News Briefs January 2024
Negotiations Will Lower Medicare Prescription Drug Costs
The landmark Inflation Reduction Act gave Medicare the authority to negotiate prescription drug prices for the first time in history, and, in late August 2023, the U.S. Department of Health and Human Services (HHS) announced the 10 drugs covered under Medicare Part D selected for the first cycle of negotiation (see https://tinyurl.com/CMS-Meds). Drug companies that manufacture these drugs have indicated that they will participate in negotiations with Medicare during the remainder of 2023 and in 2024, and any agreed-upon negotiated prices will become effective beginning in 2026. HHS Secretary Xavier Becerra said, “Negotiating provides us a critical tool to ensure they get those prescription drugs at lower prices—just as the U.S. Department of Veterans Affairs has done for years.” The negotiation process will consider the selected drug’s clinical benefit, the extent to which it fulfills an unmet medical need, and its impact on people who rely on Medicare, among other considerations, such as costs associated with research and development as well as costs associated with production and distribution. As a result of negotiations, people with Medicare will have access to innovative, life-saving treatments at lower costs to Medicare and taxpayers. CMS will publish any agreed-upon negotiated prices for the selected drugs by Sept. 1, 2024; those prices will become effective starting Jan. 1, 2026. In future years, CMS will select for negotiation up to 15 more drugs covered under Part D for 2027, up to 15 more drugs for 2028 (including drugs covered under Part B and Part D), and up to 20 more drugs for each year after that, as required by the Inflation Reduction Act.
Non-Antibiotic Treatment for Chronic UTIs
A study by UT Southwestern Medical Center researchers demonstrated the long-term efficacy of electrofulguration, a minimally invasive outpatient procedure that treats chronic urinary tract infections (UTIs) among postmenopausal women. They reviewed medical records of 96 women treated at UT Southwestern for recurrent UTIs (three or more a year) with electrofulguration between 2006 and 2012. Their median age was 64, and the median length of follow-up was 11 years. Among the patients, 72% were considered to have had successful treatment, with no more than one UTI annually. In addition, antibiotic usage declined significantly, with only 5% still on continuous antibiotics at their last follow-up compared with 74% pre-electrofulguration. The standard treatment for a UTI is antibiotics, but some women will develop another infection within a few days or weeks of treatment, which requires another round of antibiotics. Over time, they can build up resistance to antibiotics, making their UTIs extremely challenging to treat. The result may lead to a life-threatening bout of sepsis and in some cases require the surgical removal of the bladder. According to the study findings electrofulguration is a well-tolerated procedure that provides a durable clinical solution, reducing the recurrence of UTIs with minimal to no continued need for antibiotic therapy.
Microbes on Dentures Associated with Pneumonia
Research published in Journal of Medical Microbiology identified a possible link between wearing dentures and pneumonia. Pneumonia is an inflammation of the lower respiratory tract that can be caused by a variety of microbes, and it disproportionately affects people ages 65 and older. Researchers from Cardiff University, UK, took mouth, tongue, and denture swabs from a group of patients in a hospital who had pneumonia and wore dentures. They compared them to samples taken from denture-wearing people in care homes who did not have pneumonia. Researchers identified the abundance and types of microbes present in both samples. While they expected to see a difference, they were surprised to see 20 times the number of potentially pneumonia-causing bacteria on dentures in people with pneumonia, compared to people without. Researchers speculate that if dentures are not cleaned properly, they could provide a new surface where disease-causing microbes can colonize. People wearing dentures may be inhaling saliva with harmful microbes into their lungs, where an infection can then take hold. More research is needed, but it’s safe to say it’s important to clean dentures thoroughly and to see your dentist regularly.
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