November 9th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion
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Take medical uncertainty. Add financial incentive to treat. Voila! Increased utilization. Now take away financial incentive to treat. Guess what you get?
MedPageToday explains, in the case of hormone therapy for prostate cancer:
Medicare accomplished what clinical guidelines and evidence-based medicine couldn’t: it reduced unnecessary use of androgen deprivation therapy (ADT) in prostate cancer.
Inappropriate use decreased by almost 30% from 2003 to 2005, following enactment of the Medicare Modernization Act, which lowered physician reimbursement for ADT. Appropriate use of ADT did not change during the same time period, according to an article in the Nov. 4 issue of the New England Journal of Medicine.
“Our findings suggest that reductions in reimbursement may influence the delivery of care in a potentially beneficial way, with even the modest [reimbursement] changes in 2004 associated with a substantial decrease in the use of inappropriate therapy,” Vahakn B. Shahinian, MD, of the University of Michigan in Ann Arbor, and co-authors wrote in conclusion.
“The corollary is that reimbursement policies should be carefully considered to avoid providing incentives for care for which no clear benefit has been established. The extreme profitability of the use of gonadotropin-releasing hormone (GnRH) agonists during the 1990s probably contributed to the rapid growth in the use of ADT for indications that were not evidence-based.”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
November 3rd, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Research
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Continuing this week’s spontaneous theme (we didn’t make the claims and write the stories) of runaway enthusiasm for various screening tests by some researchers and journalists, HealthDay news service has reported on a study published in the Oct. 28 issue of the journal Nature that they say “provides new insight into the genetics of pancreatic cancer.” In the story, they let one of the researchers get away with saying, almost unchallenged:
“What’s important about this study is that it’s objective data in support of why everyone should be screened for pancreatic cancer.”
Mind you, this was a study that looked at tissue from just seven patients. The story continued with its breathless enthusiasm for the pancreatic cancer screening idea:
“In the future, new imaging techniques and blood tests will offer hope for early detection, the study noted. And just as people have a colonoscopy when they turn 50, “perhaps they should have an endoscopy of their upper gastrointestinal organs that includes an ultrasound of the pancreas,” said (the researcher).”
The very end of the story included some skepticism from Dr. Len Lichtenfeld of the American Cancer Society. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
October 30th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
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Kmart, Medtronic, and a bunch of specialty medical groups are sponsoring a campaign called “Find the AAAnswers” — the “AAA” standing for abdominal aortic aneurysm.
It’s clever marketing for Kmart’s pharmacy business, since the screenings are being offered throughout the Fall at more than 900 Kmart pharmacies. And it’s not bad business for the specialty medical groups, either, as Larry Husten wrote on his Cardiobrief blog:
…the expenses of the program and the coalition are entirely underwritten by Medtronic, which sells abdominal stent grafts used to repair AAAs, and the members of the coalition include organizations like the Peripheral Vascular Surgical Society, the Society for Vascular Surgery, and the Society for Vascular Ultrasound, whose members may derive a significant portion of their income from performing AAA repairs and screening.
Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
October 25th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
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Just five days ago we wrote about an American journalist’s observations of medicalization of one problem sometimes observed after menopause: Vaginal atrophy.
Today we see that this disease-mongering trend has popped up in Australia as well. This should be no surprise. Such campaigns are usually led by multinational pharmaceutical companies and their advertising and public relations agencies.
What caught our eye was an article on a women’s health foundation website — a foundation that posts a pretty thin excuse for why it won’t tell you its source of funding. Its article on vaginal atrophy uses classic disease-mongering language:
“Ask a woman over the age of 50 about the ‘signs of ag[e]ing’ and she’ll most likely lament about grey hairs, wrinkles and certain body parts having lost their youthful perkiness. What she probably won’t mention is that is that things are ageing “downstairs” too; up to 40% of postmenopausal women show signs of vaginal atrophy.”
The silent epidemic that no one talks about. The huge prevalence estimate — where does that 40 percent figure come from? Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
October 19th, 2010 by GarySchwitzer in Better Health Network, Health Policy, News, Quackery Exposed, Research
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An historic piece of journalism was published today. Six news organizations partnered on the “Dollars for Docs” project — ProPublica, NPR, PBS’s Nightly Business Report, the Chicago Tribune, Boston Globe and Consumer Reports. They examined $258 million in payments by seven drug companies in 2009 and 2010 to about 18,000 healthcare practitioners nationwide for speaking, consulting, and other tasks.
This webpage can be your gateway to the project, with links to a database searchable by doctor’s name or by state, and links to the journalism partners’ efforts:
Boston Globe
“Prescription for Prestige”
The Harvard brand, unrivaled in education, is also prized by the pharmaceutical industry as a powerful tool in promoting drugs. Its allure is evident in a new analysis of all publicly reported industry payments to physicians.
Consumer Reports
“Consumers Wary of Doctors Who Take Drug-Company Dollars”
Most Americans are skeptical of financial relationships between doctors and companies, according to a new, national from the Consumer Reports National Research Center.
Chicago Tribune
“Doctors Draw Payments From Drug Companies”
Follow drug company money in Illinois, and it leads to the psychiatry department at Rush University Medical Center, a prominent headache clinic on the North Side of Chicago, a busy suburban urology practice and a psychiatric hospital accused of overmedicating kids.
PBS
“Nightly Business Report”
A doctor talks about quitting drug company money when their marketing tactics crossed the line.
NPR
“Drug Companies Hire Troubled Docs As Experts”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
