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Anchor lead: Should we be concerned about who’s on a board to examine drug prices? Elizabeth Tracey reports

The state of Maryland has passed a law to form a board to scrutinize pharmaceutical prices and investigate price hikes. Some have criticized this by pointing out that lawmakers aren’t the best experts to take on this task. Jeremy Greene, a physician and drug pricing activist at Johns Hopkins, explains.

Greene: I think most of the people who put forward this legislation would argue that the best possible option would be for the federal government to take strong action in this arena. In the absence of strong federal action to rein in the soaring cost of prescription drug prices the state of Maryland has said we are acting within our proper domains to take action. What the state is appointing is a board that’s a set of experts that are designated entirely by the governor of the state of Maryland.  :31

Greene says this action may prompt other states to follow suit to help rein in drug prices. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Consumption of sugary drinks may increase your cancer risk, Elizabeth Tracey reports

Consumption of sugary drinks, whether those are soft drinks or fruit juices, may up your risk of cancer, a recent study in the British Medical Journal found. William Nelson, director of the Kimmel Cancer Center at Johns Hopkins, says this increased risk may be related to obesity, already known to increase cancer risk.

Nelson: Sugary beverages, there are so many of them now, not just regular soft drinks but there’s energy drinks, and various different fruit juices. In these sugary beverages the ability to get sugar from the beverage into the bloodstream very quickly is critical. These rapid acting ones, this is responsible in great part for the obesity epidemic. I think obesity, sugary beverages and carbohydrate intake are probably reasonably tightly related. The other is the notion that when taken in this way, driving obesity they tend to be somewhat pro-inflammatory.  :33

Nelson says more research is clearly needed to prove a link between sugar consumption and cancer risk. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: Dietary supplements don’t provide much benefit and may not even contain what they say they do, Elizabeth Tracey reports

If you use supplements to improve your health, you may want to spend your money elsewhere. That’s the conclusion of a recent study by Erin Michos, a cardiologist at Johns Hopkins, and colleagues looking at the impact of dietary supplements on cardiovascular health and death, and largely finding no benefit. Michos notes that supplements often do not contain what they are labeled for.

Michos: The problem with the supplement industry is that it’s not regulated by the FDA in the same way. It falls under the umbrella of food, not drugs. And so manufacturers don’t have to prove that they’re safe before they get put on counters, they don’t have to prove that they do the health claim that they put on the label. There’s been many studies where they’ve actually pulled supplements, for example fish oil, off the counter and looked. Many of them contain pharmaceutical ingredients that are not disclosed on the label, they contain not the amount of the compound that they said, so you just don’t know what you’re getting.  :32

At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: If you’re taking dietary supplements you may want to reconsider, Elizabeth Tracey reports

Dietary supplements really aren’t much good in improving health, a study by Erin Michos, a cardiologist at Johns Hopkins, and colleagues has found. The study was published recently in Annals of Internal Medicine.

Michos: The bottom line conclusion for the vast majority of supplements is there’s no benefit, and I think people would be better served really focusing on a nutritious diet, and healthy lifestyle, and that just because something is sold over the counter as a supplement doesn’t necessarily mean that it’s healthy or safe, and in fact there can be some harm. Some of these can have drug/drug interactions with prescription medications, have patients review their supplement use with their health care team to discuss what benefits they’re hoping to derive from them whether it’s really helping them or whether its actually causing harm. :32

Michos says the supplement industry rakes in billions of dollars annually, with this study showing that those dollars would be better spent elsewhere. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: if either of your blood pressure numbers is high, you may be at risk for heart disease, Elizabeth Tracey reports

If either the top number of your blood pressure reading, called systolic, or the bottom number, called diastolic, is high, you’re at increased risk for cardiovascular disease, a recent huge study in the New England Journal of Medicine found. Erin Michos, a cardiologist at Johns Hopkins, says if either or both are elevated, treatment is needed.

Michos: It’s not surprising to me. We know that both systolic and diastolic high blood pressure increase cardiovascular risk. We have targets to be considered hypertension if you’re above either of them, so if you’re above 130 or you’re above 80 diastolic. Stroke risk seems to correlate a little bit more with systolic so we focus on that a little bit more but I have quite a lot of people that have a high diastolic. The vast majority of patients I have with elevated diastolic all tend to be younger men where isolated systolic tends to be older women. :30

Treatment is known to reduce cardiovascular risk, Michos notes. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: A government report finds flaw with some hospices, Elizabeth Tracey reports

Two federal agencies, Health and Human Services and the Centers for Medicare and Medicaid Services, assess hospice services nationally, with recent reports finding some issues. Yet Tom Smith, director of palliative care at Johns Hopkins, says this information is not available to consumers.

Smith: Much of the critique of hospice has been not so much profit versus not for profit but very small hospices tend to be not as good as larger hospices, whether they’re for profit or not. One of the biggest for profit hospices is Seasons, and yet they do more music therapy than anybody else. We really need to publish that data hospice by hospice and give people the opportunities to choose and hospices the opportunity to correct things. :31

Smith says Medicare does have a consumer website called Hospice Compare where such data could be posted. At Johns Hopkins, I’m Elizabeth Tracey.

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Anchor lead: More clinicians need to get involved with palliative care, Elizabeth Tracey reports

Palliative care aims to help people live the best they can with their health challenges, and now new guidelines aim to expand that perspective beyond cancer care. Tom Smith, director of palliative care at Johns Hopkins, says studies support this approach.

Smith: Not so much in refractory lung cancer, it didn’t make that much of a difference, but for people with COPD, pulmonary hypertension, diffuse interstitial fibrosis, there was a substantial improvement in survival, and that’s not cancer. The data are there. :16

Smith says all clinicians can develop a basic palliative care skillset.

Smith: This isn’t rocket science. It’s intervention science if you will, and applying time honored principles of nursing and medicine, asking people what you can help them with and then trying to fix it.  :11

Smith notes that specialists in palliative care are few and have challenges trying to meet the need, so expanding the practice to other clinicians may help. At Johns Hopkins, I’m Elizabeth Tracey.

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