June 14, 2010 - Experts Propose Small Financial Incentives To Help Ensure Medication Adherence.
The New York Times (6/14, A1, Belluck) reports on its front page, "One-third to one-half of all patients do not take medication as prescribed, and up to one-quarter never fill prescriptions at all, experts say. Such lapses fuel more than $100 billion dollars in health costs annually because those patients often get sicker." But "now, a controversial, and seemingly counterintuitive, effort to tackle the problem is gaining ground: paying people money to take medicine or to comply with prescribed treatment. The idea, which is being embraced by doctors, pharmacy companies, insurers and researchers, is that paying modest financial incentives up front can save much larger costs of hospitalization." One physician noted that "although 'economically irrational'...small sums might work better than bigger ones."
June 14, 2010 - Companies Push Retiree Drug Benefits To Medicare.
The Wall Street Journal (6/14, Tita) reports that the United Auto Workers union's opposition to a plan by Navistar International Corp., a maker of trucks and engines, to shift some retirees' prescription drug benefits to the Medicare Part D program may represent the beginning of a shift among US companies looking to cut costs as federal healthcare rules change. New federal income taxes on government subsidies for company-sponsored drug coverage take effect in 2013 and benefits experts say many of the nearly 1,400 for-profit US companies that would be affected may switch retirees to Part D coverage. But the switch may result in higher premiums and reduced coverage for retirees, according to the union.
June 14, 2010 – Extended Valganciclovir May Reduce Cytomegalovirus Complications And Organ Rejection After Lung Transplant.
HealthDay (6/14, Preidt) reported, "Extended antiviral treatment after a lung transplant may help prevent dangerous complications and organ rejection," Duke researchers found after conducting a study that included 136 patients. All participants "completed three months of oral valganciclovir and then received either an additional nine months of placebo (66 patients) or an additional nine months of oral valganciclovir (70 patients)." According to the paper in the Annals of Internal Medicine, "CMV infection occurred in 10 percent of the extended treatment group, compared to 64 percent of the placebo group." What's more, "pneumonia caused by CMV virus occurred in four percent of the extended-treatment group and in 32 percent of the placebo group."
June 15, 2010 - Oregon Tightens Rules On Psychiatric Medication Use In Foster Children.
The Oregonian (6/15) reported that starting July 1, Oregon children in foster care "must have a mental health assessment before" being prescribed any antipsychotic "or more than one of another type of psychiatric" medicine. What's more, "there will...be mandatory medication reviews for children younger than six who are taking psychiatric medications and for older kids with more than two psychiatric prescriptions." Prior reporting on the change is Oregon law is found here.
June 16, 2010 - FDA Launches Drug And Vaccine Safety Website.
USA Today (6/16, Rubin) reports, "The Food and Drug Administration launched a website Tuesday where patients and healthcare professionals can find safety information about recently approved drugs and vaccines." On its Postmarketing Drug Safety Evaluations site, the FDA plans to include "what it has learned about the safety of a new drug or biologic, such as a vaccine, 18 months after approval, or after 10,000 patients have used it, whichever comes later." Robert Boucher, an official in the FDA's Office of Surveillance and Epidemiology in the Center for Drug Evaluation and Research, said the agency will make a "broad sweep" of adverse-event reports, medical studies and drug utilization databases. The FDA intends to publish summary reports quarterly. Bloomberg News (6/16, Peterson) points out that the first reports will include "medications for infections, hypertension and depression, the FDA said."
June 17, 2010 - FDA Extends Review Of Application To Expand Gardasil's Use.
The Wall Street Journal (6/17, Loftus) reported that the FDA has now extended its review of an application to expand Gardasil's use to include older females. The drug's maker, Merck, now anticipates a response from the agency by year's end, according to a company spokeswoman, who declined to elaborate about why the agency has decided to extend the review timeline.
June 17, 2010 – CMS To Review Coverage Of Anemia Biologics.
Reuters (6/17) reported that the Centers for Medicare and Medicaid Services on Wednesday said it is reviewing its coverage of anemia drugs, including Amgen Inc.'s Epogen (epoetin alfa) and Aranesp (darbepoetin alfa) and Johnson & Johnson's Procrit (epoetin alfa), after a panel of experts said the drugs could harm patients with chronic kidney disease. CMS also said it is accepting public comments through July 16 on the coverage and expects to issue a decision memo in March of 2011.
June 17, 2010 - FDA Panel Says New Morning-After Pill Is Safe, Effective.
ABC World News (6/17, story 7, 0:25, Sawyer) reported, "A new type of morning-after pill is a big step closer to going on sale in the US. Today, an FDA advisory panel voted unanimously that the pill called ellaOne [ulipristal acetate] is safe and effective." The CBS Evening News (6/17, story 8, 0:25, Couric) reported, "Studies show it can prevent pregnancy up to five days after intercourse. That's two days more than the over-the-counter Plan-B [levonorgestrel] pill." NBC Nightly News (6/17, story 5, 1:35, Holt) chief medical editor Nancy Snyderman, MD, explained that the new pill "is a close chemical cousin to the morning-after pill RU-486 [mifepristone]." The New York Times (6/18, A14, Harris) reports, "Ella blocks the effects of progesterone, a female hormone that spurs ovulation," but "some mystery remains over exactly how it works. That mystery spurred a fierce debate outside the committee over whether it should be considered an abortion drug." The dispute focuses on "whether the drug works by delaying ovulation (as the pill's manufacturer claims) or by preventing a fertilized egg from implanting itself in the uterus (as anti-abortion advocates say)." In a head-to-head comparison of the two drugs in nearly 1,700 women, researchers found that women taking ellaOne had a less than 1 in 50 chance of becoming pregnant, while women who taking Plan B had a 1 in 40 chance, and women with neither alternative after unprotected intercourse had a 1 in 20 chance of becoming pregnant. AFP (6/18, Montet) reported that final FDA approval is "not expected for several months," but "HRA said it hopes to market Ella in the United States by the end of the year through its US partner Watson Pharmaceuticals." WebMD (6/17, DeNoon), MedPage Today (6/17, Walker), HealthDay (6/17, Gardner), USA Today (6/17), Reuters (6/18, Heavey), and The Hill (6/17, Pecquet) "Healthwatch" blog also covered the story.
June 18, 2010 - ED Visits For Pain Reliever Misuse Have Increased Over Last Five Years.
USA Today (6/18, Brophy) reported that emergency department "visits for non-medical use of pain relievers have increased at a striking rate over the last five years, according to a new study " published in Morbidity and Mortality Weekly Report. Researchers found that, "between 2004 and 2008, the estimated number of emergency department visits linked to prescription pain relievers...jumped 111%, from 144,644 visits to 305,885 visits a year, according to a study out Thursday by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC)." Len Paulozzi, a medical epidemiologist at the CDC's Injury Center, said, "These drugs are being prescribed more often. As the number of prescriptions increase, we have seen an increase in" emergency department "visits involving the use of the drugs in a non-medical way." The Los Angeles Times (6/17, Maugh) "Booster Shots" blog reported that "the most widely abused drugs were oxycodone, which rose 152% to 105,214 visits, hydrocodone, which rose 123% to 89,051 visits and methadone, which rose 73% to 63,629 visits." The investigators "also found an 89% increase in visits for the family of anti-anxiety drugs known as benzodiazepines, with visits totaling 271,700 in 2008."
Bloomberg News (6/18, Randall) reports that, according to the researchers, "recent public health and law enforcement measures intended to prevent nonmedical use of such drugs have not prevented rate increases." Reuters (6/18, Steenhuysen) reported that in a statement, CDC Director Dr. Thomas Frieden said "We urgently need to take action." Dr. Frieden added, "These prescriptions medicines help many people, but we need to be sure they are used properly and safely." Meanwhile, SAMHSA Administrator Pamela Hyde said in a statement that "this public health threat requires an all-out effort to raise awareness of the public about proper use, storage, and disposal of these powerful drugs." The Austin American Statesman (6/17, Roser) "Salud" blog reported, "'The abuse of prescription drugs is our nation's fastest-growing drug problem. And this new study shows it is a problem that affects men and women, people under 21, and those over 21,' Office of National Drug Control Policy Director Gil Kerlikowske said in a written statement."
MedPage Today (6/17, Smith) and HealthDay (6/17, Reinberg) also covered the story.
June 18, 2010 - Celebrex May Fewer GI Events Than Diclofenac and Omeprazole.
Bloomberg News (6/18, Cortez) reported that, according to a study published online June 17 in The Lancet, Celebrex [celecoxib], an NSAID arthritis medication causes less bleeding and fewer ulcers in the gastrointestinal tract than a combination of diclofenac (an older NSAID) and omprazole (a proton pump inhibitor). In fact, the study found that "arthritis patients taking Celebrex were four times less likely to start bleeding anywhere from the stomach to the colon than those given the generic pain drug diclofenac and AstraZeneca Plc's Prilosec [omeprazole], a heartburn medicine that reduces acid production." Of course, the actual rate of “clinically significant upper or lower gastrointestinal events” was low in both groups; of approximately 2250 patients in each arm, 20 of the celecoxib and 81 of the diclofenac/omeprazole groups experienced one or more of the outcome events.
MedPage Today (6/17, Walsh) reported that an accompanying commentary said "that advice 'might be premature.'" The commentary "pointed out that the study was limited by the six month duration of treatment, so its conclusions cannot be extrapolated to long-term treatment with either celecoxib or diclofenac and, as a consequence, 'the cardiovascular data should be interpreted with caution because they might not show the true cardiovascular hazard of the two treatments.'" HealthDay (6/17, Preidt) also reported on the story.
Diclofenac may have been chosen as the comparator due to a relatively high rate of GI side effects, rather than a high prevalence of use in the population. The combination of an NSAID with omeprazole or other PPI may be common, but a more effective medication to minimize GI side effects of NSAID use is misoprostol – which is also available generically.
June 18, 2010 - Research Links Lantus To An Increased Risk Of Cancer In Patients With Diabetes.
Dow Jones Newswire (6/18, Amiel, Stovall) reported that research published in Diabetes Care links Lantus (glargine) to an increased risk of cancer in patients with diabetes. However, according to Sanofi Aventis, "The risk for cancer in subjects with diabetes has been the matter of extensive scientific debate for decades.” Reuters (6/18, Mennella, Hirschler) also covered the story.
