- California Healthline Original Stories 3
- Mylan’s Generic EpiPen — A Price Break Or Marketing Maneuver?
- UCLA Study: Taxpayers Foot 70 Percent Of California’s Health Care Tab
- How To Fight For Yourself At The Hospital — And Avoid Readmission
- Sacramento Watch 2
- Measure To Protect Patients From Surprise Medical Bills Clears Both State Houses
- Bill Setting Standards For Manufacturing Medical Marijuana Sent To Governor
- Pharmaceuticals 2
- Why Are Drug Companies Raising Prices? Because They Can
- Experimental Alzheimer's Drug Potential 'Game Changer' In Fight Against Disease
- Public Health and Education 3
- With Tough Warning Label, FDA Aims To Curb Fatal Overdoses From Mixing Opioids, Sedatives
- 'Women Have Had To Be Strong For So Long. Opioids Are A Good Way Out. Benzos Are A Good Way Out'
- Despite San Francisco's Efforts To End HIV, Infection Rates Among African-Americans Rise
Latest From California Healthline:
As news that Mylan will make available a generic version of its own brand-name product, KHN answers key questions about how this development could affect consumers. (Julie Appleby, 9/1)
The public spending on health care outpaces the nation. (Ana B. Ibarra, 8/31)
This new column explains what older adults and their families can do to avoid hospital readmission. (Judith Graham, 9/1)
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Summaries Of The News:
Under the legislation, the consumer would pay only what an in-network provider would charge.
Measure To Prevent 'Surprise' Medical Bills Heads To Gov. Brown
Legislation that would offer Californians protection against "surprise" medical bills has cleared both state houses and is on its way to Gov. Jerry Brown. Surprise medical bills happen when patients seek care from a facility within their health insurance network but then unknowingly receive services from an out-of-network provider, such as an anesthesiologist, who's not covered by their insurance. (O'Neill, 8/31)
Lawmakers Pass Measure To End Surprise Out-Of-Network Medical Bills
The California Assembly passed AB 72 late this afternoon. The bill heads next to Gov. Jerry Brown’s desk. It passed by a huge margin with bipartisan support, unlike a similar bill last year which stalled by three votes on the last day of the 2015 legislative session. (Klivans, 8/31)
In other news, adults' attitudes toward marijuana are shifting, a new analysis finds.
Los Angeles Times:
New Processing Standards For Medical Marijuana Would Be Set Under Bill Sent To Governor
The University of California would conduct a study of the effects of marijuana on motor skills, and new standards would be set for manufacturing medical cannabis products under legislation sent Wednesday by state lawmakers to the governor. The measure was approved as California prepares to begin issuing licenses to marijuana growers and sellers in 2018 and as voters consider a November ballot measure that would legalize recreational use of pot. The bill by Assemblyman Ken Cooley (D-Rancho Cordova) and others would exempt collectives and cooperatives that manufacture medical cannabis products from some criminal sanctions if they meet state requirements. The manufacturing must use processes without solvents or processes with nonflammable, nontoxic solvents. (McGreevy, 8/31)
More US Adults Using Marijuana As Concerns About Risk Decline
Marijuana use is losing some of its taboo among US adults, according to a new analysis of government survey data. In a report published in the journal Lancet Psychiatry Thursday, federal researchers conclude that pot use began increasing in about 2007, coinciding with a drop in the number of Americans who see the drug as harmful. (Samuel, 8/31)
The Los Angeles Times looks at why generics aren't helping moderate the marketplace.
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. (Petersen, 8/31)
Scientists say they are cautiously optimistic with results from a trial of the new drug, which targets the dangerous plaques that build up in the brain -- a hallmark of Alzheimer's.
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)
The agency will require "black box warnings" -- its strongest type -- on more than 400 products. The move comes following criticism that it has not done enough to stem the rising tide of the opioid crisis.
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)
The Washington Post offers a series based in California on why death rates have risen for whites in midlife, particularly women.
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)
“We’ve made tremendous strides. The problem is that we’re not doing better for everyone,” says Dr. Susan Buchbinder, director of HIV research for the San Francisco Department of Public Health.
San Francisco Chronicle:
HIV Infections In SF Hit Low, But Drive Misses African Americans
New HIV infections dropped to historic lows in San Francisco last year as the city amped up an aggressive campaign to essentially end the AIDS epidemic by 2020, but those efforts are not reaching everyone in equal measure, according to an annual report set to be released Thursday. The city recorded 255 new infections in 2015, according to the Department of Public Health report. That was a 17 percent drop from the previous year — and roughly a 10th of the total new infections reported at the peak of the epidemic in the early 1990s. However, infections increased among black men and women. And other indicators of progress toward ending the epidemic — such as getting people diagnosed early and into care quickly — also aren’t as robust among minority men and women as white men. (Allday, 9/1)
In other public health news —
As More Parents Refuse Vaccines, More Doctors Cut Ties With Families
School is back in session, and for the first time, all California kindergarteners, seventh graders and new students must be vaccinated unless they have a medical exemption. A new state law bans vaccine exemptions based on personal or religious beliefs. We've got the latest on this law and other developments in this Impatient vaccination news roundup. (Plevin, 8/31)
San Diego Union-Tribune:
Stem Cells Tapped For Schizophrenia, Bipolar Treatments
To find new treatments for schizophrenia and bipolar disorder, scientists and drug companies are turning to stem cells. Under a $15.4 million contract from the National Institute of Mental Health, Rusty Gage of the Salk Institute and Hongjun Song of Johns Hopkins University will lead a program to grow cells from patient volunteers for screening potential drugs. Skin cells from the patients will be converted into stem cells and then into brain cells, providing a "disease in a dish" model of abnormal functioning. Potential drugs will be tested on the brain cells to examine their effectiveness in restoring normal function. (Filkes, 8/31)
The complex will include a 5,000-square-foot clinic that will be open to both employees and the public. Although Adventist operates 21 hospitals and 260 clinics in four states, the company currently does not offer medical services in Roseville, where its headquarters are located. But that is about to change.
San Francisco Business Times:
What To Expect From Adventist Health's $100 Million Headquarters
Adventist Health’s new $100 million headquarters in Roseville will be a largely transparent building surrounded by a park-like setting of trees and rolling hills on 28 acres. No part of the building will be wider than 80 feet, and nearly all the walls and doors will be glass, so natural light will flow through the entire structure, said Eddie Portis, architect on the project, with Charlotte, North Carolina-based Little Diversified Architectural Consulting. (Anderson, 8/31)
The "electronic tattoo" could send information such as heart rate and blood pressure to doctors.
‘Electronic Tattoos’ Could Monitor Pregnant Moms At Home
The “electronic tattoo” may sound like an attempt by Silicon Valley to encroach on one of the last few activities still requiring an actual human being. But what the term actually refers to is a sensor that adheres like a Band-Aid to parts of your body in order to monitor vital signs like heart rate, blood pressure and breathing. Another term for the devices– equally evocative–is “smart skin.” Researchers around the country are designing electronic tattoos, which look a bit like a child’s sticker but come outfitted with wireless antennae. (McClurg, 8/31)
"We have great care for the kids; there are great programs in L.A. and all over the country," Dr. Susan Claster, the county facility's hematologist says. "But once the kids hit adulthood, they have no place to go and then they die."
Clinic For People With Sickle Cell Disease Opens In South LA
Beginning Thursday, adults in Los Angeles County with sickle cell disease can get comprehensive medical care at a new public clinic at the Martin Luther King, Jr. Outpatient Center in south L.A. This will be the only comprehensive clinic in the county serving people with the inherited blood disorder, besides one serving Kaiser Permanente members, according to Dr. Susan Claster, the county facility's hematologist. The new clinic, which can treat up to 300 patients, will offer primary care, specialty hematology, mental health services and comprehensive pain management, including alternative therapies like yoga and acupuncture. (Plevin, 8/31)
In other news from across the state —
LA County Fire Sees Massive Bump In Calls For Medical Care
L.A. County Fire Department paramedics are exhausted after seeing a massive bump in calls for emergency medical care over the past three years. Data from 2015 shows the department received 303,151 emergency medical calls, a 32 percent jump over 2012. Areas that were busy before have gotten ever more overloaded, said Fire Inspector Richard Licon, like Inglewood, South Central Los Angeles, the Antelope Valley, and Gardena. (Palta, 8/31)
Clovis Unified Parents Urge District To Fight Transgender Bathroom Law
Clovis Unified parents are pushing the school board to separate transgender students from the general student body in bathrooms and locker rooms, despite federal and state laws that protect those students’ rights. The district is considering installing bathroom trailers separate from schools’ regular restrooms after hearing concerns from parents following the federal government’s directive in May that school districts should allow students to use the bathroom that fits their gender identity. Gov. Jerry Brown signed a similar state law in 2013, allowing transgender students to use the bathrooms and locker rooms of their choice. (Mays, 8/31)
A McKinsey & Co. analysis of regulatory filings for 18 states and the District of Columbia found that only about 25 percent of the plans offered on those exchanges would be preferred-provider organizations or similar options that generally give consumers the ability to choose from larger selections of doctors and hospitals and include out-of-network coverage, The Wall Street Journal reports.
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)
How Mylan Tried To Keep Teva From Selling A Generic EpiPen
A new study finds that citizens’ petitions can “play a crucial role in delaying” generic drugs from becoming available — and cites Mylan Pharmaceuticals as a prominent example of companies whose reliance on such tactics is questionable. In particular, the study points to a petition that Mylan filed in early 2015 in an attempt to persuade the US Food and Drug Administration not to approve a rival to its EpiPen device for life-threatening allergic reactions, which was being developed by Teva Pharmaceuticals. (Silverman, 8/31)
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)
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)