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New York school wins epilepsy grant

Besides being home to some of the nation’s top hospitals and specialists in treating epilepsy, the brain disorder behind seizures, New York is now home to one of five global awardees of a $21 million federal epilepsy research grant.  In late January, the National Institutes of Health (NIH) awarded part of that $21 million to New York’s very own Albert Einstein College of Medicine.

March: Developmental Disabilities Awareness Month

Local, state and federal government entities will be joining dozens of local, state and national non-profits this coming March to mark the annual Developmental Disabilities Awareness Month.

The yearly event sees participants reach out to communities whose loved ones they support, as well as to the public at large, to draw attention to people with developmental disabilities and to educate the public on how to best embrace, integrate and otherwise support them.

Big Insurance mega-mergers fail

Two planned mega-mergers covered on Gazette #141’s cover page are now officially canceled.  In 2015, U.S. private health insurance giant Aetna tried buying and merging with rival giant Humana.  Since then, top insurer Anthem trying acquiring Cigna. 

The mergers would have reduced America’s top private insurers from five to three companies.

Both deals ended up in court, with the federal and several state governments arguing, among other complaints, that the mergers would create monopolies and reduce consumer choice.

By February 2017, both multi-billion-dollar deals had nixed by judges.

Aetna will pay Humana a $1 billion breakup fee following their $34 billion deal’s termination, it was reported on Feb. 14.   Likewise, Anthem now owes Cigna $1.85 billion.

Kids with ADHD=six million yearly doc visits: CDC

A late-January report by the CDC finds that kids with attention-deficit/hyperactivity disorder (ADHD) account for over six million U.S. doctor visits a year.

The report, which analyzed public-health statistics for 2013 (the last year for which data was available), says that ADHD visits comprised six percent of all kids’ doctor visits in 2013—an increase over 2003, when ADHD comprised a total of four percent.

The new study also found that eight out of ten kids’ doctor visits for ADHD wound up with a prescription for such stimulants as Ritalin, Focalin and Adderall.

However, it’s possible that the huge figure includes multiple visits by the same children, leading to an overestimation of visits apparently linked to ADHD drug prescriptions; kids taking ADHD drugs visit the doctor more frequently to make sure dosages are correct.

Naloxone injector maker spikes prices

The Evzio device bears several critical similarities to the Epi-Pen device: both save lives, both are user-friendly for anyone to use in any emergency situation, and both revolve around auto-injector needles and medication-filled syringes.

The single key difference is that Evzio dispenses naloxone, which saves people from deadly opioid overdoses.  The Epi-Pen rescues people from severe allergic reactions.

But now, both are outrageously expensive.

The Virginia-based Kaleo company, which makes the Evzio device, has jacked up the price for a two-pack from $690 in 2014 to $4,500 nowadays.

FDA: Toss homeopathic belladonna teething tablets

On January 28, reported CNN, the FDA urged parents to not use Hyland’s homeopathic kids’ teething products containing belladonna, commonly known as nightshade—a toxic substance.

Standard Homeopathic Co., the Los Angeles-based maker of Hyland’s, had actually discontinued its product October 7.  Some 400 reports of adverse events linked to teething products that contain belladonna were reported to the FDA since 2010.

Brexit “diabex-it” nix

Despite British voters’ recent “Brexit” decision to exit the European Union, world top diabetes drugs maker Novo Nordisk is investing $145 million in a new research center in Britain.

On January 30, the Danish company said it would invest that sum over a decade in the University of Oxford-based center, which will employ 100 scientists searching for new Type 2 diabetes treatments.

The decision was welcomed by the government of Prime Minister Theresa May, who in January highlighted life sciences when she laid out a new industrial strategy designed to rebalance Britain’s heavily services-based economy after it leaves the EU.

Will New York expand medical cannabis?

Since New York State opened its medical cannabis program a year ago, over 12,760 qualifying enrollees have benefited from the natural substance to relieve severe chronic pain where all other painkillers didn’t work (or did, but with severe side effects).

Newly proposed rules would expand access to that program to thousands of additional New Yorkers, though, Crain’s Health recently reported.

While the current rules only allow patients diagnosed with one of just ten conditions, to use medical cannabis for chronic pain, the new rules would include people with any severe pain lasting at least three months.

Medical marijuana offers an alternative to opioid drugs for treating chronic pain and gives policy makers another tool to combat the state's growing addiction crisis, according to proponents.

But only 833 New York physicians, about one percent of the state’s total, are certified to prescribe the drug.  And some experts point out that there are other safe approaches to treating pain besides cannabis or opioids, including acupuncture (which, by the way, is not covered by Medicare, or by New York State Medicaid), physical therapy, and meditation.

Top doc knocks ox(ycontin)

In pain-related news, University of Michigan Chronic Pain and Fatigue Research Center director Daniel Clauw, M.D. told MedPage Today in a late-January “Doc to Doc” interview with Yale Schoof of Medicine professor Dr. F. Perry Wilson that “I haven’t prescribed an opioid for chronic pain in at least a decade.” 

Dr. Clauw all but blames doctors—surgeons in particular—for the ongoing opioid epidemic.  Surgeons “give these large prescriptions of opioids” like the popular painkillers OxyContin or Percocet “because they don’t want to be called back for pain,” he said.  “I get that that makes your job easier.”

Heart Assoc.: U.S. heart failure rising

According to the American Heart Association (AHA)’s 2017 Heart Disease and Stroke Statistics Update, released in late January, the number of U.S. adults living with heart failure rose by approximately 800,000 between 2009 and 2014, and is projected to rise 46 percent by 2030.

Mumps outbreak in Washington

A mumps outbreak in the state of Washington grew to about 290 cases in five counties, health officials reported in late January.  The majority of those (160) were in Kings County, which includes Seattle.

Mumps is a viral infection spread through infected saliva.  It can be prevented through the MMR vaccine, commonly given to children.

Other states to see recent spikes in mumps cases include Arkansas, Iowa, Indiana, Oklahoma, and New York.

While U.S. mumps cases are no longer very common, 2016 saw the largest number of cases nationwide in a decade.  Last year, the CDC reported 5,311 mumps infections in 46 states—compared to about 1,300 cases in 2015 and just 229 in 2012.

Kaiser fined $2.5 million for missing Medicaid data

On Jan. 13, California health officials fined healthcare giant Kaiser Permanente $2.5 million for failing to turn over required data on patient care to the state’s Medicaid managed care program. 

The state relies on the data to help set rates, ensure adequate care is available and monitor how taxpayer dollars are being spent in the state program known as Medi-Cal.

Medi-Cal represents a small portion of Kaiser’s overall business, and some industry experts said the company may have been hesitant to alter its information technology systems to meet the state’s demands.  According to Kaiser, its Medi-Cal program boasts about 700,000 Medi-Cal enrollees—though rival Anthem serves over one million Medi-Cal patients.

How MACRA is changing Medicare

With the watershed Medicare Access and Summary CHIP Reauthorization Act (MACRA) now in effect since Jan. 1, Medicare providers must slowly shift to reimbursement based on quality and value of care provided, rather than the traditional fee-for-service reimbursement model.

The MACRA law imposes the Quality Payment Program on Medicare-participating doctors and caregivers.  That program requires caregivers to use one of two new systems: the Merit-based Incentive Payment System (MIPS) or advanced alternative payment models (Advanced APMs).

Under MIPS, caregivers must submit specific quality measures to get paid.  Under Advanced APMs, caregivers receive incentive payments for high-quality and cost-effective care, but also bear some risk related to patients’ outcomes.

The changes will mainly affect Medicare Part B reimbursement.  Depending on what system they now use and how they report, doctors could get incentives or in some cases, penalties.

Diabetes thrice deadlier than believed: study

A University of Pennsylvania review of federal national health data finds that diabetes causes 12 percent of annual U.S. deaths—making it the third-leading cause after heart disease and cancer.

Previous studies indicated that the number was roughly four percent, according to researchers—which would mean that the actual number, if verified, is three times that.

The new study reviewed data in the yearly U.S. National Health Interview Survey (NHIS) and the U.S. National Health and Nutrition Examination Survey (NHANES).  The study, published Jan. 25 in PLOS One, concluded that Americans with diabetes have about a 90 percent higher death rate than those without diabetes.

According to the CDC, the number of Americans with diabetes rose nearly 300 percent between 1980 and 2014, from 5.5 million in 1980 to almost 22 million.

Gov’t panel neutral on sleep apnea screenings

The U.S. Preventive Services Task Force (USPSTF) commented for its first time on whether primary care doctors should screen adult patients for sleep apnea despite lack of symptoms.

The panel, an independent panel of doctors and other experts that advises the federal government on health issues, has now officially taken no stand on sleep apnea screenings.

According to a Jan. 24 statement, the Task Force “reviewed the evidence on screening for obstructive sleep apnea” for its first time—but concluded that “unfortunately, right now, there is not enough evidence to know” if screening patients with no symptoms would be “beneficial.”

But the American Academy of Sleep Medicine (AASM) took issue with the USPSTF stance.  The AASM says people with “a high risk for obstructive sleep apnea” should be screened “even if they don’t have any sleep-related symptoms.”

Such risk factors, according to the AASM, include obesity, congestive heart failure, treatment-resistant high blood pressure and Type 2 diabetes.

Obstructive sleep apnea occurs when a person stops breathing many times during sleep due to temporary collapses of the airway, resulting in reduced airflow.  Symptoms include excessive daytime sleepiness, snoring, fatigue, insomnia and fatigue-related concentration problems.

U.S. kids’ sugary drink habits start early

A new review of public health statistics concludes that almost two-thirds of boys and girls ages two to 19 drink at least one sugar-sweetened beverage daily.  Sugary drinks are associated with a number of long-term health problems, including obesity, diabetes and heart disease.

The review, conducted by CDC researcher Asher Rosinger, also found that sweetened beverages account for over seven percent of total calorie intake for U.S. kids.  The review looked at 2011-2014 data from the annual U.S. National Health and Nutrition Examination Survey (NHANES).

Perhaps tellingly, the study did not look at parental behaviors, and also did not include 100-percent fruit juices like orange juice or apple juice.

The report was published Jan. 26 as a U.S. National Center for Health Statistics Data Brief.