Skin Cancer Breakthrough: Arthritis Drug Could Be New Weapon Against Melanoma

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Main Category: Melanoma / Skin Cancer
Also Included In: Cancer / Oncology;  Arthritis / Rheumatology;  Dermatology
Article Date: 24 Mar 2011 – 13:00 PDT

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Leflunomide, a drug commonly used to treat rheumatoid arthritis, may also inhibit the growth of malignant melanoma, a
deadly form of skin cancer, according to new research led by the University of East Anglia (UAE) in the UK and Children’s
Hospital Boston in the US.

You can read how UAE researchers Dr Grant Wheeler and Dr Matt Tomlinson and colleagues made the discovery in a paper
published online in Nature this week.

The breakthrough discovery is exciting scientists and clinicians because it takes much less time to trial a drug that is already
licensed for another disease than it does for one never previously tested, leading to speculation that this treatment might be
available in the next five years.

Wheeler, of UEA’s School of Biological Sciences, told the press that deaths from melanoma are increasing, and we desperately need
new and better treatments.

“We are very optimistic that this research will lead to novel treatments for melanoma tumors which, working alongside other
therapies, will help to stop them progressing,” he added.

For the study, Wheeler, Tomlinson and colleagues screened thousands of compounds looking for likely candidates by testing their
ability to affect the development of pigment cells in tadpoles.

They used tadpole pigment cells because they are similar to human melanocytes that produce melanin, the pigment that is mainly
responsible for skin colour. Melanoma occurs when melanocytes grow in an uncontrolled manner.

The researchers found a number of likely candidates, and after testing them on lab mice, found that leflunomide significantly
restricted tumour growth.

They also tested the effect of combining leflunomide with PLX4720, a promising new drug that is currently being tested as a
treatment for melanoma, and found it almost halted tumor growth completely.

The next stage will be to carry out clinical trials of leflunomide as a treatment for melanoma, and because it is already licensed
for the treatment of arthritis, should the trials prove successful, it could be available in about five years, which is half the usual
timescale for a new drug.

In another paper in the same issue of Nature, some of the researchers from this study describe how they and other
colleagues used zebrafish to identify a new gene called SETDB1 that is responsible for promoting melanoma.

Surprisingly, melanocytes, the pigment-producing cells in humans and tadpoles, are also responsible for producing the dark stripes
on zebrafish.

To find the gene, the researchers at Children’s Hospital Boston developed a transgenic zebrafish that had two other features that
lead to melanoma: the correct mutation of a gene called BRAF, and the absence of the tumor suppressor gene p53.

They started out with a hunch that it took more than mutations in BRAF and the absence of p53 to trigger malignant tumors, and
used the new zebrafish model to painstakingly sift through all the other genes, one by one.

The Xenopus tadpole used at UEA to find leflunomide as a possible treatment for melanoma, and this zebrafish model from
Children’s Hospital Boston, are examples of the power of using developmental models to screen large numbers of compounds.

The researchers hope such approaches will help discover even more compounds and genes as candidates for other
diseases.

As lead author Dr Richard White of Children’s Hospital Boston and Harvard Medical School explained, knowing more about
cancer is not just a matter of finding mutations in genes, but also about knowing the types of cells that tumors spring
from.

“By studying cancer development in zebrafish and frogs, we gain a unique insight into the very earliest changes that occur in
those cells,” said White.

Melanoma is the most aggressive form of skin cancer and, unlike most other cancers, it is on the rise. It accounts for 5% of skin
cancers.

More than 10,000 people are diagnosed with melanoma in the UK every year; in the US this figure was 68,000 in 2009, when
8,700 Americans also died from the disease.

If diagnosed early, melanoma tumors can be safely removed with surgery, but if diagnosed in the advanced stage, the chances of
survival are thin.

About 2,000 people die every year in the UK because their melanoma returns after being removed surgically.

If you spot any changes to the shape or color of existing moles or find a new lump anywhere on your skin, get a doctor to check
them, because these are possible signs of melanoma.

“DHODH modulates transcriptional elongation in the neural crest and melanoma.”
Richard Mark White, Jennifer Cech, Sutheera Ratanasirintrawoot, Charles Y. Lin, Peter B. Rahl, Christopher J. Burke, Erin
Langdon, Matthew L. Tomlinson, Jack Mosher, Charles Kaufman, et al.
Nature 471, 518-522, published onlin 23 March 2011
DOI:10.1038/nature09882

Additional source: University of East Anglia (23 Mar 2011)., UMass Medical School (24 Mar 2011).

Written by: Catharine Paddock, PhD

Copyright: Medical News Today

Not to be reproduced without permission of Medical News Today



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Krystal Knight To Join Medicare Rights Center As State Program And Policy Coordinator

Main Category: Medicare / Medicaid / SCHIP
Article Date: 25 Mar 2011 – 11:00 PDT

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Krystal Knight, M.P.H., will join the Medicare Rights Center’s Washington, D.C. office to serve in the newly created position of State Program and Policy Coordinator. Ms. Knight will oversee a new project funded by Atlantic Philanthropies to expand the Medicare Rights Center’s community-based education and policy programs in five states-Alabama, Florida, Kansas, Maine and Wisconsin.

Through the project, Medicare Rights will partner with local organizations in each state to establish, or in the case of Kansas, to expand, the award-winning Seniors Out Speaking (SOS) program. Through the SOS program, Medicare Rights works with host organizations nationally to enlist, train and track the outcomes of SOS volunteers as they help their peers understand Medicare and related health insurance coverage. Ms. Knight will also oversee the launch of Medicare Advocacy Coalitions in each state, bringing together consumers, advocacy organizations, policymakers and other stakeholders to help ensure that health reform is responsive to the needs of people with Medicare.

“I am delighted that Krystal will join Medicare Rights as our State Program and Policy Coordinator,” said Joe Baker, president of the Medicare Rights Center. “She brings a wealth of knowledge and experience to the Medicare Rights Center to help us serve people with Medicare and build coalitions with stakeholders across the country.”

“I am thrilled to come on board at the Medicare Rights Center at a time of great opportunity to create positive change for people with Medicare,” said Ms. Knight. “Health reform represents a tremendous opportunity for the American health care system, and much work is required to ensure that the needs of older adults and people with disabilities are met as implementation unfolds.”

Ms. Knight was formerly Public Policy Associate at the National Association of Community Health Centers, and holds a B.A. and an M.P.H. from the University of Florida.

Source:

Medicare Rights Center



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New Guide Aims To Help Long-Term Care Facilities Deliver Medicare Skilled Services

Main Category: Medicare / Medicaid / SCHIP
Article Date: 26 Mar 2011 – 0:00 PDT

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Deciding when a resident is eligible to move to skilled care ranks among the most challenging dilemmas for long-term care facilities. Tracking Medicare Part A admissions rules, MDS assessments, eligibility requirements and benefits periods can stymie even the most careful administrators and clinicians — and negatively impact reimbursements, which can average from $350 to $650 per day for each Medicare resident.

Author Elizabeth Malzahn takes the mystery out of the process with “Long-Term Care Skilled Services: Applying Medicare’s Rules to Clinical Practice,” a practical, easy-to-read, 147-page guide for anyone involved in resident care decisions, compliance or payments in the long-term care arena.

Chock-full of clear examples, the book illustrates the roles of key players like nursing or therapy directors, chief financial officers or administrators, and explains how to properly manage the skilled services maze to minimize critical mistakes like over- or under-payment. Malzahn covers a range of important topics, walking the reader through complex regulations, technical eligibility rules and the all-important MDS 3.0 assessment process. She provides tips and insight into virtually every aspect of skilled services, including how to properly communicate with residents and families, and attempts to dispel popular “myths” about Medicare.

Malzahn leverages her experience as national director of health care for Covenant Retirement Communities, a Chicago-based not-for-profit with 12 continuing care retirement communities across the country. Her observations there, as well as the decade she spent in an accounting firm’s Health Care Consulting Group specializing in skilled nursing facilities, can help facilities set up a win-win: residents get the services they need (and have paid into over a lifetime), and the facilities receive the appropriate Medicare reimbursement. This book is designed, Malzahn said, to help facilities increase their Medicare Part A census and avoid discharging residents too soon as well as improve staff support for the process.

“By cutting to the basics, the book makes Medicare admission clear and concise,” says author Elizabeth Malzahn. “It should make providers confident about admitting residents on Medicare and allow them to help patients access all appropriate services.”

“Long-Term Care Skilled Services: Applying Medicare’s Rules to Clinical Practice,” is published by HCPro, Inc. and available online April 8, 2011 in the HCPro Healthcare Marketplace.

Source: Covenant Retirement Communities



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Long-Term Safety Data Demonstrated Vimovotm Is Generally Well Tolerated In Arthritis Patients At Risk For NSAID-Associated Gastric Ulcers

Main Category: Arthritis / Rheumatology
Also Included In: GastroIntestinal / Gastroenterology;  Pain / Anesthetics
Article Date: 25 Mar 2011 – 1:00 PDT

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AstraZeneca (NYSE: AZN) today announced results from PN400-304, a long-term safety study of VIMOVO™ (naproxen/esomeprazole magnesium) 500/20 mg delayed-release tablets in osteoarthritis patients requiring daily nonsteroidal anti-inflammatory drug (NSAID) therapy who were at risk for NSAID-associated gastric ulcers.[3] The data demonstrated VIMOVO was generally well tolerated throughout the 12-month treatment period, with no new or unexpected safety issues.1 Study findings were presented at the American Academy of Pain Medicine (AAPM) Annual Meeting in National Harbor, MD, and published in Current Medical Research and Opinion, the international, peer reviewed clinical research journal.[4]

While NSAIDs are commonly prescribed for relief of pain and inflammation in patients with osteoarthritis, long-term use may increase the occurrence of gastric ulcers and other adverse events (AEs) in some patients.[5] VIMOVO, codeveloped by AstraZeneca and POZEN Inc, is a fixed-dose combination of enteric-coated naproxen, a pain-relieving NSAID, and immediate-release esomeprazole magnesium, an ulcer risk-reducing proton pump inhibitor (PPI), approved for the relief of signs and symptoms of osteoarthritis (OA), rheumatoid arthritis (RA), and ankylosing spondylitis (AS), and to decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers.[6] VIMOVO is not recommended for initial treatment of acute pain because the absorption of naproxen is delayed compared to absorption from other naproxen-containing products. Controlled studies do not extend beyond 6 months.3

“Many of the 27 million patients in the United States diagnosed with osteoarthritis[7] routinely take NSAIDs to help treat their pain and inflammation. While these treatments are effective in alleviating pain, chronic use of NSAIDs puts patients at increased risk of developing gastric ulcers2,” said Mark Sostek, M.D., F.A.C.G. and A.G. A.F., Executive Director, Clinical Research, AstraZeneca. “The findings from PN400-304 add to the body of data demonstrating that VIMOVO is an effective and generally well tolerated treatment option for osteoarthritis patients at risk of developing NSAID-associated gastric ulcers.1 In a single tablet, VIMOVO delivers both the proven pain relief of naproxen with the gastric ulcer risk reduction of esomeprazole in every dose of the medication.3”

No new or unexpected safety issues emerged throughout the treatment period.1 Among all patients in the study (N=239), the most common adverse events were dyspepsia (7.9%), constipation (5.9%), and nausea (5.0%).1 Among the 12-month population (N=135) that completed the trial, the most common adverse events were upper respiratory tract infection (URTI) (9.6%), dyspepsia (5.9%), back pain (5.2%), and contusion (5.2%).1 In addition, laboratory tests, vital signs, physical examination, and ECG assessments showed no new or unexpected findings.1


PN400-304 was an open-label, multicenter, Phase 3 study designed to evaluate the long-term safety of VIMOVO. 1 The study included H. Pylori-negative patients ages 18 and older with OA, RA, AS, or other conditions requiring daily NSAID therapy, who were at risk for NSAID-associated gastric ulcers either due to age (at least 50 years) or history of ulcer in the past five years. 1 Patients were treated with VIMOVO twice daily for 12 months.1

VIMOVO, which was approved by the FDA in April 2010, is available in pharmacies across the country. Patients and physicians can find out about VIMOVO formulary access by visiting www.yourformularyinfo.com. Physicians can also learn more about VIMOVO by visiting www.VIMOVOtouchpoints.com, an interactive forum where they can chat with a Personal Account Specialist, find health plan coverage information in your area, and easily access information about the efficacy, tolerability and safety profile of VIMOVO, and access and affordability. In addition, the e-sampling feature on the Web site allows physicians to order samples of VIMOVO at their own convenience.

Important Safety Information

— Like all medications that contain nonsteroidal anti-inflammatory drugs (NSAIDs), VIMOVO may increase the chance of a heart attack or stroke that can lead to death. This chance increases

– With longer use of NSAID medicines

– In people who have heart disease

— NSAID-containing medications, such as VIMOVO, should never be used before or after a type of heart surgery called coronary artery bypass graft (CABG)

– As with all medications that contain NSAIDs, VIMOVO may increase the chance of stomach and intestinal problems, such as bleeding or an ulcer, which can occur without warning and may cause death

– Elderly patients are at greater risk for serious gastrointestinal events

VIMOVO is not right for everyone, including patients who have had an asthma attack, hives, or other allergic reaction with aspirin or any other NSAID medicine, patients who are allergic to any of the ingredients in VIMOVO, or women in late stages of pregnancy.

Serious allergic reactions, including skin reactions, can occur without warning and can be life-threatening; discontinue use of VIMOVO at the first appearance of a skin rash, or if you develop sudden wheezing; swelling of the lips, tongue or throat; fainting; or problems swallowing.

VIMOVO should be used at the lowest dose and for the shortest amount of time as directed by your health care provider.

Tell your health care provider right away if you develop signs of active bleeding from any source.

VIMOVO can lead to onset of new hypertension or worsening of existing high blood pressure, either of which may contribute to an increased risk of a heart attack or stroke.

Speak with your health care provider before starting VIMOVO if you

— Have a history of ulcers or bleeding in the stomach or intestines

– Have heart problems, high blood pressure, or are taking high blood pressure medications

– Have kidney or liver problems

Review all the medications, even over-the-counter medications, you are taking with your health care provider before starting VIMOVO.

Talk to your health care provider about your risk for bone fractures if you take VIMOVO for a long period of time.

The most common side effects of VIMOVO include: inflammation of the lining of the stomach, indigestion, diarrhea, stomach ulcers, abdominal pain, and nausea.

Approved Uses for VIMOVO

VIMOVO is approved to relieve the signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, and to decrease the risk of stomach (gastric) ulcers in patients at risk of developing stomach ulcers from treatment with NSAIDs.

VIMOVO is not recommended as a starting treatment for relief of acute pain. Controlled studies do not extend beyond 6 months.

Notes

About VIMOVO

VIMOVO is a fixed-dose combination of delayed-release enteric-coated naproxen, a non-steroidal anti-inflammatory drug (NSAID), and immediate-release esomeprazole, a stomach acid-reducing proton pump inhibitor (PPI), approved for the relief of signs and symptoms of osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, and to decrease the risk of developing gastric ulcers in patients at risk of developing NSAID-associated gastric ulcers. 3 VIMOVO is not recommended for use in children younger than 18 years of age. 3 VIMOVO is not recommended for initial treatment of acute pain because the absorption of naproxen is delayed compared to absorption from other naproxen-containing products. Controlled studies do not extend beyond 6 months.3

VIMOVO has been developed as a sequential-delivery tablet formulation combining an immediate-release esomeprazole magnesium layer and an enteric-coated naproxen core. As a result, esomeprazole is released first in the stomach, prior to the dissolution of naproxen in the small intestine. The enteric coating prevents naproxen release at pH levels below 5.5.3

About Osteoarthritis

Osteoarthritis is a degenerative joint disease caused by the breakdown and eventual loss of the cartilage of one or more joints.[8] Osteoarthritis is the most common form of arthritis, affecting 151 million individuals worldwide[9] and 27 million Americans4. A combination of factors can contribute to osteoarthritis, including being overweight, aging, joint injury or stress, heredity, and muscle weakness[10]. Osteoarthritis commonly affects the hands, spine or large weight-bearing joints, such as the hips and knees.7

About Rheumatoid Arthritis

Rheumatoid arthritis is a chronic disease, mainly characterized by inflammation of the lining, or synovium, of the joints. It can lead to long-term joint damage, resulting in chronic pain, loss of function, and disability.[11]

About Ankylosing Spondylitis

Ankylosing spondylitis is a chronic inflammatory disease that primarily causes pain and inflammation of the joints between the vertebrae of the spine and the joints between the spine and pelvis (sacroiliac joints). Ankylosing spondylitis may also cause inflammation and pain in other parts of the body as well.[12]

[1] Sostek, et al; Evaluation of the Long-term Safety of a Fixed-Dose Combination of Naproxen and Esomeprazole Magnesium in Patients Requiring Chronic Nonsteroidal Anti-inflammatory Drug (NSAID) Therapy: Results from a 12-Month Multicenter Safety Study

[2] Prescribing Information for VIMOVO. AstraZeneca Pharmaceuticals LP, Wilmington, DE.

[3] Sostek, et al; Evaluation of the Long-term Safety of a Fixed-Dose Combination of Naproxen and Esomeprazole Magnesium in Patients Requiring Chronic Nonsteroidal Anti-inflammatory Drug (NSAID) Therapy: Results from a 12-Month Multicenter Safety Study

[4] Current Medical Research Opinion-Vol. 27, No. 4, 2011, 847-854

[5] American College of Gastroenterology. (ACG) Ulcer Physician Reference Guide. See here. Accessed April 2009.

[6] Prescribing Information for VIMOVO. AstraZeneca Pharmaceuticals LP, Wilmington, DE.

[7] Helmick, C., Felson, D., Lawrence, R., Gabriel, S.,et al. Estimates of the Prevalence of Arthritis and Other Rheumatic conditions in the United States. Arthritis Rheumatism 58(1), 15-25. 2008.

[8] Arthritis Foundation. Osteoarthritis: What is it? See here. Accessed April 16, 2010.

[9] Global Burden of Osteoarthritis in the year 2000, (Symmons, Mathers, Pfleger, 2006), Global Burden of Disease 2004.

[10] American College of Rheumatology. Osteoarthritis. See here. Accessed February 23, 2009.

[11] Mayo Clinic. Rheumatoid Arthritis. Definition. See here. Accessed October 2009.

[12] Mayo Clinic. Ankylosing Spondylitis. Definition. See here. Accessed September 2009.

Source:

AstraZeneca



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Largest-Ever Biopsy Study In Osteoporosis Demonstrates Superior Bone Forming Activity With Protelos(R) (Strontium Ranelate) Versus Bisphosphonates

Main Category: Bones / Orthopedics
Also Included In: Menopause;  Arthritis / Rheumatology
Article Date: 25 Mar 2011 – 4:00 PDT

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Protelos® (strontium ranelate) has significantly greater bone-forming activity than the commonly prescribed bisphosphonate, alendronate, according to results of the largest-ever biopsy study in post-menopausal women presented at the European Congress on Osteoporosis and Osteoarthritis (ECCEO011-IOF) in Valencia. (i) Through its unique dual impact on both bone formation and resorption, Protelos substantially reduces fracture risk, the primary goal of osteoporosis treatment.

Bone biopsy is the gold standard technique used to examine the effect of osteoporosis treatments on bone. Bone biopsies involve taking a cylindrical sample of real bone from the upper part of the pelvis called the iliac crest. Biopsies allow the identification of non-mineralized (osteoid tissue) and mineralized subparts of the bone matrix and can be used to measure bone formation rates and other parameters. Bone formation is measured by examining mineralizing surface, the proportion of bone surface on which new mineralized bone is being deposited.

In this international, double blind study of 268 women, Protelos has a significantly greater effect on mineralizing surface compared to alendronate. After six months, mineralizing surface, expressed as a percentage of bone surface (the study’s primary endpoint) was 2.94% in Protelos patients compared to 0.20% in patients receiving alendronate (p

“The results of the study show that Protelos preserves a higher bone forming activity compared with alendronate”, notes study investigator Professor Roland Chapurlat from the Hôpital Edouard Herriot, Service de Rhumatologie et Pathologie Osseuse, Lyon, France.

“The bone-forming activity seen here can be attributed to strontium ranelate’s unique mechanism of action which, unlike bisphosphonates that block bone resorption and formation, combines the dual effects of increasing or maintaining bone formation and decreasing bone resorption”, points out study investigator Professor PG Ste- Marie from the Centre Hospitalier de l’Université de Montréal, Canada.

This new trial conducted in 268 post-menopausal women with osteoporosis is the largest biopsy study ever. It sets a new standard in the assessment of the effects of different osteoporosis treatments on bone. It is also the second head to head study in which Protelos demonstrates superiority versus alendronate. In the previous trial, which used a non-invasive technique (High Resolution peripheral Quantitative Computerized Tomography), Protelos was shown to be more effective than alendronate on bone microarchitecture at both cortical and trabecular level. (iii, iv)


Over the course of both studies, the occurrence of adverse events was similar for each treatment group.

Anti-fracture efficacy sustained over 10 years

Better efficacy on bone formation and bone quality are the key determinants for Protelos and explain its well demonstrated efficacy against vertebral, non vertebral and hip fractures.(v, vi, vii) It is also the key determinant explaining why Protelos is the unique treatment which has recently been shown to have sustained anti-fracture efficacy over 10 years, making it a first choice of treatment for postmenopausal osteoporotic women.(viii)

Notes

Osteoporosis – a common, debilitating disease

Osteoporosis is a chronic condition due to decreased bone mass, leading to reduced bone strength and increased fracture risk. Because women are particularly susceptible to bone loss after the menopause, by far the most common form is postmenopausal osteoporosis. The estimated lifetime risk of wrist, vertebral or hip fracture in Caucasian women over 50 is 45%. The annual incidence rate of osteoporotic fractures in women is greater than the combined incidence rates of heart attack, stroke and breast cancer. Postmenopausal osteoporosis has a huge impact on healthcare budgets, which are already expected to double for osteoporosis by the year 2050.

Protelos is marketed by independent French pharmaceutical company, Servier. It is licensed for the treatment of postmenopausal osteoporosis to reduce the risk of vertebral and hip fractures. It is currently registered worldwide and marketed in 72 countries.

Protelos is also sold under the trade names Protos®, Osseor®, Bivalos® and Protaxos®.

References

i Chavassieux P, Brixen K, Zerbini C, et al. Bone formation is significantly greater in women on strontium ranelate than in those on alendronate after 6 and 12 months of treatment: histomorphometric analysis from a large randomized controlled trial. Osteoporos Int. 2011. Abstract OC16. Presented at the ECCEO Congress, Valencia, Spain, March 2011.

ii Ott SM. Long-term safety of bisphosphonates. J Clin Endocrinol Metab 2005; 90:1897-9.

ii Rizzoli R, Laroche M, Krieg MA, et al. Beneficial Strontium ranelate and alendronate have differing effects
on distal tibia bone microstructure in women with osteoporosis. Rheumatol Int. 2010; 30:1341-1348.

iv Rizzoli R, Felsenberg D, Laroche M, et al. Beneficial effects of strontium ranelate compared to alendronate on bone microstucture – A 2 year study. Osteoporos Int. 2010; 21(Suppl 1): S28-S29 (Abstract P107).

v Meunier PJ, Roux C, Seeman E, et al.The effects of strontium ranelate on the risk of non vertebral fracture in
women with postmenopausal osteoporosis.N Engl J Med. 2004;350:459-468.

vi Reginster JY, Seeman E, De Vernejoul MC, et al. Strontium ranelate reduces the risk of non vertebral fractures in
postmenopausal women with osteoporosis: TROPOS study. J Clin Endocrinol Metab. 2005;90(5):2816-2822.

vii Reginster JY, Felsenberg D, et al. Effect of long term strontium ranelate treatment on the risk of non vertebral and vertebral fractures in postmenopausal osteoporosis. ArthritisRhum. 2008;58(6):1687-1695.

viii Reginster JY, Kaufman JM, Goemaere S et al. Long-term treatment of postmenopausal osteoporotic women with strontium ranelate: results at 10 years. Osteoporos Int 2010; 21(suppl 5): S665-S666 (Abstract OC4).

Source:

European Congress on Osteoporosis and Osteoarthritis (ECCEO011-IOF)



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61% Of Seniors Surveyed Think Health Care Reform Bill Weakens Medicare; Yet 57% Will Take Advantage Of Free Physical Exam Included In Bill

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Seniors / Aging
Article Date: 23 Mar 2011 – 9:00 PDT

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On the eve of the one-year anniversary of the health care reform bill, a survey of 321 seniors 65 and older revealed that 61%1 think the bill has weakened Medicare in the year since it became law. At the same time, 57% of those surveyed say they will take advantage of a free physical exam and personal wellness plan benefit included in the bill that went into effect this year.

Moreover, 73% of seniors surveyed think the health care bill will continue to weaken Medicare over the long term. When asked about attempts underway in the U.S. House of Representatives to defund the bill, 43% support defunding the bill entirely and 29% think only certain provisions of the bill should be defunded.

The survey was fielded from March 18-21, 2011 by Extend Health, Inc., which operates the nation’s largest private Medicare exchange. The results highlight seniors’ varying opinions and in some cases, misperceptions about the health care reform bill. As the bill stands now, it does not cut any Medicare benefits, and instead adds some benefits, including the previously mentioned free physical exam and other free preventative care services.

Bryce Williams, CEO of Extend Health said, “Clearly, many seniors are worried about their Medicare benefits and believe that health care reform threatens them. No one can predict the future, but the current bill actually strengthens Medicare benefits, and that’s the message that needs to get out so seniors can make informed decisions about their health care.”

The questions and detailed results from the survey are as follows:

What is your opinion of the overall impact of the health care reform bill on
Medicare in the ONE YEAR since the bill was signed into law?

The bill has weakened Medicare 60.8%

The bill has had no effect on Medicare 13.9%

The bill has strengthened Medicare 10.1%

I have no opinion 15.2%

What is your opinion of the overall long-term FUTURE impact that the health care
reform bill will have on Medicare?

The bill will weaken Medicare 72.4%

The bill will strengthen Medicare 13.3%

The bill will have no effect on Medicare 2.5%

I have no opinion 11.7%

Earlier this year, the U.S. House of Representatives voted on a bill that would have
repealed the health care reform law, but the bill was voted down when it was sent to
the U.S. Senate. Now, the House is trying to stop implementation of some provisions
of the law by not funding them. How do you feel about efforts to fund or not fund
certain provisions of the health care reform law?

I support defunding the entire bill 42.8%

I support efforts to defund certain provisions of the law 28.8%

I think there are more health care needs that should be added to the bill and funded 11.3%

I think the bill should remain intact and be funded in its entirety 7.2%

I do not support efforts to defund certain provisions of the law 4.7%

I have no opinion 5.3%

A new Medicare benefit that went into effect this year offers people covered by
Medicare a free full physical exam and a personal wellness plan that focuses on
prevention. What are your plans for taking advantage of this new benefit?

I definitely plan to have a free physical exam and personal wellness plan this year 40.0%

I have not decided yet whether to get a free physical exam and personal wellness plan this year 25.5%

I have already received a free physical exam and personal wellness plan this year 16.5%

I have no interest in this benefit 18.1%

Extend Health has helped more than 300,000 seniors compare and choose the private Medicare plans that best meets their needs and budgets. Extend Health is the only place seniors can compare more than 3,500 plans from 70 carriers side by side and find a plan that best meets their needs. Licensed benefit advisors are available to help seniors evaluate their Medicare coverage and explore new options quickly and easily.

Source:

Extend Health



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Nearly 4 Million Medicare Beneficiaries Receive Help With Prescription Drug Cost Under Affordable Care Act

Main Category: Medicare / Medicaid / SCHIP
Article Date: 23 Mar 2011 – 9:00 PDT

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Through provisions of the Affordable Care Act, nearly 4 million people with Medicare who reached the program’s Part D coverage gap in 2010 have received a one-time, tax-free $250 rebate check. U.S. Department of Health and Human Services Secretary Kathleen Sebelius announced today that a similar number of Medicare beneficiaries are likely to enter the coverage gap in 2011 and will benefit from additional Affordable Care Act provisions that work to reduce and close the “donut hole” by 2020. Already, nearly 48,000 Medicare enrollees have saved $38 million – an average of $800 per person – thanks to a new 50-percent discount on covered brand-name drugs in the donut hole.

“For too long, many seniors and people with disabilities have struggled to choose between paying for needed prescription medication and other necessities, like food, rent and utilities,” Sebelius said. “The Affordable Care Act is delivering more affordable prescription drugs to seniors and giving everyone on Medicare better benefits.”

The new health care law is working to make Medicare stronger and more secure for all beneficiaries. Its provisions have increased benefits to beneficiaries and helped extend the life of the Medicare Trust Fund by 12 years. Today, HHS also released a new video outlining how the Affordable Care Act is helping seniors and others with Medicare. To watch the video, visit here.

Beginning in 2011, the Affordable Care Act provides a 50-percent discount on covered brand name prescription drugs to seniors and others with Medicare who reach the donut hole. For the 11,000 beneficiaries with the highest out-of-pocket costs, savings have averaged $1,775. The five states with the largest number of individuals who received a rebate check are: California, Florida, New York, Pennsylvania, and Texas. Millions more beneficiaries are expected to receive the discount over the course of the year. In addition, this year, Medicare began shrinking the donut hole by increasing coverage for generic drugs.

The Centers for Medicare Medicaid Services (CMS) has mailed almost 4 million rebate checks to people with Medicare, providing nearly $1 billion in out-of-pocket relief. It is clear that the $250 rebate checks provided significant financial relief to these individuals as the checks were cashed, on average, within 15 days of the checks being issued, with almost half of all beneficiaries cashing the check within 10 days of issue.

“The closing of the donut hole is just one of the ways seniors will benefit from the Affordable Care Act,” CMS Administrator Donald M. Berwick, M.D. said. “Adding even greater value to their savings on prescription drugs, the new health care law gives people with Medicare new benefits as soon as they visit their doctors this year.”


Since January 1, Original Medicare began:

– Providing a free annual wellness visit; in the first six weeks of 2011, over 150,000 beneficiaries benefited from this new option.

– Making critical preventive services, including certain cancer screenings such as mammograms and colonoscopies available for most people with Medicare, at no cost.

– Giving qualifying doctors and other health care professionals that provide primary care to people with Medicare a 10-percent bonus for primary care services. This will help ensure that those primary care providers can continue to offer professional health care services to Medicare patients.

Thanks to these types of Medicare improvements, an analysis issued by the U.S. Department of Health and Human Services in November 2010 estimated that under the Affordable Care Act, average savings for those enrolled in traditional Medicare will amount to more than $3,500 over the next 10 years.

The new report on how the Affordable Care Act is helping lower drug costs for people with Medicare is available here. To find out how many rebate checks have been distributed in your State, visit here.

For more information on how the Affordable Care Act benefits seniors, visit here, a web portal made available by the U.S. Department of Health and Human Services. People with Medicare can learn more about these new benefits, search for participating doctors in their area, and find other helpful information by visiting here.

Source:

HHS



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Exploring New Treatments To End Osteoarthritis

Main Category: Arthritis / Rheumatology
Also Included In: Obesity / Weight Loss / Fitness;  Seniors / Aging;  Conferences
Article Date: 24 Mar 2011 – 4:00 PDT

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Arthritis researchers from North America and Europe will convene in Chicago this week to present new osteoarthritis research that could lead to better ways to detect, treat, prevent and cure osteoarthritis (OA), which affects 27 million Americans. Hosted by the Arthritis Foundation, the Segal North American Osteoarthritis Workshop (SNOW) on March 25-27 will focus on specific forms of OA, such as those that follow joint trauma, obesity and the aging process.

Arthritis is the leading cause of disability in the United States, affecting 50 million adults. The most common form of this highly prevalent disease is OA – a serious, painful and potentially life-altering disease, mainly affecting hands, knees and hips.

According to the Arthritis Foundation, the prevalence of OA is expected to increase significantly in coming years due to longer life expectancies, the obesity epidemic, and the first of the 78.2 million baby boomers reaching the retirement age this year. In addition, half of all adults will develop symptomatic knee OA at some point in their lives and that risk increases with obesity to two of every three obese adults.

“Findings presented at this workshop have the potential to significantly improve the outlook in osteoarthritis,” says Arthritis Foundation Vice President of Research, Dr. John A. Hardin. “The goal of the conference is for participants to identify priority interventions that could be tested in a trial in the near future.”

The following sessions will be presented at the conference:

  • Pathophysiological mechanisms in distinct forms of OA
  • Identifying the targets for therapeutic interventions for OA that are ready to be tested now
  • Partnerships with the Arthritis Foundation that can enhance efforts to solve OA
  • Advancing the care of patients with OA
  • Potential new interventions for OA
  • Recommendations for clinical trials for new interventions for OA that can be undertaken now

Research into the underlying causes of arthritis has been a high priority of the Arthritis Foundation over the past six decades. During that time, the organization has funded more than $400 million in research grants to thousands of scientists, resulting in better diagnostic tools, a greater understanding of the genetics involved in disease development, and the discovery of new treatments.

Source:
Carol Galbreath
Arthritis Foundation



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Medicare Locals

Main Category: Medicare / Medicaid / SCHIP
Article Date: 24 Mar 2011 – 2:00 PDT

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The AMA today released its Position Statement on Medicare Locals and urged the Government to adopt the AMA recommendations to establish better primary health care organisations (PHCOs) than the currently proposed Medicare Locals model.

AMA President, Dr Andrew Pesce, said today that the main function of Medicare Locals must be to better support the role of the GP in delivering services to patients.

“GPs are the highest trained practitioners in the primary health care setting and have a key role in the coordination and management of care for patients,” Dr Pesce said.

“They provide 120 million services to patients each year.

“Medicare Locals could be useful to GPs by supporting them in carrying out their role and assisting them in accessing allied health services in the community.

“There must be no fundholding arrangements for GP and other specialist services and Pharmaceutical Benefits Scheme medicines.

“Local doctors must be on the Boards of Medical Locals and have leadership roles on other governance committees.

“These important arrangements and conditions are missing from the Government’s guidelines, which means the AMA cannot support Medicare Locals as currently proposed.

“We call on the Government to defer the current processes to establish Medicare Locals so that there can be proper consultation with the medical profession about the future of primary care in this country.

“Many stakeholders and commentators see problems with the proposed Medicare Locals.

“Even those who offer their support qualify that support with concerns about the proposed structure and governance of Medicare Locals, especially how they will coordinate care between primary and acute care settings.

“The AMA Position Statement contains sensible achievable recommendations to deliver quality primary care services to the Australian community,” Dr Pesce said.

The AMA Position Statement on Medicare Locals is on the AMA website.

Source:

Australian Medical Association



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Health Care Reform, Deficit Reduction Proposals, And Repeal Efforts And Their Effect On The Medicare Program

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Health Insurance / Medical Insurance
Article Date: 24 Mar 2011 – 6:00 PDT

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One year ago, on March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, the Health Care Reform law[1] that will provide access to health insurance for virtually all Americans.

As the Center for Medicare Advocacy has reported over the past year, Health Care Reform is good for Medicare, good for families, and good for the country. Health Care Reform does not cut Medicare benefits. In fact, Health Care Reform expands Medicare coverage, by eliminating cost-sharing for preventive services, adding a yearly Wellness Visit, limiting some cost-sharing in private Medicare plans, and closing the Part D “Donut Hole.” It also improves the solvency of the Medicare program itself, while helping reduce the deficit and creating 260,000 new jobs for Americans.[2]

Even one year after passage of the historic law, misstated reports of these changes continue to encourage public fear of cuts to Medicare benefits.

Threats to Medicare, including benefit cuts and the dismantling of the Medicare program, are real, but they do not come from Health Care Reform. The biggest threats to Medicare are from deficit reduction proposals[3] and the repeal of Health Care Reform, not from the Health Care Reform law itself. The proposals that threaten Medicare are often made by the same policy-makers who decried Health Care Reform as hurting, not helping, Medicare and Medicare beneficiaries. One year after enactment of Health Care Reform, it is these purported deficit reduction proposals that, if enacted, would cause the sweeping changes to Medicare that are often wrongly attributed to Health Care Reform.

The chart below compares Health Care Reform, deficit reduction proposals, and repeal efforts and their effect on the Medicare program.

Health Care ReformDeficit Reduction ProposalsRepeal of Health Care ReformDeficit ReductionReduces deficit by $1.2 trillion over twenty years. [4]Do not address the issue of sharply rising health care costs in the private sector, which are reflected in the costs to the federal government.[5]Adds $230 billion to the deficit[6] Medicare SolvencyExtends Medicare Part A Trust Fund solvency by 12 years to 2029. [7]Do nothing to promote Medicare solvency. Eliminates cost-savings, including development of new delivery systems, that promote Part A Trust Fund solvency. Protects Medicare’s Guaranteed Benefits“Nothing in the provisions of, or amendments made by, this Act shall result in a reduction of guaranteed benefits under title XVIII of the Social Security Act [the Medicare title]” Additionally, “Nothing in this Act shall result in the reduction or elimination of any benefits guaranteed by law to participants in Medicare Advantage plans.”[8]Eliminate Medicare as we know it by turning Medicare into a voucher program. There would be no guaranteed benefit package, and beneficiaries would face less extensive coverage or pay higher premiums than under the current system.[9]Increases the vulnerability of the Medicare Trust Fund, leading to a corresponding threat to beneficiaries’ guaranteed benefits. Medicare EligibilityMedicare eligibility is not changed. Most people are eligible at age 65.Increase the age of Medicare eligibility to 67. [10]If Health Care Reform is repealed and the age of eligibility is increased, people between ages 65 and 67 who would otherwise have had Medicare coverage would be uninsured.[11] Medicare Cost-SharingReduces cost-sharing by:

  1. Eliminating co-insurance and deductibles for most preventive services;
  2. Closing the Part D prescription drug donut hole; and
  3. Prohibiting Medicare Advantage plans from charging more than traditional Medicare for costly services.[12]

Increase cost-sharing by:

  1. Increasing deductibles and coinsurance for Parts A and B through a combined deductible and 20% coinsurance for all further costs; [13]
  2. Adding a co-payment for home health services;[14]
  3. Changing Medigap (Medicare supplemental) insurance so that beneficiaries would have to pay a co-payment for all services.[15]

These proposed increases in cost-sharing would most affect poor and sick beneficiaries, leaving them with higher costs and less access to the care they need.[16]Reinstates cost-sharing for preventive services and reopen the “Donut Hole,” ensuring higher out-of-pocket costs. Some beneficiaries would forego preventive care and stop taking their medicine. Medicare PremiumsFreezes the income level at which beneficiaries with higher incomes pay more for Part B; requires beneficiaries with higher incomes to pay more for Part D.[17]Requires ALL Medicare beneficiaries to pay higher Part B premiums, in addition to the extra premiums that people with higher incomes pay for Part B and Part D. Some proposals would increase Part B and D premiums by 30% by 2021.[18]Rescinds freeze on income levels for increased premiums. Fraud, Waste, and AbuseTargets fraud, waste, and abuse in Medicare by:

  1. Eliminating overpayments to Medicare Advantage plans.[19]
  2. Implementing stricter screening procedures and billing procedures on Medicare providers and suppliers;
  3. Appropriating additional funds[20]

Do not address fraud, waste, and abuse.Eliminates programs that target fraud and abuse, and reinstates wasteful Medicare Advantage overpayments.[21] Coordination of Care and Improved QualityAdds specific programs to improve quality of care. For example: payment reforms; auditing unnecessary hospital admissions and hospital acquired conditions; promoting programs to improve care coordination, particularly for beneficiaries with complex health conditions; improving quality measures and quality reporting.[22]Apply across-the-board payment cuts and do not seek to reduce costs by improving care coordination or quality of care. Eliminate programs that seek to coordinate care and improve quality for beneficiaries. Promotion of Health Care Delivery System ReformsCreates the Center for Medicare Medicaid Innovations (CMMI) to promote delivery systems that improve care and reduce costs, creates Medical Home and Accountable Care Organization models to improve care for people with multiple chronic conditions.[23]Eliminate funding for CMMI and for innovative delivery system models without alternative delivery system reforms to address high costs.Eliminates authority and funding for delivery system innovations, including for CMMI, thereby eliminating opportunities to find solutions to the growth in health care costs. Protection for People Dually Eligible for Medicare and Medicaid (Dual Eligibles)Creates the Federal Office of Coordinated Health Care to improve access to care for dual eligibles;[24] improves access to benchmark Part D drug plans for people eligible for the Part D low-income subsidy.[25]Turn Medicaid into a block grant program, thereby providing less or no assistance to people with limited incomes and resources, including people who need long-term care.[26]Reverses the creation of critical initiatives to improve access and navigation through the health system for vulnerable dual eligibles.



Conclusion

Enactment of the Health Care Reform law has improved the lives of the millions of Americans and their families who count on Medicare for their health insurance coverage. The law ensures future generations will have access to benefits by strengthening the Medicare trust fund and by supporting delivery system reforms that will help reduce the growth in health care costs. Health Care Reform promotes health and wellness for beneficiaries by emphasizing prevention, quality, and care coordination. Health Care Reform also benefits the families of Medicare beneficiaries by extending access to health insurance coverage to millions of uninsured individuals, and by protecting everyone against insurance company practices that deny health insurance coverage to people when they need it.

Efforts to eliminate Health Care Reform and deficit reduction proposals are dangerous threats to Medicare and harmful to its most vulnerable beneficiaries. They shift the burden of rising health care costs to Medicare beneficiaries, who do not have the means to absorb these costs, while ignoring the real culprit of skyrocketing overall costs in the private market. If passed, repeal of health care reform and deficit reduction proposals will result in substantial cuts to Medicare; cuts that will be felt most by women, sick beneficiaries, and poorer beneficiaries already paying high out-of-pocket costs.

Simply put, Health Care Reform is good for Medicare, families, and taxpayers. Medicare beneficiaries and their families should celebrate the first anniversary of the Patient Protection and Affordable Care Act, and should work hard to ensure that its provisions are fully implemented.

[1] Health Care Reform consists of two separate laws, the Patient Protection and Affordability Care Act of 2010 (PPACA), Pub.L. 111-148 (March 23, 2010), and the Health Care and Education Reconciliation Act of 2010 (HCERA), Pub. L. 111-152 (March 30, 2010). The laws often are collectively referred to as the Affordable Care Act (ACA).
[2] “The Employment Situation.” Economic News Release. U.S. Bureau of Labor Statistics, http://www.bls.gov/news.release/empsit.nr0.htm.
[3] For a comparison of the various deficit reduction proposals, see, Kaiser Family Foundation, Comparison of Medicare Provisions in Deficit Reduction Proposals (January 2011), http://www.kff.org/medicare/upload/8124.pdf.
[4] “Preliminary Analysis of the President’s Budget for 2012,” March 18, 2011, http://www.cbo.gov/doc.cfm?index=12103.
[5] Even before enactment of health care reform, experts argued that lowering spending growth in Medicare is only possible if lower spending growth is reflected in the private sector. Gail Wilensky, “The Challenge of Medicare,” in Restoring Fiscal Sanity 2007: The Health Spending Challenge, Brookings Institution Press, 2007.
[6] Congressional Budget Office, H.R. 2, Repealing the Job-Killing Health Care Law Act. Feb 18, 2011, available at: http://www.cbo.gov/doc.cfm?index=12069
[7] “2010 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds,” August 5, 2010, https://www.cms.gov/ReportsTrustFunds/downloads/tr2010.pdf.
[8] PPACA §§ 3601, 3602.
[9] Douglas W. Elmendorf, Director, Congressional Budget Office, Letter to the Honorable Paul D. Ryan, November 17, 2010, http://www.cbo.gov/ftpdocs/119xx/doc11966/11-17-Rivlin-Ryan_Preliminary_Analysis.pdf; Paul N. Van de Water, Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs To States And Beneficiaries(Center on Budget and Policy Priorities, March 17, 2011), http://www.cbpp.org/cms/index.cfm?fa=viewid=3429.
[10] Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs to States and Beneficiaries, supra.
[11] Ibid.
[12] PPACA §§ 3203,3301, 3315 4103, 4104, HCERA § 1101,amending 42 U.S.C. §§1395l(a)(1), 1395w-22(a)(1)(B); and adding 42 U.S.C. §1395w-114A.
[13] Alice Rivlin and Paul Ryan, A Long-Term Plan for Medicare and Medicaid, November 17, 2010, available at http://paulryan.house.gov/UploadedFiles/rivlinryan.pdf
[14] Medicare Payment Advisory Committee, Report to the Congress: Medicare Payment Policy, Chapter 8 (March 2011) http://www.medpac.gov/documents/Mar11_EntireReport.pdf.
[15] Report of the National Commission on Fiscal Responsibility and Reform, The Moment of Truth, December 2010.
[16] Ryan-Rivlin Plan Would End Guaranteed Medicare, Shift Medicaid Costs to States and Beneficiaries, supra.
[17] PPACA §§ 3308, 3402, amending 42 U.S.C. §§ 1395r(i), 1395w-113(a).
[18] Center for American Progress, “Higher Tolls on the Roadmap”, February 15, 2011, available at http://www.americanprogress.org/issues/2011/02/ryan_roadmap.html.
[19] HCERA §§ 1102, amending 42 U.S.C. §1395w-23.
[20] PPACA, §§ 6401-6411, HCERA § 1304.
[21] Congressional Budget Office, H.R. 2, Repealing the Job-Killing Health Care Law Act, supra.
[22] PPACA §§ 3001-3015.
[23] PPACA §§ 3021, 3022, adding 42 U.S.C §§ 1315a, 1395jjj.
[24] PPACA § 2602, adding 42 U.S.C. § 1315b.
[25] PPACA §§ 3302, 3303,amending 42 U.S.C. §§ 1395w-114(a),(b).
[26] Edwin Park, Matt Broaddus, Medicaid Block Grant Would Shift Financial Risks and Costs to States, (Center for Budget and Policy Priorities, February 23, 2011) http://www.cbpp.org/cms/index.cfm?fa=viewid=3409.

Source:
Matthew E. Shepard
Center for Medicare Advocacy, Inc.



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