a way forward; I thought I was going to die, and I was OK with that,” Charnes remembered, thinking back to that awful time in the spring of 2015. Her distraught husband didn’t know what to do until a long-time friend — a neurologist — insisted that Charnes return to the hospital." (Graham, 9/1)

California Healthline: UCLA Study: Taxpayers Foot 70 Percent Of California’s Health Care Tab
California Healthline staff writer Ana B. Ibarra reports: "This year, taxpayers will cover about 70 percent of what is spent on health care in California, according to a new analysis released Wednesday by the UCLA Center for Health Policy Research. Many people assume that the U.S. health care system is primarily supported by private dollars, such as insurance premiums from employer-based coverage, said Gerald Kominski, director of the UCLA Center for Health Policy Research and the study’s lead author." (Ibarra, 8/31)

Kaiser Health News: Trans And Adopted: Exploring Teen Identity
WBUR's Martha Bebinger, in partnership with KHN and NPR, reports: "Two summers ago, when Nathan Tasker was 13, his mom drove him from Melrose, Mass., to Maine, where he would attend his first session at a transgender camp. Nathan remembers feeling happy for the first time in years.“I finally, finally finally was not alone,” says Nathan, a young man with dark, sparkling eyes and a wise smile.But even at this camp, Nathan expected to be different. He’s transgender — and adopted." (Bebinger, 9/1)

The Wall Street Journal: Insurers Move To Limit Options In Health-Care Exchange Plans
Under intense pressure to curb costs that have led to losses on the Affordable Care Act exchanges, insurers are accelerating their move toward plans that offer limited choices of doctors and hospitals. A new McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that 75% of the offerings on their exchanges in 2017 will likely be health-maintenance organizations or a similar plan design known as an exclusive provider organization, or EPO. Both typically require consumers to use an often-narrow network of health-care providers—in some cases, just one large hospital system and its affiliated facilities and doctors. (Wilde Mathews, 8/31)

The Washington Post's Fact Checker: The White House Claim That ‘Most’ People On Obamacare Pay $75 Or Less
A number of readers asked about [a] tweet, which was a summary of comments made by Earnest during a White House press briefing. The tweet included a video of Earnest’s remarks, in which he said: “What is clear is that the vast majority of people all across the country will have access to a plan that costs $75 a month or less.” Earnest made these comments in response to a question about a Washington Post report about how enrollment in the insurance exchanges established by the Affordable Care Act is at less than half its initial forecast. Officials say he was referring to people in the exchanges, not the population as a whole, when he referred to the $75 figure. (Kessler, 9/1)

The New York Times: F.D.A. Orders Stronger Warning On Common Painkiller-Sedative Mix
The Food and Drug Administration announced on Wednesday that it would require its toughest warning labels to caution patients against taking opioid painkillers together with benzodiazepines, like Xanax and Valium. The combination makes an overdose more likely and the warning is aimed at making sure people understand that. Benzodiazepines are prescribed for anxiety, insomnia and seizures, and opioids for pain. The drugs work by depressing the central nervous system. Increasingly, doctors have been prescribing them together. The number of patients who were prescribed both drugs rose by 41 percent — about 2.5 million people — from 2002 to 2014, the agency said. (Tavernise, 8/31)

Los Angeles Times: FDA Orders Stronger Warnings About Risk Of Using Opioid Painkillers With Certain Antidepressants
The new FDA order calls for some 400 products to carry one of several “black box warnings.” Those aim to alert physicians and patients to the dangers of mixing opioids with benzodiazepines and other drugs — including insomnia medications, muscle relaxants, antipsychotic drugs and alcohol — that depress the central nervous system. The new warnings tell physicians and patients that the combined use of drugs that reduce the reflexive urge to breathe can cause dizziness, extreme sleepiness, slowed or difficult breathing, and unresponsiveness. (Healy, 8/31)

The Washington Post: FDA Requires New Warnings On Danger Of Combining Opioids, Benzodiazepines
In a call with reporters, FDA Commissioner Robert Califf implored doctors “to heed these new warnings” and to carefully evaluate, on a patient-by-patient basis, whether the benefits of using opioids and benzodiazepines together outweigh the serious risks involved. Current labels on the drugs warn of potentially dangerous interactions. But FDA officials said the tougher warnings, sometimes called “black box warnings,” are designed to catch the attention of physicians and patients and to underscore the seriousness of the threat. (McGinley, 8/31)

NPR: Opioids And Anxiety Medications Combined Can Be Deadly
The move comes after an extensive review of scientific evidence by the FDA showing that physicians have been increasingly prescribing these drugs together. There was also a request for action in February, when health officials in cities and states across the country petitioned the agency for the change to the drug labels, citing an increase in overdoses from simultaneous use of the drugs. (Neel, 8/31)

The Washington Post: Opioids And Anti-Anxiety Medication Are Killing White American Women
While death rates are falling for blacks and Hispanics in middle age, whites are dying prematurely in growing numbers, particularly white women. One reason: a big increase in overdoses, primarily from opioids, but also from anti-anxiety drugs, which are often prescribed in tandem. Between 1999 and 2014, the number of middle-aged white women dying annually from opiate overdoses shot up 400 percent, according to a Washington Post analysis of data from the Centers for Disease Control and Prevention. Anti-anxiety drugs known as benzodiazepines contributed to a growing share of the 54,000 deaths over that period, reaching a third in the last several years, The Post found, though spotty reporting in death records makes it likely that the combination is even more widespread. (Kindy and Keating, 8/31)

The Washington Post: Trolling For Drugs In A California ‘Heroin Alley’
When doctors cut off her painkillers, Samantha Burton went through withdrawal. Experts say it can feel like an extreme case of the flu, but Burton found the experience far more punishing. Opioids “make your brain’s ability to create happy chemicals completely flaccid,” she said. “It wasn’t like I felt bad. I felt like I was going to die.” So Burton, a professional illustrator who grew up in nearby Bakersfield, joined a stealthy parade of middle-aged white women trolling for drugs in Oildale, a dusty little town in central California known for its bountiful oil fields, its Appalachian-grade poverty and an open-air market for illicit drugs dubbed “Heroin Alley.” (Kindy, 8/31)

The Washington Post: How A 'Party Girl' Confronted Her Own Death At Age 58
Life as a “party girl” caught up with Beverly Layman in March. She had gone to the doctor to receive a new treatment for hepatitis C. She was excited by the prospect of getting her energy back. But the blood tests showed it was too late. Layman, 58, was dying. “The doctor said, ‘I think you need to start looking at hospice.’ That just blew me away,” Layman said. “I thought I was invincible. I thought nothing was going to kill me.” (Kindy, 8/31)

The Associated Press: Heroin Overdoses Surge In Louisville
During a recent shift spent treating numerous overdoses, Dr. Robert Couch heard a similar refrain from patients: they couldn't believe that the small amounts of heroin they took nearly killed them. On Tuesday, at Norton Hospital in Louisville, Couch treated eight overdose patients in five hours — an unprecedented number for the emergency physician. He sees it as a clear sign of a public health emergency. (8/31)

The New York Times: Study Finds Increase In Temporary Paralysis Accompanied Zika Outbreaks
In seven countries that recently experienced Zika outbreaks, there were also sharp increases in the numbers of people suffering from a form of temporary paralysis, researchers reported Wednesday. The analysis, published online in The New England Journal of Medicine, adds to substantial evidence that Zika infections — even asymptomatic ones — may bring on a paralysis called Guillain-Barré syndrome. (Saint Louis, 8/31)

NPR: Poll: Most Americans Want Congress To Make Zika Funding A High Priority
Summer is winding down, but when members of Congress return to Washington from their vacations next week, many of their constituents want them to do something about the mosquitoes — the ones carrying Zika virus, to be specific. A new survey shows that three quarters of Americans say Congress should make the allocation of more money to deal with the Zika outbreaks in Florida and Puerto Rico an "important" or "top priority" when they return to Washington. (Kodjak, 9/1)

The Associated Press: Poll: More Voters Trust Clinton On Health Care
A new poll finds that more voters trust Democratic presidential candidate Hillary Clinton to do a better job on health care issues, from Medicare to medical costs. But they're not holding out hope for big improvements. The survey from the nonpartisan Kaiser Family Foundation found that Clinton leads Republican opponent Donald Trump when it comes to the future of Medicare, Medicaid, the federal health care law, and the cost of medications. (9/1)

Los Angeles Times: Here's Why Drug Prices Rise Even When There's Plenty Of Competition
At least eight pharmaceutical companies sell a decades-old drug that treats gallstones, but the competition has done little to keep its price down.Instead the price has skyrocketed. Two years ago, ursodiol’s wholesale price was as low as 45 cents a capsule. Then in May 2014, generic drug manufacturer Lannett Co. hiked its price to $5.10 per capsule, and one by one its competitors followed suit – with most charging nearly the same price. Experts say this is not how a competitive marketplace is supposed to work. (sen, 8/31)

The Washington Post: The Dark Side Of ‘Compassionate Use’ Of Experimental Drugs
Josh [Hardy], who was 7 at the time, had undergone a bone-marrow transplant for kidney cancer that left him hospitalized with a severe infection. He was dying. There was an experimental drug called brincidofovir made by a small company called Chimerix that his doctors thought might work. But the company declined their repeated requests to provide it. His parents ... rallied friends, who rallied their friends and their friends and so forth, until it seemed as though the entire Internet were behind them. The ending was a good one: The company gave Josh the drug, and it worked and he got to go home. But not all cases like this go so well. (Cha, 8/31)

The Wall Street Journal: AstraZeneca Agrees To Pay $5.5 Million To Settle Alleged Bribery Probe
U.S. regulators said AstraZeneca PLC had agreed to pay $5.5 million to settle an investigation into alleged bribery at the drugmaker’s Chinese and Russian units. The Securities and Exchange Commission alleged that staff there made payments and gave gifts and other benefits to state-employed health-care workers, such as doctors, in return for increased prescriptions, as far back as 2005. (Roland, 8/31)

Los Angeles Times: Experimental Drug Reduces Protein Clumps And Slows Memory Loss In Early Alzheimer's
In the search for a treatment capable of changing the course of Alzheimer’s disease, new findings are offering a rare glimmer of hope: In a preliminary trial of subjects suffering from memory and thinking problems or diagnosed with early Alzheimer’s, a bioengineered medication called aducanumab has demonstrated the ability to clear accumulations of beta-amyloid proteins — a hallmark of Alzheimer’s — from the brain. And compared with subjects receiving a placebo medication, those who got monthly infusions of aducanumab in high doses appeared to experience less progressive loss in mental function. (Healy, 8/31)

NPR: Alzheimer's Drug Shows Promise Against Brain Plaques
An experimental drug dramatically reduced the toxic plaques found in the brains of patients with Alzheimer's disease, a team reports in the journal Nature. Results from a small number of patients who received a high dose of the drug, called aducanumab, hint that it may also be able to slow the loss of memory and thinking. "If that hint of a clinical benefit is confirmed, it would be a game changer in the fight against Alzheimer's disease," says Dr. Eric Reiman, executive director of the Banner Alzheimer's Institute in Phoenix. Reiman wrote a commentary that accompanies the study in Nature. (Hamilton, 8/31)

The New York Times: Moderate Drinking Does Not Affect Fertility
A new study has found that moderate alcohol consumption does not affect a woman’s ability to get pregnant, although higher amounts might. Danish researchers studied 6,120 women trying to conceive in stable relationships with male partners. The women reported their drinking habits in questionnaires. By the end of the study, 4,210 of the women had gotten pregnant. Women who drank the alcoholic equivalent of one to 13 four-ounce glasses of wine a week were no less likely to conceive than those who abstained completely. (Bakalar, 8/31)

The New York Times: Lead Tests On New York City Schools’ Water May Have Masked Scope Of Risk
When the results of tests for lead in the water at more than 1,500 New York City school buildings were announced in July, officials said that fewer than 1 percent of all the samples taken showed lead concentrations that exceeded Environmental Protection Agency guidelines. Given other safety measures in place, officials assured parents, the water was safe to drink. But a review of how the testing was conducted suggests that the amount of lead in the water that students consume could be greater than the results indicate. (Taylor, 8/31)

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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