New treatment for hepatitis C - but affordable?

New treatment for hepatitis C - but affordable?- The burden of hepatitis C public health is enormous. 

This viral infection causes severe liver cirrhosis, terminal liver cancer and liver failure, often require a liver transplant. Over 3 million people in the United States and 150 million worldwide, are infected with hepatitis C, resulting in 700,000 deaths annually.

People who are infected with hepatitis C often have no symptoms. The virus persists in the liver damage liver tissue slowly over a long period of time. For this reason, it is essential that the progression of liver damage before stopping advanced liver disease or liver cancer occurs.

But there is good news: in recent years we have witnessed remarkable progress in the development of new drug treatments for hepatitis C. sofosbuvir (Sovaldi) and combined with ledipasvir sofosbuvir (Harvoni) are two well known examples these new drug treatments.

Another new drug combination, and sofosbuvir velpatasvir, which was recently described in a report published in the New England Journal of Medicine, is extremely effective against most forms of hepatitis C will become the standard treatment when this combination FDA approved. 

But although the new drugs can cure hepatitis C in many cases they are not accessible to all who need it. New drugs for hepatitis C cost between $ 80,000 and $ 150,000 per year.

People with excellent insurance coverage see low-pocket costs for these drugs. But because of the cost, many insurance companies have set up systems that require high switching costs quotas of people with less robust plans make these medicines out of reach of many people.

In the US, drug hepatitis C are just one example of "specialty drugs." These new drugs for many chronic diseases - such as cancer and arthritis - that were issued to levels that are unaffordable to many people in need.

Up to medicines for hepatitis C, and other drugs are sold at affordable levels, some people without sufficient funds being left behind and can not benefit from modern advances in drug therapy. 

As a society, we must find ways to make these drugs available to all who need it and at the same time compensate pharmaceutical companies for its fresh research and high development. It is a difficult balance, but in a society based on justice and equity, is that we must achieve. For those who have hepatitis C should go without treatment.
By: Gregory Curfman, MD

  

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Do statins interfere with the vaccine against the flu?

Do statins interfere with the vaccine against the flu? - Statins are powerful, unusual, and as He Niño and Tom Cruise, it is not well understood. Statins have enormous potential. Improve survival after a heart attack and reduce the risk of recurrent stroke.  

They are also the only drugs to lower cholesterol that has been clearly shown to reduce heart attacks and death in high-risk patients without heart disease. In addition to lowering cholesterol, statins also lower levels of inflammation in the body.  

Reduce inflammation, statins help probably prevent heart attacks and strokes. However, evidence is emerging that these effects statins may also have a downside, hampering the ability of the immune system to fight infections.

Tease the relationship between statins and immune response 

Two recent studies have examined the relationship between statins and immune response to the vaccine against influenza. For the first study, Emory University researchers analyzed a large database of patients in a managed care organization to see if there was a link between the use of statins, vaccination against influenza, and frequency of visits to doctors for influenza-like illness.  

They found that patients who received the vaccine against influenza were more likely to seek treatment for a respiratory illness during flu season if they were also taking a statin, compared with patients who received the vaccine against influenza but they not take statins.  

This suggests that patients treated with statins may not have responded so well to the vaccine against influenza than those not taking the drug to lower cholesterol.

The other study provides concrete evidence of the lowest immunization against influenza in people taking statins immune response. For this study, researchers analyzed data from over 5000 patients in a clinical trial of a new vaccine against influenza. They found that levels of antibodies against the flu virus were lower in patients taking statins compared to patients not taking statins.

Both studies were a major constraint. Patients taking statins were more likely to have serious underlying diseases such as diabetes, heart disease, COPD, neurological disorders, or kidney disease, compared with patients not taking statins.  

Thus, the poor response to the vaccine against influenza and the apparent increased risk of influenza statins in patients with the disease could have been the result of its high burden of chronic disease, and no treatment with statins. It should be noted that a randomized trial in young healthy volunteers showed no statin treatment effect in antibody responses to the vaccine against hepatitis A. 

There is also a bewildering variety of other research on statins and their effects on the human immune response. At various times, statins were associated with each of the following: a lower risk of dying from the flu; a lower risk of dying from the flu in some years but not others; a slightly increased risk of shingles (herpes zoster); a lower risk of pneumonia; neutral effect on the risk of pneumonia; and a lower risk of dying from pneumonia.

But do not leave your statin ...

According to current data, I do not think we need to change how we prescribe statins, which are extremely beneficial medications, but I need more information on how statins influence the risk of infection. Patients taking statins may consider getting a flu vaccine against high doses, resulting in higher levels of antibodies and increased protection against the flu, compared with standard-dose vaccine.  
By: John Ross MD,FIDSA

 

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Why many generic drugs become so expensive

The high cost of prescription drugs is great news. You hear on TV, in the doctor's office, and even in the election campaign. When you think of expensive drugs, you can think of new therapies for lung cancer or hepatitis C. But in fact, prices are also soaring for generic versions of some commonly prescribed drugs.

An article published last year in the New England Journal of Medicine reported that between 2012 and 2013, captopril - a generic drug used to treat hypertension and heart failure - increase in the price of 1 cent to 40 cents pill. During this same period, the cost of doxycycline, an older antibiotic, rose 6 cents to $ 3.36 per pill. 

Connecture, a company of information technology for health insurance, reports that while the price of most generic drugs remained constant between 2008 and 2015, nearly 400 increases over 1000% saw prices generic. At a time when 18% of the costs of prescription drugs are paid out of pocket and 8% of Americans do not take their medication reports to save money, these dramatic increases in generic prices placed a heavy burden on public health.

Why is your product going in the price? 
Most of us think of cheaper generic version of a brand name for a prescription alternative - and that is often the case. Pharmaceutical companies that manufacture generic drugs can sell at lower prices because they do not have to pay for research and development that brought the drug to market first.  

However, this advantage may take a backseat in situations like these, where competition is reduced or delayed, allowing generic manufacturers to increase their prices:

  * The marketing of certain generic drugs is so small it attracts several producers such as pyrimethamine (Daraprim), an ancient drug used to treat a parasitic infection called toxoplasmosis. GlaxoSmithKline has long been the only producer of pyrimethamine, but at a modest price. This August, however, Turing Pharmaceutical acquired the rights to the drug and operated its monopoly, the price increase of 5,000% (from $ 13.50 to $ 750 per pill).

  * In some cases, the number of producers of generic drug decreases due to a continuous wave of market consolidation within the pharmaceutical industry.

  * Unforeseen safety issues may limit the supply of a generic drug. Hikma Pharmaceuticals, for example, was forced to stop production of doxycycline in 2011 because of quality problems at its plant in New Jersey. The shortage led to an increase of 6,000% in the price of drugs.

  * It can be difficult and expensive for a manufacturer for a generic drug to market first. The average time to the Food and Drug Administration (FDA) for the treatment of an application for generic drugs was 42 months in 2014, compared to an average of eight months to apply for a new standard drugs.

  * A generic manufacturer must prove that his version of a drug product is equivalent to a "reference" existing on the market. When only one company produces a tightly controlled drug and distribution, it can be extremely difficult for other companies to provide reference samples for products.

What you can do 
While Congress, the FDA and other government agencies to explore possible solutions to prevent soaring prices of generic drugs, there are several steps you can take to limit the number of victims in your wallet.

First, when the doctor recommends a drug for you, ask about its cost. In some situations, another drug (cheaper) which has a similar mechanism of action could be safe and effective.

When this is not possible or desirable, you might be able to save money by purchasing generic drugs independent of their health insurance. Websites like GoodRx offer online tools to compare the real drug prices in your area. Discount drug programs or discounts can also help. Note that while these programs may provide some relief, which are often available only for a short period of time (most are not valid after one year), and which can undermine policies to reduce insurance costs - and therefore premiums - down.

Finally, use your voice to help keep this issue a political priority. If you experience a substantial increase in the price of generic drugs, tell your elected officials. 
By: Ameet Sarpatwari, JD, PhD

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Children and vaccines against flu: two common myths

As a pediatrician, I'm really passionate about the vaccine against the flu. The flu can be a nasty disease; Each year, thousands of people are hospitalized from influenza and its complications, and some of these people die. The vaccine against influenza can protect my patients and their families, and I enthusiastically recommend to each of them.

Yet many of them refuse, despite my best efforts. What is particularly frustrating is that many of them refuse because of misconceptions about the vaccine against the flu. There are all kinds of misinformation out there, but here are the two most common myths:

1. The vaccine against influenza can make you sick.  
That's what I hear more than anything. Now, like any medical treatment, it is true that the vaccine against influenza can have side effects. Very often, people will have some pain for a few days in those receiving the vaccine, and some people may feel a little sick for a few days, and some may have mild fever. These side effects are not serious and disappear on their own; More serious side effects are extremely rare.

The vaccine against influenza, however, will not give you the flu. The vaccine itself is made of the influenza components; Here's how it works by helping the body to produce antibodies that can fight against the flu if you are exposed. But these components are dead (in the case of the vaccine) or very low (in the case of the nasal spray version) and can not give you the flu. 

To be safe, we recommend the shot instead of the nasal spray for people with very low defenses and their caregivers. But it is really only those with very weakened defenses, such as those undergoing chemotherapy for cancer, who are affected by this recommendation - and is more conservative than anything else.

It is important that we remember the vaccine against influenza during the flu season - and that can take a couple of weeks to take effect. Therefore, it is possible to get vaccinated against the flu, but to take the vaccine against the flu before you have a chance to work. The vaccine against influenza does not give a 100% protection, and there are many other viruses that cause illness similar to the flu, so it is always possible to get sick, even if you get the vaccine against flu. But it is not the vaccine against the flu makes you sick!

2. Healthy people do not need the vaccine against the flu.  
I heard many times, too. "My son got sick." "We are a healthy family, we do not need that." "I'm not worried about the flu, we will be well." Well, besides the fact that luck does not last very long time, people in good health can be very sick with the flu, too, there is one other important point: it is not only you.  

You and your family can fine Weather flu, but you could easily spend other people around you - as a newborn by his friend, his grandmother, the boy at school to chemotherapy - that the flu is extremely dangerous. Vaccination not only protects you; protects all around you. By getting vaccinated against the flu, you can literally save lives.

If you have questions about the vaccine against influenza or the flu, talk to your doctor or rendez-www.flu.gov. Make your decision based on the facts - not myths.
By: Claire McCarthy,MD

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As for drugs and treatments before they are "ready for prime time"

It is not a situation that any of us could want. What if you had a terminal illness such as cancer or ALS (Lou Gehrig's disease), a rare and debilitating disease, and I knew there was a treatment that could help you, but not FDA approved? Fortunately there is a way to get access to experimental treatments or medications. Your doctor may use through programs "expanded access" FDA or "compassionate use".

However, some patients and physicians seeking treatment for these programs have felt the process was too long. And when time is short, the delays are intolerable. Since 2014, 21 states have passed laws to help accelerate this process. These laws, laws called "right to try", allow patients to avoid the cumbersome process of FDA and allow doctors to request certain medications (which have already been tested by the FDA for safety, but are not still in the market) directly from the drug companies that make them.

This may sound good in theory, but getting the drugs before they are available to everyone is at risk - even for those with drugs that have not been rigorously tested can cause side effects that erase any profit potential so that beautiful "nothing to lose". time for these people much more unhappy than necessary. And physicians who want to weigh the risks and benefits of these treatments are effective in the dark; They have no way to access information to help them counsel patients.

These laws have also raised general ethical issues. Ask your doctor for a prescription for a drug that is still in development requires knowing this is even possible. It is likely that these applications already significant inequalities in health care perpetuate and encourage those who have access, resources and money.

There are also concerns about going unwanted, by the usual process of the consequences of the FDA. If you give a drug to a very small number of people who interfere with the usual test of a promising drug, so the benefits outweigh the needs of the few.

In an effort to answer some of these questions, a pharmaceutical company is working with the New York School of Medicine University of Medical Ethics Division to meet the demands of patients for drugs. A committee consisting of medical experts, bioethicists, and patient representatives met to consider each request for medication. The objective is to examine each request thoughtfully, fairly and consistently.

The rapid emergence of legislation on the right to try to open the door to wider options for patients, but are not actually ensure that the patient requests will be granted. These laws do not require pharmaceutical companies to provide experimental medications or health insurance companies to pay them. In fact, for example, try Colorado right laws explicitly allow insurance companies to refuse coverage - not only for the experimental drug - Patients who use drugs in research. Thus, the laws of right to be treated can actually do little to improve access.

The inadequacy of the law of the right to trial discouraged. However, in February this year, the FDA proposed a "faster" revised and expand access to treatment research process. This can be a way to deal with two powerful competing needs: to get help quickly to those whose time is short and ensure that the medicines we offer are distributed fairly and safely.
By: Amy Ship, MD.
  

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Drugs that kill bacteria and cleaning of influenza virus

Every year that is flooded with ads about how to disinfect and sterilize and use antibacterial soap to fight against the flu. It is said to worry surfaces such as door handles, door handles, telephone terminals, keyboards and other key contacts found throughout their daily lives.

Maintain colds and the flu virus at bay is quite difficult at home. If you manage a workplace, you can cope with the additional burden of determining the best way to protect your employees from getting sick. If you go to the CDC website, the list of all certified to kill viruses and bacteria, but what is safe and effective?

How long does the virus live on surfaces? 
Before spraying everything with disinfectant, one thing you should know. Some experts say that you should not bother.

I recently read an article in which the author asked the assistant professor at the University of Rochester Medical Center by germs and bacteria on surfaces. The professor said the influenza virus outside the body is a very loose virus.

There are many discussions about hand washing is the most critical step to stop the spread of viruses and microbes, closely followed by covering coughs and sneezes. There is much less information on the duration of these germs and bacteria on the surfaces once they are outside the body.

School of Medicine Director of preventive medicine at Vanderbilt says that transmission of influenza is minimal surfaces. In fact, it is said that "maybe some of transmission" of the virus from surfaces. This news is no panic and the widespread perception that advertisers seek.

Each year we receive the onslaught of coverage of influenza epidemics and are sometimes ill insurance. But the direct transmission of surfaces may not be as bad as you might think on the basis of all the media attention in each and every year the theme.

If the probability of transmission is low to minimal surfaces, look how long the latest viruses on surfaces. Studies have shown that the virus last from a few minutes to 24 hours. 24 hours is not very long and that is why the transmission of the surfaces is insignificant outside the hospital environment, and an emphasis on prevention should remain human transmission (hand washing, coughing and sneezing the management, etc.)

Bacteria and Virus Killers safe and effective 
For those who still do not want to take any chances, here is how to kill germs and bacteria on surfaces. The remedy is easier to bleach; ½ cup of bleach in one gallon of water is a good disinfectant. Then you can fill a spray bottle couple and space in the kitchen or coffee corners in your office or at home.

You should spray and wipe with a clean dry cloth. Leaving the spray solution on the surface for a period of time (3-5 minutes) will help to ensure complete disinfection work. It is essential to use a cloth or paper and clean towels that can be thrown away after use.

Using a bleach solution, you must be sure you do not use in an area that may be affected by the bleach. If you use bleach near the mat, for example, consider what can go wrong will go wrong and pour bleach on the carpet is not a "good thing".

These are some disinfectants listed on the CDC website that are effective as well.
 
       *  Lysol disinfecting SA own RTU (ready to use)
       *  Claire disinfectant spray
       *  Lysol wipes
       *  RTU fresh spray Zep
       *  Comet bathroom clean disinfect
       *  Mr. Clean Multi-Surface Cleaner

For a complete list of disinfectants dozens more, visit the CDC.
By: Jonas

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Preventing influenza outbreaks in office environments

Preventing influenza outbreaks is the main concern for most office managers and people who must work in office environments.  

The recent outbreak of measles from Disneyland emphasizes how having a large number of people in an environment where someone is sick can have far-reaching effects when it comes to the spread of the disease.

Certainly, the most critical point of preventing the disease is to wash hands properly. We have repeatedly advised, and we do not stop us!

Wash hands and disease
How many times must wash their hands?

       *  Before preparing food and after food preparation
       *  After eating
       *  Before and after using the bathroom
       *  After touching animals or animal waste
       *  After coughing or sneezing
       *  Whenever your hands are dirty
       *  More often if you are around someone who is sick

What is the hand washing technique?

Hands should be wet before applying soap. Wet hands will do better and foam soap gives better coverage on their hands when washing. Wash for 10-20 seconds.

The use of an alcohol-based disinfectant in the absence of water and soap is acceptable, however, is not as effective as the use of soap and water. 

Seven of the capacity for preventing the spread of the disease in the office 
1) Ensure that all reusable towels are washed or changed daily. In an office environment, paper towels are better to limit the spread of infection.

2) Have disinfecting wipes on hand for employees to use in their jobs. If an employee has a sneezing or coughing, they can try to clean the affected area with quick wipe. This will wipe out their own work environment and help prevent the spread of the disease, if someone comes by action or workstation.

3) The next most critical to prevent the epidemic in its desktop form is to ensure that people do not come to work when ill. This seems like common sense, but can not be overstated. Cough or sneeze cause germs in the air, and led to the beginnings of a flu epidemic spreads. 

4) Inform your employees how to contain a sneeze or cough. The simplest method being of course a tissue. However, it is not always possible to make a quick enough so make sure everyone knows how to catch a cough or sneeze into your sleeve. This is certainly not ideal, but still a better alternative than sending germs into the air for all to catch.

5) Supply and use as many distributors as possible without contact in the bathroom and the dining room. Using soap dispensers and towel dispensers touch can go a long way to stop the spread of infection by having one point of contact less where germs can get out and spread among the users of your desktop.

6) Be sure to also encourage employees to take a vaccine against influenza. If you have enough employees even organize a vaccine against clinical influenza in place is a great option to help keep your healthier office during the flu season. Even a vaccine against the mobile site or a location near the flu is a good choice.

Many people make excuses for not getting vaccinated against the flu. Often the reasons are personal and non-medical. While the vaccine against the flu is a great preventive technique to prevent the spread of flu in the office of the flu season.
By: Jonas
 

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