Category: Tips

HIV-Infected Veterans Have Higher Rates of Medicare/Medicaid Enrollment

Clinical News, Research, Social Awareness, Tips

A substantial proportion of veterans are dually enrolled in the Veterans Affairs (VA) healthcare system as well as Medicare and/or Medicaid, which leads to care received inside and outside of the VA. However, the use of non-VA healthcare among this population can lead to fragmented, inefficient, and lower quality of care.

In addition, veterans with HIV in this dually covered population may be at greater risk of poor health-related outcomes due to non-VA use. A recent study examined HIV-infected and uninfected populations of veterans to determine healthcare enrollment, usage, and outcomes

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Ten Breakthrough Drugs will Cost the US Nearly $50 Billion Over Ten Years

Medication, OMG, Recruitment News, Research, Tips

There has been heavy debate over the high cost of prescription drugs, and an analysis by Avalere Health estimates that the federal government will spend nearly $50 billion over the next decade on ten breakthrough drugs.

The US Food and Drug Administration’s (FDA) new Breakthrough Therapy program is designed to expedite drug review periods for drugs that treat serious or life-threatening diseases where no drugs exist or that are considered more effective than treatments currently available. Drugs designated as breakthrough therapies include Gilead Sciences’ hepatitis C drug Sovaldi and Bristol-Myers Squibb’s lung and skin cancer drug Opdivo, drugs with high price tags.

The report was commissioned by America’s Health Insurance Plans (AHIP) and offers a first look at estimated state and federal spending on breakthrough drugs for certain cancers and chronic conditions. According to AHIP, these ten drugs represent a small subset of the more than 5,400 drugs in the pipeline.

The high price tags for these breakthrough drugs lead to significant increases in health care spending. Last year, spending on prescription drugs increased by 13 percent from 2013, the largest percentage in over a decade. In 2014, prescription drug spend reached a record-breaking $374 billion. Nearly half of this spending increase was a result of breakthrough therapies and specialty drugs.

Among these ten breakthrough drugs over the next decade, Medicare would absorb the largest expense at $31.3 billion. This will be followed by Medicaid with an estimated spending of $15.8 billion and another $2.1 billion in spending resulting from subsidies provided through Exchange plans under the Affordable Care Act (ACA). The report notes that total US spending may exceed these numbers when accounting for spending by other government agencies, such as Veterans Affairs and Defense, costs to private sector payers, patient out-of-pocket costs, and the significant spending increases associated with off-label use.

These new, innovative drugs offer significant promise for patients with serious health conditions, however the price that comes with these drugs often make treating large patient populations unsustainable.

Often times, breakthrough therapies have a period of market exclusivity, which can last for several years. Because of the lack of competition, drugmakers may significantly markup the price of the drug, making it unaffordable for patients and private payers.

 

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Timely Treatment can save you.

Social Awareness, Tips

When one analyzes the medical records of 1.6 American adults, it turns out there’s a lot to be learned there. Researchers with the Chronic Hepatitis Cohort Study (CHeCS) did just that starting back in 2006 and tracked the ongoing health of those with hepatitis for the next numerous years. As the CHeCS researchers uncovered connections and new understandings about this population, they have published a variety of illuminating scientific papers.

Most recently, the CHeCS researchers shared an important discovery: the hepatitis C virus (HCV) causes greater liver damage earlier in the disease process than previously believed. Consequently, delaying treatment for HCV infection is now known to present a greater danger to long-term health and recovery.

The data in the current study revealed a higher than expected amount of HCV patients who had advanced liver damage. Specifically, 29% of HCV patients showed evidence of liver damage (namely cirrhosis). However, 62% of those with cirrhosis did not have documentation of this liver damage in their medical record. This means that most HCV patients with cirrhosis did not actually know about it, nor did their doctors.

Learning that liver damage is more prevalent than formerly known could change the decision making process for health care providers in terms of the timing of starting anti-viral treatment, as well as affect public policy related to accessing the new medications that can cure this disease.

What accounts for liver damage in HCV being underestimated and underdiagnosed? Health care providers generally rely on a liver biopsy to determine the presence or absence of cirrhosis. However, there are other diagnostic tests and biomarkers, which can provide a reliable indication of liver damage, such as liver enzymes, platelet counts, and Fibrosis-4 (FIB-4) score.

Moving forward, health care providers should incorporate these additional ways to uncover liver damage then use that knowledge to make more-informed decisions about the timing of starting HCV treatment.

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Two therapies to treat IBS-D

Clinical News, Industry News, Medication, Social Awareness, Tips

The U.S FDA today approved Viberzi (eluxadoline) and Xifaxan (rifaximin), two new treatments, manufactured by two different companies, for irritable bowel syndrome with diarrhea (IBS-D) in adult men and women.

According to the National Institutes of Health, patients with irritable bowel syndrome (IBS) experience a number of signs and symptoms, including pain or discomfort in the abdomen and changes in bowel movement patterns. Studies estimate that IBS affects 10 to 15 percent of adults in the United States. IBS-D is a subtype characterized mainly by loose or watery stools at least 25 percent of the time.

“For some people, IBS can be quite disabling, and no one medication works for all patients suffering from this gastrointestinal disorder,” said Julie Beitz, M.D., director of the Office of Drug Evaluation III in FDA’s Center for Drug Evaluation and Research. “The approval of two new therapies underscores the FDA’s commitment to providing additional treatment options for IBS patients and their doctors.”

Viberzi, which contains a new active ingredient, is taken orally twice daily with food. Viberzi activates receptors in the nervous system that can lessen bowel contractions. Viberzi is intended to treat adults with IBS-D.

Xifaxan can be taken orally three times a day for 14 days, for the treatment of abdominal pain and diarrhea in patients with IBS-D. Patients who experience a recurrence of symptoms can be retreated with a 14 day treatment course, up to two times. Xifaxan, an antibiotic derived from rifampin, was previously approved as treatment for travelers’ diarrhea caused by E. coli and for reduction of the risk in adult patients of recurring overt hepatic encephalopathy, the changes in brain function that occur when the liver is unable to remove toxins from the blood. The exact mechanism of action of Xifaxan for treatment of IBS-D is not known, but is thought to be related to changes in the bacterial content in the gastrointestinal tract.

The safety and effectiveness of Viberzi for treatment of IBS-D were established in two double-blind, placebo-controlled clinical trials in which 2,425 patients were randomly assigned to receive Viberzi or placebo. Results showed Viberzi was more effective in simultaneously reducing abdominal pain and improving stool consistency than placebo over 26 weeks of treatment.

The safety and effectiveness of Xifaxan for treatment of IBS-D were established in three double-blind, placebo-controlled trials. In the first two trials, 1,258 patients were randomly assigned to receive Xifaxan or placebo for 14 days, and then followed for a 10-week treatment-free period. More Xifaxan-treated patients reported improvements in abdominal pain and stool consistency than those on placebo. A third trial evaluated repeat courses of Xifaxan, because patients with IBS-D can develop recurrent signs and symptoms after a single treatment course of Xifaxan. A total of 636 patients with recurrence were randomized to receive either Xifaxan or placebo for two additional 14-day courses separated by 10 weeks. More patients treated with Xifaxan than placebo were responders in abdominal pain and stool consistency in this phase of the study.

The most common side effects in patients treated with Viberzi include constipation, nausea and abdominal pain. The most serious known risk associated with Viberzi is the risk of spasm in the sphincter of Oddi, the smooth muscle that surrounds the end portion of the common bile and pancreatic ducts, which can result in pancreatitis. Viberzi should not be used in patients with a history of bile duct obstruction, pancreatitis, severe liver impairment, or severe constipation, and in patients who drink more than three alcoholic beverages per day.

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Tips for Medical Job Search

Recruitment News, Tips

In terms of the medical job search, the employment picture for healthcare professionals presents the classic “good news/bad news” scenario. The good news? Healthcare is one of the hottest industries in the United States. The U.S. Bureau of Labor Statistics forecasts faster-than-average job growth through 2020 in disciplines ranging from physician and surgeon to medical assistants, to physical therapists and many more. The biggest gainer? Home health aides – projected to rise an amazing 70 percent as the Baby Boom generation continues into its senior years.

The bad news? The best jobs are not going to just fall into your lap. While demand is high, so is the competition as students, career-changers and others become attracted to healthcare positions. As in any employment field, you’re going to be selling yourself in a buyer’s market.

So can you navigate the choppy waters of a job search with your sanity intact? It’s not always going to be a breeze, but you can create a work-life balance that helps you stay motivated and inspired while you build your career.

Here’s what you can do…

  • Volunteer. Talk about a win-win: volunteering benefits your community and your outlook. In fact, a study of older Americans released by the Corporation for National and Community Service tied volunteering to enhanced longevity, higher functional ability and lower rates of depression. You’ll boost your confidence and self-esteem by helping others – and if you can tie your volunteerism into your healthcare specialty, you stand to make some meaningful contacts in the community as well.
  • Shadow. Job shadowing – a staple for high school students seeking career information – can help you as an adult jobseeker, too. If you are a student or recent graduate, you may inquire at local healthcare organizations about shadowing opportunities. Not only will you get a first-hand look at the work environment, you will meet others in your field who may help you network yourself.
  • Build your network. A job hunt is not the time to act shy. Tell everyone you know about your plans, goals and efforts. The “six degrees of separation” theory is a valid one. Your golf buddy may not be in the healthcare field, but his sister may be. Your chiropractor may know an associate who is opening a new practice and is hiring. That friend-of-a-friend on Facebook may be a medical transcriptionist who works for a team of physicians.
  • Go the “informational interview” route. Not every interview need be that make-or-break meeting tied to employment. The informational interview removes a lot of the stress and still gets you in front of key decision makers. The interest you show, and the questions you ask, will mark you as a thoughtful and committed individual – someone the company may well consider for future job opportunities.
  • Get a coach. If you have some disposable income, you may find a career coach to be a sound investment. A coach specializing in the medical job search fields can help you pinpoint the job best for you, fine-tune your networking skills, craft a winning resume, prepare for an interview, and more. Prepare for success Your medical job search may take days, weeks, even months — that’s just the nature of the job market. But you have chosen a thriving industry to enter. With the right blend of determination and inspiration, you will find your path.
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Cancer Cure : Compliance is the key

Research, Social Awareness, Tips, Uncategorized
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Not every cancer is curable. The patient, may sometimes need to “live with it’, as is the case with diabetes or heart diseases. Controlling, rather than curing is the best course ahead for certain types of cancers including ovarian, chronic leukemia, some lymphomas, and metastatic breast and prostate cancers. Controlling cancer implies to limit the spreading.  The cancer may shrink, but nevertheless it will be there.

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