Health Headlines - February 14

Medicare Drug Plans Hinder Access to Medicines: Critics

Many drugs supposedly covered by the new Medicare drug benefit are hard to obtain due to restrictions and requirements imposed by private insurers who administer the program, doctors and pharmacists say.

Each plan offered by the private insurers has its own list of covered drugs (called a formulary) and the plans require doctors and patients to obtain prior authorization for certain drugs, The New York Times reported.

The procedure for getting prior authorization varies from plan to plan. For example, one plan may have 25 or 30 forms for prior authorization for different drugs. On top of that, most states have at least 40 Medicare drug plans, the newspaper reported.

The assorted requirements are challenging and can delay or deny patient access to medications that they need, doctors charge. However, the insurers contend that these requirements save money and promote proper use of medications, the Times reported.

"Medicare drug plans have created significant hurdles that patients and physicians must jump over before getting their medications. The prescription drug plans are playing a dangerous game. In many cases, we're dealing with frail, very vulnerable individuals," Dr. Jeffrey A. Kerr, a Missouri doctor who has hundreds of older patients, told the paper.

"We have seen signs that Medicare drug plans are using management controls to deter access to medically appropriate drugs, including drugs on their own formularies," noted Dr. Steven A. Levenson, president-elect of the American Medical Directors Association, which represents doctors who look after people in nursing homes.

Deaths Prompt Halt of Patient Recruiting for Cancer Drug Test

A large test of the cancer drug Avastin has temporarily stopped recruiting volunteers after there were more deaths than expected of people taking the drug, the Associated Press reported.

The announcement was made Monday by biotechnology company Genentech Inc. and its majority stockholder, Roche Holding AG. Since the test began in December 2004, seven people have died, four of them suddenly, the news service said.

All seven were colon-cancer patients taking Avastin in combination with a chemotherapy called XELOX, the AP reported.

"An occurrence of sudden deaths, especially in three younger patients, was noted," said a statement from Roche. It said the temporary suspension would allow for "a full safety assessment."

The test is designed to determine the safety of using Avastin to prevent colon-cancer recurrence in patients who are in remission. In the United States, the drug is approved for treatment of advanced colon cancer.

Gene Linked to Esophageal Disease

A gene called eotaxin-3 may cause a rare esophageal disorder called eosinophilic esophagitis (EE), which can cause vomiting, heartburn, stomach pain and an esophagus that's so narrowed that food gets trapped in it.

There is no proven treatment for the disease, which is commonly confused with hard-to-treat acid reflux. This finding about a possible genetic trigger provides a new direction in the search for therapies and may lead to earlier diagnosis for people with EE, the Associated Press reported.

U.S. researchers did genetic tests on healthy people, acid reflux sufferers, and EE patients. The results revealed that EE patients had a unique genetic signature. They had more than 500 genes that operated differently than they did in people in the other two groups.

The study also found that eotaxin-3 was up to 100 more times active in the EE patients, the AP reported.

The findings appear in the Journal of Clinical Investigation.

Clinton Schools Initiative to Fight Child Obesity

Inspired by his own brush with heart disease, former U.S. President Bill Clinton on Monday unveiled an $8 million, school-based diet and exercise initiative aimed at fighting childhood obesity, the Associated Press reported.

Clinton said a total of 285 schools in 13 states will take part in the pilot phase of the program starting next fall, with additional schools able to apply for inclusion later on.

Clinton announced the initiative, called the Alliance for a Healthier Generation, at a public school in Harlem.

The program -- part of a campaign by Clinton's foundation and the American Heart Association -- is aimed at lowering child obesity rates by improving the quality of food served in school cafeterias and vending machines, raising exercise levels, providing health lessons and promoting the wellness of school staffers.

"What we want to do is to create a national recognition program shining a spotlight on schools that have done a good job, with concrete, innovative steps to create healthier learning environments for children and healthier work environments for staff," Clinton said.

Clinton and program co-founder, Arkansas Gov. Mike Huckabee, were inspired to create the Alliance after living through their own weight-linked health crises, the AP said. Clinton went through heart bypass surgery in 2004, and Huckabee dropped 110 pounds after being diagnosed two years ago with type 2 diabetes.

Pediatricians Must Do More to Prevent Skin Cancer

Even though it's crucial that children and their parents be counseled about the dangers of skin cancer and how to prevent it, the topic comes up in less than 1 percent of visits to pediatricians, say researchers at Wake Forest University Baptist Medical Center.

The findings from their review of medical literature prompted the researchers to urge pediatricians to do more to prevent skin cancer. The review appears in the journal Pediatric Dermatology.

"Pediatricians can play an important role in counseling patients and educating them about skin cancer. There is strong evidence for the relationship between UV exposure and non-melanoma skin cancer and growing evidence for the relationship between indoor tanning and melanoma," senior researcher Dr. Steven Feldman said in a prepared statement.

"Children should be encouraged to use sunscreen, wear appropriate clothing and avoid both the strong midday sun levels and indoor tanning," said Dr. Mandeep Kaur, instructor in Wake Forest's department of dermatology.

"Skin cancer is the most rapidly growing cause of cancer deaths in the United States, and childhood sun exposure increases the risk," Kaur noted.

Food Fact:
Flipped burger.

What grills like a burger, tastes meaty on a bun -- but has a fraction of the fat? Grill up broad, flat portobello mushrooms, dress 'em up like burgers, and you'll enjoy a hearty sandwich that's far better for your heart than beef. Mushrooms have what the Japanese call umami, a meaty taste, and healthy cooks use that meatiness to advantage. And that meaty taste comes with a very impressive nutrition profile: No fat, no carbs and hardly any calories. Add sauteed cremini mushrooms to spaghetti sauce for depth of flavor and satisfying chewiness. Slice shiitakes for you next stir-fry.

Fitness Tip of the day:
Think ahead.

Going to the gym in the a.m.? It pays to pack your gym bag the night before. You'll be less likely to find excuses not to get up and work out if you've got everything ready ahead of time -- and less likely to forget something in haste as you're rushing out the door.

FAQ of the day:
What are the best carbs for diabetics?

The very best contain soluble fiber, such as oats, rye and beans. Soluble fiber forms a gel in the gastrointestinal tract, which slows the rise in blood sugar after a meal and gives insulin more time to clear sugar from the blood.