The Federal Trade Commission on Tuesday sent warning letters to 10 drugmakers, taking issue with patents on popular drugs for weight loss, diabetes, asthma and other respiratory conditions. The letters allege that certain patents filed by Novo Nordisk, GlaxoSmithKline, AstraZeneca and seven other companies are inaccurate or misleading.

Brand-name drugmakers use patents to protect their medicines and stave off cheaper, generic medicines. Most blockbuster drugs are protected by dozens of patents covering various ingredients, manufacturing processes and intellectual property. Generic drugmakers can only launch their own cheaper versions if the patents have expired or are successfully challenged in court.

“By filing bogus patent listings, pharma companies block competition and inflate the cost of prescription drugs, forcing Americans to pay sky-high prices for medicines they rely on,” said FTC Chair Lina Khan, in a statement.

Ozempic is part of a class of drugs that were originally developed to treat diabetes but which have recently been approved to treat obesity, generating a surge in prescribing. Medicare spending on the drugs has also spiked in recent years.

The drug’s manufacturer, Novo Nordisk, declined to comment.

FTC’s latest announcement follows a similar action in September when regulators challenged more than 100 patents held by drugmakers, including Abbvie, AstraZeneca and Boehringer Ingelheim.

Companies receiving the letters have 30 days to withdraw or update their patent listings, or “certify under penalty of perjury” that they are legitimate, according to the FTC. The patents are registered with the Food and Drug Administration, which reviews and approves new drugs.

The patent challenges are part of a strategy by President Joe Biden to bring down drug prices, including allowing Medicare to negotiate with drugmakers and permitting states like Florida to import cheaper drugs from other countries.

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“I thought I didn’t have any, but I do,” Patricia Adams said. “I found a few and I am going to drive up there and I’m going to have those disposed of.”

Drug Take Back Day offers a chance for you to safely dispose of drugs you no longer need or that are expired — and it’s also an opportunity to help curb the opioid epidemic that’s claimed so many lives.

Adams, a retired social worker, knows firsthand about the dangers of having prescription medications in the home. Awhile back, her young 3- and 5-year-old nieces were visiting.

“And they came downstairs and said to me, ‘Oh, I have candy.’ And I thought, ‘I don’t have candy upstairs.’ And I said, ‘Let me see.’ And of course, it was a pill,” she said.

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Adams shared her story with Jean Moise of D.C.’s Department of Behavioral Health, who is helping to raise awareness about Drug Take Back Day.

“We have an opioid crisis out there right now,” Moise said. “This is one of our main harm reduction strategies. We want to make sure we get the drugs out of the home and out of the hands of youth and children or people that might be inclined to misuse them.”

Last year, on the 25th anniversary of Drug Take Back Day, nearly 600,000 pounds of drugs were collected across the country. In this region, that included:

• In Washington, D.C.: 602 pounds
• Delaware: 4,073 pounds
• Maryland: 10,599 pounds
• Virginia: 16,454
• West Virginia: 4,326 pounds

Adams is urging all her friends and neighbors to check their medicine cabinets like she did.

“Take the opportunity like I am,” she said. “Pay attention, because no matter who’s in your home, no matter how they are loved, you know, we know some of our family have addiction problems, and just pay attention and pass the word on so that they can participate.”

You can drop of any types of pills or liquid medications during Drug Take Back Day. You won’t be asked for ID. There are thousands of dropoff locations across the country Saturday in every state, with 17 locations in D.C.

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He promotes a $35 price cap for the medication for Americans on Medicare — in White House speeches, campaign stops and even at non-health care events around the country. His reelection team has flooded swing-state airwaves with ads mentioning it, in English and Spanish.

All that would seemingly add up to a sweeping political and economic impact. The reality is more complicated.

As his campaign tries to emphasize what it sees as an advantage over presumptive Republican nominee Donald Trump, Biden often overstates what those people who are eligible for the price cap once paid for insulin. It’s also not clear whether the number of Americans being helped will be enough to help sway November’s election, even in the most closely contested states that could come down to a few thousand votes.

“It is about political signaling in a campaign much more than it is about demonstrating for people that they benefit from the insulin cap,” said Drew Altman, president and CEO of KFF, a nonprofit that researches health care issues. “It is a way to make concrete the fact that you are the health care candidate.”

Many who are benefiting from the price cap were already getting insulin at reduced prices, were already Biden supporters, or both. Others who need reduced-price insulin, meanwhile, cannot get it because they do not have Medicare or private health insurance.

Biden’s campaign is emphasizing the president’s successful efforts to reduce insulin prices and contrasting that with Trump, who first ran for president promising to lower drug prices but took limited action in office.

“It’s a powerful and tangible contrast,” said Biden campaign spokesman Charles Lutvak. “And it’s one we are campaigning on early, aggressively, and across our coalition.”

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Roughly 8.4 million people in the United States control their blood sugar levels with insulin, and more than 1 million have Type 1 diabetes and could die without regular access to it. The White House says nearly 4 million older people qualify for the new, lower price.

The price cap for Medicare recipients was part of the Inflation Reduction Act, which originally sought to cap insulin at $35 for all those with health insurance. When it passed in 2022, it was scaled back by congressional Republicans to apply only to older adults.

The Biden administration has also announced agreements with drugmakers Sanofi, Novo Nordisk and Eli Lilly, to cap insulin co-payments at $35 for those with private insurance. They account for more than 90% of the U.S. insulin market.

But Biden says constantly that many people used to pay up to $400 monthly, which is an overstatement. A Department of Health and Human Services study released in December 2022 found that people with diabetes who were enrolled in Medicare or had private insurance paid an average of $452 annually, not monthly.

The high prices the president cites mostly affected people without health insurance. But the rates of the uninsured have fallen to record lows because of the Obama administration’s signature health care law and the Biden White House’s aggressive efforts to ensure those eligible to enroll are doing so more frequently.

So, in effect, one of the administration’s policy initiatives is undermining the economic argument for another.

That effort has not reached everyone, though.

Yanet Martinez who lives in Phoenix and supports Biden. She does not work or have health insurance, but gets insulin for around $16 per month thanks to steep discounts at her local clinic.

The lower prices only apply if her husband, a landscaper, does not make enough to exceed the monthly income limit. If he does, her insulin can jump to $500-plus, she said.

“I’ve heard people talk about the price of insulin going down. I’ve not seen it,” said Martinez, 42. “It should be uniform. There are a lot of people who don’t have any way to afford it and it makes things very difficult.”

Sen. Raphael Warnock, D-Ga., is sponsoring bipartisan legislation to make the $35 insulin cap universal, even for people without health insurance. In the meantime, he said, what’s been accomplished with Medicare recipients and drugmakers agreeing to reduce their prices is “literally saving lives and saving people money.”

“This is good policy because it centers the people rather than the politics,” Warnock said. He said that as he travels Georgia, a pivotal swing state in November, people say “thank you for doing this for me, or for someone in my family.”

That includes people like Tommy Marshall, a 56-year-old financial services consultant in Atlanta, who has health insurance. He was diagnosed with Type 1 diabetes at age 45 and injects fast-acting insulin several times daily. He paid about $250 for four weeks to eight weeks worth of medication last November, but saw the price fall by half in February, after Novo Nordisk agreed to cut prices.

“If I was his political consultant, I’d be telling (Biden) to talk about it constantly,” said Marshall, a lifelong Democrat and longtime public advocate for cutting insulin prices, including for the advocacy group Protect Our Care Georgia.

Marshall said the price caps “have meaningful emotional resonance” and could sway a close election but also conceded, “You’re talking about 18- to 65-year-olds. I can just imagine there’s probably two or three other issues that are in front of this one.”

“Maybe someone sort of on-the-fence, he added “this could maybe sway them.”

Geoff Garin, a pollster for Biden’s reelection campaign, said the insulin cap is one of the president’s highest performing issues. He said the data was “clear, consistent and overwhelming.”

Rich Fiesta, executive director of the Alliance for Retired Americans, which has endorsed Biden, called the insulin cap a strong issue for the president among older voters.

“For the persuadables — and there are some still out there, believe it or not — drug costs are a very important factor,” said Fiesta, whose group has 4.4-million members and advocates for health and economic security for older people.

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Trump’s campaign did not respond to questions. But Theo Merkel, senior fellow at the conservative Paragon Health Institute, countered that the insulin price cut an example of “policies written to fit the talking points other than the other way around.”

Merkel, who was a Trump White House adviser on health policy, said manufacturers that have long made insulin prefer caps on how much the insured pay because it gives them more leverage to secure higher prices from insurance companies.

The president’s approval ratings on health care are among his highest on a range of issues, but still only 42% of U.S. adults approve of Biden’s handling of health care while 55% disapprove, according to a February poll from The Associated Press and the NORC Center for Public Affairs Research.

KFF found in its own poll in December that that 59% of U.S. adults trust the Democratic Party to do a better job addressing health care affordability issues compared to 39% for Republicans, even if only 26% of respondents in the same poll said they knew about the insulin price cap.

“In political terms, the Democrats and Biden have an advantage on health care,” Altman said. “They’re pressing it.”

“Your health is one of your most important assets, and it should be prioritized in a way that makes you feel comfortable,” says Dr. LaTasha Seliby Perkins who is a family physician at Georgetown University.

There are some pretty straightforward ways to determine if you should stick with your current care provider or start searching for a new one.

Here are three signs that Seliby Perkins says means you should consider switching your doctor.

3 signs that it’s time to break up with your doctor

1. Your doctor isn’t asking the right questions: When you come to your doctor with a health concern and they don’t inquire about your symptoms or ask for further information, that’s not a good sign, Seliby Perkins says.
2. You don’t feel heard: “You should feel that your doctor is listening to you,” she says. “At the end of the day, you [should] feel heard. Feeling heard is very important.”
3. You’re receiving treatment for a curable diagnosis but aren’t getting better: It can be a red flag if “you’ve gotten a diagnosis that sounds right, and you’re treating it but it’s not getting better,” Seliby Perkins says. Sometimes it’s a matter of getting a second opinion or seeing a specialist, but your doctor should support you in that process.

How can you find the right doctor for you?

If you’re experiencing any of the above signs, then it’s probably time for you to get a new doctor. Here’s how you should go about the process, according to Seliby Perkins:

• Learn what your insurance is and see if the doctors you’re considering accept it
• Inquire about if the doctor you’re eying is in your network
• Ask your primary care doctor for recommendations if you’re looking for a specialist
• Look into the doctors’ online ratings and reviews
• Research where their clinics are to be sure you’re choosing a physician who’s a convenient distance from you
• Find out if they offer telemedicine appointments if that’s a need
• Think about if having a doctor that looks like you (based on gender, race or other factors) matters

“Once those boxes are checked, go to your first appointment, meet them and make sure that it’s a good fit for you,” she says.

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But a sweeping ruling in Alabama over frozen embryos could affect the future of IVF throughout the nation. That ruling says that frozen embryos are people, and those who destroy them can be held liable.

When Anistie Held was diagnosed with stage 3 breast cancer, doctors told her she needed chemo to save her life — but the treatment would also make her unable to conceive. The American Cancer Society says certain surgeries and treatments can cause infertility in about two-thirds of all young patients.

“I always wanted to be a mom,” said Held, who now lives in Springfield, Virginia. “I wanted to have multiple kids. And cancer took that away from me, initially, I thought.”

Living in Florida at the time, Held froze her eggs at a nearby clinic in Alabama. She and her then-fiancée had to cancel their wedding plans to afford it. They eloped on the beach instead.

This all happened as she prepared to start chemo and battle cancer.

“It is the most traumatizing thing a person can go through, and I’m sure other cancer patients can understand,” she said.

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‘The chilling effect of this decision’

Held has now finished treatment and is cancer free. She and her husband moved to Northern Virginia after Roe vs. Wade was overturned.

“We heard about that news. I was like, ‘IVF is gonna be next; I just know it,'” she said.

In the wake of the Alabama ruling, several fertility clinics there have already paused IVF treatments. The clinic where Held went is among them.

“They said they paused all their IVF treatments. So I’m so glad that I did decide to move, but I know that other people aren’t as lucky to do so,” she said. “So my heart breaks for them.”

But Held faces another challenge: getting her eggs out of Alabama. She’s trying to hire a service to help.

“I’m an IVF baby as well, so it’s passionate for me. My parents tried so hard to have me, and they explained that to me every day of my life,” she said.

If Held is able to get her eggs, she and her husband hope to start IVF later this year.

The American Cancer Society issued a statement about the Alabama ruling, saying it’s “concerned about the chilling effect of this decision on access to care and fertility services for cancer patients.”

The U.S. Food and Drug Administration said in a notice published last week that Azurity Pharmaceuticals is recalling one lot of Zenzedi 30-milligram dextroamphetamine sulfate tablets.

The move comes after a pharmacist in Nebraska found carbinoxamine maleate tablets, an antihistamine drug, inside a bottle of Zenzedi tablets. 

Zenzedi is a stimulant prescription medicine often used to treat ADHD and narcolepsy by increasing attention and decreasing impulsiveness, according to the National Institute of Health. Carbinoxamine maleate has sedative and drying properties, and is often used to treat seasonal allergies, meaning the two drugs have opposing reactions. 

“Patients who take carbinoxamine instead of Zenzedi will experience undertreatment of their symptoms, which may result in functional impairment and an increased risk of accidents or injury,” the FDA said.

Adverse effects include drowsiness, sleepiness and other serious conditions including thyroid disorder.

The recalled medication has a lot number F230169A with an expiration date of June 2025. It was shipped to wholesales nationwide between Aug. 23 and Nov. 29, 2023.

The impacted tablets are light yellow and have a hexagonal shape with “30” embossed on one side and “MIA” embossed on the other. They come in a white bottle with black lettering. Carbinomaxine Maleate tablets have “GL” imprinted on one side and “211” on the other. 

Massachusetts-based Azurity said it has not received any reports of adverse events related to the mishap.

According to the FDA, consumers should contact their doctor or healthcare provider if they’ve experienced any problems related to taking the recalled medication. Any adverse reactions could also be reported to Azurity by emailing aereports@azurity.com. 

Local hospitals have seen so many cases that, as of Friday, a major health system is bringing back mandatory masking in its Maryland facilities.

Johns Hopkins Medicine is once again requiring patients, visitors and employees to wear masks in its buildings, according to an email sent to patients.

“It’s not surprising that we have to go back to wearing masks in the hospitals, because so many people are sick,” said Dr. Elena Rios, President and CEO of the National Hispanic Medical Association.

According to Rios, the new, more contagious JN.1 variant of COVID-19 is keeping healthcare professionals on their toes and hospital beds full.

But it’s not just COVID that’s causing concern.

“What’s being called a trifecta of, not only COVID-19, but influenza and RSV,” Rios said. “And it’s increased so much that there’s been more hospitalizations.”

That’s why the experts are sending out a reminder about getting your annual COVID, flu, and RSV vaccines if you qualify.

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Those on the front lines say there’s no time to waste.

“Masks are our friends,” said allergist and immunologist Dr. Juanita Mora

Because of the JN.1 variant, many people may not realize they have COVID. So when it comes to testing, it’s better to be safe than sorry.

“It presents with a sore throat, nasal congestion, and maybe a cough and body aches,” Mora said. “It sounds like a common cold, which means our threshold for doing a rapid COVID-19 test should be low.”

Johns Hopkins Medical says it expects the mask requirement to be temporary, while cases are elevated.

Experts say if you’re vulnerable to illness, wear a mask anytime you’re around large groups of people.

Ozempic, Wegovy and similar drugs have been in short supply over the past year as demand has grown.

For those who do manage to find them, the drugs aren’t cheap. They typically cost more than $1,000 a month without insurance.

Between high costs and and nationwide shortages, many have turned to knockoff versions.

Searches for “Ozempic dupe” have skyrocketed by 373% in the past year, according to Kaly.com, and #Ozempic has gained 1.3 billion views on social media platforms like TikTok.

Some compounding pharmacies, which mix and alter drug ingredients to create custom medications for patients, are offering copycat injections at a fraction of the cost. They’re about $100 to $200 for a month’s supply, but the Food and Drug Administration hasn’t approved the medications.

The FDA told News4 it’s monitoring the internet for fraudulent or unapproved products and has issued warning letters to pharmacies to stop the distribution of illegally marketed semaglutide – the active ingredient in both Wegovy and Ozempic.

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“No one knows exactly what it is and no one knows where it’s coming from So it’s actually pretty dangerous,” said Dr. Domenica Rubino with the Washington Center for Weight Management and Research in Arlington, Virginia.

Rubino said the copycat versions of semaglutide are often mixed with vitamins or other ingredients that haven’t been tested and might not be safe.

Regulators are also sounding the alarm. Four states, including West Virginia, Louisiana, Mississippi and North Carolina, are threatening legal action over safety concerns, saying it’s almost impossible for compounding pharmacies to replicate weight loss drugs on the market.

That’s because there are no FDA-approved generic versions of Wegovy or Ozempic, and drug maker Novo Nordisk said it doesn’t supply its ingredients to others.

“You have to understand that there’s a desperateness,” Rubino said.

Despite the risk, News4 found dozens of companies selling semaglutide on social media platforms, some promising overnight delivery of vials with liquid that patients are told to inject weekly.

Several websites even offer telehealth visits in which people can get the medications without ever seeing a provider on video or in person.

“This is about health. It’s not about weight loss. It’s not about fitting into your designer dress — and I can’t stress that enough,” Rubinio said.

Patients who are considering taking weight loss medication should always consult with a doctor or health care provider.

Doctors said it’s also important for people to do their research before taking the medications and understand the potential side effects, which can include nausea and vomiting to changes in vision and kidney problems. In serious cases, Ozempic and Wegovy could cause intestinal blockages, according to the drug’s warning label.

The 67-year-old from Nashville, Tennessee, could not afford to see a dentist on the $1,300-a-month his family gets in Social Security and disability payments. So he waited for the state to roll out a program this year that offers dental care to the more than 650,000 Medicaid recipients like him who are 21 and older. Tennessee is spending about $75 million annually on the program.

“Man, I thought I had made it to heaven because the pain was over,” he said after the tooth was pulled in July at the Meharry Medical College School of Dentistry. “When they did pull it out, I was so happy. I was so glad. Everything just changed after that.”

His wife, Cindy, who also is on Medicaid, has had her teeth pulled at the clinic.

Medicaid, the federal and state health insurance program for the poor, requires states to provide dental coverage for children but not adults. But with a growing recognition of the economic and health costs of poor dental health and an influx of federal pandemic dollars, six states began or expanded their Medicaid programs this year to provide coverage for adults.

Access remains difficult in many of those states with some dentists refusing to treat Medicaid patients. Even those who want to expand their practice are finding themselves caught up in red tape.

Dr. Victor Wu, the chief medical officer for Tennessee’s Medicaid program, said he was pleased with the rollout of Medicaid dental benefits that started in January, but he acknowledges the state needs to build out its network and increase the participation rate among dentists.

While dental care often is seen as routine, the poor often go without any care for years or even decades. Doing so has significant costs, both to taxpayers and to those who cannot afford treatment.

One study from Texas A&M University found that treatment for preventable dental conditions represents up to 2.5% of emergency room visits, at a cost of $2 billion a year. An additional $45 billion is lost year in productivity in the United States annually from untreated oral disease, according to the federal Centers for Disease Control and Prevention.

“You put off care and you get sicker and then it becomes a crisis where you’re missing work or you end up going to the emergency department where you get a big bill and you don’t get the tooth actually taken care of,” said Dr. Rhonda Switzer-Nadasdi, the chief executive officer of Interfaith Dental Clinic which has offices in Nashville and Murfreesboro, Tennessee.

“You need good teeth to have good employment,” Switzer-Nadasdi said.

All states provide some Medicaid dental benefits for adults, but some limit it to only specific segments of the population, like pregnant women or those who have intellectual disabilities, or cover only emergency care, according to CareQuest Institute for Oral Health, a nonprofit that advocates for expanded dental care.

Hawaii, Tennessee, Kentucky, Michigan, Maryland and New Hampshire were the latest to begin or expand their dental coverage; they did so this year.

In New Hampshire, the state is spending $33.4 million over 12 months to provide dental care to its 88,000 Medicaid recipients.

“There is an increasing understanding that oral health is inseparable from health care,” said New Hampshire Democratic Rep. Joe Schapiro, who was the prime sponsor of the expanded dental benefits bill. “The amount of money spent on other health care problems that are related to oral health and the amount of money spent on emergency care when people can’t get any kind of preventive or restorative care is not only unfortunate for those people’s health but cost a tremendous amount of money.”

In Kentucky, Democratic Gov. Andy Beshear pressed ahead with emergency regulations ensuring that about 900,000 Kentuckians would continue having access to dental care after the Republican-led legislature rejected his proposal.

“We are focused on removing roadblocks that prevent people from getting back into the workforce, and this program does just that,” he said.

Virginia expanded its Medicaid program in 2021, budgeting $282 million for the 2022 and 2023 fiscal years to cover dental procedures for more than a million recipients. Last year, Kansas gave dental access to nearly 137,000 Medicaid recipients at a cost of $3.5 million in 2022 and $1.2 million in 2023.

While advocates are welcoming these changes, Texas, Alabama, Mississippi, Utah and Louisiana still only offer limited benefits.

Even as states add dental coverage, millions of beneficiaries are being culled from the Medicaid program nationwide as part of a review of eligibility, something states were prohibited from doing during the pandemic.

There are also plenty of hiccups in states that have expanded care, including Tennessee. Among the biggest is that too few dentists, especially in rural areas, are taking Medicaid patients, resulting in long waiting times and hours-long drives in search of care. Only about 15% of dentist take Medicaid in New Hampshire, 24% in Tennessee and 27% in Virginia.

Many dentists and groups advocating for expanded care blame Medicaid reimbursement rates. New Jersey only covers 13.3% of what a dentists normally charge, Michigan covers 17% and Rhode Island 22.4%, according to 2022 data analyzed by the American Dental Association. Illinois, New York, Ohio and Oregon each cover a little more than 28%.

Most states, though, cover between 30% and 50% with Alaska and North Dakota covering at least 55% and Delaware, 76.9%.

Dr. Heather Taylor, an assistant professor at the Richard M. Fairbanks School of Public Health at Indiana University, said some of Indiana’s Medicaid reimbursement rates for dental have not increased since 1998.

“It’s almost like we’re incentivizing our dentists not to treat the ones that are in need, because we don’t pay them even half of what they could get from private insurers,” she said.

Tennessee Family Dental, which has four clinics in the state, has experienced overwhelming demand from Medicaid patients. Dr. Ryan O’Neill, a dentist who owns the business, said he got some 300 calls on the first day and that some of his patients have traveled from 30 minutes away or more.

He wants to hire more dentists but said it can take upward of four months to get one certified under Medicaid. He also is struggling with a Medicaid billing system that routinely rejects some claims and he said there is “a lot of inconsistency over what is approved and what is denied.”

“Offices are hesitant to go in network because there’s a lot of unknowns,” O’Neill said. “We’re still learning what the rules are and, you know, trial and error in terms of how we’re supposed to deal with a particular situation.”

Danielle Wilkes, a 26-year-old mother of five from Ashland, Tennessee, drove 90 minutes to see O’Neill after calling dozens of dentists in her area and finding none who takes Medicaid. Her cousin, June Renee Pentecost, also came with her for treatment.

For the past five years, Wilkes had been waiting to see a dentist after getting several teeth knocked out in a car wreck. She was told it would cost her thousands of dollars for multiple crowns, which she could not afford.

“I was mad at first but I was like there nothing she could do. I’m just going to have to wait until my kids are grown up,” she said, adding that the pain often brought her to tears.

But here she was in a dental chair, her pink hair standing out against O’Neill and dental assistant Jasmine Webb in black scrubs. Afterward, the soft-spoken Wilkes said she was “just happy” to finally get the work done, even if she had to pay $400 that Medicaid did not cover.

In a different room, Pentecost was getting examined for a root canal. It had been more than a decade since she last saw a dentist because she was deterred by the cost despite years of pain. A mother of five, she figured dental care would take away from spending on her children.

“I couldn’t play with my kids because my head was hurting,” she said.

The 30-year-old was relieved to get the work done but wondered why the state had not offered the benefit sooner.

“I’m hoping my pain would ease up and quit once I get my teeth fixed and then I won’t have so many headaches and feel so bad,” she said.

___

Associated Press writer Bruce Schreiner in Frankfort, Kentucky, contributed to this report.

.

She rarely saw doctors who looked like her. As a child, she experienced severe hair loss, and struggled to find a dermatologist who could help.

Tolliver made a pact with two childhood best friends to become doctors who would care for Black and underserved communities like their own. Now 30, she is in her final year of dermatology residency at Wayne State University in Detroit.

She plans to spend her career caring for the body’s largest organ, where differences in melanin give humans the skin colors underpinning the construct of race. In dermatology, only 3% of U.S. doctors are Black.

Despite her success, the girls’ pact remains unfulfilled. While her friend Charmaine became a nurse, Maria, who wanted to become a pediatrician, was killed in their hometown at the age of 19.

Her friend’s death only strengthened her resolve.

“I’m going to continue to go on this path of medicine,” Tolliver said. “Not only for myself, but for Maria, and to potentially help others in the future from similar backgrounds as mine know that they can do it as well.”

But more than two months after the Supreme Court struck down affirmative action in college admissions, concerns have arisen that a path into medicine may become much harder for students of color. Heightening the alarm: the medical field’s reckoning with longstanding health inequities.

Black Americans represent 13% of the U.S. population, yet just 6% of U.S. physicians are Black. Increasing representation among doctors is one solution experts believe could help disrupt health inequities.

The disparities stretch from birth to death, often beginning before Black babies take their first breath, a recent Associated Press series showed. Over and over, patients said their concerns were brushed aside or ignored, in part because of unchecked bias and racism within the medical system and a lack of representative care.

A UCLA study found the percentage of Black doctors had increased just 4% from 1900 to 2018.

But the affirmative action ruling dealt a “serious blow” to the medical field’s goals of improving that figure, the American Medical Association said, by prohibiting medical schools from considering race among many factors in admissions. The ruling, the AMA said, “will reverse gains made in the battle against health inequities.”

The consequences could affect Black health for generations to come, said Dr. Uché Blackstock, a New York emergency room physician and author of “LEGACY: A Black Physician Reckons with Racism in Medicine.”

“It’s really about holding these larger organizations, institutions accountable and saying: ‘Right now, we’re in a crisis — a crisis of humanity,’” Blackstock said.

With affirmative action off the table at predominantly white institutions, historically Black colleges and universities may see an increase in applications, said Dr. Valerie Montgomery Rice, president and CEO of Morehouse School of Medicine in Atlanta.

The college, which typically has 115 openings for new medical students, receives between 7,000 and 9,000 applications per year, a number Rice said she believes will increase in light of the Supreme Court ruling. HBCUs have long served as a direct pipeline of Black doctors.

Experts say diversity is especially needed within specialty medicine. In dermatology, just 65 of the 796 applicants for residencies in 2020 were Black, data from the Association of American Medical Colleges shows. Only 39 were Latino.

For a field focusing on the skin, the unequal access among patients of color is stark: Patients of color are half as likely as white patients to see a dermatologist for the same conditions.

The consequences can be devastating.

“The skin is a window to the rest of your health,” said Dr. Ginette Okoye, professor and chair of dermatology at Howard University, who is a programming lead for the American Academy of Dermatology’s Pathways program.

“If you have kidney disease, if you have cancer, sometimes those clues show up on the skin first. We are able to preemptively diagnose cancer sometimes just by the way a specific rash shows up on the skin,” Okoye said. “That’s pretty impactful.”

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Black men are more likely to die of melanoma, compared with men of other races, according to a study co-authored last month by dermatologist Dr. Ashley Wysong in the Journal of the American Academy of Dermatology. They also are more likely to be diagnosed at a later stage, when the condition is more difficult to treat. Melanoma is the most invasive and serious form of skin cancer.

The reasons for the different cancer rates are unclear, and more research is needed to understand in particular how economic and social conditions impact the cancer rates, Wysong said. The study found survival rates in men with melanoma were highest among white men, 75%, while the survival rates were lowest among Black men at only 52%.

“As medical professionals, any time we see disparities in care or outcomes of any kind, we have to look at the systems in which we are delivering care and we have to look at ways that we are falling short,” Wysong said.

Without affirmative action as a tool, career programs focused on engaging people of color could grow in importance.

For instance, the Pathways initiative engages students from Black, Latino and Indigenous communities from high school through medical school.

The program starts with building interest in dermatology as a career and continues to scholarships, workshops and mentorship programs. The goal: Increase the number of underrepresented dermatology residents from about 100 in 2022 to 250 by 2027, and grow the share of dermatology faculty who are members of color by 2%.

Tolliver credits her success in becoming a dermatologist in part to a scholarship she received through Ohio State University’s Young Scholars Program, which helps talented, first-generation Ohio students with financial need. The scholarship helped pave the way for medical school, but her involvement in the Pathways residency program also was central.

Azariah Providence, a 17-year-old rising high school senior who lives in the U.S. Virgin Islands, participated in the high school Pathways program last month. She wants to become a dermatologist because of her own scalp psoriasis diagnosis, which is a skin disease causing a rash with itchy, scaly patches.

Her condition hampered her self-esteem as a 9-year-old girl. The dermatologist she saw, one of very few on the island, prescribed medication causing Providence’s skin to burn and her hair to fall out.

“It was a difficult experience because as a little girl, your hair is very important to you,” Providence recalled. “After going through that, I wanted to help little girls who have similar conditions that I have. I want to be that person for them that I didn’t have when I was younger.”

Providence, who would be a first-generation medical student, said the program exposed her to college students and doctors of color, something she had never before seen.

“I think it’s important for more Black people to get into the field of dermatology for the simple reason that some conditions may appear differently on Black skin,” Providence said. “I want to enter the field so that people who look like me can have their skin understood and fully studied so that when they come to get diagnosed, it’s a correct diagnosis and they could get the correct treatment.”

Dermatology also is working to diversify its textbooks to help improve the spectrum of skin colors so doctors can be better equipped to diagnose and provide equitable care, said Dr. Adam Friedman, chair of dermatology at George Washington School of Medicine and Health Sciences in Washington, D.C.

But targeted programs to diversify the pipeline of talent are crucial for the future of medicine, Friedman said.

As Tolliver prepares to leave residency, she hopes to be one of the people pushing for better outcomes, especially for Black women.

“Our patients are looking for us, and that kind of pushed forward my love for this field,” Tolliver said. “And that really has been my goal ongoing from when I was a little girl: for Black women to see the beauty of themselves, within themselves.”

The unnamed woman, who is in her 20s, underwent the procedure in 2020 due to complications with her pregnancy and the patient’s “elevated maternal body mass,” according to the report, which was released on Monday by New Zealand’s Health and Disability Commissioner, Morag McDowell.

The woman complained of severe chronic pain for months after the birth of her child, and doctors eventually discovered that an Alexis wound retractor — a round, soft tubular device used to draw back the edges of a wound during surgery — had been accidentally left inside her during the operation.

Read more at NBCNews.com.

Surgeon Hari Priya Bandi was performing a biopsy through a hole in the 64-year-old patient’s skull at Canberra Hospital last year when she used forceps to pull out the parasite, which measured 8 centimeters, or 3 inches.

“I just thought: ‘What is that? It doesn’t make any sense. But it’s alive and moving,’” Bandi was quoted Tuesday in The Canberra Times newspaper.

“It continued to move with vigor. We all felt a bit sick,” Bandi added of her operating team.

The creature was the larva of an Australian native roundworm not previously known to be a human parasite, named Ophidascaris robertsi. The worms are commonly found in carpet pythons.

Bandi and Canberra infectious diseases physician Sanjaya Senanayake are authors of an article about the extraordinary medical case published in the latest edition of the journal Emerging Infectious Diseases.

Senanayake said he was on duty at the hospital in June last year when the worm was found.

“I got a call saying: ‘We’ve got a patient with an infection problem. We’ve just removed a live worm from this patient’s brain,’” Senanayake told Australian Broadcasting Corp.

The woman had been admitted to the hospital after experiencing forgetfulness and worsening depression over three months. Scans showed changes in her brain.

A year earlier, she had been admitted to her local hospital in southeast New South Wales state with symptoms including abdominal pain, diarrhea, a dry cough and night sweats.

Senanayake said the brain biopsy was expected to reveal a cancer or an abscess.

“This patient had been treated … for what was a mystery illness that we thought ultimately was a immunological condition because we hadn’t been able to find a parasite before and then out of nowhere, this big lump appeared in the frontal part of her brain,” Senanayake said.

“Suddenly, with her (Bandi’s) forceps, she’s picking up this thing that’s wriggling. She and everyone in that operating theater were absolutely stunned,” Senanayake added.

Six months after the worm was removed, the patient’s neuropsychiatric symptoms had improved but persisted, the journal article said.

She had returned home but remains under medical observation. Details of her current condition have not been made public.

The worms’ eggs are commonly shed in snake droppings which contaminate grass eaten by small mammals. The life cycle continues as other snakes eat the mammals.

The woman lives near a carpet python habitat and forages for native vegetation called warrigal greens to cook.

While she had no direct contact with snakes, scientists hypothesize that she consumed the eggs from the vegetation or her contaminated hands.

Scientists around the country are racing to learn how to use animal organs to save human lives, and bodies donated for research offer a remarkable rehearsal.

The latest experiment announced Wednesday by NYU Langone Health marks the longest a pig kidney has functioned in a person, albeit a deceased one -– and it’s not over. Researchers are set to track the kidney’s performance for a second month.

“Is this organ really going to work like a human organ? So far it’s looking like it is,” Dr. Robert Montgomery, director of NYU Langone’s transplant institute, told The Associated Press.

“It looks even better than a human kidney,” Montgomery said on July 14 as he replaced a deceased man’s own kidneys with a single kidney from a genetically modified pig — and watched it immediately start producing urine.

The possibility that pig kidneys might one day help ease a dire shortage of transplantable organs persuaded the family of Maurice “Mo” Miller from upstate New York to donate his body for the experiment. He’d died suddenly at 57 with a previously undiagnosed brain cancer, ruling out routine organ donation.

“I struggled with it,” his sister, Mary Miller-Duffy, told the AP about her decision. But he liked helping others and “I think this is what my brother would want. So I offered my brother to them.”

“He’s going to be in the medical books, and he will live on forever,” she added.

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Attempts at animal-to-human transplants, or xenotransplantation, have failed for decades as people’s immune systems attacked the foreign tissue. Now researchers are using pigs genetically modified so their organs better match human bodies.

Last year with special permission from regulators, University of Maryland surgeons transplanted a gene-edited pig heart into a dying man who was out of other options. He survived only two months before the organ failed for reasons that aren’t fully understood but that offer lessons for future attempts.

Next, rather than last-ditch efforts, the Food and Drug Administration is considering whether to allow some small but rigorous studies of pig heart or kidney transplants in volunteer patients.

The NYU experiment is one of a string of developments aimed at speeding the start of such clinical trials. Also Wednesday, the University of Alabama at Birmingham reported another important success — a pair of pig kidneys worked normally inside another donated body for seven days.

Kidneys don’t just make urine — they provide a wide range of jobs in the body. In the journal JAMA Surgery, UAB transplant surgeon Dr. Jayme Locke reported lab tests documenting the gene-modified pig organs’ performance. She said the weeklong experiment demonstrates they can “provide life-sustaining kidney function.”

These kinds of experiments are critical to answer remaining questions “in a setting where we’re not putting someone’s life in jeopardy,” said Montgomery, the NYU kidney transplant surgeon who also received his own heart transplant — and is acutely aware of the need for a new source of organs.

More than 100,000 patients are on the nation’s transplant list and thousands die each year waiting.

Maryland’s Dr. Muhammad Mohiuddin cautions that it’s not clear how closely a deceased body will mimic a live patient’s reactions to a pig organ. But he said the research educates the public about xenotransplantation so “people will not be shocked” when it’s time to try again in the living.

Previously, NYU and a team at the University of Alabama at Birmingham had tested pig kidney transplants in deceased recipients for just two or three days. An NYU team also had transplanted pig hearts into donated bodies for three days of intense testing.

But how do pig organs react to a more common human immune attack that takes about a month to form? Only longer testing might tell.

The surgery itself isn’t that different from thousands he’s performed “but somewhere in the back of your mind is the enormity of what you’re doing … recognizing that this could have a huge impact on the future of transplantation,” Montgomery said.

The operation took careful timing. Early that morning Drs. Adam Griesemer and Jeffrey Stern flew hundreds of miles to a facility where Virginia-based Revivicor Inc. houses genetically modified pigs — and retrieved kidneys lacking a gene that would trigger immediate destruction by the human immune system.

As they raced back to NYU, Montgomery was removing both kidneys from the donated body so there’d be no doubt if the soon-to-arrive pig version was working. One pig kidney was transplanted, the other stored for comparison when the experiment ends.

One other trick: Surgeons attached the pig’s thymus to the transplanted kidney in hopes that the gland, which helps train immune cells, would increase human tolerance of the organ. Otherwise, the team is relying on standard immune-suppressing drugs used by today’s transplant patients.

“You’re always nervous,” Griesemer said. To see it so rapidly kickstart, “there was a lot of thrill and lot of sense of relief.”

How long should these experiments last? Alabama’s Locke said that’s not clear -– and among the ethical questions are how long a family is comfortable or whether it’s adding to their grief. Because maintaining a brain-dead person on a ventilator is difficult, it’s also dependent on how stable the donated body is.

In her own experiment, the donated body was stable enough that if the study wasn’t required to end after a week, “I think we could have gone much longer, which I think offers great hope,” she said.

AP video journalist Shelby Lum contributed to this report.

Insurers selling coverage in North Carolina, Pennsylvania and New York, among other states, told The Associated Press they won’t cover Leqembi with insurance offered on the individual market and through employers because they still see the $26,000-a-year drug as experimental.

Their decision stands in contrast to Medicare, which will wind up covering most patients who take the drug. The federal coverage program mainly for people ages 65 and older announced shortly after Leqembi received full approval last month that it will cover the treatment while still tracking its safety and effectiveness.

Leqembi is the first medicine that’s been convincingly shown to slow the cognitive decline caused by Alzheimer’s disease, though only modestly. The U.S. Food and Drug Administration approved the IV drug for patients with mild dementia and other symptoms caused by early Alzheimer’s.

That approval came after regulators reviewed data from a large study in which the drug slowed memory and thinking decline by about five months in those who got the treatment compared with those who got a dummy drug. Some Alzheimer’s experts say the delay is likely too subtle for patients or their families to notice.

Alzheimer’s mainly affects the elderly. About 76% of the people taking Leqembi will be covered by Medicare, according to the Japanese drugmaker Eisai, which developed the drug and is co-marketing it with Cambridge, Massachusetts-based Biogen Inc.

But people under 65 — even, rarely, as young as their 30s — also can get diagnosed. They are more likely to have commercial coverage.

“That’s why we’re just dumbfounded that commercial plans are not covering it,” said Christine Mann, chief operating officer of the Buffalo, N.Y.-area Dent Neurologic Institute, which will provide the IV drug to patients. “It’s almost like discrimination against these patients.”

The full picture on commercial insurance is still emerging in the patchwork U.S. system of coverage.

Companies saying no so far include Highmark, which provides Blue Cross and Blue Shield coverage in New York, Pennsylvania, Delaware and West Virginia; Blue Cross and Blue Shield of North Carolina, which has about 1.8 million commercial customers; and Philadelphia-based Independence Blue Cross.

Highmark and the North Carolina plan say they are still monitoring Leqembi and could re-evaluate their decision.

Independence Blue Cross made its decision after reviewing published, peer-reviewed studies and publicly available FDA materials.

“That re-evaluation made it clear to us that the existing evidence does not allow for conclusions to be drawn about the safety and effectiveness of Leqembi,” said Dr. Heidi Syropoulos, a medical director with the insurer.

A Highmark spokesman said that company made its decision after also consulting with specialists to determine if the drug’s benefit outweighs its side effects, which include brain bleeding and swelling.

Prominent insurers that will cover the drug for commercial plans include Kaiser Permanente and Elevance Health, the largest provider of Blue Cross-Blue Shield plans in the United States. A spokesman for another big health insurer, UnitedHealthcare, declined to comment when contacted by AP.

Because Medicare covers the drug, patients with privately run Medicare Advantage plans will receive coverage, said Juliette Cubanski, of the non-profit KFF, which researches health care issues.

Many other insurers say they have yet to make a decision.

Most insurers will probably cover the drug but heavily restrict its use through things like requiring pre-approval, said Greg Warren, a health actuary and member of the Society of Actuaries.

For commercial coverage, insurers often pay for treatments that have full FDA approval. But that is not guaranteed.

Tufts Medical Center in Boston maintain a database that includes more than 11,000 commercial insurance coverage decisions on specialty drugs. In 2% of the decisions, insurers did not cover the FDA-approved use, said researcher James Chambers.

Chambers said they have found that the decision to not cover a drug largely happens when the evidence supporting the drug is considered questionable.

The denials for Leqembi don’t surprise Jack Hoadley, a health policy researcher with Georgetown University’s Center on Health Insurance Reforms.

He noted Leqembi’s serious side effects and high cost. The price doesn’t include the cost for repeated brain scans patients need to check for side effects.

But Hoadley said insurers also may have a hard time explaining themselves.

“It’s going to be a harder-to-justify decision for them if they know that Medicare has made a decision to cover it,” he said.

Patients who don’t get coverage through a commercial plan may eventually receive it through Medicare or state- and federally funded Medicaid programs.

But waiting is risky. Those who advance out of early-stage Alzheimer’s may no longer qualify for Leqembi.

Bonnie Bortz has been caring for her 38-year-old daughter, Jaime, who has early-onset Alzheimer’s like her father did.

Bortz, who lives in the Buffalo suburb of Cheektowaga, is confident Jaime will get help paying for Leqembi because she will soon start on Medicare, which is available to some people under 65 with Alzheimer’s. Still, that hasn’t happened yet, and Bortz is anxious for treatment to begin.

She’s watched Jaime progress from repeatedly losing her phone and keys to struggling to help her 7-year-old daughter with homework.

“I don’t want to get to the next stages of all this,” Bonnie Bortz said. “I want more time.”

Tissue taken from the Black woman’s tumor before she died of cervical cancer became the first human cells to be successfully cloned. Reproduced infinitely ever since, HeLa cells have become a cornerstone of modern medicine, enabling countless scientific and medical innovations, including the development of the polio vaccine, genetic mapping and even COVID-19 vaccines.

Despite that incalculable impact, the Lacks family had never been compensated.

Doctors harvested Lacks’ cells in 1951, long before the advent of consent procedures used in medicine and scientific research today, but lawyers for her family argued that Thermo Fisher Scientific Inc., of Waltham, Massachusetts, has continued to commercialize the results well after the origins of the HeLa cell line became well known.

The settlement agreement came after closed-door negotiations that lasted all day Monday inside the federal courthouse in Baltimore. Several members of the Lacks family were in on the talks.

Attorney Ben Crump, who represents the Lacks family, announced the settlement late Monday. He said the terms of the agreement are confidential.

“The parties are pleased that they were able to find a way to resolve this matter outside of Court and will have no further comment about the settlement,” Crump said in a statement.

HeLa cells were discovered to have unique properties. While most cell samples died shortly after being removed from the body, her cells survived and thrived in laboratories. This exceptional quality made it possible to cultivate her cells indefinitely — they became known as the first immortalized human cell line — making it possible for scientists anywhere to reproduce studies using identical cells.

The remarkable science involved — and the impact on the Lacks family, some of whom suffered from chronic illnesses without health insurance — were documented in a bestselling book by Rebecca Skloot, “The Immortal Life of Henrietta Lacks,” and Oprah Winfrey portrayed her daughter in an HBO movie about the story.

Lacks was 31 when she died and was buried in an unmarked grave. A poor tobacco farmer from southern Virginia, she was raising five children when doctors discovered a tumor in her cervix and saved a sample of her cancer cells collected during a biopsy.

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Johns Hopkins said it never sold or profited from the cell lines, but many companies have patented ways of using them.

In their complaint, Lacks’ grandchildren and other descendants argued that her treatment illustrates a much larger issue that persists into the present day: racism inside the American medical system.

“The exploitation of Henrietta Lacks represents the unfortunately common struggle experienced by Black people throughout history,” the complaint reads. “Too often, the history of medical experimentation in the United States has been the history of medical racism.”

Thermo Fisher argued the case should be dismissed because it was filed after the statute of limitations expired, but attorneys for the family said that shouldn’t apply because the company is continuously benefitting from the cells.

In a statement posted to their website, Johns Hopkins Medicine officials said they reviewed all interactions with Lacks and her family after the 2010 publication of Skloot’s book. While acknowledging an ethical responsibility, it said the medical system “has never sold or profited from the discovery or distribution of HeLa cells and does not own the rights to the HeLa cell line,” while also acknowledging an ethical responsibility.

Crump, a civil rights attorney, has become well known for representing victims of police violence and calling for racial justice, especially in the aftermath of George Floyd’s murder. The Lacks family joined him Tuesday morning near Baltimore’s waterfront to announce the settlement and pay tribute to Lacks on what would have been her 103rd birthday. The group brought balloons and a cake to celebrate.

“There couldn’t have been a more fitting day for her to have justice, for her family to have relief,” her grandson Alfred Lacks Carter Jr. said. “It was a long fight — over 70 years — and Henrietta Lacks gets her day.”

Last week, U.S. senators Chris Van Hollen and Ben Cardin, both Maryland Democrats, introduced a bill to posthumously award Lacks the Congressional Gold Medal.

“Henrietta Lacks changed the course of modern medicine,” Van Hollen said in a statement announcing the bill. “It is long past time that we recognize her life-saving contributions to the world.”

At nearly 82, though, this nurse in Winchester, Virginia, is ready to retire. She spent 55 years on the job.

At a bittersweet retirement reception at Valley Health’s Winchester Medical Center on Friday, McWhinney spoke about her decades of experience.

“So I started out with white shoes, white hose, white dress and a cap,” she said, showing an old photo.

She knew when she was 9 years old that she wanted to become a nurse. Her mother was stricken with tuberculosis, and she gave her daily shots.

“I gave it to her, vomited and said, ‘I want to be a nurse,’” McWhinney said.

Her nursing career began in 1967, when she graduated as a member of Shenandoah University’s first-ever nursing class.

Over the next five decades, she worked in several hospital departments but always related to surgery. She treated some patients for decades.

“We love her a bunch,” one patient said. “I’m sure they’re going to miss her here, as will I.”

Doctors said they learned from her.

“She’s forgotten more stuff than I’ve learned in all my years of training as a doctor,” Dr. Terral Goode said.

Back in the days of strict visiting hours, McWhinney helped a young father sneak in his baby daughter to see her mother, who was dying of cancer.

She ran into that little girl, now a grown woman, in the hospital. She had become a nurse.

“She said, ‘I became a nurse because of you and I remember my mom because of all the pictures we took,'” McWhinney said. “So that was probably one of the very special days for me.”

McWhinney’s long career spanned some of medicine’s greatest recent challenges, including polio, the AIDS epidemic and the COVID-19 pandemic. She herself fell ill with COVID in September 2020, before vaccines were available.

“I kept a calendar and I wrote there one day, ‘Dear God, please let me die. I’m ready,’ because It was just horrible,” she said.

Once she recovered, though, she said she never thought twice about returning to work.

“The nurses I work with, my God, they were overwhelmed, and I didn’t want them to fight by themselves,” she said.

Nurses, doctors and hospital staff gathered Friday to say goodbye, give hugs, and share laughter and tears.

“I’ve cried all day,” McWhinney said. “It’s kind of happy tears, but I have such great support here. I mean, it’s just a wonderful place to work.”

She said it’s finally time for her to travel and take care of herself, although she’s not finished caring for others. In her retirement, she plans to volunteer as a hospice nurse.

The drug, Leqembi, received conditional approval from the Food and Drug Administration in January based on early results suggesting it could slow Alzheimer’s progression by several months. The FDA now is reviewing more definitive results to decide whether the drug should receive the agency’s full endorsement.

The decision carries extra significance because insurers have held off on paying for the infused treatment until it has full FDA approval.

The FDA panel of outside advisers voted 6-0 that a large company study confirmed the drug’s benefits for patients with mild or early Alzheimer’s. The nonbinding vote amounts to a recommendation for full approval, and the FDA is scheduled to issue a final decision on the matter by July 6.

The FDA’s initial OK for Leqembi came via the agency’s accelerated approval program, which allows early access to drugs based on laboratory and biological measures suggesting that they might help patients. The drug, marketed by Eisai and Biogen, helped clear a brain plaque that is a hallmark of Alzheimer’s.

The FDA panel reviewed more recent data from an 1,800-patient study in which people taking the drug showed a modestly slower rate of decline on measures of memory, judgment and other cognitive tests.

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“For an illness like this where we don’t have very much, these are meaningful changes for patients with Alzheimer’s,” said Dr. Merit Cudkowicz of Harvard Medical School. “A couple more months in the highly functional state is really meaningful.”

Drugs approved via the accelerated pathway can technically be withdrawn by the FDA if their benefits aren’t confirmed, though regulators rarely take that step. Gaining full approval allows medications to stay on the market indefinitely.

Normally the process of converting an accelerated approval attracts little attention, and FDA rarely convenes its advisers to weigh in on such decisions.

But concerns about the cost and effectiveness of new plaque-targeting drugs like Leqembi have attracted new scrutiny to the process from academics, members of Congress and health insurers.

Medicare, the federal health plan that covers 60 million seniors, has essentially blocked coverage of Leqembi and a similar drug, Aduhelm, pending full FDA approval. That policy, which has little precedent, was announced last year amid concerns that Aduhelm, priced at $28,000-a-year, would drive up costs for Medicare recipients.

The federal program provides health insurance for the vast majority of people with Alzheimer’s, and private insurers tend to follow its lead.

Leqembi is priced similarly at $26,500 per year and the handful of patients who have received it to date have mainly had to pay out of pocket.

Facing pressure from Alzheimer’s advocates and patients, Medicare’s administrator, Chiquita Brooks-LaSure, has made clear the program will immediately begin covering the drug if it gets FDA’s full OK.

But last week she announced extra requirements even after Medicare coverage begins: All patients receiving the drug will need to be enrolled in a federal registry to track Leqembi’s safety and effectiveness. That approach is occasionally used for complex new medical devices, but rarely for drugs.

The move was criticized by advocacy groups, including the Alzheimer’s Association, which has lobbied the federal government for months to begin paying a drug that they say could potentially help many thousands of Americans.

Leqembi is the first drug that’s been convincingly shown to slow Alzheimer’s by targeting the underlying biology of the disease. The delay in progression amounts to about five months, and some experts disagree on whether the difference is enough to meaningfully improve people’s lives.

But most FDA panelists were impressed by Eisai’s results, which they said showed significant differences in patients’ cognitive abilities and function, as well as reduced burden for caregivers.

The study, funded by Japanese drugmaker Eisai, tracked patients for 18 months using a scale measuring key indicators of cognitive function. At the end of the trial, patients receiving Leqembi declined more slowly — a difference of less than half a point on the scale — than patients who received a dummy infusion.

The drug was also associated with potentially serious side effects, including swelling of the brain and small bleeds in brain vessels.

Three patients taking Leqembi died during the study, two after experiencing a stroke linked to brain bleeding. But FDA reviewers said it was unclear whether the drug played a role in the deaths due to other underlying factors affecting the patients, including the use of blood-thinning medications that can increase the risk of bleeding.

“There are adverse effects,” said Dr. Robert Alexander of the University of Arizona, who chaired the panel. “But they’re monitorable and I think the benefit is clear.”

In the 18-month trial, people in the early stages of Alzheimer’s who received infusions of donanemab showed 35% less decline in thinking skills compared to those given a dummy drug, Lilly announced in a press release.

The drug is designed to target and clear away a sticky protein called beta-amyloid that builds up into brain-clogging plaques that are one hallmark of Alzheimer’s.

A similar amyloid-targeting drug, Eisai and Biogen’s Leqembi, recently hit the market with similar evidence that it could modestly slow Alzheimer’s — and also some safety concerns, brain swelling or small brain bleeds.

Donanemab also comes with that risk. Lilly said in its study, the brain side effects caused the deaths of two participants and a third also died after a serious case.

The preliminary study results haven’t been vetted by outside experts. Indianapolis-based Lilly plans to release more details at an international Alzheimer’s meeting this summer and is seeking Food and Drug Administration approval of the drug.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The following content is created in partnership with University of Maryland Capital Region Health. It does not reflect the work or opinions of the NBC Washington editorial staff. Click here to learn more about University of Maryland Capital Region Health.

For those unfamiliar with the terminology, it’s easy to confuse family medicine for general practice or internal medicine. And while patients should always choose the practice that best suits their needs, it’s important to understand the full range of options available. Read on to learn more about family medicine and why it might be the right choice for you.

Family medicine is a one-stop shop for most of your medical needs

As the name suggests, family medicine is a branch of medicine designed to provide continuing and comprehensive healthcare to the all members of a family. Accordingly, family medicine practices provide healthcare across all ages, genders, and conditions, meaning a single practice will offer a wide range of specialties from pediatrics, obstetrics, and geriatrics. Thanks to the sheer breadth of expertise and range of specialties in a family practice, a patient is less likely to be referred elsewhere for specialized care.

Family medicine offers convenience for busy individuals

The range of care offered in family medicine makes it an easy choice for many, but especially for parents. Instead of visiting multiple practices for different family members, everyone in your family can receive care in the same location–expecting moms, newborns, teens, adults, grandparents and more. Treating entire families also allows doctors to better understand many factors that affect people’s health, including employment, living conditions, care giving needs, educational level as well as cultural background. Additionally, many family medicine practices, like UM Capital Region Health, offer same and next-day appointments.

Family medicine promotes a long-term doctor-patient relationship

Every family medicine doctor undergoes rigorous training to address the health needs of all age groups and genders. This enables a long-term relationship between a family medicine doctor and their patients over many years. The doctor becomes better informed, and you are more empowered as a patient.

“We’re able to make a more significant impact on people’s health because of our long- lasting relationships and opportunities to interact on multiple levels at different points and important milestones in their lives,” says Alexander Kaysin, MD, MPH, medical director of the UM Capital Region Health Family Medicine Practice at New Carrollton.

Furthermore, Dr. Kaysin says, “certain family medicine practices such as our own can provide direct care for patients not just in the office but also in the hospital, including labor and delivery, the newborn nursery and regular inpatient units. This enables us to provide the highest quality of care through a deep understanding of our patients’ health and the trust we are able to build.”

Family medicine allows for a holistic approach

According to Dr. Donna Prill of UM Capital Region Health, family physicians don’t just treat illness.

“A benefit of seeing a family medicine physician is that we seek to optimize patient health from every angle. We consider what’s happening with patients psychologically and socially and how these factors affect their health.”

Indeed, health outcomes are dependent on countless factors, including lifestyle, diet, family history, relationships, and mental health. Thanks to the nature of their practice, family medicine doctors are uniquely positioned to consider the full scope of a patient’s life outside of a clinical setting. 

Family medicine improves community-wide outcomes

Family medicine physicians make up the majority of the primary care physician workforce. This is noteworthy because of the unique vantage point that family physicians have in understanding community-level factors and social determinants of health.  

“I believe that if we want to have healthier communities, we need to have healthier families,” says Dr. L. Latéy Bradford, a family physician at UM Capital Region Health.

Indeed, access to regular primary care has been shown to result in lower infant mortality, higher birth weights, higher immunization rates, lower overall healthcare costs, and longer, healthier lives. And because they consider patients’ cultural traditions as well as barriers they may face in accessing healthcare, family medicine physicians are well-positioned to understand their patients and provide outstanding care.

Navigating medical care can be overwhelming, but the experts at University of Maryland Capital Region Health are ready to assist you and support you and your family in achieving your health goals. Click here to learn more about UM Capital Region Health Family Medicine in New Carrollton and National Harbor, and Suitland, which offer telehealth and same and next-day appointments.

“The (U.S. Food and Drug Administration) says we should (clean) it twice a year, so right before spring and summer and then again in the fall and winter. I would think of it like the end of your school year for your kids and the beginning of the school year for your kids,” NBC medical contributor Natalie Azar told TODAY in a segment on April 20. 

So which items need to go and when? Certain bathroom staples are breeding grounds for bacteria and have a shorter shelf life than your twice-a-year purge: 

• Toothbrush: You should replace your toothbrush every 3 to 4 months, according to the CDC. Dr. Azar agreed, even recommending to err on the side of caution with 3 months.
• Contact lens cases: Replace every 3 months.
• Razors: Toss after every five to seven uses.
• Loofa: Replace once a month.

Medications: Do expiration dates matter?

We’ve all been there: We’re cleaning out our medicine cabinet and wonder, do I really have to toss this almost full bottle of medication?

“It depends on what the medicine is for,” said Azar. “Anything that’s prescription, anything that’s liquid or anything that is life-saving (like EpiPens or nitroglycerin), get rid of it by the expiration date.” 

But what if you have a splitting headache and the only pain-reliever you can find is a bit past due? “It’s not dangerous if it’s past its expiration date. It just might not work as well,” she said. “That’s why I say watch out with prescription drugs — because let’s say you use an antibiotic that’s past its expiration date or a blood thinner that’s past its expiration date. We don’t want that because we want that to be at its full potency.”

When it comes to medication expiration dates, follow these general guidelines:

• OTC medications: Pills are good for three years past the expiration date, but know they may not be as effective. Liquid medications like cough syrup should be thrown out after the expiration date.
• Prescription medications: Throw out by expiration date.

How do I dispose of old medications?

When you do have drugs to dispose of, Azar said the best way to dispose of them safely is through a drug take-back program, which you can find by searching on the U.S. Drug Enforcement Agency website or asking your local pharmacy. There are certain drugs that are flushable. The FDA website has a “flush list” of medications that they actually prefer you flush down the toilet, like opioids.

Finally, for the medications you are going to toss in the trash, Azar suggested putting them in a Ziplock baggie with something that doesn’t taste good like cat litter or coffee grounds, to make sure kids and pets don’t ingest them. And always use a Sharpie to cross out all personal information on medicine bottles before you recycle them.

5 medicine cabinet staples

Now that you purged your supply, it’s time to replenish your stock. What should everyone have in their medicine cabinet? To make it easy, remember the four As, said Azar:

• Acetaminophen/aspirin 
• Antihistamines
• Antacids
• Antibiotic ointments

The final thing we should all have on hand is a thermometer. It’s a matter of preference which type you use, but for parents with younger kids, the American Academy of Pediatrics recommends using rectal, underarm or in-ear thermometers for the most accurate readings.

Summer medicine cabinet essentials

This time of year, Azar suggested a few additional staples to make sure you have on hand:

• Sunscreen: The American Academy of Dermatology recommends using SPF 30 at a minimum. When it comes to that bottle of sunscreen left over from last year, Azar said to follow the same rule of thumb that you do for over-the-counter medication: It’s not dangerous, but it may not be as effective.
• Tweezers: A must for removing splinters and ticks.
• OTC ear drops: For swimmer’s ear, or the inflammation and pain that happens when water gets stuck in the ear canal.
• Hydrocortisone cream: Helps reduce the redness and itching associated with different rashes, insect bites and even poison ivy.
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Most collection locations will accept any unwanted medication from 10 a.m. to 2 p.m. on Saturday.

To find a collection site near you, visit DEA.gov/TakeBackDay, there you can enter your location and find a collection site near you.

Medications can be brought in pill containers or loose in ziplock bags.

The FDA recommends the prompt disposal of unwanted drugs to help reduce the chance that others accidentally take or misuse the medicine, and to help reduce drugs from entering the environment.

If you are unable to drop off unwanted medications on Saturday, there are dozens of pharmacies that will accept and dispose of controlled substances year-round. Go to the Department of Justice’s Controlled Substance Public Disposal Location website to search for a location near you.

You’ve likely used shampoo or sunscreen days — or even months — beyond their expiration dates and that is probably OK. But it’s a different story for medications, says Erin Burton, a pharmacy manager at CVS Health.

“It’s important to check out the expiration dates on medications because once we’re past that date, they become less effective,” Burton tells CNBC Make It.

Depending on what you’re treating, taking ineffective, or less effective, medicine can be harmful, she adds. “You don’t want to be taking a medication that’s not helping you with the disease you’re trying to treat,” especially if it’s a severe condition.

The bottom line: “People really need to follow what’s printed on the label,” says Burton. “Really we shouldn’t be using them a day past, but no one’s perfect.”

‘There are certain medications that we really don’t want lying around our home’

Keeping medication past its expiration date, or not disposing of leftover medicine, leaves room for them to fall into the wrong hands, Burton notes.

“There are certain medications that we really don’t want lying around our home,” she says, including pain medicine like opioids, stimulants or depressants. These prescriptions can be very addictive, she adds.

“We know that two-thirds of teens who misused pain relievers in the past year, say they got them from a family [member] or friend. That includes our home medicine cabinets,” says Burton.

How to properly dispose of expired medications

Given the decrease in effectiveness after expiration dates, and the potential harms of keeping old medications in cabinets, you should dispose of prescriptions that you no longer need.

But, there is an ideal way to do so, that Burton strongly encourages:

• Find a take-back site near local pharmacies. “One important note is that you want to remove any personal information from the labeling before disposing of the medication,” says Burton.
• Toss them in household trash. You should mix them with an undesirable substance and place them in a sealable container or bag.

CVS drug disposal units accept prescription medications, over-the-counter treatments and liquid medicine. They don’t accept illegal substances, needles or syringes, medical devices or batteries, aerosol cans or inhalers.

You can throw away inhalers by contacting your local trash or recycling facility, so it can be disposed of safely, Burton says.

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Eli Lilly‘s experimental Alzheimer’s drug lowered levels of brain plaque in patients who are in the earliest stages of the devastating disease, initial data shows. 

A higher dose of the up-and-coming treatment, remternetug, had a larger effect on clearing amyloid plaque, according to early clinical trial data the company presented during a conference in Sweden on Friday.

Amyloid is a protein that builds up on the brain in Alzheimer’s patients and disrupts cell function. Researchers have argued that accumulation of amyloid plaque is a crucial first step toward the cognitive decline observed in Alzheimer’s disease.

The early data comes as Eli Lilly continues its decades-long bid to bring an Alzheimer’s drug to the market. Remternetug follows another drug called donanemab and failed treatment solanezumab. Remternetug and donanemab target plaque deposited on the brain, while solanezumab focused on the kind that floats in brain fluid.

The remternetug trial featured 41 patients in the early stages of Alzheimer’s disease. They were randomized to receive infusions of a placebo or remternetug in various dose sizes every four weeks.  

Eli Lilly found the drug caused a “rapid and robust” clearance of amyloid plaque, the presentation said. Clearing amyloid plaque is defined as lowering the level to 24.1 centiloids — a unit used to measure amyloid in the brain — or less.

Plaque levels were “dose-dependent,” the company said. The majority of patients who received remternetug at the three highest dose sizes saw amyloid plaque cleared by day 169 of the study. 

The Indianapolis, Indiana-based company is conducting an ongoing phase three trial on remternetug, but it did not indicate which dose sizes are being studied. Eli Lilly expects to complete the trial in 2025. 

The results suggest remternetug “may provide more robust plaque removal” than donanemab, said J.K. Wall, an Eli Lilly spokesperson.

A phase two trial of donanemab found 40% of participants treated with the drug achieved amyloid clearance as early as six months, or around 182 days, after starting the treatment. 

But Wall added that it’s too early to make quantitative comparisons of the two drugs. 

Akash Tewari, an equity analyst at Jefferies, also highlighted “hints of faster amyloid clearance with remternetug vs donanemab” in a Friday note. But Tewari said it’s unclear if clearing amyloid plaque will lead to clinical benefits like a reduction in cognitive decline. 

He noted that some research has demonstrated a causal relationship between plaque removal and the rate of cognitive decline, but “we haven’t seen this supported in donanemab’s” data.

Tewari also compared the two drugs’ safety profiles. He estimates that remternetug could show similar or higher rates of a problematic brain swelling side effect compared to donanemab. 

Eli Lilly observed the side effect – known as amyloid-related imaging abnormality, or ARIA – in 10 out of 24 patients who received remternetug. One of those patients stopped the treatment due to a serious adverse event.

ARIA has dogged similar Alzheimer’s drugs from other companies, such as Biogen and Eisai’s Leqembi. The companies expect the Food and Drug Administration to grant full approval of Leqembi by the summer.

An estimated 6.7 million Americans age 65 and older are living with Alzheimer’s, according to the Alzheimer’s Association. By 2050, that group is projected to rise to almost 13 million. 

One in three seniors die with Alzheimer’s or another form of dementia, which kills more people than breast cancer and prostate cancer combined, the association said. 

More than 600,000 people die of cardiovascular disease in the U.S. every year — the leading cause of death for both men and women, according to the Centers for Disease Control and Prevention.

Even heart doctors themselves can suffer a heart attack.

Wouldn’t you like to lower your risk?

Hippocrates famously said, “Let food be thy medicine,” and that applies to heart health: Diet is incredibly important, noted Dr. Andrew Freeman, director of cardiovascular prevention and wellness at National Jewish Health in Denver, Colorado, and a member of the American College of Cardiology’s Prevention of Cardiovascular Disease Section Leadership Council.

“If you go to parts of the world where they have not been exposed to a Western lifestyle, meaning a sedentary lifestyle and eating processed foods, heart disease is in very limited existence,” Freeman told TODAY.

Still, it may not always be possible to eliminate problem foods, so moderation and portion control are key.

“There isn’t a food that will save your life … And there isn’t one that’s going to kill you. It is about balance,” said Dr. Sharonne Hayes, professor of cardiovascular medicine and founder of the Women’s Heart Clinic at the Mayo Clinic in Rochester, Minnesota.

“So the occasional Cheeto or piece of cheesecake isn’t going to kill you, but it really is what you eat and how much you eat that’s so critical.”

TODAY asked Freeman and Hayes to share some of the top foods they try to avoid or limit for optimal health. Here are eight of the items on their lists:

1. Bacon, sausage and other processed meats

Hayes, who has a family history of coronary disease, is a vegetarian. But even before she stopped eating animal protein some 25 years ago, she avoided processed meats because they’re high in calories, saturated fat, salt and have added ingredients like nitrates.

It’s not only heart health that may be affected by overindulging in hot dogs, salami, bacon, ham and jerky: The World Health Organization has determined eating processed meats causes cancer, Freeman pointed out.

2. Potato chips and other processed, packaged snacks

Stay away from the little pouches of salty, crunchy carbs you might encounter in a vending machine, the doctors advised.

“Our culture values convenience, which is great, but convenience doesn’t mean you have to eat packaged processed foods with added sugars and salt,” Freeman said. “Nature has provided for us the exact foods we should be eating; we just need to eat them.”

Those easy, portable, natural foods include apples, carrots and other fruits and vegetables — all fiber-rich, nutrient-full options.

Hayes agrees with many nutritionists that simple carbs — found in chips, breads and crackers — are a bigger issue than fat. Look for ways to increase the complexity of what you eat, in terms of grains and other nutrients, she advised.

3. Dessert

Enjoy added sugars in very limited quantities, if at all, Freeman noted.

When it comes to desserts like pies, ice cream and candy bars, Hayes indulges once a week at most and keeps her portion small to limit calories. Her main goal is to maintain a healthy weight: She’s weighed about the same for the past 30 years.

4. Too much protein

“We seem to be obsessed with protein in this country,” Freeman said. “It’s not uncommon to see people getting two times as much protein as they may need in a day and that taxes the kidneys and may cause more problems down the road.”

Another issue is that the extra protein often comes from meats high in saturated fats, which may raise LDL or bad cholesterol, and comes at the expense of other food groups, the American Heart Association warns.

So don’t overdo it and opt for plant protein, both doctors advised.

5. Fast food

It’s been years since Hayes has had any fast food. Some chains let you concoct a reasonably healthy item with fresh vegetables, but most burger and chicken fast food restaurants should be avoided “because there’s virtually nothing on the menu that’s healthy for you,” she said. Even the items that aren’t fried are typically high in simple carbs.

6. Energy drinks

Freeman said he avoids them because they contain added sugar, plus ingredients that may potentially induce problems like high blood pressure or arrhythmia.

That doesn’t mean you should skip caffeine. It’s quite healthful to drink tea or coffee in moderation every day, he said. Just watch what you put in your cup: Black coffee can turn into a calorie bomb if you add sugar, whipped cream, caramel and other toppings.

7. Added salt

There’s virtually no American who doesn’t get too much salt in their diet, Hayes noted. It’s not uncommon for a person to get three or four times the recommended daily amount, Freeman added. Added salt lurks in products you may not realize: cereal, a pickle that comes with your sandwich or a chicken breast that’s been brined to stay juicy and moist.

Read the labels and be aware of how much sodium you’re taking in. You need salt to live, but a high-sodium diet raises blood pressure.

8. Coconut oil

It has more saturated fat than lard, Freeman said.

“It’s used in some studies to induce atherosclerosis — sludge in the pipes, if you will, in rats and other animals,” he noted. “It works great topically — it’s a wonderful moisturizer for hair and skin — but I wouldn’t eat too much of it.”

Dr. Bradford Ferrick, 32, was arrested Tuesday morning on a charge of possessing child pornography and was due to appear virtually in federal court in Boston, according to the U.S. Attorney’s Office for Massachusetts.

About 80 devices were seized from Ferrick’s homes in Winchester and Amherst, including hidden camera systems, last month, and thousands of images and videos showing suspected sexual images of children, prosecutors said. Alleged victims appear to be between 6 and 11.

“I can think of no greater fear as a parent or guardian than potential harm coming to your child. Today we allege that this doctor, who held a position of trust with access to children, maintained child sexual abuse material,” U.S. Attorney Rachael Rollins said in a statement, noting that the investigation is ongoing.

It wasn’t immediately clear if Ferrick had an attorney who could speak to his arrest.

Ferrick is a family medicine resident at Baystate Franklin Family Medicine. A hospital website on Tuesday listed him as a current resident at the hospital system’s Greenfield Family Medicine; his biography and image was removed Wednesday.

Ferrick was placed on unpaid administrative leave in mid-February, where he’s remained, a Baystate Health representative told NBC10 Boston in a statement, noting that the hospital system can’t issue comments on pending criminal charges.

“We are cooperating with law enforcement authorities as they proceed with their investigation,” the representative said.

In Massachusetts, Ferrick had rotations in Springfield, Deerfield and Greenfield, prosecutors said. Before joining the hospital system in July 2022, he worked attended State University of New York’s Upstate Medical University in Syracuse.

Investigators have set up this FBI website for anyone with information or concerns about the case.

Police in Winchester first reviewed tips from a national clearinghouse for child sexual exploitation information in January, according to the complaint filed in federal court. Videos with suspected child pornography were uploaded to a Google Drive in November 2021 and March 2022, each done in an IP address traced to Syracuse.

Winchester and state police searched Ferrick’s parents home in Winchester, where he lives as well, on Feb. 13, and seized 61 devices, including hidden camera systems, computers, cellphones and storage devices that, in total, were able to contain more than 100 terabytes of data, the complaint said. He was arrested on four counts of possessing child pornography and released two days later on $50,000 bail under conditions including house arrest.

Several more devices were seized from the house later that week, after Ferrick appeared to have remotely manipulated one of the phones that had already been taken, investigators said.

A review of the devices found graphic videos showing a man raping a child, including two instances where the child was unconscious, according to the complaint.

The day after the search of the Ferricks’ home, Winchester police found a hidden camera in a bathroom at the home of relatives, where two young children live, the complaint said. A Winchester detective had gotten permission to conduct the search after visiting the house and informing them of the charges.

The next week, police searched a home in Amherst that Ferrick rented and found eight more devices, including the hidden camera that appeared designed as a bracelet, investigators said. Its memory card allegedly showed videos of Ferrick giving medical exams in August 2022 with another doctor, including a audio of Ferrick apparently examining a teenage boy’s genitals while his mother was present.

“It does not appear the individuals in the room are aware they are being recorded during either exam,” an FBI agent wrote in the complaint.

“The longer you have symptoms, if they’re not treated well, it builds up so that your symptoms can get worse and worse,” Dr. William Reisacher, an otolaryngic allergist at Weill Cornell Medicine, tells TODAY.com.

And with climate change causing milder winters, allergy seasons may be getting more severe, too, Dr. Michelle Pham, allergist and immunologist at UCSF Health, tells TODAY.com.

If you get spring allergies, you should start taking your medications and getting your allergy management plan in motion starting around Valentine’s Day, Feb. 14, experts say.

“It’s hard to be motivated (to start taking your medication) when you feel well,” Pham says. “But the whole idea of starting it beforehand is so that you don’t get any symptoms and you continue to feel well throughout your season.”

That’s why she recommends her patients start using corticosteroid sprays, such as Flonase, about four weeks before the start of their allergy season. “And with oral antihistamines, we have patients start about two weeks before,” she adds.

Oral antihistamines begin to work quickly (usually within 15 minutes to two hours), so it’s not the worst thing to start taking them once your symptoms start to come on, Dr. Sandra Hong, an allergist at the Cleveland Clinic, tells TODAY.com. But if you can avoid getting your symptoms in the first place by pre-treating, that’s even better.

How to know when to start taking your medications

To get the most out of your allergy medications, you’ll want to start taking them before the allergens that you’re sensitive to begin to appear.

While fluctuating temperatures can cause intense pollen spikes on an unusually warm day in the winter, seasonal allergies typically kick off in March with tree pollen, Reisacher says. That’s followed by grass pollen around June, and then weed pollen in late August and September, which continues generally until the first frost, he says. 

So, most people who get spring seasonal allergies will be safe starting their medications around Valentine’s Day, Dr. Kathleen R. May, president of the American College of Allergy, Asthma and Immunology, tells TODAY.com.

“When you think of Valentine’s Day, think of your allergist,” Hong agrees.

But the exact timing — and the specific types of plant pollen you might be exposed to — are both “contingent on where (you live),” May adds. In Texas, for instance, mountain cedar pollen, a type of tree pollen, starts to pick up as early as December, May says. 

Because the correct timing can be so individual, the experts suggest that people who get allergies see an allergist to learn what their triggers are and then keep an eye on local weather trends and pollen counts. In particular, Pham directs people to the American Academy of Allergy, Asthma and Immunology‘s website where they can look at data from pollen sampling stations in their area.

Why should you start taking allergy meds so early?

There are a few good reasons to start taking your allergy medicationsbefore you start feeling symptoms.

First off, if you’re waiting to see leaves on trees before you start those medications, you’ll be too late, May says. Pollen on trees may look like fuzzy buds, and it can appear before the leaves come back in the spring, she adds.

And some medications, particularly corticosteroid nasal sprays (commonly known by brand names Flonase and Nasacort), can take two to four weeks to build to their maximum effect.

There’s a mechanical reason to start the sprays early, too: If your nose is already full of snot, it will be harder for the spray to get where it needs to go, May explains.

Antihistamine medications, including pills, nose sprays and eye drops, can typically be used on more of an as-needed basis than the steroid sprays, Reisacher explains. But if you know you’re going to be exposed to your allergen (like at someone’s house with a pet or outside on a hike, for instance), he recommends patients take their antihistamine medication the day before, the day of and the day after the exposure.

“Steroids can decrease inflammation overall,” Pham explains, while antihistamines block histamines, the compound your body releases in response to allergens, from affect the cells that cause allergy symptoms.

What’s more, “during the initial part of the season, it takes less pollen to trigger you,” May explains, which is another “reason we always tell people to do the medications in advance.”

Other ways to combat allergy symptoms this season

As important as it is to take your medications early, don’t forget to also start putting your other allergy management tactics into motion.

• Consider wearing sunglasses, a hat and a high-quality mask outside. If you’re going to be at your child’s baseball game or out gardening, for example, a high-filtration mask can help manage your symptoms, Hong says.
• Take a shower when you get home. Pollen can accumulate on your skin and especially your hair. “You can collect almost a tree’s worth of pollen right on your own head if you have a lot of hair,” Reisacher says. So it’s important to rinse off when you come back inside.
• In addition to a shower, try using a saline nasal spray or a nasal rinse with purified water to flush pollen out of your nasal passages, the experts suggest.
• Close the windows (in your car, too!) and use a HEPA air purifierin your home, especially the bedroom, the experts advise.
• Keep an eye on pets that go outside. Pets can accumulate pollen from the outdoor environment, Hong says. So, if you can, try not to let them spread that pollen around in the house. 
• Have a few indoor-only outfits. That way, when you come home and change into your indoor outfit, “you’re not walking around the house depositing pollen into all the rooms,” Reisacher says. 

When to see an allergist

Many people with run-of-the-mill seasonal allergies can manage their symptoms with over-the-counter medications. But there are a few important reasons to check in with your doctor or an allergist. 

First, if your go-to medications aren’t helping as much as they used to, go ahead and try another brand, Hong says. But if that’s still not helping, it may be because your symptoms are simply getting worse, May advises. In that case, it’s worth talking to an allergist about your options, which could include prescription medications or long-lasting treatments, such as immunotherapy.

Finally, if you think you might have asthma or another condition that can be worsened by seasonal allergies, you should talk to your doctor about the best ways to manage those issues.

“People who don’t have allergies don’t understand how disruptive it is your quality of life,” May adds. “They don’t quite realize the impact on sleep, the impact on your daytime alertness and function.”

But addressing your allergies sooner rather than later can make your whole season much easier to deal with.

“It’s really important to think about allergies before your season starts,” Hong explained. “Getting the jump on your allergies will make all of your symptoms so much better for the entire springtime.”

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The mammoth underground structure is comprised of nearly 500 miles of pipeline — stretching from Amarillo, Texas, to the panhandle of Oklahoma to Kansas — and supplies roughly 40% of the world’s helium. 

“It was supposed to be sold off by 2021,” said Sophia Hayes, a professor of chemistry at Washington University in St. Louis and one of the nation’s leading helium experts. “But for the past year, it’s been silent.” 

For the better part of a decade, scientists like Hayes have urged government officials to hold on to the reserve, instead of selling it to a private entity — likely a major industrial gas or pipeline company, and possibly one that is foreign-owned. They say that the decision Congress made in 1996 to set into motion a 25-year plan to unload the reserve, in a bid to shrink government, was shortsighted and potentially detrimental to a host of industries, ranging from medical technology to rocket science.

Last week, a government-issued helium bulletin inflated their hopes that the United States may be thinking harder about helium.

Read the full story here at NBCNews.com.

The retail giant said Tuesday that it will launch RxPass, a subscription service for customers who have Prime memberships. Amazon said people will pay $5 a month to fill as many prescriptions as they need from a list of about 50 generic medications, which are generally cheaper versions of brand-name drugs.

The company said the flat fee could cover a list of medications like the antibiotic amoxicillin and the anti-inflammatory drug naproxen.

Sildenafil also made the list. It’s used to treat erectile dysfunction under the brand name Viagra and also treats a form of high blood pressure.

Amazon sells a range of generic drugs through its pharmacy service. Some already cost as low as $1 for a 30-day supply, so the benefit of this new program will vary by customer.

The new program doesn’t use insurance, and people with government-funded Medicaid or Medicare coverage are not eligible. It will be available in 42 states and Washington, D.C. at launch.

Any program that gets low-cost generic drugs to more patients “is a good thing,” said Karen Van Nuys, an economist who studies drug pricing at the University of Southern California. But she added that she wasn’t sure how much of an impact RxPass will have.

She noted that the program is limited to Amazon Prime customers. Other options like the Mark Cuban CostPlus Drug Co. sell more generic drugs, many for under $5.

“I just don’t know that it’s expanding access to a new set of patients,” Van Nuys said.

Still, the move could help the company take up some more space in the health care market, even though it has not always been successful in its aim. Last year, the company shuttered its hybrid virtual, in-home care service called Amazon Care after it failed to get traction from employers. And Haven, a company Amazon created in collaboration with JPMorgan and Berkshire Hathaway to improve health costs, dissolved a year earlier than that.

Amazon has said its online drug store Amazon Pharmacy is a key part of its health care plan, along with primary care organization One Medical, which the online giant is seeking to acquire for $3.9 billion. The Federal Trade Commission is investigating the proposed buyout.

In November, the company also said it would begin offering “Amazon Clinic,” a messaging service that connects patients with doctors for about two dozen common conditions, such as allergies and hair loss.

Walgreens and CVS will sell the prescription abortion pill mifepristone after the Food and Drug Administration this week dropped a long-standing rule that prevented drug stores from doing so.

The decision by the two largest drug store chains in the U.S. will significantly expand access to mifepristone in states where abortion is legal. The companies cannot offer the pill in states that have completely banned abortion in the wake of the Supreme Court decision that overturned Roe v. Wade.

The FDA on Tuesday changed its regulations to allow retail drug stores to dispense mifepristone so long as they complete a certification process. The agency dropped a long-standing rule that required patients to obtain the abortion pill in-person at clinics, hospitals and other certified health-care providers.

Walgreens plans to get certified and is working through the registration and training of its pharmacists to dispense mifepristone consistent with federal and state law, spokesperson Fraser Engerman said. CVS also plans to get certified in states where it is legal to do so, spokesperson Amy Thibault said.

This means patients in many parts of the U.S. will effectively be able to obtain mifepristone like other prescription medications, either in-person at a retail pharmacy or through the mail. Patients will still need to obtain their prescription from a certified health-care provider.

Mifepristone has become a central flashpoint in the political battle over abortion at the state level in the wake of the Supreme Court overturning Roe v. Wade. Several conservative groups have asked a federal court in Texas to overturn the FDA’s approval of mifepristone.

Mifepristone is the most common way to terminate a pregnancy in the U.S. Some 51% of abortions were performed with mifepristone in 2020, according to the Centers for Disease Control and Prevention.

The FDA first approved mifepristone more than 20 years ago in 2000 as a method to terminate early pregnancies, but the pill long had strict regulations around how it could be dispensed to patients. Medical organizations such as the American College of Obstetricians and Gynecologists had long argued that those regulations lacked a scientific basis and were rooted in politics.

Mifepristone is approved to end a pregnancy through the 10th week. It is used in combination with another pill called misoprostol. Mifepristone stops the pregnancy from continuing and misoprostol induces contractions that empty the uterus.

Some frogs found in South and Central America have the rare ability to turn on and off their nearly transparent appearance, researchers report Thursday in the journal Science.

During the day, these nocturnal frogs sleep by hanging underneath tree leaves. Their delicate, greenish transparent forms don’t cast shadows, rendering them almost invisible to birds and other predators passing overhead or underneath.

But when northern glass frogs wake up and hop around in search of insects and mates, they take on an opaque reddish-brown color.

“When they’re transparent, it’s for their safety,” said Junjie Yao, a Duke University biomedical engineer and study co-author. When they’re awake, they can actively evade predators, but when they’re sleeping and most vulnerable, “they have adapted to remain hidden.”

Using light and ultrasound imaging technology, the researchers discovered the secret: While asleep, the frogs concentrate, or “hide,” nearly 90% of their red blood cells in their liver.

Because they have transparent skin and other tissues, it’s the blood circulating through their bodies that would otherwise give them away. The frogs also shrink and pack together most of their internal organs, Yao said.

The research “beautifully explains” how “glass frogs conceal blood in the liver to maintain transparency,” said Juan Manuel Guayasamin, a frog biologist at University San Francisco of Quito, Ecuador, who was not involved in the study.

Exactly how they do this, and why it doesn’t kill them, remains a mystery. For most animals, having very little blood circulating oxygen for several hours would be deadly. And concentrating blood so tightly would result in fatal clotting. But somehow, the frogs survive.

Further research on the species could provide useful clues for the development of anti-blood clotting medications, said Carlos Taboada, a Duke University biologist and study co-author.

Only a few animals, mostly ocean dwellers, are naturally transparent, said Oxford University biologist Richard White, who was not involved in the study. “Transparency is super rare in nature, and in land animals, it’s essentially unheard of outside of the glass frog,” White said.

Those that are transparent include some fish, shrimp, jellyfish, worms and insects — none of which move large quantities of red blood through their bodies. The trick of hiding blood while sleeping appears to be unique to the frogs.

“It’s just this really amazing, dynamic form of camouflage,” said White.

She went to members of Congress and health regulators to make the case for Relyvrio, until patient-advocates finally prevailed.

In September, Relyvrio became only the third drug approved in the U.S. for ALS, or amyotrophic lateral sclerosis, an incurable neurodegenerative disease that is usually fatal within five years. But patients and physicians who celebrated Relyvrio’s approval several months ago are now contending with the obstacles posed by the U.S. health care system.

Their odyssey is an object lesson in the soaring cost of specialty drugs and the byzantine systems that insurers have created to try and control them.

Patients with insurance coverage say the $158,000 per year price tag set by drugmaker Amylyx Pharmaceutical is fueling insurance delays or denials, and sometimes exorbitant out-of-pocket expenses.

Mourey’s insurer initially refused to cover Relyvrio, but reversed itself seven weeks later after online pressure— including social media posts by Mourey and other ALS advocates.

“Amylyx priced it way too high,” said Mourey, 58, a former music teacher, who now communicates using a vision-controlled speech computer. “They could cut the price in half and still make a hefty profit.”

Even when Relyvrio is covered, some patients see themselves shouldering co-payments between $1,000 and $4,000 per month.

Unlike those patients, the Moureys have been exempt from copays due to a combination of company-managed Medicare and Medicaid coverage.

Some ALS patients are covered by private plans, while others receive government coverage through programs like Medicare.

In both cases, patients and their doctors can face onerous requirements to document their condition before insurers will pay for an expensive new treatment. Additionally, many insurers require patients to pay a percentage of their pharmacy costs. With many drugmakers now charging upwards of $100,000 for drugs approved for hard-to-treat illnesses, even a 5% copay can become unaffordable. The trend has increasingly made the drug industry deeply unpopular in the U.S.

Drugmakers say their prices reflect the years of costly clinical trials needed to win FDA approval.

Amylyx said the delays in coverage for Relyvrio are normal because many insurers are still writing their policies for the drug. The company also highlighted its multiple programs to help patients with costs, including providing the drug for free to the uninsured and covering copays for those who qualify for assistance.

The issues surrounding Relyvrio’s price highlight industry practices that have long been blamed for driving up U.S. health costs: drugmakers can patent new combinations of old ingredients and then charge whatever price the market will bear.

Insurers have responded with extra review hurdles. Those delays weigh heavily on patients with ALS which is measured in the monthly loss of functions like walking, speaking and swallowing.

“It’s just stressful and aggravating to get these multiple denial letters,” said Jim Mourey, who cares for his wife full time at their home in Hopkinton, Massachusetts.

Relyvrio is a powder-based formulation that combines two older ingredients: a prescription drug for liver disorders and a supplement used in traditional Chinese medicine that’s available on Amazon.com for about $1 per day’s supply.

Insurers typically won’t pay for ALS patients to receive the prescription ingredient, because it’s not approved for their disease. But some patients have gotten their plans to cover it or have found lower-price versions — for less than $600 a month— at specialty pharmacies. That’s led some patients to skip the new drug entirely by obtaining its two ingredients separately.

Analysts expect Relyvrio to generate $450 million in annual sales for Amylyx by 2024. It’s the company’s first product.

One group that analyzes drug pricing said a fair price for Relyvrio would be between $9,100 and $30,700 per year. The drug showed some effectiveness in slowing the progression of ALS, based on patient questionnaires. Amylyx is conducting a larger study to answer lingering questions about its effectiveness, including whether it extends survival.

Layne Oliff, 63, hasn’t yet decided whether to seek coverage from his Medicare plan. Under the federal program, he would likely owe $7,400 in copays for Relyvrio before reaching his out-of-pocket maximum. That’s on top of monthly administration fees of over $600.

But if he pays cash, Oliff says he can buy the prescription ingredient in the drug for $550 per month, or $6,600 per year, from a specialty pharmacy. He can get the supplement online for about $30 a month.

“You’re talking about a drug that’s not a cure, though it has helped slow the progression” said Oliff, who trained as a pharmacist. “But I don’t want to leave my wife someday in a financial hole; I’m not going to spend all my money on this drug.”

Amylyx has set up a program to cover the copay costs for patients with private insurance. But that financial assistance cannot be used for federal plans like Medicare and the Veterans Administration, which cover many ALS patients. After initially restricting coverage, the VA recently broadened its eligibility.

Other insurers are initially rejecting coverage or requiring multiple rounds of documentation from doctors.

“When someone’s lifespan is measured in months, making people go through these multiple rounds of review is just cruel,” said Neil Thakur of the ALS Association. The group invested in Amylyx’s early research and stands to recoup that investment.

Dr. Terry Heiman-Patterson, a neurologist at Temple University, says it’s taken about four to six hours of phone calls with insurers to get each new patient on Relyvrio.

Heiman-Patterson warns her patients to expect weeks of back-and-forth before getting the drug.

“This is the process we’re going to have to go through and I don’t know what your copay is going to be in the end,’” she says.

Some patients who are already taking a do-it-yourself approach to the treatment see little reason to change.

Sarah Nauser, a former police officer, says her insurance has covered the prescription ingredient in Relyvrio — sodium phenylbutyrate — for a $10 copay since 2020.

“After seeing all the difficulties that people are having, I’m not going to mess with what’s working,” said Nauser, 34, who credits the combination with slowing her disease and helping her to maintain her ability to walk, talk and feed herself.

The co-founders of Cambridge, Massachusetts.-based Amylyx theorize that the two chemicals in their drug work together to shield cells from premature death. But there’s little agreement among scientists about how the drug works, or even which ingredient is responsible for its benefit.

A small European study of the supplement contained in Relyvrio showed a larger effect on slowing ALS than Amylyx’s study. And researchers there are conducting a larger, 300-patient study of the ingredient.

“That study could be hugely important in telling us whether this one ingredient–which is very inexpensive– is actually effective,” said Diana Zuckerman of the non-profit National Center for Health Research, which analyzes medical research.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

In a Dec. 15, opinion piece for CNN, the 15-year-old recounted her health journey, explaining how a misdiagnosis last year proved to be incredibly dangerous — and potentially deadly.

“It started one weekend in November 2021 with stomach cramping, a low fever, chills and vomiting,” Alice wrote in the article. “Soon it became clear I needed to go to the emergency room. By the time I got there, I had low blood pressure, an elevated heart rate, intense abdominal pain and a high white blood cell count.”

Despite being given IV fluids “to combat my dehydration,” she noted that she was not getting better. At that point, Alice said she was transferred to another hospital, where her symptoms continued.

“With guidance from my pediatrician, my parents told the doctors to check for appendicitis,” she said. “But since I was tender all over my abdomen — not just on my right side — the doctors ruled it out.” 

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The teen added, “The doctors concluded that what I had must be a viral infection and would eventually just go away.”

However, things only got worse from there. Alice noted that at one point her skin even turned a “pale green” — but still, doctors weren’t recommending anything other than Tylenol for her pain.

“My mom asked my doctors why I couldn’t get a sonogram to see what was happening inside my abdomen; they said it wasn’t needed,” Alice recalled. “My dad asked why I couldn’t get antibiotics; the doctors said for a viral infection they could do more harm than good. My parents kept pushing for a gastroenterologist who might have more insight about my condition to evaluate me, but one never came.”

However, things took a turn after Alice was rushed to get an emergency ultrasound that finally revealed the cause of all her pain: a perforated appendix.

“When I learned my diagnosis, I was almost relieved,” she wrote, noting how helpless she felt not being listened to by doctors. “At least the doctors now had a plan.”

As she concluded in her essay, she’s not alone in her appendicitis diagnosis, stating that it can be missed in up to 15 percent of children.

“It breaks my heart to think about the boys and girls who don’t have parents who can get the phone number of the hospital administrator — who can’t make their voices break through,” Alice added. “I still can’t believe this happened to me — and I don’t want it to happen to anyone else.”

Her dad, too, opened up about his daughter’s health scare on his CNN show The Lead, saying “This could have happened to any child at any hospital in the United States because doctors are not sufficiently aware of how often it is that appendicitis does not appear in a standard way.”

The notice from the Food and Drug Administration about an oral solution of the drug comes as pharmacy owners report diminished inventory of the medication, which is prescribed to treat bacterial infections, including pneumonia and bronchitis.

The department also listed a shortage for an oral powder. Amoxicillin is available in chewable tablets or capsules.

It wasn’t immediately clear what prompted the shortage or how long it could last.

The FDA did not immediately respond to a request for comment, nor did three key makers of the antibiotic — Hikma Pharmaceuticals, based in the United Kingdom; Sandoz, based in Switzerland; and Teva Pharmaceutical Industries Ltd., based in Israel.

Read the full story here at NBCNews.com.