Rare superbug outbreak in Wisconsin is blamed for 18 deaths

first_imgHealthRare superbug outbreak in Wisconsin is blamed for 18 deaths Megan Thielking Nathan Reading/Flickr By Megan Thielking March 3, 2016 Reprints A rare bacterial outbreak in Wisconsin, which is suspected in the deaths of 18 people, is now attracting the attention of the Centers for Disease Control and Prevention.The bacteria, Elizabethkingia anophelis, is resistant to some common antibiotics, and can cause fever, difficulty breathing, chills, and skin infection. The Milwaukee Journal-Sentinel reports that the bacterium has been identified in 44 cases of infection. Of those, 18 people have died since Dec. 29, though it has not been determined whether the infection directly led to their deaths.Most of the cases have cropped up in people over the age of 65, who can be particularly vulnerable to bacterial infections. It’s not yet clear how those people became infected with the bacteria.advertisement The bacterium has caused small hospital outbreaks in the past, leading experts to warn of its potential for hospital-acquired infections. It is named after American bacteriologist Elizabeth O. King, who discovered it in 1959. News Editor About the Author Reprints [email protected] Disease detectives from the CDC are on the ground to figure out what might be behind the bacteria’s spread, but so far answers are lacking.“CDC is assisting Wisconsin with testing samples from a variety of potential sources, including healthcare products, water sources and the environment, but to date, none of these have been found to be a source of the bacteria,” the agency said in a statement. “CDC currently has five disease detectives in Wisconsin assisting with the investigation, and anticipates sending additional staff in coming days. Several dozen epidemiologists and laboratory staff are also assisting from CDC headquarters in Atlanta.”advertisement @meggophonelast_img read more

Harvard panel examines the 21st Century Cures Act

first_img Log In | Learn More Harvard panel examines the 21st Century Cures Act Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Health About the Author Reprints Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. The 21st Century Cures Act has sparked debate since its passage in the last days of the Obama presidency. The law promises to ramp up funding for biomedical research while it also loosens regulations governing drugs and medical devices. Supporters say it will speed up approval of new treatments, while critics are concerned that the safety and effectiveness may be compromised.To debate these points and other implications of the law — whose implementation will be a major priority for the new FDA commissioner soon to be appointed by President Trump — the Forum at the Harvard T.H. Chan School of Public Health invited experts to participate in an hour-long panel discussion. Presented jointly with STAT, the event video is below. STAT staffcenter_img What’s included? What is it? GET STARTED By STAT staff Feb. 27, 2017 Reprints Dina Rudick/The Boston Globe [email protected] Tags policylast_img read more

The patients we do not see

first_imgLeave this field empty if you’re human: At our last clinic visit, my mind turned to what could have been done to prevent her stroke. But the chances to intervene were too few. She and her husband made a living as bottle-pickers; they spent hours every day sifting through trash for bottles to recycle. Elsa told me they made enough money to get by, since they lived with her nephew. But visiting me in clinic, not to mention a cardiologist, neurologist and physical therapist, cost her time and thus cash.And so for every Elsa who walks into our clinic I know there is another patient we do not see.With health coverage for millions of Americans in limbo, we must speak out and organize just to keep seeing the many patients who have been newly brought into care. And at the same time, we must develop better ways to find and support people like Elsa – even before we see them as patients.Dave A. Chokshi, MD, is the chief population health officer of OneCity Health, senior assistant vice president at New York City Health + Hospitals, a primary care physician at Bellevue Hospital, and clinical associate professor of population health and medicine at the NYU School of Medicine.This article was originally published on The Conversation. Privacy Policy By Dave A. Chokshi — The Conversation April 29, 2017 Reprints In medicine, we speak of “seeing patients” when we are rounding in the hospital or caring for those who come to our clinics. But what about those people who may be sick but do not seek care? What is our responsibility to the patients we do not see?This question takes on greater urgency in the current political climate, as patients face the threat of losing health insurance. Renewed efforts to repeal and replace the Affordable Care Act leave millions wondering whether they will be covered.For me, as a physician practicing in the safety net, abstract numbers evoke the very real stories of my uninsured patients. One of my patients, whom I’ll call Elsa, had not seen a doctor since immigrating to the United States 15 years ago. That abruptly changed one morning: She awoke to find the room spinning around her and, terrifyingly, she could not articulate the words to explain to her husband what was going on. She was having a stroke.advertisement Please enter a valid email address. APStock Neighborhoods influence health, for better and for worse Why patients may not seek careSometimes, forgoing care is a symptom of social isolation. I asked another patient of mine – whom I had recently diagnosed with uncontrolled, likely longstanding diabetes – about his eating habits. I learned that in his routine, he would go for days at a time without interacting with another person; he did not have any family nearby and worked from his home computer.Aside from deterring access to care, loneliness and social isolation have direct effects on health. One review of 148 studies showed that the influence of social relationships on the risk of death was comparable with risk factors such as obesity and alcohol use.In other cases, the health care system must take responsibility for barriers to patients that we ourselves erect. Beyond costs, structural barriers include inadequate language interpretation services and the assumption of health literacy when conveying information. Meanwhile, historical inequities often underlie wary attitudes toward health care. Dave A. Chokshi — The Conversation Related: About the Author Reprints Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts.center_img Dr. Mary Bassett, the health commissioner of New York City, has spoken plainly about this: “We must explicitly and unapologetically name racism in our work to protect and promote health…We must deepen our analysis of racial oppression, which means remembering some uncomfortable truths about our shared history.”In the same vein, new immigration policies may have a chilling effect on the willingness of people like Elsa to see a doctor, if they perceive negative repercussions for themselves or their families.Many patients with the greatest unmet needs are therefore marginalized, with only glancing interactions with the health system – or none at all, in the most wrenching cases of suicide, drug overdose and other chronic illnesses that end in catastrophe.When they do seek care, it is sporadic. They may show up in the ER, but not to a primary care follow-up appointment. If an ensuing phone call goes unanswered, or their phone is out of service, we label them as “lost to follow-up” and move on to the next patient on the list.What needs to changeDoing better by these patients will require moving the locus of accountability for health further into communities. It means bringing more of a public health mindset to health care; that is, not reflexively restricting our purview to those who happen to cross our clinic’s threshold.Hospitals and health systems must have the humility to reach across boundaries and partner with local institutions that are sometimes more trusted, and often more relevant, in people’s daily lives, including churches, schools, food pantries and parks.In one recent example, the 54 branches of the Free Library of Philadelphia were shown to be vital community nodes for health-related services like literacy programs, healthy eating initiatives, job fairs and food preparation courses. Public libraries are particular safe havens for those experiencing mental illness, substance use disorders and homelessness – as well as youth and recent immigrants. We should consider how the these locations are therefore already a part of our health ecosystem. Doctors and other clinicians may balk at trying to take care of the patients we do not see. After all, with the harried pace set by the 15-minute office visit, it is hard enough to keep up with the patients we do see. But the goal is not to schedule doctor’s appointments for all library-goers, but rather to equip them to be better stewards of their own health, which sometimes involves health care providers, sometimes not. While physicians can’t do it alone, we can lend our voices to those calling for greater outreach, less stigma and protection of the most vulnerable.Prevention, not regressionIn Elsa’s case, when she had her stroke, she was rushed to the ER and received excellent care from the hospital team. Neurologists treated the blocked vessels in her brain and diagnosed her with a narrowed heart valve and high blood pressure.As a doctor in a system that accepts all patients, regardless of ability to pay, I was proud to be a part of her follow-up care. She underwent heart valve surgery, and we put her on blood thinners and blood pressure medicines to reduce her risk of another stroke. Her rehabilitation, all things considered, was going well. The health care system had reacted to Elsa’s crisis with swift competence. Beyond books: how libraries can help meet health needs Social justice should be a key part of educating health professionals There are many reasons that patients like Elsa may not seek care – until they have no choice. Although she felt no symptoms before her stroke, Elsa was one of about 13 million U.S. adults with undiagnosed high blood pressure. I wondered if making her aware of her blood pressure would have been enough to avoid her suffering.But even if high blood pressure may sit atop the list of problems I write out, from his or her perspective it may not crack the top five. Food security, job stability, child care and affordable housing understandably feel more urgent. Time and again, I have learned that taking care of my patients starts by trying to walk a mile in their shoes.advertisement Related: First OpinionThe patients we do not see Tags Health Disparitiesinsurancepatients @davechokshi Related:last_img read more

Andy Slavitt can’t stop: How a health care wonk became a rabble-rouser

first_img General Assignment Reporter Eric focuses on narrative features, exploring the startling ways that science and medicine affect people’s lives. About the Author Reprints Congressman Mark Amodei, of Nevada, called it “incredible.” He was one of the Republican members of Congress in whose districts Slavitt held a town hall either in person or by phone. (STAT contacted the offices of seven; neither McSally of Arizona, nor Erik Paulsen of Minnesota, nor Evan Jenkins of West Virginia, nor Alex Mooney of West Virginia, nor Don Young of Alaska responded to requests for comment.)Amodei, who was first elected in 2011, said Slavitt’s town hall project — and Slavitt’s very existence — was news to him.“I have never heard of the guy before, which is probably an indication that we didn’t have a real customer-friendly relationship with CMS under the previous administration,” he said by phone. “Until you asked me the question, I was unaware that this former CMS administrator decided it was his civic duty to hold a telephone town hall after the AHCA vote.”Amodei, who said he held his own town hall in April, before the Republican health care vote, also wondered who was organizing and paying for Slavitt’s. He said he was sure Slavitt does not have “an overriding concern about the issue; I’m sure someone asked him to come into Nevada to whip folks up.”These suggestions don’t worry Slavitt. He finds them laughable. “I was at an event with Rupert Murdoch this week,” he said. “Someone made the comment to him, ‘People are really up in arms about this bill,’ and he said, ‘Don’t believe it for a second, people are getting bussed in.’ That’s what he said. And you know, we just had 3,300 people on a call from Alaska. Where do they get bussed in from?”Participants at the town hall in Arizona were given placards to display. Mark Levy/Sierra Vista HeraldThe idea for the town halls had, in fact, come from Slavitt. His team then turned to local chapters of progressive organizations like Organizing for Action, a nonprofit offshoot of Obama’s reelection campaign, to help set up the events. Slavitt’s team said that Save My Care — an initiative organized by a coalition of liberal groups — helped pay for his plane tickets, while he paid for his own hotels.Slavitt may not have been called in to “whip folks up,” but pressing people into action was part of his goal in Sierra Vista. He knew that the Republicans only have a slim majority in the Senate. If constituents could get Senators John McCain or Jeff Flake to stand up against the bill now, that would change the landscape.Afterward, Slavitt took questions, including some about government employees’ insurance, veterans’ insurance, and why he isn’t advocating for a single-payer system. After responding to more questions and stories one-on-one, he had to go. He would have liked to stop for lunch at the best Mexican restaurant in town, but there wasn’t time: He needed to be at a Tucson news station by 3, and at the airport around 4.While he insists that he’s no politician, Slavitt’s schedule of town halls, skipped meals, and meetings all over the country make it sound like he’s on the campaign trail. “I’ve been getting a lot of ‘Andy, are you going to run for Congress?’ My answer to that is no,” he said. “My answer to that is, ‘I don’t want to run for one congressional seat, I want to run for 25 seats.’” Later that day, he added, “I’m more of an executive branch kind of person.” Please enter a valid email address. By Eric Boodman May 25, 2017 Reprints Newsletters Sign up for D.C. Diagnosis An insider’s guide to the politics and policies of health care. Related: Right now, though, he’s focused on what will happen in the Senate. “It’s not about a bunch of policy arguments,” he said, “it’s about getting out here in the real earthy world where people are going to have to place their votes, and it’s one senator at a time.”On the way back to Tucson, Slavitt leaned his head onto his right shoulder, watching the desert roll by as he did a phone interview. He was still on a business call as he walked from the car into Tucson’s public broadcasting studio. Not long afterward, Slavitt emerged from the air conditioning into the mid-afternoon heat. As he walked back toward the car, he asked Julia Strange, a vice president at Tucson Medical Center, who had driven him to and from Sierra Vista, about the show he’d just been on.Was it big?It was big, she said. Its sound bites would be played on Arizona’s public radio stations all week.“I laid it onto Flake,” Slavitt said. He’d been nice, he went on: He’d mentioned that both Flake and McCain cared deeply about their constituents. But he’d made sure to zero in on the fact that Flake was up for re-election in 2018, and that his action on the Republican health care bill wouldn’t go unnoticed.“He’ll see it,” Strange said.“Good,” Slavitt replied. Then they got in the car and headed toward the airport. Want a glimpse into the possible future of Medicaid? Head to Indiana Leave this field empty if you’re human: In Sierra Vista, the day was hot. A red-tailed hawk wheeled high over the parking lot as Slavitt paused for a photo op outside the library before heading inside.Almost as soon as he got the mic, Slavitt jumped on the Republicans who had voted for the bill: To him, they seemed more interested in “the sport of it all” than in people’s lives.“OK, Andy, why would you travel 1,624 miles to come talk about health care?” he began. “And unless she’s here”— he looked around the room with his finger out, picking through the crowd — “it’s in part because Representative McSally isn’t.”There was laughter, then cheers and applause.“I chose to come here as one of my first visits because, quite frankly, I found her comments to be representative of the fact that for some people this is a game, a sport to be won or lost.”He then laid out some ground rules for his speech. He would try to keep it short, to leave time for questions. He would try to let the audience know when he was giving his opinion, he said, and when he was saying what he held to be facts.“This is not political,” he said — and then he explained how exactly Trump had broken his three big promises on health care.Slavitt said he couldn’t know exactly how many millions of Americans would lose care — estimates are inexact — but that millions would lose their coverage under the new bill. He said the new bill definitely made health insurance more expensive if you’re over 50, and even more expensive if you’re older and live in a rural part of the country. And, he said, “On the House GOP website appeared the words that nobody with a preexisting condition should be charged more than anybody else. After the House vote, that sentence was eliminated. That’s all you need to know. … I don’t know of any other three-letter word besides ‘lie’ for that.”It’s hard to maintain that this is “not political” — and Republicans have sneered at the claim. Please enter a valid email address. Privacy Policy Eric Boodman SIERRA VISTA, Ariz. — The sighting took place on a hot day in May, in the lobby of the Sierra Vista Public Library, not far from the rack where local kids can borrow donated bikes. A blond woman in white tennis shoes nudged her twin sister, nodding toward a man who had just walked past. “That’s him,” she whispered. It was the kind of gesture you might make if you saw Mick Jagger heading into the men’s room ahead of you in the hour before a Stones concert — a mix of admiration and disbelief at seeing in the flesh someone you’ve only ever encountered in print or on screen.But the man looked like your average middle-aged dad — blue jacket, dark jeans, slip-on dress shoes, a salt-and-pepper beard neat enough to look professional — and he was here to talk about health policy.It was Andy Slavitt. From 2015 to early 2017, he had been the head of the Centers for Medicare and Medicaid Services, the government agency that administers President Obama’s Affordable Care Act and that provides health insurance for children, the elderly, the disabled, those on low incomes. He describes the job as “looking after the programs that serve 130 million people or so.”advertisement Some Republicans think of Slavitt as a carpetbagger; others suggest that his outreach is not as innocent as he says.Those who have been CMS administrators before him, though, express nothing but respect for his recent work, even if they don’t agree with all of his policy decisions. As Thomas Scully, who had the CMS job from 2001 to 2003, under the George W. Bush administration, told STAT: “I’m not sure that’s been done before, but God bless him, he has the right to whatever he wants to do. … Most of us have had to go out and get full-time jobs. But I gave speeches to defend my work when I had time.”Bruce Vladeck, who had the same role under Bill Clinton, considers the work he and others did to save Medicaid in the mid-’90s the high point of his career. “If Bush had come in in 2001 and gone after the Medicaid program, I’d be out there just like Andy, I would’ve had to,” he said. “How could you not? How could you give your life and blood for years to something and then have a bunch of assholes try to destroy it, and just sit there? How can you do that?”Slavitt isn’t, by any means. He has seemingly boundless energy, and the cellphone numbers of a lot of CEOs. The question, though, is whether a wonk-turned-evangelist — who lives outside Minneapolis, no longer a fixture of Washington’s policymaking habitat — can whip up enough public furor to affect the Senate’s plans for health reform.Slavitt (second from left) is sworn in during a congressional hearing on the Affordable Care Act in 2013. Alex Wong/Getty ImagesSlavitt’s interest in health care was crystallized by a tragedy. In the late ’90s, he had finished his undergraduate studies at the University of Pennsylvania and done an MBA at Harvard. He had worked for Goldman Sachs and McKinsey. He’d had health care clients while working as a consultant, “but by no means was that my career path,” he said. Even after he left consulting, when he was running a company that set up health and worker’s comp insurance for agribusiness companies, he still wasn’t completely committed to working in the field.But then, his college roommate Jeff Yurkofsky, who had just gotten married and had twins, was diagnosed with a brain tumor. Five months later he was dead. He had been a doctor, but, in Slavitt’s words, “was in that post-residency fellowship before … you earn real money.” Jeff hadn’t had any life insurance. So his widow and her kids moved from Baltimore to California, into the spare room in the house where Slavitt was living with his wife and their own newborn.Slavitt was at that point dealing with insurers for his work at the agribusiness company, and he noticed something strange. “Jeff and Lynn had tens of thousands, maybe $60,000 in medical bills,” he recalled. “We were trying to help Lynn to pay those bills, and one of the things that I saw was that he was getting charged a dollar for things that this little company would be contracted and paid 40 cents for.”That gave Slavitt the idea for his next company. Its aim was to help patients find the cheapest option for services that weren’t covered by their insurance.“He came away realizing that the whole health care system was not very consumer-driven,” said Rob Keil, Slavitt’s senior-year roommate in college. “I think he became very passionate because he saw a huge problem.”If a personal crisis pushed Slavitt definitively toward health care, it was a political one that propelled him to D.C. nearly 15 years later. It was October 2013. The Obama administration had launched healthcare.gov — the Affordable Care Act website — and it was immediately a technical disaster. Slavitt called D.C. on behalf of the company he was working for at the time, a subsidiary of the insurance giant UnitedHealthcare, to offer his firm’s expertise. The Department of Health and Human Services accepted. He first arrived at CMS on Oct. 24.“I got to know him at a difficult time … we had made a commitment that by the first of December the website would be functional,” Kathleen Sebelius, the secretary of the Department of Health and Human Services at the time, told STAT. One foot out the door, Medicare chief launches Twitter barrage to defend the ACA Related: Trump wants to cut $800 billion from Medicaid. Where does all the program’s money go? Privacy Policy Andy Slavitt (left) speaks with another presenter, Jeff Jeas, at a town hall at the Sierra Vista Public Library in Arizona. Mark Levy/Sierra Vista Herald Slavitt remembers being in the war room that he’d helped set up when the website rounded a corner. “All of a sudden it was popping,” Slavitt said, remembering how everyone stopped working and began staring at the enormous screen. “We were like, ‘People are getting insurance.’ There was this huge cheer.”Yet even with the crisis under wraps, the agency that Slavitt would join was still in a precarious state. One of Slavitt’s former staffers said recently that it needed to be “healed.” Sebelius recalled that the Republican-controlled Senate’s refusal to give Slavitt a confirmation hearing when he was nominated to be administrator “left him in kind of a limbo position. Not that he was any less dedicated or enthusiastic, but it sends a message to other staff people that says, ‘Maybe he will be here, or maybe he won’t.’”As Slavitt was trying to boost the morale at CMS and implement a change in the way that doctors got reimbursed for the care they provided, he was also relatively new to the workings of Washington. Senators would send him an email and put out a press release simultaneously: “Senator so-and-so tells Slavitt to fix this or else,” he recalled. “I would find out in Politico or Modern Healthcare. … And I was just trying to figure out, is this normal?”Slavitt speaks to an audience at a town hall in Sierra Vista, Ariz. Mark Levy/Sierra Vista HeraldA little over halfway to Sierra Vista, as reddish desert streamed by the car windows, Slavitt’s assistant handed him a schedule for the town hall. She had just written it up, on the back of a flyer for a Mexican restaurant that her Uber driver had given her that morning.“Especially if people have come all this way, they’re going to want their questions answered, so I want to make sure we do as much of that as we can,” he said. “And everybody in the world, including me, maybe especially me, talks for longer than we think we talk for. So … we want to keep it brief, because we really want to hear from people.”Stories are important to Slavitt. Growing up in Chicago, he dreamed of being a war reporter, partially under the influence of a melodrama called “The Year of Living Dangerously,” in which a young Mel Gibson is a foreign correspondent covering the political turmoil of 1960s Indonesia. “He plays a very swashbuckling Australian, hard-drinking journalist,” recalled Slavitt, who saw the film some 10 times.“He sees what everybody else is reporting on, which is the sport of it all, and he gets exposed to the people in the villages … and he starts to tell that story.” Related: HeavyweightsAndy Slavitt can’t stop: How a health care wonk became a rabble-rouser The 49-year-old twins hadn’t heard of Slavitt while he was on the job. They only discovered him about a month after he stepped down, when they’d gone to meet their congressional representative, Republican Martha McSally, at two town halls around Tucson. It was right around the time when President Trump was learning that health care was complicated, and the sisters wanted to know more about the Republican alternative to Obamacare. They didn’t find the information they’d been looking for, though, because they didn’t actually meet McSally at either event. “The first we were locked out, the second was an empty chair,” said Jan Stockwell. “She was invited and didn’t attend.”To get their questions answered, they went online, and quickly found Slavitt’s Twitter feed. They weren’t the only ones. “When I left CMS I had 17,000 followers. My younger son said to me, ‘Well, that’s it, you’re not going to get any more followers, no one’s going to care what you say anymore,’” Slavitt told STAT. “And a week later I was like, ‘You’re wrong, I’ve got 23,000!’ And then I had 45,000, and then I had 60,000. I’m not really sure what happened.”advertisement Leave this field empty if you’re human: Now, the Stockwell sisters had driven over an hour to hear their new trusted source on health policy in person — and their reason for being there was remarkably similar to Slavitt’s. The week before, 217 congressional Republicans voted for the bill that would “repeal and replace” the Affordable Care Act. But, as Slavitt noted during the car ride to Sierra Vista, in the congressional recess that followed the vote, only a dozen or so of those lawmakers were holding town halls about the legislation.Slavitt decided that if these members of Congress weren’t going to explain the legislation to their constituents, he would do it for them in a series of his own town halls. His explanations, though, came with an added message: Don’t let your senators pass this bill.Slavitt, 50, insists that he is not an advocate or an activist — “If the Republicans came out with a good bill, I would be out here actually supporting it,” he said — but he has become one of the strongest voices in the fight against the dismantling of the Affordable Care Act. He’s also become a kind of amplifier, turned up high enough to create feedback: It can seem as though every story he hears on the town hall trail is broadcast back to a national audience through his daily barrage of tweets, which in turn generate the sharing of more stories, the asking of more questions.While he was at CMS, Slavitt began every morning by reading and responding to emails from those whose health insurance he was administering — everything from “the battery in my wheelchair no longer work” to “my daughter is in an adult facility, she’s disabled, there’s a bad situation we need to change” — and he soon started sending messages straight to the American public on Twitter, with no intermediary.“I drove the White House a little crazy,” he said. He didn’t stop then, and has only ramped it up since he left the government in January — a Trump-like strategy in form if not in content. Related: Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. Trump budget proposes massive cuts to Medicaid, science, and biomedical funding [email protected] @ericboodman Tags insuranceMedicaidMedicarelast_img read more

Native Americans’ health threatened by denial of Medicaid expansion

first_imgHaving Medicaid cover more Native Americans provides a double benefit. It lets newly covered patients seek care outside of Indian Health Service or tribal facilities if they prefer to do that. This takes some pressure off these organizations and improves overall access to health care. Those who choose to seek care at the often more culturally focused and community-based Indian Health Service and tribal facilities on the reservations can certainly still do so. These facilities can then bill Medicaid directly for services provided. That has served as a critical source of additional funds, supplementing the scandalously inadequate funding the Indian Health Service receives directly from the federal government.To provide some perspective on funding for Native American health care, consider this: in 2014, the Indian Health Service spent just $3,107 per person, whereas Medicaid spent $5,563, the Veterans Health Administration spent $7,036, and Medicare spent $11,910. There is no doubt that the Indian Health Service is an afterthought on the long list of government health priorities.It is hard to tell exactly how Medicaid expansion through the Affordable Care Act has affected health outcomes among Native Americans. Signs that it is having beneficial effects include improvements in staffing shortages, colorectal cancer screening rates, and blood pressure control among diabetics.We are personally seeing more patients in our medical centers, a likely sign that coverage has indeed expanded and access to care is improving. When Mr. W returned to the clinic with a new large ulcer on his foot, the well-staffed team quickly began treating it. Under their excellent care, his wound is healing and he is unlikely to lose his foot. This is how diabetes care should be working. But it takes improved access to treatment, better staffing, and broader services, all of which are threatened by replacing the Affordable Care Act with something that restricts Medicaid expansion. Aaron Price A Navajo youth walks through Ft. Defiance, Ariz., on the Navajo Reservation. Matt York/AP Kevin Duan By Kevin Duan and Aaron Price May 25, 2017 Reprints @kevinduan Trump wants to cut $800 billion from Medicaid. Where does all the program’s money go? Related: America has broken several centuries worth of promises to its indigenous people. And we’re poised to do it again.The consequences of this broken promise will affect Native Americans like Mr. W, who lives on the Navajo reservation in Arizona. At only 64 years of age, the complications he has already suffered from his poorly controlled diabetes read like a list from a medical textbook: loss of sensation in his feet and damage to his kidneys and vision. He recently needed to have a toe amputated because of a diabetes-related foot infection. Sadly, Mr. W’s story is all too common.Native Americans are twice as likely to develop diabetes — and suffer from its complications — as whites. Their life expectancy is more than four years shorter and infant mortality is 60 percent higher. The list goes on. As doctors working on the Navajo reservation, we see these disparities every day.advertisement ‘It can tear a family apart’: The opioid crisis sweeps through Cherokee Nation We let out a collective sigh of relief when the Republican’s initial attempt at repealing the act were put on hold in March. Now that Republicans have breathed new life into their repeal bill, and with Medicaid expansion still on the chopping block, the progress made in Native American health is in jeopardy.Critics of the Indian Health Service and tribal facilities have long cited poor access to care, low quality of care, and agency mismanagement as problems that need to be addressed. There is no doubt that improvements must be made in all of those areas. But cutting Medicaid expansion as a key funding source for Native American health care is not the solution. And despite the flaws of the Indian Health Service and tribal health facilities, they still play an important and singular role, providing health care to more than 2 million Native Americans nationwide.The national discourse regarding the potential effects of ACA repeal efforts will again reach fever pitch as the Senate takes up the bill. Who will suffer and who will benefit? Is it poor or rich Americans? Is it young or old Americans? Amid this discussion, one group that is sure to be left out of the conversation — and sure to suffer — is Native Americans.Preserving current levels of health care access and funding for Native Americans won’t right the wrongs of several centuries. But it’s a start.Kevin Duan, MD, is a physician at Tsehootsooi Medical Center and a volunteer assistant clinical professor at the University of California, San Francisco. Aaron Price, MD, is the chief of staff at Tsehootsooi Medical Center, a HEAL Initiative fellow, and a member of the Navajo Nation. This article reflects the personal views of the authors and not necessarily those of the Indian Health Service, Tsehootsooi Medical Center, the University of California, San Francisco, or the Navajo Nation Government. Getting more eligible Native Americans covered by Medicaid provides some desperately needed relief for the overextended and underfunded Indian Health Service and tribal health systems. Previously, when an uninsured individuals like Mr. W needed care, they would go to any Indian Health Service or tribally run facility and receive care, regardless of their ability to pay.advertisement About the Authors Reprints The Affordable Care Act provided a way to improve the health of thousands of Native Americans through Medicaid expansion. It provided a much-needed injection of funding to the long-neglected Indian Health Service and tribal health facilities by raising the income level needed for eligibility. With the poverty rate at 28 percent among Native Americans, this group disproportionately benefited from Medicaid expansion. According to the Kaiser Family Foundation, Medicaid expansion meant that 440,000 more Native Americans were eligible for Medicaid in 2015. That is a huge number when you consider the population of Native Americans nationally is 5.4 million. Related: First OpinionNative Americans’ health threatened by denial of Medicaid expansion Tags diabetesinsuranceMedicaidlast_img read more

MyoKardia drug improves blood flow in patients with serious, inherited form of heart disease

first_img MyoKardia (MYOK) announced Monday that its experimental drug mavacamten demonstrated statistically significant improvements in blood flow and aerobic capacity in patients with an inherited form of heart disease in a small, mid-stage clinical trial.Eight of the 10 patients who completed the study achieved improvement in blood flow to a level where they no longer met the threshold for being diagnosed with their disease — obstructive hypertrophic cardiomyopathy, or HCM. MyoKardia drug improves blood flow in patients with serious, inherited form of heart disease Log In | Learn More STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Unlock this article — plus daily coverage and analysis of the biotech sector — by subscribing to STAT+. First 30 days free. GET STARTED By Adam Feuerstein Aug. 7, 2017 Reprints Biotech Yoshito Laboratory, Cira, Kyoto University [email protected] What is it?center_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. GET STARTED What’s included? Senior Writer, Biotech Adam is STAT’s national biotech columnist, reporting on the intersection of biotech and Wall Street. He’s also a co-host of “The Readout LOUD” podcast. Tags biotechnologycardiologydrug developmentgenetics About the Author Reprints Adam Feuerstein @adamfeuerstein last_img read more

A new Alzheimer’s drug, once worth billions, is headed for the trash

first_img National Biotech Reporter Damian covers biotech, is a co-writer of The Readout newsletter, and a co-host of “The Readout LOUD” podcast. Damian Garde GET STARTED Log In | Learn More What’s included? By Damian Garde Jan. 8, 2018 Reprints Axovant Sciences (AXON), 2017’s most talked-about biotech company, is abandoning the drug that made it famous after yet another clinical trial failure.The company, valued at more than $2.8 billion in September, will no longer study intepirdine after finding the drug to be useless against dementia with Lewy bodies, a memory-destroying disease that can affect mood and balance. Last year, intepirdine failed in a 1,300-patient Alzheimer’s disease trial, sending Axovant’s share price down more than 75 percent. @damiangarde David Duprey/AP STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond.center_img [email protected] What is it? A new Alzheimer’s drug, once worth billions, is headed for the trash Tags dementiajpm18patientspharmaceuticals Unlock this article — plus daily coverage and analysis of the biotech sector — by subscribing to STAT+. First 30 days free. GET STARTED Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Biotech About the Author Reprintslast_img read more

Fauci: NIH in a ‘scramble’ to prepare for any government shutdown

first_img What’s included? Associated Press Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. WASHINGTON — The nation’s premier medical research institute is in “a scramble” to prepare for a partial government shutdown that could ruin costly experiments and leave sick patients unable to enter cutting-edge studies, Dr. Anthony Fauci of the National Institutes of Health said Thursday.Fauci stressed that patients currently in NIH-run studies — including those at the research-only hospital often called the “house of hope” — wouldn’t be adversely affected even if President Donald Trump and Congress don’t reach a budget deal to avert a shutdown at midnight Friday. GET STARTED Fauci: NIH in a ‘scramble’ to prepare for any government shutdown What is it? By Associated Press Jan. 18, 2018 Reprints Dr. Anthony Fauci, the NIH’s infectious disease chief. Susan Walsh/AP About the Author Reprints Log In | Learn More Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Politics Tags Congresspolicylast_img read more

Evidence from the field: Fractional doses of yellow fever vaccine provided protection, study finds

first_imgLeave this field empty if you’re human: Those symptoms typically go away after three or four days. But about 15 percent of people then suffer a relapse, going on to develop jaundice and more severe illness. And in roughly half of that group of severe cases, the infection is fatal.There is limited annual production of yellow fever vaccine. And while an international stockpile of 6 million doses is maintained, the events of the past few years have raised fears about the capacity to respond when yellow fever threatens large populations of people.The problem in 2016 began with a large, rolling outbreak in Angola that eventually spread to Kinshasa, a city of 11.6 million people. When the DRC government decided to preemptively vaccinate in Kinshasa, there was not enough vaccine in the international stockpile to undertake the job.(Brazil, which has recorded an alarming number of cases of yellow fever in people and in monkeys near Sao Paolo and Rio de Janeiro in recent months, is using fractional doses to vaccinate in and around those cities.)The World Health Organization, based on expert advice, recommended using a fractional dose. The plan was to follow up a year later with a second fractional dose to ensure long-term protection. Joachim Hombach, head of immunization policy for WHO, said the recommendation for a followup shot may be waived if study participants show they retain good antibody responses a year after vaccination.Casey said the researchers went back to the people they studied to assess antibody levels at the one-year point. They are still analyzing the data, and expect to be able to publish findings in the next few months.The study monitored 716 people who were vaccinated during the Kinshasa campaign, looking for antibodies in their blood after vaccination as a measure of whether the vaccine worked. The study could not actually assess whether the vaccine was protective because the outbreak was waning by the time the vaccination campaign got underway.Nearly 500 of the people enrolled had no antibodies to yellow fever when the trial started and 98 percent of them “sero-converted” — meaning they developed what is thought to be protective levels of antibodies when they were checked a month after vaccination. HealthEvidence from the field: Fractional doses of yellow fever vaccine provided protection, study finds Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. Senior Writer, Infectious Disease Helen covers issues broadly related to infectious diseases, including outbreaks, preparedness, research, and vaccine development. ‘We didn’t expect this’: A historic yellow fever outbreak spreads in Brazil @HelenBranswell By Helen Branswell Feb. 14, 2018 Reprints Related: Please enter a valid email address. Privacy Policy A health worker in Kinshasa carries a supply of yellow fever vaccine. EDUARDO SOTERAS/AFP/Getty Images The other people had some antibodies at the start, suggesting they had either been previously vaccinated against yellow fever or they had contracted it at some point. Only 66 percent of them recorded an antibody rise after vaccination, but the lack of response in some isn’t alarming. A full dose of vaccine and infection with yellow fever are both thought to confer life-long immunity to the virus.Experts consider these results very promising, but warned this doesn’t mean the vaccine dose can be lowered for everyone. Duane Gubler, a world expert in yellow fever, suggested there aren’t data to indicate how long the protection from a fractional dose lasts.Dr. Erin Staples, senior author of the paper and a yellow fever expert in CDC’s vectorborne diseases operation at Fort Collins, Colo., said the early results are fueling questions about whether the vaccine dose could be lowered and whether using a lower dose would reduce the rate of adverse reactions to the vaccine. Yellow fever vaccine is one of the more reactogenic vaccines, meaning it can cause discomfort. And in rare cases, it can trigger serious illness.“It’s a theoretical potential benefit. But until we have data, we can’t say for sure if it will or won’t improve it — but that’s something that we hope to get data on,” Staples said.The WHO’s Hombach said fractional dosing should be used as a last resort only until it is known how long protection from a fractional dose lasts, whether smaller doses work as well in young children, and whether vaccines from other manufacturers work as well as the one used in the study.“It’s a way of having some surge capacity,” he told STAT. “I think we need to really confine it to emergency situations…. Because I think it is one of the few tools that we have, indeed, if we need to counter an outbreak and we are running short of vaccine supplies.” Helen Branswell About the Author Reprints A 2016 emergency yellow fever vaccination campaign that had to resort to using smaller than standard doses because of a global vaccine shortage appears to have protected the people who were vaccinated, a new study suggests.People who received a fractional dose — one-fifth the standard size — showed strong immune responses a month after they received the single dose of vaccine, the authors reported in the New England Journal of Medicine.While the study — conducted during a mass vaccination campaign in Kinshasa, capital of the Democratic Republic of Congo — is not the first to provide hints that fractional doses of yellow fever vaccine are effective, it was the first such study undertaken outside the artificial confines of a laboratory.advertisement “This is really the first evidence for a fractional dose coming from a vaccination campaign setting and in the context of an outbreak,” said Dr. Rebecca Casey, first author of the study and a scientist with the Center for Disease Control and Prevention’s global immunization division.Yellow fever is a serious, and sometimes fatal, disease. People who contract the virus, which spread through the bite of infected mosquitoes, can experience an array of symptoms — fever, headache, backache, and muscle pains, loss of appetite, and nausea or vomiting.advertisement Tags Vaccineslast_img read more

Acadia Pharma raised the price of its only drug twice but quarterly sales still disappoint

first_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. @adamfeuerstein Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED GET STARTED STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Acadia Pharmaceuticals (ACAD) either didn’t receive — or is ignoring — the Big Pharma etiquette memo about easing back on egregious drug-price hikes.During the fourth quarter, the San Diego-based company acknowledged Tuesday night, it took two price increases for Nuplazid, a pill used to quell hallucinations and delusions often experienced by people with advanced Parkinson’s disease. About the Author Reprints Log In | Learn More What’s included? What is it? Acadia Pharma raised the price of its only drug twice but quarterly sales still disappoint [email protected] Tags biotechdrug pricesSTAT+ By Adam Feuerstein Feb. 28, 2018 Reprints Senior Writer, Biotech Adam is STAT’s national biotech columnist, reporting on the intersection of biotech and Wall Street. He’s also a co-host of “The Readout LOUD” podcast. Adam’s Take Adam Feuersteinlast_img read more