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Medicare saved billions of dollars when statins went generic

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Here’s evidence that prescription drugs don’t have to cost a fortune: New research finds Medicare saved billions as more generic cholesterol-lowering medications became available, even though the number of Americans using the drugs increased.

“One of the most important contributors to our health care costs is expenditure on prescription drugs,” said study author Dr. Ambarish Pandey, a cardiologist and assistant professor of internal medicine at University of Texas Southwestern Medical Center. “The switch to generics is an effective strategy to cut the costs incurred by health systems.”

Between 2010 and 2018, patents on a number of cholesterol-lowering drugs expired — including Crestor and Zetia — and generic versions became available.

For the study, researchers analyzed Medicare Part D Prescription Drug data from January 2014 through December 2018. They found that the number of prescriptions for statins and other cholesterol-lowering drugs climbed from 20.5 million to 25.2 million in that period, a 23% increase.

But even though prescriptions for the drugs rose, total costs decreased, according to the study.

The number of prescriptions for generic cholesterol-lowering drugs rose by 35%, from 17.8 million to 24 million, while overall spending on statins fell by 52%, from $4.8 billion in 2014 to $2.3 billion in 2018.

Statins are the most popular type of cholesterol-lowering drug in the United States, prescribed to more than 35 million people.

During the study period, Medicare still spent $9.6 billion on brand-name cholesterol-lowering medications, but could have saved an additional $2.5 billion of that by switching to generics more quickly when they became available, the researchers noted.

The findings were published earlier this month in the journal JAMA Cardiology.

“It’s important for our health care system to find avenues to become more cost-efficient and accessible,” said study first author Dr. Andrew Sumarsono, an assistant professor of internal medicine at UT Southwestern.

“Even though there is still a lot of work to be done, it is encouraging to see how quickly patients switched to generic options once they became available,” Sumarsono said in a UT Southwestern news release. “This rapid switch to generics saved Medicare a lot of money.”

More information

The ‘Million Hearts’ initiative at the Department of Health and Human Services has more on cholesterol.

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Study: Less restrictive reproductive rights reduce birth complications risk by 7%

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Oct. 13 (UPI) — Women living in states with less restrictive reproductive rights policies are 7% less likely have low birth weight babies than those living in states with more stringent laws, according to an analysis published Tuesday by the American Journal of Preventive Medicine.

The risk was 8% lower for Black women living in less-restrictive states, the data showed.

“Our study provides evidence that reproductive rights policies play a critical role in advancing maternal and child health equity,” study co-author May Sudhinaraset, of the UCLA Fielding School of Public Health, said in a statement.

Since the Supreme Court‘s decision in Roe v. Wade in 1973, which effectively legalized abortion, states have had “substantial discretion” in creating policies governing whether Medicaid covers the costs of contraception or reproductive health care.

Some states have taken steps that effectively limit access to abortion services and other reproductive care, Sudhinaraset and her colleagues said.

Black women are more likely to die in pregnancy and childbirth than any other race group, experience more maternal health complications than White women and generally have lower quality maternity care, they said.

In addition, women of color are more likely to experience adverse birth outcomes.

Compared to infants of normal weight, low-birth-weight babies face many potential health complications, including infections early in life and long-term problems, such as delayed motor and social development or learning disabilities.

Sudhinaraset and her colleagues analyzed birth record data for the nearly 4 million births that occurred in the 50 states and Washington, D.C., in 2016, comparing reproductive rights policies and adverse birth outcomes in each state.

They also evaluated if the associations were different for women of color and immigrants.

The findings indicate that expanding reproductive rights may reduce the risk of low-birth weight, particularly for U.S.-born Black women, the researchers said.

“Important policy levers can and should be implemented to improve women’s reproductive health overall, including increasing abortion access and mandatory sex education in schools,” Sudhinaraset said.



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Pandemic-related job cuts have led 14.6M in U.S. to lose insurance

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Up to 7.7 million U.S. workers lost jobs with employer-sponsored health insurance during the coronavirus pandemic, and 6.9 million of their dependents also lost coverage, a new study finds.

Workers in manufacturing, retail, accommodation and food services were especially hard-hit by job losses, but unequally impacted by losses in insurance coverage.

Manufacturing accounted for 12% of unemployed workers in June. But because the sector has one of the highest rates of employer-sponsored coverage at 66%, it accounted for a bigger loss of jobs with insurance — 18% — and 19% of potential coverage loss when dependents are included.

Nearly 3.3 million workers in accommodation and food services had lost their jobs as of June — 30% of the industry’s workforce. But only 25% of workers in the sector had employer-sponsored insurance before the pandemic. Seven percent lost jobs with employer-provided coverage.

The situation was similar in the retail sector. Retail workers represented 10% of pre-pandemic employment and 14% of unemployed workers in June. But only 4 in 10 retail workers had employer-sponsored insurance before the pandemic. They accounted for 12% of lost jobs with employer-sponsored insurance and 11% of potential loss including dependents.

The study was a joint project of the Employee Benefit Research Institute, the W.E. Upjohn Institute for Employment Research and the Commonwealth Fund.

“Demographics also play an important role. Workers ages 35 to 44 and 45 to 54 bore the brunt of [employer insurance]-covered job losses, in large part because workers in these age groups were the most likely to be covering spouses and other dependents,” said Paul Fronstin, director of EBRI’s Health Research and Education Program.

“The adverse effects of the pandemic recession also fell disproportionately on women,” Fronstin added in an EBRI news release. “Although women made up 47% of pre-pandemic employment, they accounted for 55% of total job losses.”

More information

The U.S. Centers for Disease Control and Prevention has more on COVID-19.

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Study: Medicines, frequent counseling helps cancer patients quit smoking

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Oct. 13 (UPI) — A program that included telephone counseling sessions and one of two smoking cessation drugs was 50% more effective than telephone consultations alone at helping cancer patients quit smoking, a study published Tuesday by JAMA found.

Among cancer patients who underwent treatment with four bi-weekly and three monthly counseling sessions by telephone and either bupropion, marketed as Wellbutrin, or varenicline, marketed as Chantix, for up to six months, 35% were able to successfully quit smoking, the data showed.

But only 22% of the cancer patients who underwent treatment with the telephone counseling sessions had successfully quit after six months, according to the researchers.

“Counseling plus medication is the state-of-the art tobacco treatment for cancer patients,” study co-author Elyse R. Park told UPI.

“Smoking cessation assistance should be an integral part of cancer care and sustained tobacco support can be effective for cancer patients who smoke,” said Park, an associate professor of psychiatry at Harvard Medical School.

More than 34 million adults in the United States smoke, and some 16 million are living with smoking-related diseases, including cancer, according to the Centers for Disease Control and Prevention.

Up to 20% of cancer survivors continue to smoke, despite the fact that quitting improves prognosis with the disease, research suggests.

For their study, Park and her colleagues evaluated smoking cessation treatment programs in 303 adults recently diagnosed with breast, gastrointestinal, genitourinary, gynecological, head and neck, lung, lymphoma or melanoma cancers.

Roughly half — 153 — underwent “intensive” treatment for smoking, with telephone counseling and their choice of bupropion or varenicline, with the rest receiving “standard” care, with telephone counseling only, for up to six months, the researchers said.

Both bupropion and varenicline have been approved for smoking cessation treatment by the U.S. Food and Drug Administration.

The most common adverse events in the two treatment groups were nausea, rash, hiccups, mouth irritation, difficulty sleeping and vivid dreams, and all were more common in the patients who received “intensive” care, the researchers said.

“Nausea is a side effect of varenicline, so [its use] should be monitored for patients who are experiencing nausea from their cancer treatment,” Park said.

In addition, patients on tamoxifen for breast cancer should not take bupropion, or receive a reduced dose, because of interactions between the two drugs, she said.



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