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Current Contraceptive Status Among Women Aged 15–44: United States, 2011–2013

December 16, 2014 Comments off

Current Contraceptive Status Among Women Aged 15–44: United States, 2011–2013 (PDF)
Source: National Center for Health Statistics

Key findings
Data from the 2011–2013 National Survey of Family Growth

  • In 2011–2013, 61.7% of the 60.9 million women aged 15–44 in the United States were currently using contraception. The most common contraceptive methods currently being used were the pill (16.0%), female sterilization (15.5%), male condoms (9.4%), and long-acting reversible contraceptives (7.2%).
  • Use of long-acting reversible contraceptives was higher among women aged 25–34 (11.1%) compared with women aged 15–24 (5.0%) and aged 35–44 (5.3%).
  • Current condom use was similar across the three Hispanic origin and race groups shown in this report (about 9%).
  • Current use of female sterilization declined, and use of the pill increased with greater educational attainment. Use of long-acting reversible contraceptives was similar across education, about 8%–10%.

State Laws Prohibiting Sales to Minors and Indoor Use of Electronic Nicotine Delivery Systems — United States, November 2014

December 16, 2014 Comments off

State Laws Prohibiting Sales to Minors and Indoor Use of Electronic Nicotine Delivery Systems — United States, November 2014
Source: Morbidity and Mortality Weekly Report (CDC)

Electronic nicotine delivery systems (ENDS), including electronic cigarettes (e-cigarettes) and other devices such as electronic hookahs, electronic cigars, and vape pens, are battery-powered devices capable of delivering aerosolized nicotine and additives to the user. Experimentation with and current use of e-cigarettes has risen sharply among youths and adults in the United States (1,2). Youth access to and use of ENDS is of particular concern given the potential adverse effects of nicotine on adolescent brain development (3). Additionally, ENDS use in public indoor areas might passively expose bystanders (e.g., children, pregnant women, and other nontobacco users) to nicotine and other potentially harmful constituents (4,5). ENDS use could have the potential to renormalize tobacco use and complicate enforcement of smoke-free policies (1). State governments can regulate the sales of ENDS and their use in indoor areas where nonusers might be involuntarily exposed to secondhand aerosol (4,5). To learn the current status of state laws regulating the sales and use of ENDS, CDC assessed state laws that prohibit ENDS sales to minors and laws that include ENDS use in conventional smoking prohibitions in indoor areas of private worksites, restaurants, and bars. Findings indicate that as of November 30, 2014, 40 states prohibited ENDS sales to minors, but only three states prohibited ENDS use in private worksites, restaurants, and bars. Of the 40 states that prohibited ENDS sales to minors, 21 did not prohibit ENDS use or conventional smoking in private worksites, restaurants, and bars. Three states had no statewide laws prohibiting ENDS sales to minors and no statewide laws prohibiting ENDS use or conventional smoking in private worksites, restaurants, and bars. According to the Surgeon General, ENDS have the potential for public health harm or public health benefit (1). The possibility of public health benefit from ENDS could arise only if 1) current smokers use these devices to switch completely from combustible tobacco products and 2) the availability and use of combustible tobacco products are rapidly reduced (1). Therefore, when addressing potential public health harms associated with ENDS, it is important to simultaneously uphold and accelerate strategies found by the Surgeon General to prevent and reduce combustible tobacco use, including tobacco price increases, comprehensive smoke-free laws, high-impact media campaigns, barrier-free cessation treatment and services, and comprehensive statewide tobacco control programs.

The Cost Savings Potential of Biosimilar Drugs in the United States

December 16, 2014 Comments off

The Cost Savings Potential of Biosimilar Drugs in the United States
Source: RAND Corporation

The U.S. Food and Drug Administration (FDA) is expected to release final regulations outlining lower-cost approval pathway requirements for so-called biosimilar drugs. The introduction of biosimilars is expected to reduce prices, albeit to a lesser degree than small-molecule generics. This Perspective combines prior research and recent data to estimate cost savings in the U.S. market. We predict that biosimilars will lead to a $44.2 billion reduction in direct spending on biologic drugs from 2014 to 2024, or about 4 percent of total biologic spending over the same period, with a range of $13 billion to $66 billion. While our estimate uses recent data and transparent assumptions, we caution that actual savings will hinge on the specifics of the final FDA regulations and on the level of competition.

Births in the United States, 2013

December 15, 2014 Comments off

Births in the United States, 2013
Source: National Center for Health Statistics

Key findings
Data from the National Vital Statistics System

  • There were 3.93 million births in the United States in 2013, down less than 1% from 2012 and 9% from the 2007 high. The U.S. general fertility rate was at an all-time low in 2013.
  • Birth rates dropped to record lows in 2013 among women under age 30 and rose for most age groups 30 and over.
  • The cesarean delivery rate declined less than 1% from 2012 to 2013, to 32.7% of births. This rate rose nearly 60% from 1996 to 2009, but was down slightly from the 2009 high.
  • The 2013 preterm birth rate was 11.39%, down 1% from 2012 and 11% from the 2006 peak. Declines in preterm rates since 2006 were reported across the United States.
  • The twin birth rate, which had been mostly stable for 2009–2012, rose 2% in 2013 to 33.7 per 1,000 births.

ASTHO Announces Release of 2014 National Health Security Preparedness Index™

December 15, 2014 Comments off

ASTHO Announces Release of 2014 National Health Security Preparedness Index™
Source: Association of State and Territorial Health Officials (ASTHO) and CDC

The Association of State and Territorial Health Officials (ASTHO), in partnership with the Centers for Disease Control and Prevention (CDC) and more than 35 development partners, released today the 2014 National Health Security Preparedness Index™ (NHSPI™), which measures and advances the nation’s readiness to protect people during a health emergency or disaster. The 2014 Index includes updated data and new content, especially in the areas of healthcare delivery and environmental health.

The 2014 national result,7.4 on a scale of 10, suggests that substantial health security preparedness capability exists across the nation with progress to sustain and build upon. It also suggests significant work still needs to be done. As with 2013 findings, 2014 areas of relative strength include Countermeasure Management, Incident & Information Management, and Health Security Surveillance. Areas suggesting need for greater development include the new domain of Environmental & Occupational Health, and Healthcare Delivery (previously Surge Management) and Community Planning & Engagement.

FDA approves Gardasil 9 for prevention of certain cancers caused by five additional types of HPV

December 15, 2014 Comments off

FDA approves Gardasil 9 for prevention of certain cancers caused by five additional types of HPV
Source: U.S. Food and Drug Administration

The U.S. Food and Drug Administration today approved Gardasil 9 (Human Papillomavirus 9-valent Vaccine, Recombinant) for the prevention of certain diseases caused by nine types of Human Papillomavirus (HPV). Covering nine HPV types, five more HPV types than Gardasil (previously approved by the FDA), Gardasil 9 has the potential to prevent approximately 90 percent of cervical, vulvar, vaginal and anal cancers.

Gardasil 9 is a vaccine approved for use in females ages 9 through 26 and males ages 9 through 15. It is approved for the prevention of cervical, vulvar, vaginal and anal cancers caused by HPV types 16, 18, 31, 33, 45, 52 and 58, and for the prevention of genital warts caused by HPV types 6 or 11. Gardasil 9 adds protection against five additional HPV types—31, 33, 45, 52 and 58— which cause approximately 20 percent of cervical cancers and are not covered by previously FDA-approved HPV vaccines.

HHS OIG — Access to Care: Provider Availability in Medicaid Managed Care

December 12, 2014 Comments off

Access to Care: Provider Availability in Medicaid Managed Care
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Examining access to care takes on heightened importance as enrollment grows in Medicaid managed care programs. Under the Patient Protection and Affordable Care Act, States can opt to expand Medicaid eligibility, and even States that have not expanded eligibility have seen increases in enrollment. Most States provide some of their Medicaid services-if not all of them-through managed care. OIG received a congressional request to evaluate the adequacy of access to care for enrollees in managed care. This report determines the extent to which providers offer appointments to enrollees and the timeliness of these appointments. A companion report issued earlier this year, State Standards for Access Care in Medicaid Managed Care, OEI-02-11-00320, found that State standards for access to care vary, and that they are often not specific to certain provider types or to areas of the State. Additionally, States have different strategies to assess compliance with access standards.

HOW WE DID THIS STUDY
We based this study on an assessment of availability of Medicaid managed care providers. The assessment included calls to a stratified random sample of 1,800 primary care providers and specialists to assess availability and timeliness of appointments for enrollees.

WHAT WE FOUND
We found that slightly more than half of providers could not offer appointments to enrollees. Notably, 35 percent could not be found at the location listed by the plan, and another 8 percent were at the location but said that they were not participating in the plan. An additional 8 percent were not accepting new patients. Among the providers who offered appointments, the median wait time was 2 weeks. However, over a quarter had wait times of more than 1 month, and 10 percent had wait times longer than 2 months. Finally, primary care providers were less likely to offer an appointment than specialists; however, specialists tended to have longer wait times.

WHAT WE RECOMMEND
Together, these findings-along with those from our companion report-call for CMS to work with States to improve the oversight of managed care plans. We recommend that CMS work with States to (1) assess the number of providers offering appointments and improve the accuracy of plan information, (2) ensure that plans’ networks are adequate and meet the needs of their Medicaid managed care enrollees, and (3) ensure that plans are complying with existing State standards and assess whether additional standards are needed. CMS concurred with all three of our recommendations.

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