HealthLawProf Blog

Editor: Katharine Van Tassel
Creighton University School of Law

Saturday, July 19, 2008

U.S. Hits Weight Marker: 1 in 4 Officially Obese

The Chicago Tribune and the Washington Post report on the Centers for Disease Control and Prevention's newest study regarding American obesity.  Mississippi remains the most obese state.  Deborah L. Shelton, Judith Graham and Robert Mitchum for the Chicago Tribune write,

Weight_chart2Americans, who have been getting fatter for decades, reached an unwelcome milestone in a report released Thursday: More than one in four of us are obese.

The U.S. Centers for Disease Control and Prevention reported that the number of adults who say they are obese jumped 2 percent between 2005 and 2007—from 23.9 percent in 2005 to 25.6 percent in 2007. That doesn't include people who are overweight.

A different CDC survey—a gold-standard project in which researchers actually weigh and measure survey respondents—put the adult obesity rate at 33 percent for adult men and 35 percent for adult women in 2005 and 2006.

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July 19, 2008 | Permalink | Comments (0) | TrackBack (0)

Your Shower Curtain Might Be Bad for You

US News reports on a study indicating that PVC-containing shower curtains may be harmful to health.  Adam Voiland writes,

Shower_curtainAs part of an ongoing campaign against polyvinyl chloride, a Virginia-based environmental advocacy group today called on manufacturers and retailers to phase out its use in shower curtains. To buttress its case, the group, the Center for Health, Environment and Justice, released the results of a small study indicating that PVC-containing shower curtains are capable of emitting scores of volatile organic compounds, as well as phthalates, lead, and other potentially harmful materials, into people’s bathrooms. A previous study, conducted by Environmental Protection Agency researchers, also found that plastic shower curtains can emit toxic compounds into the air.

There’s still debate among scientists about just how serious the health effects are that have been associated with exposure to some of the chemicals highlighted as dangerous, especially at low doses. However, CHEJ, which has particularly strong concerns about the environmental and health toll in communities with factories that manufacture PVC, urges consumers to avoid using PVC shower curtains, as well as many other PVC products, particularly those that are flexible.

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July 19, 2008 | Permalink | Comments (1) | TrackBack (0)

Friday, July 18, 2008

F.D.A. Lifts Tomato Warning

The New York Times reports that the Food and Drug Administration has lifted the warning against eating raw tomatoes, one of the foods attributed to the salmonella outbreak that began in April.  Bina Venkataraman writes,

Tomato1The Food and Drug Administration revoked its warning against eating certain kinds of raw tomatoes Thursday, even though officials said they had yet to pinpoint the source of the nation’s largest foodborne outbreak in the last decade.

Meanwhile, the agency continues to advise the elderly, infants and those with weak immune systems not eat raw jalapeño or serrano peppers.

Tomatoes believed to be responsible for initial illnesses in the salmonella outbreak that began in April are no longer on the market, officials said in a telephone press conference. For more than a month, federal investigators have been testing tomatoes, with a focus on those grown in Florida and Mexico, to find the origin of the contamination. The agency had warned consumers to avoid certain raw red plum, red Roma and red round tomatoes and products containing them.

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July 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Clinton Foundation Sets Up Malaria-Drug Price Plan

The Wall Street Journal reports on Bill Clinton's new plan that aims to stabalize malaria drug prices.  Mark Schoofs writes,

Malaria_net_2 Former President Bill Clinton's foundation is set to unveil a pricing agreement Thursday that it hopes will make malaria drugs available to millions of poor people.

The agreement points to the sophistication needed to harness market forces and get lifesaving medicines to countries where treatable diseases still take a staggering toll.

First-line malaria drugs -- known as ACTs, for artemisinin-based combination therapies -- present a tricky problem: the volatile cost of the powerful antimalarial plant extract artemisinin. During the past few years, the price of that key ingredient has fluctuated from as little as $150 a kilogram to as much as $1,100, according to Chinese producers.

Such instability makes it difficult for those in the market -- from artemisinin producers to pharmaceutical companies to the health ministries that often buy the drugs -- to plan. That can make pharmaceutical companies wary of reducing prices for fear of another price spike and deter generic-drug makers from entering the market and fostering more-competitive pricing.

The agreement Mr. Clinton plans to announce aims to limit price fluctuations. It creates a consortium of two Chinese raw-artemisinin suppliers, two Indian companies that convert artemisinin into the active pharmaceutical ingredient and two Indian generic-drug companies. Among other things, the deal puts a ceiling on the price of the raw artemisinin in return for a guarantee that other consortium members will purchase large proportions of their artemisinin from the two participating suppliers, unless nonmembers can offer equal-quality product at an undisclosed discount.

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July 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Merck to Start Vioxx Settlement Payouts in August

US News reports on Merck & Co.'s recent $4.85 billion settlement with former users of its painkiller, Vioxx.  Linda A. Johnson writes,

VioxxMerck & Co. will start cutting checks for former users of its withdrawn painkiller Vioxx next month after announcing Thursday that it will fund a $4.85 billion settlement expected to resolve roughly 50,000 lawsuits.

The decision marks the beginning of the end of the four-year legal saga, which began when cardiovascular side effects forced Merck to pull Vioxx off the market in 2004, triggering tens of thousands of lawsuits, sullying its once-spotless reputation and forcing out its then-chief executive.

The Vioxx case has cost Merck at least $6.8 billion, including more than $1.53 billion through March 31 on legal costs for defense research and individual trials, most of which it has won.

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July 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Congressional Committee Will Probe Health Insurers that Cancel Sick Members' Coverage

The Los Angeles Times reports that a congressional committee will investigate health insurers' practice of canceling coverage when policyholders get sick.  Lisa Girion writes,

Health_careThe problem first came to light in California, but witnesses testifying before the House Oversight and Government Reform Committee suggested that it was more widespread.

The problem affects the individual insurance market, in which 14 million Americans, including nearly 3 million Californians, purchase medical benefits on their own.

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July 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Inflation and Oil Prices Send Costs of Medical Supplies Soaring

The Chicago Tribune reports on the increase in costs of medical supplies as a result of inflation and oil prices.  Bruce Japsen writes,

Medical_suppliesInflation is racing through the economy at a pace not seen in years, touching even the medical gloves used by hospitals, as manufacturers cope with high oil prices.

The cost of living in June shot up at the fastest rate in 17 years, with the Labor Department reporting Wednesday that consumer prices jumped 1.1 percent, a much faster clip than anticipated.

Inflation is corrosive to paychecks, cutting deeply into consumers' earning power, but the phenomenon hurts even more in an economy struggling to maintain growth. Inflation also hurts companies when they can't pass on higher costs because of competitive pressure.

Much of the inflation pressure now is due to oil prices, and its impact is most obvious at the gas pump, though high food prices are also hurting shoppers at the grocery store. While oil prices have dropped steeply the past two days, they remain at historically high levels.
There are myriad ways the impact of high oil prices touches consumers—or is likely to soon—and the medical supplies used by hospitals and sold in drugstores are one example.

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July 18, 2008 | Permalink | Comments (0) | TrackBack (0)

Thursday, July 17, 2008

Senate Agrees to $50 Billion AIDS Plan

The Washington Post reports on a new bill passed by the Senate that will spend $50 billion over the next five years, mostly to fight AIDS in the developing world.  Paul Kane writes,

Red_ribbonThe Senate approved legislation yesterday that would triple funding to fight AIDS and other diseases around the globe, rejecting efforts to pare down the bill's $50 billion price tag.

On an 80 to 16 vote, the Senate dramatically increased the U.S. contribution to a global fund to combat AIDS, tuberculosis and malaria. President Bush, who requested $30 billion over the next five years, has agreed to the larger amount for a program he started in 2003.

"We've made tremendous strides, but our work is not nearly finished. Two million people died last year of HIV-AIDS. Over two and a half million people died of malaria and TB," said Senate Foreign Relations Committee Chairman Joseph R. Biden Jr. (D-Del.). He praised Bush's "bold" support for AIDS funding, launched in the 2003 State of the Union address, calling it his greatest achievement as president.

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July 17, 2008 | Permalink | Comments (1) | TrackBack (0)

Increased HIV Risk Found in Genetic Mutation

The Los Angeles Times reports on a newly discovered genetic mutation that renders Africans and African Americans 40% more susceptibe to HIV infections. Researchers say the discovery offers a partial explanation for the disproportionate spread of the virus among Africans and African Americans.  Thomas H. Maugh II and Karen Kaplan write,

HivA genetic mutation that originally protected Africans from a virulent form of malaria now renders them 40% more susceptible to HIV infections, offering a partial explanation for the disproportionate spread of the virus among Africans and African Americans, researchers reported today.

The mutation, however, has an unusual benefit. It also slows progression of HIV, the virus that causes AIDS, giving patients an extra two years of life, said Dr. Sunil K. Ahuja of the South Texas Veterans Health Care System, lead author of the paper in the journal Cell Host & Microbe.

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July 17, 2008 | Permalink | Comments (0) | TrackBack (0)

How Changes in Medicare Affect Patients

The Wall Street Journal reports on how the new Medicare law will directly affect Medicare beneficiaries.  Anna Wilde Mathews and Jane Zhang write,

StethescopeThe major goal of the new Medicare law passed this week was to block a scheduled cut in fees paid to doctors. But there's also plenty in the law that directly affects Medicare beneficiaries.

Participants in the federal insurance program for older and disabled Americans will have lower out-of-pocket costs for mental-health services. Some widely used anti-anxiety and sleep drugs that Medicare previously didn't pay for will be covered. And the law aims to boost preventive health care, including making it easier and cheaper for new Medicare participants to get a physical checkup. Most of the new benefits will be phased in over several years.

There also are cutbacks. Consumers who relied on certain private insurance plans sold under the name Medicare Advantage could face tougher restrictions on which doctors they will be allowed to see. Another change: Doctors will be strongly encouraged to begin sending prescriptions to pharmacies electronically, rather than writing them by hand.

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July 17, 2008 | Permalink | Comments (0) | TrackBack (0)

While the U.S. Spends Heavily on Health Care, a Study Faults the Quality

The New York Times reports on a new study that describes a discrepancy between the amount of money Americans pay for health care and the quality of care they actually get in return.  Reed Abelson writes,

Health_care_2American medical care may be the most expensive in the world, but that does not mean it is worth every penny. A study to be released Thursday highlights the stark contrast between what the United States spends on its health system and the quality of care it delivers, especially when compared with many other industrialized nations.

The report, the second national scorecard from this influential health policy research group, shows that the United States spends more than twice as much on each person for health care as most other industrialized countries. But it has fallen to last place among those countries in preventing deaths through use of timely and effective medical care, according to the report by the Commonwealth Fund, a nonprofit research group in New York.

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July 17, 2008 | Permalink | Comments (3) | TrackBack (0)

Tracking Produce Proves Complex

The Washington Post provides an update on the salmonella outbreak.  The Food and Drug Administration pointed to raw tomatoes, jalapeño and serrano peppers as the cause of the outbreak, but has yet to find a single contaminated tomato or pepper.  Investigators blame the difficulty on tracking produce distribution as the reason.  Annys Shin writes,

Tomatoe_2The salmonella outbreak of 2008 may go down in history as the case of the missing tomatoes.

More than six weeks ago, the Food and Drug Administration issued a warning about a salmonella outbreak in New Mexico and Texas connected to raw tomatoes. Since then, the agency has expanded the warning nationwide and added jalapeño and serrano peppers. More than 1,100 people have fallen ill since April, but not a single contaminated tomato or pepper has been found.

Investigators said the complexity of the produce distribution system has been their biggest impediment, and some produce industry leaders agree that tracing fruits and vegetables could be easier. Though the technology to do so already exists in the form of bar codes that appear on nearly everything we buy, it could take as long as five years before the entire food industry applies it to food safety.

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July 17, 2008 | Permalink | Comments (0) | TrackBack (0)

Wednesday, July 16, 2008

Congress, Overriding Bush, Blocks Pay Cut for Doctors

The New York Times reports that Congress has overrided Bush's veto of the Medicare Bill.  Robert Pear writes,

Medicare_veto_2President Bush on Tuesday vetoed a bill protecting doctors from a Medicare pay cut, but both houses of Congress swiftly overrode the veto with large bipartisan majorities, so the bill is now law.

The vote in the House was 383 to 41, with 153 Republicans defying the president. In the Senate, the vote was 70 to 26, with 21 Republicans voting to override.

The bill won more support on Tuesday than when it was first approved. The tally in the House last month was 355 to 59, with 129 Republicans voting for passage. The crucial vote in the Senate was 69 to 30, with 18 Republicans voting yes.

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July 16, 2008 | Permalink | Comments (0) | TrackBack (0)

Vision Insurer to Ask Justices to Restore Its Tax Exemption

The New York Times reports that the country's largest eye-care insurance program plans to ask the Supreme Court to reconsider its tax exemption.  Stephanie Strom writes,

Vision_insurerThe country’s largest eye-care insurance program plans to ask the Supreme Court to decide whether the Internal Revenue Service properly revoked its tax exemption in 2003, company executives said Tuesday.

The proposed filing, by VSP Vision Care of Rancho Cordova, Calif., highlights a major debate in the nonprofit arena over what activities deserve tax exemption when most nonprofit groups charge fees for services and products to supplement their income from charitable donations.

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July 16, 2008 | Permalink | Comments (0) | TrackBack (0)

Understanding Autism: Gene Clues Suggest Autism Strikes When Brain Can't Learn Properly from Early Life Experiences

The Los Angeles Times, the Washington Post, and Time Magazine report that new gene discoveries may suggest that autism strikes in a brain that can't properly form new connections.  AP Medical Writer, Lauran Neergaard, writes,

Autism_pic_2Harvard researchers have discovered half a dozen new genes involved in autism that suggest the disorder strikes in a brain that can't properly form new connections.

The findings also may help explain why intense education programs do help some autistic children — because certain genes that respond to experience weren't missing, they were just stuck in the "off" position.

"The circuits are there but you have to give it an extra push," said Dr. Gary Goldstein of the Kennedy Krieger Institute in Baltimore, which wasn't involved in the gene hunt but is well-known for its autism behavioral therapy.

The genetics suggest that "what we're doing makes sense when we work with these little kids — and work and work and work — and suddenly get through," he said.

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July 16, 2008 | Permalink | Comments (0) | TrackBack (0)

Tuesday, July 15, 2008

Bush Vetoes Bill Protecting Doctors From Medicare Cuts

CNN reports that Bush has vetoed last week's approval of the Medicare Bill, which would have prevented cuts in Medicare payments to doctors.  Prospects of a veto override in the Senate are unclear.  CNN writes,

Bush_3President Bush has vetoed a bill that would have protected Medicare payments to doctors from being cut, White House press secretary Dana Perino said Tuesday.

The bill would reverse a 10.6 percent cut in Medicare payments to doctors. The cuts in Medicare payments -- part of a scheduled cost-saving formula -- went into effect July 1, although the Bush administration said it would hold off processing claims until mid-July to give Congress time to reach a compromise on the legislation.

The House of Representatives last month passed the bill 359-55 -- considerably more than the 290 votes needed to override a veto.

The prospects for a veto override in the Senate are murkier.

A filibuster held up the bill before being broken by a 69-30 vote Wednesday. Sixty-seven votes are needed to override Bush's veto. But there's no guarantee that all the senators who voted to end the filibuster would vote to override the veto.

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July 15, 2008 | Permalink | Comments (0) | TrackBack (0)

Amgen, Johnson & Johnson Come to Truce in Oncology Marketing Suit

The Wall Street Journal reports on the $200 million settlement between Amgen and Johnson & Johnson after a two-and-a-half year battle over marketing of rival oncology products.  Marilyn Chase writes,

Amgen_suit_articleAmgen Inc. agreed to pay $200 million to settle an antitrust lawsuit by Johnson & Johnson's Ortho Biotech Products unit, putting to rest 2 1/2 years of legal wrangling over Amgen's sales of its oncology products.

Ortho, based in Bridgewater, N.J., had filed suit in October 2005 alleging that discounts and incentives offered to oncology clinics buying Amgen's blood-cell-boosting products Aranesp, Neupogen and Neulasta constituted anticompetitive business practices.

Amgen denied and continues to dispute suggestions that such incentives constitute unlawful conduct. Ortho markets Procrit, which competes with Aranesp.

Under the settlement, Ortho's litigation in New Jersey District Court was dismissed. Amgen, based in Thousand Oaks, Calif., admitted no wrongdoing under terms of the agreement.

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July 15, 2008 | Permalink | Comments (0) | TrackBack (0)

DNA Testing Industry Wrestles with California Law

The Los Angeles Times reports that as a result of violating two types of California laws, the California State Department of Public Health ordered thirteen DNA testing companies operating in California to stop performing genetic testing.  Consumer complaints about the accuracy and cost of genetic testing services advertised online fueled action by the state.  Four of the thirteen companies have already been suspended.  Karen Ravn writes,

Dna2Is there a heart attack in your future? Or just the heartbreak of psoriasis or male pattern baldness? Companies offering genetic tests directly to consumers have proliferated. Send them your DNA, in a swab of your cheek or a bit of your spit, and they'll tell you what your genes tell them -- about your ancestry, characteristics, likelihood of developing a number of diseases and conditions.

Some test for mutations in particular genes that are linked to diseases, such as cystic fibrosis or breast cancer. Others take a big-picture approach, offering wide-scale scans of your genome.

On June 9, the state Department of Public Health sent letters to 13 testing companies operating in California telling them they were breaking California law and ordering them "to cease and desist performing genetic testing without licensure or physician order." Of the 13, five are in California, and the others are in other states or outside the country.

As of July 10, four have suspended business in California. But nine of the companies, believing they are in compliance with the law, are still up and running.

Now, as consumers are left wondering what the standoff means for them, policy experts wonder what it means for the industry long-term.

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July 15, 2008 | Permalink | Comments (0) | TrackBack (0)

Guide to Genetic Testing

The Wall Street Journal provides a brief guide to understanding the costs, processes, and legal protections of genetic testing and what insurers typically cover in such testing.  Jilian Mincer writes,

Genetic_testingIn recent years, about 1,000 genetic tests have become available. Many are covered by health insurance plans, as are additional screenings or interventions that may be advisable based on the results.

A new federal law and many state laws prohibit employers and health insurers from discriminating on the basis of genetic tests.

Consumers should recognize, however, that some genetic tests involve more out-of-pocket costs -- and also raise thorny questions about their benefits and desirability.

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July 15, 2008 | Permalink | Comments (0) | TrackBack (0)

Is Genetic Testing Really Worth the Cost?

As genetic testing becomes more widely understood and administered, Karen Ravn for the Los Angeles Times questions whether the costs (and hidden costs) of genetic testing are actually worth it.  Ravn writes,

Genetic_testing2_2Everyone agrees that the science of gene testing is imperfect, but the companies offering tests directly to consumers, along with their supporters, say the information they give is valid and valuable, noting that clients can get updates as more is learned.

Critics aren't so sure that the people being tested always get their money's worth. And many believe that even when gene tests and claims about links to diseases are accurate, they may be confusing. "This kind of testing, this kind of knowledge about ourselves, is so new," says Dr. Edward McCabe, co-director of the UCLA Center for Society and Genetics. "We can get a whole lot of information, and we're not going to know what a lot of it means."

Some testing companies work hard to solve this problem. For example, Navigenics of Redwood Shores employs three highly trained full-time genetic counselors, one of whom is assigned to each client.

Still, says Dr. Robert Nussbaum, chief of the Division of Medical Genetics at UC San Francisco, no matter how well it's explained, some of the information people get simply doesn't mean much. Some DNA tests are highly predictive of disease -- for example, tests for mutations in the cystic fibrosis gene -- but others are based on flawed data or so weakly predictive that many who test negative will end up getting the disease, while many who test positive will not (an example would be tests for risk of Type 2 diabetes).

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July 15, 2008 | Permalink | Comments (0) | TrackBack (0)