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Medicare Favors Cheaper Opioids Over Ones with Abuse-Deterrent Properties

OpioidsMedicare Part D plan coverage for abuse-deterrent, brand name opioids has declined from 2012 to 2015.

While Part D coverage rates for all prescription opioids decreased 10 percentage points during that time, coverage for branded OxyContin, which had received abuse-deterrent labeling, fell even more (28 percentage points), according to a report from Avalere.

There are currently four branded drugs with abuse-deterrent labeling and no generic opioids with abuse-deterrent labeling.

The Opioid Generic Dilemma

“While prescription opioid abuse continues to be a priority for public health experts and lawmakers, coverage for these products by Part D plans is limited and plans are increasingly favoring lower-cost generic products on their formularies,” Caroline Pearson, senior vice president at Avalere, said in a post on Avalere’s website. “Policymakers seeking to limit opioid abuse will have to balance the desire for greater access to abuse-deterrent opioids with the increased costs of such medications to public programs and private payers.”

The Elderly are Most Affected

Prescription opioid abuse among senior citizens has been particularly concerning as misuse of prescription pain relievers among individuals age 65 and older can was estimated in 2013 to have increased threefold from a decade prior, according to data from the Substance Abuse and Mental Health Services Administration’s National Survey on Drug Use and Health.

Avalere’s Report

Avalere’s analysis of opioid coverage and utilization management in Part D found that a quarter of plans require prior authorization for OxyContin in 2015. Generic Oxycodone, which has no abuse-deterrent properties, is covered by all Part D plans and faces lower levels of utilization management. In addition, although the FDA decided not to grant Opana ER abuse-deterrent labeling, it still has a higher coverage rate than OxyContin.

The Avalere report surmises that the analysis suggests plans favor covering lower-cost generic alternatives rather than opioids with abuse-deterrent labeling.

“As policymakers continue to consider options to combat opioid abuse, it will be important for them to consider how to ensure patient access, including access to new innovations that might help limit potential abuse, while balancing this imperative with cost challenges,” the report concludes.

Five Signs Which Tell Us It’s Time for Assisted Living

Leaving your loved ones to be taken care of by strangers is certainly a difficult decision to make. It is a bizarre thing for both, the elderly person and the family members. Yet, it is a decision that has to be made. Nurses and doctors in assisted living institutions are educated and caring people. They take care of the elderly on their own and help them stay safe and healthy.

It is difficult to determine the right time to move the elderly. However, time is of the essence when the health of a person is in question. You never know when the elderly might need immediate medical attention and by the time they get it, it is already too late. Let’s learn about some signs that tell us loud and clear that it’s time for assisted living;

Meandering off:

Dementia is one of the most common conditions that emerge in old age. Most elderly people are found meandering from their rooms or wandering off in the corridors. A time comes when this wondering gets to be too much and increases the risk of falling, hurting and accidents occurring.

Medications:

Regular and timely intake of medications is another necessary part of old age. Medicines are all that keep some elderly on their feet. Yet, a time comes when an old person is not taking medications on time or going days without proper eating. When this begins to happen, know that they need assistance.

Decline in Cognitive Behavior:

A time comes in old age when we begin to forget about directions, fail to make any sound decision or even complete a sentence. These are telling signs that a senior is in need of assisted living.

Injuries:

As people grow old, they begin to lose energy in their bones, their sense of balance becomes off and as a result, they become a victim of frequent injuries. It is unsafe for an elderly to live like this alone, without having anyone to look after them.

Driving:

When you begin to see lots of traffic tickets around the house, dents in the car or people complaining about the driving habits of an elderly person, it means that they are unable to get around on their own. This not only poses a threat to the seniors but to the life of others in the area as well.

As soon as you notice any of the above-mentioned signs in your old parents, grandparents or neighbors, provide them with assisted living, pronto.

 

Researchers Revise New York City Subway Bacteria Study

The New York City subway has been falsely accused of being dirty and unsanitary for decades. This stereotyped conclusion is far from the truth. Although not the place to dine in, as a transportation system, the New York City subway is as clean as any other system in the world and probably cleaner than some European subways, such as the London Metro and the Metro in Rome.

Recent research in June, 2016 confirms the assertion that the subways are respectively ‘cleaner’ than what most people would think.

The Wall Street Journal reported that in an erratum published July 29, 2015, in the journal Cell Systems that researchers who mapped DNA found in the subway system in New York City said they had mistakenly interpreted data that had led to their original claim, which said that they had found bubonic plague and anthrax DNA traces at certain subway stations. The authors of the study have subsequently revised their conclusions.

“Speaking of Science”, a Washington Post blog points out that after the CDC and the New York City Department of Health pushed back the study, authors made the correction. The method of “data collection was just fine – so they’re not retracting their study – but they admit that their interpretations may have been a bit speculative in nature, and that the media’s interpretation of those interpretations got a little out of control.”

Time reports that referring “to the bubonic plague and anthrax findings, the researchers write, ‘There is minimal coverage to the backbone genome of these organisms, and there is no strong evidence to suggest these organisms are in fact present, and no evidence of pathogenicity.’”

Attracting and Retaining Physicians in New York State

The Center for Health Workforce Studies reported recently that the in-state retention of new physicians has gradually declined from a high of 54% in 1999 to the lowest since the survey began of 44% in 2012.

This is particularly troubling as demand for physician services continues to outpace physician supply, particularly in ophthalmology, urology, psychiatry, pathology, general internal medicine, general/family medicine, and otolaryngology.

Member Physicians of the Medical Society of the State of New York protest in Albany

There are areas of the state and populations that are already underserved by the current physician supply. The implications of the forecasts for these areas and populations are dire. New York must do more to attract and retain physicians.

New York Must:

• Reduce the overhead burden shouldered by physician practices through meaningful civil justice reform;

• Assure fairness in contracting by leveling the playing field for physicians in their negotiations with health insurers;

• Continue an adequately funded Excess Medical Liability program to assure that physicians will have the coverage needed to protect them from personal financial exposure to escalating medical liability awards;

• Prevent the imposition of costly and burdensome CON requirements on physician offices and equipment purchases;

• Put additional resources toward the Doctors Across New York program to allow for more awardees and modify eligibility to assure a more equitable balance of awards between institutionally based and private practice physicians;

• Create income tax credits for physicians who practice in specialty shortage areas;

• Continue Medicaid reimbursement of primary care rates at Medicare levels beyond 2015;

• Defeat any proposal to directly or indirectly tax medical services, medical devices or products or sites of service; and

• Defeat any proposal to increase the biennial physician registration fee.

New York State currently has the worst malpractice environment and there is legislation that would allow the statute of limitations of malpractice litigation to increase from the current limit of 2.5 years.

This would result in medical liability premiums to increase by nearly 15%. A cost that would subject physicians to an additional financial burden and subsequently cause more physicians to retire early or leave the state. Sometimes called the “Chase Your Doctor out of New York Act”, this bill must be opposed.

Knowing Fibromyalgia Disease and its Causes

Fibromyalgia, also known as fibromyositis, is a disease that cause the patient to experience excruciating and self-migrating pain from head to toe. This means that the pain can migrate to any part of your body each day.

Patients who suffer from this disease wait for an average of five years before their ailment is accurately diagnosed by an MD, after they exclude any chances of it being a different disease. During this lengthy time period required by physicians to rule out other diseases, many patients do not receive any treatments and continue to suffer. A patient may also be at risk of suffering from other overlapping ailments that are equally or more painful.

Symptoms of Fibromyalgia

There are many symptoms of Fibromyalgia. The most common ones include anxiety, decreased energy, depression, chronic pain, spasms or muscle tightness, stiffness in muscles, extreme muscle pain after workouts, Irritable bowel syndrome, facial and jaw tenderness, migraines of tension related headaches, irritable bowel syndrome, moderate to severe fatigue, insomnia or agitated sleep, sensitivity to odor, bright lights, noise, medications, cold and certain foods, a feeling of swelling rather than actual swelling in the feet and hands, difficulty in concentrating, remembering and performing mental tasks that may be very simple (called fiber fog), abdominal pain, nausea, and bloating, numbness in face, arms, legs or feet and Irritable bladder.

Causes of Fibromyalgia

Fibromyalgia’s underlying causes is still a debatable subject. Many researchers have studied this disease extensively and continue to do so in order to find one possible cause for the excruciatingly painful outcomes. However, most researchers believe that the brain’s central processing is to be blamed for its manifestation.

After conducting extensive studies to figure out and understand the basic mechanisms of fibromyalgia, researchers believe that it is actually caused by a disorder of central processing with neurotransmitter abnormalities. The reason why the disease causes such pain is due to unusual or irregular sensory dispensation in the nervous system.

Fibromyalgia treatment

Fibromyalgia requires adapting to new lifestyle, or rather improve it. People who are resistant to change and adjustments are likely to experience a greater amount of discomfort.

When a patient of fibromyalgia adapts and embraces change, they experience improvement in the way they function as well as the quality of their lives. Furthermore, many medications are used to treat fibromyalgia including anti-seizure medicines such as pregabalin and antidepressants such as fluoxetine or amitriptyline. Apart from personal adjustments and medications, doctors believe acupuncture to be an effective treatment of fibromyalgia. In fact, acupuncture is the most recognized treatment for the fibromyalgia. However, a lot of other therapies are conducted as well to help the patient recover.

Five Ways to Protect Yourself From the Zika Virus

Zika MosquitoAs the number of Zika virus infections continues to rise in the US, it is important to take the right steps in order to minimize your risk of contracting the disease.

Travel Smart

Pregnant women and women planning on becoming pregnant should avoid traveling to Zika affected areas. This includes Florida, Puerto Rico, and the US Virgin Islands. Outside of the US this also includes Mexico, Central America, the Caribbean and most of South America.

Wear Mosquito Repellent

The Center for Disease Control recommends mosquito repellent products with the active ingredients DEET, oil of lemon eucalyptus, picaridin, or IR 3535. DEET is safe for pregnant women to use. Don’t forget to spray the feet and ankles as the Zika carrying mosquitos have a preference for these areas.

Wear Protective Clothing

Wear dark colored long sleeves and long pants including shoes with full coverage. You can get extra protection by wearing clothing that contains permethrin, a synthetic insecticide which is safe for pregnant women and children to use.

Remove Standing Water

Aedes mosquitoes that spread Zika feed during the morning into the afternoon and like to go inside houses for shade and reproduction. Any water located in your home could be a breeding ground for mosquitos. One tablespoon of water can serve as a breeding ground and produce up to 300 mosquitos. Be sure to get rid of any standing water in or around your home including in flower and plant pots, garbage, buckets, and any item that holds water.

Exercise Inside

Aedes mosquitoes are drawn to carbon dioxide, heat, and sweat. It’s best to switch your morning run into an indoor workout, especially in Zika affected areas and when it’s warm out. Blast the AC when you’re inside to keep those mosquitoes out.

Researchers Diagnose Autism in Children Using Smartphone, Tablet Games

Autism Child with iPad
Photo from Autism Partnership

Games on tablets and smartphones may be used to track player hand movement and identify children who might have autism, according to a new study from researchers at the University of Strathclyde in Glasgow, Scotland.

While early diagnosis and intervention are the best chances to improve health and economic gain for people with autism, diagnosis remains complex and difficult to obtain. The instruments of these evaluations are time consuming and clinically demanding, and a diagnosis can be withheld for years because of wait-list times.

Recent Study Using Technology for Autism Diagnostics

Recently, experts have identified that motor disturbance can be a new way to create assessments of autism spectrum disorder development.

“Motor patterns related to autism can be identified by machine learning from iPad game play in children between three and six years old,” the authors determined. “This motor signature appears to be predominantly derived from differences in pressure going into the device as well as differences in gesture kinematics and form.”

Results of the Study

The researchers have expanded on those findings and reasoned that sensors in tablets and touch screen sensor technologies could capture information about children’s motor patterns.

They set about testing if they could identify autism-specific motor patterns as children engaged with an iPad mini and played 2 different games. A total of 82 children between the ages of 3 and 6 were assessed. The researchers showed that children with autism can be identified with up to 93% accuracy using the analysis of motor patterns in iPad game play.

“It is not social, emotional, or cognitive aspects of the game play that identify autism,” Dr. Jonathan Delafield-Butt, one of the researchers and a senior lecturer in child development, told BBC News. “Rather, the key difference is in the way children with autism move their hands as they touch, swipe and gesture with the iPad during the game.

In addition to being a fun way of testing for autism, these games are cheaper and faster than the traditional ways of diagnosing autism spectrum disorder.

“These data support the notion disruption to movement is core feature of autism, and demonstrate autism can be computationally assessed by fun, smart device game play,” the authors concluded.

Nursing Home Information Being Added To Yelp

Consumers will now be able to look up government information on healthcare facilities thanks to the data ProPublica has compiled data on 15,000 nursing homes, 4,600 hospitals, and 6,300 dialysis clinics using information from the Centers for Medicare and Medicaid Services, according to Washington Post.

Pages for nursing homes contain information about fines paid to the government and whether inspections have shown “serious deficiencies” in the last 3 years. The data is color-coded for ease of use.

“Now the millions of consumers who use Yelp to find and evaluate everything from restaurants to retail will have even more information at their fingertips when they are in the midst of the most critical life decisions, like which hospital to choose for a sick child or which nursing home will provide the best care for aging parents,” Yelp CEO Jeremy Stoppelmen wrote in a blog post.

Healthcare and medical businesses have already been available on Yelp for consumers to review using the star-rating system, but now the additional information from ProPublica will appear on the page as well. According to Yelp, the health category makes up 6% of reviewed businesses.

Most of the information being made available on Yelp is already available on Medicare’s Hospital Compare site, which can be difficult to sift through.

“While it is helpful, having general information doesn’t really add as much value as doctor-specific feedback that pretty much every hospital in the country is capturing,” Mr. Stoppelmen wrote. “Healthcare is very personal — often it is about a one-on-one relationship, so the information that consumers crave the most is information about a particular doctor.”

Researchers Revise New York City Subway Bacteria Study

The New York City subway has been falsely accused of being dirty and unsanitary for decades. This stereotyped conclusion is far from the truth. Although not the place to dine in, as a transportation system, the NYC subway is as clean as any other system in world and probably cleaner than some European subways, such as the London Metro and the Metro in Rome.

With that said, the Wall Street Journal reported that in an erratum published July 29 in the journal Cell Systems, researchers who mapped DNA found in the subway system in New York City said they had mistakenly interpreted data that had led to their original claim they had found bubonic plague and anthrax DNA traces at certain subway stations. The authors of the study have subsequently revised its conclusions.

“Speaking of Science”, a Washington Post blog points out that after the CDC and the New York City Department of Health pushed back the study, authors made the correction. The method of “data collection was just fine – so they’re not retracting their study – but they admit that their interpretations may have been a bit speculative in nature, and that the media’s interpretation of those interpretations got a little out of control.”

Time reports that referring “to the bubonic plague and anthrax findings, the researchers write, ‘There is minimal coverage to the backbone genome of these organisms, and there is no strong evidence to suggest these organisms are in fact present, and no evidence of pathogenicity.’”

Preventing Drug Abuse among Teenagers

Drug Abuse has become a very common problem among teenagers and with every passing day, the statistics show a rise in the number of teenagers who fall prey and succumb to drug abuse. This not only includes alcohol, but also the use of crystal meth, heroin and marijuana.. Parents in particular and other adults of the community in general, can play a significant role in preventing the use and abuse of drugs among teenagers.

Bonding with Parents

This is the most crucial factor that needs immediate and proper addressing. Many parents shuffle between jobs, social activities, struggle with marital issues. And amidst all that, they neglect their children. These things, especially the uneven marital relations between parents disturb teenagers very much. In case of divorce, they feel divided between two people that they love the most. In many cases the environment of homes is very abusive. This also creates extreme anxiety, depression, and sense of loneliness among teenagers. Due to all these reasons, they cannot bond with their parents at an age where this connection is extremely important and can be a healthy support for them in many ways. This is why many teenagers seek solace in drugs.

By improving relations with our children in their teen years, we can significantly reduce the risk of drug abuse.

Keeping a Check

This is not only the responsibility of parents but also other people in community that have responsibility to various adolescents, for example, teachers, coaches, religious mentors, etc. keeping an eye out for drug use or indications of drug abuse can help identify the users at early stages and they can be given rehabilitation before they reach the level of addiction.

Providing Awareness and Guidance

Here educational institutions can play a very major role, as well as parents can take this job in their own hands as well. Providing accurate information, guiding them about the consequences, giving them safe and most importantly respectable options to open up and talk about their issues without judging them can also help. When teenagers can feel safe and accepted in their social circle, the chances of indulging in negative and harmful activities will automatically reduce.

Researchers have also suggested a community plan that is based on five key factors, namely, Identifying drugs and children having problems with it in the community; building on the currently active drug abuse prevention programs, further adding up and developing short term goals in order to select the most suitable research based drug abuse prevention program and execute it; projecting long term goals, and lastly, include the findings of currently active programs.

These measures can be very effective and if not entirely eradicate the problem from its root, they can at least serve to be stepping stones to bring about a change.