Diabetes medications and blood-test supplies are sold, traded and donated on black markets because the U.S. health-care system isn’t meeting patients’ needs, a study shows. The price of insulin continues to increase, translating to $15 per day for the average user. Recent research indicates one in four people with diabetes ration their insulin because of the cost.
(Reuters Health) – Diabetes medications and blood-test supplies are sold, traded and donated on black markets because the U.S. healthcare system isn’t meeting patients’ needs, a study shows.
In a survey, about half of people who participated in these underground exchanges said they do it because they lack access to the proper medications and supplies to manage their diabetes, researchers report in the Journal of Diabetes Science and Technology.
“It is important for healthcare providers and policymakers to understand what people are doing to support diabetes management when faced with medication and supply access issues,” said study leader Michelle Litchman of the University of Utah College of Nursing in Salt Lake City.
The price of insulin continues to increase, translating to $15 per day for the average user, the study authors note. Recent research indicates that one in four people with diabetes ration their insulin due to cost, they add.
“While there are risks to using medications and supplies that are not prescribed to them, there are also risks to rationing or not taking medications or using supplies at all,” Litchman told Reuters Health by email.
In early 2019, the researchers surveyed 159 people who were involved in online diabetes communities, including patients and caregivers. They asked questions about underground exchange activities, access to healthcare and difficulty in purchasing diabetes items from standard sources.
More than half of the survey participants said they had donated medications or supplies, 35% received donations, 24% traded medications, 22% borrowed items and 15% purchased items. These exchanges took place among family, friends, co-workers, online acquaintances and strangers.
Overall, people who reported financial stress due to diabetes management were six times more likely to engage in underground exchanges and three times more likely to seek donations.
“The current healthcare situation in the United States is substandard for many people with chronic disease,” said Mary Rogers of the University of Michigan, in Ann Arbor, who wasn’t involved in the study.
“It is too costly. It is too slow. It is too complicated,” she said by email. “Failure to fix these problems leads to diabetic complications and unnecessary hospitalizations.”
Participants who donated medications felt compelled to give because they knew about the dire need of others, the study authors note. These respondents described a sense of duty and obligation to help. Others built up stockpiles that they donated, including insulin, pills, glucose strips, sensors and pump supplies.
Underground exchange could lead to several repercussions, including unanticipated side effects, complications of incorrect use, delay in seeking professional help and drug interactions, the authors caution. In addition, sharing and trading prescription medicines is illegal in the U.S. and other countries.
In this study, the researchers did not identify any adverse events, Litchman said.
Kebede Beyene of the University of Auckland, in New Zealand, who wasn’t involved in the study, told Reuters Health, “It seems that health professionals rarely ask patients about medicine sharing, trading or exchange, so it would make sense for health professionals to ask about medicines exchange during consultations and when dispensing medicines, particularly for high-risk medicines, such as diabetes medications, antibiotics and strong pain medications.”
“Patients can then be given information about the possible risks of taking someone else’s medicine or giving their prescribed medicines to another person,” Beyene said by email. “Community pharmacy practitioners are also in a unique position to educate about risks of medicine exchange.”
SOURCE: https://bit.ly/2MtPQa6 Journal of Diabetes Science and Technology, online December 4, 2019.
Long-term care system in British Columbia minimizes SARS-CoV-2 transmission – News-Medical.Net
British Columbia found that BC was better prepared for the pandemic and responded in a more coordinated and decisive manner, leading to far fewer deaths than in Ontario.
The article is published in CMAJ (Canadian Medical Association Journal).
As of September 10, 2020, Ontario had reported 5965 resident cases in LTC homes and 1817 resident deaths from COVID-19, compared with just 466 cases and 156 deaths in BC homes.
“The BC long-term care system before the pandemic was better prepared to minimize SARS-CoV-2 transmission and respond to outbreaks,” says lead author Michael Liu, medical and graduate student at Harvard University, Boston, Massachusetts, and the University of Oxford, Oxford, United Kingdom.
In a comparison of the two provinces’ preparedness and response to COVID-19, the authors found that BC’s health system had several strengths over Ontario’s.
For example, before the pandemic, the average combined per diem funding per LTC resident in BC was $222 compared with $203 in Ontario. Long-term care residents were more likely to live in shared rooms in Ontario (63%) than in BC (24%).
Links between hospitals, LTC and public health were stronger in BC, and the organizational structure of the health system was relatively stable compared with Ontario, which was undergoing significant change with the merging of regional entities and several provincial agencies into Ontario Health.
BC overall was better prepared for the pandemic, and elected leaders and public health officials responded faster and more decisively with measures to limit transmission of SARS-CoV-2 into long-term care homes.”
Dr. Irfan Dhalla, Physician, St. Michael’s Hospital, Unity Health Toronto & the University of Toronto
The authors recommend governments should ensure clear, consistent communications; respond rapidly and proactively; ensure disparities between for-profit and non-profit homes do not affect quality of care; move to single rooms; ensure infection prevention and control teams can support LTC homes during outbreaks; and consider organizational structures to support integration between LTC, public health and hospitals.
“Residents of long-term care homes will always be vulnerable to infections,” says Dr. Dhalla. “Our analysis highlights policies and practices that, if implemented, could help protect these vulnerable seniors from a second wave of COVID-19 as well as other infectious diseases.”
Liu, M., et al. (2020) COVID-19 in long-term care homes in Ontario and British Columbia. Canadian Medical Association Journal. doi.org/10.1503/cmaj.201860.
Moderna's Covid-19 vaccine won't be ready by US election: Report – Times of India
WASHINGTON: US biotech firm Moderna won’t seek an emergency use authorization for its coronavirus vaccine before November 25, its CEO told the Financial Times on Wednesday.
The news deals a blow to President Donald Trump‘s hopes of having an injection ready before the election to give his campaign a much-needed boost.
Stephane Bancel told the newspaper: “November 25 is the time we will have enough safety data to be able to put into an EUA file that we would send to the FDA (Food and Drug Administration) – assuming that the safety data is good, i.e. a vaccine is deemed to be safe.”
Trump, whose approval has taken a hit over his handling of the Covid-19 crisis, has frequently hinted a vaccine could be ready before the November 3 vote.
This has raised concern among experts that his administration may attempt to interfere with the regulatory process for political reasons.
The Republican repeated his claim on Tuesday night, during a debate with his Democratic rival, former vice president Joe Biden.
“It’s a possibility that we’ll have the answer before November 1,” he said.
Moderna’s vaccine is one of 11 experimental vaccines in final stage trials.
Another is being developed by Pfizer, whose CEO Albert Bourla has taken the position that his company may have a clear answer about whether their shot works by October.
Most experts are skeptical of the claim, believing that the ongoing trials will not have sufficient statistical data to prove the drug’s safety and effectiveness by that time.
Speaking to the Washington Post on Tuesday, Bourla denied he was attempting to curry favor with the president by making his October claim.
“For me, the election day is an artificial day. The end of October is an artificial day. This is how we operate. If we can bring it earlier, we will,” he said.
Moderna COVID-19 vaccine appears safe, shows signs of working in older adults: study – Reuters
CHICAGO (Reuters) – Results from an early safety study of Moderna Inc’s MRNA.O coronavirus vaccine candidate in older adults showed that it produced virus-neutralizing antibodies at levels similar to those seen in younger adults, with side effects roughly on par with high-dose flu shots, researchers said on Tuesday.
The study, published in the New England Journal of Medicine, offers a more complete picture of the vaccine’s safety in older adults, a group at increased risk of severe complications from COVID-19.
The findings are reassuring because immunity tends to weaken with age, Dr. Evan Anderson, one of the study’s lead researchers from Emory University in Atlanta, said in a phone interview.
The study was an extension of Moderna’s Phase I safety trial, first conducted in individuals aged 18-55. It tested two doses of Moderna’s vaccine – 25 micrograms and 100 micrograms – in 40 adults aged 56 to 70 and 71 and older.
Overall, the team found that in older adults who received two injections of the 100 microgram dose 28 days apart, the vaccine produced immune responses roughly in line with those seen in younger adults.
Moderna is already testing the higher dose in a large Phase III trial, the final stage before seeking emergency authorization or approval.
Side effects, which included headache, fatigue, body aches, chills and injection site pain, were deemed mainly mild to moderate.
In at least two cases, however, volunteers had severe reactions.
One developed a grade three fever, which is classified as 102.2 degrees Fahrenheit (39°C) or above, after receiving the lower vaccine dose. Another developed fatigue so severe it temporarily prevented daily activities, Anderson said.
Typically, side effects occurred soon after receiving the vaccine and resolved quickly, he said.
“This is similar to what a lot of older adults are going to experience with the high dose influenza vaccine,” Anderson said. “They might feel off or have a fever.”
Norman Hulme, a 65-year-old senior multimedia developer at Emory who took the lower dose of the vaccine, said he felt compelled to take part in the trial after watching first responders in New York and Washington State fight the virus.
“I really had no side effects at all,” said Hulme, who grew up in the New York area.
Hulme said he was aware Moderna’s vaccine employed a new technology, and that there might be a risk in taking it, but said, “somebody had to do it.”
Reporting by Julie Steenhuysen; Editing by Bill Berkrot
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