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2010 Potpourri 2

By January 16, 2010Commentary

Navigenics is one of the major direct-to-consumer genetic testing companies.  These companies face a number of regulatory issues, both with FDA and increasingly with some state health regulators, who had asserted a right to regulate Navigenics and similar firms when they conduct testing on the state’s residents.  Navigenics has received permission to conduct such tests on the residents of New York State.  (Navigenics Release) There are very legitimate concerns about the accuracy and utility of genetic testing, particularly when sold directly to consumers.  But having these companies subject to a mish-mash of incoherent and ill-conceived state regulation won’t help.  It will raise costs and not likely promote quality in a service that does have potential value to patients.

Here is the solution to health care costs–keep doctors happy!  A couple of pieces of research emanating from Israel suggest that happy doctors not only interact more and in a better way with patients, they write fewer prescriptions and make fewer referrals for lab tests or specialist visits.  (Israeli Study) (2nd Israeli Study) On the other hand, being burned-out only appears to be related to more ordering of imaging tests.  So if we can figure out how to keep doctors happy, and not too burned-out, we can reduce health spending.  No information on whether outcomes for the patients differed.

The Center for Technology and Aging in California is making grants related to the use of technology to help older adults manage their health care in their home.  (Center Grant Info) The grants are specifically designed to further the diffusion and use of remote monitoring technologies.

The CBO put out a new estimate on the cost for an individual of the lowest level health plan (Bronze) under the Senate reform bill. (CBO Letter) Individuals subject to the mandate will be happy to know that it will only cost them $4500-5000 for individual coverage and $12,000-12,500 for family coverage.  That is for a plan that pays for 60% of the cost of the covered services, so the real cost of health care for that individual or family, on average, will be around $8500 or $20,000.  Lets see, the penalty is $750, wonder what a lot of people will do.  No one could possibly claim that this bill is creating “affordable” health insurance.

The Journal of the American Medical Association reported on the state of biomedical funding.   (JAMA Article) The analysis indicates that the rate of growth in biomedical research funding has slowed.  Medical device funding has grown faster than drug research spending.  Notwithstanding the fairly rapid growth in expenditures over the last decade, there has not been a commensurate increase in approved products.  Regulatory concerns and late stage drug failures may contribute to some of slowing, as does the recession.  Some may welcome the introduction of fewer new products, since it is believed that much of the increase in overall health spending is driven by new technology, but at least some innovations provide significantly better health outcomes for patients and many actually can create cost savings.  In addition, biomedical research companies provide high-paying, clean jobs for the most part.

The Institute for Clinical and Economic Review released a report on treatment options for low-risk prostate cancer.  (ICER Review) The Institute is a leading comparative effectiveness center.  The report finds that the most common treatment approaches for this cancer have similar outcomes but widely differing costs.  Largely because of avoidance of side-effects, the active surveillance approach appears overall superior and has a low cost.   Active surveillance has a little as one-fiftieth the cost of other treatment approaches.  The next step should be adoption of guidelines encouraging physicians to be very cautious in using other treatment modalities unless there is some clear reason to do so for a particular patient.  This would not only save money, but likely improve overall outcomes.

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