Prescription Drug Costs Rise 18% In U.S.
An aging population's need for drugs, the rising cost of new, expensive drugs, and doctors prescribing many more higher priced ones sent spending for prescription drugs in the U.S. up 18.8% last year. These results were reported from a new study by the National Institute for Health Care Management Foundation, a non-profit organization that researches health care issues.
The spending increase was attributed mostly to top-selling drugs for arthritis, diabetes, ulcers, and cholesterol which are aggressively marketed by drug companies directly to the consumer. Two dozen products accounted for half of this increase.
Glucophage, a diabetes drug from Bristol-Myers Squibb, is one of these often prescribed, expensive drugs. It is about to come off patent, which should make generic versions available at lower prices. To continue higher revenues, Bristol-Myers Squibb has combined Glucophage with another old drug called glyburide (Diabeta, Micronase,Glynase) to create Glucovance, a Type 2 diabetes drug that increases insulin production and reduces the amount of glucose the liver produces.
The company hopes that Glucovance's greatly increased price will be offset by the convenience of combining the two inexpensive medications. This combination drug quickly received FDA approval. It will have a longer patent duration than most drugs because the time for development and clinical trials, which usually consumes most of the 17 year patent, was quite short.
Another product, Glucophage XR, was reformulated by Bristo-Meyers to extend the action time for Glucophage. Because it was minimally changed, it also received fast FDA approval after being patented. This drug is being marketed as a free 30 day supply to replace Glucophage prescriptions through full page ads in many newspapers across the country.
If drug costs are too much, help is available. The Medicine Program helps distribute medications to those in need (usually an income less than $30,000 to $50,000), and PhRMA, which represents the drug industry, has a Drug Assistance Program where needed prescriptions can be obtained.
  
Healthy Lifestyle Cuts Diabetes Risk
How much lifestyle change does it take to significantly lower your risk for diabetes? Not that much, according to recent research.
A well-designed study in Helsinki, Finland confirms what many health experts have promoted for several years--modest changes in lifestyle so that there are a slight reduction in calories, fat in the diet, and weight, and a moderate increase in exercise. These slight changes reduce the risk of developing Type 2 diabetes by more than 50% for people who are high-risk.
The three-year study followed more than 500 middle-aged, overweight participants, who were selected from high-risk groups, such as women who had given birth to large babies and close relatives of people with Type 2 diabetes. Half the participants were put in the control group and simply given general information about diet and exercise. The other half received detailed instruction regarding ways to lose at least 5 percent of their weight and to reduce fat and increase fiber in their diet. To reinforce this, they also had nutritional counseling and supervised exercise sessions. They were encouraged to walk for 30 minutes each day.
Results, reported in the New England Journal of Medicine (May 3, 2001), showed that the risk of diabetes was reduced by 58 percent in the trained and supported group.
The more lifestyle changes the participants made, the better, but participants lowered their risk even if they did not follow all the guidelines given. For example, weight loss was not absolutely essential to benefit from the program. Those who participated in four hours of exercise per week had a reduction in diabetes risk. This occurred even if no weight was lost.
Stem Cell Research Guidelines Needed
Politics makes strange allies. The Justice Department and lawyers for Nightlight Christian Adoptions are asking a federal judge to stay a lawsuit brought by Nightlight against the government to block federal funding of stem cell research until the Bush administration and the Health and Human Services Department review the funding policy guidelines. President Bush has avoided setting guidelines but has stated his preference for adult stem cell research so that embryonic cells would not be used.
Nightlight Christian Adoptions match infertile couples and embryos left over from fertility clinics. They sued the government saying that if these embryos are used in stem cell research their business would suffer as well as prospective parents.
Meanwhile, in other news regarding stem cell research, scientists are not submitting research grant proposals using stem cells to the NIH because of the lack of clear federal guidelines. President Bush has ordered that consideration of grants for research involving human embryonic stem cells be put on hold until the review of the current federal guidelines which are a carryover from the Clinton administration. This review is expected to be completed sometime during the summer.
Results from two new studies show blacks and whites seem to respond differently to blood pressure and heart disease drugs. Angiotensin-Converting-Enzyme or ACE inhibitor drugs like enalapril prescribed for high blood pressure and heart failure have very little effect in blacks, according to one study reported in the New England Journal of Medicine (May 3, 2001).
But another study, also published in the New England Journal of Medicine, overturns a commonly held belief that Carvedilol, a beta blocker drug, is ineffective in treating black people with heart failure. The results of this study that found Carvedilol benefited both blacks and whites equally.
Blacks suffer from heart failure twice as often as whites and their heart failure seems to strike earlier and progress faster. For these reasons, it has become important to differentiate the most effective drug treatment between blacks and whites.
Stem Cells Cultivated From Cadavers
Scientists from the Salk Institute in California have taken tissue samples from cadavers shortly after death and developed them into cells that can grow, divide and form specialized brain cells. This may be a breakthrough in using adult cells capable of becoming stem cells. Stem cells are master cells that can grow into virtually any type of cell in the body. Embryos are the richest source of human stem cells but religious groups oppose their use because they may be gathered from aborted tissue.
The scientists used biopsy tissue from 23 people ranging from 11 weeks to 72 years old. All of the people had suffered from brain disorders. The researchers were using them to study the cell biology of the various brain diseases. The scientists used special growth factors to obtain cells from the tissue. The scientists are planning to transplant the brain cells into animals to see if they survive and differentiate. The results of this study were published in Nature (May 2, 2001).
Scientists want to use stem cells to develop treatments for diseases ranging from Parkinson's, diabetes and cancers to leukemia, hepatitis and stroke. A major problem with use of cadaver cells involves the shortening of telomeres. Telomeres are identical sequences of proteins at the end of each DNA.
As aging occurs, the telomere sequence becomes shorter and ultimately stops the ability of a cell to replace itself. The younger the source for stem cells the greater the number of divisions it can undergo and the longer it will survive. Dolly the sheep, for instance, was found to have fewer telomeres than other sheep her age. If cadaver stem cells can be made to work, they would not be expected to last as long as stem cells derived from embryos.
Adult Stem Cells Seem Promising
How to get the job done and skirt the controversy? Identify adult stem cells that replicate into any other cell needed, thus potentially offering a cure for many diseases without using controversial embryonic cells.
Researchers at New York University School of Medicine and Yale University School of Medicine have found a bone marrow cell in adult mice that acts like a stem cell with all the flexibility previously found in embryonic cells. The results of the research that appear in the journal Cell (May, 2001) suggest that any organ in the body could be repaired using cells derived from bone marrow.
In the experiment, female mice were irradiated, which destroys their bone marrow cells, and then they received a single florescent bone marrow cell derived from a male. The scientists then looked for all cells in the female that had come from the one male cell transplanted into the female. It was expected that the female would use the bone marrow cell to replace her missing bone marrow cells, but the researchers found that the male cell had generated progeny in tissue in the lung, esophagus, stomach, small and large intestine, liver and skin of the female. Seemingly, the cell can generate many of the organs in the body.
The next research is to see if this process is possible in humans, also. The researchers said they would not want their findings to replace research into embryonic stem cells, partly due to the telomere problem mentioned in the previous article.
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