The Times-Picayune reported that three Louisiana insurers—Blue Cross Blue Shield of Louisiana (BCBS), Louisiana Health Cooperative Inc., and Vantage Health Plan—agreed on March 10 to continue accepting third-party payments until November 2014, when 2015 annual enrollment for the healthcare marketplace would begin. The agreement followed a federal lawsuit filed on February 20, 2014, by a 30-year-old HIV-positive man who relied on the Ryan White HIV/AIDS Program to pay for his monthly BCBS health insurance premiums. The suit, filed by Lambda Legal Senior Attorney and HIV Project Director Scott Schoettes, alleged that the insurance companies’ refusal to accept third-party payment for premiums was “inherently discriminatory against people who rely on federal subsidies.” The new policy would force those individuals to pay out of pocket or to give up their insurance.
Four days after Lambda Legal filed the suit, US District Judge Brian Jackson issued a temporary restraining order to prevent the companies from instituting the new policy. He lifted the order when the three insurance companies’ attorneys promised the companies would not change or drop any policies before a March 10 hearing. The hearing resulted in a temporary agreement that would allow the US Department of Health and Human Services (HHS) to rule on the matter.
BCBS developed the policy after the Centers for Medicare and Medicaid Services (CMS) recommended that insurers stop accepting third-party payments as a strategy to prevent fraud. Although CMS amended the recommendation and urged companies to accept Ryan White payments, the companies had planned to proceed with the policy changes. HHS was following an emergency rule-making procedure to resolve the issue.
The Times of India reported that several districts in northeast India are experiencing extremely high hepatitis C virus (HCV) rates but are doing little to curb its spread. The disease is affecting mostly intravenous drug users (IDUs) in the region. One district reports that nearly 90 percent of its IDUs carry HCV, while only one quarter to one third have HIV.
HCV advocates say that most Indian health awareness programs concentrate on HIV and cancer but need to expand to include hepatitis. "The main objective is to create awareness about viral hepatitis in the region. The epidemic is at our doorstep, with people getting infected, testing positive, and some deaths being reported. However, [nongovernmental organizations] and the government continue to ignore the spread of the disease," said the general secretary of Hepatitis Coalition of Nagaland (HEPCON).
Current HCV treatment is too expensive for most people in the region and no cure exists at this time. Studies have shown that people with HCV have a higher chance than hepatitis B patients of progressing to the chronic stage of the disease, which leads to liver damage and death. A high rate of needle sharing occurs in the Indian districts, as well as sharing accessories, such as containers for preparing drugs, filter cotton, and rinse water, that can still transmit the disease.
Medical Xpress reported on a new TB antibiotic discovered by researchers from the École Polytechnique Fédérale de Lausanne (EPFL) in Switzerland and the AN Bach Institute in Moscow, Russia. The researchers developed the drug, called PBTZ169, as a European FP7 project. According to their studies, the drug is very effective against multidrug-resistant TB.
PBTZ169 attacks the bacterium cell wall, which normally functions as an impenetrable shield against antibiotics and immune cells. According to Stewart Cole, director of the study, and head of EPFL’s Global Health Institute, the drug causes the bacterium to “literally burst open.” The research showed that PBTZ169 is very effective in triple therapy with pyrazinamide and another new drug, bedaquiline. The European Union and the US Food and Drug Administration already have approved the latter two drugs. Cole noted that since these drugs attack different targets in the TB bacterium, the combination greatly reduces the risk of the TB bacterium becoming even more resistant.
PBTZ169 is easy to synthesize and is not expensive to produce. The researchers formed the IM4TB Foundation and with the support of the EPFL, the foundation will develop the new drug in its own laboratories and market it. They chose to do this because the traditional method of transferring technology from the laboratory to a pharmaceutical company results in high development costs, making the drug expensive for the countries mostly affected by TB. The IM4TB Foundation plans to begin human trials in a year with the University of Lausanne Hospitals.
The full report, “Towards a New Combination Therapy for Tuberculosis with Next Generation Benzothiazinones,” was published in the journal EMBO Molecular Medicine (2014; 6 (3):372–383).
Newsday reported that South Nassau Communities Hospital in Oceanside, N.Y., recommended that 4,247 former patients get tested for HIV and hepatitis B and C because of possible blood contamination resulting from reuse of insulin pen reservoirs intended for use only with a single patient. The hospital is sending notification letters in phases and expects to complete the mailing by March 17.
Insulin pens for diabetes are prefilled syringes intended for use with a single patient. Since a patient’s blood could backflow into the pen’s cartridge after injection, using the pen on multiple patients could expose them to blood-borne infections. Hospital Spokesperson Damian Becker explained that hospital staff had overheard a nurse saying that reusing the pen was acceptable practice, although no one had observed use of an insulin pen reservoir with multiple patients.
Becker stated that the hospital reported the potential problem to the state Department of Health and recommended HIV and hepatitis B and C testing for patients possibly exposed through pen reuse. The hospital offered free and confidential testing, and the 4,247 patients could call a dedicated phone line at (516) 208–0029 for more information. Becker noted that the hospital has received 200 phone calls thus far. Test results would take two weeks. The hospital has switched to single-patient-use vials and banned the use of insulin pens.
According to the Department of Health, two state-regulated health facilities and the Veterans Administration (VA) medical facility in Buffalo reported similar issues in 2013. Of 395 patients tested by the Buffalo VA medical facility in 2013, 12 patients had hepatitis B and six had hepatitis C. The US Food and Drug Administration alerted healthcare workers in 2009 not to reuse single-use insulin pens with multiple patients. CDC issued a clinical reminder on proper use of insulin pens in 2012.
The Gazette reported that Maryland’s Montgomery County Department of Health and Human Services sent letters to individuals informing them of their need to be screened for TB, and also let others know that they did not need to be screened after an investigation of a confirmed TB case at Watkins Mill High School in Gaithersburg. According to County Health Department Senior Nurse Administrator Cindy Edwards, the department will screen approximately 126 students and staff members for TB on March 25 at the school due to possible exposure to the TB-infected individual. Those tested will receive their screening results in 14–21 days.
The Phnom Penh Post reported that the Joint United Nations Programme on HIV/AIDS is collaborating with the Asian Development Bank and the Asian Football Confederation to launch an HIV prevention program targeting transmission and risk among youth in Malaysia, Myanmar, Thailand, the Philippines, and Cambodia. The campaign is linked with promotions for the 2014 FIFA World Cup in Brazil. Key program partners in Cambodia include the Football Federation of Cambodia; the Ministry of Education, Youth, and Sport; the football club Phnom Penh Crown; and Battambang-based SALT Academy. The program, which uses football as an outreach to individuals, hopes to achieve the “Three Zeros”—zero new HIV infections, zero discrimination, and zero AIDS-related deaths—through enhanced HIV awareness, improved access to HIV prevention and treatment, and elimination of HIV-related stigma.
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