Medi-Cal officials’ travel linked to drug makers
Records and interviews show that “Three California officials who oversee billions of dollars in Medi-Cal prescription drug spending have failed to disclose free flights, hotel rooms and meals paid for by nonprofit groups funded by drug makers,” according to Christina Jewett of California Watch.
One of the officials is directly involved in negotiating rebates with drug makers.
The nonprofits that paid for the trips are used to fund conferences and meetings and raise money by charging fees to drug company representatives who do business with Medicaid programs.
A Medi-Cal spokesman confirmed the trips and said they should have been reported as gifts. The agency has a policy against accepting gifts woth more than $320 from anyone that “has financial dealings with the department,” yet the spokesman said the agency had found no conflicts of interest in the trips.
ECRI reviews prostate cancer research
Filed under: Health data, Hot Health Headline, Studies, Tools, Uncategorized
The ECRI Institute’s new review of recent research on the utility of off-label prescription of Finasteride in the prevention of prostate cancer (PDF) presents research and clinical guidelines. Its bibliography and research review may be useful for anyone considering a follow-up to Gina Kolata’s recent New York Times piece on cancer prevention. Finasteride blocks an enzyme that aids the proliferation of prostate cancer cells. It’s used to reduce the size of enlarged prostates and, under the name Propecia, to treat male pattern baldness.
A large trial on finasteride, known as the Prostate Cancer Prevention Trial (PCPT), was published in 2003. The 18,882 men (asymptomatic, with normal PSA levels, 55 years of age or older) enrolled in the trial were randomly assigned to receive either finasteride or placebo for 7 years. … The authors of the trial reported that finasteride reduced the incidence of prostate cancer from 24.4% to 18.4%; however, the incidence of high-grade prostate cancers was 25.6% higher in the finasteride group than the placebo group. The clinical significance of these findings is unclear and has been widely debated.
The impact of prophylactic finasteride on long-term mortality and quality of life was not reported by the PCPT. Two models forecasting the impact of finasteride on mortality in participants in the PCPT were published. Grover et al. predicted that for every 1,000 men treated with finasteride, a total of 20 life-years (0.02 years per individual) would be saved, and Lotan et al. predicted that men treated with finasteride would, on average, gain 1.7 months of life.
The ECRI release was prompted by Kolata’s piece in The New York Times which questions why drugs that have been proven to prevent cancer are not being taken while many potentially harmful (and useless) supplements are. Kolata mentioned the Finasteride case in addition to similar examples involving breast cancer prevention drugs.
According to its Web site, the nonprofit ECRI Institute “dedicates itself to bringing the discipline of applied scientific research to healthcare to discover which medical procedures, devices, drugs, and processes are best to enable improved patient care.” The acronym ECRI has been adopted as the organization’s full name, but used to stand for “Emergency Care Research Institute.”
Deadlines for health journalism awards released
AHCJ has opened its call for entries for the Awards for Excellence in Health Care Journalism, recognizing the best health reporting in print, broadcast and online media.
Last year’s winners included a reporter’s revelation of astonishing conflicts of interest by scientists advocating for early detection of lung cancer, the exploration of a hidden world of illegal prescription drugs sold at swap meets, a narrative on a mechanic seeking to rebuild his life after an accident severed his arms, and a trip into the nightmarish world of a boy struggling with mental illness.
Entries can include a wide range of health coverage including public health, consumer health, medical research, the business of health care and health ethics.
The contest was created by journalists for journalists and is not influenced or funded by commercial or special-interest groups.
Is Baucus’ excise on ‘Cadillac’ plans too broad?
The New York Times‘ Reed Abelson writes that the excise tax on premium health insurance plans that Montana Sen. Max Baucus is counting on to pay for about a quarter of his $774 billion reform proposal will hit urban families and union workers as hard as it will Goldman Sachs executives. Proportionally, in fact, union workers with less disposable income will suffer even more from the tax, which hits any plan that costs more than $8,000 for individuals or $21,000 for families, than high-flying white collar types.
The current national average for family policies is around $13,375, and only 1/10 of them would fall under the tax. But, Abelson reports, the pace of health premium inflation is such that far more policies will be caught in the tax net by the time the excise would go into effect in 2013.
The tax is based on the theory that it will help control health care costs by discouraging insurers from offering fancy plans that cover too many unnecessary tests and procedures. AHCJ immediate past president Trudy Lieberman writes for CJR.org that even this attempt to rein in costs will likely just increase them further as insurers pass the costs onto customers and the weaker coverage and corresponding rise in underinsurance forces folks faced with catastrophic conditions into financial difficulty or bankruptcy.
Blogger: Flu reporters got it right this time
Bloggers at Effect Measure have some praise for “flu reporters” and their coverage of a recent NIH press release about the H1N1 vaccine in children.
The writer points out that the reporters he praises took the time to recognize that the real news was buried in the press release: that younger children will need two doses of the H1N1 vaccine.
The writer (the editors of Effect Measure sign their posts “Revere” to recognize Paul Revere, a member of the first local board of health in the United States) does call out one report for being just a rewrite of a press release but notes:
I’ve spent a lot of time here complaining how so much science reporting I see everyday is barely massaged press releases regurgitated by reporters acting as stenographers.
Pfizer tentatively tackles tweets
James Chase reports in Medical Marketing & Media that Pfizer has opened a Twitter account, @pfizer_news. The pharmaceutical behemoth will use the microblogging service for interacting and opening dialog with customers, rather than for product promotion or advertising, Chase reports. While Pfizer has been monitoring Twitter for months, executives were afraid to engage directly for fear that they would be “ripped to shreds” by the Twitterati.
“We’re trying to become transparent, but we’re doing it slowly and cautiously,” said (Ray Kerins, VP worldwide communications). “For us to jump in with two feet would be stupid. The first task was to get the communications team cleaned up because we’ve had a bad rap in that area.”
Pfizer hopes to increase its social media presence, but plans to do so cautiously and in gradual steps.
For now, Pfizer’s media relations team is charged with controlling all corporate tweeting, but Kerins said he hopes to expand the pool soon. “I would love to have by the end of the summer 100 people, from medical to public affairs, who have been anointed by the company and who can go out and Twitter.”
As of Monday morning (July 27), @Pfizer_News had gained 565 followers and was in turn following 225 users, many of them major media outlets.
Doc praises, explains benefits of electronic records
Calling the typical paper-based health record system “a primitive, fragmented and unreliable way to do business,” Rahul Parikh, M.D., writing for the Los Angeles Times, shows how electronic medical records have improved his practice.
Parikh’s piece starts from a foundation of a few electronic interactions with patients and builds a thesis from there:
In the past, these parents would have left a phone message and we probably would have spent the better part of a day or two playing phone tag. Or they would have had to make an appointment, strap their children into car seats, pack diaper bags and snacks and sit in a waiting room full of sick children — only to spend 5 to 10 minutes with me while I told them everything was fine. Instead, we fixed the issues by e-mail, allowing parents to stay in their lives at home and at work.
Parikh says that while EMRs do increase his workload – data entry is far more of a hassle than just scribbling something on a scrap of paper and shoving it into a file – they also allow him to shift between work and home when needed, giving his schedule a flexibility it lacked when he was permanently tied to the office by mountains of paper. While EMRs are “far from perfect,” he writes, they are still a significant improvement over the status quo.
Parikh acknowledges some criticisms of electronic medical records, such as a study that concluded using hand-held PDAs led to an increase in wrong and redudanct diagnoses. He says those errors can be remedied by “holding doctors and others accountable for the accuracy of their documentation.” As far as the security issues surrounding electronic records, he says they are legitimate concerns but no different from those in other industires, such as finance.
Past news about EMRs
- Kaiser’s switch to electronic records hits snags
- Failure to use digital record system hurts soldiers’ care
- Strides in efficiency don’t necessarily benefit doctors or patients
- Military resists new health records system
- Issues remain before personal health records go mainstream
- Health IT reforms move slowly in Calif. prisons
- Weigh risks, benefits of electronic personal health records
Tip Sheet
- Improving patient safety through health information technology: Presentation by Rainu Kaushal, M.D., M.P.H., assistant professor of public health, Weill Medical College of Cornell University
Reports/Studies
On the Web
- The American Health Information Community recommends specific actions to achieve a common interoperability framework for health information technology. (May 2007)
KING’s Duggan among Clarion Award winners
Pat Duggan, of KING-Seattle, has won a 2009 Association for Women in Communications Clarion Award for “Humoody,” an extended feature story that followed the struggles of a young Iraqi boy, left blinded and disfigured by gunfire, and the efforts of a Seattle surgical team to restore his face. Duggan also received a regional Emmy for the same piece.
The Clarion will be presented at the 2009 AWC National Conference in Seattle in October.
Swine flu blues: Vaccinations could be delayed
Filed under: Hot Health Headline, Public health, Uncategorized
Summertime and forgetting about swine flu is easy. But the World Health Organization yanked us back to reality.
The H1N1 virus isn’t taking a vacation. Dr. Marie-Paule Kieny, WHO director of the Initiative for Vaccine Research, said the “pandemic is unstoppable” and “all countries will need to have access to vaccines” in a briefing yesterday.
But making a swine flu vaccine looks more difficult than expected, which could delay when folks could get immunized against the bug.
Even when a vaccine becomes available there won’t be enough to go around. So WHO recommends that health-care workers get jabbed first.
A big problem remains that there simply aren’t enough vaccine factories to supply the world’s needs, WHO Director General Margaret Chan said today. She defended the patent system and called for incentives to encourage innovation by drugmakers.
Ex-Hill honchos make lobbying roundtrip
You can’t tell the health-care lobbyists without a program. So The Washington Post, working with data from the Center for Responsive Politics, has come up with one just in time for the next round of health-reform negotiations on Capitol Hill.
More than 350 former congressmen, committee staffers and federal bigwigs are busily advancing the interests of drugmakers, insurers, hospitals and medical groups, the Post reports.
Buying influence is easy but it ain’t cheap. The Post calculates the “record-breaking” campaign is costing the health-care industry more than $1.4 million a day.
What does it get for the money? A seat at the table, for starters, and maybe much more. For their part, the ex-government employees get a pretty rich payday.
“For people like me who are on the outside and used to be on the inside, this is great, because there is a level of trust in these relationships, and I know the policy rationale that is required,” Richard Tarplin, a lobbyist working for the American Medical Association, told the Post. Tarplin used to work for Health and Human Services and Sen. Chris Dodd (D-Conn.), who’s a key player in the health debate.
From The Washington Post
If you do nothing else, check out the slick graphic showing the influence of ex-staffers from the Senate Finance Committee.
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Health Journalism 2010, AHCJ's annual conference, features a world-class program with story ideas, sources, stronger reporting skills, chances to meet newsmakers and network with other journalists.
- Health and education: Covering these intersecting beats
- Reporting on the business of health care
- Health reporting resources for journalists on state and local government beats
- Shortened Lives: How location, lifestyle affect health
- Covering a complex story for the long haul
- Aging in the 21st Century: Presentations and tip sheets
- AHCJ calls for better information from Joint Commission Web site
