Health
Insulin Prices Dropped. But Some Poor Patients Are Paying More.
Maricruz Salgado was bringing her diabetes under control. Thanks to a federal program that allowed health clinics that serve poor people to buy drugs at steeply discounted prices, she was able to pay less than $75 for all five of her diabetes medications every three months.
But in July, the cost of three of those drugs soared. Ms. Salgado, who does not have health insurance, suddenly faced costs of hundreds of dollars per month. She could not afford it.
Her doctor switched her to cheaper medicines. Within days of taking one of them, she experienced dizzy spells so severe that she said could barely keep up with her hectic daily schedule as a phlebotomist and an in-home caregiver. By the time she returned to the doctor in September, her blood sugar levels had ticked up.
“We were in a good place,” said Dr. Wesley Gibbert, who treats Ms. Salgado at Erie Family Health Centers, a network of clinics in Chicago that serves patients regardless of their ability to pay. “And then all the medicines had to change.”
The price hikes at the clinic happened for a reason that is symptomatic of the tangled web of federal policies that regulate drug pricing. In 2024, drug makers lowered the sticker price of dozens of common medications, which allowed them to avoid massive penalties imposed by the American Rescue Plan, the Covid relief package passed three years earlier. But that change backfired for low-income people like Ms. Salgado.
The decision to make these medications more affordable for large swaths of patients has quietly created another problem: a severe financial hit to the clinics that are tasked by the federal government with caring for the country’s poorest people. These nonprofit clinics operate in every state and serve nearly 32.5 million people, or about 10 percent of the country’s population.
“It’s the law of unintended consequences,” said Beth Powell, the director of pharmacy at The Centers, which operates five community health clinics in the Cleveland area. Ms. Powell said that while many consumers benefited from the companies’ decision to lower prices, “for our folks, that is not the case.”
More than 1,000 community health clinics around the country rely on a decades-old federal program that requires drug companies to offer them deep discounts.
Under the 340B program, as it is called, companies typically sell their brand-name drugs to clinics at a discount, at 23 percent or more off the list price. The same discount scheme applies to state Medicaid plans. But if a company raises a drug’s list price above the rate of inflation, a penalty kicks in, forcing it to offer even deeper discounts to the clinics.
For years, that meant that every time a company raised a drug’s list price above inflation, community clinics paid less for it. Many drugs, including insulin, essentially became free.
But the American Rescue Plan made a major change that hit drug companies with even larger penalties for raising prices. In January 2024, companies that continued to raise a drug’s price would have to pay state Medicaid plans every time those drugs were used, potentially costing the industry billions of dollars.
“That was a bridge too far” for the companies, said Antonio Ciaccia, a drug-pricing researcher who advises state governments and employers.
Manufacturers lowered the price of at least 77 drugs in 2023 and 2024, according to an analysis by a nonprofit that Mr. Ciaccia leads. The list includes widely used asthma drugs like Advair and Symbicort, as well as diabetes treatments like Victoza, which Ms. Salgado used before the change.
Once the pharmaceutical companies lowered their list prices, the inflation penalties evaporated. That meant community clinics had to start paying the usual discounts of 23 percent or more off the list price — far more than the pennies they used to pay.
“Unfortunately, the complexities of the U.S. health care system can reduce access and affordability for many,” Jamie Bennett, a spokeswoman for Novo Nordisk, which makes Victoza, said in a statement. “Even when we lower our prices, too often people don’t receive the savings — this is a problem.” She said the company also has patient assistance programs to make its products more affordable.
David Bowman, a spokesman for the Health Resources and Services Administration, which oversees the 340B discounts, did not respond to questions about how community health clinics were affected by the lowered drug prices. He said that other recent policies, including directing Medicare to negotiate the price of drugs, had lowered drug costs for low-income patients.
Because of a six-month lag in the way that 340B discounts work, clinics were hit by the change last July. Some clinics began calling patients before their prescriptions expired, offering to switch them to less expensive medicines even though they sometimes had more serious side effects. Others decided to cover the higher out-of-pocket costs, which required dipping into already scarce reserves.
Ms. Salgado said a nurse from Erie called over the summer to tell her about the pricing changes. Until then, she had paid about $15 for a three-month supply of Victoza, which is injected daily to keep blood sugar down. After July, the cost rose to more than $300.
After a few weeks, Ms. Salgado adjusted to the replacement, Byetta, and her dizziness subsided. But the drug must be injected twice a day instead of once. And Ms. Salgado must now use a special pharmacy 20 minutes from her house to qualify for the federal discount on the two insulin drugs she was switched to, the result of increasingly strict rules that companies are imposing on health clinics.
Ms. Salgado, who is 39, said she is determined to avoid the fate of her mother, who died of diabetes complications at 54. But keeping up with frequent pharmacy visits and medication changes is tough. “Sometimes it does get to a point where it’s like, I just don’t want to do this anymore,” she said.
The changes are also making it harder for community clinics to offer other services.
Under the 340B program, clinics buy the discounted drugs on behalf of their patients. When those patients have insurance, the clinics can then bill insurers for the regular, higher price, pocketing the difference. But now that spread — the difference between how much they pay for the drug and what insurance will cover — has dwindled. That has left clinics with less money to spend on services that are not otherwise covered by government grants or insurance, such as helping patients find housing.
At Valley View Health Center, a network of clinics that serves patients in rural Washington, the 340B money once financed a mental health program that employed eight therapists. In September, the clinic halted the program, laying off the therapists.
“It was such an abrupt change for us that it has definitely affected our ability to care for our patients the way that we needed to,” said Gaelon Spradley, the clinic’s chief executive.
Some patients who have seen costs go up have qualified for patient-assistance programs offered by drug makers. That was the case for Lorena Sarmiento, another patient at Erie Health who uses Lantus, an insulin pen. Last fall, after the 340B discount changed, she was quoted $490 at her pharmacy — the retail price for a box of insulin pens. Erie Health sent her to another pharmacy, which helped her sign up for a manufacturer’s coupon that lowered her cost to $35 per month.
Doctors and pharmacists at several health clinics said such drug-company assistance programs can be hit or miss. Sometimes they last for a limited time or require that a patient reapply regularly. Patients often have to be legal residents of the United States or have a fixed address.
“It’s a lengthy process, and it’s a lot of hoop-jumping,” said Michael Lin, the chief of pharmacy operations at Family Health Centers in Louisville, Kentucky.
Ms. Sarmiento and her husband, Luis, spend about $500 per month on her medical needs, including special food, medications and a glucose monitor. They are no longer facing the highest insulin price, but their costs are still 10 times what they were just a few months ago, when they spent about $10 on three months’ worth of insulin.
Mr. Sarmiento said he tries not to complain. “You always have to look on the good side,” he said. “But lately, that’s been hard.”
Health
Major cannabis study finds little proof for popular medical claims, flags big dangers
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Cannabis has been linked to some significant medical benefits, but recent research calls those into question.
A major new analysis published in JAMA examined more than 2,500 scientific papers from the last 15 years, including other reviews, clinical trials and guidelines focused on medical marijuana.
“While many people turn to cannabis seeking relief, our review highlights significant gaps between public perception and scientific evidence regarding its effectiveness for most medical conditions,” Dr. Michael Hsu of University of California – Los Angeles (UCLA) Health Sciences, author of the study, said in a press release.
Many medical claims about cannabis are not supported by strong scientific evidence, according to a comprehensive review published in JAMA. (iStock)
The researchers — led by UCLA with contributions from Harvard, UC San Francisco, Washington University School of Medicine and New York University — set out to determine how strong the research is on the effectiveness of medical cannabis and to offer evidence-based clinical guidance.
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The review found that evidence supporting most medical uses of cannabis or cannabinoids is limited or insufficient, the release stated.
“Whenever a substance is widely used, there is likely to be a very wide set of outcomes,” Alex Dimitriu, MD, double board-certified in Psychiatry and Sleep Medicine and founder of Menlo Park Psychiatry & Sleep Medicine, told Fox News Digital.
“Cannabis is now used by about 15 to 25% of U.S. adults in the past year, for various reasons ranging from recreational to medicinal. This study points to the reality that this widely used substance is not a panacea,” said Dimitriu, who was not involved in the study.
There are very few conditions for which cannabinoid therapies have clear, well-established benefits backed by high-quality clinical data, according to the researchers.
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The strongest evidence supports FDA-approved cannabinoid medications for treating specific conditions, including HIV/AIDS-related appetite loss, chemotherapy-induced nausea and vomiting, and certain severe pediatric seizure disorders.
The review identified significant safety concerns, with high-potency cannabis use among young people linked to higher rates of mental health issues. (iStock)
For many other conditions that are commonly treated with cannabis — such as chronic pain, insomnia, anxiety or post-traumatic stress disorder — evidence from randomized trials did not support meaningful benefit.
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The analysis also examined safety concerns — in particular, how young people using high-potency cannabis may be more likely to suffer higher rates of psychotic symptoms and anxiety disorder.
Daily inhaled cannabis use was also linked to increased risks of coronary heart disease, myocardial infarction (heart attack) and stroke when compared with non-daily use.
Daily inhaled cannabis use is associated with increased cardiovascular risks, including coronary heart disease, heart attack and stroke. (iStock)
Based on these findings, the review emphasizes that clinicians should weigh potential benefits against known risks when discussing cannabis with patients.
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The authors suggest that clinicians screen patients for cardiovascular risk, evaluate mental health history, check for possible drug interactions and consider conditions where risks may outweigh benefits.
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They recommend open, realistic conversations and caution against assuming that cannabis is broadly effective for medical conditions.
The review highlights the need for caution, urging clinicians to weigh risks, screen patients appropriately and avoid assuming cannabis is broadly effective. (iStock)
“Patients deserve honest conversations about what the science does and doesn’t tell us about medical cannabis,” Hsu said.
This article is a narrative review rather than a systematic review, so it did not use the strict, standardized methods that help reduce bias in how studies are selected and evaluated, the researchers noted.
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The review notes further limitations, including that some evidence comes from observational research rather than randomized trials, which means it cannot establish cause and effect.
The trial results also may not apply to all populations, products or doses.
Health
Always running late? The real cost to your relationships may surprise you
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Chronic lateness is known to be a common annoyance, often leading to strain within relationships, experts have confirmed.
And for some people who struggle to be on time, the reasons may go far beyond poor planning.
Psychotherapist and author Jonathan Alpert told Fox News Digital that chronic lateness often stems from a combination of psychological patterns and neurobiological factors that people may not realize are influencing them.
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“For some people, it’s personality-driven. They’re distractible, optimistic about how long things take, or simply not tuned into the impact on others,” the New York-based expert said.
For others, the issue stems from neurobiological differences that affect how the brain manages time.
Chronic lateness may not stem from poor planning, but from psychological and neurobiological factors. (iStock)
That can make it harder to estimate how long tasks take or to transition from one activity to the next, leading to chronic lateness, according to Alpert.
Impact on relationships
In addition to disrupting schedules, chronic lateness may also strain relationships and create tension.
“Lateness erodes trust. Over time, it sends the message that someone else’s time is less important, even if that’s not the intent,” Alpert noted.
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Lateness can also become an issue in the workplace, where repeated delays can undermine teamwork and harm a person’s reputation.
These patterns are common among people with ADHD, who often experience what is known as “time blindness,” making it difficult to recognize how quickly minutes pass or how long tasks truly take.
“Adding 10 to 15 minutes of buffer between activities reduces the frantic rushing that leads to chronic lateness.”
ADHD is strongly associated with executive-function difficulties, which are the skills needed to stay organized, plan ahead and focus on essential details, according to the Attention Deficit Disorder Association.
When these abilities are weaker, it becomes more challenging to gauge time, follow a schedule and meet deadlines, which can impact personal and professional relationships, experts agree.
Frequent tardiness in a work setting can throw off group efforts and leave others with a negative impression of the employee. (iStock)
Underlying patterns
Anxiety, avoidance and perfectionism are patterns that Alpert most often sees in people who tend to run late, he noted.
“Many chronically late individuals don’t intend to be disrespectful. They’re overwhelmed, anxious or trying to squeeze too much into too little time,” he said.
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These emotional patterns often show up in different ways. For some, anxiety can make it difficult to begin even simple tasks, pushing everything behind schedule before the day has even started, according to Alpert.
For others, the struggle happens in the in-between moments. Shifting from one activity to another can feel surprisingly uncomfortable, so they linger longer than intended and lose time without noticing.
Anxiety is a major factor behind why some people have trouble being on time, according to experts. (iStock)
Others may get caught up in the details, as perfectionism keeps them adjusting or “fixing one more thing” as the minutes slip away, Alpert said.
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Another major factor, the expert shared, is that many people simply misjudge how long tasks take. Their internal sense of time is often inaccurate, which leads them to assume they can fit far more into a day than is realistically possible.
‘Time audit’
Alpert often recommends that his clients perform a simple “time audit,” where they track how long they think a routine task will take and then time it in real life. This can help them rebuild a more accurate internal clock, he said.
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“Adding 10 to 15 minutes of buffer between activities reduces the frantic rushing that leads to chronic lateness,” he said.
Many people with ADHD have a difficult time recognizing how quickly minutes pass or how long tasks truly take. (iStock)
Despite the challenges lateness can create, Alpert said people don’t have to be stuck with these habits forever. With the right support and consistent strategies, meaningful change is possible.
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“Strong routines, alarms, checklists and accurate time estimates compensate for traits that don’t naturally disappear,” he added.
People who find that lateness is affecting their everyday life and relationships may benefit from discussing their concerns with a healthcare provider or mental health professional.
Health
Holiday heart attacks rise as doctors share hidden triggers, prevention tips
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The holidays are known to be a source of stress, between traveling, preparing for family gatherings and indulging in lots of food and drinks.
The uptick of activity can actually put a strain on the heart, a phenomenon known as “holiday heart syndrome.”
Cardiothoracic surgeon Dr. Jeremy London addressed this elevated risk in a recent Instagram post, sharing how heart attacks consistently rise around the holidays.
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“Every year, like clockwork, we see a spike in heart attacks around Christmas and New Year’s,” the South Carolina-based surgeon said. “In fact, Christmas Eve is the highest-risk day of the year.”
This is due to a shift in behavior, specifically drinking and eating too much, moving less and being stressed out, according to London. “Emotional stress, financial stress, the increased pace of the holidays, increased obligations,” he listed.
Cold weather also causes vasoconstriction (narrowing of blood vessels), according to London, which increases the risk of plaque rupture and the potential for heart attack.
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Dr. Glenn Hirsch, chief of the division of cardiology at National Jewish Health in New York, noted in an interview with Fox News Digital that holiday heart syndrome typically refers to the onset of an abnormal heart rhythm, or atrial fibrillation.
This can happen after an episode of binge-drinking alcohol, Hirsch said, which can be exacerbated by holiday celebrations.
Binge-drinking at any time can drive atrial fibrillation, a cardiologist cautioned. (iStock)
“It’s often a combination of overdoing the alcohol intake along with high salt intake and large meals that can trigger it,” he said. “Adding travel, stress and less sleep, and it lowers the threshold to go into that rhythm.”
The biggest risk related to atrial fibrillation, according to Hirsch, is stroke and other complications from blood clots. Untreated atrial fibrillation can lead to heart failure after a long period of time.
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“The risk of atrial fibrillation increases with age, but also underlying cardiovascular disease risk factors increase the risk, such as high blood pressure, obesity, diabetes, sleep apnea and chronic kidney disease,” he added.
Christmas Eve is the “highest risk day of the year” for heart attacks, according to one cardiologist. (iStock)
Preventing a holiday heart event
Holiday heart syndrome is preventable, as Hirsch reminds people that “moderation is key” when celebrating.
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The expert recommends avoiding binge-drinking, overeating (especially salty foods) and dehydration, while managing stress levels and prioritizing adequate sleep.
“Don’t forget to exercise,” he added. “Even getting in at least 5,000 to 10,000 steps during the holiday can help lower risk, [while] also burning some of the additional calories we are often consuming around the holidays.”
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London agreed, stating in his video that “movement is medicine” and encouraging people to get out and move every day.
The various stresses of the holidays can have physical consequences on the body, doctors warn. (iStock)
It’s also important to stay on schedule with any prescribed medications, London emphasized. He encourages setting reminder alerts, even during the holiday break.
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“Prioritize sleep and mindfulness,” he added. “Take care of yourself during this stressful time.”
London also warned that many people delay having certain health concerns checked out until after the holidays, further worsening these conditions.
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“Don’t ignore your symptoms,” he advised. “If you don’t feel right, respond.”
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