Read a roundup of health news briefs from NPR for the week of Dec. 12-Dec. 18:
Trial Results Poor for Lung Cancer Drug
Dec. 18, 2004 — The Food and Drug Administration says a large study has shown no increased survival among patients taking a newly approved drug against lung cancer.
The drug, called Iressa, is designed to block signals that tell a cancer cell to grow.
Specialists say some lung cancer patients who take Iressa do amazingly well. But it's hit-or-miss. Earlier this year, a study showed that patients who benefit have a certain mutation on their cancer cells. Unfortunately, that's only a fraction of all lung cancer patients.
The FDA approved Iressa in 2003 after studies showed the drug shrank tumors in about 10 percent of patients. Now a study of 1,700 patients failed to show that, overall, patients on the drug lived longer than those taking a placebo. The agency says there are other new drugs that do improve survival of lung cancer patients.
The FDA has not decided whether to withdraw Iressa from the market.
-- Richard Knox
ADHD Drug Linked to Liver Damage
Dec. 18, 2004 — The Food and Drug Administration says the only drug approved for treating attention deficit-hyperactivity disorder in both adults and children can, in rare circumstances, cause liver damage.
The drug is Strattera. It's been on the market for two years. Unlike Ritalin, another commonly used drug for ADHD, Strattera is not a stimulant.
The drug's label will now contain a bold-print warning that says Strattera may injure the livers of a small number of patients.
Problems appear to be relatively minor. There were no liver injuries in 6,000 patients in clinical trials. The agency has since received reports of a teenager and an adult on the drug for several months who both developed serious liver problems. Both recovered.
One FDA observer suggested that the agency is being especially careful, given the current pressure from Congress to be out front about safety problems.
-- Joanne Silberner
Flu Vaccine to More People
Dec. 17, 2004 — The Centers for Disease Control and Prevention will greatly expand the number of Americans who should be able to get flu shots, at least in areas where there's enough vaccine.
The CDC says beginning Jan. 3, state and local health officials should take stock of their flu vaccine supplies.
If there's enough, they should expand flu vaccination to adults over 50, caregivers in settings such as day-care centers, and people who live in households with elderly people, pregnant women, or those with chronic diseases. That covers many Americans.
It's a far cry from the concern this fall about a flu vaccine shortage. The shortage arose when one of the nation's two flu vaccine suppliers withdrew 48 million doses because of contamination in its British plant.
But demand for flu shots has been low. Most states now report they have enough vaccine. And CDC director Julie Gerberding says, "We don't want those doses to go to waste." — Richard Knox.
Dioxin Poisoning
Dec. 17, 2004 — Ukrainian opposition leader Viktor Yushchenko appears to have been poisoned with an especially dangerous form of dioxin.
Yushchenko has been in bad health since September. His symptoms include digestive problems, fatigue and disfiguring acne.
Scientists in the Netherlands have been working to find out why. A preliminary analysis of Yushchenko's blood suggested high levels of chemicals in the dioxin family.
Now the Dutch scientists say sophisticated tests confirm that Yushchenko was poisoned by an especially toxic form of dioxin called TCDD. It tends to remain in the body's fatty tissues for many years. It's been linked to certain forms of cancer.
But doctors say Yushchenko appears to be getting better. He remains a candidate for the Ukranian presidency, which will be decided later this month. — Jon Hamilton
AIDS Council Shift
Dec. 17, 2004 — The President's Advisory Council on HIV/AIDS has a new co-chair.
Outgoing Health and Human Services Secretary Tommy Thompson has named Anita Smith to replace former Oklahoma Congressman Tom Coburn as co-chair of the council. The other co-chair is Louis Sullivan, who served as HHS Secretary under the first President Bush.
Coburn, a leading social conservative, resigned when he began a successful run for the Senate.
Smith, who's been a member of the council since 2002, is likely to follow in Coburn's footsteps. She is currently vice president and co-founder of the Institute for Youth Development, which promotes abstinence-only education programs and federal funding for faith-based groups. — Julie Rovner
Study Shows Celebrex Risk to Heart
Dec. 17, 2004 — Officials at drug manufacturer Pfizer say they're concerned that their pain-killing drug Celebrex causes heart problems.
Celebrex is similar to Vioxx. Vioxx manufacturer Merck recently pulled its drug off the market because studies showed it causes heart attacks and strokes.
Pfizer is conducting two studies on Celebrex to see if it can prevent colon cancer. According to the company, scientific overseers of those studies told Pfizer officials Thursday night that they had found an increased risk of cardiovascular disease in one of the two studies.
The chairman and CEO of Pfizer, Hank McKinnel, said in a statement that the result is unexpected. Another official, Dr. Joseph Feczko, president of worldwide development for Pfizer, says the company considers Celebrex to be an important medicine that provides necessary pain relief to many patients.
Heart disease concerns have also been raised about the third drug in this class — Bextra. — Joanne Silberner
Flu Vaccine Surplus?
Dec. 16, 2004 — The nation is in the midst of its most severe shortage of flu vaccine ever. But officials in many states say they're more worried about having a surplus.
Half the nation's expected flu vaccine supply disappeared on Oct. 5, when one of only two suppliers withdrew from the market because its vaccine was tainted.
That led health officials to ration flu vaccine. The goal was to get flu shots to most people at high risk of flu deaths and complications.
Dr. Richard Raymond, president of the Association of State and Territorial Health Officials, says many at high risk who want flu shots have gotten them.
"Once that goal appeared to be achieved in many states," he said, "it was then decided to open up the categories slightly to make sure no vaccine was wasted at the end of the year."
Some states now allow flu shots for anybody. In others they're available to anyone over age 50. — Richard Knox
New Drug Eases Cancer Treatment
Dec. 16, 2004 — The Food and Drug Administration has approved a drug that should make life easier for many patients undergoing intensive therapy for certain cancers.
Patients undergoing stem cell transplants for leukemia and lymphoma get high doses of radiation and chemotherapy. One of the most agonizing side effects is called mucositis. The lining of the mouth and throat becomes inflamed and may even slough off.
The new drug, called palifermin, prevents mucositis in many people and reduces its severity and duration in others.
A study funded by the drug's maker, Amgen, is in this week's New England Journal of Medicine. The drug's brand name is Kepivance.
Almost all patients got mucositis in the group who received a placebo. But among those who got the new drug, the incidence was 63 percent. Severe mucositis, which prevents swallowing and requires that nutrition be given intravenously, occurred in 62 percent of those who received a placebo, compared with 20 percent of those taking the new drug. — Richard Knox
Merger Between Medical Device and Drug Makers
Dec. 16, 2004 — Johnson & Johnson is buying Guidant, a medical device company, for $25.4 billion.
It's the fourth-largest acquisition announced this year.
For its money, Johnson & Johnson will get a company that analysts describe as scrappy and entrepreneurial. Guidant makes implantable cardiac defibrillators and pacemakers. These devices steady the irregular or racing heart.
Guidant also makes stents, which are small scaffolds that prop open clogged arteries.
Defibrillator use has been growing rapidly in recent years, and is expected to get a big boost soon. Medicare has said it will start paying for defibrillators in patients with even moderate heart problems.
Consumers may know Johnson & Johnson for Baby Shampoo and Band-Aids. But most of J&J's profits come from prescription drugs. Growth in that part of the company is expected to slow, since J&J has no new blockbuster drugs in sight and patents on profitable drugs are set to expire soon.
Johnson & Johnson is hoping that Guidant will pick up the slack in the next couple of years. — Snigdha Prakash
Power Wheelchairs Get Scrutiny
Dec. 15, 2004 — Congressional investigators say Medicare spends too much on power wheelchairs, arguing the health insurance program for the elderly and disabled has been too slow to respond to evidence of fraud and abuse.
Between 1999 and 2003, Medicare's overall spending rose by about 11 percent. But its spending for power wheelchairs went up by more than 400 percent.
Investigators for the Government Accountability Office say many people who did not qualify for the expensive wheelchairs were getting them and that Medicare officials got repeated warnings of the problem, going all the way back to 1997.
The report also complained that the agency did not respond to the warnings for another six years. During this time, spending continued to go up, reaching $1 billion last year.
The GAO says Medicare needs to better analyze its own spending. The agency also needs to tighten its rules for who can get a power wheelchair, the GAO says.
Medicare officials say they've already begun taking such steps. — Joseph Shapiro
Battle Brewing over Medicaid
Dec. 15, 2004 — A major fight is shaping in up in Washington over the fate of the Medicaid health program for the poor.
For several years, governors have been complaining about rising costs for Medicaid. The health program recently passed education as the largest item in nearly half the states' budgets. States receive federal subsidies for Medicaid; the amount of the subsidy varies from state to state.
But in Washington, Republicans are looking to cut back on the federal contribution to Medicaid as part of overall deficit-reduction efforts.
Now 48 of 49 current Senate Democrats have put President Bush on notice in a new letter. They are telling the President that they will oppose any efforts to cap federal spending on Medicaid, including turning it into a block grant. — Julie Rovner
New Chief for Drug Group
Dec. 15, 2004 — The pharmaceutical manufacturers' trade group has named a new president and CEO. He's a 12-term member of Congress.
Billy Tauzin represented a Louisiana district for 24 years, first as a Democrat, then as a Republican. From his position as head of the House Energy and Commerce committee, he was one of the leaders on the Medicare prescription drug bill.
Tauzin fought against the importation of prescription drugs from Canada and other countries — a position he shares with his new employer, the Pharmaceutical Research and Manufacturers of America (Phrma). After word got out last January that Tauzin was under consideration for the Phrma job, he resigned his committee chairmanship.
Phrma lauded Tauzin for being able to work across party lines and develop meaningful partnerships. In a statement, Tauzin said his bout earlier this year with intestinal cancer inspired him to work for the pharmaceutical industry.
Tauzin's job officially begins January 3. — Joanne Silberner
Drug Combo Risky for Some Women
Dec. 15, 2004 — A study in the Journal of the American Medical Association suggests that a widely used drug regimen for high blood pressure poses a risk for older women.
One in three postmenopausal women being treated for high blood pressure is taking a two-drug combination of a diuretic plus a calcium-channel blocker.
Diuretics are also known as "water pills" because they help the body remove excess fluids and lower blood pressure. Calcium-channel blockers work to lower blood pressure by blocking the entry of calcium into key cells in blood vessels.
There are many drugs in each of these categories (see the links on this page to the Texas Heart Institute for a complete list of drugs by category).
The new study compared women taking a diuretic and a calcium-channel blocker to those taking a diuretic and a different kind of drug. The second drug in these combinations was either a beta-blocker or an ACE inhibitor. These drugs control heart rate and/or blood pressure.
Researchers found that women who received a calcium-channel blocker had twice the rate of cardiovascular deaths than women taking one of the other combinations.
The study is large, though critics say it has flaws. Even the study's authors say that their results do not mean that women with high blood pressure should stop taking calcium-channel blockers plus diuretics.
But one study author says women might want to ask their doctors if they need to take that particular combination. — Richard Knox
Retiree Drug Plans Remain Intact
Dec. 14, 2004 — A majority of large employers say they'll continue their current drug plans for retirees even after the federal Medicare program starts covering prescription costs for retirees in 2006.
A special subsidy Congress added to last year's Medicare law appears to be working. It was designed to encourage employers to maintain existing drug coverage to retirees. At least that's the preliminary message from the annual retiree benefits survey of large employers by the Henry J. Kaiser Family Foundation and the consulting firm Hewitt Associates.
Some 58 percent of firms surveyed said they plan to take the government subsidy and continue to offer drug benefits as part of their retiree packages when Medicare's drug benefit starts. Of those who plan to continue to offer drug coverage, 85 percent said it would be at the same level as now.
But overall, the survey found, current recipients of employer-sponsored retiree benefits are paying more and getting less. And many workers being hired now face the prospect of no retiree health coverage at all. --Julie Rovner
Immigrants' Obesity Risk
Dec. 14, 2004 — Coming to the United States puts immigrants at risk of gaining weight, according to a study in this week's issue of the Journal of the American Medical Association.
Researchers from Northwestern University, led by Dr. Mita Sanghavi Goel, looked at when people migrated to this country and compared that to government health statistics about body mass index.
They found that when immigrants arrived here, they were of normal weight. But 15 years later, they looked more like an overweight American.
On average, the men had gained 11 pounds; the women, 9 pounds. Researchers say many of the immigrants apparently adopted the American lifestyle. They ate out more, often at fast food restaurants. They also drove more and sat in front of the television more.
In their home countries, subjects walked more, prepared meals with more fresh vegetables and fruits and ate far fewer sugary, high-fat processed foods. — Patricia Neighmond
Mammogram Timing
Dec. 14, 2004 — A new study suggests that every-other-year mammograms are just as good for women over 50 as annual mammograms.
Researchers from several U.S. universities studied databases that contain the mammography history of nearly 8,000 women with breast cancer. They had had either annual or biennial mammography.
In the current Journal of the National Cancer Institute, the scientists report that for women age 50 or older, the interval of mammography didn't matter. There were no more late-stage cancers discovered in the women who only had every-other-year mammography.
But the story was different for women in their 40s who had every-other-year mammography. When their cancers were detected, they were at a later stage, which is presumably less treatable. Those who had mammograms every year had early-stage cancer for the most part.
The research becomes a part of a series of conflicting studies on the best timing for mammography. — Joanne Silberner
For more information on recommended intervals for mammography, visit the National Cancer Institute Web site, www.nci.nih.gov, or the American Cancer Society, www.cancer.org.
Supplements Safer Than Fish?
Dec. 14, 2004 — A product-testing company claims that fish-oil supplements are free of the mercury, PCBs and other contaminants often found in fish.
The supplements contain omega 3 fatty acids, which are found naturally in fish. Many people believe these oils can fight heart disease, arthritis and other problems, though the Food and Drug Administration considers the heart disease claim suggestive, not conclusive.
But fish flesh can contain high levels of mercury and PCBs. So ConsumerLab.com tested 41 fish oil products, including products from 27 companies that paid for the test, and another 17 selected because they're widely available.
None of the 41 supplements contained appreciable levels of PCBs or mercury. One possible reason is that the contaminants tend to concentrate in the flesh of the fish, not the oil.
Two products had less fish oil than listed on the bottle, though one of the manufacturers said testing by three independent labs showed the oil content was accurately represented on the label. One supplement was found to be spoiled. — Joanne Silberner
Contacts Prevent Near-Sightedness
Dec. 14, 2004 — New research suggests that hard contact lenses may help slow the progression of nearsightedness among children. The study appears in this month's Archives of Ophthalmology.
Researchers from Ohio State University say that rigid gas permeable contacts seem to alter the shape of the cornea, which plays a role in the development of nearsightedness. Soft lenses apparently have no effect on the shape of the cornea.
More than 100 children between the ages of 8 and 11 years were enrolled in the study. The children had moderate myopia and all wore glasses. Myopia typically develops at around this age.
Each child in the study was taught how to use contacts. Then about half the children were given rigid contacts; the other half were given disposable soft contacts.
Every year for three years, the children received annual eye exams. Researchers found those who wore the rigid lenses slowed progression of nearsightedness by nearly 30 percent. They say the findings should encourage parents to consider this type of contact. — Patricia Neighmond
SARS Vaccine Tests Begin
Government researchers start first human tests of vaccine against Severe Acute Respiratory Syndrome.
Dec. 14, 2004 — Government researchers are beginning human tests of a vaccine against SARS, less than two years after scientists discovered the cause of the disease.
Severe Acute Respiratory Syndrome took the world by surprise in November 2002. Eight months later it had struck nearly 8,100 people and killed almost 800. To be ready for the next time, scientists launched a crash program to develop a vaccine.
Now they're ready to try it on people. The vaccine contains a tiny circle of DNA that codes for the so-called spike protein that sticks out of the SARS virus.
When human cells take up the piece of SARS DNA, researchers hope those cells will churn out pieces of spike protein that the immune system will be primed to recognize if it ever encounters a real SARS virus. But since SARS has disappeared for now, nobody knows when that might be. Presumably, health care workers would be first to get a SARS vaccine.
-- Richard Knox, NPR News
Leavitt Faces Daunting Agenda at HHS
If confirmed as the new HHS secretary, Mike Leavitt will deal with battles over Medicaid, Medicare's prescription drug benefit and welfare reform.
Dec. 14, 2004 — Environmental Protection Agency administrator Mike Leavitt will face a daunting array of issues if he's confirmed as the new secretary of Health and Human Services.
As the former governor of Utah, Leavitt knows a great deal about the state-federal Medicaid health program. That's important, because a battle over whether the federal government should provide less Medicaid money to states is expected to be front and center next year.
The controversial Medicare law — with prescription drug benefit to begin in 2006 — is facing key implementation issues. Leavitt will also have to deal with the issue of prescription-drug pricing, particularly whether to allow Americans to purchase drugs from Canada and other developed nations.
Also on the HHS agenda is a closer look at the way the Food and Drug Administration approves new drugs, and reauthorization of the 1996 welfare law. That was supposed to be done three years ago, but Congress has been unable to agree on a plan.
-- Julie Rovner
SARS Vaccine Tests Begin
Dec. 14, 2004 — Government researchers are beginning human tests of a vaccine against SARS, less than two years after scientists discovered the cause of the disease.
Severe Acute Respiratory Syndrome took the world by surprise in November 2002. Eight months later it had struck nearly 8,100 people and killed almost 800. To be ready for the next time, scientists launched a crash program to develop a vaccine.
Now they're ready to try it on people. The vaccine contains a tiny circle of DNA that codes for the so-called spike protein that sticks out of the SARS virus.
When human cells take up the piece of SARS DNA, researchers hope those cells will churn out pieces of spike protein that the immune system will be primed to recognize if it ever encounters a real SARS virus. But since SARS has disappeared for now, nobody knows when that might be. Presumably, health care workers would be first to get a SARS vaccine.
-- Richard Knox
Leavitt Faces Daunting Agenda at HHS
Dec. 14, 2004 — Environmental Protection Agency administrator Mike Leavitt will face a daunting array of issues if he's confirmed as the new secretary of Health and Human Services.
As the former governor of Utah, Leavitt knows a great deal about the state-federal Medicaid health program. That's important, because a battle over whether the federal government should provide less Medicaid money to states is expected to be front and center next year.
The controversial Medicare law — with prescription drug benefit to begin in 2006 — is facing key implementation issues. Leavitt will also have to deal with the issue of prescription-drug pricing, particularly whether to allow Americans to purchase drugs from Canada and other developed nations.
Also on the HHS agenda is a closer look at the way the Food and Drug Administration approves new drugs, and reauthorization of the 1996 welfare law. That was supposed to be done three years ago, but Congress has been unable to agree on a plan.
-- Julie Rovner
Abortion Suit Filed
Dec. 13, 2004 — A group representing family planning providers is suing the federal government to block anti-abortion language enacted last week.
The $388-billion spending bill signed by President Bush includes language protecting hospitals, health plans and other groups of health providers who refuse to provide abortions or abortion-related services.
But there's a twist, says the National Family Planning and Reproductive Health Association. Under current federal rules, those who receive federal family planning funds must promise to provide abortion referrals if a patient requests one. The NFPRHA sued because it leaves health-care entities with two conflicting requirements.
The suit was filed in U.S. District Court in Washington D.C. It also charges that the new law would leave hospitals or clinics powerless to ensure that abortion referrals get made to women whose lives are threatened by continuing a pregnancy.
Backers of the new law's language say it's needed to ensure that abortion-rights supporters can't force hospitals or health plans to provide abortions. — Julie Rovner
Medicare Overpays
Dec. 13, 2004 — The federal Medicare program paid nearly $20 billion it shouldn't have last year.
The claims error rate for fiscal 2004 was 9.3 percent, the Department of Health and Human Services reported. That means just under one of every 10 dollars paid by Medicare wasn't properly accounted for.
Some cases were due to fraud, but others were for services not deemed medically necessary, services that were inadequately documented or claims filed using the wrong codes.
In total, officials calculated that Medicare overpaid health care providers by nearly $22 billion. But it also underpaid other providers by just under a billion dollars.
The rate is down slightly from last year, but the dollar amounts continue to rise as costs for Medicare increase. The program cost an estimated $213.5 billion last year. — Julie Rovner
Cholesterol-Lowering Drug Without Rx?
Dec. 13, 2004 — Drug maker Bristol-MyersSquibb says it will soon ask the Food and Drug Administration for permission to sell its cholesterol-lowering drug, Pravachol, without a prescription.
Pravachol belongs to a class of drugs called statins. They're the world's top-selling drugs, and thus big profit-makers.
But Pravachol, which is known generically as pravastatin, will stop yielding big profits for Bristol-MyersSquibb in about a year and a half. That's when the company's patent on the drug expires. Generic drug makers will likely rush to the market with inexpensive copies of Pravachol.
Bristol-MyersSquibb could protect some of its profits by getting permission from the FDA to start selling Pravachol over the counter.
But getting the FDA's go-ahead is not a sure thing. Bristol tried once before in 2002. The FDA turned it down because of concerns that consumers couldn't treat a problem like high cholesterol without a doctor.
The FDA is already considering a similar application by Merck for its cholesterol-lowering drug, Mevacor. — Snigdha Prakash
Malaria Drug Alternative in Works
Dec. 13, 2004 — A nonprofit drug company in San Francisco is receiving a large grant to speed the development of a synthetic malaria drug.
The $42.6-million grant from the Bill and Melinda Gates Foundation goes to the Institute for OneWorld Health. The institute will work in partnership with the University of California, Berkeley, and Amyris Biotechnologies to develop a new, synthetic form of artemesinin, a drug increasingly used in malaria treatments around the world.
In recent years, the parasite that causes malaria has developed resistance to some of the drugs used for treating the disease. Artemesinin remains effective, but there are problems with it.
In it's natural form, artemesinin is extracted from the wormwood plant, a labor-intensive process that requires many purification steps. At approximately $2.50 per treatment, the drug is too expensive for the people who need it most.
The institute hopes to develop a synthetic alternative that will be as effective as the natural version of artmesinin, but which costs less. — Joe Palca
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