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Health Highlights: April 14, 2008

Some People Face Huge Drug Costs Under New Policies Baby Boomers May Overwhelm Health System: Report Parents Often Misinformed About Drugs Prescribed for Children Sludge Spread on Yards of Low-Income Families Gene Discovery May Lead to New Treatments for Iron Disorders Exercise Boosted Prostate Tumor Growth in Mice

Here are some of the latest health and medical news developments, compiled by editors of HealthDay:

Some People Face Huge Drug Costs Under New Policies

Under new policies being adopted by health insurance companies, patients have to pay hundreds and even thousands of dollars for expensive prescription medications that can slow the progress of serious diseases or save their lives, The New York Times reported.

Traditionally, patients paid a fixed price for a prescription, no matter what the drug actually cost. Now, many insurers are charging patients a percentage (often 20 percent to 33 percent) of the cost of hundreds of expensive medications, including those used to treat diseases such as rheumatoid arthritis, multiple sclerosis, hemophilia, hepatitis C and some types of cancer.

Since there aren't less expensive options, patients have to pay or do without the drugs. As a result, some patients drug expenses are higher than their mortgages or even than their monthly incomes, The Times reported.

Insurers say this new system, called Tier 4, helps keep everyone's drug premiums down at a time when some new treatments for diseases such as cancer, rheumatoid arthritis and multiple sclerosis can cost $100,000 a year.

But the Tier 4 system leaves seriously ill people with massive drug bills, James Robinson, a health economist at the University of California, Berkeley, told The Times.

"It is a very unfortunate social policy. The more the sick person pays, the less the healthy person pays," he said.


Baby Boomers May Overwhelm Health System: Report

Aging American baby boomers could swamp the country's health care system for seniors, warns an Institute of Medicine report cited Monday by the Associated Press.

The report evaluates the state of future health care for the 78 million baby boomers about to start reaching age 65. Among its findings:

  • There aren't enough geriatric medicine specialists. Currently, there are about 7,100 doctors certified in geriatrics in the United States, which works out to one per 2,500 older Americans. There's insufficient training, and geriatric specialists are underpaid.
  • Turnover among nurse aides averages 71 percent a year, and as many as 90 percent of home health aides leave their jobs within the first two years.
  • Medicare doesn't provide for team care that's required by many elderly patients.
  • Elderly people tend to be healthier and live longer than in previous generations, but people aged 65 and older often have more complex conditions and health care needs than younger people.

"We face an impending crisis as the growing number of older patients, who are living longer with more complex health needs, increasingly outpace the number of health care providers with the knowledge and skills to care for them capably," said John W. Rowe, a professor of health policy and management at Columbia University, the AP reported.

Rowe led the Institute of Medicine committee that wrote the report. The Institute of Medicine is an arm of the National Academy of Sciences. The committee recommended that: all health care workers be trained in basic geriatric care; the minimum number of hours of training for direct-care workers be increased from 75 to at least 120; and that geriatric specialists, doctors, nurse and care workers get better pay.


Parents Often Misinformed About Drugs Prescribed for Children

Less than one-third of prescription medicines used to treat children have been formally approved by the U.S. Food and Drug Administration for use in youngsters, but many parents believe all such drugs are FDA-approved, says a survey released Monday by the University of Michigan C.S. Mott Children's Hospital National Poll on Children's Health.

Among the findings:

  • 83 percent of parents believed the last medication prescribed for their child was FDA-approved.
  • 94 percent of parents feel a child's doctor is responsible for disclosing whether a medication is not FDA-approved for use in children.
  • 77 percent want their child's doctor to prescribe only medicines that are FDA-approved for use in children.
  • Women are more likely than men to want their child's doctor to prescribe only medicines with pediatric labeling.
  • Parents with less education are more likely to want only FDA-approved medicine for their children.

"FDA labeling is very important to parents, but that's a problem when only one-third of medicines have FDA approval for use in children," Dr. Matthew M. Davis, director of the National Poll on Children's Health, said in a prepared statement. "The solution to that is to either get more medicines that are FDA-approved by increasing clinical studies, or working to help physicians and parents negotiate the situation when physicians want to use medicines that are safe and effective, but may not have FDA approval."

The national online survey included 2,131 adults, ages 18 and older.


Sludge Spread on Yards of Low-Income Families

In a U.S. government-funded study, researchers spread sludge made from treated industrial and human waste on the yards of nine low-income black families in Baltimore to test whether the sludge would protect children from lead poisoning, the Associated Press reported.

The families were told the sludge was safe and never informed about any possibly dangerous elements. In exchange for allowing the sludge to be spread in yards, the families received food coupons and new lawns, according to documents obtained by the AP.

The researchers said the sludge (leftover solid wastes from treatment plants) reduced the children's risk of lead-related brain or nerve damage. The phosphate and iron in sludge can bind to lead and other hazardous metals in soil. This means that, if a child eats contaminated soil, the harmful metals will pass safely through the body. The study was published in the journal Science of the Total Environment in 2005.

However, many experts are skeptical about this claim. While the sludge can bind to lead in soil, "it's not at all clear that the sludge binding the lead will be preserved in the acidity of the stomach" when it's eaten, said soil chemist Murray McBride, director of the Cornell Waste Management Institute.

He questioned why the families weren't told about possibly harmful ingredients in the sludge and why low-income people were chosen for the research.

"If you're not telling them what kinds of chemicals could be in there, how could they even make an informed decision. If you're telling them it's absolutely safe, then it's not ethical," McBride told the AP.


Gene Discovery May Lead to New Treatments for Iron Disorders

The discovery of a gene (TMPRSS6) that causes a rare form of iron deficiency may help in the development of new ways to treat iron disorders in the general population, according to researchers who studied five families with iron-refractory iron-deficiency anemia (IRIDA).

The families all had a variety of mutations in TMPRSS6. Deficiency of the TMPRSS6 protein results in overproduction of a hormone called hepcidin, which inhibits intestinal absorption of iron, Agence France-Presse reported.

The finding suggests that drugs designed to stimulate TMPRSS6 production may help some patients with anemia, particularly those with hepcidin overproduction. On the other hand, a drug that blocks TMPRSS6 production could help patients with iron overload disorders by increasing levels of hepcidin in order to limit intestinal iron absorption.

The study was published online Sunday in the journal Nature Genetics.

Lack of iron is the most common of nutritional deficiencies and a leading cause of anemia, AFP reported.


Exercise Boosted Prostate Tumor Growth in Mice

Exercise caused prostate tumors to grow more quickly in mice, but men shouldn't take that to mean they can protect themselves by not exercising, say Duke University Medical Center researchers.

They implanted prostate tumors into 50 mice and then put half the mice in cages with exercise wheels and half in cages with no wheels. The exercising mice ran an average of more than one-half mile a day. All the mice were fed the same diet, United Press International reported.

"Our study showed that exercise led to significantly greater tumor growth than a more sedentary lifestyle did, in this mouse model," senior investigator Lee Jones of the Duke Comprehensive Cancer Center, said in a prepared statement.

The study was presented this weekend at the annual meeting of the American Association for Cancer Research in San Diego.

The Duke team urged caution in interpreting the findings, UPI reported.

"These mice were not receiving (cancer) treatment and we were allowing aggressive tumors to grow unchecked for the sake of the experiment. Patients would not find themselves in the same situation," study investigator Stephen Freedland said in a prepared statement.

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