Family inHome Caregiving Blog
There is quite a bit of controversy revolving around a number of new expensive drugs, and whether or not Medicare and private insurance companies should pay for them. Over the past year, of the 27 drugs which were approved by the Food & Drug Administration (FDA), 19 were so-called "specialty drugs" which typically come at a very high price. Novartis, for instance, introduced the first ever oral medication for those suffering from multiple sclerosis in 2010 called Gilenya. Although this was a watershed event at the time, it also set a new high bar for the price of an MS drug at $4,000 per month. However, one lesson that has been learned is that when a drug comes on the market it's often very expensive but as more people start to use it and demand rises, the price drops. Gilenya is now the cheapest drug for MS so Medicare and private insurance companies must consider this price curve when looking at whether or not to approve new drugs. Inevitably, if there is demand, the price will fall dramatically.
Diabetes is a huge problem in America and those dealing it often initially struggle with how to manage their blood glucose level while avoiding severe hypoglycemia. A recent study in JAMA Internal Medicine found that every year about 100,000 people end up in the emergency room because of hypoglycemia, with a third of them having to be hospitalized. This number is too high! One important thing to remember is that friends and family can help. Let those close to you know about your condition because if your blood sugar levels get too low you may pass out, or close to it, and be unable to care for yourself. There's also a bracelet that you can get to let medical staff and others know that you have diabetes. Communication is key to staying healthy and fit.
The extremely slow pace of new treatments for ALS, also known as Lou Gehrig's disease, has caused a local man to start a non-profit biotech organization called SciOpen Resarch Group to try to spur more scientists to pay attention to this rare neuro-degenerative disease. It's an inspiring story as the man is in extremely bad health but calls himself a "biotech guerilla" who searches databases for new compounds, designs study protocols, while also doing fundraising. "His intellect and willingness to contribute to the fight should be an inspiration to all scientists to find a therapy for ALS and all neurodegenerative diseases," Dave Schubert, director of the Salk Institute's Cellular Neurobiology Laboratory, said of the man who was diagnosed with the disease at age 36. He soon found out that there is no cure for amyotrophic lateral sclerosis, and no known cause. Like many who receive a diagnosis of something which is degenerative and there is little hope of recovering from, he found hope in himself to try and seek out new information and in this case took it to the extreme, to try and change the diagnosis for anyone with ALS.
Many towns in Monterey County have a number of restrictions regarding what you can and can not do on your own property. Most rules revolve around water, building more square footage being added (particularly when it can obstruct views) and cutting down trees. The latter is causing quite a bit of stress for an elderly PG couple after the city rejected a bid by 80-year old Gene Olsen to install a wheelchair ramp so that he can get to his car safely. To do so, they would have to remove three trees, which is a no-no in Pacific Grove. "It's a bucket of worms," Olsen told the Carmel Pine Cone, adding that he is considering legal action. "They are creating an extremely dangerous situation," David Davis, his son-in-law, told the Pine Cone. It's not just Olsen who could get injured, but caregivers and home health workers who have to walk across a lawn which is buckled and bulging due to intrusive roots. Utility lines have also been damaged so the city may bear some expense as well. The sad thing is, the Veterans Health Administration came down to install the wheelchair ramp at no charge but because the land was not compliant with the Americans with Disabilities Act they packed up the equipment and left.
Medical costs have been skyrocketing in this country and I am glad to see that law enforcement and Medicare have been vigilant about uncovering major fraud cases. The cases have ranged from small mom and pops to multi-million dollar criminal enterprises. The latest, reported in the Wall Street Journal,,is a clinic in Los Angeles which billed Medicare more than $2 million for a rarely used cardiac treatment. The clinic collected more money from this treatment than any other medical facility in the nation. A clinic and an affiliated lab owned by an internist collected more than $17.5 million from Medicare between 2006 and 2012. The FBI, private insurers and Medicare have all honed in on this clinic and I am sure there will be more written on this case and many others like it.
There was a disturbing story in The Wall Street Journal entitled, "Life lessons from dad." It took up the entire review section, and Dave Shiflett talked about caring for his 91-year old father, who suffered from dementia. Like most children faced with this difficult issue, he took the task seriously and it had a long-lasting impact on how he thought about life. "Even in the sadness of hopeless decline, my parents—members in good standing of the Greatest Generation—had a few things to teach their baby-boomer offspring about toughness, perseverance, quality of life and, especially love. We were reminded, vividly, that we are often at our best when life is at its worst," Shiflett wrote. Caring for someone with Alzheimer's disease is an extremely difficult task and I feel for him. Regular readers of my blog know that both my father and my grandmother had Alzheimer's disease when they passed away. It's a terrible disease for which there is no cure. I am currently raising money for the Alzheimer's Association's annual Walk to End Alzheimer's event. If you can afford to help, please click here.
Criticism has been lobbed at a number of physicians after a report from Medicare came out with a report in April detailing how much the government paid on a doctor-by-doctor basis during 2012. Oncologists were high on the list of the best paid, although many complained the report was unfair because the numbers that were released included chemotherapy treatments which were done at little to no profit. The Wall Street Journal, however, came out with a story last week stating that many cancer doctors were using Procrit, which helps with the side effects of chemo, despite the fact that it's expensive and has recently been found to speed tumor growth and hasten death in those with cancer. One large oncology group was singled out by the Journal for billing Medicare a whopping one-sixth of the total $128 million the agency paid doctors to administer the drug in 2012. Despite the fact that the FDA has warned doctors not to use the drug on chemotherapy patients and to warn patients of the risk of taking the drug, it's being used quite frequently by a handful of medical clinics. It's likely that the Wall Street Journal has, once again, done great journalistic reporting and may have identified a multi-million dollar fraud. I hope that's not the case. Doctors are supposed to be one of the top professionals that we trust in our day to day lives and it's sad when you see them in the headlines accused of fraud.
Most people don't view IBM as a company that's on the cutting edge of creating breakthroughs in new medical treatments. A recent article in Fast Company magazine, however, pointed out that the company is trying to reinvent itself with nanotechnology, using hardware in order to solve a wide range of medical programs. The company is working on creating better antimicrobial and antifungal agents, new methods of drug delivery and novel ways of combating diseases ranging from HIV to tuberculosis. IBM has devoted a huge amount of resources into experimental nanomedicine. This company has such a massive amount of resources that it's bound to make cutting edge discoveries in a number of arenas. After many stumbles, it's great to see IBM reinventing itself in a sector with such great potential.
There haven't been a lot of advancements in the treatment of diabetes over the last few years, but there appear to be several workable theories on how the treatment of this widespread disease will become much easier over the next five years. Two small studies were released this month at the meeting of the American Diabetes Association in San Francisco which implied that patients with Type 1 diabetes might be able to control their blood sugar levels using a new insulin pump system. It's controlled by an algorithm in a smartphone which determines the timing of injections. Although small, both studies were published in the widely respected New England Journal of Medicine and were conducted by Boston University, the Massachusetts General Hospital, and both were funded by the National Institutes of Health. Although a commercial roll-out is probably a couple of years away, independent experts have said that these studies provide a solid proof-of-concept which could speed up approval by the FDA of such a device. Type 1 Diabetes is typically diagnosed in childhood and impacts about 1.5 to 2.0 million Americans, which have to deal with the disease their entire lives. "What we're providing is a smart pump that overtakes your diabetes management completely," Dr. Edward Damiano, told the Wall Street Journal.
There are amazing advancers in cancer treatment which are being announced almost on a daily basis. Many experimental drugs are being developed based on DNA research and so-called personalized medicine. Now, a former Google employee has formed a start-up called Flatiron Health. It is making use of a vast amount of information about those without the disease which isn't currently being exploited. The company is taking advantage of the time gap between when clinical trials are conducted and information is reported in medical journals. Many cancer centers are now contributing information about actual cases with the names taken out of the file, and the company has built its database into a massive amount of information, with case studies on 550,000 patients. Google Ventures has just made its biggest investment ever in a start-up, $130 million in Flatiron Health, so they obviously have high expectations for this line of business. I hope this type of anonymous sharing of information becomes more widespread in the medical community, particularly regarding patients with rare types of cancer where there isn't much data out there to show physicians how to treat the disease.