MDR-TB, WHO knew?

From the WHO website:

Multidrug-resistant tuberculosis (MDR-TB) has been recorded at the highest rates ever, according to a new report published today. The report presents findings from the largest survey to date on the scale of drug resistance in tuberculosis.

The report, "Anti-tuberculosis drug resistance in the world", is based on data collected between 2002 and 2006 on 90 000 TB patients in 81 countries. It found that extensively drug-resistant tuberculosis (XDR-TB), a virtually untreatable form of the respiratory disease, has been recorded in 45 countries.

Click here to go to the WHO website:

America's Health Insurance Plans on the offense

From the Wall Street Journal article:

The health-insurance industry is racing to defuse a growing furor over retroactive policy cancellations that have saddled some patients with big medical bills and sparked lawsuits.

America's Health Insurance Plans, an industry group, is pushing a proposal with state regulators that would give consumers the right to appeal such policy cancellations, known as rescissions, to an external panel, whose decisions would be binding. Some insurance companies, eager for even quicker action, are preparing to roll out their own independent review programs.

Click here to access (sub. req.).

Surgeons as consultants to device companies under more scrutiny

From the Wall Street Journal article:

The Senate Special Committee on Aging plans to discuss the practice of device manufacturers retaining surgeons as paid consultants in today's hearing. Sen. Herb Kohl, a Wisconsin Democrat who is chairman of the committee, has proposed legislation that would mandate disclosure of consulting payments by medical-device makers and drug companies.

Click here to access (sub. req.).

Health insurer's action called "egregious"

From the Los Angeles Times article:

One of California's largest for-profit insurers stopped a controversial practice of canceling sick policyholders Friday after a judge ordered Health Net Inc. to pay more than $9 million to a breast cancer patient it dropped in the middle of chemotherapy.

The ruling by a private arbitration judge was the first of its kind and the most powerful rebuke to the state's major insurers whose cancellation practices are under fire from the courts, state regulators and elected officials.

Calling Woodland Hills-based Health Net's actions "egregious," Judge Sam Cianchetti, a retired Los Angeles County Superior Court judge, ruled that the company broke state laws and acted in bad faith.
...
Earlier, Health Net had defended its actions, saying it never would have issued Bates a policy in the first place if she had disclosed her true weight and a preexisting heart condition on her application.

Click here to access the article.

Freestyle reinin'

Inspiring? You Bet!

"Google this'

From the New York Times article:

For 18 months, Google has been working to come up with a product offering and a strategy in the promising field of consumer health information. Until now, the search giant hasn’t had anything to show for its labors other than bumps along the way — delays and a management change.

But on Thursday, Google’s technology for personal health records, which is still in development, is getting a big endorsement from the Cleveland Clinic. The big medical center is beginning a pilot project to link the health information for some of its patients with Google personal health records.

Click here to access the NYT article.

Study delineates cancer dx disparities

From the New York Times article:

A nationwide study has found that the uninsured and those covered by Medicaid are more likely than those with private insurance to receive a diagnosis of cancer in late stages, often diminishing their chances of survival.

The study by researchers with the American Cancer Society also found that blacks had a higher risk of late diagnosis, even after accounting for their disproportionately high rates of being uninsured and underinsured. The study’s authors speculated that the disparity might be caused by a lack of health literacy and an inadequate supply of providers in minority communities. The study is to be published online Monday in The Lancet Oncology.

Click here to access the NYT article.

Perhaps he's never heard of pharmacists?

Check out the Forbes.com article "A Free Lunch" by Paul H. Rubin, Professor of Law and Economics at Emory University and former Chief Advertising Economist at the Federal Trade Commission and Chief Economist at the U.S. Consumer Product Safety Commission; an excerpt:

Drug company reps offer overworked doctors useful, lifesaving information in an efficient manner. The drug companies are of course motivated by profit, but economists have known since Adam Smith that the profit motive is the best way to induce someone to do something useful.

Click here to access the article.

Will off-label uses have another avenue besides CME?

Maybe...from the Wall Street Journal article:

The Food and Drug Administration wants to allow drug companies to give doctors information about unapproved uses of prescription drugs, a controversial move that is already drawing objections from Capitol Hill.

Companies generally aren't allowed to advertise or market such "off-label" uses, though doctors can prescribe drugs for any condition. The FDA has proposed guidelines allowing manufacturers to give physicians reprints of medical journal articles about uses of drugs and medical devices that haven't won the agency's approval.

The regulator is stepping into a high-stakes business issue, because off-label uses of prescription drugs are a mainstay of the industry -- an estimated 21% of drug use overall, according to a 2006 analysis published in the Archives of Internal Medicine.

Click here to access the WSJ article (sub. req.).

ACCME news release re: partnership between ACCME, ANCC, and ACPE

Click here to access.

Institutional conflicts of interest

Interesting survey results just published in JAMA on academic institutional conflicts of interest relating to research (upstream of CME). Click here to read the abstract.

The patient's perspective...what a concept!

Check out the New York Times book review of "When Doctors Become Patients"; an excerpt:

When doctors get sick, they discover fissures in the health system that they didn’t know existed. They learn that seemingly small annoyances they never paid attention to as doctors — like long waiting times or a broken television in a hospital room — really are a big deal when you are the patient. Even doctors who thought of themselves as compassionate recognize they can do better once they experience life as a patient.

The book's author is Columbia University psychiatrist Dr. Robert Klitzman. Click here to read the entire review.

Merck settles whistleblower suit

From the New York Times article:

A sales manager who ''just couldn't abide'' by the way Merck wanted him to market the drugs Vioxx and Zocor to doctors took the lonely step of filing a whistleblower suit against his employer.

Seven years later, Merck & Co. will pay $671 million to settle complaints it overcharged government health programs and gave doctors improper inducements to prescribe its drugs.

Click here to read the article.

Does body double spell double trouble for Dr. Jarvik?

From the New York Times article:

Dr. Robert Jarvik is best known for the artificial heart he pioneered more than a quarter-century ago. Since then he had toiled in relative obscurity — until he began appearing in television ads two years ago for the Pfizer cholesteral drug Lipitor.
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Some of the questions may involve his credentials. Even though Dr. Jarvik holds a medical degree, for example, he is not a cardiologist and is not licensed to practice medicine. So what, critics ask, qualifies him to recommend Lipitor on television — even if, as he says in some of the ads, he takes the drug himself?

And, for that matter, what qualifies him to pose as a rowing enthusiast? As it turns out, Dr. Jarvik, 61, does not actually practice the sport. The ad agency hired a stunt double for the sculling scenes.

Click here to access.

"Never pay" PA policy for never events...

From the Philadelphia Inquirer article:

In 2006, 11 hospital patients in Southeastern Pennsylvania died after getting transfusions with the wrong blood type. An additional 40 died after medication errors, and four more after being accidentally burned during their stays, according to an Inquirer computer analysis of hospital billing records.

Such deaths, nearly 1,500 all told, are a rough estimate of what the Rendell administration would initially find if it applied its new Medicaid policy on medical errors to all 708,657 hospital admissions in 2006 from Philadelphia, Bucks, Chester, Delaware and Montgomery Counties.

Under that policy, the state will stop paying hospitals for the added costs of care for Medicaid patients that result from serious, avoidable medical mistakes.

Click here to read the entire article.

NJ AG issues subpoena to ortho device makers

From the New York Times article:

The New Jersey attorney general’s office issued subpoenas Monday to two companies involved in the development of the Prodisc, an artificial spinal disk for the lower back.

Click here to read the NYT article.

Review article published on herbal extract

From the New York Times article:

Dr. Pittler said it makes him uncomfortable that hawthorn is available without a prescription. “We don’t really know the mechanisms by which hawthorn works,” he said, “and it is important to caution that patients should not self-diagnose, and then self-treat with hawthorn.”

Click here to access the NYT article.

Nurses and pharma

Interesting article "Soft Targets: Nurses and the Pharmaceutical Industry" over at PLoS Medicine; an excerpt:

But it is not only prescribing nurses who must be the focus of these strategies. As we have described above, non-subscribing nurses play an under-appreciated role in prescription and administration choices. One of us (AJ), an experienced staff nurse, recalls guiding new house staff in the choice of treatment; the other (DBM) was grateful for such guidance as a medical intern.

Click here to access.

SafeRX Amendment Act of 2008 in D.C.?

From the AMNews article:

The measure, dubbed SafeRx, would require detailers to pay a licensure fee, adhere to an ethics code, receive continuing education and refrain from misleading doctors about drugs. Sales reps could be fined up to $10,000 for operating without a license.

Click here to access the article.

The heat is on...

Just came across the 1-22-08 entry "Variations on a Theme of Sleaze" at the Health Care Renewal Blog -- an excerpt:

Medical journals are not the only compromised medium. Continuing Medical Education (CME) is a second front in the campaign to expand the AAP drug market. The standard formula calls for corporate sponsorship channeled through an “unrestricted educational grant” to a medical education communications company (MECC). The MECC employs writers to prepare the “educational content,” and academic KOLs are recruited to deliver this content.

Click here to read the entire posting. Fasten your seatbelt!

NAAMECC and Coalition for Healthcare Communication Response

to the Macy conference summary on CE. Click here to access.

Venous thromboembolism prophylaxis gap

From the medpage today article:

Hospital patients at risk for venous thromboembolism don't receive appropriate preventive care, no matter how developed a country they live in, researchers here said.

More than 40% of surgical patients and 60% of medical patients at risk for venous thromboembolism in a large international study failed to receive prophylaxis as recommended by the American College of Chest Physicians, reported Alexander T. Cohen, M.D., of King's College Hospital, and colleagues in the Feb. 1 issue of The Lancet.

Some 5% to 10% of overall inpatient mortality is attributed to pulmonary embolism. It is the leading preventable cause of death in hospitals, Dr. Cohen and colleagues said.

Click here to access the article.

FDA issues Public Health Advisory on Chantix (varenicline)

Click here to access.

Hospitals making the grade...

From the Washington Post article:

Patients admitted to the top-rated hospitals in the United States have an average 27 percent lower risk of dying than patients admitted to other hospitals in the country, a new study shows.

Released Thursday by HealthGrades, an independent health-care ratings organization, the analysis of 27 procedures and diagnoses also found that patients who have surgery at the top-rated hospitals have an average 5 percent lower risk of complications during their hospital stay.

Click here to access the article.