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Medicaid Health Plans Provide Cost Savings To States And High Quality And Value To Beneficiaries, New Analysis Shows
Medicaid health plans are producing cost savings for states, increasing access to services for individuals covered by Medicaid, improving quality of care, and earning high satisfaction ratings from enrollees, according to a Lewin Group report released today by America"s Health Insurance Plans (AHIP). Twenty-four existing studies were analyzed by the Lewin Group to determine the savings achieved when states have implemented private Medicaid health plans.

Tamiflu-Resistant H1N1 Identified Along Texas-Mexico Border
PAHO on Monday announced it had found Tamiflu-resistant H1N1 (swine) flu along the Texas-Mexico border, Agence-France Press reports. The discovery of several cases in El Paso and McAllen, Texas, adds the U.S. to a growing list of countries with antiviral-resistant H1N1, such as Canada, Denmark, Hong Kong and Japan. "Experts had gathered in La Jolla on Monday to discuss the response to the outbreak, and warned that resistant strains were likely emerging because of overuse of antivirals like Tamiflu," the news service writes (8/3).
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Washington State Drops Budget Provision That Would Have Cut Medicaid Pharmacy Payments
Washington state lawmakers this week eliminated a budgetary proposal that would have reduced Medicaid payment rates to pharmacies to the lowest levels in the country, the AP/Spokane Spokesman-Review reports. The provision would have reduced the payment rate from 86% to 80% of the average wholesale price of branded drugs. It had been approved by the state House and Gov. Chris Gregoire (D) and was intended to address the state"s $9.3 billion shortfall for the current fiscal year.The state"s Department of Social and Health Services moved to make the rate change on April 1, but pharmacy operators and a person living with HIV/AIDS brought a suit in federal court in Tacoma, Wash., and a judge blocked the change. According to the judge"s order, the plaintiffs likely could prove that their best interests had not been sufficiently considered and that the proposal would diminish the quality of Medicaid care in the state. Walgreen had stated that if the rate change occurred, 44 of its 111 stores in the state would no longer be able to fill Medicaid prescriptions. Other pharmacies made similar arguments. The state prepared an argument on behalf of the rate cut, but later decided against it.Along with eliminating the payment reduction, state legislators added a provision that a DSHS analysis is required before rates can be lowered in the next budget, as well as one placing a 2% cap on any future rate cuts. DSHS spokesperson Jim Stevenson said the agency had not started to analyze what would be required to get a rate cut approved, but added, "I think we"re at a stage where we"re going to have to do it soon if we want to get ready for July 1," the start of fiscal year 2010 (AP/Spokane Spokesman-Review, 5/13).
Sexual Health

Biochemical Signals Identified That Help Immune Cells Remember How To Fight Infection

Immunology researchers at UT Southwestern Medical Center have discovered how two biochemical signals play unique roles in promoting the development of a group of immune cells employed as tactical assassins. In their initial response, these immune cells, known as cytotoxic T lymphocytes, or CTLs, kill cells infected with pathogens. They also provide long-term protection against pathogens by "remembering" which proteins the pathogen makes. Targeting the ability of these CTLs to remember the pathogen is one way vaccines protect against infection. "Until now, no innate signals have been identified that regulate the development of memory cells," said Dr. David Farrar, assistant professor of immunology at UT Southwestern and senior author of the study appearing online and in a future edition of Blood. "Our study is the first to identify the signals that promote the development of these memory cells when you first get infected." The researchers previously showed that two molecules - interferon alpha and another signaling protein, cytokine, or IL-12 - are needed to induce the creation of memory cells. They also found that interferon plays a key role in "teaching" the immune system how to fight off repeated infections of the same virus. Dr. Farrar said the findings suggest that in order to be most effective, a vaccine should induce the secretion of both of these innate cytokines. The immune system consists of two components - the innate system, which provides immediate defense against infection, and the adaptive system, whose memory cells are called into action to fight off subsequent infections. The human immune system churns out both IL-12 and interferon alpha in large quantities in response to a viral infection. "The concept in the field has been that these cytokines perform the same function, but our new findings suggest that they actually have very distinct roles," said Hilario Ramos, student research assistant in immunology and the study"s lead author. "It turns out that the IL-12 signal is really important in driving that immediate, or effector, immune response while interferon drives the development of long-term memory." Past UT Southwestern studies have shown that the two cytokines work together in CD4+ T-cells to generate memory cells; the new research suggests that these molecules perform distinct roles in another type of immune cell called CD8+ T lymphocytes. For these cells, whether they become killers or long-term memory cells depends upon which cytokine they respond to. Those that receive the IL-12 become killers while those that receive interferon alpha turn into long-term memory cells. "Regardless of the precise mechanism, what we know now is that you can develop both long-term and immediate memory cells at the same time," Dr. Farrar said. The next step, he said, is to identify pools of memory cells that "remember" specific pathogens in humans. "There are some vaccines that are extremely effective, while others are only moderately effective," Dr. Farrar said. "If we can isolate pools of antigen-specific memory cells, we should be able to determine what it is about those pools of memory cells that is different between an extremely effective vaccine and one that"s not so effective. "If we can figure that out, then we can start to think about altering our approach to vaccinating based on the different type of microorganism that we"re trying to vaccinate against," he said. Other UT Southwestern researchers involved in the study were Ann Davis, former student research assistant in immunology; Alexander Cole, undergraduate research fellow; Dr. John Schatzle, associate professor of pathology; and Dr. James Forman, professor of immunology. The National Institutes of Health supported the research. Kristen Holland Shear UT Southwestern Medical Center


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