Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

Q: The story says the federal government is paying about $2,250 per patient for a standard 5-day treatment course. It also notes that the approved alternative treatments are less expensive. The story points out that the benefits of peramivir have yet to be proven and that it is being offered only because some patients are not helped by approved drugs or are they are so sick they need a drug that can be given intravenously. The approved antiviral drugs are currently available only in pill or inhaled form. The story should have mentioned the side effects seen in clinical trials so far, as well as the risk that patients could suffer harms like those sometimes seen in people who have been given similar antiviral drugs. These side effects are clearly spelled out in an FDA fact sheet prepared for patients and caregivers: “The most common side effects of PERAMIVIR are: • diarrhea • nausea • vomiting • white blood cell count decreased These side effects may go away after you stop receiving PERAMIVIR. These are not all the possible side effects of PERAMIVIR. Peramivir is still being studied so it is possible that all of the risks are not known at this time. Other medicines that are used to treat people with 2009 H1N1 flu have side effects that may also happen in people who receive PERAMIVIR. These side effects include: • Signs of unusual behavior. People with the flu, especially children and adolescents, may be at a higher risk for seizures, confusion, or abnormal behavior early in their illness. These events may happen after starting PERAMIVIR or may happen if the flu is not treated. These events are not common. Patients should be watched for signs of unusual behavior. • Allergic reaction or severe rash Not a lot of people have taken PERAMIVIR for 5 days or longer. Serious and unexpected side effects may happen. The side effects of getting any medicine by vein are brief pain, bleeding, bruising of the skin where the needle enters, soreness and swelling at that spot, and possible infection at that spot.”  Patient fact sheet available at: http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM187799.pdf Provider fact sheet available at: http://www.fda.gov/downloads/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/UCM187811.pdf The story points out more than once that peramivir is still being tested and that questions remain about its potential effectiveness. The story points out that the experimental drug is being offered only to patients who are already in the hospital and aren’t being helped by approved drugs. The story did not point out that one of the supporters of faster and broader access to peramivir, Dr. Richard Whitley, has long been a booster of the drug, which is being commercially developed by a spin-off of the University of Alabama department he works in. See Whitley comments in a 2005 article promoting the potential of peramivir: http://main.uab.edu/show.asp?durki=87834 Here we also point out that the story profiled only one patient and includes a quote from the patient’s father crediting peramivir with saving his daughter’s life. The story does not give any examples of similar patients who either survived after getting approved drugs or who received peramivir and yet did not survive. Despite the clear caveats in the story, the reliance on only a single anecdote may give readers a skewed sense of the benefits of the unapproved drug. The story makes clear that the approved antiviral flu drugs are Tamiflu and Relenza. The story makes very clear that peramivir is experimental and is being offered only because some patients cannot take or aren’t helped by approved antiviral drugs. The story is quite clear that peramivir is still being tested. The story does not appear to rely on a news release.

A: New Drug for H1N1 Flu Offers Hope
****
Q: Although there was no discussion of costs, the article was clear in stating that vaccines are for the most part in an early stage of development, so this omission is understandable. We wanted to see better coverage of the data here. The story leads with an anecdote about a patient who kicked a pack-a-day smoking habit after treatment with a nicotine vaccine in a study. And later, the story says that smokers who received that vaccine were “about three times as likely to be off cigarettes 44 weeks after vaccination than subjects given a placebo.” The story should have provided the absolute rates of success reported in the study, which were only 16% for the treatment group compared with 6% for the placebo group, according to theheart.org. Elsewhere, the story describes an experimental anticocaine vaccine that was apparently very effective in a mouse study; it could have reported on phase II human data that is available for the TA-CD anticocaine vaccine that was also mentioned in the story. These data again suggest that only a minority of patients may benefit from the use of anti-addiction vaccines. The story states that “clinical trials have so far revealed no significant side effects” from vaccine treatments. However, we think the story should have included an important caveat: that these are early stage trials involving small numbers of patients that can’t provide conclusive evidence of safety. In addition, it should be recognized that addictions are chronic conditions and these vaccine treatments are likely to be long-term as well. Therefore, longer-term adverse effects should be expected, especially for a treatment that interferes with molecules closely related to the body’s natural chemical messengers. The story could have been a bit more circumspect on this point. The promise of this new vaccine technology is counterbalanced by coverage of the uncertainties. The story gives appropriate weight to the disappointing results reported in a number of early clinical studies, noting: “Failures have so far outnumbered successes.” The story adds that even in one of the successful vaccine studies, the benefits were not as robust as those seen with a smoking cessation drug that is already on the market. There also is no prospect for a vaccine to treat alcoholism, according to the story. The article should have been more direct about the limitations of mouse research, and there was not enough detail on the data published in the various studies reported on (a deficiency we address under the “Benefits” criterion). However, since the story was trying to present a broad overview of happenings in the field and wasn’t attempting to summarize any particular study, we’ll give the benefit of the doubt here and award a satisfactory. The story didn’t exaggerate the effects of substance abuse disorders or otherwise engage in disease-mongering. The sourcing of this story was good. We hear from academics, government researchers, and industry executives. Their voices provide balance and give texture to the coverage. It should be noted, however, that most of these experts have a vested interest in the field or the success of a particular treatment, whether because of industry ties or because they are leading experiments on a particular approach. Even the government experts might be biased by their provision of significant financial support for research in this area. It would have been nice to hear a comment about the vaccines from someone who is certifiably free of all potential conflicts. But we can’t justify docking points since there is no voice that is overly enthusiastic about the concept. The story compares the potential of vaccines with the benefits of existing medications for addiction–and notes that the available drugs might work better. We would like to have seen more ink given to the role of behavioral approaches in the management of addiction, which are supported by considerable evidence. However, the story does acknowledge that vaccines “would likely be used alongside psychological therapy.” We’ll call it good enough for a satisfactory. The article helpfully states that “It could be years, if ever, before any vaccines to treat addiction reach the market.” The article does a good job of describing how far along the various experimental vaccines mentioned in the article are in their development. Although the story could have provided more background on the history of anti-addiction vaccines (a heroin vaccine was explored in the 1970s), the treatments being explored now are different from anything currently available. So we don’t think this story overstates the novelty of the research. This story is not based on a news release.

A: Quest for Vaccines to Treat Addiction
****
Q: The chamber’s top Republican, who said he was making enactment of the bill “one of my highest priorities,” issued his proposal at a time when the use of e-cigarettes is growing and underage vaping has soared, raising concerns by health expert s. The measure would apply to all tobacco products, e-cigarettes and vapor products and was co-sponsored by Sen. Tim Kaine, D-Va., whose state has also been a major tobacco producer. “Kentucky farmers don’t want their children to get hooked on tobacco products while they’re in middle school or high school any more than any parents anywhere want that to happen,” McConnell said on the Senate floor. Fourteen states, including Arkansas, California and Virginia, have enacted laws raising the minimum age for tobacco sales to 21, according to the anti-smoking Campaign for Tobacco-Free Kids. So have 470 municipalities, including New York City, Chicago, Boston and Minneapolis. Even so, the use of e-cigarettes and vaping has surged, with much of the increase among teenagers. The CDC says most e-cigarettes contain highly addictive nicotine, which can harm the development of young people’s brains and may them likelier to smoke cigarettes later in life. “Youth vaping is a public health crisis,” McConnell said. “It’s our responsibility as parents and public servants to do everything we can to keep these harmful products out of high schools and out of youth culture.” A government survey found that last year 1 in 5 U.S. high school students reported vaping the previous month. “Today, we are coming together to side with young people’s health,” said Kaine, acknowledging the rarity for bipartisan legislation at a time when the two parties can seldom find middle ground. The bill quickly won the endorsement of the American Cancer Society. Its advocacy organization, the Cancer Action Network, said the measure was a “welcome indication that Congress is taking the alarming crisis of increased youth tobacco use seriously and is committed to taking action.” The group also warned the sponsors to resist amendments that could let the federal government pre-empt stronger measures by states and municipalities, exempt some young people or exclude certain products. A similar bill was introduced last month by Sens. Brian Schatz, D-Hawaii, Todd Young, R-Ind., Dick Durbin, D-Ill., and Mitt Romney, R-Utah. Most experts agree e-cigarettes are less harmful than the paper-and-tobacco variety because they don’t produce all the cancer-causing byproducts found in smoke. But researchers say they are only beginning to understand the risks of e-cigarettes, which they think may damage the lungs and contribute to precancerous growths. McConnell has long been involved in tobacco issues. He helped pass the 2004 tobacco buyout, when the government provided billions of dollars for growers who lost money with the end of federal price supports. Kentucky has the highest cancer mortality rate in the country, with nearly 186 deaths per 100,000 residents in 2017, according to the federal Centers for Disease Control and Prevention. As health concerns about tobacco have grown in the U.S., demand and production of the crop have fallen in Kentucky, where it had long been a pillar of the state’s economy. Growers have been relying increasingly on industrial hemp, which McConnell has helped legalize. The CDC calls tobacco products the country’s top cause of preventable disease and death, with almost 40 million adult cigarette smokers. The agency says around 4.7 million middle school and high school students use at least one tobacco product, including e-cigarettes. Treating adults with smoking-related diseases costs the country nearly $170 billion annually for medical care. The country’s biggest tobacco company, Altria Group, has invested in the e-cigarette company Juul and has backed bills raising the minimum age for buying tobacco and vaping products to 21. Critics have suggested that support is aimed at forestalling tougher restrictions such as banning flavored vaping products and menthol cigarettes. ___ AP Health Writer Matthew Perrone contributed to this report.

A:
Senate GOP leader would raise age for buying tobacco to 21.
****