What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.
Civica Rx initially expected to offer 14 drugs in 2019. It now believes it will exceed that number after forging relationships with several companies with licenses to manufacture additional medicines, company officials said in an interview. Within three to five years, it aims to offer up to 100 generic medicines critical to the everyday function of its member hospitals. Via Reuters.
An estimated 17,000 Americans are on the waiting list for a liver transplant, and there’s a strong chance that many of them have alcohol-associated liver disease. ALD now edges out hepatitis C as the No. 1 reason for liver transplants in the United States, according to research published in JAMA Internal Medicine. One reason for the shift, researchers said, is that hepatitis C, which used to be the leading cause of liver transplants, has become easier to treat with drugs. Another could be an increasing openness within the transplant community to a candidate’s history of alcohol and addiction and when a candidate combating these issues can qualify for a liver. For years, conventional wisdom suggested that people with a heavy drinking past who did not have a period of sobriety under their belts would not be good candidates to receive a new liver. But, of almost 33,000 liver transplant patients since 2002 who were studied, researchers from the University of California-San Francisco found 36.7 percent of them had ALD in 2016, up from 24.2 percent in 2002. Via ABC News.
The Minnesota Department of Health is investigating a tuberculosis outbreak among eight people associated with Minnesota State University, Mankato. State health officials are asking clinics to look out for tuberculosis symptoms in college-aged individuals who have spent time at the university since August 2016. “Typically, health care providers seeing respiratory issues in an average, otherwise healthy 20-something Minnesotan wouldn’t normally be thinking TB,” Doug Schultz, a Health Department spokesman said. Risk factors for the infection usually include travel abroad to a country where TB is common, but in this case, all but one contracted TB in the United States. Investigators believe the bacteria originated with an international student and spread to at least seven others who had close contact with them, Schultz said. The majority of those affected are MSU students or former students. Via Star Tribune.
“It’s natural in medical thinking that if a person is deficient in something and you have a disease, maybe replacing that deficiency would either prevent it, improve it, or, possibly, even cure it,” Bart L. Clarke, M.D., a Professor of Medicine in the Division of Endocrinology, Metabolism, Diabetes, and Nutrition at the Mayo Clinic College of Medicine in Rochester, Minnesota, and President of the American Society for Bone and Mineral Research, told Endocrine Today. “Like most things in medicine, the pendulum swings from cynicism to enthusiasm, and over time, as more data become available, things settle back down to some middle level, where it probably should have been all along.” Via Healio.
The National Institutes of Health has awarded a R01 grant to a multi-institutional team to develop and evaluate a pregnancy-specific artificial pancreas in a sequence of in-clinic and transitional environment clinical trials. The researchers hope that the first-in-the-nation studies will lead to a safe and effective at-home clinical trial with an extension phase to the end of pregnancy. "Women with type 1 diabetes experience significant insulin reactions as they try to manage their glucose within a narrow target range throughout pregnancy. There has been no artificial pancreas trial involving pregnant women with type 1 diabetes in the U.S.," states Yogish C. Kudva, Professor of Endocrinology at Mayo Clinic, Rochester. "We are excited that we will be adapting automated insulin delivery to relieve the burden on pregnant women with type 1 diabetes and their families." Via Chronicle Journal.
Some people develop infections in the heart itself—a condition called myocarditis. Many people with this infection experience no symptoms and recover before they even know they have it. But for others, symptoms may include chest pain; rapid or abnormal heartbeat; shortness of breath; fluid retention in the legs, ankles, and feet; fatigue; and general signs of an infection like headaches, body aches, joint pain, fever, and sore throat, according to the Mayo Clinic. Severe myocarditis weakens the heart and impedes blood circulation. Clots can form in the heart, leading to a stroke or heart attack. Via Reader's Digest.
Armed with this knowledge, experts have for decades stressed the importance of regular cervical cancer screenings, which can catch HPV infections and related abnormalities before they develop into deadly disease. And yet many women still don't get tested as much as they should. The screening rate isn't entirely clear. A study published last year found that, as of 2014, screening adherence ranged from a low of about 60% for women ages 50 to 65 to a high of 77% for women in their 30s. Meanwhile, a January Mayo Clinic report found that in one Minnesota county representative of many in the Midwest, cervical cancer screening rates were "unacceptably low," hovering around 54% of women ages 21 to 29 and 65% of women ages 30 to 65. "Most of the cervical cancer cases in our country are either women that have never been screened previously, or that haven’t been screened regularly or that haven’t had follow-up [care] for abnormal results," says Dr. Kathy MacLaughlin, a family-medicine physician at the Mayo Clinic who co-authored the new report. Via TIME.
Olive oil has been widely recommended as one of the key components of the Mediterranean diet. As you may know, the plant-based eating pattern has received much praise from nutrition experts. Among the associated health benefits, many studies have highlighted better heart health in particular. While the oil does contain fat, they are the healthy kind—monounsaturated fatty acids or MUFAs. "In addition, some research shows that MUFAs may benefit insulin levels and blood sugar control, which can be helpful if you have or are at risk of type 2 diabetes," notes Katherine Zeratsky, a Registered Dietician of the Mayo Clinic. She also cautions how unhealthy foods cannot be made healthier by simply adding olive oil to them. Via Medical Daily.
An Edina cardiologist is building her case for food as medicine to combat high cholesterol and heart disease. Dr. Elizabeth Klodas presented data at a recent American Heart Association conference showing that a diet including her Step One line of prepackaged healthy foods could reduce a patient’s LDL and total cholesterol levels within weeks. Eating Step One foods did not improve HDL cholesterol or blood sugar levels, but Klodas said the short-term results were significant enough to gain credibility and interest from doctors. Some insurers and employers are allowing people to buy Step One foods through health savings or flexible spending accounts, she added. Klodas’ company helped pay for the study, along with agricultural interests in Manitoba that produce Step One ingredients. But the study included scientists from Mayo Clinic and the University of Manitoba who reported no conflicts of interest. Via Star Tribune.
Kidney transplants are good, but can be bettered. That’s how a leading U.S. scientist who has been working on organ transplant described life post transplant. Dr. Mark Stegall, Professor of Surgery Research, Department of Surgery and Immunology, Mayo Clinic, U.S., who was in Bengaluru to address transplant surgeons and nephrologists, said the trial period of five years for new medicines needs to be reduced in patients’ best interest. “The mortality rate is 2–3% in the first year after kidney transplant and over 10% at the end of five years. The immunosuppressants that organ recipients have to take cause lifelong side-effects. Patients now say that medicines are making them sick and they want new drugs. But new drug discovery has to happen when the patient is alive,” he said in an exclusive interaction with TOI. Via Economic Times.