Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.

Q: Paragraph: Keytruda is already approved as a cost-effective treatment in melanoma and the National Institute for Health and Care Excellence also on Dec. 2 approved its use in the treatment of lung cancer patients who had started on chemotherapy, after Merck & Co cut the price further for the NHS. But trial data so far on the survival benefit of Keytruda as an initial lung cancer treatment has not been reliable enough,   according to NICE’s draft guidance, which will be subject to public consultation until 21 March. “The exact size of the overall survival gain for Keytruda compared to the current standard of care was uncertain because of the immaturity of the data,” a NICE spokeswoman said. Keytruda has proved effective in fighting non-small cell lung cancer in patients with high levels of a protein called PD-L1, which makes them more receptive to immunotherapy. The average cost of a course of treatment in Britain is around 29,000 pounds ($36,000) at the full list price but the NHS will pay less after getting a confidential discount. ($1 = 0.8042 pounds) Claim: UK rejects Merck's Keytruda as initial treatment for lung cancer.

A: Britain’s healthcare watchdog NICE, which assesses the cost-effectiveness of medical treatments, has stopped short of recommending the use by the National Health Service (NHS) of Merck & Co Inc’s immunotherapy drug Keytruda in newly diagnosed lung cancer patients, after giving the go-ahead in December for patients who had prior treatment.
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Q: Paragraph: No discussion of costs, something we always look for and wish would be provided. As already noted, the story explained that the drug “isn’t a magic bullet. The study showed that 37 percent of women who got weekly injections of it delivered prematurely, compared to 55 percent of women who got injections of a placebo.” Good discussion of concerns and ongoing monitoring of the drug’s safety. The story explains the drug “isn’t a magic bullet. The study showed that 37 percent of women who got weekly injections of it delivered prematurely, compared to 55 percent of women who got injections of a placebo.” No disease-mongering of prematurity or its consequences. The medical director of The March of Dimes was quoted throughout. (Although they are seen as having a very pro-progesterone slant that is not held by consumer/advocacy/health policy/maternity care groups in UK, Australia, and Canada. in those countries surveys of providers uniformly get low utilization responses with the reason stated being need for more data. Similar surveys of US providers (specialty and generalists) show the vast majority use >70% (as opposed to low double digits in more evidence-driven countries) and that mission creep has started. Indications for which it is not tested see regular use in the US.) There was at least the historical perspective on “the last drug thought to prevent premature birth – a synthetic estrogen called diethylstilbesterol, or DES.” The focus of the story is FDA approval of the drug. Good historical context, explaining that “Interestingly, the drug is not new — it’s just taken a long and circuitous route to approval.” It’s clear the story didn’t rely solely on a news release. Claim: FDA Approves First Drug To Prevent Preterm Births

A: Given that 50% of care is covered by Medicaid and 49% by private payors, the costs for this drug are invisible to the individual. It is administered in clinic or by home health nurses and does not typically have a co-pay structure although patients will sometimes tell providers they can’t afford it. News of new drug approvals can be washed over with giddy hype. But not in this story, which offered perspective, context and restraint.
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Q: Paragraph: Since Nov. 1, South Carolina has recorded 86 reported cases of the contagious disease. State Epidemiologist Linda Bell said Monday that’s more than four times what state officials normally expect to see. Over the last 10 years, South Carolina averaged 19 reported cases of hepatitis A annually. Most of the new cases have occurred in Aiken County, and almost half of all cases involve individuals who reported drug use, Bell said. Still, the general population needn’t be overly concerned, she said. “But we are seeing cases higher that what we expect to see,” Bell said. “And so it’s important for us to do our prevention efforts early to reach those high-risk groups, get them vaccinated ... so that we can prevent” a severe outbreak. The State reports the Department of Health and Environmental Control is offering no-cost vaccines to high risk groups including drug users, homeless, formerly incarcerated and sexually-active gay men. Additionally, health officials recommend all children get two doses of the vaccine as part of their immunization schedule. Of the 86 reported cases in South Carolina, 59 have led to hospitalization and one resulted in death, the DHEC said. Hepatitis is a disease characterized by inflammation of the liver. It comes in many forms, including hepatitis A, B and C. As a result, individuals with chronic liver disease, like cirrhosis, are at increased risk of complications if infected and should be vaccinated. The virus-borne infection can be prevented by vaccination and is usually transmitted person-to-person through consumption of contaminated food or water, according to the U.S. Centers for Disease Control and Prevention. Antibodies produced in response to hepatitis A infection last for life and protect against reinfection. Infection usually results in sickness in two to six weeks after exposure. Symptoms include fatigue, loss of appetite, stomach pain, nausea, and yellowing of the eyes and skin. Symptoms usually resolve within two months of infection, according to the CDC. State public health officials in February declared an outbreak in Aiken County after an employee at a second restaurant in Aiken tested positive for the virus, the DHEC said. Bell, though, stressed transmission by food or beverage is uncommon. “Most transmission in the United States is through person-to-person contact,” Bell said. “Good hygiene - diligently washing your hands - is a good way to prevent hepatitis A, as well as not sharing personal items,” including drug equipment, she said, adding the state has received reports of hepatitis A from people using various drugs, “everything from marijuana to meth.” Residents can schedule an appointment for a vaccination at their local health department by calling 855-472-3432 or going to http://bit.ly/2HhEsM8 . ___ Information from: The State, http://www.thestate.com Claim: South Carolina declares hepatitis outbreak.

A:
What began as a spike in reported hepatitis A cases in Aiken County has now spread to other parts of South Carolina, prompting public health officials to declare a statewide outbreak.
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