Checking Up On Health: January 22, 2013

Benita M. Dodd, Vice President, Georgia Public Policy Foundation
Benita M. Dodd, Vice President, Georgia Public Policy Foundation

Health Policy Briefs

Compiled by Benita M. Dodd

The trials of running clinical trials: About 89 percent of clinical trials meet their enrollment goals but 48 percent of trial sites miss enrollment and timeline goals, according to the Tufts Center for the Study of Drug Development. About 90 percent of drugmakers and research organizations use conventional methods such as physician referrals and mass media advertising to enroll participants. Considering how many of us use WebMD and Google to diagnose our ailments, it’s a real surprise that only 14 percent of these organizations use social media, online data mining and electronic health records to recruit participants. …
In a related story: Pfizer last year gave up on a “clinical trial in a box” pilot that it had hoped would create a money-saving model using  personal technology to recruit patients and monitor their progress. The drugmaker was unable to convert social media interest into enough people willing to participate in the study testing the Detrol overactive bladder drug. But Pfizer hopes to revive its effort sometime this year.

Botox use expands: The popular Botox wrinkle treatment  by Allergan has been approved to treat adults with overactive bladder who can’t be helped by other drugs for the condition, the U.S. Food and Drug Administration said last week. Botox injected into the bladder muscle causes the bladder to relax, increasing its storage capacity and reducing episodes of urinary incontinence or leakage. Overactive bladder is a condition that affects an estimated 33 million Americans. Botox had previously been approved for other non-cosmetic uses, such as migraine headaches, severe underarm sweating and loss of bladder control due to nerve damage. Source: Reuters

A rose by any name: The Obama administration is rebranding the central component of the Patient Protection and Affordable Care Act, The Hill reports. The Health and Human Services Department (HHS) suddenly stopped referring to insurance “exchanges” this week, opting in press materials and a Web site for the public to refer to them as insurance “marketplaces.” The change comes amid a determined push by conservative activists to block state-based exchanges in hopes of crippling the federal implementation effort. FreedomWorks described the move by HHS to ditch the “exchanges” label as a sign that ObamaCare opponents are succeeding. “They could call them motherhood or apple pie, but it wouldn’t change our feelings about them,” a spokesman said. “We’re encouraged that they’re showing signs of desperation. I think that it’s too late in the game to try to start calling this something different. And [we’re] not going to spend a lot of effort fighting over a word.”

Whole Foods CEO eats his words: Using “fascism” to describe the federal health care law was “poor use of an emotionally charged word,” according to John Mackey, co-chief executive and co-founder of Whole Foods Market. In a blog post last week, Mackey said he “definitely” regrets using the term, which “today stirs up too much negative emotion with its horrific associations in the 20th century.” Mackey came under fire for a recent interview with NPR in which he said President Obama’s policies are “technically speaking … more like fascism” instead of socialism. Mackey clarified his position in his blog, saying that what he wants out of health care is a more competitive open-market system for providers, or a combination of “free enterprise capitalism with a strong governmental safety net.”

Shopping for health care: Rumor has it that Wal-Mart may offer small businesses health-care coverage, MSN reports. Executives seem reluctant to confirm this, but, “The larger trend is, however, that small-business health insurance exchanges are starting to get organized.” MSN notes that a Wal-Mart or a Costco Wholesale may be involved in exchanges as opposed to exchanges set up by states because the stores have the expertise on negotiating plans covering many thousands of people, particularly Costco. At the same time, big retail chains, like Wal-Mart, Costco and Target which have large pharmacy operations and offer flu shots and the like, are looking to make their stores one-stop destinations for everything, including outpatient clinics. They’re following the lead of CVS Caremark’s MinuteClinics and Walgreen’s Take Care clinics, which have opened in some 800 locations.

Not just 30 hours working: Dothe paid hours taken for vacation, holidays or extended leaves count toward mandated full-time benefits for each employee under ObamaCare? According to The Washington Post, most employers won’t like the answer: Regulators have suggested that hours used to determine full-time status will include hours worked and hours for which employees are entitled to compensation even if no work is performed. That includes paid vacation, illness, maternity leave and even jury duty, which can push workers over the threshold that requires businesses to offer full-time benefits.

Define “adequate and affordable:” The Taxman has started to clarify the tax penalty side of the ObamaCare  equation, but plenty of large employers are still waiting for HHS to define the law’s essential health benefits package, The Washington Post reports. Because they haven’t yet been told what type of medical and health-related expenses their plans must cover for full-time employees, projecting future health costs for many businesses remains difficult.

More mergers, more money? Hospitals and health systems are consolidating at a feverish pace, a market transformation giving those organizations an unprecedented form of pricing power, according to an article from consulting firm Alvarez & Marsal. Federal health care law is spurring consolidation among providers as hospitals and health systems de-emphasize inpatient visits and focus more on outpatient visits and procedures, which are significantly more profitable, at least in terms of revenue generated from private health insurers. Plus, a recent report from the Medicare Payment Advisory Commission found that Medicare payments rates for surgeries are 74 percent higher in hospital outpatient departments than in ambulatory surgery centers, according to the article. The authors predict the trends “are likely to lead to a spike in healthcare inflation.” Source: Becker’s Hospital Review

In exchange for a grant: California’s state health insurance exchange (whoops,”marketplace!”) has received a $674 million federal grant. It will use part of the money to market its health exchange, Covered California, to the estimated 5 million Californians who will be eligible to use it. California and 10 other states received funds from the $1.5 billion in exchange grants awarded last week; the others states receiving funds were Delaware, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, New York, North Carolina, Oregon and Vermont. Curious about the state of exchanges in your state? Click on this link.

Not just a game anymore: XBox Kinect has been proven to be a great member of the surgical team, helping keep patients undergoing surgery free from infection, and helping keep doctors focused on the patient and not the keyboard, according to a ZDNet health report. Now, Kinect games are being used to help people recover from injuries, including brain injuries and strokes. Plus, physical therapists like it because patients are engaged and interested in the process, and because the improvements in score give them concrete feedback about patient improvement.

Niche drugs: For the nearly 30 million Americans who suffer from a rare disease, there’s new hope. Drugmakers are shifting much of their research away from pills for the millions to uncommon disorders with few or no treatment options. Pharmaceutical and biotech companies are running patient tests of more than 5,400 potential new medicines; nearly 1,800 research projects are for rare diseases,and hundreds more are for disorders for which there’s been no new medicine in a decade or more. Among the reasons cited for the resurgence: Improved understanding of the biology and genetics of diseases is opening up new research avenues; the spike in new generic competition for profitable blockbuster pills has nudged them to do more in neglected areas, trying to develop “specialty” or niche drugs meant for much smaller groups of patients but carrying six-figure price tags. And more companies are taking advantage of grants, tax credits and other incentives of the Orphan Drug Act passed in 1983. Source: Yahoo/Associated Press

Quotes of Note 

“A man’s health can be judged by which he takes two at a time – pills or stairs.” – Joan Welsh 

“Good health and good sense are two of life’s greatest blessings.”Publilius Syrus

“Prayer indeed is good, but while calling on the gods a man should himself lend a hand.” – Hippocrates


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