This week we continue to look at gender medicine- how diseases may manifest themselves differently, and how medications may affect differently- depending on whether you are male or female.

An editorial in Nature in 2010 urged us to “put Gender on the Agenda,” as increasingly we are seeing from research results that there are distinct gender-based differences in disease incidence and activity, and treatment methods, especially medication. Cancer, for example, is the second leading cause of death among women and men, (Anderson, R.N., Deaths: Leading Causes for 2000. National Vital Statistics Reports. 2002, National Center for Health Statistics: Hyattsville, MD), however mortality rates and the disease course differ according to gender.

In looking at cancer, we see that in general, more women are screened but more men are diagnosed, and that “The gender differential in cancer incidence rates is comparable to ethnic and racial disparity in magnitude, and yet, most studies fail to look for it.” That is beginning to change with recent studies and clinical trials seeking to reduce disparities by including more women.

If we look at lung

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“Women are from Venus, Men are from Mars.” “Women think differently than men.”

These viewpoints appear to be widespread and popular, fueling spirited and on-going debate in the media and the arts, but what about healthcare and medicine?

Most medical research over the years has focused on white men as subjects, and results were then extrapolated to include everyone else. From an ethical perspective, there were some humanistic reasons for this, e.g., protecting women and children from experimental research that may not have benefited them. In many cases, however, research focused on those in positions of power. This situation is slowly but surely changing, and we are now witnessing the rise of Gender Medicine.

A very interesting article in Clinical Chemistry and Laboratory Medicine, entitled “Gender Medicine: A Task for the Third Millennium,” defines gender-specific medicine as the study of how diseases differ between men and women in terms of prevention, clinical signs, therapeutic approach, prognosis, and psychological and social impact. They

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Biosimilars are defined as “similar versions of an existing biological medicine by a different manufacturer.” Biosimilars may be used to treat difficult-to-manage conditions including rheumatoid arthritis, multiple sclerosis, chronic pain, HIV and cancer, among other conditions. Because they are more complex and more difficult to manufacture than other pharmaceuticals, rigid compliance to regulations and quality control are crucial to avoid contamination and drug shortages. Their complexity also means that they are more expensive for the patient.

A recent article by NBC News suggests that “the number of patients who could benefit from these more sophisticated therapies will only continue to grow, in some cases by 15% annually.” But how will we afford them?

Changes are afoot in many health insurance plans, and some new rules state that any cost-savings must be weighed against severe health consequences, particularly where obtaining prior approval (an often lengthy process) or “step therapy” where a number of cheaper drugs are tried before moving on to more expensive ones.

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Healthcare costs continue to be a concern, despite efforts underway to reduce them through healthcare reform initiatives.  One area, in particular, is worrying patients and physicians alike: specialty drugs or biologics. An article in Workforce Management reports that specialty drugs “make up about 17% of employers’ total drug costs, even though just 1% of the workforce takes them.”  Reuters reports that “approximately 57 million Americans rely on specialty drugs,” with the average prescription costing $1,766.00 in 2011.

“Specialty drugs are high-cost drugs used to treat complex or rare conditions, such as multiple sclerosis, rheumatoid arthritis, hepatitis C and hemophilia. The drugs are often self-injected or administered in a physician’s office or through home health services,” according to Wellmark. Specialty pharmacies specialize in the delivery and clinical management of specialty drugs.  It is reported that the average cost per specialty medication is $2,000.00 per month,

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The passing of the Affordable Care Act has implemented a number of changes to American healthcare. Many of these changes directly affect families, the elderly, and people with pre-existing conditions, leaving many of 20-somethings wondering “What does this mean for me?” One major impact of the new law is that young adults can stay on their parents’ healthcare plan until age 26. Before the passing of the Affordable Care Act children could only stay on their parents’ insurance up to age 19, with exceptions for full-time students. Since the law has been enacted, over 3 million young adults have gained insurance.

As a recent college graduate, I took full advantage of the new law and remained on my parents’ insurance until 26. After that I had options – lots of options – most of which I knew very little about (sound familiar?). I did know that as a Massachusetts resident I had to be insured, or I would face an increase on my taxes.

The first option was to wait for an open enrollment period and get back on my parents’

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