Washington, Jul 24 (AP/uNB) — Two veteran senators — a Republican and a Democrat — unveiled compromise legislation Tuesday to reduce prescription drug costs for millions of Medicare recipients, while saving money for federal and state health care programs serving seniors and low-income people.
Iowa Republican Chuck Grassley and Oregon Democrat Ron Wyden said the bill would for the first time limit drug copays for people with Medicare's "Part D" prescription plan , by capping patients' out-of-pocket costs at $3,100 a year starting in 2022. They're hoping to have it ready soon for votes on the Senate floor.
The legislation would also require drugmakers to pay a price-hike penalty to Medicare if the cost of their medications goes up faster than inflation. Drugs purchased through a pharmacy as well as those administered in doctors' offices would be covered by the new inflation rebates.
Political compromises over health care are rare these days. The bill reflects efforts by lawmakers of both parties to move beyond the rancorous debates over the Obama-era Affordable Care Act and focus on ways to lower costs for people with health insurance. Separate legislation to address "surprise medical bills" has already cleared the Senate Health, Education, Labor and Pensions committee.
The senators said preliminary estimates from the Congressional Budget Office show that the Medicare program would save $85 billion over 10 years, while seniors would save $27 billion in out-of-pocket costs over the same period, and $5 billion from slightly lower premiums. The government would save $15 billion from projected Medicaid costs.
CBO also projected that Medicare's inflation rebate would have ripple effects, leading to prescription drug savings for private insurance plans sponsored by employers or purchased directly by consumers.
The senators announced a Thursday vote on the package by the Finance Committee, which oversees Medicare and Medicaid. Grassley is the panel's chairman, while Wyden serves as the senior Democrat.
"Pharmaceutical companies play a vital role in creating new and innovative medicines that save and improve the quality of millions of American lives, but that doesn't help Americans who can't afford them," Grassley and Wyden said in a joint statement. "This legislation shows that no industry is above accountability."
The White House encouraged the Senate negotiations, and spokesman Judd Deere said the Trump administration stands ready to "work with senators to ensure this proposal moves forward and advances the president's priority of lowering drug prices."
Democrats controlling the House want to go farther by granting Medicare legal authority to directly negotiate prices with pharmaceutical companies. Direct negotiations are seen as a nonstarter in the Republican-controlled Senate, but the bill's drug price inflation penalty may yet find support among Democrats in the House.
Grassley's office said the bill will force drugmakers and insurers to take greater responsibility for keeping Medicare prescription prices in line, instead of foisting increases on taxpayers and beneficiaries.
The lack of a cap on out-of-pocket costs for Medicare's popular prescription benefit has left some beneficiaries with bills rivaling a mortgage payment. That's because with Medicare's current protection for catastrophic costs, patients taking very expensive drugs are still responsible for 5% of the cost, with no dollar limit on what they pay. For example, 5% of a drug that costs $200,000 a year works out to $10,000.
The Grassley-Wyden bill does not directly address the problem of high launch prices for new medications, but its inflation rebates could put the brakes on price hikes for mainstay drugs such as insulin.
The bill drew a rebuke from the pharmaceutical industry, while AARP praised Grassley and Wyden.
Other provisions of the legislation would:
— Change an arcane Medicaid payment formula through which drugmakers can avoid paying rebates on certain drugs, depending on fluctuations in prices.
— Allow state Medicaid programs to pay for expensive gene therapy treatments on the installment plan, spreading out the costs over several years.
— Require drugmakers to provide public justification for new high cost drugs or steep hikes in the prices of existing medications.
— Require middlemen known as pharmacy benefit managers to disclose details of the discounts they are negotiating and how much they are passing on to consumers. The benefit managers negotiate with pharmaceutical companies on behalf of insurers and consumers.
— Provide doctors with new computer tools they can use to estimate out-of-pocket medication costs for patients with Medicare.
Dhaka, July 23 (UNB) - A new research has suggested that one can fall asleep quicker and experience better quality sleep if a hot water birth is taken 90 minutes before bedtime. Biomedical engineers at University of Texas-Austin reached this conclusion after analysing thousands of studies linking water-based passive body heating, or bathing and showering with warm/hot water, with improved sleep quality, reports The Indian Express.
“When we looked through all known studies, we noticed significant disparities in terms of the approaches and findings,” said Shahab Haghayegh, lead author on the paper.
“The only way to make an accurate determination of whether sleep can, in fact, be improved was to combine all the past data and look at it through a new lens.”
In collaboration with the UT Health Science Center at Houston and the University of Southern California, the researchers reviewed 5,322 studies.
Meta-analytical tools were used to assess the consistency between relevant studies and showed that an optimum temperature of between 104 and 109 degrees Fahrenheit (40-42 degrees Celsius) improved overall sleep quality. The paper explaining the method was recently published in the journal Sleep Medicine Reviews.
When scheduled one-two hours before bedtime, it can also hasten the speed of falling asleep by an average of 10 minutes.
It is understood that both sleep and our body’s core temperature are regulated by a circadian clock located within the brain’s hypothalamus that drives the 24-hour patterns of many biological processes, including sleep and wakefulness.
The average person’s circadian cycle is characterised by a reduction in core body temperature of about 0.5 to 1 Fahrenheit around an hour before usual sleep time – dropping to its lowest level between the middle and later span of night-time sleep. It then begins to rise, acting as a kind of a biological alarm clock wake-up signal.
The researchers found the optimal timing of bathing for cooling down of core body temperature in order to improve sleep quality is about 90 minutes before going to bed.
“If baths are taken at the right biological time – 1-2 hours before bedtime – they will aid the natural circadian process and increase one’s chances of not only falling asleep quickly but also of experiencing better quality sleep,” read the findings.
Dhaka, Jul 23 (UNB)- While most of us happily consume anything that says “sugar-free”, assuming that it doesn’t have sugar at all, what we don’t realise is that “sugar-free” doesn’t mean ‘no sugar’. Like we add white table sugar or brown sugar to our cakes, coffee, cookies and even fruits, food manufacturers are also known to add artificial sweeteners, a form of sugar, or typically high-fructose corn syrup to foods and beverages including crackers, tomato sauce and salad dressing. Even low-fat foods like flavoured yogurt are considered to be high on sugar reports the Indian Express.
Pune-based diabetes researcher Dr Pramod Tripathi, founder, Freedom from Diabetes center, tells indianexpress.com, “Sugar-free and no added sugar labelled products do not mean the same thing”. “According to United States’ Food and Drug Administration guidelines ‘no added sugar’ means no sugar-containing ingredient is used during processing and ‘sugar free’ means a food must have 0.5 gram of sugar (naturally occurring or any sugar ingredient) per serving. Both these terms do not say anything about artificial sweeteners.”
Either added by consumers themselves or found in processed foods, such sugars are called free sugars, and include glucose, dextrose, fructose, household sugar (sucrose), malt sugar (maltose) and also sugars that are found in honey, syrups, fruit juices and fruit juice concentrates.
Why is added sugar a concern? Sugar in all forms is a simple carbohydrate that the body converts into glucose and uses for energy. But the effect on the body and your overall health depends on the type of sugar you are eating. Since added sugars are easily broken down by once’s body, sugar levels tend to rise very rapidly unlike natural sugars.
Aside from adding calories to your body, added sugar provides no nutrition which is why it is often referred to as ’empty calories’ that causes weight gain and obesity. Having too much sugar can lead to many problems, ranging from trouble in concentration, mood swings, sudden drop and rise in blood sugar level, inflammation in the body to chronic illnesses like heart problems and diabetes.
According to FDA, the added sugar-intake recommendation should not be more than 10 per cent of one’s daily calorie intake. But World Health Organisation (WHO) reduced this percentage from 10 to five per cent. For an adult who has a normal BMI, WHO recommends no more than five teaspoons of sugar.
But the guideline does not refer to naturally occurring sugar that is found in fresh fruits, vegetables, milk and whole grains as these food items are known to have less amount of sugar and also have other additional health benefits. Even doctors are concerned about added sugars and not the naturally occurring sugar.
In fact, accumulating evidence also suggests that frequent consumers of these sugar substitutes may also be at increased risk of excessive weight gain, metabolic syndrome, type 2 diabetes, and cardiovascular disease as per a Purdue University study in the US.
Since the generally accepted definition of sugar includes just glucose and sucrose, these sugar-free products are laden with FDA-approved artificial sweeteners, suggests Dr Mayank Uppal, Consultant, Internal Medicine, Sitaram Bhartia Institute of Science & Research, Delhi.
“Neotame, Saccharin, Aspartame, Acesulfame Potassium, Sucralose and Advantame are some of the artificial sweeteners. When people end up using these products, it not only adds to their calories but makes the product very sweet due to the use of high-intensity artificial sweeteners. As consumers gorge on these products, they tend to develop a distaste for healthier options like fruits that are mildly sweet. This makes them add a large amount of calories to their diet,” he tells indianexpress.com.
So what is the way out? Dr Uppal recommends that while looking for sugar-free products, consumers should also be aware that products that claim to be sugar-free may not necessarily be low in calories and carbohydrates as perceived. “Consumers should not be satisfied with the conventional definition of sugar but also stay away from products that may contain ingredients like corn syrup extract, maple syrup and honey,” he says.
Washington, Jul 23 (AP/UNB) — Millions of people who take aspirin to prevent a heart attack may need to rethink the pill-popping, Harvard researchers reported Monday.
A daily low-dose aspirin is recommended for people who have already had a heart attack or stroke and for those diagnosed with heart disease.
But for the otherwise healthy, that advice has been overturned. Guidelines released this year ruled out routine aspirin use for many older adults who don't already have heart disease — and said it's only for certain younger people under doctor's orders.
How many people need to get that message?
Some 29 million people 40 and older were taking an aspirin a day despite having no known heart disease in 2017, the latest data available, according to a new study from Harvard and Beth Israel Deaconess Medical Center. About 6.6 million of them were doing so on their own — a doctor never recommended it.
And nearly half of people over 70 who don't have heart disease — estimated at about 10 million — were taking daily aspirin for prevention, the researchers reported in Annals of Internal Medicine.
"Many patients are confused about this," said Dr. Colin O'Brien, a senior internal medicine resident at Beth Israel who led the study.
After all, for years doctors urged people to leverage aspirin's blood-thinning properties to lower the chances of a first heart attack or stroke. Then last year, three surprising new studies challenged that dogma. Those studies were some of the largest and longest to test aspirin in people at low and moderate risk of a heart attack, and found only marginal benefit if any, especially for older adults. Yet the aspirin users experienced markedly more digestive-tract bleeding, along with some other side effects. .
In March, those findings prompted a change in guidelines from the American Heart Association and American College of Cardiology:
—People over 70 who don't have heart disease — or are younger but at increased risk of bleeding — should avoid daily aspirin for prevention.
—Only certain 40- to 70-year-olds who don't already have heart disease are at high enough risk to warrant 75 to 100 milligrams of aspirin daily, and that's for a doctor to decide.
Nothing has changed for heart attack survivors: Aspirin still is recommended for them.
But there's no way to know how many otherwise healthy people got the word about the changed recommendations.
"We hope that more primary care doctors will talk to their patients about aspirin use, and more patients will raise this with their doctors," O'Brien said.
Sydney, July 19 (Xinhua/UNB) -- Tooth decay and other oral diseases present a major global public health crisis with sugar as the main culprit, according to a Series on oral health published in The Lancet medical journal on Friday.
The Series brought together 13 experts from 10 different countries to explore why oral diseases have persisted globally over the last three decades, despite scientific advancements in the field.
Currently, oral diseases are among the most common in the world, affecting an estimated 3.5 billion people, yet oral health has been largely ignored by the global health community, the experts said.
Co-author, Professor Marco A Peres from Australia's Griffith university joined his colleagues in calling for radically improved global dental care, increased regulation of the sugar industry and more transparency of scientific studies which may be falling victim to conflicts of interest.
"I think that there is a global health challenge regarding oral disease," Peres told Xinhua.
"It's a big challenge and we recognize in the papers that the traditional approach to managing dental disease probably fails."
Peres and his colleagues identify three main determinants, being sugar, tobacco and alcohol, among which sugar is the single greatest contributor to deteriorating oral health worldwide.
While there have been some countries which have adopted a tax on sugar products with promising results, according to Peres in other countries such as Australia, powerful interest groups are exerting their influence to avoid the measure.
"Many public health, academic and consumer groups support a tax on sugar, but political support is limited and there is a strong lobby against the implementation of a sugar tax led by sugary drinks companies," he said.
The Series authors also suggest that oral health be less removed from general health, with dentistry rarely being thought of as a mainstream part of healthcare policy, despite its intrinsic link to health and wellbeing.
"A clear need exists for broader accessibility and integration of dental services into healthcare systems, especially primary care, and for oral health to have more prominence within universal health coverage commitments," said Dr. Jocalyn Clark, an executive editor at The Lancet.
"Everyone who cares about global health should advocate to end the neglect of oral health."