THE NIH ADMITS IT: Ivermectin has a place in the treatment of Covid-19
Commentary by Patrice Greanville
NOTE: In this medical news section we try to give our readers information about interesting and promising developments on the fight against major diseases, but readers must keep in mind that we are often forced to publish materials originating within the US-style capitalist healthcare industry in which profits and not wellness is the main driver for action or inaction.
Editor's Note: Our readers know that, by and large, the US medical establishment and its Big Pharma arm, are highly compromised due to the capture of political, regulatory and research institutions by corporate interests. This, of course, applies not only to Congress and state politicians, a crowd already well known for their astonishing venality, but to the NIH, the FDA, and other critical US government institutions responsible for the health of all US citizens. Indeed, the Covid pandemic has provided the American nation with a stern lesson about the wrongheadedness, nay, crime, of allowing profits to rule the nation's medical decisions. In this context, we have witnessed (and still do), Big Pharma's aggressive meddling to control the extremely lucrative production and approval (in record time) of drugs and modalities to handle the SARS-CoV-2 coronavirus (which, as we know, causes COVID-19), with practically no legal liability, the latter a highly unusual provision guaranteed by the US government, which has also exerted its influence on behalf of certain players such as Pfizer to ensure that even the WHO would follow global guidelines benefiting this firm and its associates. As a result, strange things have characterised this global emergency. We'll leave the contentious origins of Covid-19 for another discussion, although we suspect that Covid came into being as a misfire (?) in the development of "ethnoweapons", a form of biowarfare targeting specific nationalities, races, etc., currently prohibited by international treaties such as the Geneva Protocol. The US is supposed to have ended its program in 1969, but this is a field in which the US military—given a bloated budget that affords it to leave no technology untouched—is strongly suspected to engage. During the Ukraine war, and to Washington's embarrassment, advancing Russian troops discovered more than a dozen US-funded biolabs apparently involved in this type of sordid research. Along with the pharmaceutical industry, a key component these days of global capitalism, the pandemic also gave other sectors of the US ruling elite excuses to institute dubious policies and rules, such as massive lockdowns, (useful in future mass pacification campaigns), all in the name of safeguarding the nation's health. One of the most bizarre and controversial phenomena (albeit with little of this controversy reflected in the mass media) has been the rapid erosion of standard medical ethics and long-accepted practices, with virtually no serious discussion in professional circles and institutions, nor peer reviews. Indeed, the protocols to treat patients were suddenly upended, and while actual therapies were denied or put aside, the public was herded into accepting the notion that a new "vaccine" —which is formally a preventative—should be exclusively used. Further, and compounding this curious shift, we also saw an unjustifiable delay in the treatment of patients with known and effective antiviral drugs such as Ivermectin—a low-cost (it's a generic), widely used and well-known drug, and the subject of an all-out defamation campaign by Big Pharma, especially Pfizer—that could have prevented a substantial number of deaths in patients being treated with other dubious pharmacological options. Equally disturbing, many patients in the US and worldwide were admitted to ICUs showing signs of respiratory failure due to Covid's more dangerous inflammatory phase but denied proven antivirals like Ivermectin, using instead chiefly compensatory invasive mechanical ventilation with a high mortality rate. (See, for example, ICU and ventilator mortality among critically ill adults with COVID-19, and draw your own conclusions. The paper admits alarmingly high mortality rates among patients hooked to ventilators, even among the best cohorts examined, but still defends the practice of aggressive ventilation without showing enough data nor providing an adequate discussion of whether effective antivirals had been used or not instead of just mRNA vaccines). That said, while ventilators do save lives under certain circumstances, as an expert reminds us, being put on a ventilator is a serious matter: "When using a ventilator, you may need to stay in bed or use a wheelchair. This raises your risk of blood clots, serious wounds on your skin called bedsores, and infections. Fluid can build up in the air sacs inside your lungs, which are usually filled with air. This is called pulmonary edema..." The NIH has a helpful paper on this topic. See Risks of Being on a Ventilator (Last updated on March 24, 2022.) The record shows that the entire medical and political establishment, supported by a revoltingly complicit media (an instance in which the normally subterranean "Censorship Industrial Complex", set up to supposedly fight disinformation, was first deployed en masse), embarked on practices of such cost, unconstitutionality, and mediocre-to-poor results, that the whole thing may eventually obligate an extensive formal inquiry. Meanwhile, to defend the narrative favoring Big Pharma and the complicit NIH and FDA—as good an example of a captive agency as they come— dozens of reputations were tarnished. Many highly qualified and ethical doctors such as Dr Robert Malone, who objected to the corporate-government alliance's handling of the pandemic, were simply defamed or rendered invisible. Just observe this infamous stab by none other than our paper of record. If anyone needs an example of why liberal authoritarianism is both underhanded and repellent, this piece on the New York Times will do just fine.
In this ongoing mess, some corporations and their circles of influence played a singularly nefarious role. Pfizer, in particular, stands out for its outsize greed and lack of an ethical conscience in an industry where outrageously exploitative behavior is the norm. Its malignant footprint, which has even attracted the attention of corrupt entities such as the EU, includes not just the wholesale and often high-handed bribery of the US political and medical establishments, but, through a gigantic advertising budget, the mass media themselves, which, as commercial entities, put profits, too, above the public interest. Incidentally, do note that while the value of Ivermectin is well established in all phases of Covid treatment, the author(s) chose to suggest restricted use to only its "mild" stages, or relegation to a distant, purely secondary role in the presence of supposedly more modern and powerful antiviral agents. This is totally wrong, and prejudicial against Ivermectin, but the upshot is that most doctors, especially those working at large group practices that operate like (and often are part of) some much larger Wall Street conglomerate, refuse to include it in their formularies. As usual, this is America, where conformity rules and nobody wants to make waves. —PG |
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The paper below was published by the NIH, a US-taxpayer-funded public health entity. As such it belongs to all US citizens.
Does ivermectin have a place in the treatment of mild Covid-19?
Does ivermectin have a place in the treatment of mild Covid-19?
Ivermectin has been used to treat humans for the past 4 decades. It was approved as a broad-spectrum anti-parasitic agent, initially indicated in 1987 to treat onchocerciasis and was given as a mass drug administration (MDA) in endemic countries. Its success awarded the discoverers the Nobel prize of Medicine in 2015. Ivermectin's principal activity was to treat infections caused by roundworm parasites. Over the years, the spectrum was broadened to include ectoparasites such as scabies among others. Through the years more than 3 billion doses have been given to humans (not to horses) with a high safety profile, and the drug was added to the World Health Organization's List of Essential Medicines [https://apps.who.int/iris/bitstream/handle/10665/345533/WHO-MHP-HPS-EML-2021.02-eng.pdf ].
In the last decade, several in-vitro studies have shown its anti-viral activity against a broad range of viruses. At the beginning of the COVID pandemic, ivermectin was tested in vitro against SARS-CoV-2 and showed a highly significant reduction (99.8%) in viral RNA after 48 hours [1], but it was criticized that this was achieved by using a much higher dose in comparison to the standard dose in human use [2]. However, its anti-COVID activity in real-life in patients who were treated with standard dose of 3 days of ivermectin showed the significant reduction in culture viability in the ivermectin group compared to placebo [3]. In addition, ivermectin has anti-inflammatory properties based on in-vitro and in animal model studies. An extensive review of the potential mechanisms of action for ivermectin against COVID-19 was recently published [4].
SARS-CoV-2 infection includes several stages, where the initial stage is manifested by high viral replication followed by the second stage (occurring in the high risk groups mainly) of excessive inflammatory response causing severe disease and death. Therefore, ivermectin may have a dual role in this infection, acting as both an anti-viral and anti-inflammatory agent. With its high safety profile, ivermectin is a potential treatment against COVID-19 in its different stages.
There are already over 80 studies assessing the impact of the drug in the different stages of the disease such as: preventing infection, shortening viral shedding, preventing hospitalization, and death and more [https://ivmmeta.com]. Several reviews and meta-analyses disputing the value of this drug in fighting the COVID pandemic were published with the main argument against using ivermectin being that the level of existing evidence for its positive effect is based mainly on studies lacking a high standard of rigorous methodology [5,6]. One must also consider however that since the drug no longer has rights for patent, pharmaceutical companies have no monetary incentive to conduct clinical trials using this medication, and governmental agencies are reluctant to sponsor trials for drug repurposing.
Efforts have been made to identify high quality studies in order to come to consensus [5]. In regard to reduced hospitalization for patients receiving the drug at the early stage of the disease, three studies were identified by Hill et al. [3,7,8]. Combing the results of these three studies, with the recent TOGETHER trial in Brazil [9], there has been shown a significant reduction in hospitalization, with risk ratio of 0.74 (p = 0.02) [see Fig. 1]. In all studies patients were recruited within 7 days from symptom onset (at a median of 4-5 days).
The introduction of COVID 19 vaccines was a game changer in fighting the pandemic. However, it has become clear that we cannot rely on vaccines as a sole agent in this battle. The phenomena of waning immunity within several months, the viral mutations which can elude the virus from vaccine efficacy, all highlight the need for anti-viral drugs to prevent deterioration, hospitalization and death. In fact even the big vaccine/pharma companies have entered the race of finding an efficient anti-COVID drug.
In addition to the repurposed-drug ivermectin mentioned above, the first new drug to show anti-COVID activity was molnupiravir (manufactured by Merck). It initially demonstrated a 50% reduction in hospitalization in high-risk groups but in final analysis, unfortunately showed only a 30% decrease in hospitalization [10].
The second new drug was nirmatrelvir, which given together with ritonavir under the brand name paxlovid (manufactured by Pfizer), showed an 89% reduction in hospitalization [11]. The main disadvantage of paxlovid is the potential and serious interactions with a long list of medications and it is also contraindicated for use in those with certain medical conditions. Unfortunately these are often the patients with co-morbidities, on a chronic medication regime who are in need of this drug. Another drawback of these two drugs is the fact that they should be administered within five days of symptom onset, and the treatment course costs several hundreds USD.
Both drugs (paxlovid and molnupiravir) were received an emergency use authorization by the FDA, and were authorized to be used by health authorities in many countries. So far there have been no published post-marketing field studies looking at the real-life results of their efficacy in preventing hospitalization, death as well as the actual profile of their adverse-events. In addition, unpublished data by Pfizer about paxlovid efficacy in mixed populations of vaccinated and non-vaccinated patients (who are the current candidates for therapy these days), showed that the drug did not reach a significant advantage over placebo [12].
So, is there a role for ivermectin early treatment in an era when we have new anti-COVID drugs?
Comparing molnupiravir to ivermectin in preventing hospitalization [Table 1], we see that based on existing data the performance of ivermectin is similar to molnupiravir. Furthermore, ivermectin has a good safety-profile in terms of adverse events, and in addition the cost is in order of 100 times less when compared to the newer drugs. In addition, ivermectin is easily available in most countries, an important fact especially in low-middle-income countries where getting these newer and expensive drugs may not be feasible. Accordingly, in countries where the two new medications (paxlovid and molnupiravir) are not available, ivermectin should be offered.
Table 1
Risk of hospitalization in non-hospitalized patients treated with ivermectin vs. molnupiravir
Drug (Ref) | Ivermectin [3,[7], [8], [9]] | Molnupiravir [10] |
---|---|---|
Total number of participants | 2346 Drug- 1079/Placebo-1044 |
1408 Drug-709/Placebo-699 |
% High Risk | Any co-morbidity = ∼75% | All |
% positive in Placebo arm | 129/1170 = 12.3% | 68/699 = 9.7% |
% positive in active drug arm | 98/1176 = 9.0% | 48/709 = 6.8% |
Risk Ratio (95% CI) | 0.74 (0.58-0.94) | 0.69 (0.48 to 1.01) |
P-value | 0.02 | 0.04 |
Even in high-income countries where these two drugs might be available, there remains a role for ivermectin. Data from MOH in Israel show that only the minority (about 10%-15%) of high-risk patients are actually getting treatment. This is due to the limited supply of these drugs, the hesitancy to take these drugs related to fear of their unknown adverse events or to known contraindications in using them. Therefore offering them ivermectin should be a viable option.
Since in most countries ivermectin has not been approved for COVID treatment, performing ivermectin vs. placebo studies appears to be unethical when these two newer drugs have been officially approved by health-authorities. However, offering ivermectin to those who refuse the new drugs seems to be a reasonable option. Since eligibility criteria in getting these early treatments are targeted to high-risk patients only (although the definition of high risk might differ from one country to the other), observing the outcome of these arms of treatment: paxlovid vs. molnupiravir vs. ivermectin might shed light on the value of ivermectin in comparison to the newer drugs. Since, undoubtedly there will be patients who will refuse any treatment, they in fact can serve as a control arm receiving SOC (standard of care). Although COVID regulations are loosening, the pandemic is still circulating and therefore this suggested prospective observational study is still highly important and timely, and potentially will give us the value of each treatment arm.
References
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Covid-19: A Second Opinion
Facilitators: P. Greanville • B. Havlena
COVID-19: A Second Opinion
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Big Pharma and health agencies cry, “Don’t take ivermectin!” A media storm follows. Why then, does the science say the opposite?” |
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Ivermectin is a dirty word in the media. It doesn’t work. It’s a deadly horse dewormer. Prescribe or promote it and you’ll be called a right-wing quack, be banned from social media, or lose your license to practice medicine. And yet, entire countries wiped out the virus with it, and more than ninety-five studies now show it to be unequivocally effective in preventing and treating Covid-19. If it didn’t work, why was there a coordinated global campaign to cancel it? What’s the truth about this decades-old, Nobel Prize-winning medication? |
(NOTE: The above is NOT an advertisement, and The Greanville Post has received no compensation for the mention. We do it out of conviction, and to support Dr Kory's work and wider public awareness about this wonderful drug. Ivermectin is a generic, and it costs a fraction of Big Pharma's closest competitors. )
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Leading Doctor Exposes TRUTH About Anti-Ivermectin Propaganda Campaign
the establishment media is an enabler of endless wars and illegitimate oligarchic power
Jimmy Dore • Dr Pierre Kory
Jimmy talks to Dr. Kory about the calculated propaganda campaign waged by the medical and pharmaceutical establishment against the “wonder drug” Ivermectin.
Leading Doctor Exposes TRUTH About Anti-Ivermectin Propaganda Campaign • Meanwhile, Pfizer aggressively pushes its far more expensive and inferior anti-Covid drug, Paxlovid.
Dr. Pierre Kory was among the earliest members of the U.S. medical community to raise his voice in opposition to the nation’s response to the coronavirus pandemic. Now that he’s become something of a pariah for speaking the truth, he’s consolidated his experience and wealth of information into a new book, The War on Ivermectin. Jimmy talks to Dr. Kory about the calculated propaganda campaign waged by the medical and pharmaceutical establishment against the “wonder drug” Ivermectin.
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The $20 Billion Scam At The Heart Of Medicare Advantage
By Matthew Cunningham-Cook and Andrew Perez
PNHP
The $20 Billion Scam At The Heart Of Medicare Advantage
As Medicare privatization continues, insurers are milking massive profits from systematic overbilling and kneecapping modest Biden proposals to stop the scheme.
The health insurance behemoth Humana enjoyed a banner 2022. The Louisville, Ky.-based insurer made $2.8 billion in profits last year, while paying out $448 million in dividends to shareholders and more than $17 million in compensation to its CEO.
The main driver of those earnings? The federal government spent $20.5 billion overpaying Humana and other private insurers for the Medicare Advantage plans they manage on behalf of seniors and people with disabilities. If not for those overpayments, Humana could have suffered a nearly $900 million loss in 2022, according to a Lever analysis.
Humana is the most prominent example of how insurers have built a major cash cow out of systematically overbilling Medicare Advantage, the private Medicare program operated by private interests. These overpayments are symptomatic of a broader profit-driven policy agenda that seeks to completely privatize Medicare, one of the nation’s most popular social programs, and lock program recipients into subpar private insurance plans, even when they get sicker and need the best care possible.
Medicare Advantage plans have higher claim denial rates and more prior authorization restrictions than traditional Medicare plans. Last year, regulators found that nearly one in five payment requests rejected by Medicare Advantage plans in 2018 were wrongfully denied, representing an estimated 1.5 million claims.
And while Biden administration proposals could have helped slow the for-profit takeover by tightening the screws on Medicare Advantage overpayments, insurers recently led a fierce lobbying campaign to dissuade the government from fully cracking down on the practice.
At the root of Medicare Advantage overpayments is “upcoding” by insurers, a scheme by which the companies systematically overbill the public as if their patients are sicker than they really are. Companies have offered bottles of champagne and bonuses to entice doctors to add diagnoses to patients’ records, according to government lawsuits reviewed by the New York Times.
In total, these practices led to $20.5 billion total excess payments to Medicare Advantage insurers in 2022, according to a March report from the Medicare Payments Advisory Commission (MedPAC), a federal body tasked with overseeing Medicare. In the coming years, the overpayment problem could get substantially worse. A November 2021 study suggested that Medicare costs from 2023 to 2031 will be $600 billion higher than if Medicare Advantage beneficiaries were instead enrolled in traditional Medicare.
23 percent over the past five years.
Humana isn’t alone in benefiting from Medicare Advantage overpayments. The other major for-profit insurers — UnitedHealth, Centene, and CVS Health, which owns Aetna, would have seen major hits to their 2022 profits had the government eliminated the overpayments.
UnitedHealthGroup would have seen its profits deteriorate by more than one-third, from $14.4 billion to less than $8.8 billion, according to an analysis by The Lever. CVS Health would have seen its profits cut by more than half, from $4.1 billion to $1.9 billion. And Centene would have seen its profits deteriorate by more than one-quarter, from $3.4 billion to $2.4 billion.
Experts say the enormous sums of money going towards overpayments endanger the overall financial stability of Medicare as a whole.
“It’s threatening the solvency of our Medicare trust fund,” said Ana Malinow, a physician active in pro-Medicare for All groups. “The trust fund is made up of payments that people make throughout their entire working lives. If you are working, you’re paying into Medicare every two weeks with your paycheck. Instead of money going to pay for health care for seniors and people with disabilities, it’s going to UnitedHealth and Humana.”
Cutting back Medicare Advantage overpayments could be transformative for the social program, said David Lipschutz, associate director of the Center for Medicare Advocacy, which lobbies for a robust Medicare system. “These are huge amounts of money that could be directed to shoring up Medicare’s finances,” said Lipschutz. “Or expanding benefits for everyone, not just in Medicare Advantage plans.”
The government’s inability to crack down on Medicare Advantage overpayments is a product of major lobbying campaigns by the industry. Two Biden administration proposals that would have tightened the screws on Medicare Advantage overpayments by enhancing audits and cutting the growth of payments to Medicare Advantage plans were both scaled back in the face of aggressive industry lobbying and TV campaigns.
Instead, while there will likely be some cutbacks, the Medicare Advantage gravy train will continue. The number of people enrolled in Medicare Advantage is set to outpace traditional Medicare for the first time ever this year, with more than 30 million beneficiaries.
Better Medicare Profits
In February, the Centers for Medicare and Medicaid Services (CMS), which oversees Medicare, proposed a rule that would have reined in upcoding abuses by reducing extra payments that insurers receive for certain diagnoses, including diabetes “with complications” and a rare form of malnutrition. But in the face of widespread industry lobbying, the agency settled on a weaker three-year phase-in effort.
Even the original proposed rule might not have been enough to address Medicare Advantage overpayments. MedPAC called the initial proposal “insufficient” in a comment letter, and said that Secretary of Health and Human Services Xavier Becerra had “not taken significant action” in response to MedPAC’s analyses of fraudulent billing in Medicare Advantage.
Another way to crack down on upcoding schemes would be to limit government payments to Medicare Advantage plans, since it would send a message to Medicare Advantage providers that overall program costs are far too high. Last December, CMS did so by proposing increasing payments to Medicare Advantage plans by just 1 percent, compared to the 8.5 percent payment increase it approved last year.
In response, the Better Medicare Alliance, an advocacy group for Medicare Advantage plans, spent at least $13.5 million on ads pressuring the administration to increase the planned rate hike.
Fighting Medicare Advantage - Changes Are Coming, Finally!
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spent $570,000 lobbying Congress in the first quarter of this year, nearly double the $330,000 spent in the prior quarter. All told, the four major publicly traded health insurance companies that operate Medicare Advantage plans, as well as the insurance lobby America’s Health Insurance Plans, spent nearly $19 million on federal lobbying in the first quarter of 2023, a 66 percent increase from the prior quarter, according to a Lever analysis of data from OpenSecrets.
announced a 3.3 percent payment increase at the end of March.
“The industry’s aggressive lobbying campaign showcases that they clearly want to protect their profit stream,” said Lipschutz. “Their disingenuous campaign tried to paint some very minor payment adjustments as being catastrophic to the Medicare Advantage program. They tried to ‘Medi-scare’ beneficiaries into contacting their elected officials to get CMS to back off — which CMS did to a certain extent.”
While industry analysts have said that this modest rate increase will strain insurers’ prodigious profits, the bond ratings agency Moody’s declared in April that “we believe [Medicare Advantage] will continue to be a growth driver for the industry and will take further market share from traditional Medicare.”
Medicare Advantage payment increases like Biden’s 3.3 percent hike will result in higher dividends to shareholders at the expense of the solvency of traditional Medicare.
The insurance industry also took aim at a recently proposed rule to claw back years of inflated risk adjustment payments, which are made to incentivize Medicare Advantage plans to accept riskier patients.
Initial proposals floated by CMS included retroactive audits of risk adjustment payments going back to 2011. Instead, the final pared-back proposal released in March only included retrospective audits going back to 2018.
Lipschutz said he does give the administration some credit for the audit rule change and the smaller rate hike for Medicare Advantage insurers relative to the prior year.
“On the other hand, it can be seen as far too little too late,” he said, adding that federal policy being so weighted towards Medicare Advantage plans at the expense of traditional Medicare is a “serious imbalance that is long overdue for course correction.”
Privatizing Medicare
Traditional Medicare operates on a fee-for-service basis. This means that doctors and hospitals are paid directly by Medicare for the services they provide. Private plans have operated as part of Medicare since just after the program was launched in 1965, but typically did so on a very limited basis. That changed in 2003, when Congress substantially increased subsidies for plans to enter the market, after intense industry lobbying.
While the traditional Medicare model is not without problems — Medicare only covers 80 percent of expenses, which means that seniors need either Medicaid or a Medigap insurance plan to get full coverage — it has major benefits relative to Medicare Advantage.
The principal benefit of traditional Medicare is that there is not a profit-driven insurer attempting to limit the scope of care that a patient needs.
Medicare Advantage “seems like a good idea,” said Ted Doolittle, the State Health Care Advocate for Connecticut. That’s because Medicare Advantage plans often offer expanded benefits like dental, vision, or wellness. They also eliminate the need for a potentially expensive Medigap plan if a senior isn’t eligible for Medicaid coverage.
But then, said Doolittle, “The scholarship shows that when patients get sick, they try to go back to traditional Medicare.”
According to Doolittle, most people who are either Medicaid eligible or who could afford a Medigap plan would balk at signing up for Medicare Advantage plan “if folks had adequate information about the nature of Medicare Advantage versus traditional Medicare, and the higher denial rates and the prior authorizations required for care in Medicare Advantage.”
Doolittle pointed out that there’s a key barrier to patients to getting full medical coverage if they try to switch back to Medicare once they become sick: In most states, Medigap insurers are allowed to discriminate against seniors on the basis of preexisting conditions if they are already enrolled in Medicare Advantage, something that is prohibited when seniors first become eligible for Medicare three months prior turning 65.
This problem is amplified by the rapid growth of Medicare Advantage. In 2010, a little over one-quarter of Medicare beneficiaries were in Medicare Advantage. By 2016, it was still less than one-third. But this year, a majority of Medicare beneficiaries will be on the private plans.
And the exorbitant government costs of Medicare Advantage are not limited to just overpayments related to upcoding. This year, Medicare Advantage plans will receive taxpayer rebates averaging $196 per participant. These rebates have more than doubled since 2018.
The total cost of the rebates could be as high as $75 billion this year, according to analysis by Bill Kadereit, president of the National Retiree Legislative Network.
“The extra $196 is spent on fringe benefits, and only on fringe benefits that go towards Medicare Advantage beneficiaries,” Kadereit said. “The other 30 million people in traditional Medicare get nothing. When Joe Manchin in West Virginia says ‘I like sending money to the Medicare Advantage plans, give them more,’ well, 40 percent of his people in West Virginia are not on Medicare Advantage, so they don’t get a nickel.”
Expanded attention to Medicare Advantage abuses has led some members of Congress to speak up and pressure the Biden administration to rein in the industry, even in the face of aggressive lobbying.
In February, 70 lawmakers, led by Congressional Progressive Caucus chair Pramila Jayapal (D-Wash.), sent a letter to the Biden administration pointing out that “as enrollment in [Medicare Advantage] grows, spending per beneficiary has grown faster in [Medicare Advantage] than original Medicare, and that spending is being funneled into corporate profits under the guise of operating costs instead of into care for patients.”
That said, there is no voice in Congress advocating for the phasing out of Medicare Advantage and allocating expanded benefits equally to all Medicare beneficiaries, which is by far the most cost-effective option.
And the larger Medicare Advantage becomes, the more politically difficult it will be to rein in, noted Doolittle.
“As Medicare Advantage keeps getting more embedded in Medicare, the situation keeps getting worse,” he said. “It’s gotten up to a real critical mass at this point, which makes it very hard to stop.”
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The 21st Century may see the death of cancer. (But it might come sooner under a more rational system.)
Edited by Patrice Greanville
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Addendum
ITALY: Novel treatment shows promise against rare cancer in kids
A novel treatment using supercharged immune cells appears to work against tumors in children with a rare kind of cancer, researchers reported Wednesday.
Nine of 27 children in the Italian study had no sign of cancer six weeks after the treatment, although two later relapsed and died.
The treatment – called CAR-T cell therapy – is already used to help the immune system fight leukemia and other cancers in the blood. This is the first time researchers have achieved such encouraging results in solid tumors, experts in the field said, and raises hopes that it can be used against other kinds of cancers.
It's too soon to call it a cure for neuroblastoma, a nerve tissue cancer that often starts in infancy in the adrenal glands near the kidneys in the abdomen.
Standard treatment can be intense, involving chemotherapy, surgery and radiation, depending on the cancer's stage and other factors. The children in the study had cancers that had come back or were particularly hard to treat.
Eleven children were alive when the three-year study ended, including some who only partially responded to treatment and got repeat doses of the modified cells.
"Those kids were all destined to die without that therapy," said University of Pennsylvania's Dr. Carl June, a pioneer of CAR-T therapy who was not involved in the new research.
"No one's ever had patients responding like this before, so we just don't know what it's going to look like a decade from now," June said. "For sure, there are going to be more trials now based on these exciting results."
CAR-T cell therapy harnesses the immune system to create "living drugs" able to seek and destroy tumors. T cells from the patient's blood are collected and strengthened in the lab, then returned to the patient through an IV where they continue to multiply.
Six CAR-T cell therapies have been approved by the U.S. Food and Drug Administration for blood cancers. Some early patients have been cured.
But success in solid tumors has been elusive. The latest study was done by researchers at the Vatican's Bambino Gesu pediatric hospital in Rome.
"They seem to have found a unique combination" to get the modified cells to multiply initially, then last a long time to continue their cancer-killing work, said Dr. Robbie Majzner of Stanford University School of Medicine, who was not involved in the new study.
Study co-author Dr. Franco Locatelli said they also added a safety switch to eliminate the cells if a patient had a severe reaction. When one patient had problems, they flipped the safety switch, showing that it worked, although later they determined the patient's problem was caused by a brain bleed unrelated to the CAR-T cells.
Many of the children had a side effect that is common with CAR-T therapy – an immune overreaction called "cytokine release syndrome." It can be serious, but was mild in most, the researchers reported.
They concluded that CAR-T therapy was "feasible and safe in treating high-risk neuroblastoma."
China makes breakthrough in cancer treatment via immunotherapy
Chinese researchers have made a breakthrough in the treatment of cancer via immunotherapy, identifying a particular hormone receptor as a potential target, the University of Science and Technology of China (USTC) said.
The receptor, MC5R, acts with a hormone called α-MSH, which is produced by the pituitary gland, to promote the growth of tumors, according to a paper published in the journal Science on August 4.
According to the paper, increased levels of the hormone can lead to tumor growth in the human body by promoting myeloid cell accumulation and immune suppression through its receptor MC5R.
The researchers identified MC5R as a possible target for immunotherapy that could provide a means of interrupting the hormone.
According to the university, previous studies have found that patients suffering from long-term depression and stress show more rapid development of tumors and a weakened response to cancer immunotherapy, indicating that the nervous system and its mediated stress reactions play an important role in tumor growth and immune regulation.
(With input from Xinhua)
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