Why Driving and Sleep Drugs Don't Mix

"PHOTO: ABC News' Lisa Stark demonstrates the dangers of driving after taking sleeping medication at the University of Iowa, home of the most advanced driving simulator in the country." title

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WHO: On track to 15 million on AIDS drugs by 2015

The World Health Organization says the global target of 15 million people taking life-saving AIDS drugs by 2015 is just a first step.

With 8 million people in poor countries taking them now, WHO's Dr. Gottfried Hirnschall told the International AIDS conference the world should meet the higher goal.

But the number needing drugs rises to 23 million with the goal beyond that: People who aren't yet as sick but need treatment to lower their chances of spreading the virus. That includes high-risk populations, people in relationships with healthy partners, and pregnant women who would need to be kept on medication after their babies are born.

Hirnschall urged countries to expand HIV testing so they can start reaching those people, saying "now is not the time to be timid."

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Many drugs remain legal after "bath salts" ban

"FILE - In this Jan. 26, 2011 file photo, containers of bath salts, synthetic stimulants that mimic the effects of traditional drugs like cocaine and speed, sit on a counter at Hemp's Above in Mechanicsburg, Pa. On July 10, 2012, President Obama signed a law banning more than two dozen of the most common chemicals used to make the drugs. Over the past two years health care and law enforcement professionals have seen a surge in use of the drugs, often sold under the guise of bath salts, incense and plant food. (AP Photo/The Patriot-News, Chris Knight) MANDATORY CREDIT" title

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Sex, drugs, stigma put Thai transsexuals at HIV risk

"Thanakorn, or Gigi, packs condoms with leaflets before giving them to transgender people at The Poz Home Center in Bangkok. From a cafe near the go-go bars of a Bangkok red light district where she campaigns for safe sex, Gigi gives an unvarnished view of how she joined Thailand's growing ranks of transgender people with HIV" title

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Mom's HIV Drugs May Pass to Baby in Womb, Breast-Feeding

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Mom's HIV Drugs May Pass to Baby in Womb, Breast-Feeding

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AIDS deaths worldwide drop as access to drugs improves

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Genes Influence Whether Psych Drugs Lead to Weight Gain

HealthDay – 1 hr 23 mins ago FRIDAY, July 20 (HealthDay News) -- Researchers have discovered two genetic variants associated with substantial, rapid weight gain in people taking antipsychotic medications.

The researchers said the findings could eventually be used by doctors to identify which patients have the variations so they can be treated without the risk of weight gain, which can lead to obesity and health problems including diabetes and heart disease.

"Weight gain occurs in up to 40 percent of patients taking medications called second-generation or atypical antipsychotics, which are used because they're effective in controlling the major symptoms of schizophrenia," Dr. James Kennedy, of the Center for Addiction and Mental Health, in Toronto, said in a center news release.

Kennedy, senior author of a study published online recently in the journal Archives of General Psychiatry, pinpointed a variation near the melanocortin-4 receptor gene, which is known to be linked to obesity.

The study of patients in Europe and the United States being treated with atypical antipsychotics found that those with two copies of the variant gained about three times as much weight as those with one or no copies -- about 13 pounds vs. 4 pounds.

"The weight gain was associated with this genetic variation in all these groups, which included pediatric patients with severe behavior or mood problems, and patients with schizophrenia experiencing a first episode or who did not respond to other antipsychotic treatments," Dr. Daniel Muller, study co-author and Center for Addiction and Mental Health scientist, said in the news release.

"The results from our genetic analysis combined with this diverse set of patients provide compelling evidence for the role of this

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Many Medicaid Patients Skip Drugs That Could Prevent Heart Trouble

HealthDay – 1 hr 22 mins ago FRIDAY, July 20 (HealthDay News) -- Many Medicaid recipients with chronic health conditions that can lead to heart disease -- diabetes, high blood pressure and high cholesterol -- do not take their prescribed medications, a new study has found.

The researchers said failure to take medications leads to higher costs of care and an increased risk of hospitalization and even death.

They looked at 2008 and 2009 data from more than 150,000 Medicaid patients in New York City, aged 20 to 64, and found that only 63 percent of those with the three chronic conditions took their prescribed medications. Older patients and white and Asian patients were most likely to take their medications, while black and Hispanic patients were least likely.

"The outcome of this study is concerning, as it shows a large number of people with chronic conditions that lead to cardiovascular disease aren't taking prescribed medications, which could prevent a potential stroke or heart attack," lead author Dr. Kelly Kyanko, an instructor in the department of population health at the NYU Langone Medical Center, said in a center news release.

"We hope these findings will help local health authorities in the New York City area address this problem by creating programs to increase adherence rates, specifically in patient populations most at risk," Kyanko added.

The study was published online recently in the Journal of Urban Health.

"We believe that patients and their doctors can work to improve medication adherence through simple measures such as switching to once-a-day or combination pills, keeping a pill box and obtaining 90-day refills instead of 30-day refills for medications they take on a regular basis," Kyanko said.

High-risk patients may require more intensive interventions, such as working with a nurse or pharmacist to ensure they take their prescribed medications, she added.

Cardiovascular disease is the leading cause of death both in New York and in the United States, according to the release.

More information

The U.S. Centers for Disease Control and Prevention outlines ways to prevent heart disease.

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Drugs 'arsenal' could help end AIDS: WHO

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U.S. busts $108 million black market in Medicaid drugs

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U.S. busts $108 million black market in Medicaid drugs

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Studies Show Value of AIDS Drugs as Prevention

HealthDay – 1 hr 3 mins ago WEDNESDAY, July 11 (HealthDay News) -- Researchers have released the final results of two studies that suggest AIDS drugs can prevent exposed people in Africa from getting infected with HIV by their sexual partners. However, another study indicates that it's a tough job to convince African women who aren't at the highest risk to take preventive medications.

In the big picture, the studies show that "we have a new HIV-prevention strategy, one that's quite powerful but also depends on adherence," said Dr. Jared Baeten, an associate professor of global health at the University of Washington, in Seattle. "The next step is figuring out how to motivate people to take it."

The studies appeared online July 11 in the New England Journal of Medicine.

The general findings of the studies have been previously released, but only now has the research become available in a medical journal after going through a peer-review process.

Two studies offer promising details about the potential for the drugs to prevent -- although not all the time -- the transmission of HIV to heterosexual men and women from their infected partners.

One study in Kenya and Uganda looked at heterosexual couples -- almost all married -- in which one person was infected with HIV, the virus that causes AIDS. The uninfected partners were randomly assigned to take an inactive placebo or a once-daily dose of the drug tenofovir (Viread) or a tenofovir-emtricitabine combination (Truvada) for up to three years. Nearly 5,000 people completed the study.

Those who took Truvada had a 75 percent lower risk of becoming infected with HIV compared to those who received a placebo. The risk was 67 percent lower in those who took Viread compared to a placebo. Even in those who got the placebo, the overall risk of getting infected was low: 52 of 1,468, or a little more than 3 percent, did so.

Truvada treatment in the United States costs several thousand dollars a year, Baeten said, but the discounted price can be as cheap as 25 cents a day in Africa. The drug, which stops the AIDS virus from reproducing in people who are infected, appears to do the same thing in uninfected people who are exposed to the virus, he said. In their cases, the virus doesn't already have a foothold in the body so it dies off.

In this study, 10 percent or less of those who took the drugs reported side effects such as fatigue, diarrhea and nausea, and only in the first month.

The second study of 1,219 HIV-negative adults in Botswana looked at Truvada versus a placebo. Comparing the 33 participants who became infected during the trial -- nine people in the drug group and 24 people on a placebo -- the study found those who took Truvada were 62 percent less likely to become infected with HIV.

In this study, significant loss of bone mineral density was a side effect for participants receiving the drug, compared to those on a placebo.

Another study, in Kenya, South Africa and Tanzania, assigned 2,120 women at higher risk of HIV infection to receive Truvada or a placebo. However, there wasn't much difference in HIV infection rates between the two groups -- about 5 percent in both became infected.

Baeten explained the finding, saying many women stopped taking the drug, which prevented an accurate assessment of its effectiveness.

The next step in research into the use of the drugs to prevent infection is to "figure out how to make them work in the real world, outside of an intensive research setting," Baeten said. In the United States, for example, researchers are studying their use in gay men who are at high risk for infection.

As for condoms, another major player in HIV prevention, Baeten said the prevention drugs will add to their level of security or provide some protection in cases where people can't use condoms.

In an editorial accompanying the studies, two experts stressed that medications should never be viewed as a substitute for the condom.

"Although no evidence of increased risky sexual behavior or decreased condom usage was reported in these studies, we must ensure that pre-exposure prophylaxis does not indirectly encourage such behavior," wrote Dr. Myron Cohen of the University of North Carolina at Chapel Hill and Dr. Lindsey Baden of Brigham and Women's Hospital, Boston.

They added that more research is needed to properly assess who stands to benefit most from these drug regimens, the best timing and dosage, as well as any potential side effects from long-term use.

More information

For more about AIDS, visit the U.S. National Library of Medicine.

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Studies Show Value of AIDS Drugs as Prevention

HealthDay – 1 hr 2 mins ago WEDNESDAY, July 11 (HealthDay News) -- Researchers have released the final results of two studies that suggest AIDS drugs can prevent exposed people in Africa from getting infected with HIV by their sexual partners. However, another study indicates that it's a tough job to convince African women who aren't at the highest risk to take preventive medications.

In the big picture, the studies show that "we have a new HIV-prevention strategy, one that's quite powerful but also depends on adherence," said Dr. Jared Baeten, an associate professor of global health at the University of Washington, in Seattle. "The next step is figuring out how to motivate people to take it."

The studies appeared online July 11 in the New England Journal of Medicine.

The general findings of the studies have been previously released, but only now has the research become available in a medical journal after going through a peer-review process.

Two studies offer promising details about the potential for the drugs to prevent -- although not all the time -- the transmission of HIV to heterosexual men and women from their infected partners.

One study in Kenya and Uganda looked at heterosexual couples -- almost all married -- in which one person was infected with HIV, the virus that causes AIDS. The uninfected partners were randomly assigned to take an inactive placebo or a once-daily dose of the drug tenofovir (Viread) or a tenofovir-emtricitabine combination (Truvada) for up to three years. Nearly 5,000 people completed the study.

Those who took Truvada had a 75 percent lower risk of becoming infected with HIV compared to those who received a placebo. The risk was 67 percent lower in those who took Viread compared to a placebo. Even in those who got the placebo, the overall risk of getting infected was low: 52 of 1,468, or a little more than 3 percent, did so.

Truvada treatment in the United States costs several thousand dollars a year, Baeten said, but the discounted price can be as cheap as 25 cents a day in Africa. The drug, which stops the AIDS virus from reproducing in people who are infected, appears to do the same thing in uninfected people who are exposed to the virus, he said. In their cases, the virus doesn't already have a foothold in the body so it dies off.

In this study, 10 percent or less of those who took the drugs reported side effects such as fatigue, diarrhea and nausea, and only in the first month.

The second study of 1,219 HIV-negative adults in Botswana looked at Truvada versus a placebo. Comparing the 33 participants who became infected during the trial -- nine people in the drug group and 24 people on a placebo -- the study found those who took Truvada were 62 percent less likely to become infected with HIV.

In this study, significant loss of bone mineral density was a side effect for participants receiving the drug, compared to those on a placebo.

Another study, in Kenya, South Africa and Tanzania, assigned 2,120 women at higher risk of HIV infection to receive Truvada or a placebo. However, there wasn't much difference in HIV infection rates between the two groups -- about 5 percent in both became infected.

Baeten explained the finding, saying many women stopped taking the drug, which prevented an accurate assessment of its effectiveness.

The next step in research into the use of the drugs to prevent infection is to "figure out how to make them work in the real world, outside of an intensive research setting," Baeten said. In the United States, for example, researchers are studying their use in gay men who are at high risk for infection.

As for condoms, another major player in HIV prevention, Baeten said the prevention drugs will add to their level of security or provide some protection in cases where people can't use condoms.

In an editorial accompanying the studies, two experts stressed that medications should never be viewed as a substitute for the condom.

"Although no evidence of increased risky sexual behavior or decreased condom usage was reported in these studies, we must ensure that pre-exposure prophylaxis does not indirectly encourage such behavior," wrote Dr. Myron Cohen of the University of North Carolina at Chapel Hill and Dr. Lindsey Baden of Brigham and Women's Hospital, Boston.

They added that more research is needed to properly assess who stands to benefit most from these drug regimens, the best timing and dosage, as well as any potential side effects from long-term use.

More information

For more about AIDS, visit the U.S. National Library of Medicine.

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Last drugs standing: Key Alzheimer results coming

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Law Offers Drug Companies Vouchers in Exchange for New Cancer Drugs for Kids

Frozen Meat Recall: Meatballs, Patties Listeria Scare Previous
Dr. Richard Besser’s Tips for Cutting Sugar Consumption in Your Daily Diet User Comments

So what. Who’s going to be the one to get em to market the cure?

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India to give free generic drugs to hundreds of millions

Reuters – 6 hrs ago MUMBAI (Reuters) - India has put in place a $5.4 billion policy to provide free medicine to its people, a decision that could change the lives of hundreds of millions, but a ban on branded drugs stands to cut Big Pharma out of the windfall.

From city hospitals to tiny rural clinics, India's public doctors will soon be able to prescribe free generic drugs to all comers, vastly expanding access to medicine in a country where public spending on health was just $4.50 per person last year.

The plan was quietly adopted last year but not publicized. Initial funding has been allocated in recent weeks, officials said.

Under the plan, doctors will be limited to a generics-only drug list and face punishment for prescribing branded medicines, a major disadvantage for pharmaceutical giants in one of the world's fastest-growing drug markets.

"Without a doubt, it is a considerable blow to an already beleaguered industry, recently the subject of several disadvantageous decisions in India," said KPMG partner Chris Stirling, who is European head of Chemicals and Pharmaceuticals.

"Pharmaceutical firms will likely rethink their emerging markets strategies carefully to take account of this development, and any similar copycat moves across other geographies," he added.

But the initiative would overhaul a system where healthcare is often a luxury and private clinics account for four times as much spending as state hospitals, despite 40 percent of the people living below the poverty line, or $1.25 a day or less.

Within five years, up to half of India's 1.2 billion people are likely to take advantage of the scheme, the government says. Others are likely to continue visiting private hospitals and clinics, where the scheme will not operate.

"The policy of the government is to promote greater and rational use of generic medicines that are of standard quality," said L.C. Goyal, additional secretary at India's Ministry of Health and Family Welfare and a key proponent of the policy.

"They are much, much cheaper than the branded ones."

Global drugmakers like Pfizer, GlaxoSmithKline and Merck will be hit. They spend billions of dollars a year researching new treatments and target huge growth for branded medicine in emerging economies such as India, where generics account for around 90 percent of drug sales by value, far more than in developed countries.

U.S.-based Abbott Laboratories, which bought an Indian generics maker in 2010, is the biggest seller of drugs, both branded and generic, in India, followed by GlaxoSmithKline.

BIG PHARMA BLUES

In March, India granted its first ever compulsory license, allowing a domestic drugmaker to manufacture a copy-cat version of Nexavar, a cancer drug developed by Germany's Bayer, unnerving foreign drugmakers that fear a lack of intellectual property protection in emerging markets.

That enabled India's Natco Pharma to sell its generic version of Nexavar at 8,800 rupees ($160) per monthly dose, a fraction of the 280,000 rupees Bayer's version cost.

In another blow to Big Pharma's emerging market ambitions, China recently overhauled regulations to grant authorities the power to allow domestic drugmakers to produce cheap copies of medicines protected by patents.

Emerging markets are on track to make up 28 percent of global pharmaceuticals sales by 2015, up from 12 percent in 2005, according to IMS Health, a healthcare information and services company.

Most sales in emerging markets come from branded generics, which are off-patent drugs priced at a premium to those made by local manufacturers.

The Organisation of Pharmaceutical Producers of India (OPPI), a lobby group for multinational drugmakers in the country, argues that the price of drugs is just one factor in access to healthcare and that the scheme need not be detrimental to manufacturers of branded drugs.

"I think this will hasten overall growth of the pharmaceutical industry, as poor patients who could not afford will now have access to essential medicines," said Tapan Ray, director general of OPPI.

About 600 billion rupees ($11 billion) in drugs are sold each year in India, or 482 billion at wholesale. Drugs covered under the new policy account for about 60 percent of existing sales, or 290 billion rupees at wholesale cost.

The government's annual cost is likely to be lower due to bulk purchasing and because patients at private clinics would still pay for their own drugs. States will pay for 25 percent of the free drugs and the central government will cover the rest.

Under various existing programs, around 250 million people, or less than a quarter of India's population, now receive free medicines, according to the health ministry.

India's new policy, to be implemented by the end of 2012 and rolled out nationwide within two years, is expected to provide 52 percent of the population with free drugs by April 2017, at a cumulative cost of 300 billion rupees ($5.4 billion).

That requires a major funding ramp-up from a deficit-strapped government. The scheme has been granted just 1 billion rupees thus far from central government coffers.

STRICT INSTRUCTIONS

Public doctors will be able to spend 5 percent of the budget, equivalent to around $50 million a year, on drugs outside of the government's list, on branded drugs or on medicines that are not on the list. Beyond that, they can be punished, said Goyal, the health ministry official.

"If doctors are found to be prescribing medicines which are not on the list, or which are branded, then disciplinary action will be initiated," he said.

Free medicine is just one solution to better healthcare in India, where just getting to a state clinic can require a long journey.

Swapnil Yadav, who runs a clinic in Ambegaon, a village 170 km (105 miles) southeast of Mumbai, said India should set up free drug retailers instead of government clinics.

"Patients can approach a private clinic and then get free medicines from government-run medicine shops," he said.

The free generics scheme, which mirrors policies in the states of Tamil Nadu and Rajasthan, is expected to be fully operational by the time voters go to the polls for the 2014 general election, when the populist Congress party will seek a third straight victory.

Indian makers of generics such as Dr Reddy's and Cipla are best placed to benefit.

"The move will please the generics manufacturers who stand to gain substantially in competing for contracts," said KPMG's Stirling.

($1

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Antipsychotic Drugs Linked to Higher Odds for Diabetes in Pregnancy

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Could Fertility Drugs Make Kids Shorter?

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More ADHD drugs, fewer antibiotics for US kids: study

"A pediatrician performs a check-up on a child at the University of Miami Pediatric clinic in 2007 in Miami, Florida. More drugs for attention deficit hyperactivity disorder and fewer antibiotics are being prescribed to US children and teenagers compared to a decade ago. (AFP Photo/Joe Raedle)" title

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