300px-EpipenMartin Shkreli, the smirking Pharma CEO, has been replaced for now as the national symbol for outrage over Big Pharma’s price gouging. Enter, stage right: Heather Bresch, a 47-year-old executive−who also happens to be the daughter of a prominent U.S. senator. Bresch has become the villainess of the moment for her firm’s jacking up the cost of a drug that millions of Americans rely on to protect them from life-threatening allergy reactions.

Mylan is her company, and it is at the heart of the public furor over the adrenaline-dispensing device known as the EpiPen. (Adrenaline and Epi or epinephrine are the same drug.) The company’s name may sound as if it were taken from a Disney  movie. But it is unclear whether there will be a happy ending to its current tale.

Will a sustained public outcry lead to real change in its business practices? Will this incident curb the ever-escalating efforts by Big Pharma to extract sky-high prices for products, some of which have been around so long the industry is far beyond recouping any research-and-development costs?

Medical_studies-02.0In case health information consumers already haven’t learned to turn a jaundiced eye on the flood of “news” about the latest, greatest  medical research, the Vox news site has compiled some eye-opening charts and concrete examples to show what a fool’s errand it can be to look at a lone published study and think it describes a genuine therapeutic breakthrough.

The site’s story starts by reminding that experts in 2003 looked at 101 studies published over four years in top journals  that promised therapeutic advances.  After a decade, just five of those big deals made it to market — and only one of the 101 was still in widespread use.

That efficacy gap hasn’t acted as any kind of deterrent to the torrent of research publication, as the Vox chart shows.

StrollerSafety-200x200Whoa, mom and dad and grandma and grandpa: Take it easy with the toddler in that stroller. Accidents in strollers and baby carriers send four dozen youngsters a day to emergency rooms for treatment, including for brain injury or concussion, new research has found.

Researchers looked at data from the National Electronic Injury Surveillance System, finding more than 360,000 kids younger than five suffered stroller- or baby carrier-related injuries sufficient to send them to ERs. Most were boys younger than one; most suffered injuries to the face or head. More of them had soft-tissue injuries, though about a quarter of them had concussions.

As one of the lead researchers told National Public Radio: “We know that traumatic brain injuries can lead to long-term consequences on cognitive development. So we really want to make sure these injures are avoided.”

prescriptionAmong the plenty of worries when an older patient has to be hospitalized, here’s one to think about:  treating physicians and their ever-ready prescription pads which put patients at risk for serious side effects that can be worse than the problem they’re treating.

Kaiser Health News has continued writer Anna Gorman’s series on the woes that elderly patients experience when hospitalized, with her latest piece giving an eyebrow-raising look, from a pharmacist’s point of view, at the prescribing practices of MDs in hospitals.

As the drug expert observes, it all is “a bit alarming.”

South_Beach_20080315The Zika outbreak in Miami-Dade County, Fla., has spread, with federal and state officials confirming infections by mosquitoes now in South Beach, the tourist-popular heart of Miami Beach. Pregnant women have been advised to stay out of the 20-block resort area, and, more generally, to consider avoiding unnecessary travel to all of Miami-Dade.

This isn’t the high tourism season in South Florida, which can be even more sultry than Washington, D.C., at this time of year. But officials clearly are uneasy about the effect of Zika warnings on one of the major industries for Miami Beach, a city of 92,000 where seven million visitors stayed in local hotels.

The latest health alerts were issued after officials confirmed five cases of locally acquired infections of the tropical disease that, for many, can be mild and flu-like, with fever, chills, headaches, and muscle soreness.  It also has been linked to birth deformities in children whose mothers were exposed during their pregnancy, with hard-hit Brazil recording 1,800 cases of youngsters afflicted with microcephaly tied to their moms’ Zika infection.

calpers-headquartersWith 450,000 California members, a giant public employee group in the Golden State has successfully found one way to curb medical costs, slashing prices for a set of common procedures by 20%, and saving its members millions of dollars.

It all starts with an idea radical in many parts of American health care: that hospitals should have to disclose their true costs up front so patients have a chance to vote with their feet.

As reported by health economist Austin Frakt in the New York Times’ “Upshot” column, the California Public Employees Retirement system, aka Calpers, in 2011 put in place a new payment plan for members hospitalized for knee and hip replacement surgery, colonoscopies, cataract removal surgery and other common elective procedures. Under this “reference pricing,” Calpers capped what it would pay to hospitals for the various operations, while still allowing its members to choose where they wanted to be treated; if patients picked pricier hospitals, they paid the difference. It could amount to thousands of dollars.

Ron Schwarz, 79, says he has hardly been able to eat since being admitted to the hospital. (Heidi de Marco/KHN)

Ron Schwarz, 79, says he has hardly been able to eat since being admitted to the hospital. (Heidi de Marco/KHN)

Although America grows grayer by the day, the care that elderly patients get at all too many hospitals after they’re admitted leaves them worse off when they are discharged, the Kaiser Health News service finds in a devastating report.

Kudos to writer Anna Gorman who puts together published studies and tough reporting to detail that, “About one-third of patients over 70 years old and more than half of patients over 85 leave the hospital more disabled than when they arrived. As a result, many seniors are unable to care for themselves after discharge and need assistance with daily activities such as bathing, dressing or even walking.”

elderly-hospitalUncle Sam is stepping up to try to help ailing elderly patients who may get stuck with big hospital bills and gaps in their medical coverage due to a linguistic loophole. A Medicare law, newly in force, requires hospitals to tell Medicare patients that they are “under observation,” and not formally admitted. The difference to patients’ wallets can be huge.

Doctors and hospitals have jammed patients into this nightmare status to work around auditors for Medicare. Those fiscal overseers can accuse them of giving seniors inappropriate care, with the auditors then earning a share of financial penalties imposed against the hospitals and MDs; doctors called this approach bounty hunting by the private auditors hired by Medicare to ferret out waste. Advocates had hoped that stepped up scrutiny of admissions might get doctors and hospitals to treat more seniors in medical offices or with hospital outpatient services, instead of checking them into pricey hospital rooms.

But “observing” seniors, who actually could be receiving extensive care, ended up slapping them with big bills that Medicare might not cover; if they then needed to be transferred to nursing home care, Medicare also would not recognize their observation time and count it against its requirement that patients first have spent three days admitted to a hospital. Seniors and their families, then, could be liable for thousands of dollars for skilled nursing care.

Barry_Goldwater_photo1962muskieThey’re crazy, right? Or maybe they have a “personality disorder.” Our current political season is raising the issue about how wise it is for commentators and the rest of us to put labels on politicians we don’t like  in terms of their mental health.

Susan Molchan, a psychiatrist in the Washington, D.C.-area, provides a thought-provoking commentary on this topic at Healthnewsreview.org, the excellent watchdog site for hype and misinformation about health-related matters. She argues that, barring a careful, expert, and actual diagnosis of a patient, it can be destructive to the public dialogue and stigmatizing to those with true mental health afflictions, for the media, in particular, to speculate about public figures’ mental disorder.

Many of these pieces, of course, focus on a polarizing current candidate−and she provides examples of his coverage with commentators’ theorizing. Others could be added, such as: this column in which its author analogizes her own negative health experiences on to the candidate; or this piece−which drew attention because its author also happens to be a psychiatrist.

Cupping_resultsWith fans around the world fixated on  the U.S. gold medal-winning Olympic swimming team, curious minds wanted to know: Just what were those circular, purple marks covering the much-bared bodies of athletes like Michael Phelps?

To anyone who has spent time in East Asia or who lives in a metropolis (like Washington, D.C.) with sizable populations of people of Asian descent, the answer was easy: the Olympians had undergone “cupping.” It’s a treatment for muscle soreness or pain from over-exertion.

Practitioners put special cups on their patients, then use heat (sometimes from burning candles or mug wort or “moxa”) or pumps to extract the air from them, pulling up the skin, and providing drug-free benefit. The treatment, akin to a teen-aged “hickey,” leaves a superficial bruise or discoloration.

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