The field of longevity research is running high on optimism these days. “Life expectancy is lengthening almost linearly in most developed countries, with no sign of deceleration,” say the authors of the recent Lancet article “Ageing Populations: the challenges ahead.”  They add, “Continued progress in the longest-living populations suggests that we are not close to a limit" for age.

Life expectancy is increasing in all developed countries; reaching 82.1 years in Japan, 81 years in France and 78.1 in the U.S. In total, during the twentieth century, life expectancy increased by a remarkable 30 years or more in Western Europe, the USA, Canada, Australia, and Japan. And there is no sign that this trend is slowing.

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Are we finally ready to close the door on the much-disputed link between the MMR vaccine and autism?

On January 30, Britain’s General Medical Council ruled that Andrew Wakefield, a gastroenterologist, had acted “dishonestly and irresponsibly” in conducting his research that established a link between autism and the MMR vaccine. And yesterday, the British medical journal Lancet finally retracted the resulting 1998 study authored by Wakefield that helped drive MMR vaccination rates in the U.K. down to the point where in 2008, measles was officially declared “endemic” in the country.

The Lancet’s editor, Richard Horton, told The Guardian "It was utterly clear, without any ambiguity at all, that the statements in the paper were utterly false," he said. "I feel I was deceived."

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Health reform may be stalled in Congress, but you need only look to the overburdened Medicaid program to find evidence of the continued toll the current economic crisis is taking on Americans’ ability to afford and access medical care.

At the same time that states are experiencing huge budget deficits, more and more of their residents are unemployed; more and more are joining the ranks of the uninsured and clamoring for Medicaid benefits. The result: Even with emergency federal infusions of funding, state safety nets are being stretched dangerously thin.

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Just in case you were wondering what the public thinks about the recent upheaval over health care reform, a USA TODAY/Gallup Poll taken Wednesday finds some 55% of Americans say President Obama and congressional Democrats should suspend work on the health care bill that was this close to being passed and consider alternatives that would draw more Republican support.

What might these alternatives be? Besides attacking every major Democratic version of reform, the Republicans have been fairly quiet about their own grand vision for the future of health care. Still, there is a vision. At the end of July, the Republican Study Committee, led by Rep. Tom Price (R-GA) (an orthopedic surgeon) introduced the “Empowering Patients First Act” (H.R. 3400) as their contribution to the debate.

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The value of using antidepressants to treat mild to moderate depression came under fire recently after a study in the Journal of the American Medical Association found that the drugs didn’t work much better than a placebo in those with mild to moderate depression. These findings were widely reported because with 164 million prescriptions written and $10 billion in sales in 2008, according to IMS Health, these antidepressants (called SSRIs) were the third most popular class of therapeutics sold in the U.S.

Companies are promoting an ever-increasing arsenal of SSRI’s and a whole new class of drugs—the atypical antipsychotics—for treating depression and other mental disorders. But despite their widespread use, the JAMA study adds to an emerging body of research that raises more questions than it answers about the safety and efficacy of using current drugs in treating moderate or mild depression. Though sometimes extremely helpful, it has becoming increasingly clear that these drugs are no panacea for many patients, and may even cause harm.

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Recently, a series of anecdotes appeared on the website People’s Pharmacy, posted by readers who suffer from depression. They detail how switching from name brand antidepressants to generics—or in some cases from one generic to another—caused a return in symptoms. Here’s one excerpt:

“I've been on the big yellow 300 mg Buproprion XL for about 6 months and my last refill was filled with Actavis (smaller white ones). While the old ones…made me feel great, I've been doing poorly on Actavis…I certainly feel more unmotivated, lethargic, and sadder.”

People’s Pharmacy isn’t connected to the Food and Drug Administration, a medical center or a mental health or other professional group. Joe Graedon, the site's founder is a consumer advocate and writer, not a health professional. But nevertheless, the New York Times prominently quotes him and includes similar anecdotes in a recent article that questions whether generic drugs are as effective as their name-brand counterparts.

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There is much to be hammered out before a final health reform bill emerges from Congress. Disputes over the public plan, abortion, financing and when reforms will actually take effect continue to delay progress. But on one thing, apparently, there is broad consensus: Nearly everyone supports prevention. In fact, a recent poll found that 71% of Americans favor increased investment in disease prevention and believe it will save money in the long run.

Prevention is a broad concept, encompassing everything from flu shots to prostate screening to smoking bans to confronting racism. And just because Americans say they favor increasing funding for “prevention” does not mean they all envision the same approach. Some personal-responsibility advocates, for example, throw their support behind pay-to-play prevention efforts—like increasing insurance premiums for people who smoke or are overweight. Others, like Senator Barbara Mikulski, believe the most important investment in prevention is to guarantee access to routine screening tests—mammography, Pap smears and colonoscopies—even if evidence suggests this may not always be the case.

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Women have a lot at stake in the debate over health care reform. Some seven in ten women are either uninsured or underinsured, and more than half report forgoing care or preventive visits because they can’t afford it. Meanwhile, insurance companies can charge women more for coverage, and can exclude them from plans because of “pre-existing conditions” like pregnancy or being victims of domestic abuse. Finally, women facing cancer or other serious illnesses are far more likely to suffer financial collapse when faced with benefit caps and high out-of-pocket spending limits.

This state of affairs is unacceptable and achieving affordable, comprehensive and accessible care for all Americans should be the goal of any final health reform bill. Both the House and Senate bills would end gender rating (the practice of charging higher premiums for women) in the individual and small business markets. Both bills also would end the practice of denying coverage because of pre-existing conditions and would set minimum benefit standards that ensure access to primary care and preventive services. Finally, the two versions both cap out-of-pocket spending and get rid of lifetime or annual benefit limits.

Yet, despite these important initiatives, controversy over women’s health issues remains strong in the reform debate—even among Democrats and traditional women’s advocates.

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If an expensive, name-brand cholesterol drug costs four times more than a generic but provides no clear clinical benefit, why do insurers—both public and private—continue to pay for it? The answer, in the case of Vytorin, a combination of two drugs designed to lower LDL or bad cholesterol, is that the influence of big Pharma in maintaining the status quo—even when unsupported by evidence—remains a formidable barrier. By suppressing negative studies, relentlessly pursuing positive trial results, and paying academic researchers to promote their therapy, Merck Schering-Plough has managed to hold onto a $4.6 billion market for a drug that has never been proven to be better than cheaper generics in preventing heart attacks or death.

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The new recommendation from the U.S. Preventative Services Task Force that women under 50 should not undergo routine mammography is generating a lot of controversy—it is a direct challenge to the strong message women have been receiving for two decades that they should have yearly screening starting at age 40. The task force also recommends that women age 50-74 have a mammogram every two years (rather than yearly) and finds that there is little benefit in screening women over 74 at all.

To the experts who have been questioning the benefits of mammography for several years, these recommendations are no surprise—and they are welcome. The World Health Organization, and many European countries where the government pays for routine mammography screening, already follow these guidelines. But how is this news playing in Peoria?

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