MONEY Health Care

The Scariest Health Care Statistic of 2014

Express Scripts reports that spending on medicine surged by 13.1% in 2014.

Healthcare has no shortage of frightening statistics, but a recent review of U.S. spending on medicine last year by the pharmacy benefit manager Express Scripts EXPRESS SCRIPTS HOLDING COMPANY ESRX 1.6% contained a particularly scary revelation: Last year, Americans shelled out 13.1% more for medicine than they did in 2013. That surge in spending could put our healthcare system on a perilous path, especially given that healthcare utilization is climbing on the tailwind from aging baby boomers and healthcare reform.

Better drugs equals pricier medicine

Thanks to innovative new therapies, people are living longer, but they’re doing so at a steep cost.

A decade ago, medicines were primarily small molecule drugs that were easy to manufacture and duplicate. As a result, these drugs were less costly to prescribe and were more quickly challenged by generic alternatives once their patent protection ended.

Today, medicines are increasingly complex biologics. These biologic drugs are medicines that are developed inside living systems such as plant or animal cells. Most biologics are complicated molecules or combination molecules that aren’t easily replicated. The complexity of biologics often translates into increased efficacy over prior generation drugs, but it also makes them much more expensive to develop and manufacture. It also makes it incredibly difficult for generic drugmakers to duplicate them once their patents expire.

The ongoing shift toward these increasingly complex — and correspondingly more expensive medicines — has resulted in them accounting for an increasingly larger share of our healthcare dollars.

According to Express Scripts, despite specialty drugs like biologics representing just 1% of all annual prescriptions, they accounted for a whopping 31.8% of drug spending last year.

Unsustainable spending?

Across the tens of millions of health insurance members covered by Express Scripts pharmacy plans, spending on the average member climbed to $668.75 per year for traditional drugs and $311.11 for specialty medicines.

As you can see in the following table, annual spending per member increased by 6.4% year over year for traditional drugs and by 30.9% for specialty drugs. In both instances, higher drug prices were overwhelmingly behind the increases.

If left unchecked, drug spending growth of this magnitude could be unsustainable. In 2013, IMS Health reported that U.S. spending on medicine clocked in at about $329 billion.

If spending increases by 13.1% per year over the next 20 years, the amount spent annually on prescription medicine would surpass $3.8 trillion (yes, with a “t”).

Taking matters into hand

Such a surge in drug spending would undeniably put patients at risk. Medical costs are the biggest reason for personal bankruptcy, particularly among patients with diseases like HIV and cancer.

In an attempt to blunt the risk to the system posed by runaway drug costs, pharmacy benefit managers, or PBMs, like Express Scripts and CVS Health CVS HEALTH CORPORATION CVS -0.6% — the two largest PBMs — are rethinking how they pay for drugs.

In December, Express Scripts negotiated a steep discount to AbbVie’s ABBVIE INC. ABBV 0.52% new hepatitis C drug Viekira Pak by offering exclusivity. In January, CVS Health similarly orchestrated a discount for Gilead Sciences’ GILEAD SCIENCES INC. GILD -2.54% competing hepatitis C drugs, also in exchange for exclusivity. Express Scripts estimates that its deal with AbbVie will save its clients $1 billion annually.

In addition to more aggressive price contracts with drugmakers, healthcare payers are also developing programs that can increase patient adherence to medicine to lower the risk of costly future healthcare events, as well as programs to increase the use of generic alternatives.

PBM programs that increase the use of lower cost generics could prove to be critical. Despite biologics’ difficult-to-copy nature, technology advances are helping generic drugmakers develop biosimilars. While not exact copies, these biosimilars deliver similar efficacy to their brand name counterparts. So far, biosimilars have been a bigger story in Europe than in the U.S.; however, the FDA approved its first biosimilar this month when it gave Novartis’ Sandoz unit the go-ahead to begin marketing its biosimilar of the top-selling cancer drug Neupogen. That approval is likely to be the first of many over the coming years.

Looking ahead

The financial stakes are high for patients and drugmakers. If prices are too low, it could force drug developers to focus only on diseases that offer the biggest payoff. That could derail advances in a range of orphan diseases. However, if prices for medicine continue to grow at this rate, it’s unlikely that the system will be able to afford it. Clearly, a middle ground is not only necessary, but in the best interest of everyone. Finding that middle ground, however, may remain difficult.

TIME medicine

Here’s How 23andMe Hopes to Make Drugs From Your Spit Samples

The company is making a bold move to enter the drug-making business by using the genetic information donated by its clients

On March 12, 23andMe, the genetic testing company best known for analyzing your DNA from a sample of spit, announced the creation of a new therapeutics group. The group’s mission: to find and develop drugs from the world’s largest database of human genetic material.

That’s a huge shift for the company, which must now build a research and development arm from scratch. Richard Scheller, formerly of the biotechnology corporation Genentech, will lead the group and will also be 23andMe’s chief science officer.

Scheller admits that for now, he’s the therapeutics group’s only member. But soon after he starts on April 1, he anticipates that things will move quickly, as they do in the genetics world. That’s what attracted him to 23andMe after overseeing early drug development at Genentech for 14 years. “I’ve seen over the last couple of years how human genetics has impacted the way Genentech does drug discovery, and I thought it might be fun and interesting to work in an unrestricted way with the world’s largest human genetic database,” he says. “The questions we will ask are research based, but we could identify a drug target extremely quickly. I believe there is the real possibility to do really, really great things for people with unmet medical needs.”

MORE: Genetic Testing Company 23andMe Finds New Revenue With Big Pharma

More than 850,000 people have paid 23andMe to sequence their DNA since the company launched in 2006 until 2013, when the Food and Drug Administration requested that the company stop selling its medical genetic information services over concerns that their marketing claims weren’t supported by strong enough evidence about how the genetic information influenced human health. The company still retains that genetic information and continues to sell kits, but provides only non-medical information now while it continues to work with the FDA on further regulatory issues.

That experience “transformed” the company, as CEO Anne Wojcicki said to TIME earlier this year. Since then, the company has expanded its collaborations with pharmaceutical companies to access its database. The latest addition of drug development is a further evolution in the company’s identity.

Of those who have sent in samples, 80% have agreed to allow their genetic information to be used for research purposes. That’s the database that Scheller is eager to investigate. While at Genentech, he helped broker a collaboration between the biotech firm and 23andMe in which Genentech would have access just to the genetic testing company’s Parkinson’s disease patients, to search for any genetic clues to new therapies. Now, he says, “I plan on asking hundreds or maybe thousands of times more questions of the database than any pharmaceutical partner.”

MORE: 23andMe Finds Genes for Motion Sickness

He will be looking, for example, at whether patients who develop a certain disease tend to have specific hallmark genetic changes in their DNA, which could serve as potential launching points for new drugs. Or he might focus on the extreme outliers: people who have advanced cancer, for example, but somehow survive, or those who seem to succumb early. Mining their genomes might yield valuable information about what makes diseases more or less aggressive, and might become targets for drugs as well.

To do this, Scheller will have to create a drug development team from the ground up. The company is not divulging how much it intends to invest in this effort, but is soliciting another round of financing in the coming months. Initially, Scheller anticipates that even before the company has labs set up, he and his team will take advantage of labs-for-hire, or contract research organizations, to start doing experiments within weeks. Because his drug candidates will be more targeted and designed to address specific mutations or processes in the body, he anticipates that the cost of developing drugs that patients might eventually benefit from may be “substantially reduced” from the average $1 to $2 billion most pharmaceutical companies now spend.

MORE: Time Out: Behind the FDA’s Decision to Halt Direct to Consumer Genetic Testing

As for which disorders or medical issues he will tackle first, Scheller is being democratic. “We are going to be opportunistic,” he says. “That’s the nice thing about being part of 23andMe. We don’t really have a say. We can look generally at the database, and try and let it teach us what we should be working on.” In other words, anything is game.

TIME medicine

First Successful Penis Transplant ‘Massive Breakthrough’, Doctors Say

The operation took 9 hours to perform

A 21-year-old man has received the world’s first successful penile transplant, surgeons say.

The man, whose name was not revealed for privacy reasons, had his organ amputated three years ago after a circumcision went wrong. Doctors at Stellenbosch University and Tygerberg Hospital in South Africa operated for nine hours in December, and just a few months later they say he’s already regained full function in the transplanted organ —a much faster recovery than they had hoped for.

“It’s a massive breakthrough. We’ve proved that it can be done – we can give someone an organ that is just as good as the one that he had,” Prof Frank Graewe, head of the Division of Plastic Reconstructive Surgery at Stellenbosch University, said. “It was a privilege to be part of this first successful penis transplant in the world.”

While at least one other attempt has been made at penile transplant, the surgeons say this is the first such operation to succeed.

In their announcement, the doctors emphasized the psychological trauma of penile amputation, a problem they say is particularly acute in South Africa.

TIME ebola

Why West Africa Might Soon Have 100,000 More Measles Cases

Now more than ever: Measles vaccinations have dramatically cut disease rates in Africa
Spencer Platt; Getty Images Now more than ever: Measles vaccinations have dramatically cut disease rates in Africa

One lethal epidemic could give rise to another

Correction appended, March 12

There’s not a war college in the world that couldn’t learn a thing or two from the way viruses operate. They’re stealthy, they’re territorial, they seek and destroy and know just where to hit. And, just when you think you’ve got them beat, they forge an alliance with another of your enemies. That, according to a new paper published Thursday in Science, is what’s poised to happen with Ebola and measles—and it’s the babies and children of Africa who will overwhelmingly pay the price.

The Ebola epidemic is by no means over, but it is being contained and controlled. With nearly 24,000 cases and more than 9,800 fatalities so far—mostly in Guinea, Sierra Leone and Liberia—the epidemic is still claiming new victims, though more slowly. The crisis, however, has disrupted health-care delivery across the entire affected region, preventing children from receiving badly needed measles vaccines. That, the new study reports, could result in an additional 100,000 measles cases over the next 18 months, leading to an additional 2,000 to 16,000 deaths. Rates of vaccination against other diseases—particularly polio and tuberculosis—have fallen too. But measles’ ease of transmission makes it especially worrisome.

“When there’s a disruption of medical services, measles is always one of the first ones in the door,” says Justin Lessler, of the Johns Hopkins Bloomberg School of Public Health, a co-author of the paper. “The Ebola epidemic significantly increases the likelihood of a major measles outbreak occurring.”

Lessler and his co-authors arrived at their numbers painstakingly. First, they used health data to map and estimate the share of vaccinated and unvaccinated children in 5 km by 5 km (3.1 mi. by 3.1 mi.) squares across the three affected countries. They then estimated a 75% reduction in vaccination rates during the epidemic and projected forward by 6, 12 and 18 months. They factored in the transmissability of the virus within each region and estimated the likely number of deaths using what’s known as a Case Fatality Ratio—a mathematical tool that, as its name suggests, estimates lethality for any particular disease under any particular set of circumstances.

The final numbers—especially the potential 16,000 deaths—rightly alarmed the researchers, though lessler does admit that they are by no means a certainty. “The 75% decrease in vaccinations is a little too pessimistic,” he concedes. But the critical word in that admission is “little,” and the investigators did consider 25%, 50% and 100% rates too, before settling on 75% as at least the most plausible. No matter what, the odds are still high of a five figure death rate and a five to six figure additional case rate—and the Ebola epidemic, which led to the problem in the first place, has not even fully abated.

Lessler and his colleagues are not waiting until it does to sound the alarm, urging global health groups to mobilize a vaccination campaign now so it can be ready to launch in the affected areas the moment the Ebola all-clear sounds. The new push would first target children who were born during the Ebola epidemic since they would have likely received almost no medical attention at all up until that point, and then expand to all children in the most measles-susceptible age group—about 6 months to 5 years.

“The best time to start the campaign would be as soon as it’s logistically feasible,” says Lessler. “For every month no campaign begins, the risk of an outbreak occurring and the impact of such an outbreak worsens.”

The happy news, Lessler believes, is that done right, the campaign could not only prevent the measles epidemic from beginning, but could actually put West Africa in a better position than it was before Ebola, with vaccine coverage for measles and other diseases exceeding the pre-outbreak rates. “Previous campaigns have reached coverage in excess of 90%,” he says.

Victory in the battle against Ebola—to say nothing of the battle against measles—is by no means yet assured. But, again as the war colleges would teach, with the right cooperation and the right deployment, the good guys can win.

Correction: An earlier version of this story misidentified an assistant professor at the Johns Hopkins Bloomberg School of Public Health. He is Justin Lessler.

TIME health

What Made the Spanish Flu so Deadly?

Red Cross 1918
APIC / Getty Images Red Cross volunteers fighting against the spanish flu epidemic in United States in 1918

Mar. 11, 1918: A soldier in Fort Riley, Kans., reports to the infirmary with what will become known as Spanish flu

Nearly a century after it made its grisly debut, the mysteries surrounding Spanish flu continue to plague epidemiologists. In 2005, as Slate has reported, scientists succeeded in sequencing the virus’ RNA — eight years after exhuming a flu victim’s frozen corpse from an Alaskan grave to obtain a sample. But they still don’t know exactly where the virus came from or how it achieved such staggering lethality, killing more than half a million Americans and an estimated 50 million people worldwide in a single year.

Some researchers believe the story began on the morning of this day, Mar. 11, 1918, when a soldier in Fort Riley, Kans., went to the camp infirmary with a fever. According to the PBS documentary Influenza 1918, more than 100 soldiers had reported to the infirmary by noon. Within a week, that number had quintupled. Several dozen soldiers died there that spring, before the contagion seemed the ebb; the official cause was pneumonia.

As soldiers fanned out to fight World War I, however, the virus made its way around the globe, from European battlefields to remote areas of Russia and Greenland, spawning two more pandemic waves that were even deadlier than the first. (It became known as Spanish flu only because the Spanish news media was the first to widely report the epidemic, which had been hushed by wartime censors elsewhere in Europe.)

What made this flu different from all other flus was a dramatically higher fatality rate, plus the fact that while ordinary flus claimed casualties among the very young and the very old, this virus was especially deadly to young adults between the ages of 20 and 40. And their deaths weren’t pretty. As Slate tells it, “Many sufferers came down with severe nosebleeds — some spewed blood out of their nostrils with such force that nurses had to duck to avoid the flow. Those unable to recover eventually drowned in their own bodily fluids.”

Why Spanish flu was so fatal, especially to people in the prime of their lives, is what scientists are striving to understand, as TIME reported in the wake of Hong Kong’s 1997 avian flu outbreak. It was during that outbreak that a pathologist named Johan Hultin collected an intact, long-frozen sample of the Spanish flu virus from a mass grave in a tiny Alaska town called Brevig Mission, where 85 percent of the population had been felled by the flu in a single week. Research on that sample has shown that one way Spanish flu worked was by overstimulating the immune system and turning it against its owner — so having a strong immune system to begin with may have been a disadvantage.

But there is more to it than that, other scientists say. And understanding the full story of Spanish flu could help develop vaccines to protect us from the next flu epidemic — an epidemic that is inevitable, as Hultin told TIME in 1998. In the meantime, there’s only one surefire method of surviving pandemic flu, according to Hultin: Isolate yourself in a mountain hideaway until the outbreak subsides. TIME explains: “It was a tactic… successfully used in 1918 by a village just 30 miles from Brevig. Its elders, after learning of the advancing plague, stationed armed guards at the village perimeter with orders to shoot anyone who tried to enter. The village survived unscathed.”

Read original coverage of the Hong Kong outbreak, here in the TIME archives: The Flu Hunters

Read next: Why the Government Has Legal Authority to Quarantine

Listen to the most important stories of the day.

TIME Innovation

Five Best Ideas of the Day: March 6

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

1. India has banned a documentary on the 2012 gang rape that rocked the country. That was a huge mistake.

By Shashi Tharoor at NDTV

2. Berkeley decided to give campus departments a real incentive to cut power consumption by charging them directly — and energy use went down.

By Meredith Fowlie in The Berkeley Blog

3. Pakistan is helping Afghanistan’s president make peace with the Taliban. Other powers should back him.

By the Economist

4. Ukraine’s military will never be strong enough to beat Russia outright. But it doesn’t have to be.

By Alexander J. Motyl in Foreign Policy

5. Micro-bubbles — guided with magnets, deployed with sound waves — could revolutionize the delivery of medicine and even chemotherapy.

By Charvy Narain at the Oxford Science Blog

The Aspen Institute is an educational and policy studies organization based in Washington, D.C.

TIME Ideas hosts the world's leading voices, providing commentary and expertise on the most compelling events in news, society, and culture. We welcome outside contributions. To submit a piece, email ideas@time.com.

TIME medicine

Chain of Kidney Transplants Begins at San Francisco Hospital

Kidney donor Zully Broussard speaks at California Pacific Medical Center on March 4, 2015 in San Francisco
Leah Millis—AP Kidney donor Zully Broussard speaks at California Pacific Medical Center in San Francisco on March 4, 2015

This is the largest kidney-donation chain in the transplant center's history

(SAN FRANCISCO) — Zully Broussard thought she was going to help one person by donating a kidney.

Instead, she helped six.

The Sacramento woman’s donation to a Benicia man set off an organ swap that resulted in five more sick people getting new kidneys at a San Francisco hospital. Three transplants were completed Thursday, and the remaining three will be done Friday.

“I thought I was going to help this one person who I don’t know. But the fact that so many people can have a life extension, that’s pretty big,” Broussard said.

Domino-like kidney swaps are still relatively new, but they are becoming increasingly common.

With a total of a dozen patients and donors, this week’s surgeries at the California Pacific Medical Center represent the largest kidney donation chain in its transplant center’s 44-year history, hospital spokesman Dean Fryer said. The patients at are between 24 to 70 years old, and most of them are from the San Francisco Bay Area.

Transplant chains are an option when donors are incompatible with relatives or friends who need kidneys.

In this case, six donors are instead giving kidneys to strangers found through a software matching program developed by 59-year-old David Jacobs, a kidney recipient whose brother died of kidney failure. Its algorithmic program finds potential matches using a person’s genetic profile.

Jacobs, of San Francisco, said he understands firsthand the despair of waiting for a deceased donor.

“Some of these people might have waited forever and never got the kidney,” he said. “But because of the magic of this technology and the one altruistic donor, she was able to save six lives in 24 hours.”

Fewer than 17,000 kidney transplants are performed in the U.S. each year, and between 5,000 and 6,000 are from living donors, considered the optimal kind.

Kidney swaps are considered one of the best bets at increasing live-donor transplants, and they are becoming more common as transplant centers form alliances to share willing patient-donor pairs. The United Network for Organ Sharing has a national pilot program underway.

In 2001, Johns Hopkins Hospital in Baltimore, Maryland, performed a transplant chain that started as a two-way kidney exchange and grew to 30 pairs.

Jacobs’ kidneys failed in early 2000 from a genetic disease. In late 2003, a living unrelated donor provided an organ for a transplant.

A new chance at life got him thinking.

“I talked to my doctor about kidney-paired donation. He was excited about the idea but didn’t know how to do it,” he recalled. “I was a tech person. I’ve been in technology my whole professional career. I thought of it as an enterprise software problem I could solve.”

He said the two months he imagined it would take to take to develop the software stretched into six years.

The National Kidney Foundation reports more than 100,000 people in the United States are awaiting kidneys, and 12 people die a day while waiting.

Broussard said her son died of cancer 13 years ago and her husband passed away 14 months ago, also from cancer.

Asked why she volunteered to donate a kidney to a stranger, the 55-year-old said: “I know what it feels like to want an extra day.”

TIME medicine

One Hour of Sleep Makes a Difference In What You’ll Eat

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Lynn Koenig—Getty Images/Flickr RF

When it comes to teens and sleep, it’s not how much sleep, but how consistently they sleep the same amount that’s important for their health

Plenty of studies have documented that teens don’t get enough sleep. They’re supposed to be in bed for eight to nine hours a night, but most get seven or less. Now the latest sleep research, presented at the American Heart Association EPI/Lifestyle 2015 meeting, shows when it comes to weight gain—which has been tied to sleep deprivation and disturbances—it’s not necessarily the amount of sleep that tips the scales but rather the consistency of that nightly rest.

Fan He, an epidemiologist at Penn State University College of Medicine, and his colleagues found a strong correlation between the variation in sleep patterns among a group of teens and the amount of calories they consumed. And for every hour difference in sleep on a night-to-night basis over a week, for example, they ate 210 more calories—most of it in fat and carbohydrates. Those with uneven sleep patterns were also more likely to snack.

Previous studies have linked poor or disrupted sleep to obesity; people not getting enough shut-eye, for example, may experience changes in the hormones that regulate appetite and how well they break down glucose in their diet. Levels of the hormone leptin, for instance, drop in those who are sleep deprived, and less leptin prompts the body to feel hungry.

MORE: The Power of Sleep

In the current study, however, all the teens got an average of seven hours a night, so it wasn’t as if some of the teens were sleeping for extremely long or short periods of time. Any metabolic changes they would have experienced due to their sleeping less than the recommended eight to nine hours would have been similar among the consistent and inconsistent sleepers.

Dr. Nathaniel Watson, president-elect of the American Academy of Sleep Medicine and co-director of the University of Washington Medicine Sleep Center, stresses that good quality sleep involves three things — getting enough sleep, making sure the timing of the sleep if appropriate, and avoiding sleep disorders. While the amount of sleep has gotten the lion’s share of attention in recent years, a new phenomenon called social jet lag, which the current study investigates, may deserve equal consideration. “We live in a society of yo-yo sleep in which people sleep less because of social or work demands, then try to catch up,” says Watson. “There haven’t been a lot of studies that looked at what kind of impact this has on our health, but teenagers may be particularly susceptible to social jet lag than older adults, and this study assessed that.”

MORE: This Is What’s Keeping Teens From Getting Enough Sleep

These results show that it was the variability in their sleep that was most strongly linked to their eating habits.

Why? The researchers guess that teens who aren’t sleeping consistently are more likely to get too little sleep on one night, for example, and therefore be more tired or sedentary the following day, which leads them to sit around and eat more. It may also be possible that teens with irregular sleep habits are more likely to stay up later on weekends; He found that these adolescents had a 100% higher chance of snacking on weekends compared to those who slept more regularly.

MORE: School Should Start Later So Teens Can Sleep, Urge Doctors

That suggests that health experts should focus not just on the amount of sleep teens are getting, but on their sleep patterns. “Instead of focusing on how much we sleep, we also need to pay attention to maintaining a regular sleep pattern,” says He. Such consistency, however, may not be so easy for teens to master.

 

TIME medicine

4 Things to Know About Zinc And Your Cold

woman-using-tissue
Getty Images

Zinc can help treating a cold, but it doesn't prevent

Zinc is often touted as a way to fight the common cold. But while research suggests it does work, there are some caveats. Tod Cooperman, MD, president of the independent testing group ConsumerLab.com, provides the scoop:

Zinc helps treat—not prevent—a cold

Popping zinc within 24 hours of the start of symptoms helps shorten your sniffle, according to a 2013 Cochrane review. The authors say significant effects were seen at doses of at least 75 mg (the equivalent of three or four lozenges) per day, taken as long as your cold lasts. How does it work? The theory, according to the Mayo Clinic, is that zinc may keep cold viruses from multiplying and taking up residence in your nose and throat. But don’t bother taking it just to take it; there’s no evidence it’ll actually prevent a cold.

Read more: Best and Worst Foods to Eat When You’re Sick

Pick a lozenge, not a spray

Back in 2009, the U.S. Food & Drug Administration warned against using zinc gel sprays and nasal swabs after receiving more than 130 reports of people losing their sense of smell after using these products. (The manufacturer pulled the products from store shelves, though they claim no link has been established.)

Though you can no longer buy zinc nasal spray, it’s still available as a throat spray, which might be problematic, according to Dr. Cooperman. “If you spray it into your throat it can still go up your nose,” Dr. Cooperman says.

The best way to go is still the good old lozenge. Just make sure you suck—not crunch—it: “It needs to dissolve slowly to be effective so it can coat your throat,” explains Dr. Cooperman.

Read more: Best and Worst Exercises to Do When You Have a Cold

Not all lozenges are created equal

In order for a lozenge to provide enough zinc to be effective, it needs to contain between 13 and 23 milligrams, Dr. Cooperman says. Yet only two of the four lozenges Consumer Lab tested—Cold-Eeze Homeopathic Cold Remedy and Nature’s Way Zinc—provided enough. (There are other brands of zinc they didn’t test.)

Read more: 14 Reasons You’re Always Tired

You can’t pop ’em like candy

The safe upper limit for zinc in adults is 40 milligrams per day, as determined by the Institute of Medicine. While it’s okay to exceed that 40mg limit for three to five days (or roughly the length of a cold), you still don’t want to down the lozenges like crazy. At most, only take one every three hours if you’re sick, and limit yourself to one a day if you’re healthy: “Too much zinc can actually depress your immune system,” explains Dr. Cooperman.

Read more: How to Stop a Cold In Its Tracks

This article originally appeared on Health.com.

TIME medicine

Antipsychotics Frequently Prescribed to Adults with Dementia Despite Risks

TIME.com stock photos Health Prescription Pills
Elizabeth Renstrom for TIME

The drugs can increase the risk of death for certain people with dementia

Antipsychotic drugs are being over-prescribed to men and women with dementia, according to a new report from the federal government.

The report published on Monday shows that around one third of older adults with dementia living in nursing homes had been prescribed an antipsychotic in 2012, as well as 14% of older adults with dementia who lived outside a nursing home. The U.S. Government Accountability Office (GAO) discovered the numbers when reviewing Medicare’s prescription drug program.

The high number of prescriptions is a concern since the U.S. Food and Drug Administration (FDA) has warned that antipsychotic drugs can increase the risk of death for certain people with dementia. The officials note that while the Department of Health and Human Services (HHS) has taken steps to address the use of antipsychotic drugs in nursing homes, it still has more outreach to do to educate people about the hazards of prescribing the drugs.

The report shows that patients with dementia are often given the drugs at a hospital, possibly to treat the irritation and mood swings caused by the disorder, and then the drugs continue to be used when the patients enter a nursing home. The drugs are most often prescribed when facilities have low staff numbers.

“Educational efforts similar to those provided for nursing homes should be extended to other settings,” the GAO study’s authors write. The agency recommends more education be provided for caregivers working with patients living at home or in assisted facilities.

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