fda-smoking-300x152The federal Food and Drug Administration has taken a big step on what’s likely to be a long legal path to slash the levels of highly addictive nicotine in cigarettes — a step officials say could save millions of lives and billions of dollars in the years ahead.

Commissioner Scott Gottlieb called the agency action “unprecedented,” and said the FDA now will start consulting with medical scientists and policy-makers to figure how to better combat smoking, including with other measures to curb menthol and other flavored cigarettes and premium cigars.

Slashing the acceptable levels for nicotine will be a significant task, if it can be accomplished, as the FDA earlier had said it planned to.

maryland-flag-300x200Yes, Virginia (and Washington, D.C., and the rest of the U.S.): Ever-rising hospital costs can be constrained without the world coming to an end. Maryland’s four-year-old experiment — converting hospitals from a fee-for-service model to a global payment system with total revenues set at the outset of each year — is saving millions of dollars annually for patients, taxpayers, employers, and others who pay for medical services in the state.

The Baltimore Sun reported that Maryland’s Health Services Cost Review Commission and the Maryland Department of Health, found that the state’s unique test, already produced $586 million in hospital-related savings for Medicare in its first three years.

As the Sun said:

ivf-300x271Equipment failures in two clinics in Cleveland and San Francisco not only resulted in the loss of thousands of frozen human embryos and eggs, the incidents also have raised new concerns about safeguards and regulation of booming and costly fertility programs.

Experts said the mishaps were uncommon, and they were hard pressed to explain how advanced refrigeration systems, with rigorous checks and back-ups, could have malfunctioned at large, respected facilities, leading to a likely boom of lawsuits by women and couples against the University Hospitals Ahuja Medical Center’s Fertility Center in Cleveland and the  Pacific Fertility Center in San Francisco.

The centers serve different types of women and couples, with the San Francisco facility dealing with younger, career-driven, and international patients eager to freeze eggs and embryos in hopes of starting families later in life. It has attracted public notice, partly because high-tech firms in the nearby Silicon Valley offer financial assistance to women employees who want to freeze their eggs. The Cleveland center, meantime, seeks to assist women and couples in the city’s western suburbs with infertility issues, especially through in vitro fertilization.

cnnopioids-300x130Doctors already taking heat for selling out  their prescription pads for financial gain may want to brace themselves for new anger from patients, regulators, and lawmakers over two sets of data detailing unsavory links between MDs’ payments from Big Pharma and their opioid drug prescribing.

CNN, Harvard University, and CareDash.com — a site that says it seeks to serve low- to middle-income patients with reliable health care information — have examined national prescribing data, finding links between Big Pharma pay and doctors’ ordering of prescription painkillers central to a nationwide epidemic of abuse.

CNN, with Harvard, reported its findings:

shulkin-240x300More than 100,000 patients in the area surrounding the nation’s capital rely on a flagship hospital for what should be blue-chip care. They deserve better than the continuing scandal that envelops not only the VA Medical Center in Washington, D.C., but also its parent Department of Veterans Affairs.

Investigators have excoriated the VA and its leader for failing to address problems in the agency’s medical facilities nationwide but especially in Washington, because officials, as USA Today reported,  “had been informed of the issues repeatedly since 2013.”

The news organization added that investigators concluded “a culture of complacency and a sense of futility pervaded [VA] offices at multiple levels,” such that, “In interviews, leaders frequently abrogated individual responsibility and deflected blame to others. Despite the many warnings and ongoing indicators of serious problems, leaders failed to engage in meaningful interventions of effective remediation.”

bloodcells-300x150Soaring prescription drug prices aren’t just an economic or policy-making puzzle, they’re also a constant nightmare for millions of Americans, whether their conditions are common, chronic, or rare.

Or as reporters Katie Thomas and Charles Ornstein wrote recently in the New York Times:

The burden of high drug costs weighs most heavily on the sickest Americans. Drug makers have raised prices on treatments for life-threatening or chronic conditions like multiple sclerosis, diabetes and cancer. In turn, insurers have shifted more of those costs onto consumers. Saddled with high deductibles and other out-of-pocket costs that expose them to a drug’s rising list price, many people are paying thousands of dollars a month merely to survive.

cdc-opoid-overdose-300x136America’s drug overdose crisis keeps  worsening, with federal officials reporting that emergency room treatment of opioid overdoses spiked by 30 percent across the nation in 2017.

Abuse of opioids, including the synthetic painkiller fentanyl and heroin, also is triggering significant outbreaks of diseases, including hepatitis C, which is costly to treat, and deadly major bacterial infections.

And the prescription painkiller crisis — which studies increasingly show was been launched, in part, based on wrong information about drugs’ purported benefits — may be masking the worrisome rise, yet again, of cocaine abuse.

acp-A1C-300x184What are patients supposed to do when medical experts feud over key disease metrics like the optimal blood sugar level  for diabetics?

Here we go again, figuring out medical figures:  That’s because the American College of Physicians and the American Diabetes Association are tussling over the much-watched blood sugar test — the hemoglobin A1c. It’s also known just as the A1C or the HbA1c, or glycohemoglobin test.

As the Mayo Clinic describes the A1C, it “reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications.”

frail-300x150Although patient advocates long have pressed Big Medicine to eliminate unnecessary care — waste in the health care system that some experts estimate adds as much as $765 billion annually in needless costs — it may be past due for a public condemnation of a notably extreme example of this practice: The all too frequent, unhelpful surgeries for the old, many of whom are at the end of life.

Liz Szabo of the independent, nonprofit Kaiser Health News Service, and National Public Radio deserve credit for their report, detailing how 1 in 3 Medicare patients undergoes a serious procedure, “even though the evidence shows that many are more likely to be harmed than to benefit from it.”

As the story explains:

Big Pharma’s notorious middle-men, aka prescription benefit managers or PBMs, are coming under yet more fire — this time over so-called gag orders that they impose on pharmacists they work with, preventing these front-line health care providers from telling patients about cheaper options for drugs.

The New York Times reported that states are leading the push, and soon may be joined by the federal government, to bar companies from preventing this money-saving practice.

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