Archive for February, 2017

Fruits and Vegetables Healthy? Who knew…?

Posted by on February 28th, 2017

Did you know eating fruits and vegetables are part of a healthy diet? Of course you did. We all know that. Whether it’s being regularly reminded of the fact in the news, being lectured to by your physician or reminded by your parents as a kid, we all need more fruits and vegetables in our diets. There’s scientific research to back it up too. For many people having to force down another helping the dreaded cauliflower or the much maligned broccoli (not to mention spinach) is too much. After all, leaving home meant you can now eat whatever you want.

Well it turns out mom was right (but you knew this all along). You need to eat more fruits and vegetables. A diet rich in fatty foods, sugar, and a lot of meat is tempting but doesn’t cut it health-wise. A new study by Imperial College London underscores the point. Researchers determined that eating ten portions of fruits and vegetables each day had a big impact in reducing the chances of contracting certain illnesses like heart disease and cancer.

For the study a portion equaled 80 grams or 3 oz. The study determined that green, yellow and cruciferous vegetables were linked to reductions in the risk of cancer. Examples include spinach, peppers or cauliflower respectively. Reductions in the risk of heart disease and stroke were linked to foods like apples, pears, citrus fruits, salads, green leafy vegetable and cruciferous vegetables.

The study also looked at the likelihood of contracting certain diseases and early death. It compared people who did not consume fruits and vegetables and those who consumed 10 portions per day. The results are startling. Eating 10 portions cut the risk of cardiovascular disease by 28%, the risk of cancer was cut by 13%, and the risk of premature death was cut by 31%. If you want to read the whole study you can do so at the International Journal of Epidemiology. The BBC also wrote a good piece about it.

Understandably many people may not be able to get 10 portions of fruit and vegetables per day. It’s a lot. But even smaller portions like 200 grams have been shown to have a significant impact. So there you have it, your mom was right and so was your doctor.  Eat your fruits and vegetables.

Alzheimer’s A Scientific Conundrum, But A Healthy Lifestyle Can Help

Posted by on February 27th, 2017

Alzheimer’s is an illness affecting millions of people in North America. The disease robs people of their independence and their minds. For an illness that is so common remarkably little is known about its pathology, its causes, progression and how to potentially combat it. Current scientific research is focused on amyloid plaques that build up in the years preceding an Alzheimer’s diagnosis. Other research targets a specific protein called tau which causes tangles in the brain, another indicator of Alzheimer’s.

Science has had a difficult time cracking the Alzheimer’s problem. The dry spell of new therapies began in 2003 and continues to this day. No new treatments have been approved since then and several promising drugs have recently failed their trials. Perhaps the most recent high profile failure was Eli Lilly’s solanezumab. It was designed to remove amyloid plaques from the brain. However after hundreds of millions of dollars Lilly shut the project down after multiple failed trials and no promising results.

Other research efforts are focusing on BACE inhibitors. BACE is an enzyme that regulates the production of amyloid. The idea is by blocking the BACE enzyme Alzheimer’s could be stopped earlier before it actually sets in. Solanezumab is an example of the greater problem facing Alzheimer’s research. About 99% of experimental drugs for it have fail during their trials. Despite all this, overall rates of dementia are falling.

Between 2000 and 2012 dementia rates in the United States fell 25%. A study published in the Journal of the American Medical Association confirmed Americans aged 65+ have less of a chance of developing dementia than they did in 2000. Interestingly, the reason may have to do with the levels of education among that age group. People with a higher education engage in more cognitive stimulation exercises. In effect, they’re exercising their brain more regularly. They often have healthier lifestyles and get better health care as well.

One of the leading causes of dementia is stroke. The risk of stroke is increased if a person is obese or has diabetes. Yet this study also concluded, interestingly, that even though the rate of American seniors who are obese or have diabetes has increased, dementia rates are still falling. This indicates that these people are doing a much better job managing their conditions than in the past, thereby reducing the risk of stroke.

Living a healthier lifestyle, actively controlling chronic conditions and stimulating the brain all seem to help lower the risk of getting dementia. A healthy lifestyle also prevents or helps mitigate many other illnesses like heart disease. These findings were not just limited to the US but were found to be consistent in Europe as well. It’s important to take care of yourself both mentally and physically. It’s the key to a long healthy life.

Grandma Wasn’t Trying To Kill You, Chocolate Is Good

Posted by on February 24th, 2017

At some point some ancient Greek philosopher said “moderation in all things” or something like it. Eat in moderation, exercise in moderation, sleep in moderation etc. there’s a lot of common sense there. Now research is suggesting that a moderate amount of chocolate, particularly dark chocolate, may be good for your circulatory system. For those of you who have a sweet tooth and care about heart health that’s good news.

An observational study out of England tracked the health of 21,000 people in Norfolk, England over an 11 year period. It included people who ate up to 3.5 ounces of chocolate per day. Over the course of the study 17.4% of those who didn’t eat chocolate developed, or died of, cardiovascular disease, compared to 12% for those who ate chocolate.

Due to the fact that this was an observational study it cannot determine cause and effect. Yet it is tantalizing. Several other studies have concluded that chocolate has the ability to positively influence heart health. It may have to do with flavonoids. Flavonoids are a type of plant chemical found fruits and vegetables. They are antioxidants and have anti-inflammatory properties. Cocoa beans, the raw ingredient needed for chocolate, are rich in flavonoids. This may explain why moderate chocolate consumption can be healthy. Dark chocolate, because it contains a higher proportion of cocoa bean, is the best option. It also avoids the added sugars and fats associated with milk chocolate.

This is obviously not a license to begin consuming massive amounts of chocolate. Too much of a good thing can be bad. Combining dark chocolate with a healthy diet rich in fruits and vegetables, and regular exercise can mean a long life with a healthy cardiovascular system meaning you can be active long into old age. So don’t feel bad about indulging your love of chocolate…just do so in moderation.

Little Orphan Deflazacort

Posted by on February 22nd, 2017

As EpiPen® was to Fall 2016 so Deflazacort is to Winter 2017? The frustration continues. The result is a growing understanding among congressional leaders and the public that importation has big advantages for the American public. Senators Chuck Grassley (R-IA), John McCain (R-AZ), and Amy Klobuchar (D-MN), along with Bernie Sanders (I-VT) are by now, the most well-known voices advocating for personal prescription importation. The first three have recently sent a letter to newly confirmed HHS Secretary Tom Price asking him to open personal prescription importation under four conditions:

  1. If a drug is off patent and is no longer marketed in the US,
  2. If there are unexplained significant increases in prices,
  3. If no competitor drug is available and a competitor would lower prices, or
  4. If a drug is produced in another country by a brand name manufacturer or by a generic manufacturer who also produces pharmaceutical products for the US.

This is a reaction to the Deflazacort controversy that emerged earlier this month. Marathon announced FDA approval of Deflazacort to treat symptoms of Duchenne Muscular Dystrophy, an illness that affects mainly boys and young men. Deflazacort can provide some relief of the symptoms. It was not approved in the US until this year but had been imported by families with children with Duchenne muscular dystrophy for many years. Marathon’s announcement was supposed to be a relief for them. They would no longer have to order their medications online and deal with potential shipping delays or customs hang ups. Yet the announcement was met with disappointment when the list price was announced…$89,000/year. The company says rebates and discounts will bring that price down to $50,000-$54,000 per year.

Marathon did not develop this drug, neither have they improved it nor found a new use for it. Usually these are the main reasons drug companies cite for the need for high drug prices. Yet it just helps to prove that drug pricing makes absolutely no sense. Take, for example, the Hepatitis C drug Harvoni. Harvoni is a drug that doesn’t just manage Hepatitis C, it pretty much cures it in 95% of people. That’s huge. The cost of ongoing care for Hepatitis C is big, tens of thousands of dollars per year. Add in that Hepatitis C can severely damage the Liver and cause Liver cancer, the costs increase even more. With Harvoni, the virus can be stopped dead and the ongoing cost of care is much reduced. The catch is the list price of Harvoni is $98,000. Rebates bring the cost down to around $50,000 for a course of treatment. The difference between Harvoni and Deflazacort is Harvoni only needs to be paid for once, Deflazacort is an ongoing cost.

Harvoni is a blockbuster and novel new drug. It took years to research and develop and has the ability to ultimately eliminate a common but very serious illness. Deflazacort has been around for decades. It is off patent and has been used for Duchenne muscular dystrophy for a long time. Unlike Harvoni, it is not a cure. It is a maintenance drug that slows progression of the illness. Further it has to be used along with other drugs to be effective. To price it at the same level as a brand new and novel new drug does not make sense. Granted the market for Deflazacort is not close to the size of the market for Harvoni. Duchenne muscular dystrophy is comparatively rare. Marathon doesn’t have as big a market to make a profit in. But the circumstances still do not justify the high price. There is little chance that a competitor will come into the market.

Marathon was adamant that people wouldn’t see these massive prices. They would pay the co-pays and insurance would cover the rest. The insurance conundrum is another big part of this problem. Insurance companies are big and wealthy but they’re not unlimited. They have to earn enough money to pay claims and yet they also need to make money for their shareholders. Pharmaceutical companies have relied on health insurers (including the government) to pick up most of the tab for prescription drugs for decades. They have acted like a mask for the pharmaceutical industry, shielding the wider public against the actual costs of their health care. Yet insurers are starting to do what was, in fact, inevitable. They are changing their plans to increase cost sharing and also being much more selective in compiling their drug formularies.

Marathon announced a pause in the rollout of Deflazacort the day after its approval was announced. The pricing uproar may have them rethinking their position. However, in reality, there is very little to push them to change their strategy. The orphan drug status given to Deflazacort means they have a monopoly over the sale of the drug for seven years, and given the potential size of the market, it’s unlikely a competitor will arise.

30% have not filled prescription due to cost: Poll

Posted by on February 22nd, 2017

A new poll commissioned by the group Prescription Justice shows that costs continue to prevent many Americans from accessing prescription drugs. It found that 75% of those polled agree with President Trump’s comment that pharmaceutical companies are “getting away with murder.” Here’s a summary of the poll’s interesting findings:

  • 79% of Americans think drug prices are too high. That’s fairly consistent with other recent polls on the issue.
  • 52% believe pharma is engaged in price gouging, putting their profits ahead of patient health.
  • 30% (94.5 million Americans) have not filled at least one medication due to cost.
  • 25% (over 78 million Americans) have, at some point, had to choose between their prescription drugs and other necessities like food and shelter.
  • 11% (over 34 million Americans) have ordered prescription drugs online from a Canadian or international pharmacy at least once.

What this poll tells us is not much has changed. These results are largely consistent with previous polls on prescription drugs prices in the US. If anything, people’s perceptions about drug prices are becoming more jaded. It’s easy to see why too. Despite loud outcry and near universal anger over prescription drug prices, pharmaceutical companies continue to jack up prices.

The most shocking, and worrisome, statistic is the huge number of Americans who have been forced to choose between necessities and their prescription drugs. Over 78 million people have had to make a decision like this before and many have to do it a lot. Many of them likely account for a big portion of the 11% of Americans who have ordered prescription drugs from Canadian or international pharmacies.

The personal importation of prescription drugs saves lives and money. It allows people to buy the drugs they need at prices they can afford. As long as the drug is purchased from an accredited and licensed pharmacy you can be assured it’s a high quality product. The Canadian International Pharmacy Association and PharmacyChecker are excellent places to look for reputable online pharmacies. People should not have to choose between their health and other necessities.