Stanley Cup Finals Action Begins Monday Night
The Boston Bruins return to the Stanley Cup finals for the first time since 2013, but the wait has been much longer for the St. Louis Blues. They were last in the finals 49 years ago.
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Tylenol For Infants And Children Is The Same. Why Does 1 Cost 3 Times More?
Infants’ Tylenol comes with a dosing syringe, while Children’s Tylenol has a plastic cup. Both contain the same concentration of the active ingredient, acetaminophen.
Ryan Kellman/NPR
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Ryan Kellman/NPR
If you’ve ever had a little one at home with a fever, you might have noticed two options for Tylenol at the store.
There’s one for infants and one for children. They’re contain the same amount of medicine — 160 milligrams of acetaminophen per 5 milliliters of liquid — but the infant version costs three times more.
What gives? It turns out, there’s a backstory.
For decades, Infants’ Tylenol was stronger than the children’s version. The thinking was that you don’t want to give babies lots of liquid medicine to bring down a fever — so you can give them less if it’s stronger.
“It was three times more concentrated,” says Inma Hernandez of the University of Pittsburgh School of Pharmacy. Since it contained more acetaminophen, the active ingredient, she says, it made sense that it was also more expensive. “The price per milliliter was five times higher,” Hernandez says.
But there was a problem: Parents were making mistakes with dosing. Babies got sick — some even died. So in 2011, at the urging of the Food and Drug Administration, the maker of brand-name Tylenol, Johnson & Johnson, announced a change: Infants’ Tylenol would be the same concentration as Children’s Tylenol.
Now it’s the same medicine, but the price is still different
A quick search online shows 4 ounces of Children’s Tylenol selling for $5.99, and Infants’ Tylenol also selling for $5.99, but for only 1 ounce of medicine. With many store brands of acetaminophen, it’s the same story: The infant version is generally three times more expensive than the one for children.
Kim Montagnino of Johnson & Johnson said in a statement to NPR that Infants’ Tylenol is more expensive because the bottle is more sturdy and it includes a dosing syringe, instead of a plastic cup. “These safety features of Infants’ Tylenol (dosing syringe, rigid bottle) are more expensive to manufacture than the dosing cup and bottle for Children’s Tylenol,” Montagnino wrote.
Hernandez doesn’t buy it.
“The cup versus the syringe doesn’t really explain the price difference in my opinion,” Hernandez says. “They’re really cheap because they’re just plastic. When we think of what’s expensive in a drug, it’s actually the active ingredient, and the preparation of that active ingredient in the formulation, not the plastic cup or the syringe.”
But Johnson & Johnson’s explanation makes sense to Edgar Dworsky, a consumer advocate and founder of the website Consumer World. “There’s an extra thing in the box, and extra things usually cost money,” he says.
“Think of a spray cleaner. You can buy the spray cleaner in the spray bottle, and that costs a little more money. Or you can buy the refill that gives you more ounces but it doesn’t have the sprayer on top — it’s kind of the same concept.”
But this, of course, is not a spray cleaner. It’s medicine. And parents are sensitive to marketing because the stakes are so high.
“I would certainly imagine that product-makers know that parents want to be very cautious when buying products for their kids,” Dworsky says. “Really, the lesson is — read the label. See what you’re getting for your money.”
Pediatrician Ankoor Shah at Children’s National Health System in Washington, D.C., knows how confusing all of this is for parents because he gets tons of questions from them about over-the-counter medications.
“The packaging and the dosing is not easy, it’s not simple and — personal opinion — it’s not parent-friendly,” Shah says.
For instance, Infants’ Tylenol doesn’t say on the label what the correct dosing is for a baby under age 2. It just says “ask a doctor.” Shah says he still uses a calculator to figure out how much to give a child, based on their weight, and gives slips to parents at kids’ well visits. You can also find the information from reputable sources online.
He says whether you opt for the Children’s or Infants’ bottle of acetaminophen at the store, the most important thing is to get the dosing right.
“When you start giving more acetaminophen than recommended, there are serious side effects that could happen,” he says.
The bottom line is: Know what you need. And if you need to spend that extra couple of dollars for the syringe and the special bottle to get the dosing just right, maybe the markup is worth it.
If you think you might have inadvertently overdosed a child, contact your doctor or call your local poison control center. There are 55 poison control centers across the U.S.; all of them can be reached at the same hotline number: 1-800-222-1222.
What Happens When A World-Class Athlete Decides To Have A Baby
NPR’s Rachel Martin talks to sprinter Allyson Felix, an Olympic champion, about her contract with Nike through her pregnancy and her advocacy for black maternal health care.
Olympic Track Star Rebukes Sponsorship Pay Penalties For Pregnant Athletes
NPR’s Michel Martin speaks with Olympic track runner Alysia Montano about how sport endorsement companies treat maternity leave.
Why Mount Everest’s Death Toll Keeps Climbing
NPR’s Susan Davis talks to Outside magazine editor Grayson Schaffer about the recent deaths of climbers on Mount Everest.
SUSAN DAVIS, HOST:
This year is on track to be one of the deadliest ever on the world’s tallest peak. Ten people have died in the last week or so on Mount Everest, scrambling to reach the summit during a break in the weather. There are reports of a massive traffic jam as climbers waited their chance to stand atop the mountain at just over 29,000 feet. Joining us now on the line is Grayson Schaffer, an editor at large at Outside magazine. Welcome to the program.
GRAYSON SCHAFFER: Thanks for having me.
DAVIS: For those who haven’t seen the images, can you explain what the logjam at the top looks like?
SCHAFFER: Well, you essentially have something that looks like people are waiting in line for concert tickets to a sold-out show, only instead of trying to, you know, get in to see their favorite artist, they’re trying to reach the top of the world and are running into, you know, essentially just traffic. The danger there is that, at that altitude, the body just can’t survive. They’re breathing bottled oxygen. And when that oxygen runs out because you’re waiting in line, you are at much higher risk for developing high-altitude edemas and altitude sickness and dying of those illnesses while you’re still trying to reach the summit.
DAVIS: You’ve been to Everest yourself. Could you describe a bit of what it’s like for a climber to be in the upper reaches of the mountain – the area known as the death zone?
SCHAFFER: I’ve never actually been into the death zone myself, but once you get above about 25,000 feet, your body just can’t metabolize the oxygen. Your muscles start to break down. You start to have fluid that builds up around your lungs and your brain. Your brain starts to swell. You start to lose cognition. Your decision making starts to become slow. And you start to make bad decisions – and all of this is happening in the face of, you know, each person trying to sort of reach their ultimate dream. I mean, the reason that people try to climb Mount Everest is because it grabs a hold of them and they feel like they just have to make the summit. And so you’ll have some people, you know, in distress and not necessarily, you know, getting help from the people who are around them. So it’s this kind of bizarre thing to be surrounded by hundreds of people and yet totally alone at the top of the world.
DAVIS: A Sherpa who has climbed the mountain many times told The New York Times that this spring’s traffic jam was the worst he’s ever seen. Are the Nepalese authorities simply giving out too many permits?
SCHAFFER: Well, one of the issues is that the Chinese side of the mountain – the Tibetan side – now limits their permits. So more and more people are climbing from the Nepalese side. And what we’ve seen in the past is that every year is the worst traffic jam just because there are more and more people who are climbing the mountain. More of those people are trying to summit during the same good summit windows because everybody has the same weather forecasting. And so you’ll have, on any given year, several hundred people trying to pack themselves into the same summit window. And that has created this bizarre phenomenon of blue-sky Everest deaths, where people are trying to reach the top – they have good weather, but the thing that is causing all these fatalities is just the fact that everybody is trying to reach the summit in the same 12-hour weather window.
DAVIS: Tragedies on the mountain are nothing new. One of the most famous we remember is the 1996 tragedy, recounted in Jon Krakauer’s book “Into Thin Air,” where eight people died in a single day on Everest due, at least in part, to a crowd trying to reach the summit. Has nothing changed in the years since?
SCHAFFER: Well, I mean, the only thing that’s changed is that it’s gotten exponentially worse since 1996. In that incident, there was actually a storm that came. And that’s why you had eight people die in that tragedy. Now what we’re seeing and what we will probably see every year forward is eight to 10 people dying just in a routine manner, just because of the sheer number of people trying to fit onto the route.
DAVIS: Grayson Schaffer of Outside magazine, thanks for speaking with us.
SCHAFFER: Thanks for having me.
(SOUNDBITE OF STEVE TIBBETTS’S “CHANDOGRA”)
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Saturday Sports: Stanley Cup, NBA Playoffs, Minnesota Twins
NPR’s Scott Simon talks with ESPN’s Howard Bryant about the Stanley Cup, the NBA and the Minnesota Twins making history.
SCOTT SIMON, HOST:
Time for sports.
(SOUNDBITE OF MUSIC)
SIMON: You got to suffer if you want to sing the blues. And the St. Louis Blues sure have. But after all these years, they’re in the Stanley Cup Finals. Also, who’ll face the fearless Golden State Warriors? And what about the Twins? Howard Bryant of ESPN joins us. Morning, Howard.
HOWARD BRYANT, BYLINE: Good morning, Scott.
SIMON: The Stanley Cup Finals between the Boston Bruins and the St. Louis Blues begin Monday. This is kind of Cinderella versus Godzilla.
BRYANT: (Laughter) In a way, they weren’t that far apart in terms of the regular season – only really a game. But in terms of history, absolutely. The St. Louis Blues have not been to the Stanley Cup since 1970, when they lost to the Boston Bruins – and the famous shot of Bobby Orr leaping through the air, giving the Bruins their first Stanley Cup since 1929, I think. It was just an amazing moment if you’re a Bostonian.
However, this is a – going to be a fun matchup. I really sort of enjoy what the Blues have done. And they – they’re so tough. They were down two games to one against San Jose. And then they just went on a tear. The Bruins are the hottest team in hockey. They’ve won seven straight. So you have this great clash.
And the Blues are just so tough. And they’re tough on the road. They play better on the road than they do at home. And I’m really looking forward to seeing what this matchup brings, especially the two lines – Tarasenko and Schwartz and this – these guys are playing really, really good hockey. I didn’t think they were going to take out the Sharks the way they did.
And on the other hand, of course, the Bruins – that Boston City just keeps winning championships in their top line in there – whether it’s Bergeron or Pastrnak or Marchand. And then, of course, they’ve got the hottest goalie in the world, as well, with Tuukka Rask. So it’s going to be a great matchup.
SIMON: OK. NBA Eastern Conference Final – Game Six tonight between the Toronto Raptors and Milwaukee Bucks.
BRYANT: (Laughter).
SIMON: My bleat of fear the deer may have…
BRYANT: You’re the jinx, Scott Simon.
SIMON: I – exactly.
BRYANT: You’ve ruined it for everybody.
SIMON: So I have a cheer for Toronto, OK? I want – the producer of our show is from Toronto. So I want to give him a good one. Ready for this? Abhor the dinosaur.
BRYANT: (Laughter).
SIMON: What do you think?
BRYANT: I think that’s terrible, Scott. I do.
SIMON: (Laughter).
BRYANT: I think we the north is so much more appropriate and fun. And, you know, when they made this deal last year – because trading DeMar DeRozan was not a popular move, considering that he felt lied to. He had committed to the organization. And then the organization then traded him to to San Antonio for Kawhi Leonard, who just happens to be one of the top three players in the game. It wasn’t a great move considering that you want to show loyalty.
And – but here’s the deal, Kawhi Leonard is that good. He’s been carrying this team. He’s been fantastic. He’s – between he and Kevin Durant – between Durant, Kawhi Leonard and LeBron James, they’re as good as it gets in the game. And when you watch Kawhi play basketball, he has carried this team to a place that they’ve never been. They’ve never been this close to the NBA Finals before.
And Milwaukee, meanwhile, they’ve got to win a basketball game. They’ve been the best team in basketball all season long record-wise. They won 60 games. And now they’re facing it.
Now they’re facing the adversity of having to go to Toronto on the road and winning a game to bring it back for a Game Seven. And at some point in the playoffs, you find out who you are. And the Milwaukee Bucks are going to find out when they get to Toronto.
SIMON: Let’s just note on our way out in just a few seconds, the Minnesota Twins have already hit 100 home runs this season. What are they eating for breakfast?
BRYANT: Spinach, like Popeye.
SIMON: (Laughter).
BRYANT: It’s incredible. I think they’ve got the best record in baseball. You’ve got guys you’ve never heard of – Rosario, Kepler – just hitting the ball out of the ballpark. And we’ll see if they’re built for 162. But right now, it’s the story in baseball. It’s a lot of fun.
SIMON: Howard Bryant, thanks so much.
BRYANT: Thank you.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
Colorado Caps Insulin Co-Pays At $100 For Insured Residents
Colorado Gov. Jared Polis, pictured in January, signed a bill into law on Wednesday placing a $100 per month cap on insulin co-payments starting next year.
David Zalubowski/AP
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David Zalubowski/AP
As nearly 7.5 million Americans contend with covering the skyrocketing costs of insulin to manage the disease, diabetics in Colorado will soon have some relief.
A new law, signed by Gov. Jared Polis earlier this week, caps co-payments of the lifesaving medication at $100 a month for insured patients, regardless of the supply they require. Insurance companies will have to absorb the balance.
The law also directs the state’s attorney general to launch an investigation into how prescription insulin prices are set throughout the state and make recommendations to the legislature.
Colorado is the first state to enact such sweeping legislation aiming to shield patients from dramatic insulin price increases.
“One in four type 1 diabetics have reported insulin underuse due to the high cost of insulin … [t]herefore, it is important to enact policies to reduce the costs for Coloradans with diabetes to obtain life-saving and life-sustaining insulin,” the law states.
The price of the drug in the U.S. has increased exponentially in recent years. Between 2002 and 2013, it tripled, according to 2016 study published in the medical journal JAMA. It found the price of a milliliter of insulin rose from $4.34 in 2002 to $12.92 in 2013. And a March report from the House of Representatives, found “prices continued to climb, nearly doubling between 2012 and 2016.”
Dramatic price hikes have left some people with Type 1 and Type 2 diabetes who use insulin to control their blood sugar levels in the unfortunate position of making dangerous compromises. They either forego the medication or they ration their prescribed dose to stretch it until they can afford the next prescription.
In some instances, those compromises can lead to tragedy. As NPR reported, an uninsured Minnesota man who couldn’t afford to pay for $1,300 worth of diabetes supplies, died of diabetic ketoacidosis, according to his mother. The man, who was 26, had been rationing his insulin.
The move in Colorado comes on the heels of recent commitments by manufacturers to limit the drug’s cost to consumers, which in turn comes on the heels of mounting pressure (and some skewering) from elected officials.
Following a U.S. Senate Finance Committee hearing in February and a subcommittee hearing in the House in April, pharmaceutical company leaders have reluctantly admitted they have a role to play in reducing drug prices.
Last month Express Scripts, one of the largest pharmacy benefit managers in the country, announced it is launching a “patient assurance program” that will place a $25 per month cap on insulin for patients “no matter what.”
In March, insulin manufacturer Eli Lilly said it will soon offer a generic version of Humalog, called Insulin Lispro, at half the cost. That would drop the price of a single vial to $137.35.
“These efforts are not enough,” Inmaculada Hernandez of the University of Pittsburgh School of Pharmacy tells NPR, of the latest legislation in Colorado.
Hernandez was lead author of a January report in Health Affairs attributing the rising cost of prescription drugs to accumulated yearly price hikes.
While the Colorado out-of-pocket caps will likely provide financial relief for diabetes patients, she noted “the costs will kick back to all of the insured population” whose premiums are likely to go up as a result.
“Nothing is free,” Hernandez said.
“It also doesn’t fix the real issue,” she added, pointing to her own research which found “that prices have increased because there’s not enough competition in the market, demand will always be high and manufacturers leverage that to their advantage.”
Trump Administration’s Proposed HHS Rule Would Redefine What ‘Sex’ Means
The Health and Human Services Department has proposed to end Obama-era rules that protect transgender people from discrimination in health care. That could impact the Trump administration’s plan to fight HIV.
Trump Administration Proposes Eliminating Protections For Transgender People In ACA
The Department of Health and Human Services has announced a proposal to end Obama-era rules protecting transgender people from discrimination in health care.
Trump Administration Proposes Eliminating Protections For Transgender People In ACA
The Department of Health and Human Services has announced a proposal to end Obama-era rules protecting transgender people from discrimination in health care.
RACHEL MARTIN, HOST:
The Trump administration wants to redefine the word sex, at least in terms of the Affordable Care Act and who gets protected from discrimination. With us now to explain, NPR’s Selena Simmons-Duffin, who is following this. Thanks for being here, Selena.
SELENA SIMMONS-DUFFIN, BYLINE: Hi.
MARTIN: So explain this. We’re talking specifically about transgender people – right? – and what kind of health care they can receive.
SIMMONS-DUFFIN: Well, in 2016, the Obama administration put out a rule that defined sex to include gender identity and added that as part of the Affordable Care Act. So the rule redefined discrimination on the basis of sex to include termination of pregnancy or pregnancy and gender identity. So it defined that as one’s internal sense of being male, female, neither or a combination of male and female. And that would’ve allowed people who had complaints of discrimination on those bases to bring complaints before the Health and Human Services Office for Civil Rights…
MARTIN: Right.
SIMMONS-DUFFIN: …Which is what fields these kinds of complaints. But the provision never took effect because of two lawsuits that resulted in injunctions. And Roger Severino, the director of the office in the Trump administration, says the new proposal will remove the gender identity language. And that probably makes those lawsuits moot.
MARTIN: OK, but what is the problem the Trump administration is trying to fix here?
SIMMONS-DUFFIN: So Severino was asked that on a press call today. He said if the lawsuits – basically, if the lawsuits had not been successful and the definition was allowed to take effect, it would’ve created billions of dollars in paperwork expenses – he says $3.2 billion over the next five years – to notify people of their rights under the rule and to process their complaints. And part of that, he said, were printing costs and things like translation and the cost of grievance procedures.
More broadly, they say they’re just returning to a plain understanding of the meaning of the word sex – in other words, biological sex or sex at birth.
MARTIN: So it sounds like it was preemptive in nature. It has to do with whether or not those lawsuits were going to go through, and they’re not anymore. And then this other, more philosophical idea of what sex means – I mean, what does this signal to transgender people?
SIMMONS-DUFFIN: So advocates for trans people were expecting this, and they’re already reacting this morning. They say in addition to making it more permissible for health care workers to discriminate against trans people, it could discourage them from seeking care in the first place, which could have serious health impacts.
MARTIN: Part of what they’re changing has to do with something called conscience rights, correct?
SIMMONS-DUFFIN: Right. So part of the definition of sex that’s being changed today would have prohibited discrimination based on pregnancy or termination of pregnancy. So this new rule, if adopted, would remove that protection as well. And Severino said that will protect health care providers who do not want to perform abortions or other procedures that go against their moral or religious beliefs.
MARTIN: Thus, conscience protections – conscience rights.
SIMMONS-DUFFIN: Right. Exactly.
MARTIN: So just briefly, why do you think this is happening now?
SIMMONS-DUFFIN: Well, this is what Severino really came in to do. He was formerly with the Heritage Foundation. He’s been very vocal about his religious beliefs and protecting those of others. He’s really shaping his Office of Civil Rights to emphasize the protections of health care workers’ moral and religious beliefs. And the changes today are part of that.
MARTIN: All right. NPR’s Selena Simmons-Duffin for us. Thank you. We appreciate it.
SIMMONS-DUFFIN: Thank you.
Copyright © 2019 NPR. All rights reserved. Visit our website terms of use and permissions pages at www.npr.org for further information.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.