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ARCHIVED  June 4, 1999

Xenical offers hope in battle of the bulge

Xenical, the brand name for Orlistat, an anti-obesity drug manufactured by Hoffman-LaRoche Pharmaceuticals Inc., is now available in the United States.

It is the first anti-obesity drug ever developed that blocks the body’s absorption of dietary fat — a change from appetite suppressants such as Fen-Phen, the medication that was pulled from shelves in the mid-1990s because of dangerous side effects, including the possibility of heart-valve defects.

Currently, the only side effects tied to Xenical include bowel incontinence and flatulence, which can be minimized by reducing fat intake — yet another incentive to take the drug while adhering to a low-fat diet.

Paul Rotuno, pharmacy manager for the Bittersweet Safeway in Greeley, has already been visited by a drug-company representative extolling the virtues of the new drug, which is said to help people reduce their body weight by 5 percent to 10 percent in conjunction with a low-fat diet. Rotuno said that his wholesaler has 2,000 pills in stock, waiting to be dispensed.

Rotuno himself is not convinced, however; he believes that there is no magic pill a person can take to lose weight if he or she is not completely committed to the cause.

“As a society, I think, we have too much fat in our diets, and Americans are getting sent mixed messages,” he said. “I think that if we could look at obesity as a societal ill, not just as a personal failing, we’d be a lot better off and have no need for these sort of cures that might give false hope to people who aren’t really prepared to change their diets but expect this magic pill to work for them anyhow.”

The cost of treatment with Xenical will be as high as $5 a day, and it is unlikely that insurers will pick up the tab. But for the more than 50 percent of Americans who are overweight, that expense could bring a huge reward.

GAO has good news for Colorado

A recent report by the General Accounting Office analyzing assisted-living facilities in four states: California, Oregon, Florida and Ohio, found that more than 25 percent were cited for five or more quality-of-care or consumer-protection problems that could result in harm to residents.

Colorado’s more than 500 facilities are inspected annually by the state Department of Health, in conjunction with various county agencies. Terry Zmell, director of residential programs, said that the state has nothing to worry about.

“Sure, there are some that are marginal and can use some improvement, but overall, the facilities in this state do not face those kinds of problems,” she said. “Those that do have deficiencies are dealt with.”

The state has an extensive protocol it uses to evaluate facilities, and it has compiled a list of the top 10 most serious deficiencies at Colorado’s assisted-living facilities. The issue of highest concern was hot-water temperature, something that could potentially cause harm to patients. But that concern, along with many others on the list, could be quite simple to rectify.

“We do a pretty thorough evaluation of each facility, doing interviews with patients, their families and the staff,” Zmell said. “Plus, we do a lot of training of staff to help them correct problems before they become serious. We try to give these facilities as much support as we can.”

The GAO study will have more of an impact on facility employees and operators, said Jackie Starr-Bocian, public-relations coordinator for the health department.

“As the market has expanded, with more professional operators and big corporations coming in, we have a sophisticated group of providers who are well-trained,” she said. “This study can not only go to increase public awareness of these kinds of facilities but also force those providers who were unwilling to keep up to provide good services to stay afloat in the market environment. It can only be good for consumers.”

Funded health care up for grabs

Less than 25 percent of Colorado’s eligible low-income children have been enrolled in the Child Health Plan Plus program, which has access to more than $21 million through federal Title XXI funds and state matching grants.

“We have done everything we can to get kids on this program,” lamented Mary O’Brien, office manager for the Children’s Clinic, one of three sites in Larimer County that enrolls children in the program. “It is an absolutely fantastic service, providing so much for so many kids that need it, and we can’t get them in.”

One of the biggest obstacles to enrollment has been the application form, a time-consuming and difficult series of questions that has caused many parents to balk at even applying. This is being remedied, said Child Health Plan Plus marketing director Susan Tyler, and a new form will be available at the end of August 1999.

Another barrier was the amount of documentation parents were required to provide, something that has also been eased in an effort to enroll the nearly 76,000 Colorado children who are eligible to participate in the program.

In Larimer County, 995 children are enrolled, compared with 4,158 who are eligible; and in Weld County, 745 of the eligible 3,097 children are enrolled.

“Sometimes, the only thing standing in the way of children being eligible was the absence of documentation, something that a lot of these kids don’t have,” O’Brien said. “That has been a problem in the past, but the Colorado Child Health Plan is working on easing the documentation required.”

Child Health Plan Plus was created for low-income children who are not eligible for Medicaid, the federal program that provides health care services for poor children who qualify.

The Plus program is a revamped incarnation of the Colorado Child Health Plan, which provided only outpatient services at a low annual cost of $25. The new program requires families to pay a monthly premium, depending on income, ranging between $5 and $30, and provides a full range of in-patient and mental-health services as well.

This problem plagues not only Colorado, but almost all other states that offer health plans to supplement Medicaid, leading some health care professionals to question why that money isn’t used to cover all children with Medicaid benefits.

“Enrollment is done by different agencies, which already are under-funded and can’t afford to spend the time explaining the application forms to a population desperately in need of health care,´ said Dr. Adrienne LeBailly, director of the Larimer County Department of Health and Environment.

“Medicaid already has intake people. It is a well-established, comprehensive program that provides excellent health care to those children who need it. Why they don’t make all these kids eligible for Medicaid is beyond me.”

Xenical, the brand name for Orlistat, an anti-obesity drug manufactured by Hoffman-LaRoche Pharmaceuticals Inc., is now available in the United States.

It is the first anti-obesity drug ever developed that blocks the body’s absorption of dietary fat — a change from appetite suppressants such as Fen-Phen, the medication that was pulled from shelves in the mid-1990s because of dangerous side effects, including the possibility of heart-valve defects.

Currently, the only side effects tied to Xenical include bowel incontinence and flatulence, which can be minimized by reducing fat intake — yet another incentive to take the drug while adhering to a low-fat diet.

Paul…

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