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The progress the world has made in reducing maternal mortality has stalled in recent years, with some regions — including Europe and Northern America — backsliding since 2015, according to a new report from United Nations agencies. (Joseph, 2/22)

In two of the eight UN regions – Europe and Northern America, and Latin America and the Caribbean – the maternal mortality rate increased from 2016 to 2020, by 17% and 15%, respectively. The report, however, noted there was a significant reduction in maternal deaths between 2000 and 2015, where they fell roughly 2.7% every year, but the progress largely stalled or even reversed after a point. (Roy, 2/23)

In the United States, maternal deaths rose sharply during the pandemic. In 2021, hundreds of deaths resulted from pregnancy complications exacerbated by Covid infections, according to data from the U.S. Government Accountability Office. But while the pandemic may have contributed to maternal deaths worldwide, it “does not explain the stagnation that we’re seeing,” said Dr. Jenny Cresswell, an epidemiologist at the W.H.O. and one of the new report’s authors. (Caryn Rabin, 2/22)

“While pregnancy should be a time of immense hope and a positive experience for all women, it is tragically still a shockingly dangerous experience for millions around the world who lack access to high quality, respectful health care,” said WHO Director-General Tedros Adhanom Ghebreyesus. (McShane, 2/22)

The U.S. government health plan for people over the age of 65 on Wednesday said it would not reconsider strict coverage limits put in place last year for new Alzheimer's treatments, rejecting a request from the Alzheimer's Association. (Beasley, 2/22)

The insurance industry and Republicans are using the debt ceiling fight and President Biden’s vows not to cut Medicare to fend off changes to private Medicare Advantage plans, which are popular among the public but have faced criticism about their costs to the government. (Hellmann, 2/22)

More news, from the Biden administration —

Today, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices kicks off a three-day meeting to discuss a variety of vaccinations. This meeting is one of the group’s regularly scheduled discussions, which typically occur three times a year, and comes with a hefty agenda, including mpox, respiratory syncytial disease and Covid-19 immunizations. (Lim and Ellen Foley, 2/22)

The Food and Drug Administration (FDA) on Tuesday widened an advisory on artificial tear products to include additional ones manufactured by Global Pharma Healthcare Private Limited over concerns of a potential bacterial contamination that could result in blindness or death. The FDA warning now urges consumers and health care professionals not to use EzriCare Artificial Tears, Delsam Pharma’s Artificial Tears and Delsam Pharma’s Artificial Eye Ointment, which are intended to be sterile. (Mueller, 2/22)

Under the draft rules, the agency recommends that beverage makers label their products clearly by the plant source of the food, such as “soy milk” or “cashew milk.” The rules also call for voluntary extra nutrition labels that note when the drinks have lower levels of nutrients than dairy milk, such as calcium, magnesium or vitamin D. They would continue to allow labels that note when plant-based drinks have higher levels. Fortified soy milk is the only plant-based food included in the dairy category of U.S. dietary guidelines because of its nutrient levels. (Aleccia, 2/22)

For tobacco manufacturers — including e-cigarette manufacturers — to legally sell products, they must demonstrate to the FDA that their products are appropriate for the protection of public health, meaning potentially beneficial for adult smokers and not appealing to minors. If the FDA issues marketing orders for various products, they can be displayed on store shelves; so far, the agency has authorized only 23 e-liquid products and has denied millions more. (Ellen Foley, 2/22)

For the first time ever, the Food and Drug Administration has fined four businesses that have ignored its orders to stop selling unapproved vapes. The move is the latest escalation by the agency’s tobacco center, which has been criticized in recent months for allegedly standing by while vape and tobacco companies ignore its rules. (Florko, 2/22)

Also —

The Air Force’s review of cancers among its nuclear missile corps will include all personnel who worked on, guarded, supported or operated the nation’s ground-based warheads, Air Force Global Strike Command announced Wednesday. (Copp, 2/22)

Mass shootings in America invariably raise questions of fault. The police’s delayed response outside an elementary school in Uvalde, Texas. A district attorney’s failure to prosecute the alleged Club Q shooter a year before five were killed in the LGBTQ nightclub. That finger of blame, however, rarely lands on the manufacturer of the guns used in the massacres. (Bedayn, 2/22)

Major abortion rights organizations and private law firms have teamed up to provide legal counsel to patients and providers navigating the complicated patchwork of U.S. abortion laws, the groups said on Wednesday. The newly created Abortion Defense Network, which includes such groups as the Center for Reproductive Rights and the American Civil Liberties Union (ACLU), said it will match people providing or supporting abortion services to attorneys who can defend them in a rapidly shifting legal landscape. (Borter, 2/22)

A New Mexico legislative panel advanced a bill to protect abortion providers and patients from out-of-state interference, prosecution or extradition attempts, as Democratic leaders seek to shore up existing rights to abortion access for residents as well as visitors from states with bans on the procedure. (Lee, 2/23)

A bill allowing abortion in case of rape, incest, fetal abnormality was filed in Kentucky. Current trigger, heartbeat laws are total ban. (Acquisto, 2/22)

More than 1,000 health care providers across North Carolina have signed a letter urging lawmakers to oppose any additional abortion restrictions beyond the current 20-week limit, which some say already restricts their ability to care for patients. While Republicans in the General Assembly have not yet filed legislation this year to further restrict abortion access, the GOP legislative leaders have repeatedly signaled their intention to do so. (2/22)

In news about abortion medication —

West Virginia's attorney general is urging a judge to dismiss a lawsuit seeking to overturn the state's restrictions on the abortion pill. State Attorney General Patrick Morrisey on Tuesday asked the federal court in West Virginia's southern district to throw out the suit brought by GenBioPro, which manufactures the generic version of the abortion pill called mifepristone. (Kimball, 2/22)

The fight over abortion pills has been escalating since before Roe v. Wade was overturned, but the pills' availability is in danger now more than ever. With pills now accounting for the majority of abortions, opponents of the procedure are focusing on legislatures and courts to erect barriers. But that's triggering thorny legal questions, foremost of which is playing out in a federal court in Texas over whether the FDA has the final say on whether the pills are safe. (Gonzalez and Chen, 2/22)

Soon after the Supreme Court overturned Roe v. Wade, a former Republican congressman made what might sound like an unusual offer. Did abortion pill makers want him to try to get federal legislation passed to explicitly stop states from restricting medications that have been approved by the Food and Drug Administration? (Boodman, 2/23)

Also —

A lawyer’s attempt to have his pregnant client released from jail ahead of trial by arguing that her fetus has been subject to “unlawful and illegal detention” could have profound consequences for the rights of women in Florida. (Wong, 2/23)

The Justice Department on Wednesday indicted eight people under the Freedom of Access to Clinic Entrances Act, or the FACE Act, for an incident that took place outside an abortion clinic in Michigan in 2020, adding to the growing list of the DOJ’s prosecutions of abortion clinic protesters.(Herlihy, 2/22)

In Indiana, Wednesday’s Senate bill is the second approved this week that opponents say targets trans people. Residents shared testimony, their voices often shaking in anger or getting choked up with tears, as protesters cheered with joy outside the Senate chambers. A similarly enthusiastic crowd chanted outside House chambers Monday after lawmakers advanced a bill in committee that would require public school teachers to divulge students’ social transitions or pronoun changes to parents. (Rodgers, 2/22)

A bill introduced in the Texas Senate is triggering alarm among LGBTQ+ advocates in the state, who say it would make nearly all gender-affirming health care illegal, including both surgical and nonsurgical treatments — even for trans adults. "While we've seen several bills that would criminalize life-saving health care for trans people, none go as far as this," Rachel Hill, the government affairs director at the advocacy organization Equality Texas, told CBS News. (Mandler, 2/22)

Senate Bill 140 was passed on a 10-4 vote Wednesday by the Senate Health and Human Services Committee. It would ban most sex reassignment surgeries and hormone replacement therapies. However, unlike laws adopted in some other states, it would still allow doctors to prescribe medicines to block puberty. (Amy, 2/22)

Meanwhile, Indiana lawmakers take aim at a famous sex research institute —

Indiana Republican lawmakers voted Wednesday to prohibit Indiana University from using any state money to support its sexual research institution after a far-right legislator unleashed disputed allegations of child exploitation by its founder and famed mid-20th century researcher Alfred Kinsey. The Indiana House voted 53-34 to block state funding toward the Kinsey Institute that has long faced criticism from conservatives for its ongoing research and the legacy of Kinsey’s work that they blame for contributing to liberalized sexual morals, including more acceptance of homosexuality and pornography. (Davies, 2/22)

Americans say they're worried about opioids and gun violence, but what they really want the government to tackle is rising drug costs and health bills, according to the new Axios-Ipsos American Health Index. Pocketbook health issues still resonate the most with voters, who are increasingly convinced businesses and politicians don't have their backs. (Bettelheim, 2/23)

In other news concerning public health —

Strep A is back on parents’ radar after an 11-year-old boy reportedly died of a bacterial infection after being injured at the gym. Jesse Brown, a healthy fifth-grader in Winter Park, Fla., was using a treadmill at a gym when he rolled his ankle. The boy was healing but soon developed a red and purple rash on his leg, Good Morning America reported Feb 19. (Prater, 2/22)

This year’s flu shot generated relatively robust levels of protection, new data show, with the vaccine’s effectiveness ranging between about 45% and 55%, depending on the age group and the metric studied, such as whether there was protection against any infection or infection that was severe enough to require hospitalization. (Branswell, 2/22)

The vaccines were more than 40% effective in preventing adults from getting sick enough from the flu that they had to go to a doctor’s office, clinic or hospital, health officials said during a Centers for Disease Control and Prevention vaccines meeting Wednesday. Officials generally are pleased if a flu vaccine is 40% to 60% effective. (Stobbe, 2/22)

When I inquired about cannabis products at a vape shop on the west side of Kansas’ capital city, the employee asked me one question: “Do you have pain, or are you trying to get f—- up?” There were plenty of options for the latter — especially for someone with a sweet tooth. (Florko, 2/23)

Meanwhile, some fascinating medical history is in the news —

When archaeologists uncovered the burial site of two brothers who lived during the 15th century BC in Israel, they were surprised to discover that one of them had brain surgery shortly before he died. The finding marks the earliest example of trephination, a type of cranial surgery, found in the ancient Near East. (Strickland, 2/22)

Also —

KHN: Looming Cuts To Emergency SNAP Benefits Threaten Food Security In Rural America
On a cold morning in early February, Tammy King prepared and loaded boxes and bags of vegetables, fruits, milk, frozen meat, and snacks into cars lined up outside the Friends in Service Helping food pantry, known in rural northeastern Nevada as FISH. (Orozco Rodriguez, 2/23)

KHN: States Seek Crackdown On Toxic Ingredients In Cosmetics To Close Gaps In Federal Oversight
Washington has joined more than a dozen other states in seeking to crack down on toxic substances in cosmetics after a state-funded study there found lead, arsenic, and formaldehyde in makeup, lotion, and hair-straightening products made by CoverGirl and other brands. (Scaturro, 2/23)

Exposure to “forever chemicals” interferes with several critical biological processes — including the metabolism of fats and amino acids — in children and young adults, a new study has found. The disruption of these processes can increase susceptibility to a variety of illnesses, such as developmental disorders, cardiovascular disease, cancer and metabolic diseases like diabetes, according to the study, published on Wednesday in Environmental Health Perspectives. (Udasin, 2/22)

Pancreatic cancer rates are rising faster among women than men, according to a new study by researchers from Cedars-Sinai Cancer in Los Angeles, California. The findings were published recently in the journal Gastroenterology. (Rudy, 2/22)

A randomized controlled trial in four European nations found that implementing a multifaceted antibiotic stewardship intervention safely reduced antibiotic prescribing for urinary tract infections (UTIs) in frail older adults, researchers reported today in The BMJ. (Dall, 2/22)

Research presented at this week's Conference on Retroviruses and Opportunistic Infections (CROI) suggests that the use of doxycycline after sex to prevent sexually transmitted infections (STIs) may not significantly increase resistance to the antibiotic. (Dall, 2/22)

Electronic health records do not accurately reflect some social determinants of health, a new study published in JAMA found. Screenings of food insecurity, housing instability and financial strain in adult primary care were found to reach varying levels of accuracy. (Burky, 2/22)

In research relating to covid —

A recent meta-analysis in the Lancet compared protection conferred upon individuals by prior infection from COVID-19 and vaccination against the virus and found protection from a prior COVID infection to be on par with the shot. But one expert argued that this interpretation misses the nuances in the meta-analysis, which looked at 65 studies from 19 countries published up until Sept. 30, 2022, and therefore could not fully take into account how prior infection fared against the omicron variant and its growing list of subvariants. (Diamond, 2/22)

COVID-19 outpatient treatment information on US state public health department websites is difficult to read and access, especially for people with low literacy or limited English language proficiency and in states with Republican governors, according to a research letter published yesterday in JAMA Network Open. (Van Beusekom, 2/22)

A majority of Americans in a new poll say they’d be uncomfortable with their health care provider relying on artificial intelligence (AI) as part of their medical care, and less than half think using AI would lead to better health outcomes. A Pew Research poll released Wednesday found just 39 percent of U.S. adults say they’d feel comfortable with AI as part of their medical care — in practices like screening, diagnosis and treatment — while 60 percent would feel uncomfortable. (Mueller, 2/22)

Health tech companies are in a tizzy: After years of letting companies roll out software tools to guide patient care with little oversight, the Food and Drug Administration is taking a tougher stance. In September, the FDA announced its intentions to regulate many of these AI-powered clinical decision support (CDS) tools as devices — which regulators say has always been their plan and within their purview. (Lawrence, 2/23)

On developments relating to treatments and therapies —

Advisers to the U.S. Centers for Disease Control and Prevention (CDC) on Wednesday voted in favor of use of Bavarian Nordic's (BAVA.CO) Jynneos vaccine for all adults at risk of mpox during an outbreak. The panel of outside experts voted unanimously in favor of use of two doses of the vaccine, and finalizing the interim guidelines provided by CDC during the mpox outbreak in the United States. (2/22)

Pfizer yesterday announced that the US Food and Drug Administration (FDA) has accepted it licensing application, which starts the review of its candidate respiratory syncytial virus (RSV) vaccine (RSVpreF) for use in pregnant women to help protect babies against the virus. In a press release, Pfizer said the FDA's review will be done on a priority basis and that the agency expects a decision in August. In December, the FDA granted priority review of the vaccine for use in older adults. (Schnirring, 2/22)

Moderna Inc (MRNA.O) said on Wednesday its experimental personalised mRNA skin cancer vaccine in combination with Merck & Co Inc's (MRK.N) drug Keytruda has received breakthrough therapy designation from U.S. regulators as an additional treatment for high risk patients. (2/22)

Meanwhile, a new drug to combat HIV shows promise —

“We were so confident in Cabenuva. We’re certain that people, no matter what they were on, actually could derive a benefit from being on Cabenuva,” ViiV’s R&D head Kim Smith, M.D., said in an interview. In the SOLAR trial, five of 447 patients (about 1%) who switched from Biktarvy to Cabenuva had detectable HIV at or above 50 viral copies per milliliter of blood at 12 months. Among 223 patients who stayed on their original Biktarvy regimen, one (less than 1%) had detectable HIV. (Liu, 2/22)

British drugmaker GSK's (GSK.L) HIV treatment division, ViiV Healthcare, published data on Wednesday showing its long-acting HIV injection is as effective as the market-leading daily pill made by Gilead Sciences Inc (GILD.O). GSK's ViiV ran the so-called "head to-head" clinical study on its own injection Cabenuva, which is given every two months, and Gilead's Biktarvy, an oral pill taken daily. (Fick, 2/22)

In other industry news —

After an FDA approval last year, Eli Lilly’s diabetes drug Mounjaro has been on fire right out of the gate. Now, the Indianapolis pharma giant says it's resolved a months-long shortage. Lilly has satisfied wholesalers’ backorders for Mounjaro and is continuingly shipping all six doses of the diabetes med, a company spokesperson said. (Liu, 2/22)

Diabetes patients said they are spending hours trying to find nearby pharmacies that have their prescriptions in stock. If they don’t, some patients have had to reduce dosing of Ozempic and similar drugs to stretch out their supplies, or switch to alternative drugs. (Loftus, 2/22)

Gilead Sciences is no stranger to legal claims surrounding its market-leading HIV franchise. Now, the company and two other major biopharma players are heading to trial over claims they worked together to restrict competition in the marketplace. (Becker, 2/22)

Moderna is aiming to build a gene editing franchise powered by some of the same technologies used in its COVID-19 vaccines. The Cambridge biotech company announced Wednesday that it will partner with Life Edit Therapeutics to develop potentially permanent treatments for rare genetic diseases and other conditions. (Cross, 2/22)

Amazon said Wednesday it has closed its $3.9 billion acquisition of the primary care organization One Medical. The e-commerce giant has said the buyout, which was announced in July, is a key component of its growing health care business, which includes its online drugstore Amazon Pharmacy and a patient to doctor messaging service called Amazon Clinic. (Hadero, 2/22)

The first report card on the state of the nation’s primary health care is out today, and it’s nothing to brag about. The report comes in response to a 2021 report by the National Academies of Sciences, Engineering, and Medicine, which called for a scorecard to be developed to monitor — and improve — America’s primary care. (Mahr and Payne, 2/22)

Payroll expenses at health systems nationwide increased by nearly 10% last year, highlighting continued issues with wage inflation and increased competition to recruit full-time employees. The number of healthcare workers slowly has been picking up, but the higher headcount only contributes in small part to the increased labor costs, according to healthcare consulting firm SullivanCotter. (Devereaux, 2/22)

Environmental Protection Agency (EPA) Administrator Michael Regan said officials will not “second-guess” the symptoms that the people of East Palestine, Ohio, are experiencing following the train derailment earlier this month. Regan said in an interview on “CNN This Morning” on Wednesday that the tests that have been conducted on the water and the air in the local community have shown that they should not be causing adverse health effects. (Gans, 2/22)

The chemicals that spilled and were later burned near East Palestine, Ohio, after the Feb. 3 train derailment have the kinds of names that bring back visions of high school chemistry: vinyl chloride, butyl acrylate and isobutylene. Scientists know the names well, along with the harms these chemicals can cause to the environment and human health — from irritation of the eyes and skin to breathing difficulties and cancer — raising major concerns about exposure and contamination in the wake of the incident. (Chow and Abou-Sabe, 2/22)

Residents of East Palestine and the surrounding areas could be able to claim Medicare under a little-known clause of the Affordable Care Act that gives victims of environmental disasters extended coverage—though it remains unclear if it will be granted in this case. (Phillips, 2/22)

Most Americans support more regulations on the transportation of hazardous materials in a new poll, which comes after a train carrying dangerous chemicals derailed in Ohio earlier this month. The poll, conducted by The Economist and YouGov, found that 54 percent of American adults supported more regulations on transportation hazardous materials. Twenty-one percent said they supported no changes, 17 percent were not sure and 8 percent said there should be fewer regulations. (Sforza, 2/22)

Meanwhile, in Florida —

The Florida Department of Health’s inspector general last fall investigated Joseph Ladapo, the state’s surgeon general, after the agency received an anonymous complaint alleging he falsified a report focusing on the safety of Covid-19 vaccines for young men. (Sarkissian, 2/22)

In health news from California —

The Sacramento City Council approved a permit for a cannabis dispensary in a 8-0 vote on Tuesday, denying a request to prevent the store from opening near a detox center. City officials said La Krisha Young, the owner of the proposed dispensary and graduate of the city’s equity cannabis program, met requirements and added extra restrictions to respond to the detox center’s concerns. (Lam, 2/22)

California’s birth rate is at its lowest level in roughly 100 years, according to a new report from the Public Policy Institute of California. According to the January report, the number of births hit a peak in 1992 at roughly 613,000 children born. Now, more than 30 years later, that number dropped by nearly a third to 420,000. Authors called the trend “a new baby bust.” (Gonzalez, 2/23)

The state Supreme Court rejected a challenge Wednesday to a ruling that said school districts in California cannot require their students to be vaccinated against COVID-19 because only the state government can issue such a mandate. While public health agencies have recommended the vaccinations for children as young as 6 months old, legislation calling for vaccine mandates in schools has stalled in Sacramento. (Egelko, 2/22)

In other news from across the country —

A state Senate committee recommended permanently reauthorizing New Hampshire’s Medicaid expansion program Wednesday, after a broad coalition of businesses, health care providers and patients testified in support. “The question for us today is: has Medicaid expansion worked?” Republican Senate President Jeb Bradley said at the start of a hearing Wednesday. “And I think you're going to hear a lot of testimony today that the answer clearly and unequivocally is yes.” (Cuno-Booth, 2/22)

COVID had so ravaged Tamika Jones’ lungs she could barely finish a sentence without gasping for breath when the emergency medical technicians arrived at her Delaware County home on Jan. 22, 2021. The 46-year-old struggled to stand, and couldn’t get to the bathroom without a walker. An EMT did not check her temperature, blood pressure, or heart rate — or see if she needed oxygen — yet urged her not to go to the hospital. (Laughlin, 2/23)

A West Virginia legislative panel on Wednesday advanced a bill that would let the state establish “baby box” safe surrender locations. The House Judiciary Committee forwarded the bill to the full House of Delegates. West Virginia’s Safe Haven Law already allows children less than 30 days old to be turned over to a hospital, health facility or fire department that is staffed 24 hours a day. (2/22)

The United States banned leaded gasoline for cars long ago, but smaller aircraft continue to use the fuel — and it’s exposing hundreds of thousands of children to lead poisoning. POLITICO’s E&E News reporter Ariel Wittenberg dug into the issue in an investigation this week. She found that fuel producers such as Chevron and Exxon Mobil have repeatedly blocked efforts to create unleaded fuels for small aircraft. (Skibell, 2/22)

Few studies have reported the long-term health effects of COVID-19. The regional population-based Linköping COVID-19 study (LinCoS) included all patients hospitalised due to COVID-19 during the first pandemic wave. (Wahlgren, et al, 2/23)

Researchers have created and preliminarily tested what they believe may be one of the first models for predicting who has the highest probability of being resistant to COVID-19 in spite of exposure to SARS-CoV-2, the virus that causes it. (Johns Hopkins Medicine, 2/22)

Does ivermectin, with a maximum targeted dose of 600 μg/kg daily for 6 days, compared with placebo, shorten symptom duration among adult (≥30 years) outpatients with symptomatic mild to moderate COVID-19? (Susanna Naggie, MD, MHS, David R. Boulware, MD, MPH and Christopher J. Lindsell, PhD, 2/20)

Unilateral focused ultrasound ablation of the internal segment of globus pallidus has reduced motor symptoms of Parkinson’s disease in open-label studies. (Krishna, M.D., et al, 2/23)

The shouting began soon after my son was born. “We’ve got an inversion!” the doctor yelled to his team. Moments earlier, a nurse had pressed my newborn son against my chest. I bent to kiss his dark curls through my surgical mask, then he and my husband were escorted out of the operating room. (Lisa Rab, 2/23)

Front-line workers at HCA hospitals from California to Florida have experienced the same struggles, while the corporation made more than $16 billion in profits in the past three years. (Erika Watanabe, 2/23)

I’ll never forget my parents’ reaction when I was accepted to the University of California at San Francisco’s medical school. Having attended segregated schools, my mother and father were thrilled that their daughter would attend a fully integrated, top-tier institution. (Marilyn Singleton, 2/22)

A recent study published in JAMA Network Open found that people with long COVID are more likely to be unemployed, particularly if they suffer from cognitive symptoms that make holding on to full-time employment difficult if not impossible. (Kimberly Atkins Stohr, 2/22)

Our collective response to the COVID-19 pandemic constituted history's biggest public health mistake. We did not properly protect older high-risk Americans, while many ineffective COVID restrictions have generated long-term collateral public health damage that is now upon us. Both have yielded excess deaths. Public health crashed. (Martin Kulldorff and Jay Bhattacharya, 2/22)

Also —

The silence from corporate America amid new attacks on women’s reproductive health care has been deafening. As the federal courts consider whether to override the FDA’s judgment on first-trimester abortion pills, it’s time for health care leaders to speak out about the repercussions of taking away medical sovereignty from 40 million women. (Paul J. Hastings, 2/23)

Minnesota's state legislators are considering a pair of bills that could inadvertently restrict patients' access to new medicines and drive high-paying biotech jobs out of the state. (John Stanford, 2/22)

When Kris Kobach is your attorney general, you can count on him to do Kobach things. But it’s a little unusual for someone as large and sophisticated as pharmacy titan Walgreens to roll over for him like the company did on Mifepristone, a drug commonly used to induce abortion. Over the past couple of weeks, Kobach threatened Walgreens with prosecution if the company tries to distribute the drug through its pharmacies in Kansas — and Walgreens blinked. (Dion Lefler, 2/22)

Hospitals annually discard an estimated $3 billion a year in unused prescription medications nationwide. The value of unused drugs thrown away by long-term care facilities: another $2 billion annually. (2/22)