J’accuse

Americans pay too much for brand-name drugs, but we also pay through the nose for generics — and a new white paper out of USC explains why. Rather, it explains who is to blame.

“If you filled a prescription for a generic medicine recently, there is a good chance you overpaid, and PBMs and other intermediaries are making record profits.”

And here we thought PBMs were saving us money, while making the sun shine, the birds sing, and unicorns prance through the forests. But apparently they’ve been lying to us: “[P]ricing practices and distortions across the market have allowed them to inflate prices of generics in recent years, at the expense of patients and payers.”

Get this: In 2018, Medicare could have saved $2.6 billion if it sent Jimmy from the mailroom to the local pharmacy down the block to pay cash for 184 common generic meds.

Or you can just take your chances

Is it time to renew your workers’ compensation or business liability insurance? Talk to Hutton Madden first: (404) 375-7209 or hutton.madden@phmic.com.

The 3-gram solution

Omega-3 fatty acids can lower blood pressure, but how much should you take? The answer, per a review published by the American Heart Association, is about 3 grams a day. Now you know. (More may be beneficial to people with high blood pressure, but that’s not what this study was about.)

Antibiotics vs jocks

If you have athletic mice that used to be jocks but are turning into couch potatoes (or worse, nerds), it might be thanks to antibiotics.

It’s Ye Olde Gut Bacteria at work again. Turns out that antibiotics change the gut biome and actually affect motivation. Mice that were bred for running by UC Riverside researchers (don’t ask me how) and given antibiotics spent 21 percent less time on the wheel; “normal” mice weren’t affected.

In addition, the high-runner mice did not recover their running behavior even 12 days after the antibiotic treatment stopped. “A casual exerciser with a minor injury wouldn’t be affected much. But on a world-class athlete, a small setback can be much more magnified.”

The researchers’ plan: Determine which bacteria makes the difference, so they can implant it in lazy folks and get them to exercise.

The article includes this helpful image:

Vanity, vanity, all is not vanity

But someone should tell insurance companies. They’ve been refusing to pay for anti-obesity meds when prescribed by physicians, even though obesity is the path to diabetes, joint and back pain, heart disease, and more — and some people simply can’t lose weight on their own.

“The evidence is now overwhelming that there are physical changes in weight regulating pathways that make it difficult for people to lose weight and maintain their weight loss. It’s not that they don’t have willpower. Something physical is holding them back.”

Medically necessary or not, the insurers say they know better — meds like Saxenda, they say, are “vanity drugs.”

Let’s talk vaping

And also with you

Research is coming out that secondhand, er, vapor, may not be as safe as we’ve thought. The American Stroke Association explains.

In addition to nicotine, the aerosols include heavy metals such as lead, nickel, and zinc; cancer-causing substances such as benzene; and diacetyl, which has been linked with a condition nicknamed “popcorn lung” in people who vape.

If people who vape already have a nickname like “popcorn lung,” you really do have to think twice.

Down the wrong pipe

Forget for a moment all the obviously bad stuff in e-cigarettes, like solvents and nicotine. E-cig makers are dumping all sorts of other chemicals into their products that (at best) belong in your food hole, not your air hole.

Stanford Medicine scientists found ‘supplements’ like melatonin, essential oils, tea, vitamins, and caffeine in non-nicotine vaping cartridges. Those ingredients might be fine if eaten, but breathing them is a whole different matter. In most cases we don’t know what inhaling them will do; in some cases we know it’s Not Good.

Diabetes and tooth decay: It’s the enamel

Why do people with both type 1 and type 2 diabetes seem to have tooth decay? Weak enamel — the hard part of your (that is, their) teeth. Apparently, Rutgers dental researchers found, “diabetes can interfere with the ongoing process of adding minerals to teeth as they wear away from normal usage.”

Elsewhere

Up north

Realizing that nothing else is working to stop the opioid epidemic, Canada is decriminalizing the possession of up to 2.5g of drugs — yes, all drugs — in British Columbia. The idea is to “break down the stigma that stops people from accessing life-saving support and services.” Oh, and the millions of loonies it’s saving the government doesn’t hurt. (Oregon did something similar in 2020, but there isn’t much data yet on how it’s working.)

Down south

Mexico has banned all — yes, all — electronic cigarettes.

The Long Read: We Can Do Better edition

The U.S. has the worst health among rich, developed nations — shortest life expectancy, worst cardiovascular health, highest maternal mortality … the list goes on, and the gap is growing. But why? Lack of affordability, high rates of violence, and drug overdoses are a part, but that can’t explain it all.

A supplement to the latest issue of the Journals of Gerontology tackles that question in a series of papers, “Why Does Health in the U.S. Continue to Lag Behind?” (Spoiler: “There’s no simple answer.”)