House OKs prescription drug imports
Fri, 03 Aug 2007 11:49:28 GMTBy ANDREW TAYLOR, Associated Press Writer
WASHINGTON - The House passed legislation Thursday effectively permitting the importation of lower-cost prescription drugs from places such as Canada, Australia and Europe.
The move came as lawmakers passed a $91 billion spending measure funding farm subsidies and nutrition programs for the budget year beginning Oct. 1.
The bill, passed by a 237-18 vote, faces a promised veto from President Bush over its price tag, and the administration also opposes the drug importation provision.
The sprawling measure is the final domestic spending bill to pass the House. It contains almost $1 billion more than requested by Bush. But the overall measure is more than $10 billion below comparable costs for the current budget year because it does not contain farm disaster aid and reflects lower crop subsidy costs due to the good farm economy.
The administration "strongly opposes" the drug provision, which would effectively permit individuals, wholesalers and pharmacists to import lower cost U.S.-made and FDA-approved prescription drugs from Canada and other countries.
The White House says there is no system in place to protect consumers from counterfeit or unsafe drugs, but an administration policy statement stops short of an outright veto threat.
"I understand the intention to lower drug prices to the seniors, that is critically important," said Rep. Mike Rogers, R-Mich. "What we're doing is throwing open the gates to every counterfeiter in the world."
A move supported by drug companies to strike the drug importation provisions from the bill was defeated 283-146.
Supporters of the idea say it would save consumers great sums by allowing them to purchase U.S.-made medications from other countries where they often sell for much lower prices than in the U.S. Under current law, consumers are permitted to buy a 90-day supply in Canada.
Overseas, drugs can cost two-thirds less than they do in the United States, where prices for brand-name drugs are among the highest in the world. In many industrialized countries, prices are lower because they are either controlled or partially controlled by government regulation.
"I would prefer to stand up for my constituents in Missouri as opposed to the pharmaceutical companies keeping competition and low prices out of this country," said Rep. Jo Ann Emerson, R-Mo.
Similar drug importation language has passed the House in recent years but has been forced out by GOP leaders and the White House during House-Senate negotiations.
On spending matters, the measure funds both mandatory programs such as farm subsidies — whose budgets are set according to eligibility criteria — as well as discretionary funding set by lawmakers each year.
The Women, Infants and Children program, which provides food aid to pregnant women and children, would receive $233 million, or 4 percent, more than requested by Bush.
The bill also finances farm subsidies and loan programs, whose costs have gone way down because of high commodity prices. The Commodity Credit Corp. would receive $13 billion, a $10 billion cut from current levels.
The measure also seeks to block the practice of slaughtering horses for human consumption by making it illegal to transport or export horse for that purpose. The House last year passed a bill banning horse slaughter for human consumption, but the Senate failed to act.
Tensions flared late in the debate as the House voted on a GOP motion to require a further amendment to the measure ensuring that illegal immigrants would not benefit from any programs funded by the bill. Rep. Rosa DeLauro, D-Conn., insisted illegal immigrants weren't eligible anyway.
The vote was close as almost 20 swing district Democrats initially supported the idea.
Just as Rep. Michael McNulty, D-N.Y., gaveled the vote to a close and said the GOP motion failed on a 214-214 tie, the tally board inside the chamber read that it had passed by a 215-213 vote. After final switches by Democrats, the tally moved back in their column.
Republicans cried "Shame, shame, shame," and Majority Leader Steny Hoyer, D-Md., moved for a revote.
Senate OKs wider kids health program
Fri, 03 Aug 2007 08:11:25 GMTBy JULIE HIRSCHFELD DAVIS, Associated Press Writer
WASHINGTON - The Senate passed legislation Thursday to add 3 million lower-income children to a popular health insurance program in bipartisan defiance of President Bush's threatened veto.
The 68-31 vote, one day after the House passed a more ambitious and expensive version over bitter Republican opposition, handed Democrats a solid achievement to trumpet as they leave Washington for a summer break.
It also gave Democrats, who secured a veto-proof margin, a chance to draw a stark distinction between their priorities and Bush's on an issue that resonates with voters.
"For the life of me, I can't understand why the president would want to veto this legislation," said Sen. Max Baucus, D-Mont., the Finance Committee chairman. "It's moderate, it's bipartisan, it helps low-income kids. ... It's just the right thing to do for the country."
Bush has proposed spending $5 billion to extend the State Children's Health Insurance Program. He says the Senate's $35 billion expansion would balloon the decade-old program beyond its original mission of covering working poor children and would move more people toward government-run health care.
The program expires Sept. 30.
The Senate measure now must be reconciled with the House-passed $50 billion expansion, which was paid for partly by cutting government payments to Medicare health maintenance organizations.
Both bills include hefty tax increases on tobacco products to pay for the spending increase.
Architects of the legislation "have seized the reauthorization of SCHIP as a license to raise taxes, increase spending and take a giant leap forward into the land of government-run health care," said Sen. Mitch McConnell, R-Ky., the minority leader.
He was one of 31 Republicans to oppose the measure, while 18 Republicans joined 48 Democrats and two independents to support it.
The health program is designed to subsidize the cost of insurance for children whose families earn too much to participate in Medicaid, but not enough to afford private health insurance.
Through federal waivers, the program has expanded in many states to include middle-income children and adults. That has led Republicans to argue that it has become a backdoor way to extend government-provided health care to an increasing number of people.
National polls show overwhelming majorities of voters support expanding the children's health program and are more likely to support candidates who back it.
Simple method detects cervical cancer
Thu, 02 Aug 2007 23:24:38 GMTBy MARIA CHENG, AP Medical Writer
LONDON - A cheap method to detect cervical cancer using vinegar, cotton gauze and a bright light could save millions of women in the developing world, experts reported Friday.
The study, published in The Lancet medical journal, found a simple visual screening test to look for the early signs of cervical cancer reduced the numbers of cases by a quarter.
"This is a landmark study," said Dr. Harshad Sanghvi, medical director at JHPIEGO, an international health organization affiliated with Johns Hopkins University that has worked on preventing cervical cancer in poor countries. Sanghvi was unconnected to the Lancet study.
Cervical cancer is largely preventable. It causes about 250,000 deaths every year and is the second-most common cancer in women. Nearly 80 percent of those women are in the developing world.
The visual screening test is done by a nurse or trained health care worker who washes a woman's cervix with vinegar and gauze using a speculum to hold it open. After one minute, any pre-cancerous lesions turn very white and can be seen with the naked eye under a halogen lamp.
Researchers from the International Agency for Research on Cancer in France and their colleagues from Tamil Nadu in India used the technique to screen 49,311 women in Dindigul district, India, from 2000 to 2003. When pre-cancerous lesions were found, health care workers gave immediate treatment to destroy the abnormal cervical tissue.
Another 30,958 women received standard care. They were told to watch for signs and symptoms of cervical cancer and encouraged to visit health care facilities where screening was available. These women were tracked from 2000 to 2006.
There were 167 cases and 83 cervical cancer deaths in the women who received the screening, compared with 158 cases and 92 deaths in those who didn't. That represents 25 percent less cervical cancer and a 35 percent lower death rate among those screened.
All of the women in the study were healthy and between 30 and 59 years old when the study began. The research was funded by the Bill & Melinda Gates Foundation.
Previous research has shown visual screening is almost as effective in catching cancer as Pap smears, a more expensive technique used in the West, which involves scraping cells from the cervix to be examined under a microscope in a laboratory.
"This is the final proof that with an extremely simple test, we can have a dramatic impact on cervical cancer rates," Sanghvi said.
Experts think that the simple, inexpensive technique could be rolled out across the developing world relatively easily. Pilot projects are already under way in a handful of countries in Asia and Africa.
"This study has given us a road map of how we can deliver this kind of screening widely," said Dr. David Kerr, Rhodes Professor of Clinical Pharmacology and Cancer Therapeutics at Oxford University. Kerr was not involved in the study.
Still, the test isn't perfect. It can produce many false positives, so health care workers giving the test must be properly trained. Also, the test cannot be used in post-menopausal women or in women who have had more than two or three children, since pre-cancerous lesions in those women develop in parts of the cervix not normally visible.
But other tests, like Pap smears or those to detect the human papillomavirus, or HPV, which can cause cervical cancer, are too expensive for poor countries to adopt. "The visual screening approach is within our grasp," Sanghvi said. "Visual inspection won't have as dramatic an impact as the sophisticated tests, but will have 70 percent of the impact for a minuscule cost."
Officials are already working on a cheaper version of the cervical cancer vaccine, which currently costs about $360 per dose, for the developing world. Together with stepped-up screening, doctors think that cervical cancer might one day be wiped out as a major health problem.
Moms too quick to reach for baby bottle
Thu, 02 Aug 2007 18:25:54 GMTBy MIKE STOBBE, AP Medical Writer
ATLANTA - Nearly three-quarters of new mothers in the United States are breast-feeding their babies, but they are quitting too soon and resorting to infant formula too often, federal health officials said Thursday.
A government survey found that only about 30 percent of new moms are feeding their babies breast milk alone three months after birth. At six months, only 11 percent are breast-feeding exclusively.
Formula isn't as good at protecting babies against diseases, eczema and childhood obesity. Ideally, nearly all mothers should breast-feed their babies for six months or more, said Dr. David Paige, a Johns Hopkins University reproductive health expert.
But many do not because of their jobs, the inconvenience, and perhaps because of convincing advertising for baby formula.
What's wrong with giving a baby a bottle every once in a while? Not much, except it can begin a pattern as a child sucks at the breast less, causing less stimulation needed to produce milk, Paige said.
"It creates a downward spiral," he said, adding that often, a woman then moves away from breast-feeding altogether.
The annual random-digit-dial survey by the Centers for Disease Control and Prevention showed that the percentage of women who start breast-feeding rose slightly from 2000 to 2004, from 71 percent to 74 percent. That's a new high, CDC officials said, and is based on nearly 17,000 responses.
A previous survey suggested a higher percentage breast-fed exclusively — 39 percent at three months and 14 percent at six months. However, researchers think there may have been confusion in that earlier survey that led to the higher percentage.
The new results are being called the best national data to date on "exclusive breast-feeding," in which mothers give their infants nothing but breast milk except for vitamin drops.
The CDC study found that rates of exclusive breast-feeding were lowest among black women and among those who are unmarried, poor, rural, younger than 20, and have a high school education or less. Those findings are consistent with earlier studies.
This year, the government announced goals for 2010: getting 60 percent of women to breast-feed exclusively for the first three months and 25 percent through six months.
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On the Net:
Breast-feeding survey in CDC's Morbidity and Mortality Weekly Report:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5630a2.htm
Fatburning defect in liver may cause obesity
Fri, 03 Aug 2007 19:26:21 GMTBy Anne Harding
NEW YORK - Rats with a genetic predisposition to burn fat more slowly tend to put on weight more readily than rodents bred to resist becoming obese, a new study shows.
The findings could help explain why some people get fat more readily than others, Dr. Mark I. Friedman of the Monell Chemical Senses Center in Philadelphia, one of the study's authors, told Reuters Health.
Just like the animals in the study, he explained, it may be harder for obesity-prone people to use energy from the fats they eat -- as well as to burn fat from their own bodies -- forcing them to overeat to get enough energy. Essentially, Friedman said, &;they overeat because they're getting fat.&;
Previous studies in people have found that individuals who burn fat slowly are more likely to subsequently gain weight, Friedman and his colleague Dr. Hong Ji note in the current issue of the journal Metabolism: Clinical and Experimental. To determine if impaired fat oxidation might be involved in the development of obesity, the researchers fed a low-fat diet to rats bred to either be susceptible or resistant to obesity, and then switched them to a high-fat diet.
No weight difference developed between the two groups of rats while they were eating a low-fat diet, the researchers found. However, the obesity-prone rats showed a 35-percent lower rate of fatty acid oxidation. And after the animals were switched to a higher fat diet, the obesity-prone rats gained 36 percent more weight than the obesity-resistant rats, even though they consumed just 14 percent more calories.
The obesity-prone rats also showed reduced expression of genes involved in transporting fatty acids to the liver cells and burning them to make energy.
The findings imply that impairment of fatty acid oxidation may contribute to obesity in humans, Ji and Friedman conclude.
While fat metabolism may be at fault, Friedman added, people who want to control their weight should be paying attention to carbs, too. &;As far as diet recommendations go, I personally would not pin it all on the fat. I would say that it really depends on a mix of fat and carbohydrates.&;
Friedman and his colleagues are now looking into the enzymes involved in fatty acid oxidation and how their function might be altered in obesity-prone rats, which could provide an approach to treating or preventing obesity in humans.
SOURCE: Metabolism: Clinical and Experimental, August 2007.
Kazakhstan appeals court upholds prison terms in AIDS case
Fri, 03 Aug 2007 16:50:39 GMTSHYMKENT, Kazakhstan - An appeals court in Kazakhstan Friday upheld prison sentences for 21 people convicted after 118 children and 14 mothers were infected with HIV in public hopsitals and nine deaths.
But the court said four of the women would only begin serving their sentences once their children turned 14 years old.
Two of them would start their jail terms in 2018, another in 2014 and the last, who is currently eight months pregnant, would only start her sentence in 2021.
The heaviest sentence passed by the court in Shymkent at the end of June was eight years in jail for three of the defendants.
The scandal shocked the oil-rich Central Asian country and revealed alarming corruption in hospitals, leading to the firing of the health minister.
Three paediatricians at the hospitals where the infections occurred got eight-year sentences and 14 others were given jail terms ranging between nine months and seven and a half years.
Four of the accused, including the former head of the regional health ministry, Nursulu Tasmagambetova, were given suspended sentences.
Most of those infected with the virus, which can lead to AIDS, fell victim during blood transfusions, often involving unsterilised medical equipment, the prosecution said.
Hospitals were also found selling equipment meant for single-use only, including needles for syringes, obliging doctors to employ used and badly-sterilised needles.
