The Centers for Disease Control and Prevention is reporting that last year polio increased by 55 percent worldwide. Nearly 2,000 cases of the disease were reported.
Nearly half the cases were found in Nigeria, which since 2003 has fueled outbreaks in countries that were previously free of the disease. Countries now having to battle the disease include Yemen, Indonesia and Somalia. But under one-third of countries that experienced new outbreaks are still affected. Earlier this year Egypt and Niger were removed from the list of countries with remaining wild polio virus.
Both India and Pakistan also reported declines, with the world moving close once again to eradicating the disease. Still Nigeria remains a threat to the continued spread of polio. In the northern Muslim regions of the country were most of Nigeria's cases were found, under 40 percent of the children were immunized in 2005.
Worldwide, more than 90 percent of children have been immunized. — Brenda Wilson
United HealthCare Dominates Medicare Drug Market
April 28, 2006 — Insurance giant United HealthCare is dominating the new market for Medicare prescription drug coverage, according to new figures released by the federal government.
Capitalizing on its longtime alliance with the senior group AARP, United has enrolled nearly 3.8 million Medicare beneficiaries into its array of stand-alone drug plans. That's more than one-fourth of the total nationwide enrollment in the program. United also owns PacifiCare, a longtime presence in the health insurance market for seniors.
In second place is Humana Inc., which distinguished itself by offering the plans with by far the lowest monthly premiums — as little as $1.87 in some parts of the country. Humana has enrolled about 18 percent of the total.
Wellpoint and Member Health rank third and fourth, with 7 percent each, followed by 14 other firms offering coverage. The companies are already planning for next year, which is expected to see some with the lowest enrollment drop out of the market entirely. — Julie Rovner
Medicare Requires Plans to Cover More Drugs
April 27, 2006 — Medicare officials have decided to reverse a controversial policy and require prescription drug plans to continue to provide medicines patients are currently taking.
After May 15, most Medicare beneficiaries will be locked into their drug plans for the rest of the year. Until now, however, those plans were free to drop or change prices for covered drugs, which caused a lot of consumer complaints about the program.
Now the government has decided to change that policy. New guidance tells plans they must in most cases continue to provide patients with drugs they are currently taking, at the price they were promised. But plans will still be able to change coverage if cheaper generic versions of a drug are approved during the plan year, or if new effectiveness or safety information becomes available.
The change comes as Congress considers whether to extend the enrollment deadline for the drug program, now just over two weeks away. — Julie Rovner
Vaccine Prevents Deadly Marburg in Monkeys
April 27, 2006 — Scientists say they have saved the lives of experimental monkeys infected with Marburg virus, one of the deadliest known microbes. The research appears in the current issue of the medical journal The Lancet.
In Angola last year, Marburg virus killed more than 9 of out every 10 people it infected. So researchers were surprised when an experimental vaccine rescued 100 percent of infected monkeys. Animals that didn't get the vaccine all died.
U.S. Army researcher Dr. Thomas Geisbert says the first use of the vaccine in humans will probably be in lab workers who get accidentally exposed to the virus while doing research in maximum-containment labs.
"With the increased building of the level four facilities that you're seeing in the U.S. right now, I'm certainly interested in protecting against a potential lab exposure," he said.
Geisbert hopes the vaccine will eventually be used to treat health workers and ordinary citizens who become infected during a Marburg outbreak. — Richard Knox
Enrolled Seniors Satisfied with Medicare Drug Plan
April 26, 2006 — Most of the seniors now enrolled in Medicare prescription drug plans are satisfied and getting the medicines they need, according to a new survey. But overall, the programs popularity is still lagging.
Fully three-quarters of seniors surveyed earlier this month who've already enrolled in a plan say they're satisfied, and just over half report they're saving money.
At the same time, however, seniors still have a more negative than positive perception of the program overall: 46 percent to 30 percent. And even among those seniors who are already enrolled, less than half have a favorable impression. The survey was conducted by the Kaiser Family Foundation, which has been tracking attitudes toward the new benefit.
The survey also found that despite public and private outreach efforts, nearly half the respondents don't know that the deadline to enroll in a Medicare drug plan is less than three weeks away, and that if they don't sign up by May 15, they'll have to pay a premium penalty. — Julie Rovner
Reliability Rate Questioned on Heart Devices
April 25, 2006 — New research raises concerns about the reliability of implanted cardiac defibrillators.
Researchers from the Beth Israel Deaconess Medical Center in Boston and Harvard Medical School analyzed malfunctions in nearly 3 million devices implanted in patients between l990 and 2002. Problems with pacemakers — which slow a fast heartbeat — decreased dramatically. But problems with implanted cardiac defibrillators increased. These devices slow a dangerously fast heartbeat. Over 12 years, about 1 in every 50 defibrillators had a malfunction. These were mostly minor battery, capacitor or electronic circuitry failures. But there were 31 deaths which resulted from the device not working when needed. Researchers say patients who have these devices should visit their doctor two to four times a year to make sure the devices are in good working order.
The study appears in the current issue of the Journal of the American Medical Association. — Patricia Neighmond
Conflicts of Interest May Not Influence FDA Panel Votes
April 25, 2006 — A new study finds that close to a third of university scientists who sit on the Food and Drug Administration's influential advisory panels had financial conflicts of interest. The panels advise the FDA on the safety and efficacy of drugs and medical devices.
Four years ago, the agency began requiring members of its advisory panels to disclose consulting contracts, grants, investments and other financial ties to companies whose products would be affected by their advice. This study, conducted by the advocacy group Public Citizen, covers the period from 2001 to 2004.
Twenty-eight percent of members disclosed a conflict of interest. The conflicts were widespread across medical specialties. Seventy-eight percent of advisory committee meetings included at least one member with a conflict.
But the study found that excluding those members from advisory panels — which rarely happened — wouldn't have changed the outcomes of the panels' votes.
The study is published in this week's Journal of the American Medical Association. — Snigdha Prakash
Number of Uninsured Moderate-Income Americans Rises
April 25, 2006 — The number of moderate-income Americans without health insurance has risen dramatically in just the past few years.
More than 40 percent of working-age Americans with incomes between $20,000 and $40,000 a year were uninsured for at least part of 2005, according to the survey for the New York-based Commonwealth Fund. That's up from just over a quarter in 2001.
The biennial survey also found a growing number of respondents dealing with unpaid medical debts. And that debt is not only a problem for those without insurance. Nearly two-thirds of those who said they experienced problems paying their medical bills said they had insurance when the debt was incurred. Of the uninsured adults who reported problems with medical debt, nearly half said their medical bills consumed all of their savings. — Julie Rovner
End-of-Life Care Decisions Hard to Plan
April 25, 2006 — A new study says it's hard for people to predict what kind of care they'd want at the end of life. The study also found that many people who think they wouldn't want to live with a mild or severe disability change their minds when they find themselves facing one.
Researchers followed more than 200 older people who had cancer, heart failure or lung disease. Many said they'd rather die than be disabled. But one out of five changed their minds once they needed treatment. And said they now were willing to accept being unable to leave the house for work or needing someone to get them out of bed.
The study appears in the Archives of Internal Medicine. The researchers say their study shows why it's so hard to write up a living will, which is an instruction, written in advance, that says what kind of care someone would want at the end of life. The authors say people might do better to appoint a health-care proxy, someone who will listen to their changing wishes and represent those feelings over time. — Joseph Shapiro
Review: Health Improving Among Minorities
April 24, 2006 — A Kaiser Family Foundation review of government health data in 2005 shows the quality of health for some racial and ethnic minorities in the United States is improving. But for many of those without health care, quality of health is getting worse.
Among black and Hispanics, AIDS cases are increasing faster than among whites. And both groups have trouble getting treated in an emergency room in a timely way. Nearly all ethnic and racial groups had trouble communicating with physicians. The disparities were greatest among those with lower income.
African-American children were less likely to receive care for asthma or to get immunizations on time. Hispanics had trouble getting substance-abuse treatment when needed. Asian Americans didn't get mental-health care even though they were likely to have health insurance. But access to care is improving, with, for example, a narrowing of the gap between African American and White women over 40 who had mammograms. And there was little difference among whites, blacks and Hispanics in controlling diabetes. — Brenda Wilson
GAO Backs Ongoing Drug-Safety Surveillance
April 24, 2006 — Backers of federal bills to boost the Food and Drug Administration's oversight of drugs after approval say a new government report boosts their case.
Lawmakers in both the U.S. House and Senate introduced a raft of bills to beef up the FDA's drug-safety processes in the wake of the removal from the market of the painkiller Vioxx in 2004. But those bills have largely languished.
Now the Government Accountability Office (GAO) says Congress needs to step in. The GAO report says the FDA's own actions to emphasize drug safety, taken in the wake of the Vioxx withdrawal, have improved some oversight, but the FDA has not addressed a "lack of systematic tracking of ongoing safety issues."
The GAO says Congress should consider expanding the FDA's authority to require drugmakers to conduct post-approval studies. The report was ordered by Sen. Charles Grassley (R-IA), who is among those who have introduced comprehensive drug -safety legislation. — Julie Rovner