December 27, 2015

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Doctor Behind 'Concussion' Wanted To 'Enhance The Lives' Of Football Players

Dr. Bennet Omalu speaks on stage during the 2015 Health Hero Awards hosted by WebMD on Nov. 5 in New York City.
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Dr. Bennet Omalu speaks on stage during the 2015 Health Hero Awards hosted by WebMD on Nov. 5 in New York City. Bryan Bedder/Getty Images hide caption

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The new Will Smith movie Concussion has put the spotlight back on the dangers of football. Smith portrays Dr. Bennet Omalu, the Nigerian immigrant who was the first to publish research on the degenerative brain disease he called chronic traumatic encephalopathy, or CTE.

Omalu, a forensic pathologist, noticed something strange in 2002 when performing an autopsy of Mike Webster, a famous former player for the Pittsburgh Steelers. In the years following his retirement, Webster suffered from mental and financial problems. He died at age 50 of a heart attack, Omalu said.

Omalu expected Webster’s brain to look like that of a boxer with dementia pugilistica, but it looked normal.

“I remember that moment very vividly. I was so downcast; totally confused. And I felt I had let down Mike Webster,” Omalu recalled.

Omalu took it upon himself to find the source of Webster’s mental problems in the years before his death. A deeply religious man, Omalu believes the spirit is alive after death, and talks with his “patients” accordingly. “I said to him, ‘Mike I will get to the bottom of this, I think there is something wrong with you.'”

Omalu ordered special tests, and even took the brain home for six months to investigate. When looking through stained slides, he told GQ he discovered accumulations of tau proteins, which are associated with diseases like Alzheimer’s.

He searched the scientific literature for similar cases involving football players, but found nothing. This was a new disease, and needed a new name. Omalu settled on chronic traumatic encephalopathy. “Chronic means long term,” Omalu says. “Traumatic means associated with trauma. Encephalopathy means a bad brain.”

The goal, Omalu said, was to “brand” the term CTE — not to sell anything, but to create awareness. “It was more likely to be impactful,” he said. “If I had just published it as a case report without a name in a scientific journal, it would have just fizzled, and become swallowed up by the body of existing literature.”

He found that repetitive impact to the head, like the players take in football, causes microscopic injuries in the brain. Hundreds of these blows over time cause permanent brain damage.

“Sometimes it may take weeks, months, years, decades, sometimes up to 40 years later … and you will now begin to manifest with symptoms like mood disorders, major depression, suicidal attempts, suicides, loss of intelligence … you begin to lose your learned behavior,” Omalu said.

Dr. Bennett Omalu and Will Smith attend a screening of Concussion in Westwood, Calif., on Nov. 23.

Dr. Bennett Omalu and Will Smith attend a screening of Concussion in Westwood, Calif., on Nov. 23. Valerie Macon/AFP/Getty Images hide caption

toggle caption Valerie Macon/AFP/Getty Images

Omalu’s research on CTE had an impact, but not the one he expected. When the NFL responded aggressively, he was genuinely surprised. He thought professional football would welcome his research as a way to “enhance the lives and safety and health of the players,” Omalu said.

“The NFL made a very calculated attempt, very mean attempt to decapitate me professionally,” he said. “They sent a very, very strong letter accusing me of fraud. Accusing me of practicing something that was not science, insinuating I was a voodoo doctor. Calling me all types of names.”

Still, Omalu said he never considered retracting his research.

“I had met the families of the sufferers of this disease. They were suffering in silence, they were suffering in obscurity. And it offended my sense of America. … I used my knowledge and education … to become the voice for the voiceless. To make a difference and enhance the lives of these players.”

Omalu said he’s happy with the way Concussion tells his story. He said he was involved in the whole process of production and wanted to ensure it was historically accurate.

And how about Will Smith playing him on the big screen?

“I think Will Smith did a phenomenal job. Will Smith’s acting reaffirms my belief in the American perfection,” Omalu said.

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Auto Industry Poised To Wrap Up A Blockbuster Year

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Amid falling gas prices and easy access to credit, auto dealers sold a record number of cars and trucks in 2015. The last few weeks of the year may be one of the best times to get a deal.

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MICHEL MARTIN, HOST:

As the year comes to a close, it looks like 2015 will be the year of the automobile. The auto industry is poised to sell a million and a half vehicles by New Year’s. That would be an all-time high. Not only is the year expected to be blockbuster, but more people are expected to buy cars and trucks in the days after Christmas than the rest of December combined. NPR’s Sonari Glinton has covered the highs and lows of the car industry, and he joins us from NPR West. Sonari, welcome.

SONARI GLINTON, BYLINE: It’s good to be with you.

MARTIN: So analysts say this is going to be the best year on record. What is leading to these high sales? Is the economy that great?

GLINTON: Well, consumers are a little stingy elsewhere in the economy, but when it comes to your car, there’s a lot of pent-up demand. So if you remember when the economy bottomed out, we sold almost half as many cars. And right now, the average car on the road is about a decade old. There’s also access to credit, so credit has loosened up. People are defaulting less on their auto loans. Interest rates are low, and there’s an expectation that they’re going to go up. And so people are sort of running to their cars to lock in low interest rates. And cars are safer and more efficient and cooler than they’ve ever been.

MARTIN: But you know, Sonari, just to kind of set the contrast here, you reported on Detroit. And I remember when we talked about the state of the auto industry some years ago. Do you remember that?

GLINTON: What’s funny is I started reporting on Detroit with GM exiting bankruptcy. So it’s been five years of my career, and I remember talking to you during the Super Bowl when this commercial came out. Remember it?

(SOUNDBITE OF CHRYSLER ADVERTISEMENT)

UNIDENTIFIED MAN: What does this city know about luxury, huh? What does a town that’s been to hell and back know about the finer things in life? Well, I’ll tell you – more than most.

GLINTON: And that was a Chrysler commercial. Now, each of the three Detroit automakers has come roaring back. And Chrysler has probably traveled the furthest distance between any of them. They are benefiting a lot from this big sales year.

MARTIN: So what are the cars that are selling?

GLINTON: Well, the reason Chrysler’s benefiting a lot is because of the truck and the compact SUV. So compact SUVs and trucks and SUVs, in general, make up 58 percent of the overall sales of cars. And so that is helping all of the Detroit carmakers.

MARTIN: Is anybody not benefiting from this buying boom?

GLINTON: Hybrids – hybrid sales have taken a hit, in part because gas prices are as low as $2 in parts of the country, and so hybrids have lost a bit of their shine. Also, regular gasoline engines have become a lot more fuel-efficient. In some ways, some of the regular gas engines are more fuel-efficient than some of the lesser hybrids, so there are really fuel-efficient gas cars out there.

MARTIN: Sonari, before we let you go, we talked about the fact that the domestic auto industry has struggled, how autoworkers were certainly pressured to give up a lot in terms of pay and benefits in the recession. What about this year? Has any of that changed?

GLINTON: Well, each of the three Detroit automakers renegotiated their contracts with the UAW. And each of the groups of workers made some gains to get back some of what they lost during the depths of the recession. So wages are going to go up for the first time for a lot of autoworkers, and their share of the profits are going to increase, as well, because of this boom year.

MARTIN: Sonari Glinton covers business for NPR and our Planet Money podcast, and he joined us from NPR West in Culver City. Sonari, thank you.

GLINTON: It’s a pleasure.

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States Deny Pricey Hepatitis C Drugs To Most Medicaid Patients

A 12-week regimen of Harvoni is 90 percent effective in curing an infection with hepatitis C, doctors say. It also costs about $95,000.
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A 12-week regimen of Harvoni is 90 percent effective in curing an infection with hepatitis C, doctors say. It also costs about $95,000. Baltimore Sun/TNS via Getty Images hide caption

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Sarah Jackson had quit abusing drugs and had been sober for six months when she found out she had hepatitis C.

“That was weeks of not sleeping and just constant tears,” she says. “I had already put a lot of that behind me and had been moving forward with my life and this was just a major setback.”

To get rid of the infection, her doctor prescribed Harvoni, one of the new generation of highly effective hepatitis C drugs. But Jackson never started the treatment because her insurance, Indiana’s Medicaid, refused to pay for it.

“There’s nowhere else to go,” says Jackson. “The doctor tried and now I have no other place to turn.”

More than 3 million people in United States are infected with hepatitis C, a virus that can destroy the liver and cause liver cancer. The number of cases is increasing, and most new cases are attributed to injection drug abuse, according to the Centers for Disease Control and Prevention.

In the last few years, new medications have come on the market that can cure hepatitis C with a more than 90 percent success rate. But these new drugs are famously expensive. A full 12-week course of Harvoni costs about $95,000. Because of that, Medicaid in many states restricts who receives the medication.

Medicaid in at least 34 states doesn’t pay for treatment unless a patient already has liver damage, according to a report released in August. There are exceptions—for example, people who also have HIV or who have had liver transplants—but many living with chronic hepatitis C infection have to wait and worry.

“It is just not feasible to provide it to everyone,” says Matt Salo, director of the National Association of Medicaid Directors. “States have to make sure that we’re going to prioritize and that those who need it the most get priority treatment, and that’s what you’re seeing.”

States get a discount on the drugs, but Salo says even if they could cut prices in half, treating everyone with hepatitis C would still cost too much for states’ limited Medicaid budgets.

Officials in Washington state, for instance, estimate that at full price, treating everyone on Medicaid for hepatitis C would cost three times the state’s total pharmacy budget.

States are caught between the high prices and those who say that rationing care is illegal.

“If something is medically necessary, it’s medically necessary and must be covered by the Medicaid program,” says Gavin Rose, an attorney for the ACLU of Indiana.

Rose is representing Sarah Jackson in a class action lawsuit to fight the Indiana restrictions. He argues in the lawsuit that if a doctor says you need a drug, Medicaid must pay for it. The lawsuit cites a recent letter from the Centers for Medicare and Medicaid Services reminding states of the law.

Furthermore, Rose argues, treating hepatitis C early would keep the virus from spreading and actually save money in the long run. “We are talking about drugs that might prevent Medicaid from having to deal sometime in the future with treatment for liver cancer, with treatment for liver transplants,” he says.

There seems to be consensus that the new drugs for hepatitis C are too expensive. Even the U.S. Senate has criticized the pricing in a report released earlier this month. States spent $1 billion last year on Sovaldi, another commonly prescribed hepatitis C drug. A new treatment is set to come to market next year, and that competition may help bring prices down.

In the meantime Sarah Jackson will wait for her lawsuit to get resolved. “This is weighing over me every day. I have to worry about it all the time,” she says.

Despite the anxiety, she’s willing to go through it to help others like her who want to be cured.

This story is part of a reporting partnership with NPR, local member stations and Kaiser Health News.

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