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Neurology Breaking News

August 29 - The price negotiation program, established by Democrats as part of the Inflation Reduction Act, is projected to save the government tens of billions of dollars in the coming years.

The medications — which treat diabetes, cancer and other conditions — are taken by millions of older Americans and cost Medicare billions of dollars annually. The Centers for Medicare & Medicaid Services selected the drugs through a process that prioritized ones that account for the highest Medicare spending, have been on the market for years and do not yet face competition from rivals. Additional medications will be selected for price negotiations in the coming years.

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Eris, BA.2.86: Do I need to worry about COVID again?

Aug 19 (Reuters) - The World Health Organization and the U.S. Centers for Disease Control and Prevention are tracking a new, highly mutated lineage of the virus that causes COVID-19.

Six cases in four countries have been detected since late July. Scientists are keeping an eye on the new lineage, named BA.2.86, because it has 36 mutations that distinguish it from the currently-dominant XBB.1.5 variant.

So far there is no evidence that BA.2.86 spreads faster or causes more serious illness than previous versions. The CDC said its advice on protecting yourself from COVID remains the same.

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EG.5 is spreading quickly, but experts say it’s no more dangerous than previous versions.

Concern is rising about the Covid-19 variant EG.5. This week, it became the dominant variant in the United States, and the World Health Organization classified EG.5 as a “variant of interest,” meaning it has genetic changes that give it an advantage and its prevalence is growing. So how worried should people be about it?

While severe illness in older adults and people with underlying conditions is always a concern, as is long Covid in anyone who gets infected, experts say EG.5 does not pose a substantial threat — or at least no more of one than any of the other major variants currently circulating.

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A new formulation is coming this fall, and there are two main reasons to wait for it.

An uptick in Covid-19 cases and the fast-approaching new school year have many people wondering when they should get their next booster. The short answer, according to experts: not quite yet — you’ll be a lot better off if you wait another month or two.

In June, an advisory panel to the Food and Drug Administration recommended that the next Covid vaccine formulation target the Omicron XBB.1.5 variant.

Pfizer, Moderna and Novavax are now working to update, test and mass-produce their vaccines, which will then need to be officially authorized by the F.D.A. Experts estimate that shots will be available to the public by late September or early October.

“For most people right now, it seems to me waiting makes more sense,” said Dr. Paul Sax, the clinical director of the division of infectious diseases at Brigham and Women’s Hospital.

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Long-term use of certain reflux medications is associated with a higher risk of dementia, study suggests

Millions of Americans take medications known as proton pump inhibitors every day to treat heartburn and acid reflux, and in recent years, these drugs, also known as PPIs, have been linked to a greater risk of kidney failure, stroke, and early death from any cause.
And new research suggests that there may also be a higher risk of dementia for people who take the medications over several years.
People 45 and up who took PPIs for over four years had a 33% higher risk of developing dementia than people who never took the drugs, according to a study published Wednesday in the journal Neurology.

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Cumulative Use of Proton Pump Inhibitors and Risk of Dementia: The Atherosclerosis Risk in Communities Study

August 09, 2023

Background. Studies on the association between proton pump inhibitor (PPI) use and dementia report mixed results and do not examine the impact of cumulative PPI use. We evaluated the associations between current and cumulative PPI use and risk of incident dementia in the Atherosclerosis Risk in Communities (ARIC) Study.

Methods. These analyses used participants from a community-based cohort (ARIC) from the time of enrollment (1987-89) through 2017. PPI use was assessed via visual medication inventory at clinic Visits 1 (1987-89) to 5 (2011-13) and reported annually in study phone calls (2006-2011). The present study uses ARIC Visit 5 as baseline, since this was the first visit in which PPI use was common. PPI use was examined two ways: current use at Visit 5 and duration of use prior to Visit 5 (Visit 1 to 2011, exposure categories: 0 days, 1 day – 2.8yrs, 2.8-4.4yrs, >4.4yrs). The outcome was incident dementia after visit 5. Cox Proportional Hazard models were used, adjusted for demographics, co-morbid conditions, and other medication use.

Results. A total of 5,712 dementia-free participants at visit 5 (mean age 75.4±5.1 years; 22% Black race; 58% female) were included in our analysis. The median follow-up was 5.5 years. Minimum cumulative PPI use was 112 days and maximum use was 20.3 years. There were 585 cases of incident dementia over median follow up time. Participants using PPIs at Visit 5 were not at a significantly higher risk of developing dementia during subsequent follow-up than those not using PPIs (Hazard Ratio (HR): 1.1 [95% Confidence Interval (CI): 0.9-1.3]). Those who used PPIs for >4.4 cumulative years prior to Visit 5 were at 33% higher risk of developing dementia during follow-up (HR: 1.3 [95%CI: 1.0-1.8]) than those reporting no use. Associations were not significant for lesser amounts of PPI use.

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Promising new Alzheimer's drugs may benefit whites more than Blacks

NEW YORK, July 31 (Reuters) - Groundbreaking treatments for Alzheimer's disease that work by removing a toxic protein called beta amyloid from the brain may benefit whites more than Black Americans, whose disease may be driven by other factors, leading Alzheimer's experts told Reuters.

The two drugs – Leqembi, from partner biotech firms Eisai (4523.T) and Biogen (BIIB.O), and an experimental treatment developed by Eli Lilly (LLY.N), donanemab - are the first to offer real hope of slowing the fatal disease for the 6.5 million Americans living with Alzheimer's.

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Biden-Harris Administration Announces Medicare Dementia Care Model

Jul 31, 2023
New Model Enhances Care Coordination and Increases Support for Caregivers

The Biden-Harris Administration is taking further action on its commitment to promote care and support for people with Medicare living with dementia and their unpaid caregivers. Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), announced its Guiding an Improved Dementia Experience (GUIDE) Model, which aims to improve the quality of life for people living with dementia, reduce strain on unpaid caregivers, and help people remain in their homes and communities through a package of care coordination and management, caregiver education and support, and respite services. The GUIDE Model will be tested by the Center for Medicare and Medicaid Innovation and is a key deliverable from President Biden’s April 2023 Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers, as well as key goals of the National Plan to Address Alzheimer’s Disease (National Plan).

“HHS continues to innovate to help Americans living with dementia and their unpaid caregivers. Our new GUIDE Model has the potential to improve the quality of life for people with dementia and alleviate the significant strain on our families,” said HHS Secretary Xavier Becerra. “We are proud to take these steps to deliver on the President’s promise to increase care coordination and improve access to services and supports for our families.”

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On July 31, 2023, the Centers for Medicare & Medicaid Services (CMS) announced a new voluntary nationwide model – the Guiding an Improved Dementia Experience (GUIDE) Model – a model test that aims to support people living with dementia and their unpaid caregivers. CMS is accepting letters of interest for the GUIDE Model through September 15, 2023, and will release a GUIDE Request for Applications (RFA) for the model in Fall 2023. The model will launch on July 1, 2024, and run for eight years.

Model Overview

The GUIDE Model will focus on dementia care management and aims to improve quality of life for people living with dementia, reduce strain on their unpaid caregivers, and enable people living with dementia to remain in their homes and communities. It will achieve these goals through a comprehensive package of care coordination and care management, caregiver education and support, and respite services.

GUIDE delivers on the Biden Administration’s April 2023 Executive Order 14095 on Increasing Access to High-Quality Care and Supporting Caregivers, which directed the Secretary of Health and Human Services to “consider whether to select for testing by the Center for Medicare and Medicaid Innovation an innovative new health care payment and service delivery model focused on dementia care that would include family caregiver supports such as respite care.”

It also advances key goals of the National Plan to Address Alzheimer’s Disease, which was established through the bipartisan National Alzheimer’s Project Act (NAPA) and has, for over a decade, accelerated federal actions to optimize the quality of care for people living with dementia and their caregivers while advancing research towards a cure. The GUIDE Model builds off of this extensive coordination within HHS and major input from various external stakeholders.

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