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Health Highlights: Dec. 18, 2006

Echinacea Ups Cancer-Linked Gastrointestinal Bacteria: Study U.S. Government May Cut Medicaid Drug Payments to Pharmacies States Sue EPA to Lower Soot Levels Eli Lilly Promoted Unapproved Use of Anti-Psychotic Drug Zyprexa Common U.S. Breast Cancer Chemotherapy Less Effective than Other Regimes

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

Echinacea Ups Cancer-Linked Gastrointestinal Bacteria: Study

The popular herbal cold remedy Echinacea may increase concentrations of gastrointestinal bacteria linked with colon cancer, says a University of Arkansas study in the Journal of Clinical Pharmacy and Therapeutics.

The study included 15 healthy adults who took 10 days of daily doses of Echinacea purpurea, a commonly used variety of Echinacea. An analysis of the participants' stool samples revealed increased concentrations of anaerobic Bacteroides bacteria in general and of Bacteroides fragilis in particular.

Bacteroides play a role in the normal functioning of the colon but, under certain conditions, they can also act as pathogens. This is especially true of B. fragilis strains, the study authors said.

They noted that increased Bacterioides concentrations have been reported in people at high risk for colon cancer. Previous research has shown that B. fragilis may contribute to inflammatory bowel disease and diarrhea.

The findings indicate the need for larger studies on Echinacea and gastrointestinal bacteria, the study authors said.


U.S. Government May Cut Medicaid Drug Payments to Pharmacies

The Bush Administration was expected Monday to propose wide-ranging cuts in Medicaid payments to pharmacies, The New York Times reported.

The payment reductions would be designed to enable Medicaid to get drug discounts similar to those given to large private market customers. Currently, Medicaid pays 35 percent more than the lowest price paid by private companies for certain popular brand-name drugs.

Under the proposed changes, states would receive new data to use in their calculations for what pharmacies are paid. The new data would redefine the "average manufacturer price" for generic and brand-name drugs, The Times reported.

States share the costs of Medicaid with the federal government and have the final say, subject to federal limits, on drug payments to pharmacies.

The proposed changes, which will not directly affect consumers, could save the federal and state governments $8.4 billion over the next five years, which represents a 5.6 percent decrease in total estimated Medicaid spending on prescription drugs, The Times reported.


States Sue EPA to Lower Soot Levels

A lawsuit to force the U.S. Environmental Protection Agency to reduce levels of soot spewed from exhaust pipes and smokestacks was launched Monday by more than a dozen states, the Associated Press reported.

Cutting soot emissions could save thousands of lives, but the Bush administration refuses to reduce the allowed threshold for soot, despite scientific evidence and the opinions of federal government experts, the states argue.

New York Attorney General Eliot Spitzer said that "fine particulate matter" in soot contributes to premature death, chronic respiratory disease, asthma attacks, increased hospital admissions, and other public health costs, the AP reported.

"It's unfortunate that this coalition of states must resort to legal action to get the EPA to do its job -- protect the environment and the public health," said Spitzer, the Democratic governor-elect of New York.

Other states that joined New York and the District of Columbia in the action filed in the U.S. Court of Appeals in Washington: California, Connecticut, Delaware, Illinois, Maine, New Hampshire, New Jersey, New Mexico, Oregon, Pennsylvania, Rhode Island, and Vermont.


Eli Lilly Promoted Unapproved Use of Anti-Psychotic Drug Zyprexa

Internal company marketing documents show that Eli Lilly encouraged primary care doctors to prescribe Zyprexa, a powerful medication for bipolar disorder and schizophrenia, for older patients who did not have either condition, The New York Times reported Monday.

Beginning in late 2000, the company began telling its sales representative to suggest to doctors that they prescribe Zyprexa to older patients with symptoms of dementia. The documents were given to The Times by a lawyer representing mentally ill patients.

The drug is not approved by the U.S. Food and Drug Administration to treat dementia or dementia-related psychosis. In fact, the drug carries a prominent FDA warning that it increases the risk of death in older people with dementia-related psychosis.

Anne Nobles, vice president for corporate affairs at Eli Lilly, told The Times that the company never promoted Zyprexa for off-label use and, as required by law, always showed the FDA the marketing materials used by the company's sales representatives.

Off-label use refers to prescribing drugs for conditions for which they have not been approved. While doctors can prescribe drugs for off-label use, U.S. federal laws prohibit drug companies from promoting off-label prescriptions.

On the weekend, The Times reported that, for more than a decade, Eli Lilly executives told sales representatives to downplay the fact that Zyprexa may increase the risk of developing diabetes. The drug is the company's biggest-selling medicine. The generic name for Zyprexa is olanzapine.


Common U.S. Breast Cancer Chemotherapy Less Effective than Other Regimes

A combination chemotherapy treatment called AC/T that's commonly used to treat breast cancer patients in the United States is not as effective as a treatment called CEF (commonly used in Canada) and an experimental treatment called EC/T, according to a study presented Sunday at a major breast cancer conference in San Antonio, Texas.

American and Canadian researchers compared AC/T (which uses the drugs doxorubicin and cyclophosphamide followed by paclitaxel) to CEF (cyclophosphamide, epirubicin and fluorouracil), and EC/T (a shorter, concentrated course of epirubicin and cyclophosphamide followed by paclitaxel), the Canadian Press reported.

The study of 2,104 breast cancer patients, aged 60 and younger, found that 30 months after treatment, cancer recurrence rates were 10 percent for women who received CEF and EC/T and 15 percent for those who received AC/T.

It's too early to determine whether EC/T or CEF is more effective, co-lead researcher Dr. Margot Burnell of Saint John Regional Hospital in New Brunswick, Canada, told CP. Researchers will continue to follow the study participants in order to try to answer that question and to determine if either combination offers breast cancer patients a survival advantage.

Burnell also said she doesn't believe the findings will lead to a wide-scale phasing out of AC/T, which causes the fewest side effects of all three treatments.

"You may see that this regime decreases in its . . . frequency of use, but . . . it is still a good regime for many women," Burnell noted.

Drug makers Pfizer, Bristol-Myers Squibb, Amgen, Janssen Ortho and Ortho Biotech helped fund this study.


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