Health and Medication Info

Wednesday, June 08, 2005

Prescription Drug Prices

U.S. Prescription Drug Prices

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Sunday, May 01, 2005

Lowering Your Cholesterol

Cholesterol has been around for thousands of years. It’s a natural function of the human body. The modern story of cholesterol and how it affects us today, actually began during a government study in 1951.

The Pentagon sent pathologists to Korea to examine the bodies of servicemen who lost their lives during the war. Autopsies were conducted on 2,000 soldiers.

The results were astounding to the medical community of that time. Normally, no one under 35 dies of coronary heart disease. Remember, this was 1951!

More than 75 percent of the soldier had yellow deposits of atherosclerotic plaque on their artery walls. The average age of these soldiers was 21 contradicting the assumption that such artery clogging deposits were only prevalent in older men.

The results of the Army pathologists rocked the medical community. Prior to these autopsies, doctors had no idea how early the process of heart disease began.

Not long after this discovery, a name was given to the major contributor to the buildup of plaque and to heart disease risk – cholesterol. More recent studies have shown that for every 1 percent drop in cholesterol levels, there is a 2 percent decrease in the risk of a heart attack.

Since those original studies, the risk of heart disease stemming from cholesterol has exploded. In 2002 it was estimated that 107 million American adults now have a blood cholesterol level high enough to require medical advice. Unfortunately, the numbers keep rising.

Despite this epidemic problem, there is good news. You can do something about the problem and that’s what this web site is all about. In plain English, we will take a laymen’s look at cholesterol, the causes, effects and what you can do to reverse the negative impact it has on your personal health.

High cholesterol claims thousands of lives every year. The really sad thing is that it's treatable as long as you don't ignore it. Find out now what is cholesterol, learn how to diagnose cholesterol levels, discover the causes of high cholesterol, review cholesterol medications, discover cholesterol natural treatments, and herbal remedies. You'll also find cholesterol lowering tips a cholesterol detox diet and much more.

# posted by Rich @ 5:36 AM 0 comments

Thursday, March 03, 2005

Adult ADD

ADD in Adults

Since the concept that ADD occurs in adults is a fairly new concept over the past decade or so, much more information is available about ADD in children at this time. However, in a nutshell, as an adult, ADD has matured into a chronic neurobiological disorder, displaying three main traits: impulsivity, hyperactivity and inattention.

Although there is yet a positively identified determined set of factors, by they genetic, biological or physiological, that cause a person to become afflicted with ADD, fingers point to biological and heredity factors as playing major roles.

Cases in which heredity has been ruled out point to the following contributing factors: alcohol and tobacco exposure during fetal development, extremely high levels of lead in the body, birth weight recorded low, difficulties with birth and/or premature delivery, and postnatal injury to the prefrontal brain areas.

Note several popular "mythical" factors that many attribute to causing ADD when in reality they don't: too much television, too much sugar and food additives, social environment (like divorce, poverty) or "bad" parenting.

Adult ADD seems to know no national boundaries, afflicting people worldwide where studies have been performed. And although ADD strikes both genders, adult male sufferers seem to outnumber females in a 2:1 ratio (or lower).

Adult ADD Symptoms

Now let's take a look at the symptoms or traits characteristic of adults who have ADD. According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), adults with ADD most generally:

Fail to give close attention to details

Make negligent mistakes at work

Fidget with hands or feet, twist about in seat

Have difficulty with attention span during tasks and activities

Are unable to remain seated in situations where seating is expected

Don't appear to listen when spoken to directly

Feel unable to relax

Have difficulty following instructions, often failing to finish work

Express difficulty with quiet participation in leisure activities

Suffer difficulties with organizational skills and activities

Feel energized; i.e. "on the go" or "motor-driven"

Don't like engaging in lengthy mental effort; i.e. they prefer NOT to engage in anything that asks for sustained mental effort

Talk a lot (an inordinate amount of time)

Lose necessary items for tasks and activities

Rush to supply answers before questions are completed

Become distracted easily

Tend to be impatient

Are forgetful with regards to everyday activities

Interrupt frequently or intrude upon others

As a result of the above major characteristics in adults with ADD, the following issues are among the most popular that are prevalent in adult ADD lives. Note that both the characteristics above and the following problematic issues can range in scope from mild to extreme, depending upon the person's own unique health combined with their ADD and other social, personal and economic situations. A professional health practitioner is recommended for best evaluating each case.

Adult ADD major problems areas include:

Suffering repeated anxiety, depression and / or mood swings

Experiencing relationship, behavioral and self-control problems

Struggling with poor memory skills and work effort

Managing troubles with emotional, arousal and motivational issues

Undergoing low self-esteem, boredom and time mismanagement issues

Ongoing employment or substance abuse issues

Annoying chronic tardiness, risk-taking and (greater than average) multi-tasking behaviors

Actually any of the variety of social, personal and economic problematic areas in adult ADD lives is what causes the person to seek professional help when their disorder is undiagnosed. Often referred to as a "hidden disorder," ADD in adults can underlie many outstanding mood disorders, substance abuse and other complicated cases. Often it's not until after a person has been diagnosed with something else like anxiety or depression, or until after his or her own child is diagnosed with ADD, that healthcare providers are alerted to the adult's ADD. Thus many today still go undiagnosed, untreated, which is a shame, because without the diagnosis, many believe ADD sufferers to be lazy, unintelligent and immature.

And there is help with ADD treatment. Many afflicted with ADD can even apply for help under the Americans with Disabilities Act of 1990 (prohibits employment and public accommodations discrimination against people with a record of and / or who have current physical or mental impairments that substantially limit one or more major life activities, including learning and working.)

For a diagnosis, people can begin with their healthcare provider or consult an educational psychologist, a behavioral neurologist, a psychiatrist or a clinical psychologist. They would undergo an evaluation that would generally include a complete developmental, medical, psychiatric, educational and work history, interview about any medications used and noted ADD symptoms / characteristics and overall look at personal health, well-being and life in general (relating to social and environmental factors).

Normally more than one person is involved in this diagnostic processing that spans a couple hours time. And main areas of focus are whether or not, and if so, to what extent, the person has the three main ADD traits (hyperactivity, lack of attention and impulsivity). Adult ADD evaluations also include DSM-IV AD/HD symptom rating scales to go over previous records; for instance, past medical evaluations and test results, past work and school records in order to present a more accurate assessment and diagnosis. Then a program of treatment and coping skills can be put in place and any possible other health issues may be uncovered for further treatment or ruled out.

Learn more about ADD and ADHD and discover successful ADD treatment strategies along with detailed information on ADD coping tips as well as how to set up and use organizer and filing systems.

Arm yourself with knowledge about the causes and symptoms of ADD in children and ADD in adults. Visit our comprehensive ADD and ADHD Directory, learn about related disorders and find helpful ADD support groups.

# posted by Rich @ 6:51 PM 0 comments

Monday, February 28, 2005

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# posted by Rich @ 2:27 PM 0 comments

Friday, February 25, 2005

Depression - The Invisible Disease

Depression is a serious medical condition. In contrast to the normal emotional experiences of sadness, loss, or passing mood states, clinical depression is persistent and can interfere significantly with an individual's ability to function. There are three main types of depressive disorders: major depressive disorder, dysthymic disorder, and bipolar disorder (manic-depressive illness).

Symptoms and Types of Depression

Symptoms of depression include sad mood, loss of interest or pleasure in activities that were once enjoyed, change in appetite or weight, difficulty sleeping or oversleeping, physical slowing or agitation, energy loss, feelings of worthlessness or inappropriate guilt, difficulty thinking or concentrating, and recurrent thoughts of death or suicide. A diagnosis of major depressive disorder is made if a person has 5 or more of these symptoms and impairment in usual functioning nearly every day during the same two-week period. Major depression often begins between ages 15 to 30 but also can appear in children. Episodes typically recur.

Some people have a chronic but less severe form of depression, called dysthymic disorder, which is diagnosed when depressed mood persists for at least 2 years (1 year in children) and is accompanied by at least 2 other symptoms of depression. Many people with dysthymia develop major depressive episodes.

Episodes of depression also occur in people with bipolar disorder. In this disorder, depression alternates with mania, which is characterized by abnormally and persistently elevated mood or irritability and symptoms including overly-inflated self-esteem, decreased need for sleep, increased talkativeness, racing thoughts, distractibility, physical agitation, and excessive risk taking. Because bipolar disorder requires different treatment than major depressive disorder or dysthymia, obtaining an accurate diagnosis is extremely important.

Facts About Depression

Major depression is the leading cause of disability in the U.S. and worldwide.
Depressive disorders affect an estimated 9.5 percent of adult Americans ages 18 and over in a given year, 3 or about 18.8 million people in 1998.
Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive disorder each year.

Depression can be devastating to family relationships, friendships, and the ability to work or go to school. Many people still believe that the emotional symptoms caused by depression are "not real," and that a person should be able to shake off the symptoms. Because of these inaccurate beliefs, people with depression either may not recognize that they have a treatable disorder or may be discouraged from seeking or staying on treatment due to feelings of shame and stigma. Too often, untreated or inadequately treated depression is associated with suicide.

Treatments

Antidepressant medications are widely used, effective treatments for depression. 6 Existing antidepressants influence the functioning of certain chemicals in the brain called neurotransmitters. The newer medications, such as the selective serotonin reuptake inhibitors (SSRIs), tend to have fewer side effects than the older drugs, which include tricyclic antidepressants (TCAs) and monoamine oxidase inhibitors (MAOIs). Although both generations of medications are effective in relieving depression, some people will respond to one type of drug, but not another. Other types of antidepressants are now in development.

Certain types of psychotherapy, specifically cognitive-behavioral therapy (CBT) and interpersonal therapy (IPT), have been found helpful for depression. Research indicates that mild to moderate depression often can be treated successfully with either therapy alone; however, severe depression appears more likely to respond to a combination of psychotherapy and medication. 7 More than 80 percent of people with depressive disorders improve when they receive appropriate treatment.

Research Findings

Brain imaging research is revealing that in depression, neural circuits responsible for moods, thinking, sleep, appetite, and behavior fail to function properly, and that the regulation of critical neurotransmitters is impaired.

Genetics research, including studies of twins, indicates that genes play a role in depression. Vulnerability to depression appears to result from the influence of multiple genes acting together with environmental factors.

Other research has shown that stressful life events, particularly in the form of loss such as the death of a close family member, may trigger major depression in susceptible individuals.

The hypothalamic-pituitary-adrenal (HPA) axis, the hormonal system that regulates the body's response to stress, is overactive in many people with depression. Research findings suggest that persistent overactivation of this system may lay the groundwork for depression.

Studies of brain chemistry, mechanisms of action of antidepressant medications, and the cognitive distortions and disturbed interpersonal relationships commonly associated with depression, continue to inform the development of new and better treatments.

# posted by Rich @ 3:17 PM 0 comments

Monday, February 21, 2005

Generic Drugs By Mail Can Be a Raw Deal

In an attempt to rein in its employees' fast-rising prescription drug costs, General Motors Corp. requires its workers to fill prescriptions for chronic conditions through the mail-order operation of Medco Health Solutions Inc. But some simple comparison shopping shows that GM, despite its formidable bargaining clout, is paying far higher prices for some drugs than ordinary individuals can get walking into retail pharmacies.

Consider GM's price for ranitidine, the generic form of the popular anti-ulcer pill Zantac. GM pays Medco $176.22 for 90 pills mailed to a worker, who pays an additional $5 co-pay, bringing the total cost to $181.22, according to Medco's Web site for GM employees. If a GM employee were to simply buy the same ranitidine prescription at a retail pharmacy, it would cost a total of $62.88 for the 90 pills. A person without insurance could buy the same medication at Wal-Mart in Secaucus, N.J., for $78.62. At Costco Co.'s online service, Costco.com, the prescription would cost only $22 -- and include 10 extra pills.

That GM pays Medco higher prices for many generic drugs than regular pharmacies charge customers without insurance illustrates the complexities, and potential pitfalls, of prescription-drug coverage. It's also a rare glimpse into how such plans work.

Pharmacy-benefit managers, such as Medco, administer the drug benefits of large employers, acting as the middlemen between the employers and the pharmacies. Such PBMs create large networks of participating pharmacies and use their size to drive down prescription-drug prices. Some, including Medco, also own their own mail-order pharmacies, and prod employers to move more of their workers' prescriptions into the mail business.

PBMs promise to realize savings for their corporate customers by keeping the overall cost of prescription medications down. But they also preserve large profit margins for themselves, as the GM prices show. The price GM pays for prescription drugs is available to any of its employees or retirees through the workers' benefits Web site. The Wall Street Journal reviewed Web page printouts provided by a pharmacist with access to the site and who is working to get GM to roll back its mandatory mail policy -- in which employers require workers to fill prescriptions through a mail program.

Some companies, like GM, say they are satisfied with the overall savings Medco is providing. But others simply aren't aware of the vast price discrepancies on generic drugs.

Susan Hayes, a consultant with Pharmacy Outcomes Specialists in Lake Zurich, Ill., which helps employers control their drug costs through audits and contracting, says some companies are surprised when she tells them about the price differential. "It's a big deal," says Ms. Hayes. "Why should you pay more than $1 a pill for generic Prozac to the mail-order pharmacy when you could get it for 23 cents in the retail store?" she asks. [Pill Prices]

GM has used Medco to manage its drug benefit since 1994, yet the auto maker's drug costs are climbing by more than 15% a year, almost double the rate of increase of GM's overall healthcare costs.

GM's pharmacy chief, Cynthia Kirman says GM is getting a good deal from Medco, saving $80 million by using mandatory mail based on 2003's drug costs of $1.3 billion. GM declined to explain how it figures it would save $80 million. The company spent $1.5 billion on prescription drugs in 2004.

Last week GM moved to strengthen3 Medco's mandatory-mail program further by preventing its 1.1 million employees and retirees from filling any prescriptions at the Walgreen Co. drugstore chain.

GM's Ms. Kirman says its not fair to "cherry-pick" certain drugs for a price comparison, though she declined to provide a list of GM's most-used generic drugs. "Numbers on the Medco Web site may not be reflective of the actual GM prices," a GM spokeswoman said yesterday subsequently. The GM spokeswoman declined to explain why the numbers may not be reflective.

A Medco spokeswoman, too, says it is misleading to look at individual drug prices for GM and draw any conclusions about overall costs. The spokeswoman, Soraya Rodriguez-Balzac, said in an e-mail response to questions that "mail-service pricing for generics is usually a flat percentage discount for all drugs and adds value in aggregate."

Because generic drugs are so cheap to begin with, PBMs and retail pharmacies alike typically make big margins on generic drugs, which account for about half of prescriptions filled in the U.S. That's why pharmacies have a big incentive to switch prescriptions for branded drugs to their generic versions.

Aggressively switching of branded prescriptions to generics does help reduce employers' drug costs. Employers also believe they are getting better prices on branded drugs through PBMs, which is why they are willing to pay bigger markups on generic medications.

Mail-order pharmacies generally fill a three-month's supply of medication at once. Medco benefits greatly from its mail-order pricing system. When a patient fills a prescription through Medco's mail pharmacy, the full profit belongs to Medco, rather than having to split it or get very little when the transaction happens at the retail store. The Franklin Lakes, N.J., company derives more than half of its corporate profits just from selling generic drugs from its own mail order unit.

For example, 90 ranitidine pills usually cost pharmacies about $7. At retail, customers can pay $22. Medco's mail-order price to GM is $181.22. Medco can show its customers a great savings because the list price, called the average wholesale price, quotes ranitidine at about $264 for 90 pills. Medco declined to comment on specific prices on its Web site.

The dizzyingly complex system of drug pricing makes it difficult for employers to know whether they are getting the best prices. Generic drug prices in mail programs are based on average wholesale price, or AWP. AWP is considered an inflated price among those in the drug industry. For example, the average wholesale price for 90 fluoxetine pills, the generic drug for Prozac, is $240.12 but pharmacies usually pay less than $5.

Employers can't choose to use a PBM for only brand-name drugs, where they get a price break, and use another service for generic drugs. PBM services are purchased the way employers purchase a health plan -- the same health insurer covers all the different physicians and services for a worker.

Medco's generic pricing policy isn't unusual. Caremark Rx Inc., the pharmacy-benefit manager for millions of federal government employees, charges $96.05 for 90 pills of fluoxetine and $105.42 for 90 pills of ranitidine from its mail-order pharmacy. The prices are available to federal employees on Caremark's Web site.

In addition to GM, International Business Machines Corp., Southwest Airlines Co., Citigroup and numerous states and municipalities, have started mandatory-mail programs in recent years. A survey by consultant Hewitt Associates found that 22% of employers will have mandatory mail plans in place this year, with another 51% considering such programs. Copyright 2005 Dow Jones & Company, Inc.

By BARBARA MARTINEZ
Staff Reporter of THE WALL STREET JOURNAL

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Friday, February 11, 2005

Valentine's Day: Good for the Heart

Chocolate, red wine, and other expressions of love can be good for you.

The stuff of Valentine's Day may be good for the heart, in more ways than one. Chocolate, red wine, and expressions of love could not only make thumpers go pitter-patter in romantic fashion, they could also lead to better heart health.

According to a growing amount of research, chocolate, red wine, and love can play a role in keeping the blood flowing throughout the body. Experts do not always agree on how these elements boost cardiovascular fitness, nor do they always recommend them as tools for disease prevention. But it's clear that a little of each isn't too bad -- in moderation.

The Sweet Stuff

Many people see chocolate as a guilty pleasure. There's no doubt chocolate can contribute to weight gain and tooth decay, but now researchers are finding it can do good things for the body as well.

"It seems a component in cocoa -- flavonoids -- can be heart healthful," says Susan Moores, RD, a spokeswoman for the American Dietetic Association (ADA). She says flavonoids are antioxidants, known to protect against free radicals in the body. Free radicals are suspected of damaging arteries and triggering buildup of plaque (fatty substances) in the wall of blood vessels, which can lead to atherosclerosis.

Antioxidants can also help lower the level of "bad" cholesterol (LDL), and increase the amount of "good" cholesterol (HDL). This antioxidant effect is apparently greater in dark chocolate, because it has more cocoa beans, a natural source of flavonoids.

The flavonoids in dark chocolate may also improve the health of the endothelium (the lining in arteries and veins), says Joe Vinson, professor of chemistry at the University of Scranton in Pennsylvania.

In one study, he says people with one risk factor for heart disease (i.e. high blood pressure, high cholesterol, high triglycerides) drank a single 6-ounce glass of cocoa, rich in flavonoids. From that one drink, researchers reportedly found a significant improvement in the flexibility of the arteries.

"With rich chocolate, it doesn't take much to be satisfied," she says, noting that people who take time to savor, and let the candy melt in their mouth, tend to be more content with smaller servings.

Heartwarming Toast

Wining and dining has long been a Valentine's Day tradition for sweethearts, and now there may be more reason to clink glasses.

For people who drink a moderate amount of red wine, there's a heart health benefit. Research has shown that the flavonoids in red wine -- originally from grape skins -- have an antioxidant effect, may raise good cholesterol levels and may help prevent blood clotting in vessels.

Other, more controversial findings reveal that not just red wine, but moderate amounts of alcohol in general, wards against cardiovascular disease.

"Alcohol has a blood-thinning effect, and that was what was found to be effective against stroke and heart disease," says Sass.

Additionally, Vinson says alcohol can also produce free radicals, which are bad for the liver, counteracting any antioxidant benefits. The only exception, he says, is red wine in moderation.

Cupid's Arrow

The word "love" has stumped people for ages. It has made people feel like they're floating, or become crybabies upon hearing a certain song. It has also made otherwise sensible people do crazy things.

Yet, as mysterious a force love is, there seems to be no surprise that it is capable of many, many things.

How about improving heart health? As ludicrous as it may sound -- yes -- there is proof that it can do that, too, and more.

"The evidence is very strong that good relationships have health benefits," says Blair Justice, PhD, professor emeritus of psychology at the University of Texas School of Public Health.

Gifts From and for the Heart

According to Justice, various investigators have looked into different types of relationships (i.e. marriage, family, and friendship), and have shown that love can:

Help prevent plaque buildup in the arteries.
Protect against heart disease.
Boost levels of antibodies in the body.
Reduce levels of stress chemicals, which can damage the immune system.
Lower risk of disease in general.
Decrease risk of early death.
Lengthen life.

One theory explaining love's effect on physical health involves human nature. "It's instinctual to have this need for touching and talking," says Justice. He says the personal contact turns on a part of the nervous system, which has a calming effect, and allows for a smaller amount stress chemicals in the body.

In addition, the human touch can lower blood pressure, and illicit a sense of safety, connection, and comfort, says Carol Rinkleib Ellison, PhD, author of Women's Sexualities, and a psychologist in private practice.

"People who do affirm their love for each other before going to sleep tend to sleep more deeply, in a more relaxed way, and they'll wake in the morning more refreshed, in a better mood, and, therefore, they'll get along better," says Ellison.

Real life may not always be as simple, but experts do agree that having less stress is good for the health of the overall body, including the heart.

Gifts From and for the Heart

Offering your sweetie love, red wine, and chocolate for Valentine's Day may, indeed, help you score big in the heart department. But romantic and healthy gift giving need not be boring.

"Whether it's a small box of chocolates, red roses, or it's time spent together, the point is to give a gift on Valentine's Day to somebody you care about," says Novak, reminding that the effort is what usually touches a person's heart.

# posted by Rich @ 7:43 AM 0 comments

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