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08/03/12

  01:09:23 pm, by MedBen5   , 181 words,  
Categories: News, Prescription

Generics Saved U.S. Nearly $200 Billion Last Year

Generic Savings By Year

Generic drugmakers are basking in the glow of good news: A new report from the Generic Pharmaceutical Association states that the use of generics over brand-name drugs reduced U.S. drug spending by $193 billion in 2011 and more than $1 trillion over the past decade (see chart).

According to the Pharmalot blog, the report noted that the 22% rise in savings last year marked the largest single-year increase since 1998. The increase was attributed in part to expiring patents for such major brand-name drugs as the Lipitor cholesterol pill, the Zyprexa antipsychotic, and the Concerta ADHD medication. Additionally, generic versions of antidepressants, anticonvulsants and cardiovascular drugs accounted for 57% of the annual savings.

The report also found that generics that have entered the market since 2002 represented $481 bilion of the total savings. And in 2011, roughly 4 of every 5 prescriptions written in the U.S. were for generics, but they accounted for only about one-quarter of total drug spending.

As more brand-name medications lose patient protection, more generic drugs will take their place. As a result, generic utilization wll reach almost 87% by 2015, predicts IMS Health, which compiled the report.

  12:25:41 pm, by MedBen5   , 187 words,  
Categories: News, Wellness

Almost Half Of U.S. Adults At Risk For Heart Disease

HealthDay News reports that nearly half of American adults have at least one risk factor for heart disease, such as uncontrolled high blood pressure, uncontrolled high levels of “bad” LDL cholesterol and smoking.

The U.S. Centers for Disease Control and Prevention reviewed data from a national health and nutrition survey, and found that adults have actually shown some improvement over the past decade – the risk factor rate dropped from 58% in 1999 to 46.5% in 2010. But overall numbers still remain high.

According to the CDC report:

  • Men (52%) are more likely than women (41%) to have one of these risk factors.
  • From 1999 to 2010, there was a drop in the percentage of whites and Mexican Americans who had at least one risk factor (about 47% and 45%, respectively).
  • There was no decline in the percentage of blacks with these risk factors, which remained at 58%.
  • The prevalence of uncontrolled high blood pressure and uncontrolled high LDL cholesterol dropped between 1999 and 2010 (almost 8% and 9%, respectively).
  • There was no drop in the percentage of adult cigarette smokers, which remained at 25% of adults 20 and older.
  • Disparities remain among people of different income levels and racial and ethnic groups.

08/02/12

  05:19:10 pm, by MedBen5   , 547 words,  
Categories: News, Wellness, Health Plan Management

Changes to Women's Preventive Services Take Effect

On August 1, 2011, the U.S. Department of Health and Human Services adopted women’s preventive health care services guidelines developed by the Institute of Medicine. The services listed in these guidelines are added to the required covered preventive services for non-grandfathered health plans under the Patient Protection and Affordable Care Act (PPACA). If your plan is non-grandfathered and self-funded, these must be covered at 100% beginning with the first plan year on or after August 1, 2012. If your plan is fully-insured through Medical Benefits Mutual, these services will be covered under your plan starting with your next renewal on or after August 1st.

What preventive services will be added?

  • Annual well woman exam: Including all services that are age and developmentally appropriate, such as pre-conception and pre-natal care. This could include the first prenatal visit, even for a dependent child. Additional visits may be required to provide all necessary services.
  • Gestational diabetes screenings: For all women, including dependent children, at twenty-four (24) to twenty-eight (28) weeks of gestation (or on the first pre-natal visit, if identified at high risk for diabetes).
  • HPV testing: Once every three (3) years, beginning at age thirty (30).
  • All Food and Drug Administration (FDA) approved contraceptive methods: These contraceptives could still be covered through a prescription drug card/mail order program. No copayment applies.

    Certain non-profit religious organizations may claim an exemption from this requirement if they have not previously covered contraceptives under their health plan. If you feel you may qualify for this exemption, contact MedBen for more information.

  • Elective sterilization procedures: Coverage is required for all females, including dependent children. Coverage is not required for covered males, though consideration for providing equal coverage for male employees and spouses is recommended, as such procedures performed on males are generally less costly.
  • Breast-feeding counseling and rental (but not purchase) of breast-feeding equipment: Coverage for all females, including dependent children.
  • Annual counseling regarding sexually transmitted diseases for all sexually active women.
  • Annual screening and counseling regarding domestic abuse.

Full story »

  04:50:53 pm, by MedBen5   , 196 words,  
Categories: News, Wellness

Sports Drinks Not The Best Cure For Olympic-Sized Thirst, Studies Say

Has watching the Olympics motivated you to exercise more? If so, it’s not surprising – two weeks of morning-to-night competition brings out the superjock in some individuals. And just like the Olympic athletes, many people fuel their workouts with sports drinks.

But not so fast with those store-bought beverages, says the Harvard Health Blog. Based on the conclusions of several studies published in the British Medical Journal (BMJ), sports drinks are no more effective than water in maintaining proper fluid balance during exercise – and they deliver unneeded calories to boot.

The BMJ team also noted that the makers of sports drinks push their products as a better fix for dehydration than water. But dehydration isn’t the biggest concern when working out, the researchers argue – overhydration is. Drinking too much liquid can result in hyponatremia, a potentially fatal condition that sports drinks don’t appear to prevent.

In response to a question from the blog about how an athlete can tell when to replenish fluids, Harvard team physician Dr. Francis Wang replied, “For most players, thirst is a good guide for hydration.” And the same goes for those us who aren’t necessarily striving for gold-medal glory.

07/31/12

  05:07:01 pm, by MedBen5   , 161 words,  
Categories: News, Prescription

Are Wi-Fi Pills In Our Future?

Pharmaceutical techology in the news that’s two parts “remarkable” and one part “odd"… a pill that electronically records when it’s been taken.

MedCity News reports that the Food and Drug Administration has approved what is being called America’s first smart pill system. Simply swallow the pill as normal, and a tiny ingestible sensor activates when it reaches the stomach. A companion wearable patch then marks the ingestion time and passes the information onto a mobile phone application, which in turn can be accessed by caregivers and clinicians.

The system has been tested in conjunction with such conditions as tuberculosis, mental health, heart failure, hypertension and diabetes, said CEO Andrew Thompson of Proteus Digital Health, the pill’s creator and manufacturer. Proteus hopes the system will help to improve the prescription compliance rate in the U.S., which is currently around 50%.

The battery-operated, wearable patch lasts seven days and also works as a heart rate monitor and can measure body temperature and activity.

  11:47:58 am, by MedBen5   , 267 words,  
Categories: Health Plan Management

Toothless Tax Won't Push People To Buy Health Insurance

Last month, the Supreme Court ruled that the penalty for not buying health insurance constitutes a tax – a decision that had Capitol Hill Democrats and Republicans scrambling to, respectively, do damage control or make political hay. But as Joseph Antos and Michael R. Strain point out, the tax will do little to spur insurance purchases:

“Generally speaking, if you owe the IRS, it will get the money from you – with the possible exception of the ObamaCare tax. Though ObamaCare’s individual mandate imposes a tax on people who do not purchase government-approved health insurance, the law explicitly neuters the IRS’s ability to collect the tax.

“Bizarre? Yes. And it matters. If policymakers expect uninsured young people to buy health insurance when it is even more expensive than it is today, the threat of serious consequences for not doing so must be real. Yes, the threat that the IRS might come after you if you do not do what you are told looks real at first glance. But Democratic politicians, fearing public backlash for making the mandate too intrusive, pulled its teeth. […]

“[T]he law counts on most of the scofflaws turning themselves in. If you do not have insurance and think you owe the tax, then you will be asked to check a box to that effect on your tax return. If you choose to ignore the mandate, you might also choose not to check the box. But even those who do confess that they do not have insurance may not be liable for the new tax.”

Read more at The Health Care Blog.

  11:10:27 am, by MedBen5   , 193 words,  
Categories: News, Wellness

Government Panel Recommends Changing EKG Guidelines

The United States Preventive Services Task Force has advised against the use of treadmill testing with electrocardiograms (EKG) for people who have no known risk factors or symptoms of heart disease, The New York Times reports.

Once a regular part of physical examinations for older Americans, walking or jogging on a treadmill while an EKG monitors heart function has fallen out of favor in recent years. The government panel recommended that people who don’t have shortness of breath, chest pains or oher common signs of heart disease not get the test, while those at higher risk of heart disease be considered on a case by case basis.

“In my own practice I’ve seen people who thought they shouldn’t be exercising anymore because someone put them on a treadmill and got an abnormal test result when in fact there was nothing wrong with them,” said Dr. Michael L. LeFevre, a vice chairman of the task force.

In April, a collective of U.S. medical societies placed the stress test on its on its list of 45 common tests and procedures that doctors should perform less often, as part of their “Choosing Wisely” Campaign.

07/30/12

  05:23:14 pm, by MedBen5   , 165 words,  
Categories: News, Health Plan Management

Government Enlists Insurers For Fraud Crackdown

The Department of Health and Human Services is working with health insurers to fight against health care fraud, the Associated Press reports.

Several larger insurers have pledged to share raw data and industrial expertise in order to reduce incidents of questionable payments that have added up to billions of dollars in ill-gotten funds. State investigators will also participate.

“Lots of the fraudsters have used our fragmented health care system to their advantage,” said HHS Secretary Kathleen Sebelius. “By sharing information across payers, we can bring this potentially fraudulent activity to light so it can be stopped.”

While MedBen is not directly involved with the government’s efforts, we’re no less dedicated to preventing fraudulent activity. We help to keep client costs down through our Anti-fraud Unit, which reviews questionable claims and other related information. Additionally, claims examiners are trained to refer potentially fraudulent claims to their departmental manager.

For additional information about MedBen’s anti-fraud measures, contact Vice President of Sales & Marketing Brian Fargus at (888) 627-8683.

  01:12:41 pm, by MedBen5   , 125 words,  
Categories: News, Prescription

Ohio Providers Battle Painkiller Abuse With Military Technology

The Wall Street Journal Health Blog reports on high-tech efforts by southern Ohio health care providers to combat painkiller abuse:

“Starting this week, patients must submit to a fingerprint scan to see a doctor at one hospital system. At several pharmacies, patients must use fingerprint IDs to get their prescriptions filled.

“The one-year pilot program, announced Thursday, was green-lighted in recent weeks by the state’s Republican Gov. John Kasich. If the technology works, fingerprint scans could become more commonplace in Ohio – a state where an average of 67 opioid painkillers are prescribed to every resident each year, state data show.”

The biometric tools used to perform the scans are similar to those used by U.S. forces in Afghanistan and Iraq, the blog notes.

  12:41:59 pm, by MedBen5   , 193 words,  
Categories: News, Health Plan Management

CBO: Court Ruling Will Cut Costs But Add To Uninsured

The nonpartisan Congressional Budget Office recently reported that the Supreme Court’s ruling to uphold most of the Affordable Care Act will save about $84 billion, but also means that 3 million more people will lack health insurance.

According to The Hill’s Healthwatch blog, the two changes result from the court’s decision that states must be allowed to opt out of the health care reform law’s Medicaid expansion.

CBO also estimated that a complete repeal of the ACA would increase federal deficits by $109 billion in 10 years, though that did mark a reduction from a previous estimate of $210 billion.

Both political parties found partisan ammunition in the report:

  • “Our Republicans keep talking about repealing the deficit, but they’ve now voted more than 30 times to bore a hole in the deficit by more than $100 billion,” said Rep. Chris Van Hollen (D-Md.).
  • “CBO exposed the president’s partisan health law for what it is: a massive expansion of government paid for with over a trillion dollars in tax increases, while increasing costs on the backs of middle-class families, job creators and states during the worst economic downturn in a generation,” Sen. Orrin Hatch (R-Ut.) said in a statement.
  11:54:21 am, by MedBen5   , 242 words,  
Categories: News, Wellness

Prostate Cancer Studies Offer Support For And Against Testing

The debate regarding the usefulness of prostate-specific antigen (PSA) tests rages on, with separate research offering evidence for both the “pro” and “con” camps:

  • According to WebMD, a study suggests that routine PSA tests can catch prostate cancer before it spreads, potentially sparing 17,000 Americans each year the worst form of the disease.

    Researchers compared data from the years 1983-85 – a period preceding widespread PSA testing – to 2006-08. They found that men getting their first diagnosis of the disease in the earlier period were three times more likely to learn they had late-stage metastatic prostate cancer, which is typically fatal within two years or less.

    “By not using PSA tests in the vast majority of men, you have to accept you are going to increase very serious metastatic disease threefold,” says study leader Edward Messing, MD, chief of urology at the University of Rochester Medical Center.

  • Men with prostate cancer are more likely to die from heart disease or other conditions than from their cancer, a Harvard School of Public Health study finds.

    HealthDay News reports that, according to study researchers, men who live a healthy lifestyle that helps prevent chronic disease can prolong their lives even if they have the disease.

    “We hope it will encourage physicians to use the diagnosis as a teachable moment to encourage men to modify lifestyle factors, like losing weight, increasing physical activity and stopping smoking,” explained Mara Epstein, a postdoctoral researcher at the school.

07/25/12

  01:07:38 pm, by MedBen5   , 210 words,  
Categories: News, Health Plan Management

Reform Rules Spur Employers To Explore Self-Funding

The Affordable Care Act will spur more small business to self-fund their health care coverage, says a new paper by the Center for Studying Health System Change.

According to Modern Healthcare, the report concluded that employers with fewer than 100 workers may accept the risk of employee health care cost because it exempts them from certain provisions of the reform law, such as state review of premium rate increases, community rating for premiums and essential health benefits.

The Center based its findings on interviews with health plans, stop-loss insurers and third-party administrators.

At MedBen, small employers can explore alternatives to fully-insured coverage. MedBen third party administration offers groups the advantage of having a custom plan design to provide greater control over their money. MedBen delivers the expertise and technology to manage your self-funded health plan in the most cost-effective manner.

Groups not yet ready to totally make the switch to self-funding may want to consider the advantages of a partially self-funded plan. MedBen Split Solution lets employers share in the savings that come from a favorable claims experience by partially self-funding their benefits, while retaining the security of a fully-insured contract.

To learn more about these funding alternatives, contract MedBen Vice President of Sales and Marketing Brian Fargus at 888-627-8683.

07/24/12

  05:13:58 pm, by MedBen5   , 212 words,  
Categories: Wellness

Waiting For Medical Results Can Be A Test Of Patience

Anyone who has had to wait for important medical test results knows how stressful the experience can be, as thoughts alternative between hoping for the best and fearing for the worst. Increased online availability of test results speeds up the process, but leaves the patient unassisted when interpreting the information.

The New York Times highlights the physical and mental effects of prolonged anticipation:

“The impact of waiting for test results on patient anxiety is significant. It has been studied in breast cancer biopsy patients, infertility patients and patients undergoing genetic testing, among others. Stress alone, these studies show, can affect recovery time and exacerbate side effects from medications. The psychological toll in households can also be harsh, especially among family members with clashing coping styles – if, say, one person has an optimistic bent, while the other tends to presume the worst.”

The Times also suggests some pretest questions to ask doctor and medical staff:

  • What precisely can this test reveal? What are its limitations?
  • How long should results take, and why? Will the doctor call with results, or should I contact the office?
  • If it’s my responsibility to call, what is the best time, and whom should I ask for?
  • What is the doctor’s advice about getting results online?
  04:37:13 pm, by MedBen5   , 189 words,  
Categories: News, Prescription, Wellness

Rise In Diabetes Spurs New Treatment Strategies

The rise in U.S. obesity over the past several decades has been accompanied by a increase in Type 2 diabetes. The best strategy for reducing the risk of the disease is a sensible weight loss program. But for those already afflicted, the solution is less clear.

The Wall Street Journal recently explored new strategies for treating diabetes. Revised guidelines for treating the disease suggest doctors eschew a one-size-fits-all program, instead varying treatments based on a patient’s age, general health and even personal preferences.

For example: Earlier standards advocated reducing the blood sugar of diabetes patients to a standard targeted level. But the new guidelines recommend that doctors reserve that strategy for younger patients, while using a less aggressive approach with older patients.

A more extreme approach for treating the disease is bariatric surgery, which results in dramatic weight loss. In spite of its potential complications, the treatment has increasingly found favor in the medical community as obesity rates have grown.

The latest guidelines do reaffirm a gradual boost in drug therapy dosage. But recent research suggests that hitting the disease early and hard may be a more effective approach.

07/23/12

  04:27:04 pm, by MedBen5   , 253 words,  
Categories: Prescription

All Pharmacies Are Not Created Equal

On the KevinMD.com blog, Medical student Arvin Akhavan argues for a more transparent pharmaceutical pricing system:

“I consider myself well educated. I’m a college graduate and in the throes of professional school – in healthcare nonetheless. I have an open mind and I read quite a bit. But I still wouldn’t have guessed that Coumadin would cost my uninsured father in Texas $15 for thirty pills at CVS, but only $4 for the same number of tablets at Walmart (I can actually vouch for this number).

“I would have thought it was safe to assume that drug prices are comparable across the board. After all, that’s how it usually works, right? When I buy gum, I have faith that I won’t pay triple the price at one convenience store compared to another. But with pharmacies, this just isn’t the case. […]

“That’s why transparency is so important to the prescription medication consumer. Few of us have any idea as to how much drugs should cost. And, since many states don’t require their pharmacies to release their drug costs unless someone is buying them, the consumer has no convenient way of amassing the information it needs to choose from the options.”

MedBen agrees that the more information about drug prices, the better. That’s why we encourage our pharmacy plan members to visit RxEOB online, to check retail costs of thousands of brand name and generic medications. Simply log on to the MedBen Access website and click on “My Rx”.

  01:08:47 pm, by MedBen5   , 125 words,  
Categories: News, Health Plan Management

Senate Republican Efforts To Repeal ACA Thwarted

In an ongoing political tennis match, Senate Republicans have once again served up an attempt to repeal the Affordable Care Act, and Democrats have once again lobbed it right back at them.

According to The Hill’s Floor Action Blog, Senate Majority Leader Harry Reid (D-Nv.) blocked a Senate vote on striking down the health care reform law. Republicans amended the repeal language to the Bring Jobs Home Act, which had a procedural vote last week.

This marks the second time this month that Republicans have offered an amendment to repeal the ACA. Earlier in July, they made a similar effort as part of a small-business bill.

Senate Minority Leader Mitch McConnell (R-Ky.) has vowed to continue fighting for a repeal vote before the August break.

  12:25:31 pm, by MedBen5   , 163 words,  
Categories: News, Wellness

Do E-cigarettes Benefit Smokers? The Jury's Still Out

Electronic cigarettes are gaining in popularity among smokers, as both a tobacco substitute and a tool to hopefully wean them from the habit.

According to WebMD, the devices resemble regular cigarettes but work by means of a vaporizer filled with a nicotine-containing solution. Because they don’t contain the many other chemicals found in tobacco, they may be a safer alternative for smokers – emphasis on “may be".

“This is an unproven device and we know very little about its long-term health effects,” says researcher Jennifer Pearson, PhD, MPH. She is a research investigator at Legacy, an antismoking group in Washington, D.C. “E-cigarettes are probably less harmful than combustible cigarettes, [but] we don’t have data to say that and can’t talk about long-term effect.”

While e-cigarettes are not marketed as smoking cessation devices, it’s likely that some smokers made the transition from traditional cigarettes as a stepping stone to kicking the habit. But Pearson suggests smokers stick with FDA-approved smoking cessation tools instead.

07/20/12

  12:12:08 pm, by MedBen5   , 318 words,  
Categories: News, Prescription, Wellness

New Weight Loss Drugs Generate Questions, Opinions

With two new weight loss drugs approved by the Food and Drug Administration within three weeks of each other, questions about their comparative effectiveness are inevitable. In response, WebMD has developed a Belviq/Qsymia FAQ. Here, we highlight their response to the question likely on the mind of potential users:

Which works better, Belviq or Qsymia?

There’s no way to know for sure. Qsymia and Belviq have never been tested in a head-to-head clinical trial.

In the placebo-controlled clinical trials that led to approval:

  • People taking Belviq had an average weight loss that was 3% to 3.7% greater than people taking placebo.
  • After taking Belviq for one or two years, some 47% of people without diabetes lost at least 5% of their body weight. Only 23% of patients taking an inactive placebo lost this much weight.
  • People taking Qsymia for up to one year had an average weight loss of 8.9% over those taking an inactive placebo.
  • 70% of people taking Qsymia lost at least 5% of their body weight. Only 20% of patients taking an inactive placebo lost this much weight.

These numbers cannot be used to compare the two drugs, as the clinical trials had different designs.

Meanwhile, Healthday News talked to two health experts about how the drugs will affect the country’s obesity epidemic – and both said some perspective is needed:

“The bottom line is there’s no such thing as a magic pill and I hope that individuals do not think by taking this pill that it will ensure long-term weight loss,” said Keri Gans, a registered dietitian in New York City. “We need to be reminded that diet and exercise are still critical.”

And Dr. Michael Aziz, an internist at Lenox Hill Hospital in New York, said, “The problem that all the drug companies are overlooking is the fact that obesity is really multi-factorial. It’s not only related to diet and exercise but also to hormonal imbalances, stress and lack of sleep.”

  11:38:30 am, by MedBen5   , 206 words,  
Categories: News, Health Plan Management

House Subcommittee Passes Bill To Defund ACA

Republicans in the House of Representatives are certainly not letting any moss grow beneath their feet these days. Just one week after the full legislature passed a bill to repeal the Affordable Care Act, a House Appropriations subcommittee voted 8-6 to approve a spending bill that would defund the law.

According to POLITICO, the Labor-Health and Human Services appropriations bill would cut $1.3 billion in funding for HHS. It would also eliminate the 20-year-old Agency for Health Care Quality and Research, a move that upset Democratic committee members, all of whom voted against the bill.

AHRQ is “the only federal agency whose sole mission is to improve the quality, safety and cost efficiency of health care,” said Rep. Lucille Roybal-Allard (D-Ca.) She called it “our best weapon” to advance health research.

In response to the criticism, subcommittee Chairman Denny Rehberg (R-Mont.) told POLITICO, “It all boils down to, we have more government right now than we can afford. We were given an allocation of $150 billion. We did everything we possibly could to meet as many of the needs as we could,”

One lone Republican, Rep. Jeff Flake of Arizona, joined Democrats in opposing the bill, saying it did not go far enough in reducing the federal deficit.

  10:37:32 am, by MedBen5   , 164 words,  
Categories: News, Wellness

Whooping Cough On Pace For Most Cases In 50+ Years

The Centers for Disease Control and Prevention warn that 2012 will probably experience the highest number of whooping cough cases since 1959, USA Today reports.

Known formally as pertussis, whooping cough is a highly contagious bacterial disease that is particularly dangerous to infants and young children. It results in severe coughing that causes children to make a distinctive whooping sound.

As of July, almost 18,000 cases have been reported – over twice as many at this point last year. Public health officials theorize that a switch in vaccine types 15 years ago may be partially responsible for the increase.

While most infants are vaccinated against the disease, only 8.2% of adults are – and they are the one most lilkely to infect infants, said Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases.

In addition to ensuring infants and young children receive the tetanus-diphtheria-pertussis vaccine, CDC also recommends that adults get a booster shot every 10 years. Women should also get vaccinated before or early in pregnancy.

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