Pulling no punches

The latest issue of Medical Meetings magazine is now available online, and the lead article is "CME Pros Duke It Out In D.C." Click here to access the article.

Senate Finance Committee rejects public option

From the New York Times article:

After a half-day of animated debate, the Senate Finance Committee on Tuesday rejected efforts by liberal Democrats to add a government-run health insurance plan to major health care legislation, dealing the first official setback to an idea that many Democrats, including President Obama, say they support.

All of the other versions of the health care legislation advancing in Congress — a bill approved by the Senate health committee and a trio of bills in the House — include some version of the government-run plan, or public option.

Click here to access the NYT article.

October 18-24, 2009 is National Healthcare Quality Week

From the National Association for Healthcare Quality website:

Healthcare Quality Week (HQW) features the work of healthcare quality professionals and highlights their influence on improved patient care outcomes and healthcare delivery systems. National Association of Healthcare Quality (NAHQ) members are encouraged to alert administrators, allied health professionals, and the public about the impact of healthcare quality through special events during the week of October 18–24, 2009.

Click here for more information.

Glaxo SmithKline gives MECCs a thumbs down

From the GSK press release:

“GSK will not support as many medical education programs, but we will continue funding those with the greatest potential to improve patient health,” said Deirdre Connelly, GSK’s President North America Pharmaceuticals. “Continuing medical education offers healthcare professionals important information on disease prevention, diagnosis and management. Independent and balanced information on the latest discoveries about disease and treatment options helps healthcare professionals make higher quality decisions and achieve better patient health outcomes.”

GSK will invite grant applications from approximately 20 medical education providers with a documented track record of developing and delivering high quality medical education programs that have a measurable impact on improved patient health. Potential grant applicants will be limited to academic medical centers and their affiliated teaching and patient care institutions, as well as national-level professional medical associations that represent healthcare professionals responsible for the delivery of patient care. All selected providers must be directly accredited by a recognized accrediting body.

GSK will no longer fund CME by commercial providers including medical education and communication companies (MECCs) under the policy which takes effect immediately.

Click here to access the GSK press release.

Ghostbusting

From the New York Times article "Medical Editors Push for Ghostwriting Crackdown":

As Washington tries to revamp the health care system, concerns about ghostwriting are taking on new urgency. One of the underlying assumptions of the health care overhaul effort is that money can be saved and medical care improved by relying more heavily on research showing which drugs and procedures are the most effective. But experts fear that the process could be corrupted if research articles are skewed by the hidden influence of drug or medical device makers.

Click here to access the NYT article.

Chocolat 2009 and 2000

From the New York Times article:

In a study that will provide comfort to chocoholics everywhere, researchers in Sweden have found evidence that people who eat chocolate have increased survival rates after a heart attack — and it may be that the more they eat, the better.

Click here to access the NYT article. Click here to access the Journal of Internal Medicine article (sub. req.). The movie (2000) was right!

Side-by-Side Comparison of Major Health Care Reform Proposals

The Kaiser Family Foundation's has an interactive side-by-side health reform comparison online tool at their website which allows users to compare "any or all of 12 different plans, including the plans approved by the Senate Health, Education, Labor and Pensions Committee and by the three House committees with responsibilities for health reform (H.R. 3200, America's Affordable Health Choices Act of 2009, also known as the House Tri-Committee bill)," and it is current as of today. Click here to access said tool!

Strokes in children

From the upi.com article:

Strokes in infants and children may be two to four times higher than previously thought, U.S. researchers say.

The study, published in Stroke: Journal of the American Heart Association, finds strokes undercounted due to coding errors ranging from typographical mistakes to coders not accustomed to using stroke codes in children.

Click here to access the upi.com article.

ACCME debuts new monthly e-newsletter

Giving new meaning to the phrase "The ACCME Report," the ACCME just published their new monthly e-newsletter of the same name. This first issue contains some important information for accredited providers on ACCME's online program and activity reporting system:

...a web-based portal for the collection and analysis of up-to-date, comprehensive data from CME providers, has moved into the testing phase. With the deployment of the system, the ACCME aims to improve the CME enterprise’s transparency, efficiency and accountability, as well as save time and streamline requirements for accredited CME providers. Currently, the ACCME plans to have the database operational by January 2010.

Click here to access The ACCME Report. Tamar, great job!

FDA Requires Boxed Warning for Promethazine Hydrochloride Injection

Click here to access the FDA release. Click here for information for healthcare professionals. Methinks that if a provider has CME enduring materials in this content area they might want to conduct an internal review of said materials.

20th Annual Conference of the National Task Force on CME Provider/Industry Collaboration

The conference is titled "Learning From the Past; Planning for the Future" and will be held Oct. 14-16, 2009 in Baltimore. Click here for the conference brochure.

Cracking FRAX?

From the New York Times article:

...the World Health Organization has developed an online tool meant to help doctors and patients determine when treatment for deteriorating bones is appropriate.

A preliminary version of the tool, called FRAX, was released last year and can be found at www.shef.ac.uk/FRAX/index.htm. A revised version is to be released later this year.

But FRAX is proving almost as controversial as the diagnosis of osteopenia. While some experts applaud it for taking factors besides bone density into account, others say that the formula on which the tool is based is faulty and that the advised threshold for medication is too low.

“FRAX is coming from the same people who came up with osteopenia in the first place,” said Dr. Nelson Watts, director of Bone Health and Osteoporosis Center at the University of Cincinnati, who said the diagnosis unnecessarily frightened women and should be abolished.

Click here to access the NYT article.

Shortage of primary care physicians!

From the Boston Herald article:

Among the many hurdles facing President Obama’s plan to revamp the nation’s health care system is a shortage of primary care physicians - those legions of overworked doctors who provide the front line of medical care for both the sick and those hoping to stay healthy.
...
To keep up with the demand for primary care doctors, the country will need to add another 40,000 to the existing 100,000 doctors over the next decade or face a soaring backlog, according to Dr. Ted Epperly, president of the Kansas-based American Academy of Family Physicians.

Click here to access the BH article.

Scary stuff?

From the New York Times article "Ghostwriting Is Called Rife in Medical Journals":

Six of the top medical journals published a significant number of articles in 2008 that were written by ghostwriters financed by drug companies, according to a study released Thursday by editors of The Journal of the American Medical Association.

Among authors of 630 articles who responded anonymously to an online questionnaire created for the study, 7.8 percent acknowledged contributions to their articles by people whose work should have qualified them to be named as authors on the papers but who were not listed.

Click here to access the NYT article.

Will tort reform happen?

From the Wall Street Journal Opinion Journal (Kimberly A. Strassel):

Tort reform is a policy no-brainer. Experts on left and right agree that defensive medicine—ordering tests and procedures solely to protect against Joe Lawyer—adds enormously to health costs. The estimated dollar benefits of reform range from a conservative $65 billion a year to perhaps $200 billion. In context, Mr. Obama's plan would cost about $100 billion annually. That the president won't embrace even modest change that would do so much, so quickly, to lower costs, has left Americans suspicious of his real ambitions.

It's also a political no-brainer. Americans are on board. Polls routinely show that between 70% and 80% of Americans believe the country suffers from excess litigation. The entire health community is on board. Republicans and swing-state Democrats are on board. State and local governments, which have struggled to clean up their own civil-justice systems, are on board. In a debate defined by flash points, this is a rare area of agreement.

Click here to access (sub. req.).

Murray Kopelow, MD, Appointed Special Advisor to White House Office of National Drug Control Policy

From the ONDCP press release:

The Office of National Drug Control Policy (ONDCP) has engaged experts to help formulate and address long-term policy goals for increasing the Nation's focus on preventing and treating substance abuse. With backgrounds in continuing medical education, state and local substance abuse prevention systems, and academia, these specialists bring a wealth of knowledge and experience to ONDCP, which is working to develop the Administration's first National Drug Control Strategy.

Currently there are three experts on detail to ONDCP: Dr. Keith Humphreys, Professor of Psychiatry, Stanford University; Dr. Murray Kopelow, Chief Executive, Accreditation Council for Continuing Medical Education; and Mike Lowther, Director of the Division of State Programs at Substance Abuse and Mental Health Services Administration/Center for Substance Abuse Prevention.

Click here to access the press release.

"Framework for Comprehensive Health Care Reform"

is posted at the website of Senator Baucus. Some excerpts:

Health Insurance Exchange. States would establish an exchange in 2010 to provide easier, more efficient comparison of health insurance plan benefits and premium costs. Information about coverage and cost-sharing would be available in a standard format. So-called “mini-medical” plans with limited benefits and low annual caps would not be offered in the exchange.

Ombudsman. In 2010, states would be required to establish an ombudsman office to act as a consumer advocate for those with private coverage in the individual and small group markets. Policyholders whose health insurers have rejected claims and who have exhausted internal appeals would be able to access the ombudsman office for assistance.

Transparency. Beginning in 2010, to ensure transparency and accountability, health plans would be required to report the proportion of premium dollars that are spent on items other than medical care. Also, beginning in 2010, hospitals would be required to list standard charges for all services and Medicare DRGs.
...
Individual Responsibility. Beginning in 2013, all US citizens and legal residents would be required to purchase health insurance or have health coverage from an employer, through a public program (i.e., Medicare, Medicaid, or CHIP), or through some other source that meets the minimum creditable coverage standard. Exemptions from the requirement would be allowed for religious objections consistent with those allowed under Medicare and for undocumented immigrants. Individuals who choose to keep the plan they have today would be deemed to have satisfied the requirement.
...
Employer Responsibility. Employers would not be required to offer health insurance coverage. However, employers with more than 50 full-time employees (30 hours and above) that do not offer health coverage must pay a fee for each employee who receives the tax credit for health insurance through an exchange. The assessment is based on the amount of the tax credit received by the employee(s), but would be capped at an amount equal to $400 multiplied by the total number of employees at the firm (regardless of how many receive a credit in the exchange). Employees participating in a welfare-to-work program, children in foster care and workers with a disability are exempted from this calculation.
...
Interstate Sale of Insurance. Starting in 2015, states may form “health care choice compacts” to allow for the purchase of non-group health insurance across state lines. Such compacts may exist between two or more states. Once compacts have been formed, insurers would be allowed to sell policies in any state participating in the compact. Insurers selling policies through a compact would only be subject to the laws and regulations of the state where the policy is written or issued.

State Health Insurance Exchanges. State-based “exchanges” will be established to facilitate enrollment for individuals and separately for small group (through a SHOP exchange modeled after S. 979, the “Small Business Health Options Program Act”). The exchange will provide a standardized enrollment application, a standard format for describing insurance options and marketing, call center support and customer service. The exchanges must be self-sustaining after the first year.

Click here to access the posted document.

Advamed speaks out against proposed $4 billion tax

From the New York Times article:

The future of Senator Max Baucus’s compromise health care proposal is far from certain, but one industry group was quick to fire back on Tuesday. The protest came from makers of medical devices like heart pacemakers and artificial hips – companies that would have to pay hefty new fees under the Baucus plan.

Click here to access the NYT article.

Accreditation Council for CME Releases Summary of July Board of Directors Meeting

Click here to access the news release.

Panda boy (or should that be boy panda?)

From the San Diego Zoo's website:

We are thrilled that our newest panda is a sturdy little male that is healthy and well fed. His first exam, on September 3, also told us that at four weeks of age he weighs 2.8 pounds (1,259 grams) and is 14.7 inches (37 centimeters) long.

Click here to access the pandacam.

"Third Party Educational Activity"

Click here to access Pfizer's Corporate Integrity Agreement. CME providers should read all the stuff relating to Third Party Educational Activity. Keep smiling!

Pfizer to pay $2.3 Billion in settlement

From the bloomberg.com article:

Pfizer Inc. agreed to a $1.2 billion criminal fine, the largest in U.S. history, and a felony plea by a subsidiary to close an investigation into what government lawyers described as fraudulent marketing of drugs.

The fine, over sales practices for a painkiller since pulled from the market, makes up the biggest single share of a record $2.3 billion settlement, announced today, between the U.S. Justice Department and New York-based Pfizer. The deal includes $1 billion in civil penalties, the largest non-criminal fraud case against a drugmaker, the department said.

Click here to access the bloomberg.com article. Also check out the examiner.com article, an excerpt:

In an FBI press release today, the federal government announced that pharmaceutical giant Pfizer will pay $2.3 billion in civil and criminal fines for promoting "off label" uses of three of its big selling drugs by doctors treating patients in the Defense Department and Postal Service health plans. Even the FBI admits in its release that the "fraud" charges result not from injury or illness suffered by any of these patients, but rather from government payment of health insurance claims for "off label" prescriptions to federal employees.

Click here to access the examiner.com article. Click here to read the FBI news release.

Where there's smoke, there's

just smoke? From the the Milwaukee Journal Sentinel article "Academic Integrity in UW's CME program" written by Robert N. Golden, Dean of the University of Wisconsin-Madison School of Medicine and Public Health and Vice Chancellor for Medical Affairs:

An objective, unbiased assessment confirms that the academic integrity of the UW School of Medicine and Public Health's Office of Continuing Professional Development is not in question. The Accreditation Council for Continuing Medical Education, the nonpartisan organization that sets and monitors the standards for CME programs across the country, recently completed an independent inquiry, which was triggered by the Journal Sentinel's first article about our CME activities.

The ACCME wrote that we had "implemented a careful and deliberate process to ensure that large amounts of commercial support do not in any way compromise the integrity of the university or the integrity of the continuing medical education program."

This assessment of our Office of Continuing Professional Development is consistent with other recent evaluations of our approach to identifying and managing apparent conflicts of interest.

Click here to access the article. Hat tip to Capsules.

Forest and the trees

From the New York Times article "Document Details Plan to Promote Costly Drug":

The document, “Lexapro Fiscal 2004 Marketing Plan,” is an outline of the many steps Forest used to make Lexapro a success. Because of concerns from Forest, the Senate committee released only 88 pages of the document, which may have originally run longer than 270 pages. “Confidential” is stamped on every page.

But those 88 pages make clear that one of the principal means by which Forest hoped to persuade psychiatrists, primary care doctors and other medical specialists to prescribe Lexapro was by finding many ways to put money into doctors’ pockets and food into their mouths.

Click here to access the NYT article. Click here to access the aforementioned plan.