TIME Healthcare

Birth-Control Costs Nearly Halved After Obamacare, Study Finds

TIME.com stock photos Birth Control Pills
Elizabeth Renstrom for TIME

"Spending on the pill could be cut by $1.5 billion annually"

Average out-of-pocket spending on birth control pills and intrauterine devices (IUDs) have dropped significantly since the Affordable Care Act took effect, a new study finds.

The study, published on Tuesday in Health Affairs by University of Pennsylvania researchers, compared contraceptive prescription claims from a large national insurer between the first six months of 2012, or before the “Obamacare” mandate took effect, and the first six months of 2013, or after Obamacare took effect. Comparing the two time periods, researchers found that consumers’ average out-of-pocket spending for birth control pills fell from $32.74 to $20.37, and, for IUDs, from $262.38 to $84.30.

Under the mandate, private health insurance plans are required to cover prescription contraceptives at no cost, though many women still faced costs due to insurers’ failure to comply, among other reasons.

“We estimate that the ACA is saving the average pill user $255 per year, and the average woman receiving an IUD is saving $248,” said lead author Nora V. Becker in a statement. “Spread over an estimated 6.88 million privately insured oral contraceptive users in the United States, consumer annual contribution to spending on the pill could be reduced by almost $1.5 billion annually.”

Though the report notes that it cannot definitively attribute the cost declines to Obamacare, the results are consistent with those of smaller studies that have also found sharp falls in out-of-pocket payments for contraception prescribed to privately insured women.

TIME advice

Everything You Need to Know About Heat Rash

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Getty Images

Stay safe this summer

When you think of summer, you probably picture relaxing with friends and family on the beach, looking like a bronze goddess, and fruity drinks. What you try to forget are the annoying downsides, like excessive sweating, sunburns, and heat rash. We’re all familiar (too familiar, probably) with sweating and sunburns, but what is heat rash, really?

I decided to find out once and for all. I enlisted the help of Rachel Nazarian, M.D. of Schweiger Dermatology Group to get to the bottom it.

Classic heat rash (doctor talk: miliaria), “is a red, sometimes itchy or painful rash that can occur after skin has been exposed to a hot or humid environment.” Also included: small blisters. Yikes.

In other words, heat makes you sweat. We sweat to lower our body temperature. So when the sweat can’t escape, the skin gets angry. Cue heat rash forming.

Now, prepare for your mind to be blown in a semi-embarrassing way. Heat rash technically has nothing to do with UV rays from the sun. The only true cause of heat rash is, well, heat. That doesn’t mean you should skimp on the SPF, though.

Luckily, there are ways to avoid It. Obviously, spending long periods of time outside is no good, but if that is unavoidable (especially on a long holiday weekend), wear light, breathable clothing, avoid lathering up with thick creams and ointments, and try to keep skin as cool and dry as possible.

If you do begin to feel a rash developing, immediately head inside. Nazarian recommends removing any restrictive clothing items, washing the skin with cold water, and applying a topical hydrocortisone lotion to decrease the inflammation if you have it on hand.

This article originally appeared on MIMI.

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TIME Addiction

Majority of Americans Agree You Should Be 21 to Buy Tobacco

Three out of every four American adults favor increasing the minimum age from 18

Three out of every four American adults favor increasing the minimum age to purchase tobacco from 18 to 21, according to a survey released Tuesday.

The study, released by the American Journal of Preventive Medicine on Tuesday, also found that smokers overwhelmingly agreed; 7 of 10 cigarette smokers backed raising the minimum age.

Brian King, acting deputy director for research translation at the Center for Disease Control’s Office on Smoking and Health, highlighted the health benefits that could come from such an increase. “It could delay the age of first experimenting with tobacco, reducing the likelihood of transitioning to regular use and increasing the likelihood that those who do become regular users can quit.”

Most states require tobacco purchases to be made by someone who is at least 18; in Alabama, Alaska, New Jersey, and Utah, the minimum age is 19. Hawaii, however, already has a must-be-21 to purchase tobacco rule in place.

The data came from a 2014 online survey of 4,219 adults over 18. A separate study earlier this year found that if the all states were to raise the minimum age for tobacco sales to 21, there would be a 12% decrease in smokers along with 250,000 fewer premature deaths.

TIME health

Brazil Tries to Cut High Rate of C-Section Births

Over 8 in 10 births in private hospital are currently cesarean deliveries

It’s not a well-known fact, but Brazil is the C-section capital of the world: 85% of all deliveries in the country’s private hospitals are done by cesarean section, and 45% of births in public hospitals.

Now, Brazil is attempting to reverse the trend with rules introduced Tuesday that require doctors to inform expectant mothers of the risks that accompany having a C-section. A woman who chooses a C-section must sign a consent form prior to the procedure. Her doctor must also sign a form justifying the C-section.

The law is aimed at reducing the number of unnecessary C-sections that have been criticized for their negative health consequences; many wealthier women opt for cesarean births for their speed and predictability.

But the issue driving the rate of C-sections in Brazilian maternity wards may in fact be a low bed count. The scarcity of beds, combined with hospitals ill-equipped to deal with natural births that can be unpredictable, is likely to keep the method of delivery popular.

“The best way to guarantee yourself a bed in a good hospital is to book a cesarean,” Pedro Octavio de Britto Pereira, an obstetrician and professor with the Federal University of Rio de Janeiro, told the BBC last year.

[BBC]

TIME public health

At Least 5 Children Received Wrong Immunizations at New Jersey Clinic

None of the children has apparently suffered any adverse health effects because of the errors

(SALEM, N.J.) — At least five children were given the wrong immunizations at a health clinic for the uninsured, including a 2-year-old boy who got an “excessive dose” of a cervical cancer prevention vaccine, authorities said.

The Salem County-run “Shots for Tots” program has been shuttered while officials try to determine how and why the errors occurred. Two full-time nurses who ran the clinic have resigned from the county Health Department, and the county prosecutor’s office is reviewing the matter.

None of the children has apparently suffered any adverse health effects because of the errors. But the county has agreed to pay for the children’s medical monitoring costs “for the foreseeable future.”

Officials say the five children visited the clinic between October 2014 and June 2015. The irregularities there came to light during an annual state compliance audit.

A further review found two children were injected with expired vaccines, and a third got a flu mist dose even though the child was under the age recommended to receive the mist.

There is concern that the 2-year-old who received the Gardasil vaccine for cervical cancer might later suffer neurological effects, officials said.

Officials are still trying to determine what type of vaccine the fifth child received.

TIME Addiction

Heroin Use in U.S. Reaches Epidemic Levels

Heroin use has increased 63% in 11 years

Heroin use in the United States has skyrocketed, spreading to include groups who previously were less likely to abuse the drug.

New data released Tuesday by the U.S. Centers for Disease Control and Prevention (CDC) show that heroin use increased 63% between 2002 and 2013, and heroin-related overdose deaths have nearly quadrupled over the same time period. In 2013 an estimated 517,000 people reported that they had used heroin in the last year or had a heroin-related dependence, a 150% increase from 2007. More than 8,200 people died of heroin-related overdose in 2013, according to national surveys published in the CDC’s Morbidity and Mortality Weekly Report.

While heroin use continues to be most common among men between the ages of 18 and 25 who make less than $20,000, the CDC researchers note that in recent years people in nearly every demographic group are using the drug more. For instance, heroin use has doubled among women and non-Hispanic white people.

MORE: Why You Don’t Know About the Heroin Vaccine

“Heroin use has increased rapidly across the U.S. and throughout society,” said CDC director Dr. Tom Frieden during a press conference. “With that increase we are seeing a dramatic rise in deaths.”

Addiction to prescription pain killers may be fueling some of the rise in heroin use. As TIME has reported, people who are addicted to painkillers may make the switch to heroin since it’s cheaper, doesn’t require a prescription, and offers a similar high. According to the CDC, those who are addicted to prescription opioid painkillers are 40 times more likely to be addicted to heroin. “Most heroin users have a history of nonmedical use of prescription opioid pain relievers, and an increase in the rate of heroin overdose deaths has occurred concurrently with an epidemic of prescription opioid overdoses,” the study authors write.

The report also shows that Americans using heroin are likely to be using other drugs. People addicted to cocaine are also 15 times more likely to be addicted to heroin. And the latest data shows that 96% of people who used heroin in the last year reported using at least one other drug during the same period, with 61% reporting they used at least three different drugs.

The CDC says comprehensive interventions need to happen at the federal and state levels, and health care providers need to follow best practices prescribe pain killers responsibly. As part of that effort, the government is increasing access to substance abuse treatment under the Affordable Care Act and increasing education and training for providers. States can address the problem by implementing prescription drug monitoring programs and expanding access to opioid overdose antidote naloxone, the CDC says.

Read Next: Why America Can’t Kick its Painkiller Problem

TIME pharma deals

Ireland’s Horizon Pharma Launches Hostile, $3 billion Bid For U.S. Rival

FRANCE-INDUSTRY-PHARMACEUTICAL-HEALTH-COSMETIC
JEAN-CHRISTOPHE VERHAEGEN—AFP/Getty Images

Offer represents a 42% premium over Depomed's Monday closing price

Ireland’s Horizon Pharma is bringing its $3 billion takeover offer for U.S. rival Depomed directly to the company’s shareholders after being rebuffed in its attempts to negotiate with Depomed’s management.

Horizon’s hostile bid for Depomed, announced on Tuesday, values the Newark, Calif.-based specialty pharmaceutical company at $29.25 per share, which represents a 42% premium over Depomed’s Monday closing price. Depomed’s share price jumped nearly 40% on the news of Horizon’s offer.

The Irish manufacturer of drugs to treat arthritis and other inflammatory diseases said in a press release that it made “repeated attempts” to enter into deal discussions with Depomed’s management and board starting in March, only to have those advances and its takeover offer rejected. Depomed makes a range of pain treatments and products that treat conditions related to the central nervous system. Horizon believes the deal would increase sales for both companies’ products while the five different drugs Depomed currently has on the market would nearly double the size of Horizon’s current portfolio.

“The strategic and financial benefits of our proposal are highly compelling,” Horizon CEO and chairman Timothy Walbert said in a statement. Walbert added that his company’s proposal offers “substantial long-term value for Depomed’s shareholders,” whom he encouraged to urge the Depomed board to enter deal discussions.

If the two companies are able to reach an agreement, it would represent the latest in a string of deals for Horizon, which paid $660 million for Vidara Therapeutics International last year and also acquired Hyperion Therapeutics for $1.1 billion earlier this year. The pharma industry in general has seen more than its share of dealmaking recently, with deal volume and value on the rise in the first quarter of 2015, led by mega-mergers such as AbbVie’s $21 billion purchase of Pharmacyclics and Pfizer’s $17 billion acquisition of Hospira.

TIME ebola

WHO Politics Interfered With Ebola Response, Panel Says

The World Health Organization (WHO) headquarters building in Geneva, Switzerland on Wednesday, March 11, 2015 .
Raphael Satter — AP The World Health Organization (WHO) headquarters building in Geneva, Switzerland on Wednesday, March 11, 2015 .

Office politics were largely responsible for the WHO's slow Ebola outbreak response, a panel says

An advisory panel selected to assess the response of the World Health Organization (WHO) to the Ebola outbreak blamed the agency’s politics and rigid culture for the poor response to the epidemic. The outbreak has infected more than 27,500 people and killed more than 11,200 in West Africa.

In a report published Tuesday, the panel blamed the organization as a whole for being late in activating emergency procedures, despite early warnings from other groups like Doctors Without Borders/Médecins Sans Frontières. The panel concluded that the agency made noise about the outbreak with little action and poor preparation: “Although WHO drew attention to the ‘unprecedented outbreak’ at a press conference in April 2014, this was not followed by international mobilization and a consistent communication strategy,” the authors write.

The panel argues that the culture at the WHO greatly prohibited action, writing:

“WHO does not have a culture of rapid decision-making and tends to adopt a reactive, rather than a proactive, approach to emergencies. In the early stages of the Ebola crisis, messages were sent by experienced staff at headquarters and the Regional Office for Africa, including after deployments in the field, about the seriousness of the crisis. Either these did not reach senior leaders or senior leaders did not recognize their significance. WHO does not have an organizational culture that supports open and critical dialogue between senior leaders and staff or that permits risk-taking or critical approaches to decision-making. There seems to have been a hope that the crisis could be managed by good diplomacy rather than by scaling up emergency action.”

The panel says that a number of factors were responsible for the delay in declaring the outbreak a pubic health emergency of international concern, including a late understanding of the gravity of the situation, denial among country authorities, culture problems within the WHO and a failure of the international community as a whole to take notice.

The report suggests instituting a variety of reforms and priorities, including focusing on fast-tracking vaccines and drugs and calling upon WHO member states and partners to immediately contribute $100 million in voluntary contributions for an emergency fund.

Response to the report has been mixed. As the Associated Press reports, some members of the public health community involved were disappointed that individuals were not called out by name and that the agency was already focusing on lessons learned, when the outbreak is still ongoing.

TIME Drugs

What Are Quaaludes and Why Did Bill Cosby Use Them?

A brief history of the drug Cosby admitted to purchasing in a recently uncovered deposition

Interest in quaaludes, a powerful sedative popular among housewives in the 1960s and disco partiers in the 70s and 80s, has peaked again following revelations about disgraced comedian Bill Cosby’s use of the drug. An Associated Press report revealed that Cosby admitted to acquiring the drug with intentions of giving it to women he planned to have sex with during a deposition in 2005. Cosby has been accused of sexual assault by over two dozen women.

But, just what are quaaludes?

Methaqualone or quaaludes— also known as ‘ludes, Lemmons, and 714s—were initially synthesized in India in the 1950s. The pill is part sleeping pill, part sedative that was initially marketed as not being as addictive as barbiturates.

By the mid-1960s, the pill was being manufactured in the United States and prescribed to housewives with trouble controlling their nerves and sleeping. But soon another use of the drug was discovered: mix it with alcohol and achieve a “drunken, sleepy high,” according to PBS News. Using the drug to reach a euphoric feeling was one thing, but taking too much could lead to “respiratory arrest, delirium, kidney or liver damage, coma, and death.”

According to the Atlantic, by the 1970s abuse of the pill caused a panic and in 1973 the previously prescription-only drug had been labeled a Schedule II Controlled Substance. But by then the drug had grown in popularity among big city club goers and fraudulent doctors willing to write quick scripts to folks looking to get a fix. The Paris Review describes the appeal thusly:

To stay home feeling ecstatic was one thing, but imagine being out! Music! Lights! Sweaty, writhing bodies! Of course quaaludes were at the center of the seventies disco movement. Manhattan was littered with “juice bars,” nightclubs where no alcohol was sold but quaaludes could be had for a song.

Even as the Drug Enforcement made attempts to crack down on use and distribution of the drug, the drug was picked up by another manufacturer and was continuously marketed as a sleeping aid. And because people so enjoyed taking it, as noted in the Atlantic and Paris Review articles, people kept taking it.

Its history, however, isn’t all based in its euphoric effects. Film director Roman Polanski was accused of drugging a 13-year-old girl with quaaludes before sexually assaulting her. Playboy bunnies recall using the pill during risky sexual encounters. The 2013 film The Wolf of Wall Street gruesomely depicts the destruction a ‘lude induced bender inflicted on Jordan Belfort’s car, neighborhood, and life. And continuous episodes of bad press and abuse led manufacturers to cease producing the pill in the mid-1980s. Now, as Leonardo DiCaprio’s Belfort laments in the Martin Scorsese film, it’s nearly impossible to get prescription grade versions of the pill in 2015.

And now, the drug will be further associated with risky activity. Under oath, Bill Cosby was asked, “When you got the Quaaludes, was it in your mind that you were going to use these Quaaludes for young women that you wanted to have sex with?”

“Yes,” Cosby said.

TIME Aging

Here’s Why You May Be Aging Faster Than Your Friends

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Nick Dolding—Getty Images

Researchers zero in on more than a dozen factors that can predict how fast you’re aging—and have some ideas about what makes people age more slowly

We all have friends who were born in the same year but look years younger (or older) than we do. Now researchers say that such perceptions aren’t just about outward appearances but about something deeper—the different pace at which each of us ages, and what that means for our health.

In a study published in the Proceedings of the National Academy of Sciences, scientists led by Daniel Belsky, an assistant professor of medicine at the Duke University School of Medicine’s division of geriatrics, describe a panel of 18 measures tested in 20- and 30-year olds that showed how quickly they are aging. The markers proved to be a good indicator of physiological age; they mirrored the biological effects of aging found in older people. But they were also good markers of physical age, meaning that those who aged faster also looked older, according to unbiased assessments by random people looking at their photos.

MORE: The Cure for Aging

Most studies on aging, and the factors that affect aging, come from investigations of older populations, says Belsky. And in most cases, the chronic diseases or physiological changes that come with aging are already well established in these groups. But it’s clear that aging doesn’t happen overnight; rather, it occurs gradually over a period of decades, much like water affects the shape of riverbanks or stones over time. It’s not obvious on a day-to-day basis, but can be dramatic if several years have passed.

In the study, 954 people born in 1972 or 1973 in Dunedin, New Zealand, agreed to participate in a study that followed them from age 26 to age 38. Each participant agreed to be tested on a range of 18 different factors that earlier studies have linked to aging, including blood pressure, lung function, cholesterol, body mass index, inflammation and the integrity of their DNA. Based on their scores on these measures, researchers calculated a biological age for each volunteer. They did this again when the people in the study were 32 and 38 years old, and combined them to calculate the pace at which each person was aging.

MORE: This Diet Has Been Linked to a Longer Life—Again

Some people were biologically older and aging faster than others, despite being the same chronological age. Not only that, but the researchers showed, by giving the 20- and 30-somethings the same tests of balance and thinking skills that gerontologists give for older adults, that these aging changes were the same as those occurring later in life.

Though some people really were biologically older than they are, the good news is that some were younger than their chronological age and aging more slowly than they should be. Comparing the slower and faster aging groups should reveal some hints about how to keep aging in check. And of the factors that influence aging, says Belsky, the vast majority, as much as 80%, aren’t genetic and therefore well within our control. (Even the 20% that’s DNA-based is modifiable to some extent.) “This is just the beginning,” he says. “The next step is to figure out what knowing this information helps us to do. One of the things it can help us do is identify the causes of accelerated aging so that we might slow it down. And the other thing it can help us do is evaluate therapies that slow down aging.”

MORE: Eat Better and Stress Less: It’ll Make Your Cells (and Maybe You) Live Longer

Having a way to measure, relatively accurately, the pace at which people age provides a good way of tracking whether any anti-aging treatment works or not. Some of those keys to youth likely won’t be surprising; given the 18 factors that the scientists studied, they will probably involve habits like having a healthy diet that’s low in fat and salt, maintaining a healthy weight, reducing stress, having a strong immune system and getting regular exercise. Not smoking, or quitting smoking may also play a role. To find out, Belsky says he will continue to follow the study group and re-evaluate them again when they are 45. The researchers are charting the participants’ diet, exercise and other behaviors. “We can start to evaluate which behaviors are working to slow down aging,” he says, by seeing which changes slow down the pace of aging. “It’s a tremendous opportunity to begin to sort things out.”

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