Senior News Line
by Matilda Charles

Three years ago I started thinking about getting a dog. My friends had told me about sites like shoppok that have dogs listed for sale and rehoming, but I wasn’t sure whether to buy a younger dog, or whether to rehome an older dog. All I knew was that seeing neighbors out with their small dogs, made me realize that I wanted a real dog, a big one, not a dog that would fit in my purse. I made a pro-con dog ownership list, but over time the list of reasons for not getting a dog has gotten longer and longer.

Maybe my story will help if you’re considering adopting a dog.

Where I live there are a lot of rules, and one of them concerns the size of dogs. Specifically, the dog cannot top 25 pounds. The neighborhood rumor mill supplied this story: A woman was told to get rid of her dog after management showed up at her door with a set of scales and demanded to weigh the pooch, which unfortunately came in at nearly 30 pounds. The owner moved out and took the dog with her.

A size limit means I can’t adopt a young mixed-breed shelter mutt because there’s no real way to know how large the dog will be when it grows.

There are no sidewalks here. What we have for half the year are increasingly narrow roads with snow banks on the sides. I don’t have a fenced yard either, which means no place to let a big dog romp and play.

By the time I got this far, I knew it was hopeless. I never even got to the part about potential veterinary costs, or the price of quality dog food and grooming, flea treatments like the difference between frontline plus and gold, and toys.

I’ve found a partial solution, however. I’m thinking of signing up as a dog walker volunteer at the shelter. Maybe I’ll fall in love with a tiny, purse-size dog.

(c) 2019 King Features Synd., Inc.

by Barbara Radziszewska Health Scientist Administrator, Division of Geriatrics and Clinical Gerontology.

Starting this year, a new NIH inclusion policy mandates that participants of all ages be included in human subject’s research, unless there is a scientific or ethical reason for exclusion of any age category. The NIH Inclusion Across the Lifespan policy, developed in response to requirements in the 21st Century Cures Act, has been in effect since the Jan. 25, 2019, grant submission deadline.

The inadequate inclusion in clinical trials of older adults, especially those affected by age-related conditions, has been amply documented across many disease areas, including those that disproportionally affect older people. Participants enrolled in clinical trials are frequently younger and healthier than the typical population affected by a given disease or condition.

Some studies impose arbitrary upper age limits of enrolled participants. Others use exclusion criteria that disproportionally affect older people, such as multiple morbidities, polypharmacy, frailty, and physical or cognitive impairments. These restrictions reduce the relevance of the data collected in clinical trials to real-life patients in clinical settings. As a result, there are critical gaps in the evidence base and in clinical guidelines for older, more complex patients.

NIA staff and our NIH colleagues have been conducting ongoing research and analysis of this issue for a number of years. The 21st Century Cures Act mandated a workshop held in 2017, which resulted in recommendations for change (PDF 857K). More recently, NIA Deputy Director Dr. Marie A. Bernard and I, along with our colleagues Dr. Jaron Lockett and Dr. Samir Sauma, analyzed data on subject inclusion in Phase III clinical trials from 1965 to 2015, focusing on diseases that are the most frequent causes of hospitalization and/or disability in older adults.

Our analysis revealed striking evidence for the need to include more older adults. We found that 33 percent of the studies had arbitrary upper age limits, and 65 percent of the trials reported data of participants who were younger than the typical population affected by the disease under study. In addition, many clinical trials excluded participants based on multimorbidity and polypharmacy.

The expanded inclusion policy presents a new set of challenges to the scientific community, as it has implications for study design and recruitment planning. Although the implementation of the new policy may necessitate increasing the planned sample size to overcome the additional variability introduced by more inclusive enrollment policies, the expected result is well worth the additional effort and expense, given the urgent need to address critical gaps in the evidence base on the diseases and conditions of later life. This is a solid step in the right direction for improving clinical care for the nearly 50 million U.S. adults over age 65.

by Stacy Washington

President Trump thinks Americans pay too much for prescription drugs — and says foreign countries are to blame. In a speech, he criticized nations that use socialist price controls to artificially hold down the cost of pharmaceuticals. “For decades,” he noted, “other countries have rigged the system so that American patients are charged much more . . . for the exact same drug.”

The president’s criticism is spot on. That’s why a new initiative from his Department of Health and Human Services is so shocking. HHS Secretary Alex Azar just proposed a major overhaul of Medicare that would impose those socialist price controls here in the United States.

Instead of putting America first and forcing other countries to play by the rules, the proposal legitimizes foreign freeloading. The price controls would limit seniors’ access to lifesaving drugs and chill pharmaceutical research efforts.

President Trump correctly notes that prescription drugs are more expensive in America. The reason for the price disparity is simple. Nations with socialized medicine, including Canada, the United Kingdom, and France, cap prescription prices. If a drug is too expensive, the government won’t offer it to patients.

Once drug companies have developed a medicine, they have a limited amount of time to sell it and recoup their costs before the patent expires. So it makes sense for American drug companies to market their products in price-controlled nations, even if that means granting steep discounts. The alternative is earning no foreign revenue at all.

As a result, American patients fund the lion’s share of global research and development costs. The HHS proposal wouldn’t rectify this injustice — it would only further harm American patients.

Right now, Medicare drug payments are based on each medicine’s average domestic sales price. Sec. Azar wants to instead index Medicare payments to the average prices paid in 14 other countries.

Copying other nation’s socialist price controls would reduce American patients’ access to the latest medicines.

Consider treatments for respiratory conditions. All new respiratory drugs released globally in the last seven years are available to Americans. Patients in Japan and France — two of the reference countries included in Sec. Azar’s pricing index — can only access 55 percent of those medicines.

Domestic price controls would also smother drug innovation, depriving future patients of potentially lifesaving cures.

Europe is a cautionary tale. The region led the world in biopharmaceutical R&D investment in the 1980s. But once several nations adopted price control policies, Europe suffered a dramatic decline in research investment. Today, the United States spends 40 percent more on biopharmaceutical R&D than Europe.

Sec. Azar’s proposal would reward the forces of socialism abroad and threaten American ingenuity and prosperity at home. Patients can only hope that President Trump orders his HHS secretary to scrap the plan.

Stacy Washington is a decorated Air Force Veteran, an Emmy nominated TV personality, and the host of the nationally syndicated radio program “Stacy on the Right.”