Tag: "drugs"

Hits and Misses

Smiling NurseThree more states — Connecticut, Nebraska and New York — are in the process of allowing nurse practitioners to work without oversight from a doctor, in an effort to alleviate physician shortages.

Tom Sargent summarizes economics in 335 words. Or is it 297 words?

eHealth, Inc., an online insurance broker, is ObamaCare’s biggest winner.

If we had a drug to delay Alzheimer’s by five years, annual treatment costs would drop by almost half a trillion dollars a year.

Headlines I Wish I Hadn’t Seen

prescription-drugsPrices for a dozen generic drugs jumped 2,000 percent in one year: FDA to blame.

Users report better experience on broken state ObamaCare exchanges than federal healthcare.gov exchange.

Did Kathleen Sebelius request kickbacks from H&R block for enrolling ObamaCare applicants?

Man covered by ObamaCare owes half the cost of a $54,000 helicopter ambulance bill.

The Heartbleed virus infected Heatlhcare.gov: ObamaCare exchange enrollees advised to change passwords.

Headlines I Wish I Hadn’t Seen

nutrition-labelAre serving sizes on food packages intentional attempts to mislead us? No, they are dictated by the government.

Medicare kept paying dozens of doctors after they were suspended or terminated from state Medicaid programs or were indicted or charged with fraud.

Terminal cancer patients in Russia are sent home to die; can’t get pain medication; some are committing suicide. (HT: Jason Shafrin)

Patients at risk: More than 100,000 doctors, nurses, medical technicians, and healthcare aides abuse prescription drugs.

Why We Spend So Much on Drugs

The editors at Bloomberg explain:

prescription-bottleHere’s how the system works: When a doctor administers a drug in his or her office, Medicare pays 106 percent of its average selling price. The doctor keeps the extra as compensation for administering the injection.

What has this got to do with eye doctors? The drug Lucentis, used to treat macular degeneration, cost Medicare almost $2,000 a shot in 2012. Another drug, Avastin, which works just as well, costs about $50. If you were the doctor, faced with a system that pays you 6 percent of the drug’s cost, which would you choose? That Medicare spent a total of about $1 billion on Lucentis in 2012 suggests most ophthalmologists went with the more expensive one.

It gets worse:

This problem goes beyond a single drug. Of the $20 billion Medicare spent on drugs administered by doctors in 2010, 85 percent went to the 55 most expensive ones. In what seems unlikely to be a coincidence, 42 of those drugs also showed an increase in use from 2008 to 2010.

Scary Facts about Antibiotics

What is indisputable is that the status quo is untenable. An estimated 48,000 people die in Europe and the U.S. each year from infections caused by antibiotic-resistant bacteria, and this number is very likely to increase in years to come. “This is a global issue and a moral issue that needs to be dealt with in collaboration,” says Otto Cars, of the Swedish Institute for Communicable Disease Control in Solna.

From Nature Medicine via Kevin Outterson.

Headlines I Wish I Hadn’t Seen

Canvbnadian study: Almost one-third of patients never fill the prescriptions for the medicines they are told to take.

Jails house 10 times more mentally ill than state hospitals.

Doctor billed Medicare for $21 million in 2012; investigated by the FBI; makes large donations to Democrats.

Washington Post fact checks TV ad Barrack Obama ran against John McCain and finds that all the scary predictions actually came true — it’s called ObamaCare.

Most of the 4,000 doctors who received at least $1 million from Medicare in 2012 billed mainly for giving patients injections, infusions and other drug treatments.

Can States Overturn the FDA’s Limits on Compassionate Use?

At National Review Online, Jillian Kay Melchior, reports on a cancer patient who has run out of therapies. There are medicines under development that might help, but drug-makers won’t let her have them under the FDA’s “compassionate use” doctrine.

ClVariety of Medicine in Pill Bottlesinical trials accept only “typical” patients — Mikaela’s rare form of kidney cancer has ruled her out, but for others in her situation, complications as common as diabetes or high blood pressure could also be reason for ineligibility. And the Food and Drug Administration’s approval process for “compassionate use” of an experimental drug outside of clinical trials is extremely arduous.

First, a pharmaceutical company has to be willing to provide the experimental drug — a high-risk proposition, given that an atypical result in an atypical patient can prompt the FDA to delay approval or require significant and expensive additional testing…And approval from a pharmaceutical company is just the first step. Next, patients and doctors must fill out an exhaustive paperwork disclosure to submit to the FDA, which is estimated to take at least 100 hours to complete. The FDA then begins a review, which is supposed to take no longer than a month — but if the agency’s reviewers have any additional questions or need more information, that 30-day clock is reset. Finally, the hospital’s institutional review board has to give approval — and if a patient is being treated at a small hospital that lacks such an administrative panel, the case has to be reviewed by a bigger facility, often one unfamiliar with the patient.

Headlines I Wish I Hadn’t Seen

Blue Cross: 15% to 20% of enrollees aren’t paying premiums.

EPA tested deadly pollutants on humans.

Long-term antibiotics apparently work for lyme disease patients; but many doctors are afraid to prescribe them.

Hits and Misses

Pediatrician Examining ToddlerA medical student wants “to do the greatest good for the greatest number.” What kind of doctor should he/she become? Tyler Cowen answers. So does David Henderson.

The health co-ops are failing.

Can teledentistry actually work?

Eli Lilly’s answer to fake drugs: A $110 million bar code system with secret codes.

Are Foreign Drugs Safer Than You Think?

There are no reported examples of Americans dying by taking real, but F.D.A.-unapproved, medication bought online from a foreign pharmacy that requires valid prescriptions. This is after tens of millions of prescriptions have been filled online and internationally over the past 15 or so years, since online pharmacies were created. (NYT)