Today's News and Commentary

About diagnostics

C2N Diagnostics Receives Breakthrough Device Designation from U.S. FDA for Blood Test to Screen for Alzheimer’s Disease Risk: Testing for Alzheimer’s Disease has been very difficult because its cause has been debated. One fact is certain- there is an association with a protein (amyloid) accumulation in affected brain cells. PET scanning can pick up concentrations of this protein but it uses radiation and is expensive. The FDA has just approved a blood test to screen for amyloid in the blood. If a certain threshold is met, PET scanning can be considered. Here is the problem: Even if we can predict who is at risk for Alzheimer’s, the disease progresses at different rates in different people. Further, there is no treatment. Like other new tests, this one should be in great demand by older people who “just want to know.”

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Is Pap testing still needed after hysterectomy?: Years of research studies have proven that Pap smear screening should be routinely done every 3 years, assuming normal interval tests. Many women, however, still get Pap smears every six months- because that’s what their doctors tell them to do. Most egregious, however are that women who have had hysterectomies with removal of the cervix (for non-cancerous reasons) are still getting routine Pap smears. Those who still advocate for testing in this population claim vaginal cancer can still be detected. This article reviews the research and recommendations and is easily understandable for people with a medical background. It concludes :
”Pap testing to screen for vaginal cancer in women who have undergone hysterectomy for a benign indication is an example of more testing, not better care. Evidence is lacking to justify this test in women who are not at high risk of cervical cancer.”  

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Generex Subsidiary NuGenerex Diagnostics Announces CE-Mark Certification for its Rapid Point-of-Care Express II Syphilis Treponemal Assay: With a resurgence of syphilis and recommendation for routine screening in pregnancy, this point-of-care diagnostic should see wide adoption in obstetrician’s office when it is approved in the US. (CE-Mark Certification is for EU distribution).

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About the public’s health

Arsenic and Lead Are in Your Fruit Juice: What You Need to Know: For those of you with children and grandchildren, this article is a must-read. Consumer Reports published a study on commercially sold fruit juices- both in larger containers and juice packs, which are popular with children. Read this article for brands that you can safely buy and those you should avoid. By the way, they can be harmful to adults as well.

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A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy: This research was just published in the New England journal of Medicine but is available by the link below. Bottom line:
“E-cigarettes were more effective for smoking cessation than nicotine-replacement therapy, when both products were accompanied by behavioral support.” But use of e-cigarettes remains controversial. Two editorials comment on this issue. One recommends banning flavored nicotine delivery devices because of their increased addictive potential. The other notes that a ket finding of the research “is that among participants with sustained abstinence at 1 year, 63 of 79 (80%) in the e-cigarette group were still using e-cigarettes, whereas only 4 of 44 (9%) in the nicotine-replacement group were still using nicotine replacement. This differential pattern of long-term use raises concerns about the health consequences of long-term e-cigarette use.” 

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AHRQ National Scorecard on Hospital-Acquired Conditions: Now some good news: “The National Scorecard on Rates of Hospital-Acquired Conditions, 2014 to 2017, the most recent report, shows that from 2014 to 2017 (preliminary data), HACs fell by 13 percent, saving about 20,500 lives and about $7.7 billion in healthcare costs.”

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About pharma

House Dems launch probe of 'skyrocketing' insulin prices: Continuing yesterday’s post about rising insulin prices is this announcement of investigation of major insulin manufacturers.

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OxyContin Maker Explored Expansion Into “Attractive” Anti-Addiction Market: Purdue Pharma was considering playing both sides of this issue. A new definition for “Chutzpah?”

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About health insurance

Deputy HHS Secretary Hargan Talks Stark Law, Kickbacks: The “Stark Laws” (there are more than one) were intended to prevent kickbacks for such things as referrals. Newer value-based models of care, however, require all parts of the care continuum to work together. Further, payment is often bundled. HHS has been talking about relaxing the rules in order to facilitate better care coordination. So far, many arrangements still fall into a gray area that requires signify by legal departments.

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New study aims to convince skeptical employers to embrace narrow networks: This article explains the cost advantages of narrow networks (“about 12% less to hospitals than PPO plans with broader networks”) and the pushback from employers who don’t like the limitation. The original article is by subscription only and is much more technical.

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2020 Medicare Advantage and Part D Advance Notice Part II and Draft Call Letter: This second call for comments deals with Medicare Advantage and Part D plans. It continues to propose allowances for the former plans to offer products and services that will help the overall health of members. Currently about 34% of all medicare beneficiaries belong to a Medicare Advantage plan, with projections that the proportion will grow to 42% in the next 10 years.

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University of Minnesota study finds ACA didn't shrink employer health coverage: One concern about the ACA was that it would encourage employers to drop employees from their sponsored plans— saving the company money and shifting the cost burden to employees and the federal government. This study finds that this fear was unwarranted.

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First Phase of New Association Health Plans Reveal Promising Trends: The non-ACA Exchange plans allowed by the Trump administration have caused public worry. Although premiums are cheaper than some Exchange products, the concern was they will reduce benefits and screen for pre-existing conditions. This report claims that these worries are unfounded and provides details about the structure and composition of these plans.

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