Health Highlights: Feb. 1, 2019

Published 02/01/2019

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Medicare/Medicaid Drug Rebates Would be Banned Under Trump Administration Proposal

A proposal to ban drug companies from giving rebates to pharmacy benefit managers and insurers in Medicare Part D- and Medicaid-managed care plans was announced Thursday by the Trump administration.

Instead of those rebates, drug makers would be urged to provide discounts directly to pharmacy customers, and pharmacy benefit managers would receive a set fee, CNN reported.

The proposal would be a major change and was welcomed by the drug industry, but criticized by insurers and pharmacy benefit managers.

"If this rule goes into effect in its current form, it would be the largest change the administration has yet announced on drug pricing," Rachel Sachs, an associate law professor at Washington University, told CNN.

Currently, pharmacy benefit managers negotiate rebates from drug makers to insurers in exchange for better coverage terms -- typically lower copays for brand-name drugs.

The goal is to get insurers' enrollees to choose that cheaper brand-name medication over a competitor's version. Pharmacy benefit managers keep a part of the rebate, CNN reported.

In 2016, insurers received $89 billion in rebates, lowering their spending on prescription drugs to $279 billion in 2016, according to estimates from the research and consulting firm Altarum.

That doesn't include the portion of the rebate kept by pharmacy benefit managers, which is not made public, CNN reported.

The proposal's impacts are uncertain. While Medicare and Medicaid patients with high drug costs would save money, there could be higher premiums for all beneficiaries.

About 30 percent of Medicare Part D enrollees spend enough that their savings under the proposal would likely exceed any premium hikes, according to the Trump administration, CNN reported.

And because the government provides various subsidies in the Part D program, federal spending could rise between $35 billion and $196 billion over 10 years, projections suggest.

Another unknown is how the proposal will affect drug costs for the more than 150 million Americans who get their insurance through work, CNN reported.

Drug makers are responsible for high drug costs and this proposal could boost patients' drug costs, according to the Pharmaceutical Care Management Association, which represents pharmacy benefit managers, and America's Health Insurance Plans, an industry group for insurers.

"PBMs keep coverage affordable by negotiating rebates with drug-makers, which are used to enhance benefits and reduce beneficiary cost sharing and premiums," JC Scott, the association's president, told CNN.

Drug makers say high drug prices are the fault of others.

"This proposal would also fix the misaligned incentives in the system that currently result in insurers and pharmacy benefit managers favoring medicines with high list prices," Stephen Ubl, chief executive of PhRMA, a trade group for drug makers, told CNN.

The proposal was panned by some Democrats.

"The Trump administration's rebate proposal will increase government spending by nearly $200 billion and the majority of Medicare beneficiaries will see their premiums and total out-of-pocket costs increase if this proposal is finalized," Reps. Richard Neal of Massachusetts and Frank Pallone of New Jersey said in a statement, CNN reported.

"While we agree that the cost of prescription drugs must be addressed, we are concerned that this is not the right approach," they said.


Shortage of Anxiety Drug Concerns Patients, Doctors

A shortage of the anti-anxiety drug buspirone has patients and doctors concerned.

Some people rely on the medication to prevent debilitating anxiety and panic attacks, and doctors say not knowing when the normal supply will resume makes it difficult to manage patients, The New York Times reported.

Buspirone is among one of the generic drugs whose prices have fallen so low that many manufacturers claim they can't make a profit on them.

About 20 percent of people in the United States had an anxiety disorder in the past year, according to the U.S. National Institute of Mental Health.

It's considered a much safer drug than benzodiazepine anti-anxiety drugs like Valium and Xanax, The Times reported.

Buspirone is not addictive, has few side effects, and does not cause sexual dysfunction. It can also be used to augment antidepressants and to help reduce sexual dysfunction caused by antidepressants.

There is no equivalent medication that works the same way as buspirone.

"Buspirone is in a class by itself. It occupies a unique niche," Dr. Elias Aboujaoude, chief of the anxiety disorders section at Stanford University School of Medicine, told The Times.


Too Many Kids Using Too Much Toothpaste

Overuse of toothpaste puts many young American children at increased risk for splotchy or streaky teeth when they're older, a U.S. Centers for Disease Control and Prevention survey finds.

The poll of more than 5,000 parents of children aged 3 to 15 found that 40 percent of children aged 3 to 6 used a brush that was full or half-full of toothpaste, rather than the recommended pea-sized amount, the Associated Press reported.

Health officials say children under age 3 should use a smear of toothpaste the size of a grain of rice, while those aged 3 to 6 should limit it to a pea-sized amount.

The problem with using too much toothpaste is the fluoride in it. While fluoride protects teeth, too much of it when teeth are forming can lead to tooth streaking or spottiness (dental fluorosis), the AP reported.

The survey also found that about 60 percent of children brushed their teeth twice a day, and that about 20 percent of white and black kids, and 30 percent of Hispanic kids, didn't start brushing until they were 3 or older, the AP reported.


Pain Often Missed in Girls

Americans tend to overestimate pain severity in boys and underestimate it in girls, a new study finds.

Yale University researchers found that when adults were shown a video of a child's finger being pricked, they rated the child's level of pain higher if they thought it was a boy and lower if they thought it was a girl, CNN reported.

"Explicit gender stereotypes -- for example, that boys are more stoic or girls are more emotive -- may bias adult assessment of children's pain," the authors wrote, CNN reported.

The study was published in The Journal of Pediatric Psychology.


Staying Off Facebook Brings Benefits: Study

Turning away from Facebook could benefit you in a number of ways, according to a new study.

You'd have more in-person time with family and friends, be less politically partisan, have a slight improvement in daily moods and life satisfaction, and have an extra hour a day of downtime if you're an average Facebook user, The New York Times reported.

One downside among those who stopped using Facebook was a decrease in political knowledge.

The Stanford University and New York University-led study included nearly 3,000 Facebook users over age 18 who spent at least 15 minutes on the platform each day. The daily average was an hour, but it was two to three hours or more for heavy users.

Half were asked to deactivate their Facebook accounts for a month, in exchange for payment. On average, the amount was about $100, The Times reported.

The study, posted recently on the open access site Social Science Research Network, has not yet undergone peer review.

"This is one study of many on this topic, and it should be considered that way," a Facebook press officer said in a statement, The Times reported.

In quoting from the study itself, the statement said ""Facebook produces large benefits for its users," and that "any discussion of social media's downsides should not obscure the fact that it fulfills deep and widespread needs."

There are about 2.3 billion Facebook users worldwide.

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