Bird Flu Kills Five in Azerbaijan

Asian bird flu has infected as many as eight people in adjacent villages near the Caspian Sea in Azerbaijan, according to the World Health Organization.

The WHO suspected that bird flu caused the deaths last week. Now it says there's no doubt the H5N1 virus killed five teenagers and young adults. Four lived in a coastal settlement in the Salyan district. The virus sickened two others in Salyan, who are still alive. Test results are pending on two cases from a neighboring village. Bird flu has also killed a young woman in the western part of Azerbaijan.

The unusual cluster of cases has given rise to fears that the bird virus has adapted to pass readily from person to person. But WHO officials say there's no evidence of that. One possibility is that victims got infected from collecting dead swans and removing their feathers. A WHO spokesman says that task often falls to teenage girls and young women. — Richard Knox

U.S. Government Sued over Budget Law

March 21, 2006 — A government watchdog has filed a lawsuit charging that the $39-billion deficit-reduction law signed by President Bush last month is invalid.

In a suit filed in U.S. district court in Washington D.C., the group Public Citizen says the budget law should be thrown out because it didn't pass the House and Senate in exactly the same form — a violation of the Constitution's requirement. A clerical error resulted in the House and Senate passing the massive measure with different provisions regarding rental periods for some medical equipment.

An administration spokesman said the White House considers the matter closed, but several constitutional scholars have expressed their own doubts about the law's validity. — Julie Rovner

Study: Medicare Plan Provides Fewer Drugs

March 21, 2006 — A new study finds that low-income patients in California have access to fewer drugs under the new Medicare drug plan than were offered through their previous Medicaid coverage.

The study for the California Health Care Foundation found that the million beneficiaries eligible for both Medicare and Medicaid — known in California as Medi-Cal — are now getting very different levels of drug coverage. Most were randomly enrolled into a private Medicare drug plan as of Jan. 1, but those plans cover anywhere from a low of 626 drugs to a high of more than 3,300.

The study also showed that special protections for certain classes of drugs written into the Medicare law by Congress are working. All the drug plans serving people on both Medicare and Medi-Cal cover more than 90 percent of medications that treat AIDS/HIV and severe mental illness. But on average, the plans cover less than two-thirds of drugs to treat high blood pressure and high cholesterol. — Julie Rovner

FDA to Bar Use of Flu Drugs in Poultry

March 21, 2006 — The Food and Drug Administration (FDA) plans to prohibit veterinarians from using anti-flu drugs in poultry, over concerns that it might make the drugs useless for humans.

The proposed rule would prevent the use of several anti-viral drugs to prevent or treat flu in chickens, turkeys and ducks. The drugs are amantadine, rimantadine, oseltamivir and zanamivir.

These drugs are not approved for use in animals. The FDA says it has no evidence that poultry producers are using them. But the agency is worried that if they're given to poultry, flu viruses could become resistant. If that happened, the drugs wouldn't help humans.

Veterinarians who violate the rule would be subject to an FDA warning, legal injunction or even criminal prosecution.

Last year, international agencies said poultry producers in China had misused an antiviral drug, giving rise to flu resistant viruses. Chinese officials promised to stop the practice. — Richard Knox

Pols Disagree Over Medicare Drug Savings

March 20, 2006 — President Bush has been touting the fact that competition has brought down the estimated cost of the new Medicare drug benefit. But Democrats say the cost reductions are unrelated to the benefit itself.

The latest 10-year estimate from the Congressional Budget Office (CB)) predicts the Medicare drug benefit will cost about 6 percent less than predicted last year at this time. In several events last week, President Bush attributed that decline to competition between the dozens of drug plans offering the benefit.

In fact, Democrats on the House Ways and Means Committee point out that the lowered estimates are based on a slowdown in overall prescription drug spending between 2003 and 2004 — two years before the Medicare benefit was launched.

Another reason for the lower estimate is that the CBO is now predicting fewer seniors will sign up for the subsidized drug coverage. The office estimates 24 million will sign up this year, down 10 million from last year's prediction. — Julie Rovner

FDA Investigates Reports of RU-486 Deaths

March 18, 2006 — The Food and Drug Administration (FDA) is investigating reports of two more deaths associated with the abortion pill RU-486.

The new reports bring to seven the number of women who have died after taking the pill, marketed under the brand name Mifeprex. More than 560,000 U.S. women have used the medication to terminate pregnancies up to 49 days' gestation since it was approved six years ago.

It's unclear how the two latest deaths occurred, although earlier deaths were due to a rare bacterial infection. In response to the FDA's report, Planned Parenthood announced it would no longer recommend intravaginal use of misoprostol, the second drug in the two-drug medical abortion regimen. Such use had been found more convenient in some cases, but it was not the regimen formally approved by the FDA. Most if not all of the deaths have occurred in women who used the intravaginal option. — Julie Rovner

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