NPR Health News Briefs: Feb. 6 -- Feb. 12 Among the week's stories: President Bush says he's standing behind the new Medicare prescription drug law, despite its growing price tag; the CDC recommends that many adolescents and young adults get vaccinated against bacterial meningitis; and Canada removes Adderall XR, a popular medication for treating attention deficit hyperactivity disorder (ADHD), off the market.
NPR logo NPR Health News Briefs: Feb. 6 -- Feb. 12

NPR Health News Briefs: Feb. 6 — Feb. 12

Read a roundup of the latest health news stories from NPR:

Bush: Don't Change Medicare Drug Law

Feb. 11, 2005 -- President Bush says he's standing behind the new Medicare prescription drug law, despite its growing price tag.

When Congress narrowly passed the Medicare bill in 2003, members were promised it would cost no more than $400 billion over 10 years. Two months later, the administration admitted its own internal estimates were a third higher. And this week, news that the first full 10 years of the drug benefit could cost between $700 billion and $1 trillion has some lawmakers talking about revisions.

President Bush, however, said as far as he's concerned, that's a non-starter. "I signed Medicare reform proudly," he said at the swearing-in ceremony for new Health and Human Services Secretary Mike Leavitt. "And any attempt to limit the choices of our seniors and to take away their prescription drug coverage under Medicare will meet my veto."

Efforts to directly address drug prices, however, appear to be picking up bipartisan support on Capitol Hill. -- Julie Rovner

Hajj Polio Cases No Cause for Alarm, Experts Say

Feb. 11, 2005 -- Although there have been three recent cases of polio in Saudi Arabia, authorities there and at the World Health Organization say they're not overly concerned.

A WHO spokesperson says three children in Saudi Arabia have been paralyzed by polio. One case, reported in September, was an already paralyzed girl from Sudan. In November, a girl who had very recently arrived from Sudan was diagnosed.

Also diagnosed was a Nigerian boy who had been in Saudi Arabia for years. Authorities are investigating whether visiting relatives, who came from an area where transmission is more common, may have infected him.

In late January, Muslim pilgrims traveled to Mecca, posing a theoretical concern. But because the polio vaccination rate is 95 percent in Saudi Arabia, and because only adults make the pilgrimage, neither Saudi officials nor the WHO are particularly worried about an outbreak. -- Joanne Silberner

CDC Recommends Meningitis Shots for Youths

Feb. 11, 2005 -- An advisory committee to the Centers for Disease Control and Prevention recommends that many adolescents and young adults get vaccinated against bacterial meningitis, a rare but potentially fatal disease.

The advisory committee is calling for vaccination of all 11 and 12-year-olds, as well as 15-year-olds and college freshmen living in dorms, because these two groups are at particularly high risk. Bacterial meningitis starts out like the flu; stiff necks are common. Within a day or two, it can cause hearing loss and brain damage. By one estimate, more than 20 percent of cases are lethal.

The recommendation -- the first for a meningitis vaccine -- is for a newly licensed product made by Sanofi Pasteur. The company already makes a product for college students, which lasts three to five years and costs about $70 a dose. A company spokesman says the new vaccine will be available sometime in March, at a comparable price. -- Joanne Silberner

ADHD Drug to Remain on U.S. Market

Feb. 11, 2005 -- Canada has taken Adderall XR, a popular medication for treating attention deficit hyperactivity disorder (ADHD), off the market.

But U.S. officials, examining the same data, say the drug is safe and can remain on pharmacy shelves.

Adderall is a mixture of amphetemine stimulants. It's used to treat hundreds of thousands of children and adults who suffer from ADHD.

Adderall XR is gaining in popularity because it requires only one dose per day, whereas Ritalin, another ADHD treatment, requires two.

Canadian health officials took the action after examining reports of 20 sudden heart-related deaths among children and adults over the past 10 years. Last year, U.S. health officials revised the drug's label to include a warning that it should not be used by children or adults with serious heart abnormalities.

Dr. James McGoff, who runs the ADHD program at UCLA, said Canada's move is an overreaction.

"This particular drug has been used for decades without any evidence of real clear concern," he said. "And we now have several long-term studies where we looked very specifically at the long-term safety of being on this medicine. We've had several hundred children followed for several years now, and there's not been any evidence of any significant effect on cardiovascular issues or any other medical concerns."

The largest advocacy group for people with ADHD, Children and Adults with Attention-Deficit/Hyperactivity Disorder, said that it doesn't take positions on individual drugs or actions taken by regulatory agencies. In a statement, the organization said that it "stands firm" in its belief that using a "multi-modal approach" is the best form of treatment.

"Medication, under the prescription of a treating medical professional and when taken as prescribed, along with other non-medication interventions -- including seeking proper education and counseling -- provides the most effective and comprehensive form of treatment of ADHD," the statement said. -- Patricia Neighmond

New Flu Vaccine Recipe Suggested

Feb. 10, 2005 -- A new strain of influenza has emerged in California, and the World Health Organization is predicting that it will be the dominant flu strain next fall and winter.

The new strain is called A/California. Health officials in Santa Clara County discovered it late last year. Scientists at the Centers for Disease Control and Prevention found that the California flu already represents 20 percent of influenza cases nationally this year. A WHO flu expert says the California strain has popped up in Canada, Mexico, Europe, Asia, Africa and Pacific islands.

That rapid spread has led WHO to recommend that the California strain replace the A/Fujian virus that's one of three main components in this year's flu vaccine. U.S. officials are expected to follow suit.

Researchers are working on a prototype vaccine by March so that manufacturers can start growing it in chicken eggs, the first step in producing next year's vaccine. -- Richard Knox

Reaction to Higher Medicare Estimates

Feb. 10, 2005 -- News that the Medicare prescription drug benefit could cost twice as much as originally thought is prompting calls for change on Capitol Hill.

Administration officials now say the drug benefit -- which lawmakers were promised would cost no more than $400 billion over 10 years -- will actually cost more than $700 billion. Democrats say the number is closer to $1 trillion.

The news has galvanized both those who think the benefit is too generous and those who think it's not generous enough.

Conservative Republicans who opposed adding a new entitlement for drugs are talking about efforts to limit the drug benefit to those with low incomes, which they say would be easier now then after the benefit starts next year.

Meanwhile, a bipartisan coalition wants to go after the drug industry with bills that would allow Americans to import cheaper drugs from other countries, and also allow Medicare to negotiate directly for lower prices. -- Julie Rovner

Heart Failure Possible after Scare or Intense Stress

Feb. 9, 2005 -- Researchers have recognized a new kind of cardiac problem that affects mainly older women. Some are calling it the "broken heart syndrome."

The syndrome looks like a heart attack but in fact is very different. Two groups of researchers in Minneapolis and Baltimore have found dozens of cases, all but one of them women. The common thread is emotional stress.

In a few cases it was from a happy occasion, such as a surprise party. But more often the trigger is bad news, including court appearances, being robbed or a fierce argument.

Dr. Ilan Wittstein of Johns Hopkins Medical School led one study in this week's New England Journal of Medicine. He says calling it "broken heart syndrome" can be misleading.

"While the heart is broken, it's only temporarily broken," he said. "And, actually, these patients go on to have full recovery of their heart muscle."

Of 3 million heart attacks among U.S. women each year, some researchers think as many as 60,000 are really "broken heart syndrome," which needs different treatment. -- Richard Knox

More Doctors Taking Medicare?

Feb. 9, 2005 -- A government report says doctors are not turning away people on Medicare because of low government payments.

In 2002, the government cut by more than 5 percent its payments to physicians taking care of people on Medicare. Some people predicted that doctors would start charging patients to make up the difference or stop treating patients on Medicare.

So the Government Accountability Office counted the number of Medicare recipients who received care through the program in April of 2000, 2001 and 2002. The GAO reports that access to physicians actually went up, even in rural areas, where doctors are sometimes in short supply.

But the American Medical Association calls the numbers false comfort. In a statement, they said a 2003 survey shows that nearly a quarter of family physicians have stopped taking new Medicare patients. The doctors' group predicts that planned future cuts in doctors' pay will make the situation worse. -- Joanne Silberner

Routine HIV Testing Supported

Feb. 9, 2005 -- New research indicates that routine testing for HIV infection is more cost-effective than screening for other illnesses, such as high blood pressure.

Health experts have long debated whether to test Americans routinely for HIV. David Paltiel of Yale University says many people are still falling through the cracks.

"We estimate that there are 900,000 people with HIV infection in this country," Dr. Paltiel said in an interview. "And, of those, as many as 280,000 may be unaware of their infection."

Many of these people miss out on effective AIDS treatment.

Now, two studies in the New England Journal of Medicine show routine HIV testing makes economic sense. The cost of testing, for each year of life gained, is less than screening for cholesterol or colon cancer. And it would also reduce the spread of HIV.

Paltiel says routine testing should begin in urban hospitals, but it should be voluntary. -- Richard Knox

Health Insurance Woes for Diabetics

Feb. 9, 2005 -- Americans with diabetes face many barriers to health insurance and often go without care, according to a study from Georgetown University and the American Diabetes Association.

Researchers examined stories told by 851 people who contacted the diabetes association's hotline about problems with health insurance. The vast majority of problems, 80 percent, arose because of changes in health insurance. People either moved or divorced, or their employers changed the health benefits they received in order to save money.

After that, some people said, companies simply refused to sell them coverage when they found out they had diabetes. Others said they were paying for policies that left them with huge co-payments.

And because some people could not afford to pay for their own medical care, they did without routine care. As a result, many developed serious complications like eye problems and high blood pressure. -- Patricia Neighmond

High-Deductible Insurance Gains in Popularity

Feb. 9, 2005 -- More employers are expected to offer employees new health plans with high deductibles in the next two years. That's according to a yearly survey of employers by the health-consulting firm Mercer Investment Consulting Inc.

Mercer analyzed the experience of 88 employers who offered so-called "consumer-directed health plans."

The plans are basically high-deductible, preferred-provider organizations (PPOs). Average deductibles for individuals are about $1,200. For families, the average is $3,000.

Employees also receive a pot of money from employers, on average about $700, to spend on routine medical care like doctor visits, medications and physical therapy.

Once that's gone, however, employees have to spend their own money until they reach the deductible. The plans are saving money for the companies, which are spending significantly less per employee on health costs. The larger the company, the more likely they were to offer this type of plan. -- Patricia Neighmond

Rising Medicare Costs

Feb. 8, 2005 -- Medicare's new drug benefit doesn't begin until next year, but new estimates in President Bush's budget show an ever-escalating price tag.

The Medicare bill Congress passed in 2003 was supposed to cost no more than $400 billion over 10 years. Last year, the administration conceded its actuaries estimated the 10-year cost about a third higher.

The budget released Monday, however, shows costs growing higher still -- with a five-year total for the drug benefit of $350 billion. Over 10 years, the cost nears a trillion dollars, according to documents obtained by NPR.

Medicare officials say their estimates haven't changed since last year. Independent analysts say while that's true, the larger number is still correct, because the 10-year total starting in 2006 includes 10 full years of benefits, while in 2003 the timeline included two years with no costs.

The new numbers are likely to cause heartburn on Capitol Hill, where conservative Republicans have already been complaining about the new benefit's cost. -- Julie Rovner

Budget for Federal Health Programs Slashed

Feb. 7, 2005 -- Some federal health programs would take a hit under President Bush's proposed budget.

The president's blueprint calls for $60 billion in spending reductions for the Medicaid health program for the poor, although $15 billion would be plowed back into the program.

And while the budget calls for overall increases in bioterrorism spending, it would cut the budget for the Centers for Disease Control and Prevention by more than half a billion dollars.

Several popular programs are set for total elimination, including the Preventive Health Services Block Grant and the Community Services Block Grant.

Among the few programs slated for increase are the National Institutes of Health, Community Health Centers, and funding for abstinence education. The Food and Drug Administration would get more money for drug and food safety.

Congress will have to endorse the cuts if they are to take effect. And many of the programs targeted remain popular with many Republicans. -- Julie Rovner

Budget Gains for FDA

Feb. 7, 2005 -- President Bush's proposed budget for the next fiscal year includes a 4.5 percent increase for the Food and Drug Administration.

The increase would come from congressional appropriations and users' fees paid by drug companies. If granted, the agency's budget would total $1.9 billion.

Most of the proposed increase would go toward protecting the food supply.

Some $6.5 million extra would go to the Office of Drug Safety, which monitors drugs once they're on the market. After safety questions arose last year about the safety of certain antidepressants and painkillers, Congress began pressuring the FDA to give more support to its drug safety office. The extra money would allow the agency to hire 25 more staffers, bringing the total to134.

If the administration's budget request goes though, it would mean the FDA would get twice as much as it got in fiscal 2001. -- Joanne Silberner

HIV Misconceptions

Feb. 7, 2005 -- A new survey finds that many parents infected with the AIDS virus mistakenly fear they might transmit HIV to their children by hugging and kissing.

RAND Corporation researchers asked 344 HIV-infected parents how much they feared infecting their children. More than a third felt at least "a little" fear, and one in five reported "moderate" fear. More than a quarter said they avoid hugging and kissing their children or sharing utensils.

The researchers say more work is needed to educate parents infected with HIV about how the virus is and is not transmitted. It requires sexual contact, sharing contaminated needles, or blood-to-blood contact -- for instance, when the blood of an infected person comes in contact with someone else's open sore.

There's no evidence HIV is transmitted by affectionate interaction or sharing the same household.

The survey appears in the Archives of Pediatrics and Adolescent Medicine. -- Richard Knox

Blood Test for Pregnant Women

Feb. 7, 2005 -- A group of researchers is calling for universal blood tests of pregnant women for a bacterium that can harm their babies.

Nearly 40 percent of women have been infected with a bacterium that causes a sometimes symptomless infection called toxoplasmosis.

The bacteria reside in cat feces, garden soil, undercooked meat and other places. If the infection occurs during pregnancy and goes unnoticed, a baby can eventually develop severe, potentially fatal neurological problems. Each year, between 500 and 5,000 babies in the United States are born with toxoplasmosis.

A group of researchers found that most of the 131 mothers of children born with toxoplasmosis had no idea they had been exposed to the bacterium. In the current American Journal of Obstetrics and Gynecology, the researchers call for all pregnant women to be screened so that mothers or newborns can be treated.

The American College of Obstetricians and Gynecologists, which publishes the journal, says the bacterium is not common enough in the United States to warrant routine testing. -- Joanne Silberner

Blacks and Asthma Treatment

Feb. 7, 2005 -- African Americans respond differently to a common asthma drug, according to a new study. This may explain why it's harder to control asthma in blacks.

African Americans are more likely to require hospital admission for asthma, and more likely to die of it. Researchers at the National Jewish Medical and Research Center in Denver and the University of Colorado offer one possible explanation. Their report is in CHEST, a journal on lung disease.

Researchers compared different ethnic groups' responses to glucocorticoids, steroid drugs that suppress the inflammation in asthma patients' airways that causes difficulty in breathing.

Blacks had a lower response to glucocorticoids than white asthma patients. This was true even of blacks without asthma, suggesting there may be an underlying racial difference that has nothing to do with asthma.

The researchers say blacks may require higher steroid doses. -- Richard Knox

Parental Views on Notification Laws for Minors

Feb. 7, 2005 -- Parents generally think laws that require them to be notified before teenagers can receive prescription contraceptives are a good idea, but most also embrace exceptions to those laws, a new survey finds.

The survey of more than 1,000 parents of teens aged 13 to 17 found that more than half support the idea of parental notification laws for contraceptives.

At the same time, however, four out of five of those surveyed thought those laws should allow exceptions in at least some cases, particularly if a minor is the victim of abuse or incest. And few parents thought such laws would actually deter their children from having sex or becoming sexually active.

The survey results track relatively closely similar surveys about attitudes towards abortion -- those have consistently shown majorities of Americans opposing abortion in general, but supporting its legality in some circumstances.

The survey appears in the current issue of the Archives of Pediatric and Adolescent Medicine. -- Julie Rovner