Drugs donated by manufacturers and services provided by pharmacy chains are allowing a government program to provide HIV-preventative medications to 200,000 uninsured Americans. They will receive these drugs at no cost.
The medications being given out are for pre-exposure prophylaxis, known as PrEP. People who use PrEP as a preventative strategy will take one pill each day. Their two choices are Truvada an Descovy, both manufactured by Gilead Sciences.
Taking PrEP medications has been deemed to be 99 percent effective at preventing HIV, according to studies. Some cities with a high rate of HIV have their own programs to pay for the medications for anyone without insurance.
Ready, Set, PrEP
The new program from the federal government is the first to provide this type of medication to anyone outside of Medicaid, the VA or other federal health programs without cost. Any patient who isn’t enrolled in health insurance and has taken an HIV test recently which was negative and has a prescription for one of the medications will be eligible.
The person can go online to sign into the government website, getyourprep.com or call 855-447-8410 to apply for the free drugs. They can also go to a community clinic and apply in person.
The government is paying the manufacturer $200 per bottle to pay for the cost of moving the drugs. They will pay the cost until March 30, 2020. After that, they will look for cheaper ways to get patients access to these drugs. CVS, Walgreens and Rite Aid are donating their services for dispensing the medications as well as counseling for patients.
Reducing the Rate of Infection
Statistics show that around 1.2 million people in the US could benefit from these drugs, but only about 270,000 are taking them currently. Those in this category are considered at a high risk for developing HIV due to sharing needles or having unprotected sex.
Gilead has promised to continue donating the drugs to care for as many people as 200,000 over 11 years. The payment is designed to move the medications faster. One of the criticisms of the program is that even though people can get the drugs for free, they still must pay for the lab tests and exam as well as renewals. Studies show that could cost as much as $1000 annually.
The pharmacies will promote the program to bring awareness to those who would benefit. Promotions vary greatly based on location. For instance, in large cities, it’s not uncommon to find posters and even billboards telling about the use of PrEP. In more rural areas, there are few advertisements on the PrEP benefits.
These medications are also used to treat HIV in people who have already been diagnosed with the condition. However, the use for prevention could be a significant factor on lowering the number of cases being diagnosed annually, especially for those who are considered high risk. Anyone interested in learning more about the program should talk to their medical provider and find out how to apply and if they qualify.
FDA Failed in Monitoring of Program to Curb Opioid Prescriptions
The US Food and Drug Administration (FDA) requested that drug manufacturers of long-acting opioid prescriptions pay for safety training in 2011. However, records show that the agency failed to follow up on whether the program was successful.
The goal of the program was to determine if the training for physicians who prescribed opioids was effective and to monitor other measures being taken to reduce addiction of opioid prescriptions as well as overdoses and fatalities.
A Flawed Program
According to critics, the program had a flawed design from the beginning, but it was never evaluated accurately either. Congress granted authority to the FDA back in 2007 to require training of physicians on drugs that were likely to cause addiction. The bill went into effect as a response to the oversight of the agency to monitor dangerous drugs.
Documents showed that the FDA couldn’t determine if the program was effective because the design of the studies was poor. Around 60 drugs can be included in the risk-management program. This not only includes opioids but other medications, such as isotretinoin, which is a drug to treat acne and often branded as Accutane.
Critics of the program say that the FDA allowed the pharmaceutical companies to monitor their own training. It also fails to monitor the quality of the training being given. According to a report from the Department of Health and Human Services, only about 14 percent of the programs for safety that had been reviewed by the FDA were able to meet the requirements.
The Dangers of Prescription Drugs
When it came to opioids, the requirement was that 60 percent of prescribers must take the classes, but only less than 30 percent followed through during 2012 to 2016. Even though the number of prescriptions given out was dropping, it couldn’t be determined if it was because of the training. Another issue with the program is that it didn’t provide accurate data on the correlation between the training and the reduction in overdoses and deaths. National data on overdoses had no distinction to show which doctors had taken the training and which ones hadn’t. Because of this, it was impossible to determine if the program was effective in this area.
This same problem has occurred in other programs. For instance, one program was designed to monitor the prescribing of fentanyl drugs that are to be given only to patients with cancer. While these drugs were meant only for those specific patients, many doctors prescribed the medication for other conditions.
The FDA made it a requirement for safety programs to be in place when prescribing all opioid prescriptions and not just the long-acting kinds. This change happened in 2017, but it implies that the long-acting opioids are safe for chronic pain, which goes against most research.
Prescription painkillers have been responsible for many deaths related to overdose. Doctors were prescribing these drugs at a high rate that reached its peak in 2012 at 81.3 prescriptions per 100 patients. While the rate has declined, overdosing is still a major problem in the US, especially in certain regions.
House Approves Bill Which Could Reduce Prescription Drug Prices
The House recently approved a bill that is aimed at lowering the cost of prescription medications by allowing the government to negotiate with manufacturers of the drugs.
Bill H.R. 3
The bill is titled H.R. 3 and would have a direct impact on Medicare programs. The provisions include benefits for vision, dental and hearing, and it also caps the costs Medicare beneficiaries pay out of pocket to $2000.
This bill was proposed and supported by Democrats, but the Republicans have also been working on legislation to cut prescription costs. Pharmaceutical companies oppose both this bill and the Senate bill.
One of the features of the bill includes allowing the Department of Health and Human Services to negotiate pricing for as many as 250 of the most common drugs. Manufacturers would have to provide the same prices to insurers as what was agreed upon during negotiations.
Drug manufacturers would be required to pay rebates to Medicare if prices went up faster than inflation. The Senate bill, which is sponsored and supported by Republicans, doesn’t contain the same provisions, but it does require the companies to pay rebates for raising prices above the rate of inflation.
Other Options for Legislation
Even though the Republicans didn’t agree with the Democrats’ bill, they did come up with a similar measure, which had the support of eight Democrats at the vote. It would not only cap the expenses paid out of pocket, but it would require insurance providers to provide information about medication prices to patients before they were prescribed the drugs.
The argument against the legislation to allow government to negotiate prices is that it would reduce the amount of money for research and development with pharmaceutical companies, which could limit the number of new medicines available for life-threatening illnesses. It has been estimated that the enactment of the bill would reduce the number of new drugs available by 40 for the next 20 years.
H.R. 3 allocates over $10 billion for the National Institutes of Health, which would be used for research to provide breakthrough cures. Taxpayers could save as much as $5 billion during the next ten years if it is enacted.
The rising costs of prescription medications has placed a hardship on many Americans. Some even have difficulty affording food and other necessities because of the expensive drugs they need. The situation has put pressure on lawmakers to find a solution.
Prescription manufacturers do not support the measures that limit their ability to raise prices. However, politicians recognize the need to make drugs more affordable for the average American. With another election year coming up, they are working on their campaign promises to ensure support from their constituents for the next election.
While it’s not expected for the bill to become law in its present state, there is hope that the overall goal will be met even with the changes that would be made. Some day in the future, Americans may be able to afford the drugs they need to manage their medical conditions or cure them.
FDA Tests Diabetes Drug for Carcinogen Levels
The US Food and Drug Administration is testing for the presence of certain cancer-causing chemicals in the diabetes medication metformin. This medication is a prescription drug that is given to patients with type 2 diabetes to control high blood sugar.
Continued Risks with NDMA in Drugs
Several drugs have been discovered to contain known carcinogens at levels not acceptable to the FDA in the past year. Now, metformin is under scrutiny due to the possibility that it may also contain a carcinogenic substance. The concern with these chemicals is that continued exposure could raise the risk for developing cancer in the future.
Other countries have found some metformin drugs to have low levels of N-nitrosodimethylamine or NDMA. After testing those medications, it has been determined that the level of NDMA is in the acceptable range, which is what is naturally found in food and water. However, some countries are recalling metformin medications. The US is not on that list at this time.
The FDA has a current investigation into the medication to determine if NDMA is found and whether it is above the acceptable limit of 96 nanograms per day. The agency is working with manufacturers to test the samples of the drug. If levels above 96 nanograms are found, the FDA will recommend recalls.
Experts recommend that patients continue taking the medication. If a recall is issued, the FDA will provide information to health care personnel and patients. It can be dangerous to stop taking this medication without the advice of their physician. There are no alternative medications to treat the high blood sugar in the same way.
What Does Metformin Do?
This medication works in several ways to control blood sugar in diabetics. It reduces the amount of sugar the liver makes as well as how much is absorbed throughout the body from the person’s diet. It also causes the insulin receptors in the body to be more accurate in how much insulin the system manufactures.
One of the benefits of this medication is that it doesn’t increase the amount of insulin being made in the body, which means the patient has a lower risk of hypoglycemia or low blood sugar. Other medications carry a higher risk for this condition.
The doctor may prescribe metformin in tablet form, a liquid or one of two long-acting medications. Brand names for metformin include Glucophage XR, Glumetza, Fortamet and Riomet. The medication was originally manufactured by Bristol-Myers Squibb, but several manufacturers make the generic version.
Taking a medication like metformin can control sugar levels and prevent many health issues that are related to high blood sugar. This includes diabetic neuropathy, heart disease and diabetic retinopathy. Regular use of the medication may prevent complications which arise from diabetes.
Manufacturers of metformin are working with the FDA to determine if metformin is safe for use. Anyone who is concerned about the risk of carcinogenic chemicals in this medication or other medicines should discuss the issue with their health care provider. The doctor can recommend other options or put their minds at ease.
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