The Choice Blog: The Choice Takes a Holiday

Kurt Wilson/Missoula Missoulian, via Associated PressA 13-foot snowman in Missoula, Mont., in late January.

With school on vacation for at least some Choice readers — as well as for the family of at least one Choice editor — my colleagues and I are planning to take some time away from the blog, through Monday Feb. 27.

If news breaks, or a feature comes together, we’ll still post it. But for those students — including seniors awaiting decisions, or juniors contemplating their applications — who are getting a holiday, we wish you a relaxing few days.

When we return, we pledge to provide you with tips and “news you can use” from our Rolodex of experts, deans and other contacts on the most pressing issues of the season.

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Astra takes brand cancer drug straight to patients

(Reuters) - AstraZeneca Plc is selling breast cancer drug Arimidex directly to U.S. patients, offering an option for people who want to pay for the brand instead of generic versions.

Under the drugmaker's new program, patients with a prescription can pay $40 a month for Arimidex to be mailed to their homes.

That is less than patients would generally pay for the brand, but is typically more than the co-payment for generic versions of the drug, also known as anastrozole.

AstraZeneca said it started the program in response to patients asking for options to buy the brand, which are prohibitively more expensive compared with generics since the cheaper copies became available in mid-2010.

"We definitely got lots of calls every month to our information center on how they could get a branded option," said Steve Davis, Astra's executive director overseeing its mature brands in the United States. "There are patients that prefer not to be on the generic option."

Health plans generally try to steer patients to generic versions once they become available because they are significantly less expensive.

AstraZeneca's move is similar to one by Pfizer Inc, which has offered delivery of brand versions of its Lipitor drug to patients after the big-selling cholesterol treatment lost U.S. patent protection in November.

Arimidex was once a big seller for Astra. In 2009, the last full year before generics arrived, Arimidex sales reached $1.9 billion globally and about $880 million in the United States alone. Last year, Astra's U.S. sales of the drug fell 91 percent to $42 million, reflecting the toll taken by generic rivals.

In Arimidex's class of drugs, known as aromatase inhibitors, some 96 percent of prescriptions are generic, Davis said.

A major wrinkle in the Arimidex Direct program is that patients do not use their health insurance to get their pills, but pay out of pocket. AstraZeneca is contracting with Express Scripts Inc, a pharmacy benefit management company that mails the prescription to patients.

At $40 a month, the price is more than the usual $10 co-pay for generics, but less than insured patients would otherwise pay for the brand, which may only be available at close to the full price, according to Express Scripts.

Drugstore.com lists a one-month supply of Arimidex at $458.97 and anastrozole at $186.01.

"Given the seriousness of the condition, there may be individuals who are willing to pay $40 for the brand," said Everett Neville, chief trade relations officer Express Scripts. "That's completely different than you might see with some less emotionally charged conditions."

Aromatase inhibitors are used to treat breast cancer or help keep breast cancer from recurring after surgery, according to the American Cancer Society.

Davis said AstraZeneca started the program late last year, initially marketing it through brochures left in oncologists' offices and wanted to make sure it was working smoothly before publicizing it. About 300 patients are enrolled so far.

"This is a very emotional disease and it brings a lot of patient concerns," Davis added. "There is brand loyalty."

(Reporting By Lewis Krauskopf; editing by Andre Grenon)

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Diabetes Takes Toll on Women's Hearing: Study

FRIDAY, Feb. 3 (HealthDay News) -- Diabetes is associated with hearing loss in women, especially if the blood sugar disease isn't well-controlled, new research indicates.

The study, done by researchers at Henry Ford Hospital in Detroit, examined the medical records of 990 men and women who had hearing tests between 2000 and 2008. Patients with diabetes were divided into two groups: well-controlled and poorly controlled.

Among women aged 60 to 75, hearing loss was 14 percent worse even in well-controlled diabetics compared to those without diabetes. That is not a clinically significant loss, noted study author Dr. Kathleen Yaremchuk, chairwoman of the department of otolaryngology at the Henry Ford Healthcare System in Detroit.

"An individual might not notice it," Yaremchuk said.

On the other hand, poorly controlled diabetics' hearing was 28 percent worse than the non-diabetic group's hearing.

Younger women who had diabetes, well-managed or not, were more likely to have hearing loss than those unaffected by the illness, the study found.

Diabetes is known to affect the eyes, kidneys and other organs, Yaremchuk said. "Our study shows it can affect hearing as well."

In the study, presented recently at the Triological Society's annual meeting in Miami Beach, Fla., there was no link between hearing loss among men and diabetes, whether it was well-managed or not. Men are more likely in general to suffer from hearing loss than women, so the prevalence of the condition among males may mask diabetes' effect, the study suggested.

Men are exposed to more environmental causes of hearing loss, such as loud noise, either in the workplace or during leisure activities, such as attending large sporting events, explained Yaremchuk.

Managing diabetes properly should help prevent hearing loss or keep it from getting worse, Yaremchuk said.

What's unknown is if better management of diabetes can reverse hearing loss that's already occurred.

"We do not know if losing weight and improving control of diabetes will reverse the hearing loss that is seen. However, it will stop progression of the hearing loss," she said.

Recommendations call for diabetics' to have their vision checked every year, said Dr. Spyros Mezitis, a clinical endocrinologist at Lenox Hill Hospital in New York City.

This latest finding suggests diabetics may also need to have their hearing tested, Mezitis said.

"This study will help make doctors more aware to ask about hearing, particularly in women between 60 and 75," said Mezitis, also an assistant professor of clinical medicine at New York Presbyterian Hospital-Cornell Medical Center.

About 26 million Americans have diabetes, mostly type 2, which is associated with obesity.

Because this study was presented at a medical meeting, the conclusions should be viewed as preliminary until published in a peer-reviewed journal.

More information

To learn more about diabetes, visit U.S. National Institutes of Health.

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