Potential evidence that one type of chronic condition raises the risk of other illnesses: People with heart failure are more likely to be diagnosed with cancer, a new study suggests.
Reuters Health reports that the study matched newly diagnosed heart failure patients (average age: 73 years old) with those of the same age that did not have the condition. Eight years later, after accounting for certain disease risks such as people’s weight and whether they smoked, the researchers calculated that heart failure patients were 68% more likely to be diagnosed with cancer than their heart failure-free pairs.
The research team, led by Dr. Sudhir Kushwaha of the Mayo Clinic, noted that the finding doesn’t prove that heart failure causes cancer, and that more research and study is required. But the association makes sense because heart disease, caused by a lack of blood and oxygen, could create problems in many organs.
Kushwaha’s group added that there may be other explanations for the link, such as heart drugs that could increase cancer risks, stress and inflammation from heart failure itself, or a lack of oxygen.
The Food and Drug Adminstration is continuing to take action against online pharmacies that sell illegal drugs. Following last year’s shutdown of 18,000 shady websites, the agency announced that another 1,600 sites are out of business.
CNN reports that the closed sites sold counterfeit or substandard medication, or sold drugs without appropriate safeguards. The FDA seized more than $41 million worth of illegal medicines – Viagra, Levitra, Celebrex and Avandaryl among the most popular – while officials arrested 58 people.
Crooked online vendors have stepped up their game since the days of spamming suspicious e-mails that advertised low-cost medicines without a prescription. Now, some of the sites have professional-looking interfaces and user names that can be confused with actual pharmacy retailers. For example, the FDA shuttered Walgreens-Store.com; the well-known drugstore chain’s website is actually Walgreens.com.
“It impacts consumers every day,” FDA Commissioner Margaret Hamburg told CNN’s Dr. Sanjay Gupta. “These products can have none of the active ingredient that people need for the treatment of their disease. They can have too much or too little (of the ingredient); they can have toxic ingredients, and they can prevent patients form getting the actual medications that they badly need to treat their disease.”
Micheal Edmond, a professor of internal medicine VCU Medical Center, offers his professional perspective on the problem of “presenteeism", or coming to work while under the weather:
“While most humans inherently know that it’s not a good idea to come to work with fever or diarrhea, many either can’t or won’t stay home and risk infecting co-workers, customers, or patients.
“One major reason for presenteeism is lack of sick time, a particular problem for food service workers and other low wage earners. But the healthcare industry has its problems too, as many hospitals provide workers with paid time off (PTO) as opposed to sick leave. PTO is time that can be used for vacation, personal days or sick time. While this has some advantages, it also presents problems. For example, time off for illness reduces vacation time, so a sick worker may have to choose between working with the flu or going to Disney World. A worker that has used all of his PTO, may also feel compelled to work while ill.
“New York City took a step in the right direction when it mandated five days of sick leave with pay for employees who work in companies with 20 or more workers. Smaller businesses will be forced to allow workers to have sick leave without pay with no threat of job loss.”
An aging and more chronically ill population, plus the lure of more lucrative specialty practives, has created a shortage of primary care physicians in the U.S. – and the forthcoming addition of millions of newly insured individuals promises to make a tough situation even more difficult, the Associated Press reports.
While about a quarter million primary care physicians work in America now, that’s not nearly enough to meet current needs. Nearly 20% of Americans already live in a region with a inadequate number of family doctors – and the Association of American Medical Colleges projects the shortage will reach almost 30,000 in two years and will grow to about 66,000 in little more than a decade. Poorer inner cities and rural areas will be especially hard hit.
The Affordable Care Act is expected to add another 30 million potential patients looking for general care.
In an attempt to ensure that more Americans have access to primary care, various political solutions have been proposed. Some state legislators have introduced bills to expand the scope of practice of dentists, dental therapists, optometrists, psychologists, nurse practitioners and others. Others have suggested expanding student loan reimbursements. Neither idea has been favorably received.
Dr. Andrew Morris-Singer, president and co-founder of the non-profit group Primary Care Progress, warns, “If you don’t have a primary care provider, you should find one soon.”
A new study suggests that cigarettes and surgery don’t mix – and simply quitting a couple months before a medical procedure won’t help, Reuters Health reports.
Based on a post-surgery review of current smokers, former smokers who had quit at least a year earlier and people who had never smoked, the study found that smoking increases the risk of serious health complications after major surgery, such as heart attack, developing blood clots and pneumonia. The chance of death is also higher.
Study leader Dr. Faek Jamali noted that, while his research concluded that current smokers were more likely to die than nonsmokers post-surgery, former smokers had the same risk of death as those who had never smoked. However, former smokers did have a 28% greater risk of heart attack than never-smokers – still much better than the 77% greater risk among current smokers.
“We knew that smoking increased risk, but it was difficult to distinguish between risk caused by smoking-related problems like heart and lung disease and the risk of smoking itself,” Dr. David Warner of the Mayo Clinic told Reuters. “Knowing that smoking itself is a risk is important because it suggests that quitting can reduce risk.”
If your hospital of choice has a good track record for treating heart attack, pneumonia and congestive heart patients, chances are it also performs well for patients with other conditions – and these three mortality measures may be enough to identify high- and low-performing hospitals for patients and policymakers, Modern Healthcare reports.
An analysis of performance across more than 2,300 hospitals compared Medicare mortality rates for pneumonia and the two heart conditions for high- and low-performing hospitals with those for 19 medical and surgical conditions, such as stroke, renal failure, coronary artery bypass grafting and colon resection. It found the composite medical and surgical mortality rates was 3.6% lower, after adjusting for risk, among hospitals in the top performance quartile on the trio of Medicare mortality rates when compared with the worst-performing hospitals.
The correlation suggests there may be factors at work across an entire hospital – not just one department, such as cardiology– that improve quality outcomes, said study co-author Dr. Ashish Jha, a professor of health policy and management at Harvard University. “Leadership and culture probably matter a lot.”
Modern Healthcare noted that the ability to judge hospitals based on a limited set of factors would be a boon for patients, who would not have to wade through dozens of mortality statistics to find a suitable facility.
Monitoring early stage prostate cancer is more effective and economical than performing surgery and radiation from the start, a new study finds.
“Most of the men who are diagnosed in this country these days have low-risk prostate cancer,” said study leader Dr. Julia Hayes to Reuters Health. “There’s a huge group of men out there who are probably treated unnecessarily.”
Conducted by the Dana-Farber Cancer Institute, the study of slow-growing, early-stage prostate cancer tracked the health of men ages 65-75, taking into account tests costs, missed work, treatment side effects, quality of life and their chance of dying from prostate cancer.
The risk of men dying from prostate cancer was 4.8% for those who were monitored with active surveillance, through PSA blood tests, rectal exams and ultrasounds at regular intervals. The risk was 6.0% for those men under “watchful waiting” – less intensive treatment, fewer tests, and greater reliance on symptoms for the provider to decide whether treatment is necessary. In contrast, men who went directly for treatment had an 8.9% risk of death.
UPDATE (7/3/13): Reuters Health has also reported on a separate study which concluded that the “wait-and-see” treatment approach may not work as well with low-risk black men as it does with white men.
“It’s known that outcomes for African Americans with prostate cancer are less good,” said Dr. Edward Schaeffer, the study’s senior author from Johns Hopkins Hospital in Baltimore. “This study’s number one highlight is that because of that observation, we don’t think you should just recommend active surveillance.”
The generic drug industry scored a major win yesterday, when the Supreme Court ruled that patients who claim to be injured by generics cannot sue the makers for the design of their drugs.
According to The New York Times, the 5-to-4 decision overturned the verdict of a New Hampshire jury, which in 2010 awarded $21 million to a woman who developed a debilitating skin disease after taking a generic version of the pain medication sulindac. Because the drug’s manufacturer, the Mutual Pharmaceutical Company, was required by federal law to make a copy of the brand-name drug, Clinoril, it could not be held responsible for claims that the drug was unsafe.
Claimant Karen Bartlett lost nearly two-thirds of her skin, was placed in a medically induced coma and is legally blind after suffering a reaction to the medication she took for a sore shoulder. But while acknowledging the horrific injuries she suffered, Justice Samuel A. Alito Jr. wrote on the majority opinion that “sympathy for respondent does not relieve us of the responsibility of following the law.”
Bill Curtis, a Houston lawyer who specializes in pharmaceutical cases, took exception to the ruling. “Now, presumably, a patient harmed by those drugs has no remedy, either through a defective warning or a defective design argument,” he said.
Jay P. Lefkowitz, who represented Mutual before the Supreme Court, countered that “it makes much more sense to rely on the judgments of the scientific and medical experts at the [Food and Drug Administration] who look at drug issues for the nation at large, than those of a single state court jury that only has in front of it the terribly unfortunate circumstances of an adverse drug reaction.”
With childhood obesity more than tripling in American adolescents over the past 30 years, the need for parents to step in and take action has never been greater. But a new study suggests that rather than dwelling on their kid’s extra pounds, mom and dad should promote better health habits, HealthDay News reports.
Childhood obesity is the number one health concern among parents in the United States today. “Because of the increasing rates of obesity, unhealthy eating habits and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents,” said former Surgeon General Richard Carmona.
There is a right way and a wrong way to discuss healthy eating with children and teens, said Dr. Jerica Berge, who led the study. She advised that parents need to have a conversation with their children about healthy food choices. Instead of emphasizing weight, encourage children to eat more fruits and vegetables.
The study found that adolescents pressured to lose weight were actually more likely to have a problem with dieting and other eating behaviors. But parents who discussed healthy eating were less likely to have teens who exhibited unhealthy eating behaviors, such as anorexia, binge eating or bulimia.
School may be out for the summer, but MedBen University remains in session! Our team of experts is traveling the Midwest to share its knowledge of health care benefits with employers of all sizes.
At an MBU on June 25 in Lima, Ohio, MedBen Vice President of Caroline Fraker spoke on the topic, “Health Care Reform; Are You Ready for the Next Step?” In her presentation, Fraker discussed how the Affordable Care Act will impact businesses starting in 2014, focusing on the shared responsibilities for employers and individuals. The event was hosted by Stolly Insurance Group.
A key for employer groups to recognize their responsibities under health care reform, Fraker explained, is understanding the “pay or play” rules found in the law. For a group to “play” – that is, to be legally required to offer employee health care coverage – it must have at least 50 full-time equivalent employees. “Full time” is defined as an average of 30 or more hours per week or 130 hours a month.
A group that has to “play” must provide minimum essential coverage to its full-time employees and their dependents as defined under the ACA. Failure to do so means that the employer must “pay” a penalty – either a greater penalty if it does not offer essential coverage, or a lesser penalty if, under the rules, the coverage offered does not have minimum value or is not affordable.
With less than 100 days to go before open enrollment begins for health insurance exchanges, it’s critical for companies to understand how the “pay or play” concept will affect their health care coverage. In that spirit, MBU will continue to continue to offer seminars throughout 2013, to help employers better navigate their responsibilities under the ACA. Be sure to check this blog for future opportunities to attend a session!
David Katz, MD, Director of Yale University’s Prevention Research Center, says that the American Medical Association made a mistake in recognizing obesity as a disease:
“The notion that obesity is a disease will inevitably invite a reliance on pharmacotherapy and surgery to fix what is best addressed through improvements in the use of our feet and forks, and in our Farm Bill.
“Why is the medicalization of obesity concerning? Cost is an obvious factor. If obesity is a disease, some 80 percent of adults in the U.S. have it or its precursor: overweight. Legions of kids have it as well. Do we all need pharmacotherapy, and if so, for life? We might be inclined to say no, but wouldn’t we then be leaving a ‘disease’ untreated? Is that even ethical?
“On the other hand, if we are thinking lifelong pharmacotherapy for all, is that really the solution to such problems as food deserts? We know that poverty and limited access to high quality food are associated with increased obesity rates. So do we skip right past concerns about access to produce and just make sure everyone has access to a pharmacy? Instead of helping people on SNAP find and afford broccoli, do we just pay for their [weight loss drug] Belviq and bariatric surgery?
“If so, this, presumably, requires that everyone also have access to someone qualified to write a prescription or wield a scalpel in the first place, and insurance coverage to pay for it. We can’t expect people who can’t afford broccoli to buy their own Belviq, clearly.”
With over half of American adults relying on smartphones for everything from mapping trips to buying groceries, it should come as no surprise that many want to use their devices to make health care simpler.
HealthDay News reports that many Americans are already using phone applications to record and organize personal health information – and that’s just the tip of the iceberg. Many companies are designing apps along with specific types of equipment that will enable the user to can help diagnose everything from ear infections and eye diseases to irregular heartbeats and malaria.
And once the smartphone has gathered the information? A recent poll compiled by Harris Interactive/HealthDay reports that more than one-third of respondents said they are “very” or “extremely” interested in using their phone or tablet to ask their medical provider questions, make exam appointments and retrieve test results.
Of course, for such an app to be effective would require your provider to have the proper systems in place, noted Titus Schleyer, who heads the Center for Biomedical Informatics at the Regenstrief Institute. “This poll shows us that the public is interested in using these apps. But the health-care system has to make it easier for them to do it,” he said.
The national average of claims incorrectly processed by heath plans dropped to 7.1% in 2013, according to a new National Health Insurer Report Card released by the American Medical Association (AMA). It contines a trend of falling inaccuracy rates, from more than 19% in 2011 to 9.5% last year.
The timeliness of medical claims processed has also improved by 17% since the AMA first started its report card in 2008.
MedPage Today reports that, based on AMA estimates, processing claims accurately and expediently could have saved more that $43 billion since 2010. Administrative waste also accounted for billions of dollars lost in that period.
At MedBen, we recognize the importance of getting claims paid right the first time, and getting them processed quickly. Our proprietary claims software conducts over 400 automatic checks, keeping a virtual eye peeled for inconsistencies and errors. The software also “rebundles” miscoded claims and coordinates benefits with other insurance companies.
Independent CPAs review every procedure related to MedBen’s claims operating system, and have repeatedly reported no findings in annual SSAE 16 audits. In addition, internal staff members review 5% of each examiner’s claims every day – a level unmatched by other health benefits managers.
And how does MedBen’s claims processing abilities compare to the national average? In 2012, we had a 99.6% accuracy rating. Moreover, 97.2% of claims were handled within 15 days of receipt.
A new study supports the importance of colon cancer screenings, HealthDay News reports. Researchers found that patients whose cancer was detected by a colonoscopy tended to be in an earlier stage at the time of diagnosis, and therefore had a better survival rate.
“The findings provide yet another compelling reason for asymptomatic, average-risk individuals over the age of 50 to get screened by colonoscopy,” said Dr. David Carr-Lock, chief of the division of digestive diseases at Beth Israel Medical Center in New York City.
The study, led by Ramzi Amri of Massachusetts General Hospital and Harvard Medical School, reviewed the case studies of 1,100 colon cancer patients. Amri concluded that of the 1,100 cases, 217 were detected early by a colonoscopy. The study also revealed those patients who did not have their cancer detected by a colonoscopy had odds that doubled for an invasive tumor, and had three times a greater risk of metastasized cancer spread.
The American Cancer Society recommends that people with an average risk of developing colon cancer get screened starting at age 50. MedBen Worksite Wellness members can check their compliance with colonoscopies and other critical wellness examinations by visiting the MedBen Access website and clicking on the Wellness Plan link under “My Plan”.
Following a statement by the Justice Department earlier this month that it would not appeal a federal judge’s order to allow girls of any age to buy Plan B One-Step without prescriptions, the Food and Drug Adminstration has approved expanded access to the so-called “morning after” pill.
“Over-the-counter access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States,” read Thursday’s statement from Dr. Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research.
According to the Los Angeles Times, U.S. District Judge Edward Korman of New York reluctantly gave approval last week to a request from the FDA and the Department of Health and Human Services to approve Plan B One-Step for over-the-counter sales, but not other versions of the drug. The change will take affect once the drug’s manufacturer Teva has changed all its packaging to reflect the new rules – a process that could take several months.
Plan B One-Step, which blocks ovulation and impedes the mobility of sperm, retails for about $60 a dose. It will not work if a woman is already pregnant, nor will it harm a developing fetus.
Every year thousands of patients undergo surgery they don’t need, according to the findings of a USA Today investigation. In some specialities, unnecessary surgeries might account for 10% to 20% of all operations.
Six of the most common unnecessary surgeries, based on medical research and government databases:
MedBen helps protect against certain unneeded surgeries with comprehensive care management. This service ensures plan members receive the correct treatment for such conditions as cardiovascular disease, cancer and kidney disease.
Care management is necessary to ensure that the medical procedures a physician/provider is proposing for patient’s condition are the best options from an effectiveness and patient risk perspective, and maximize benefits under his or her health care plan. To learn more, contact MedBen Vice President of Sales and Marketing Brian Fargus at email@example.com.
If you don’t take a prescription drug, chances are you know one or two people who do… or three, or four, or more, Drug Store News reports.
According to a new study by the Mayo Clinich, nearly 70% of Americans use at least one prescription drug, and more than half are taking two. Most of the drugs are antibiotics, antidepressants and opioid painkillers, followed by medications to control blood pressure and vaccines.
“Often, when people talk about health conditions, they’re talking about chronic conditions, such as heart disease or diabetes,” study author Jennifer St. Sauver said. “However, the second most common prescription was for antidepressants; that suggests mental health is a huge issue and is something we should focus on. And the third most common drugs were opioids, which is a big concerning considering their addicting nature.”
The study also found that women receive more prescriptions, and nearly 25% of women aged 50 to 64 are on an antidepressant. Older adults also account for a large number of prescriptions overall, escpecially cardiovascular drugs. Antibiotics and asthma drugs were most commonly prescribed to those younger than 19 years, while antidepressants and opioids were most common among young and middle-aged adults.
According to The Hill’s Healthwatch blog, legislation has been introduced in the Senate to modify the employer mandate in the Affordable Care Act.
The mandate, which will take effect in 2014, requires businesses to offer health insurance to their employees who work 30 hours or more. The bipartisan bill would move the working hours from 30 to 40 hours to match the traditional definition of a full-time worker.
Critics of the current mandate believe it will hurt small businesses, as employers will be forced to reduce workers’ hours. Proponents of the bill say that changing working hours to 40 per week ensures that all people have access to affordable health care.
“Businesses are baffled by the definition of 30 hours,” said Susan Collins (R-Maine), a co-sponsor of the bill. She noted that other federal laws generally define a full-time employee as someone who works at least 40 hours per week.
Some liberal Democrats say that they will not consider the change, as setting the employer mandate at 30 hours per week was the best way to ensure that people who work 30 to 40 hours per week have access to health care.
Smarter use of prescription medications could have saved Americans $200 billion in 2012, according to a new study from the IMS Institute for Healthcare Informatics. These “avoidable costs", as the study calls them, lead to millions of unnecessary hospital admissions, outpatient and emergency room visits and prescriptions.
“Access to medications is a very important priority,” Murray Aitken, executive director of the IMS Institute for Healthcare Informatics, said during a call with reporters. “We believe that the responsible use of those medications is equally important.”
Modern Healthcare reports that the single biggest avoidable cost was medical nonadherence – not following a doctor’s instructions for taking drugs properly cost Americans an estimated $105 billion last year. Cost, a patient’s lack of information about long-term effects of certain diseases and fear of a drug’s side effects all contributed to nonadherence.
Misuse of antibiotics, medication errors and suboptimal use of generic drugs were among the other avoidable cost addressed by the study.
The study did note that improvements have been made that address some of these problems. Generic drug usage, for instance, is on the rise and the percentage of patients who are inappropriately prescribed antibiotics for the cold or flu dropped to 6% in 2012, compared with 20% in 2007.
A recent government study conducted by the Centers for Disease Control (CDC) has found that the proportion of U.S. adult smoking has dropped to 18% within the last two years, the Associated Press reports. Overall smoking rates have fallen over the past seven years, but this marks the first time the habit has dipped under 20%.
The study analyzed surveys taken from 35,000 US adults. Smokers were identified by how many cigarettes they smoke in their lifetime and how often. The rate was only 9% for people of age 65 and older, but 20% for younger adults. The study also determined that about 16% of high school students smoke.
Patrick Reynolds, executive director of the Foundation for a Smoke Free America,
said he felt that many factors have contributed to the decline in adult smoking, such as the federal tobacco taxes, a campaign launched by the CDC to strike against smoking and more laws banning smoking in public.
Smoking is the leading cause of preventable illness and death in the United States. A major contributor to lung cancer, smoking kills 440,000 people each year.
A January 2013 study in the New England Journal of Medicine found people who quit smoking before age 40 lived as long as people who never smoked. Research also supports that smoking can cut 10 years off a person’s life.