A recent Government Accountability Office report warns Americans about the risks of buying prescription drugs from Internet pharmacies, USA Today reports.
Federal investigators say that rogue Internet pharmacies skirt U.S. and state regulations and sell misbranded, adulterated and counterfeit drugs. Most of these operations are located overseas, which often puts them beyond U.S. enforcement action, and are also skilled at avoiding detection and identification.
According to the Food and Drug Administration, one in four online consumers has purchased medications online. Even though the agency has shut down thousands of illegal online pharmacies in recent months, there were more than 34,000 active rogue websites as of April 2013, according to Internet pharmacy verification service LegitScript.
To help educate the public, the National Association of Boards of Pharmacy publishes on its website a list of legitimate and illicit Internet pharmacies as a consumers’ guide. Additionally, both Google and UPS have stopped doing business with rogue pharmacies.
Yet another good reason to follow doctor’s orders: A new study found that patients who don’t take their blood pressure medication as prescribed increase their risk of stoke and death, HealthDay News reports.
By following patients with high blood pressure, aged 30 and up, from 1995 through 2007, researchers determined that those who didn’t stick to the schedule had nearly four times the risk of dying from a stroke in the second year after being prescribed their medicines and three times the risk in the 10th year, compared to patients that followed their schedule.
The study also found:
“These results emphasize the importance of hypertensive [high blood pressure] patients taking their antihypertensive medications correctly in order to minimize their risk of serious complications such as fatal and non-fatal strokes,” said study first author Dr. Kimmo Herttua, a senior fellow in the Population Research Unit at the University of Helsinki in Finland.
The U.S. Chamber of Commerce has released some interesting statistics from its quarterly Small Business Survey. Based on the responses, many employers still haven’t warmed up to government-mandated health care reform:
It’s no secret by now that some of the ACA provisions are just downright confusing, and may even force small businesses to make difficult hiring decisions. That’s why MedBen is helping empolyer groups to navigate the maze of regulations that make up health care reform.
Throughout this year, MedBen University has traveled the Midwest to explain the provisions of the law that will affect businesses in 2014 and beyond. We’re also offering a series of webinars to our self-funded clients that look at specific elements of the law in even greater detail. To learn more about these webinars, contact MedBen Sales Analyst Sally Wood at email@example.com.
MedBen clients with questions regarding any aspect of the ACA are welcome to contact Vice President of Compliance Caroline Fraker at firstname.lastname@example.org.
With the supply of primary care doctors already lagging behind demand – and about to get even more strained when millions of additional Americans get health insurance in January, under the health care reform law – many states are turning to nurses to address the shortage.
According to MedCity News, at least 17 states have relaxed “scope of practice” laws to allow nurses to work without a supervising physician, so long as they have advanced degrees in family medicine. Lawmakers in five big states are considering similar measures.
Advocates for patients, hospitals and insurers say that nurse practitioners (NPs) have the skill set necessary to provide basic health services by themselves. But physician groups disagree, arguing that nurses lack the training to safely diagnose, treat, refer to specialists, admit to hospitals and prescribe medications for patients, without a doctor’s oversight.
Based on a study reported this month in the journal Health Affairs, relaxing NP licensing laws appears to improve patient access to care. The authors found that between 1998 and 2010, as more states relaxed their laws, the number of patients receiving care from NPs increased by a factor of 15. Moreover, earlier research has shown that primary care provided by NPs has been as safe and effective as care provided by doctors.
Despite the best efforts of politicians and nutritionists, Americans continue to stubbornly favor taste over calorie count when it comes to selecting restaurant food. Today Health reports that even when given detailed information about healthy eating, a new study found that most individuals tend to go – literally – with their gut.
Researchers from Carnegie Mellon enlisted over 1,100 customers at two New York City McDonald’s to see how real people responded to the menu nutritional labels, which are required by municipal law (and will soon by nationwide under the Affordable Care Act). Prior to ordering, one group received a sheet of paper with the recommended calories for a single meal (650 calories for women; 800 calories for men); a second group received information about recommended calories for a day (2000 calories for women; 2400 for men), and a third group received no instructions.
So, armed with the additional information, surely members of the first two groups made more sensible dining decisions, right? Uh, not so much. Regardless of group, the majority of men and women ate more than the recommended intake for a meal – and whether a participant was overweight or healthy-weight made no difference in their selection.
In spite of the results, the researchers still say providing nutritional information of menus is a helpful tool, albeit mainly to those already inclined to choose healthier food options.
In a move likely meant to make a statement, the House of Representatives yesterday followed a vote on legislation supporting the delay of the Affordable Care Act’s employer mandate with a second bill that would similarly postpone the law’s individual mandate until 2015. Both bills passed the Republican-led House but have little chance of approval in the Senate, The New York Times reports.
“Under the president’s policy, million-dollar corporations with access to the White House can be excused from Obamacare, but the struggling family gets left out,” said Representative Pete Olson (R-Tx). On the other side of the aisle, Rep. Louise M. Slaughter (D-NY) called the Republican attacks “the height of irresponsibility and nihilistic obstruction.”
Today, during a speech to promote his signature legislative achievement, President Obama accused Republicans of “rooting for this law to fail” and urged them to end their efforts to repeal the ACA.
According to ABC News, the President also touted the $500 million in rebates that insurance companies are sending out to roughly 8.5 million Americans this summer. The rebate is a penalty to companies that spent too much on overhead, violating the requirement that they spend at least 80% of premiums on medical care. (Most insurers, including MedBen, met this requirement prior to the ACA’s passage.)
Concurrent with the President’s remarks, the Department of Health and Human Services (HHS) released a report claiming that preliminary 2014 premiums for mid-range plans for insurance exchanges in 10 states are expected be 18% lower on average than earlier estimates for individuals and small groups. Reuters reports.
A new study suggests that long-term aspirin use may reduce a woman’s risk of colon cancer, even if not taken daily, Reuters Health reports.
Researchers found that women who took just 100 mg of aspirin every other day for at least 10 years ended up with about a 20% lower risk of colon cancer over the ensuing two decades, compared to women who took a placebo. The study did not show the same effect for other cancer types such as breast or lung.
The extended use of aspirin was not without risk, however. Study participants in the aspirin group had higher rates of stomach bleeding and ulcers.
“Aspirin use is recommended for most people who have had a heart attack, and has some benefits for colorectal cancer as well, but at this point the American Cancer Society does not recommend that people use aspirin specifically to prevent cancer,” noted Eric Jacobs, ACS’s strategic director of pharmacoepidemiology, who was not involved in the study
As we reported last week on this blog, any regular aspirin regimen should only be started under a family doctor’s care.
The health care industry hasn’t gone entirely paper-free yet, but it’s well on its way. USA Today reports that over half of the nation’s physicians and more than 80% of hospitals now use electronic health records (EHRs).
Since 2011, doctors or their assistants have filled more than 190 million prescriptions electronically, according to data provided by the Centers for Medicare & Medicaid Services. Providers have also shared more than 4.3 million health care summaries with colleagues when patients change doctors.
Not only is the electronic storage and transmission of medical information more efficient, it also saves a bit of money. A recent study found that doctors’ offices that use EHRs would be expected to spend about $5 less on the care of each patient per month.
At MedBen, we’ve similarly made the transition to nearly “paperless” claims submission. About 80% of provider claims reach our office electronically, allowing for faster processing time and an even greater degree of accuracy.
We are also dedicated to ICD-10 compliance, which ensures that all of our system components are able to accept and process updated medical codes without interruption to our day-to-day processes. MedBen is well on schedule to meet the federally-mandated deadline of October 1, 2014.
To learn more about the ways that MedBen’s claims processing efficiency benefits can benefits your group, contact Vice President of Sales & Marketing Brian Fargus at email@example.com.
Average cholesterol levels in Americans have stopped falling since 2008 – a development that has pharmaceutical companies scrambling to come up with a new class of drugs, The New York Times reports.
A large analysis of patient records suggest that statins, the drugs that have contributed to reducing cholesterol levels throughout the population, may be reaching the limits of their effectiveness. Blood levels tested by the lab chain Quest Diagnostics found that LDL, or “bad” cholesterol, declined from 120 milligrams per deciliter of blood in 2001 to 104.7 in 2008 – a 13% drop. But in the next three years, average LDL levels flattened out.
While the study didn’t look at causes for the plateau, the researchers speculated that when the economy worsened in 2008, less people visited their doctors and, consequently, received statin prescriptions. The recession may also have affected stress levels, diet and evercise – factors that can contribute to higher LDL.
An LDL of 100 mg/dL is considered healthy, but experts say people at very high risk of heart disease should bring their levels down even further, to about 70 mg/dL or lower. However, a Times article from earlier this month notes that several drugmakers are working on pills that could drive LDL levels to new lows.
If you drink diet soda, chances are it’s for the low calorie count to help you lose weight, or keep it off. But a Purdue University study has found that the beverage may not be a healthier alternative to its sugary counterpart – and may actually contribute to weight gain.
According to USA Today, a review of recent studies found results that linked artificially sweetened sodas to a number of health problems. One large study found that people who drank diet soda were more likely to experience weight gain than those who drank non-diet soda. Others found those who drank diet soda had twice the risk of developing heart disease than those who abstained.
Some studies even suggested that diet soda, which contain such artificial sweeterers as aspartame, sucralose and saccharin, may be just as bad for our health as non-diet. Such findings may lead some to ask, are diet sodas worse for you that regular sodas?
“I think that’s the wrong question,” said Susie Swithers, Purdue University professor. “It’s, ‘What good are sodas for you in the first place?’”
In response to the study, the American Beverage Association said in an emailed statement, “This is an opinion piece not a scientific study. Low-calorie sweeteners are some of the most studied and reviewed ingredients in the food supply today. They are a safe and an effective tool in weight loss and weight management, according to decades of scientific research and regulatory agencies around the globe.”
Health care spending has slowed in recent years, but is still growing faster than the nation’s GDP, and amounts to nearly 1/5 of the total US economy. Carrington College (via MedCity News) identifies seven significant factors that contribute to health care spending growth – and if not kept in check, higher insurance costs:
At MedBen, we strive to find clients solutions to minimize the impact of rising health care spending. Our advanced surveillance system finds potential for large loss, inappropriate billing, and cost reduction opportunities. Our worksite wellness program promotes the use of your primary care doctor and personal coaching to members with chronic illness. And our fraud detection unit reviews questionable claims and other related information to help conserve plan assets.
Cutting back from a full pack to cigarettes a day to just half may help your pocketbook, but will do little to extend your lifespan, a new Scottish study suggests.
According to HealthDay News, the study, which tracked individuals’ smoking habits from the 1970 to 2010, concluded that only kicking by the habit altogether can a person hope to gain extra years. The researchers found no difference overall in death rates between those who smoked and those who only cut down.
“These inconclusive results support the view that reducing cigarette consumption should not be promoted as a means of reducing mortality, although it may have a valuable role as a step toward smoking cessation,” the researchers wrote.
Another tobacco-use researcher questioned the accuracy of the findings. “It is not possible to know the detailed smoking history of every subject, and there’s a myriad of subtle differences in consumption. There is little doubt that there is a difference in risk between one cigarette per day and 20, but it is not possible to measure all gradations in between,” said Brad Rodu, a professor of medicine at the University of Louisville. He added that participants who smoked fewer cigarettes may have underreported their habit, or compensated by “smoking more intensely.”
Writing for the Los Angeles Times, Tracy Weber and Charles Ornstein explain their concern about little patients know in regard to how their doctors determine what medications to prescribe:
“For most of us, evaluating a doctor’s prescribing habits is just about impossible. Even doctors themselves have little way of knowing whether their drug choices fall in line with those of their peers.
“Once they graduate from medical school, physicians often have a tough time keeping up with the latest clinical trials and sorting through the hype on new drugs. Seldom are they monitored to see whether they are prescribing appropriately, and there isn’t even universal agreement on what good prescribing is.
“This dearth of knowledge and insight matters for both patients and doctors. Drugs are complicated. Most come with side effects and risk-benefit calculations. What may work for one person may be absolutely inappropriate, or even harmful, for someone else.”
To give consumers greater inside into physician prescriving habits, the authors requested, and were given, a list of the drugs prescribed by every health professional to enrollees in Medicare’s prescription drug program, known as Part D. That information has been put into an online database that allows anyone to look up a doctor’s prescribing patterns and see how they compare with those of other doctors.
To learn more about Weber and Ornstein’s findings, visit latimes.com.
More employees prefer a lower-cost, high-deductible employer health insurance plan to traditional coverage, a new study reveals.
According to USA Today, data from 2,503 employees in New York and New Jersey showed that given a choice between a tradtional no-deductible plan, a higher-deductible health plan (HDHP) in conjunction with a health savings account (HSA), and a plan built around one primary care doctor or a limited network (also knows as an accountable care organization), 80% chose the non-traditional offerings. Benefits were the same regardless of the plan design; just the payment structure differed.
The number of people enrolled in HSAs has more than tripled in the last six years, from 4.5 million people in January 2007 to 15.5 million in January 2013, according to trade association America’s Health Insurance Plans. “HSA plans encourage individuals to take an active role in their health care decisions while stretching their health care dollars,” said Karen Ignagni, AHIP president.
MedBen offers consumer-driven health plans (CDHPs) across all group sizes. In addition to the administration of a HDHP tied to an HSA, we offer HRAs and flexible spending accounts (FSAs). These plans can be offered on a stand-alone basis or in a variety of combinations.
To learn more about CHDP options available to your group, contact MedBen Vice President of Sales and Marketing Brian Fargus at firstname.lastname@example.org.
The Internet has become the go-to place for all manner of personal inquiries, including medical research: A recent survey found that 6 in 10 adults have gone online in the past year to diagnosis health issues. But how accurate is the information we find?
On KevinMD.com, family physician Kenneth Lin warns than many health websites contain “flawed, inaccurate, or biased” information. Sometimes, the group running the site may have a hidden agenda, such as a drug company that promotes awareness of a previously unrecognized to spur consumer demand for its new product – a practice known as “disease mongering". Or an organization may willfully disregard scientific evidence to promote certain health beliefs.
For his patients who need trustworthy health information, Lin recommends several websites that have received a high quality rating from independent medical associations, such as Healthfinder.gov and FamilyDoctor.org. The latter site offers a variety of handouts about preventive test basics or newly diagnosed health conditions, including one that advises patients to ask themselves three questions about every health-related website they visit:
While Lin warns patients not to use online information to self-diagnose or treat a medical problem, he does believe that visitng a high-quality health website can help them make better-informed choices – so long as its in conjunction with a doctor’s care.
The U.S. Food and Drug Administration has approved a new drug to treat advanced lung cancer, HealthDay News reports. Gilotrif (afatinib) will be available to patients with a specific subtype of non-small cell lung cancer (NSCLC).
The agency approved the drug to treat tumors that carry key deletions on the epidermal growth factor receptor (EGFR) gene, long a target for lung cancer therapeutics. Mutations in the EGFR gene – thought to occur in about 10% of NSCLCs – are targeted by Gilotrif.
“This drug represents a new important alternative to standard chemotherapy in the 10-15% of lung cancer patients who have EGFR mutations,” said Dr. Jorge Gomez, medical director of the thoracic oncology program at Mount Sinai Medical Center in New York City.
Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City, added that new drugs such as Gilotrif “complement standard chemotherapy [and] give hope of increased survival even in late stage lung cancer.”
Along with common side effects such as itching, bladder inflammation, low blood potassium levels, fever, and eye inflammation, serious side effects associated with Gilotrif include diarrhea that can result in kidney failure and severe dehydration, severe rash, lung inflammation and liver toxicity, the FDA said.
Spurred by last week’s postponed enforcement of the Affordable Care Act’s employer mandate by the White House, House Speaker John Boehner (R-Oh.) has announced that the House will vote next week to similarly delay the individual mandate until 2015, ABC News reports.
in his announcement, Boehner said it’s “indefensible” that financially burdened individuals would have to struggle to meet the mandate, which would require them to buy coverage beginning in 2014 or pay a fine. “Is it fair for the president to give American businesses an exemption from the health law’s mandates without giving the same break to individuals and families across the country? Hell, no, it isn’t!”
House Minority Leader Nancy Pelosi refuted Boehner’s comments, explaining that while a “certain reporting” requirement by businesses was indeed delayed for a year, the Obama administration still hoped that employers would still maintain or enact coverage during the 2014 transition period.
Consumers apparently agree that the individual mandate should go on the back burner, at least for the time being (see chart). A survey by HealthPocket found that 41% of respondents believe the mandate waiver should apply equally to individuals and businesses, compared to 12% who said the mandate should remain and 47% who weren’t sure.
Just because the Food and Drug Administration approves a medication doesn’t mean that the manufacturer is free to relax and reap the rewards – often the agency will require more research be done even after the product hits the market. But not every drugmaker is quick to act on such requests, NPR reports.
Post-approval research used to be conducted more or less at the discretion of the manufacturer before the FDA was given the power to enforce the request in 2007. Curious to see if the mandate had improved compliance, Kevin Fain and some colleagues took a look at the five-year period ending in 2011.
Fain’s team found that prior to the FDA’s new powers, over half of the of the 2,000+ studies the agency expected to be performed hadn’t been started by drugmakers. That number fell to 775 studies, or about 44%, in 2011. Progress. But that’s “still a fairly large number,” said Fain, a research fellow at Johns Hopkins Bloomberg School of Public Health.
The proportion of tardy starts to studies ordered by FDA since the agency got mandatory powers has increased steadily and stood at 271, or about 15%, in 2011. More of the old studies got finished, though none of the newly mandatory ones had been.
The NPR article notes that failure to comply with agreed deadlines can land the drugmaker in hot water, though so far the FDA’s enforcement has been limited to warning letters.
An increase in the amount of time Americans spend exercising hasn’t slowed the rise in obesity, the Los Angeles Times reports.
Data published in the online journal Population Health Metrics revealed that while individuals in two-thirds of the nation’s counties have stepped up their physical activity in the past decade, national obesity rates have also climbed. On the positive side, some recent evidence suggests the rates may be leveling off.
“There has been a lot of progress on physical activity,” said Christopher Murray, lead author of the research. “But we probably also need to do more. There are still more calories coming in … than calories going out in physical activity.”
Indeed, bad diet choices are the single leading cause of America’s poor health compared to other countries, said Robert Lustig, a neuroendocrinologist and clinical professor at UCSF School of Medicine. While physical activity is a critical component of well-being, “[t]here is not one study anywhere in the world that shows that exercise [alone] causes weight loss.”
Lustig noted that poor diet also reduces the will to exercise, and advised that people reduce their insulin levels by drinking less alcohol and eating less sugar, trans fats and corn-fed beef and chicken.
Despite last year’s recommendation by the U.S. Preventive Services Task Force that older men shouldn’t get a prostate cancer screening, most still plan to do so, HealthDay News reports.
A survey of over 1,000 men aged 40 to 74 with no history of prostate cancer found that only 13% of respondents plan to follow the USPSTF recommendation and not get tested, compared to 54% who said they’d ignore it and 33% who were undecided. Blacks, wealthier men, those who’d had a recent PSA test, and those who were at least somewhat worried about prostate cancer were more likely to plan to get a test.
Overall, the survey shows that “we need to do a better job of presenting both the benefits and harms of screening to all patients,” said Linda Squiers, lead author of a report on the survey. “We also should explain the science behind the recommendation in plain language so everyone can understand it.”
The USPSTF website states that “current methods of PSA screening and treatment of screen-detected cancer are not the answer", and critics of the test believe it can lead to unnecessary and harmful treatment. Nevertheless, many physicians say the test serves a useful purpose.
MedBen follows American Cancer Society screening guidelines, which recommend that men at age 50 who are at average risk of the disease and are expected to live at least 10 more years consult with their primary care physician about getting tested.