wear a mask - wellrx blog image

By Nancy Swezey, BSN, RN, CNOR

There are over 16 million confirmed cases of coronavirus globally and more than 600,000 deaths from the virus, and these numbers are changing quickly. The current estimation is based on inconsistent diagnoses and reporting of acute illness, and likely underestimates the global scale of coronavirus infection.

COVID-19 is the designation of the novel coronavirus disease of 2019. This coronavirus is “novel” because it was never identified before its appearance in late 2019 in China. The “coronavirus,” as we know it, is actually one type of coronavirus, which has many variations. Severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2 for short, is the virus that causes coronavirus disease 2019, or COVID-19.

A Hot Topic in Politics

What is to some a universal public health crisis has become to others a polarizing, highly political situation. The validity of the coronavirus and the means by which to reach a comprehensive resolution have stimulated discourse on issues of health, economy, individual rights, and social justice. Perhaps one reason is that, to a great extent, we still don’t know much about COVID-19 and its future. Another reason is that this disease has affected everyone. Whether it’s the transition to remote work, a canceled event or vacation, a retreat from social life, job or financial insecurity, or affliction with the virus itself, COVID-19 has, to some extent, touched all of our lives.

Transmission

Many epidemiologists believe that the spread of this coronavirus began in Wuhan, China, in late 2019, and it was potentially transmitted from animals to humans. Under a microscope, the virus most resembles two established coronaviruses found in bats. Since the outbreak in Wuhan, it has been transmitted mainly via person-to-person contact. The virus is believed to be spread via droplet transmission, where respiratory droplets suspended in the air from coughing, sneezing, and talking makes contact with another person’s mucous membranes, such as those in the eyes, mouth, or nose, thus infecting a new host. Droplets can also travel indirectly through contaminated surfaces that an infected person touches, such as thermometers and tabletops. Droplets rarely travel more than six feet.

Scientists believe that SARS-CoV-2 can also travel via the airborne route, where particles much smaller than droplets are suspended in the air. This can happen during certain types of medical procedures in the airway where an aerosol is produced, such as endotracheal intubation, bronchoscopy, and nebulizer treatment.

Data indicate that people with COVID-19 are most contagious at the earlier stages of infection, possibly before they even have symptoms if they develop symptoms at all.

Preventative Medications and a Coronavirus Vaccine

It was initially thought that hydroxychloroquine could be used to prevent infection after exposure, but data do not support this use. No FDA-approved postexposure prophylaxis for COVID-19 is available, although several clinical trials are underway. There is also no vaccine for COVID-19, but the World Health Organization has an increasing catalog of candidate vaccines and their stage of clinical evaluation.

Keeping Your Distance

The principle of social distancing is based on findings that the risk of coronavirus transmission increases as closeness and duration of contact increase among people. In most cities now, social distancing is sanctioned by local and regional government policies that prohibit or restrict access to nonessential public places where social proximity and crowds are likely, such as theaters, bars, and restaurants. In cities where such restrictions are not in place, individuals must use their own discretion when socializing. Even as restrictions lift, many choose to avoid public gatherings, particularly if they or a close family member is in a vulnerable state of health. Many essential services and organizations, such as public transportation and grocery stores, mitigate their inability to fully enforce social distancing by requiring masks, closing early to thoroughly disinfect, and, in some cases, restricting capacity.

Wearing a Mask

It is well established that wearing a mask over the nose and mouth largely prevents the inhalation of large droplets, such as those by which SARS-CoV-2 spreads. Historically, patients with upper respiratory infections, such as influenza, are advised—and required in healthcare settings—to use a mask. N95 respirators are different than cloth or surgical face masks in that they require fit testing to establish a seal around the nose and mouth. This allows the wearer to breathe only air filtered through the N95 mask, which can filter out very small airborne particles. N95 masks are not necessary for use outside of the healthcare setting, particularly in procedural areas, where healthcare workers are exposed to airborne and fluid hazards. Instead,  using cloth face masks is a prudent alternative in public spaces where social distancing is not feasible.

Hygiene and Lifestyle Practices

By protecting ourselves, we protect others. Social distancing and mask-wearing will protect us and others from spreading the virus, but there is more to protecting ourselves than our actions in public spaces. The importance of frequent handwashing and surface disinfection cannot be overstated. To many experts, having clean hands is the most important action to prevent the spread of any infectious disease.

High-quality nutrition and physical fitness are essential components of a healthy immune system, and scientists have made the case for both as protective factors against COVID-19. The availability of resources necessary to maintain a healthy lifestyle varies among different communities; thus, the current pandemic has further highlighted health disparities. That being said, healthy lifestyle recommendations amid the coronavirus are essentially no different than any other time: stay home when sick, wash your hands, eat well, and exercise. The only difference is that now we see clearly these actions in light of both their personal and social impacts.

Related stories:

What Are Social Determinants and How Do They Impact Your Overall Health?

COVID-19 Family Health Activities

How to Improve Your Mental Health During COVID-19

Nancy Swezey, BSN, RN, CNOR is a freelance writer and nurse researcher. She develops and presenting on initiatives in clinical settings, such as general healthcare, sustainability in surgery, and creating clinical teaching modules for nurses through CUNY Hunter in New York. NS also authors a blog on vegan and vegetarian topics. She is also a trained Epic EMR SuperUser.

Resources

https://www.cdc.gov/coronavirus/2019-ncov/faq.html#:~:text=A%20novel%20coronavirus%20is%20a,like%20the%20common%20cold.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-epidemiology-virology-and-prevention?search=coronavirus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2513094760

https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191114/

https://www.pewresearch.org/politics/2020/06/25/republicans-democrats-move-even-further-apart-in-coronavirus-concerns/

https://www.nejm.org/doi/full/10.1056/NEJMp2021209?query=featured_coronavirus

https://www.wellrx.com/hydroxychloroquine%20sulfate/drug-images/

https://clinicaltrials.gov/ct2/results?cond=Coronavirus+Infection&term=exposure&cntry=&state=&city=&dist=

https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

https://www.nejm.org/doi/full/10.1056/NEJMp2021264

https://www.vumc.org/coronavirus/sites/default/files/COVID%20Documents/Wearing%20a%20Mask%20During%20CV-19%20%28HC-2008%29%2005-2020.pdf

https://www.bryanhealth.com/app/files/public/4960/wear-a-mask_8-5×11-2.pdf

https://www.cdc.gov/handwashing/when-how-handwashing.html

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.htmlhttps://www.cdc.gov/handwashing/index.html

history of american pharmacies - wellrx blog image

How They Started and Where They Are Today

By Rosanna Sutherby, PharmD

American pharmacies have come a long way from the years of colonial apothecaries to the modern automated pharmacies of today. Evolution in pharmacist education and changes in the legislature has shifted the roles of pharmacists. Read on for a brief history of pharmacies in the United States.

The Birth of American Pharmacy

In 1630, Governor John Winthrop, founder of Boston, hired British apothecary Robert Cooke to assist him in preparing remedies using herbs imported from England and other natural ingredients.

In 1729, the Irish immigrant Christopher Marshall opened one of the first apothecaries in colonial America. It was located in Philadelphia. For 96 years, the Marshall Apothecary served as a community pharmacy as well as a training ground for aspiring pharmacists. Marshall’s granddaughter, Elizabeth Marshall, took over the store in 1805 and became the second American female pharmacist. The first was Elizabeth Gooking Greenleaf, who bought and ran an apothecary in Boston in 1727.

In 1821, almost 100 years later, the first pharmacy school, Philadelphia College of Pharmacy, opened. Shortly after, in 1852, the first national pharmacy association, the American Pharmaceutical Association (APhA), was established.

Changes in Education

Initially, the way into the profession of pharmacy was through apprenticeship. Someone interested in pharmacy would train under the tutelage of an established pharmacist. The opening of the first pharmacy school shifted education to formal institutions, and even these institutions underwent several changes over the years. Early colleges offered a Graduate in Pharmacy (Ph.G.) degree, which could be turned into a Pharmaceutical Chemist (Ph.C.) degree with an additional year of study.

By the 1940s, the Bachelor of Science in Pharmacy (B.S.Pharm.) was introduced, and in 1997, the Doctor of Pharmacy (Pharm.D.) six-year program became the only accredited pharmacy degree.

The Role of the Pharmacist

Early American pharmacies were referred to as apothecaries, and pharmacists were often called druggists or chemists. The role of the pharmacist then included preparing and dispensing remedies and counseling patients. By the 19th century, Edward Parrish of the APhA standardized the name “pharmacist” for all pharmaceutical practitioners. Until the 1950s, pharmacists prescribed, made, and dispensed medicines and provided patient counseling.

The passing of the 1951 Durham-Humphrey Amendment to the Federal Food, Drug, and Cosmetic Act of 1938 shifted the role of pharmacists. Until then, pharmacists were able to prescribe and dispense any medication except narcotics. The Durham-Humphrey Amendment restricted pharmacists to dispensing medications only with a physician’s prescription. Pharmacist recommendations were limited to over-the-counter (OTC) medications, and their role shifted to dispensing drugs and ensuring medication safety.

In the 1980s, a movement toward clinical pharmacy began to expand the role of pharmacists. By 2003, the Medicare Prescription Drug Improvement and Modernization gave pharmacists the ability to, once again, counsel patients on prescription drugs as well as OTC medications. The clinical pharmacy movement expanded the pharmacist’s role in the community pharmacy to include administering vaccines, counseling patients, and other patient care services. Pharmacists now can focus on disease and chronic condition management, medication management, health and wellness, and other services that help improve patients’ quality of life.

The Evolution of Community Pharmacies

The role of modern-day community pharmacies differs from that of the apothecaries of colonial America. Pharmacists of colonial apothecaries prepared most of the remedies that they dispensed. By 1900, the industrial revolution introduced new forms of medications, such as tablets, gelatin capsules, and enteric-coated pills. These medication forms were mass-produced and lined the shelves of pharmacies of the 1900s. However, compounded medicines, including liquids, creams, ointments, lotions, eye drops, and eardrops, were still common. Today’s pharmacies are largely automated, with robots that count and bottle commonly used medicines, and compounding has become less common.

Record-keeping in the pharmacy has also seen significant advances. Pharmacists have moved from handwriting all prescriptions to using systems in which prescriptions are transferred electronically directly from the prescriber’s office to the patient’s community pharmacy.

To keep track of patient records, pharmacists handwrote all the patients’ prescriptions on index cards that used carbon to transfer the information to receipts. Today’s pharmacies keep electronic patient records.

As the roles of community pharmacists have evolved over time, so have those of pharmacy technicians. The support staff of precomputer pharmacies consisted mainly of cashiers. The introduction of computers in the pharmacy shifted the pharmacy support role from cashier to pharmacy technician. Technicians now are responsible for more than ringing up sales at the register. They can input prescriptions in the computer, answer telephone calls, and assist the pharmacist in preparing medications and setting up immunizations.

Pharmacies today can include patient care areas where pharmacists can provide various clinical patient care services. Clinics with prescribing practitioners inside the stores are becoming more prevalent. The role of pharmacists in community pharmacies has come full circle from colonial times, but today’s highly automated and computerized pharmacies are quite different from yesteryear’s nostalgic apothecaries.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://aihp.org/wp-content/uploads/2018/08/1-Early-Pharmacy-in-America.pdf

http://www.pharmacy.auburn.edu/about/pdf/history-pictures.pdf

https://www.aphafoundation.org/sites/default/files/ckeditor/files/WIP%20mural%20descriptions.pdf

https://brewminate.com/a-brief-history-of-the-pharmacy-in-the-united-states/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821736/

https://www.stlcop.edu/practice/about.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789634

https://www.pharmacytoday.org/article/S1042-0991(16)30677-6/fulltext

summer first aid - wellrx blog image

By Karen Eisenbraun, CHNC

Summer is well underway in North America, and after a springtime spent in isolation due to COVID-19, many people are venturing outdoors again. It’s more important than ever to be prepared for common summertime injuries and mishaps. Social distancing is still critical as COVID-19 cases continue to climb in many states. While you can still go to the ER for medical emergencies, many healthcare facilities are advising patients to use telemedicine for non-emergency health concerns when possible to reduce their exposure to the disease. 

Cuts, sunburns, poison ivy, infected bug bites, eye injuries, and broken bones often lead to emergency room visits during the summer. Whether you’re headed out to go camping, take a hike, or spend a day at the beach, be prepared by packing a first aid kit with a few healthcare essentials. 

Pack Your Own Kit

Store-bought first aid kits are a good start but don’t rely on them for everything your family needs, as they are often lacking some essential items. Build your own kit—and do so well before you need it—so you don’t risk forgetting anything as you head outdoors. 

It’s also a good idea to prepare a first aid kit for each family car. Keep it in the vehicle in case anyone experiences an injury while you’re away from home. Below are the items you should buy: 

Premade First Aid Kit

Store-bought kits are a great place to start because they often contain small quantities of essential items such as bandages, tape, and gauze. Choose a large kit with a sturdy case so you can add to it and customize it. You can also use a small backpack to hold all of your first aid supplies. 

Water Bottle

Any time you head outdoors, make sure you have plenty of clean drinking water. It’s important to stay hydrated in the heat, and you’ll also need clean water to clean out any wounds. 

Antihistamines

Pack over-the-counter antihistamines such as Benadryl (diphenhydramine) to treat allergic reactions to insect stings and plants. Include doses for children and adults. Benadryl can also be used to treat an attack of seasonal allergies. 

Hydrocortisone Cream

Over-the-counter hydrocortisone creams or ointments can treat almost anything that itches, such as poison ivy or insect bites. Soothing the itch can help prevent kids from scratching, which often leads to a secondary infection. 

Tweezers and Scissors

Tweezers will come in handy for removing splinters or anything else that can get caught under the skin, such as fishing hooks. A small pair of scissors allows you to cut gauze or bandages to the right size. You can also use them to trim fingernails or hangnails. You may also want to include a small magnifying glass. 

Note that tweezers are not the best way to remove ticks. Tweezers may remove the body but leave the head stuck in the skin. To remove a tick, cover it with a cotton ball soaked in soap for 30 seconds, or sterilize the edge of a credit card and use it to scrape the tick off. 

Alcohol Wipes and Soap

Use alcohol wipes to sterilize all your first aid instruments before using them. You can also use them to clean the skin. A small bottle of antiseptic soap can also be used to clean up wounds or remove ticks as mentioned above. 

Numbing Spray

Numbing spray can be purchased over the counter and can be used to soothe burns, sunburns, cuts, scrapes, and other irritations. 

Pain Relievers

Premade first aid kits will often contain some pain medications, but make sure to include liquid pain relievers for children if necessary. 

Sunscreen

Always use at least 30 SPF sunscreen if you’ll be outdoors for any length of time. Be sure to cover spots like the tops of the ears and the back of the neck. Even if you wear a hat or expect to stay in the shade, it can be easy to get burned when you least expect it. 

Bug Spray

Insect bites aren’t just annoying, they can also become infected if they’re scratched. Ward off bugs with a repellent containing 30% DEET. 

Clean Towel

A clean towel comes in handy if you need to set up a first aid station on the beach or in another outdoor area. If necessary, you can also use it to contain bleeding on larger injuries. Choose a microfiber towel that can be packed down and won’t take up a lot of space. 

Feminine Hygiene Supplies

In addition to their obvious uses, pads and tampons can also come in handy for treating wounds. A small tampon can be used to treat a nosebleed, and a maxi-pad can be used to control a bleeding wound. 

Prescription Medications

Be sure to include any prescription medications your family may need, including EpiPens or inhalers. 

When to Go to the ER

When your first aid kit isn’t enough, make sure you know the location of the nearest ER. A trip to the hospital may be necessary if anyone suffers a head injury or a fall without wearing a helmet, any loss of consciousness or altered behavior following a head injury, a broken bone, a high fever that doesn’t respond to over-the-counter medications, severe chest pain, or breathing problems. 

With some careful planning and preparation, your family can enjoy a safe and fun summer. Remember to wear a mask in public areas and practice social distancing as much as possible to reduce your risk of COVID-19. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://health.clevelandclinic.org/yes-you-can-and-should-still-go-to-the-er-for-emergencies-during-the-covid-19-pandemic/

https://www.wellrx.com/health-conditions/about/drug/diphenhydramine/~default/

https://www.wellrx.com/health-conditions/about/drug/hydrocortisone/~default/https://www.healthychildren.org/English/health-issues/conditions/from-insects-animals/Pages/How-To-Remove-A-Tick.aspx

advancements in aids treatment - wellrx blog image

By Nancy Swezey, BSN, RN, CNOR

Hope for Those With HIV

The history of HIV treatment is one of continuous progress and, for many, a source of hope. Today, an HIV diagnosis is very different from what it was 30, 15, or even 10 years ago. Advancements in medicine and the establishment of HIV as a care specialty have made high quality of life with HIV a reality for many.

Being diagnosed with HIV is still, however, a life-changing and frightening experience. It requires lifelong diligence on the part of anyone with HIV, their partners, and their health care providers. If you are diagnosed with HIV, you may need to change your lifestyle and diet; adhere to consistent, lifelong treatment; and maintain proximity to your providers. Although the progress of HIV testing and treatment is promising, significant work still needs to be done on a global scale. It is estimated that of those infected, 81% are aware of their HIV status, and 67% are utilizing antiretroviral therapy (ART), the recommended treatment.

A Brief History of HIV Treatment

In the ’80s and early ’90s, an HIV diagnosis had a grim, fatal prognosis. The medical and science communities were baffled by what was then, and to some extent still is, a mysterious disease. In 1996, with the establishment of Highly Active Antiretroviral Therapy (HAART) as the treatment of choice, HIV began to be considered more of a chronic illness. Today, if you have HIV and are on a consistent, supervised treatment plan, you can reasonably expect to have a high quality of life and, in general, a near-normal life expectancy. In fact, most treated HIV-positive individuals today do not die from AIDS-related causes. Even pregnant women can protect their babies from HIV transmission with ART. Furthermore, day-to-day treatment regimens are generally simpler and easier than they used to be. 

Antiretroviral Therapy

HIV is a retrovirus, so-named because of the method by which it infects our body’s cells. Hence, the treatment for HIV involves a drug class called antiretroviral therapy, or ART. Most HIV medications include a combination of two to three of the multiple types of ART. ART is a lifelong medication for people with HIV. Side effects and drug interactions are specific to each type of ART, and ARTs are chosen by health care providers in accordance with patient-specific needs and circumstances. The initiation of antiretroviral therapies normally consists of one to three pills per day.

The goals of ART are to suppress the virus, improve quality of life, reduce the risk of transmission, optimize immune function, and conserve future treatment options. The preservation of treatment options requires the avoidance of drug resistance. Resistance can occur when HIV mutates, thus rendering certain medications ineffective against the virus. Mutations can result from a multitude of causes, including inconsistency in treatment. When a virus becomes drug-resistant, the already-limited number of HIV treatment options is reduced.

Preventing HIV

PrEP

Pre-exposure prophylaxis (PrEP) is intended to protect people at high risk for HIV, such as those with HIV-positive sexual partners or those who inject drugs. If you are taking PrEP to prevent sexual transmission of HIV, safe sex practices, such as using condoms, are still advised because PrEP does not protect against other sexually transmitted infections.

Prep uses a combination of antiretroviral medications to prevent the virus from creating an enduring infection in a new host. The most widely researched and prescribed PrEP regimen is Truvada, a once-daily pill that combines two HIV medications: emtricitabine and tenofovir disoproxil fumarate. Truvada is safe for most people and generally has minimal side effects, such as abdominal discomfort. If taken as directed, it can prevent transmission reliably and effectively in most cases. If you have kidney, liver, or bone conditions or are pregnant, Truvada may not be appropriate. In these cases, your provider can discuss alternatives with you.

PEP

Post-exposure prophylaxis (PEP) is intended to protect you if you’ve been exposed to HIV through sex, injection drug needle-sharing, or occupational exposure, such as that of health care workers. Similar to PrEP, PEP consists of antretroviral therapy or HIV medication. For PEP to work, the sooner it is taken, the better. The latest point at which PEP can be initiated effectively is 72 hours after exposure. PEP consists of a 28-day course of medication either once or twice daily. However, PEP is for emergency situations; it is not an alternative to PrEP. If you are at high risk for frequent exposure to HIV, PreP is a more appropriate option.

The Cost of HIV Treatment

HIV treatment is expensive, both from an individual and public health standpoint. For some individuals, the cost may prohibit them from pursuing treatment. Treatment and diagnostic pricing are highly variable, and they depend on insurance and government policies in your geographic area. It can be difficult for providers to navigate these systems and ensure optimal and cost-effective treatment. Fortunately, many ARTs either are or will soon become generic, and thus less expensive. Furthermore, discount prescription cards are available that can offer medication coupons and allow you to compare medication prices among local pharmacies.

The Future of HIV Treatment

Although great strides have been made in the treatment of HIV, work still needs to be done. People with HIV today are still more likely to develop health conditions such as kidney, liver, and heart disease, and cancer. They are also more likely to have age-related illnesses at a younger age than noninfected people. Research for an HIV vaccine has been ongoing since 1984; although it is still underway today, there is reason to hope that it may be available soon. At the 23rd International AIDS Conference in July 2020, the goals of 75% infection reduction by 2025 and 90% by 2030 were discussed at length, and new avenues of finding a vaccine, more effective prevention, and even a cure were explored. New milestones and next steps were announced in the progress of all of these areas, and scientists remain hopeful. 

Nancy Swezey, BSN, RN, CNOR is a freelance writer and nurse researcher. She develops and presenting on initiatives in clinical settings, such as general healthcare, sustainability in surgery, and creating clinical teaching modules for nurses through CUNY Hunter in New York. NS also authors a blog on vegan and vegetarian topics. She is also a trained Epic EMR SuperUser.

References:

https://www.wellrx.com/health-conditions/about/health-condition/hiv-and-aids-support/~default/

https://hivhistory.org/

https://www.cdc.gov/hiv/basics/livingwithhiv/healthy-living.html

https://www.hiv.gov/blog/final-hiv-research-highlights-aids-2020

https://www.uptodate.com/contents/initial-treatment-of-hiv-beyond-the-basics

https://www.uptodate.com/contents/hiv-and-pregnancy-beyond-the-basics

https://aidsinfo.nih.gov/guidelines/htmltables/1/7355

https://www.who.int/hiv/topics/drugresistance/en/

https://www.uptodate.com/contents/administration-of-pre-exposure-prophylaxis-against-hiv-infection

https://www.wellrx.com/TRUVADA/drug-information/

https://www.wellrx.com/health-conditions/about/health-condition/hepatitis/~default/

https://www.wellrx.com/health-conditions/about/health-condition/osteoporosis/~default/

https://www.wellrx.com/health-conditions/pregnancy-and-maternity/

https://www.uptodate.com/contents/patient-evaluation-and-selection-for-hiv-pre-exposure-prophylaxis

https://www.cdc.gov/hiv/basics/pep.html

https://www.uptodate.com/contents/management-of-health-care-personnel-exposed-to-hiv?search=pep&source=search_result&selectedTitle=1~25&usage_type=default&display_rank=1

https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv/459/cost-considerations-and-antiretroviral-therapy

https://www.uptodate.com/contents/primary-care-of-adults-with-hiv

https://www.niaid.nih.gov/diseases-conditions/hiv-vaccine-research-history

sources of omega-3 fatty acids - wellrx blog image

By Karen Eisenbraun, CHNC

Do you take an omega-3 fatty acid supplement? Omega-3 fatty acids are essential for good health, yet many American adults are not meeting the recommended daily intake of this important nutrient. If your diet is low in fish, you may benefit from taking a daily fish oil supplement or another form of omega-3. 

Continue reading to learn why omega-3 fatty acids are so important and how to choose a good omega-3 supplement. 

What Are Omega-3 Fatty Acids?

Omega-3 fatty acids are a type of fat that provides nutritional benefits. Specifically, omega-3 fatty acids are polyunsaturated fatty acids. These fatty acids have been widely studied and have been found to help reduce the risk of heart disease, improve cognitive function, reduce inflammation, improve the skin, and help manage weight, among other health benefits. 

The primary source of omega-3 fatty acids in foods is fish. However, most people aren’t getting enough fish in their diet. Further complicating the issue, the standard American diet is high in inflammatory omega-6 acids, which are found in foods such as soybeans, corn, and vegetable oil. Soybean and other vegetable oils are widely used in processed foods, which has led to huge increases in omega-6 consumption, while omega-3 intake remains low.

Anthropological studies suggest that humans evolved on a diet with a ratio of omega-6 to omega-3 fatty acids that was 1:1. Today, that ratio is around 16:1. This imbalance in essential fatty acids contributes to a wide variety of health problems that are common in America today. 

Symptoms of Omega-3 Deficiency

Depression and Anxiety

The brain requires omega-3 fatty acids to function properly. A lack of omega-3s may contribute to mental health issues, including depression and anxiety. Studies suggest that people who get enough omega-3s are less likely to be depressed and that omega-3 supplements can help improve symptoms of depression. Another study found that omega-3s can help ease anxiety symptoms

Increased Risk of Heart Disease

Heart disease kills more than 600,000 people every year, making it the leading cause of death in the United States. People who live in communities that consume more fish have been found to have lower rates of heart disease, which has been linked to higher omega-3 consumption

Omega-3 fatty acids help improve numerous risk factors associated with heart disease. Studies have shown that regular consumption of omega-3s can help:

  • Lower triglycerides 
  • Reduce blood pressure
  • Increase “good” HDL cholesterol 
  • Prevent the formation of harmful blood clots
  • Prevent the buildup of plaque that can harden the arteries 
  • Reduce inflammation

Premature Skin Aging

Omega-3 fatty acids are a structural component of the skin and are necessary for healthy cell membranes. Inadequate omega-3 intake can contribute to dry skin, wrinkles, acne, and small bumps on the skin. 

Omega-3s also help protect your skin from sun damage. A type of omega-3 acid known as eicosapentaenoic acid (EPA) blocks substances that damage collagen after the skin is exposed to the sun. 

Increased Risk of Cognitive Decline

Low levels of omega-3s have been linked to an increased risk of cognitive impairment, including dementia and Alzheimer’s disease. While there is no known cure for Alzheimer’s disease and dementia, studies show that regular omega-3 consumption can help keep the brain healthy as long as possible. Omega-3 supplements may also help slow down the progression of Alzheimer’s disease if taken early when symptoms are mild. 

Sources of Omega-3 Fatty Acids

There are three main types of omega-3 fatty acids: EPA, DHA, and ALA. 

EPA and DHA, which are found in fatty fish and algae, seem to provide the most health benefits. ALA, which is found in nuts and seeds, such as walnuts, chia seeds, and flax seeds, is less bioavailable because the body must first convert it into EPA and then DHA to use it. 

The best sources of EPA and DHA are fish, which obtain omega-3s by eating microalgae. The omega-3s accumulate in the fatty tissue of the fish, which is why it’s best to eat fatty fish such as salmon, tuna, mackerel, and herring. 

Try to eat fish at least twice a week. Wild-caught fish are higher in nutrients than factory-farmed fish. Some fish can be high in mercury and should be consumed in moderation, especially shark, swordfish, and king mackerel. 

Choosing a Fish Oil Supplement

When choosing a fish oil supplement, look for one that contains both EPA and DHA. Make sure to check the amount of each type of omega-3 acids present; some fish oils contain mostly AHA and only small amounts of EPA and DHA. 

Look for products that display the GOED standard for purity, verification from the International Fish Oil Standards, or other third-party seals that indicate they have been tested for product quality and purity. Always check the date because fish oil is prone to going rancid.

For best results, take the recommended dosage daily. It may take time for the anti-inflammatory properties to take effect throughout the body. Some people will notice an immediate improvement, while others may not see noticeable results for several weeks. To further balance your levels of omega-3 and omega-6 acids, avoid inflammatory foods such as sugar, processed meats, and vegetable oils. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3992162/

https://www.sciencedirect.com/science/article/abs/pii/S0753332206002435

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3976923/

https://www.sciencedirect.com/science/article/abs/pii/S0165178115003844

https://www.health.harvard.edu/mind-and-mood/omega-3s-for-anxiety

https://pubmed.ncbi.nlm.nih.gov/18541598/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019002/https://pubmed.ncbi.nlm.nih.gov/28466678/

alzheimers month - wellrx blog image

By Rosanna Sutherby, PharmD

June is Alzheimer’s and Brain Awareness Month, and the past decade has seen exciting research and advancements affecting the diagnosis and treatment of Alzheimer’s disease and dementia.

According to the Alzheimer’s Association, in 2020, approximately 5.8 million Americans age 65 and older are living with Alzheimer’s. Eighty percent are 75 years or older. As the American population ages, the number of people with Alzheimer’s dementia will increase. It is projected that by the year 2050, 13.8 million Americans age 65 and older will have Alzheimer’s disease.

These alarming numbers have spurred scientists to advance research in Alzheimer’s treatment and diagnostic tests.

Advancements in Diagnosing Alzheimer’s and Dementia

Until recently, an Alzheimer’s diagnosis was only possible through an autopsy. During the last 10 years, researchers have developed screening tools for diagnosing Alzheimer’s while the patient is alive. Being able to recognize the disease early gives doctors and scientists the ability to develop drugs that target critical characteristics of Alzheimer’s dementia.

Beta-Amyloid PET Scan

A significant way to identify Alzheimer’s is by using biomarkers that reveal key characteristics of the disease. The first biomarker approved for diagnosing Alzheimer’s disease is the beta-amyloid positron emission tomography (PET) scan.

A characteristic of the brain of a person with Alzheimer’s disease is the formation of abnormal levels of beta-amyloid protein. This protein occurs naturally in the brain, but in Alzheimer’s disease, clumps of beta-amyloid (beta-amyloid plaques) form between neurons (brain cells) and interfere with brain signals.

The beta-amyloid PET scan allows doctors to see if beta-amyloid plaques are present in a patient’s brain. Knowing this information dramatically improves scientific research on treatment. Developing and using drugs that can break up or clear beta-amyloid plaques has moved to the forefront of Alzheimer’s research.

Tau Radiotracer

In May of this year, the U.S. Food and Drug Administration (FDA) approved a new biomarker for use along with a PET scan to diagnose Alzheimer’s. Tauvid (flortaucipir F18 injection) is a radioactive tracer that binds to tau protein tangles in the brain and makes them visible under a PET scan.

Tau proteins help transport nutrients and other substances from one part of the brain cells to another. In Alzheimer’s disease, tau proteins collapse and form tangles that interfere with the transmission of nutrients through the neurons. Without the necessary nutrients, brain cells deteriorate and die.

Both beta-amyloid plaques and tau tangles must be present to diagnose Alzheimer’s disease. Tauvid is the first biomarker approved that can help visualize tau tangles in the brain. This important advancement is crucial in helping develop drugs that target this particular Alzheimer’s pathology.

Advancements in Treatment

Since the late 1990s, over 100 drugs have been tested for treating Alzheimer’s disease. Of those, only four medications have emerged from clinical trials for the treatment of Alzheimer’s dementia:

These medications have been moderately effective at reducing symptoms of Alzheimer’s dementia, but they have not been successful in stopping disease progression. New advances in Alzheimer’s treatment aim to slow or stop the progression of Alzheimer’s disease by reducing or breaking up beta-amyloid plaques or tau protein tangles.

Medications That Target Beta-Amyloid Plaques

Researchers are investigating the use of three monoclonal antibodies to reduce the number of amyloid plaques in the brain and modify the progression of the disease. The following are the three drugs under investigation:

  • Aducanumab
  • Solanezumab
  • Gantenerumab

Additional compounds are under investigation to determine if they can prevent or delay the onset of Alzheimer’s symptoms. These agents work by preventing the accumulation of beta-amyloid in the brain or by inhibiting the enzyme that makes beta-amyloid protein.

Targeting Tau Protein Tangles

vaccine that targets tau protein tangles is currently under investigation. It works by stimulating the body’s immune system to attack tau protein tangles. This vaccine shows promise in potentially stopping the progression of Alzheimer’s disease.

Despite previous failures of some drugs studied to treat Alzheimer’s disease, researchers continue to look for ways to target hallmark characteristics of Alzheimer’s and prevent or stop the progression of the disease. Successful treatment may require multiple drug therapies in the same way that several agents are used in combination with HIV/AIDS and cancer treatment.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.alz.org/alzheimers-dementia/facts-figures#:~:text=More%20than%205%20million%20Americans%20of%20all%20ages%20have%20Alzheimer’s,10%25)%20has%20Alzheimer’s%20dementia.

https://www.wellrx.com/hn/us/assets/health-condition/alzheimers-disease/~default/

https://www.alzdiscovery.org/news-room/blog/top-5-advances-in-2018

https://www.medscape.com/viewarticle/931369

https://www.brightfocus.org/alzheimers-disease/article/tau-protein-and-alzheimers-disease-whats-connection

https://www.wellrx.com/aricept/drug-information/

https://www.wellrx.com/exelon/drug-information/

https://www.wellrx.com/razadyne/drug-information/

https://www.wellrx.com/namenda/drug-information/

https://www.brightfocus.org/alzheimers/article/whats-new-alzheimers-treatment-pipeline

https://www.alz.org/alzheimers-dementia/research_progress/treatment-horizon

operation relief - wellrx blog image

More than 33 million Americans have lost their jobs during the coronavirus pandemic. Many without jobs are now also without health insurance.

Sriptsave WellRx has created Operation Relief, a completely free-to-use program that will provide deeper discounts to bring even lower prices to all consumers, regardless of their employment, insurance or financial situation. No enrollment, email or sign-up is required. There are no fees or subscriptions required from any patient wishing to use the program, and no need to enter any debit or credit card details to get started. With the new program there are:

  • 6,000-plus drugs under $20
  • more than 4,572 drugs under $10
  • over 2,500 drugs under $5!

Just visit WellRx.com/Relief and download a card, search for the medication price and show the card at the pharmacy.

You can also get our free prescription discount app from the Apple Store and Google Play. Just download and use the invite code RELIEF for heavily discounted prices on your medications during the pandemic*.

Related content:

Out of Work and Health Insurance?

Best Ways to Save Money on Healthcare without Insurance

* Savings average 60%, with potential savings of up to 80% (based on 2019 national program savings data). All prescriptions are eligible for savings. Cannot be used in conjunction with insurance. To price your medications and to find participating pharmacies near you, visit: www.wellrx.com/relief.

Do Proton Pump Inhibitors Increase the Risk of Death - wellrx blog image

By Misgana Gebreslassie, PharmD Candidate 2020,
University of Colorado

Proton pump inhibitors (PPIs) are prescription medications that help with symptoms of acid reflux or heartburn. Appropriate use of PPIs is generally safe. However, some studies have associated certain health risks with long-term use.

How Do Proton Pump Inhibitors Work?

Proton pump inhibitors work by reducing acid secretion in the stomach. The use of PPIs has been increasing since they entered the market in the late 1980s due to their treatment success. Their use has increased from 4% to 8% between 1999 to 2012 in the US adult population. Alarmingly, more than half of this population use them for incorrect medical conditions.[1] It’s important to work with your doctor to make sure you’re taking the right medications for the right conditions.

Common proton pump inhibitors include:

Pay less for your acid reflux medication:

Do Proton Pump Inhibitors Increase the Risk of Death?

A study published in 2017 found a small association between the use of PPIs and increased risk of death. The study compared the rate of death among people who took PPIs, histamine 2 receptor antagonists (H2RAs – another type of stomach acid suppressant) or neither medication. 

There was a higher number of deaths reported among people taking PPIs compared to people taking H2RAs or neither medication. However, this study shows only an association and does not prove taking PPIs directly causes death. Due to the nature of the study, the increased risk of death may be real or may be due to chance.[1,2]

Is It Safe to Take Proton Pump Inhibitors Long-term?

Some studies have associated long-term use of PPIs with a small risk of bone fractures, diarrhea, infection of the gut or lungs, and heart and kidney problems. However, there are no claims that suggest PPIs are the direct cause of these adverse drug outcomes. [1,4]

Another study assessing the overall safety of long-term PPI use was published in May 2019. The study reported no adverse drug outcomes except for increased number of gut infections among participants taking a PPI for 3 years compared to participants taking no PPIs.[3]

Side Effects of Proton Pump Inhibitors

Short-term side effects of proton pump inhibitors are generally mild and may include:

  • Headache
  • Upset Stomach
  • Nausea 
  • Vomiting
  • Diarrhea
  • Constipation
  • Flatulence

Let your doctor know of any side effects you experience while taking a PPI.

Should I Stop Taking a PPI?

If you are taking a PPI, you should continue using it as directed by your doctor. PPIs are generally considered safe when taken as directed by your doctor or pharmacist for short periods of time. 

Sometimes, PPIs are used for gastrointestinal diseases that require a long-term or life-long treatment. In such patients, the benefit of PPI use outweighs the small or modest increased risk of adverse drug outcomes. If you are concerned about your PPI use, talk to your doctor or pharmacist about treatment options. [4]


See available discounts for your PPI prescription:



References

1.     Xie Y, Bowe B, Li T, et al. Risk of death among users of Proton Pump Inhibitors: a longitudinal observational cohort study of United States veterans. BMJ Open 2017;7:e015735.

2.     Does taking proton pump inhibitors increase the risk of death? Retrieved from: https://www.nps.org.au/professionals/ppis/does-taking-proton-pump-inhibitors-increase-the-risk-of-death. Accessed on 8/12/2019 

3.     Moayyedi P, Eikelboom JW, Bosch Jackie, et al. Safety of proton pump inhibitors based on a large, multi-year, randomized trial of patients receiving rivaroxaban or aspirin. Gastroenterology. 2019 May 29. Pii:S0016-5085(19)40974-8

4.     Wolfe MM. Proton pump inhibitors: Overview of use and adverse effects in the treatment of acid related disorders. In: Feldman M & Grover S (Editors). UpToDate. [Internet]. Published place unknown: UpToDate; 2019 [cited Nov 29, 2017]. Available from: https://www-uptodate-com. Accessed on 9/10/2019



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5 heart problem signs - blog image

By Libby Pellegrini MMS, PA-C

It’s hard to miss the classic presentation of a heart attack—hands clutching the chest in agony, sweating, rapid breathing. Whether in movies, drug commercials, or television shows, popular media have likely drilled the warning signs into your head. Even more nuanced signs of a heart problem, such as neck, arm, or jaw pain, tend to get our attention in a hurry. However, some heart problems make themselves known with signs that are far more subtle. 

Don’t be caught off guard when it comes to protecting your own and your loved ones’ hearts. Read on to learn five signs of a heart problem that are worth worrying about. 

1. Passing Out with No Warning

Fainting can occur for many reasons, including exhaustion, emotional distress, illness, dehydration, rising quickly from a seated position, or a brain condition. Usually, such episodes of fainting, also known as syncope, come with warning signs such as lightheadedness, dizziness, weak legs, or tunnel vision. However, fainting without any preceding clues could be caused by an electrical heart problem.

Typically, electricity drives the normal functioning of the heart. However, when the heart’s chambers receive certain abnormal electrical signals, the chambers can start pumping out of sync, creating a condition called complete heart block. The heart rate slows and blood pressure drops, causing your heart to temporarily stop sending blood to your brain. This can cause you to faint.

The causes of heart block include structural abnormalities in the heart, inflammation, infection, heart attack, surgical procedures, certain genetic abnormalities, or certain medications. If you or a loved one is experiencing episodic fainting, follow up with a healthcare provider immediately.

2. Getting Winded During Normal Activities

If you notice a sudden change in your ability to perform your normal daily activities, such as grocery shopping or walking up a flight of stairs, it could be caused by a problem with your heart.

As a muscle, the heart contracts in a coordinated effort to pump blood throughout the body, pushing blood from chamber to chamber and then out to the body. If one of the valves between the chambers becomes too narrow (due to infection, cumulative damage, or a structural problem), the heart has to work harder to pump blood. This increased pumping effort can cause you to feel more tired than usual during your normal activities. 

One specific valve that can become too narrow is the aortic valve. This valve, which sits on the left side of the heart, is the doorway between the heart and the rest of the blood network. If your healthcare provider suspects you have this heart condition, known as aortic stenosis, he or she will listen to your heart with a stethoscope to check for a murmur and likely order an ultrasound of the heart to better evaluate what is going on. 

3. Fast Weight Gain Without Explanation

Some types of weight gain can be easily explained by a few too many holiday parties, an ice cream marathon, or a bum knee that derails a workout routine. However, rapid weight gain without explanation could be a sign of a heart problem called heart failure.

When the heart is pumping (which is all the time, hopefully!), it relies on a series of mechanisms to keep blood flowing throughout the body. Typically, this is a beautifully orchestrated feedback loop: the heart beats, pushing blood to the kidneys and other organs; the kidneys filter out waste and excess fluid, creating urine; and the blood then is returned to the heart. However, if the heart weakens, it can’t keep up with the cycle, triggering a backup in the plumbing system. Fluid will start to accumulate in the body, outside of the blood vessel network, in places such as the legs, abdomen, or lungs. Retaining excess fluid in this manner can cause sudden weight gain.

Heart failure can come on gradually or suddenly. There are many causes or risk factors, including coronary artery disease, cigarette smoking, obesity, diabetes, high blood pressure, aging, infection, pregnancy, illicit drug use, and heart valve problems. Follow up with your healthcare provider for urgent evaluation if you are experiencing rapid weight gain that has no clear explanation.

4. Shortness of Breath When Lying in Bed

Shortness of breath that increases when you are lying flat can also be a sign of heart failure. When fluid backs up into the lungs, it can cause orthopnea, or feeling airless (short of breath) when lying down. Many people with heart failure will compensate by increasing the number of pillows they use to sleep so they are in a more upright position. 

If you or a loved one are experiencing this sign, follow up with your healthcare provider immediately for a thorough medical evaluation. Many people with heart failure are able to control their condition using medication. If you are prescribed a medicine, visit ScriptSave® WellRx to find the lowest prescription price.

5. Dizziness

Dizziness is a cardinal sign of many heart conditions, particularly problems with the heart’s rhythm. One common heart rhythm problem is atrial fibrillation, or “a-fib.” When the heart switches into a-fib, it beats rapidly in an irregularly erratic pattern, which results in inconsistent delivery of blood to the brain. This sporadic brain perfusion from the variability in blood delivery to the brain can cause the symptom of dizziness.

Atrial fibrillation can be caused by coronary artery disease, high blood pressure, age, infection, or hormonal problems. If you or a loved one is feeling dizzy, especially if you also have a noticeably rapid heartbeat, seek medical attention immediately.

Putting It All Together

Some signs of a heart problem are subtle. If you are experiencing any of the five signs above, follow up with a medical provider immediately. If, after a thorough evaluation, you are diagnosed with a heart condition, you will likely be prescribed a medication. Make sure to check out ScriptSave WellRx at a pharmacy near you to receive the lowest prescription price. 


References:

Cleveland Clinic, Heart Block

Cardio Smart, American College of Cardiology, Aortic Stenosis

Mayo Clinic, Heart Failure

Harvard Health, Atrial Fibrillation

Libby Pellegrini is a nationally certified physician assistant. She currently works in emergency medicine, where she sees and treats a broad spectrum of illnesses across all age ranges. She holds a journalism degree from Northwestern University. 



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patent assistance program - blog image

While employer health insurance and government programs like Medicare offer prescription coverage for many Americans, there are still a large number of people who fall through the coverage gap. 

Patient assistance programs (PAPs) are offered by many pharmaceutical manufacturers. These programs provide eligible patients with access to brand-name medications at little or no cost.

There are a growing number of PAPs available in the U.S. While most of these programs are funded by drug companies, there is an increasing number offered by states, local governments, and non-profit organizations. Regardless of the organization offering them, PAPs can be a big help to anyone who is unable to afford their medication.

How Patient Assistance Programs Work

Patient assistance programs provide medications for free or at a reduced cost for individuals who are uninsured or underinsured and can’t afford their medication.

Each program differs, however, most will require patients to complete an application form. Some programs may also require financial and medical information from the applicant. In addition, almost every PAP will require some level of information from your doctor. Some programs only request your doctor’s signature while others may require your doctor complete a form. 

Once you have been accepted by the program, your medication may be delivered in several different ways. Some PAPs distribute the medication directly to your doctor’s office, some will send it to a pharmacy, and others may send the medication directly to you. 

Qualifying For Patient Assistance Programs

Eligibility requirements will vary for each patient assistance program. However, there are a number of common requirements that patients must meet to qualify for a program. 

  • Health requirements – Organizations often require patients to provide proof of need for the drug. A written prescription for the medication is often enough, but some programs may require additional documentation, including signed forms from the patient’s doctor.
  • Insurance Requirements – Patients will typically have to provide proof that they are uninsured, under insured, or that their insurance plan does not cover the medication or medical supply.
  • Financial Requirements – Income is another qualifying factor considered by organizations offering PAPs. In order to qualify, patients must demonstrate a financial need. PAPs often use the Federal Poverty Guidelines to establish qualifying income thresholds and some will use tiered eligibility requirements; in other words, a patient in the lowest income tier may receive the medication completely free, while someone in the next eligibility tier will receive the medication at a discount.

Each PAP’s benefits will vary widely and they often have different requirements for patients. If you’re unsure of the program’s requirements, programs will often have a support line you can contact with questions. 

Patient Assistance Programs vs. Prescription Discount Cards

While looking for help to save on prescriptions, you might come across information about both PAPs and prescription discount cards. While both are meant to help individuals lower their prescription costs, they differ in how they work and who is eligible

You might also find information about manufacturer copay coupons. These programs can also provide significant savings to patients who qualify for them. You can read more about how they work in the blog post, “What Are Drug Coupons, Why Do They Exist and How Do They Work?

Unlike PAPs and copay coupons, most prescription discount cards, including the ScriptSave WellRx discount card, are available to anyone, regardless of financial or insurance status. Additionally, you are not required to involve your doctor or meet any medical requirements to use your discount card.

While PAPs are usually sponsored directly by pharmaceutical companies, prescription discount card programs help people save by negotiating discounted cash prices on both generic and brand name medications. Patients can then receive lower cost prescriptions by showing their discount card at participating pharmacies.

Related Article: Rx Discount Cards vs Drug Coupons

Prescription Savings With ScriptSave WellRx

ScriptSave WellRx is freely available to anyone and is accepted at thousands of pharmacies across the U.S. If you’re searching for savings on your prescription medications, get your ScriptSave WellRx discount card and start saving today.



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Medicare Part C, also known as Medicare Advantage, is a health insurance plan offered by private insurance companies that have been approved by Medicare. Advantage plans give you the option to enroll in a single policy that contains the same coverage as Medicare Parts A and B, as well as prescription drug coverage.

With so many parts and plan options, Medicare can be confusing. We’ll explain everything you need to know about Medicare Advantage plans, and whether they’re right for you.

How Is Medicare Part C Different from the Other Parts of Medicare?

A major difference between Medicare Advantage (Part C) plans and Original Medicare plans is the insurance providers. While the U.S. government provides the coverage on Original Medicare plans, Medicare Advantage plans are offered by private insurers who are vetted by the government.

Medicare Advantage plans and Original Medicare also differ in coverage. Original Medicare consists of Part A, B, and D. Part A covers inpatient services like hospitalization or care in a skilled nursing facility. Part B covers outpatient care such as routine doctor visits, lab tests, and preventative care. Part D provides coverage for prescription drugs.

Medicare Advantage plans provide the same coverage as Part A and Part B, as well as prescription drug coverage that varies with each plan. Since private insurers offer Medicare Advantage plans, drug formularies vary.

Find discounts on drugs not covered by your Medicare Part C plan:

Some Part C plans can also provide additional vision and dental benefits that may not be covered by Original Medicare. They may even give you extra wellness benefits like discounted gym memberships.

Is Medicare Advantage Right for Me?

Individual needs vary, so it’s important to compare your health insurance options and choose the coverage that is right for you. Here are some of the benefits of Medicare Advantage plans:

  • Same coverage as Medicare Part A and Part B.
  • Added benefits such as prescription drug coverage, dental, and vision (varies by plan).
  • Care coordination; under certain Part C plans, you can designate a Primary Care Physician (PCP) to help coordinate your care. Certain plans also provide medication therapy management.

Overall, a Part C plan offers more comprehensive coverage in one plan. If you were to enroll in an Original Medicare plan, you would have to elect for Part D prescription drug coverage separately, and dental and vision care would be limited. 

However, there are a few drawbacks to Medicare Advantage plans, including:

  • More limited provider networks
  • Special authorization or referral requirements

While Original Medicare plans allow you to see any provider who accepts Medicare, a Part C plan requires you to see a provider in that plan’s specific network. The Part C provider networks are usually regional, not national like Original Medicare. Additionally, your Part C plan may require you to obtain prior authorization for certain medical procedures or get a referral from your PCP to see a specialist.

Medicare Supplement Insurance

You may have heard about Medicare Supplement Insurance, or Medigap. Like Medicare Advantage plans, Medigap is offered by private health insurance providers. 

However, Medigap requires you to maintain Medicare Part A and Part B coverage. In fact, it is illegal for you to purchase Medicare Supplement Insurance if you have an Advantage Plan. If you currently have Medigap and are thinking of joining an Advantage Plan, you should contact your insurance company to drop your policy.

A Medigap policy is meant to help cover additional healthcare costs that Original Medicare does not, like:

  • Deductibles
  • Coinsurance
  • Copayments

As a supplement to Original Medicare, you must pay a separate monthly premium for your Medigap policy. This payment is made to the private insurer issuing the policy. 

It is important to note, Medigap policies are supplemental and only offer limited coverage. For example, policies may not cover:

  • Prescription drugs
  • Vision or dental care
  • Most long-term care
  • Private-duty nursing

In this regard, Medicare Advantage plans offer the benefit of an all-in-one comprehensive policy. 

Can I Be Turned Down For A Medicare Advantage Plan?

In general, if you are eligible for Medicare Parts A & B, then you will not be denied coverage by Part C. Patients with pre-existing medical conditions are also still eligible for Medicare Advantage plans. The only exception is for End-Stage Renal Disease (ESRD).

Individuals with ESRD may be ineligible for most Medicare Advantage plans. However, certain Special Needs plans may still provide coverage. 

Medicare Advantage Plan Costs

Monthly premiums for Medicare Advantage plans can range from $0 to more than $300. Premiums vary between plans and even by location. However, when comparing plans, it’s important to consider more than just premiums. 

For example, while some plans may have a $0 premium, copays and deductibles for these plans can be much higher than in plans with more expensive premiums. Always compare all the costs of a plan and make sure that it meets your healthcare needs.

Medicare Advantage Plan Prescription Drug Coverage

While many Medicare Advantage plans include prescription drug coverage, drug formularies vary across plans. This means co-pays may differ and not all drugs will be covered by your plan. 

If your medication is not covered by your Medicare Part C policy, or the co-pay is too high, ScriptSave WellRx may be able to help you save. Our drug price comparison tool lets you check prices at multiple pharmacies in your area. You can also get a free prescription discount card to help you save at the pharmacy.

References:



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why do my drugs cost so much - blog image

By Joel Yambert, MS, Pharm.D. Candidate, Class of 2020,
University of Arizona College of Pharmacy

We’ve all seen it happen before. You’re in line at the pharmacy and next thing you hear, “No way. How do you expect anyone to afford that? I’m not paying for that!” Healthcare costs in the United States have continued to skyrocket. A recent poll from the Kaiser Family Foundation shows that nearly one-in-four (25%) people stated they have difficulty affording their medications and three-in-ten (30%) report not taking their medications as prescribed due to drug costs.

So why are all these medications so expensive?

The Main Players in Drug Costs

There are a number of players in the pharmaceutical pipeline who impact the price of medications.

Government/
lawmakers
Pharmaceutical Companies/
Manufacturers
Pharmacy Benefit Manager (PBM)/
”Insurance”
Pharmacy stores/hospitals Patient
Pass laws that affect pricing, taxing, and reimbursement of drug creation and distribution Base pricing on a variety of factors: cost to create the drug, number of people with potential to take the drug, and severity of need for the drug Acts as the middleman between health plans, drug manufacturer, and pharmacy Pharmacies pay a wholesaler to get drugs from the manufacturer and have contracts with PBMs to dispense the drugs There are a variety of places to get your drugs, private or government insurance, and other elements

Government Factors

According to a government survey from the National Health Expenditure Accounts Team, spending on prescription drugs increased 12.2% in 2014. There was a drug recently approved for a rare childhood disorder that costs $2.1 million for treatment. Policymakers and legislature are constantly working on ways to control drug costs to try to find a balance between those creating the drugs, those paying for them, and the companies that act in between them—such as PBMs. Government officials and lawmakers look to other countries’ policies to continuously evaluate the state of drug costs, and healthcare in general, in the United States.

High Costs of Drug Development

As discussed in my article “Antibiotic Overprescribing: Creating the Next Big Superbug?,” the manufacturing and development of new antibiotics has been halted by most drug companies due to the lack of profit from their investment in antibiotics.

Drug development costs for pharmaceutical companies continue to rise as well as the cost to the consumers. The median cost of drug development for a single drug was $648 million, according to a 2017 study. Another study stated the cost to be an average of $2.7 billion.

These costs have put more pressure on pharmaceutical companies to be profitable in their drug development processes. Some diseases, like Alzheimer’s, have had their drug development funding cut in order to tackle more profitable diseases like cancer.

Pharmacy Benefit Managers and Pharmacies

Pharmacy Benefit Managers (PBMs) act as middleman, so they negotiate drugs from the manufacturers at a discounted price for pharmacies. The pharmacy then purchases the drug from a wholesaler and the PBM charges the pharmacy a fee for getting the drug at a discounted cost. By doing this, the PBM retains the rebates on the medications instead of passing them down to pharmacies or consumers. Rebates are also gained by the PBM when they put the drug from the drug manufacturer on their PBM formulary. Due to this, the pharmacy is paying the wholesaler for the discounted cost and paying a fee to the PBM.

For pharmacies to gain money back from paying for the PBM service and for the medication itself, they pass the financial burden downstream to the patient (or buyer). You can see that there are many different processes occurring that result in the way drugs are priced and how much they end up costing the patient.

Advantages of a Free Market

This may seem like finding affordable medication is helpless. What can you do to combat high drug prices? Many pharmaceutical company (or drug) sites will have coupons for their drugs that patients can use. There are also apps available, like ScriptSave WellRx, that provide discount pricing, sometimes less than the amount your insurance is willing to provide, on certain medications. There are many more avenues patients can take in order to combat against the high price of their medications. Talk to your pharmacist or doctor about potential price burdens.

Your health is in your own hands. You have the ability to research these pathways in order to get the best deal you can for your mediation needs. Don’t be afraid to ask questions to your various healthcare providers in order to get the help you need. Sometimes pricier drugs have alternatives that may be more affordable to fit your budget!

References:

  1. https://www.kff.org/health-costs/press-release/poll-nearly-1-in-4-americans-taking-prescription-drugs-say-its-difficult-to-afford-medicines-including-larger-shares-with-low-incomes/
  2. Martin AB, Hartman M, Benson J, Catlin A. National Health Expenditure Accounts Team. National health spending in 2014: faster growth driven by coverage expansion and prescription drug spending. Health Aff. 2016;35(1):150–60.
  3. Prasad, V., & Mailankody, S. (2017). Research and Development Spending to Bring a Single Cancer Drug to Market and Revenues After Approval. JAMA internal medicine177(11), 1569–1575. doi:10.1001/jamainternmed.2017.3601
  4. Ventola C. L. (2015). The antibiotic resistance crisis: part 1: causes and threats. P & T: a peer-reviewed journal for formulary management, 40(4), 277–283.
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