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Selected news articles which highlight important policy issues.

News: Weekly Archives

News for the week of 08-30-2004

How to Kill Cancer So It Doesn't Grow Back Quest Seems as Elusive as Hercules's Second Labor
Washington Post, 8-30-04

Stem cells are the undifferentiated cells from which all other cells in the human body are derived. While some researchers are rushing to learn how to use adult or embryonic stem cells to cure degenerative diseases like Lou Gehrig's disease or Alzheimer's, other scientists are discovering the even lethal cancers have their origins in stem cells.

Scientists have found evidence that the recurrence of cancer after radiation or chemotherapy treatment that wipes out the majority of cancer cells in a patient's body is due to a small number of "[cancer stem cells] that acts as the source of the malignancy, leaving the cancer able to rise again and again." Scientists have found these cells in a variety of cancers, including leukemia and brain cancers. Finding new treatments that specifically target cancer stem cells may mean the difference between a brief remission of the disease and a true cure.

To date, one researcher has found a "molecular switch" that seems to be unique to leukemia stem cells and has begun testing drugs that target these cells but leave normal blood stem cells untouched. Hopefully, in the future, scientists will be able to develop tests to specifically identify all cancer stem cells and use them as biomarkers for quickly testing the effectiveness of cancer treatments.

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Canadian sites look overseas for drug supply; To combat shortages, online pharmacies used by U.S. consumers are seeking new sources. Safety could be an issue.
Los Angeles Times, 8-30-04

Canadian pharmacies selling drugs online to U.S. consumers are finding domestic supplies stretched thin by rising demand and are "increasingly selling U.S. consumers drugs that originate through pharmacies in England, Fiji, Israel, and Chile." Of course, not all national regulatory agencies meet the high standards of the FDA, raising the possibility that the U.S. drug supply could become more vulnerable to counterfeit or diluted drugs imported from countries with more lax regulations than are found in the U.S. or Canada.

More mundane questions also come to mind: "How exactly are Canadian companies deciding which companies to include? How can a U.S. consumer decipher one country's safety environment and compare it to another? Whom do people contact if they have a problem with the medication? Also, what if the labels aren't in English." All good questions without, at least for the time being, good answers. Until we have answers, perhaps we should focus on finding other solutions.

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Reassessing a Popular Cholesterol Drug: Big Zocor Doses Fail to Offer Benefit to High-Risk Patients; Insights on Statins Emerge
Wall Street Journal, 8-31-04

There are several statins on market today but a growing body of research is showing that, as far as patients are concerned, all statins are not created equal. A new study of Merck's statin drug Zocor has failed to show a benefit for patients at high risk for heart attacks and other adverse cardiovascular events, even when prescribed at high dosages (80 milligrams).

This finding comes on the heels of an earlier study showing that a rival statin drug, Pfizer's Lipitor, showed a benefit for high-risk patients (reducing both LDL cholesterol and the risk of serious heart problems) when given at high doses (also 80 mg). Cardiologists had expected similar findings for the other statin drug but, even though they both reduced LDL cholesterol levels, Zocor "had no difference in heart attacks, death from heart attacks, strokes, or hospital readmissions for heart problems" versus placebo.

Zocor will not doubt remain an effective treatment for the majority of patients at moderate risk for cardiovascular problems. However, while critics lambaste the industry for producing too many "me-too" drugs that have marginal benefits for patients, research is showing that, even in the same class of medications, compounds can have very different effects for different groups of patients.

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ACE Inhibitors Protect the Heart with Dual Action
Wall Street Journal, 9-1-04

Researchers have discovered that ACE (angiotensin converting enzyme) inhibitors not only reduce blood pressure, but also improve the health of artery walls in patients who take them. Scientists have long suspected that the drug's health benefits couldn't be entirely explained by the effects of lowered blood pressure; they have gone on to discover that ACE inhibitors slow the rate of apoptosis, or programmed cell death, in the blood vessel linings of patients with heart disease.

This is critical because as the linings of arteries (called endothelial cells) decay, they become more vulnerable to plaque formation and thus to cardiovascular problems. This study supports the thesis that the growing number of treatments for heart disease from statins to ACE inhibitors and other drugs just coming on market not only offer patients more options, but broadens our understanding of this deadly ailment, the leading cause of death in America.

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HMO To Unveil Plan For Elderly Poor; Colorado Access To Key On Increased Medicare Payments
Rocky Mountain News, 9-1-04

One of the provisions of the Medicare Modernization Act of 2003 increased premium payments for HMOs in an attempt to encourage them to enroll low-income elderly patients who may have costly prior health problems.

At least in Colorado, the plan seems to be having its intended effect. Colorado Access has created "Colorado's first health plan for elderly people with incomes at or below the poverty level." Increased payments are giving HMO's like Colorado Access the financial incentives to find cost-effective ways to treat these patients, and to improve the health of low-income seniors. The Colorado plan includes "a network of 2,000 providers and no co-pays, premiums, or deductibles", and also provides "free annual check-ups, free eyeglasses, $500 worth of dental care and a hearing benefit" for enrolled seniors.

Creating competition between public and private providers, and holding them both accountable for results is one of the goals of Medicare reform advocates. Colorado Access has taken a good first step in that direction.

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