2011 Potpourri XI

By March 11, 2011 March 28th, 2011 Commentary

Medicare beneficiaries’ perception of their health care appears unrelated to the supply of physicians in the area where they live, according to results of a survey reported in Health Affairs.  Beneficiaries in areas with fewer doctors per beneficiary reported no more difficulty in accessing physicians and there was no significant difference in the number of visits to the physician, the amount of time spent with doctors or access to tests or specialists.  The authors believe the results suggest that policies aimed at increasing the supply of physicians are misguided.  (Health Affairs Article)

The Food and Drug Administration clarified its regulatory stance in regard to software and associated hardware contained in medical devices.  These products are technically known as Medical Device Data Systems and previously had been subjected to scrutiny as Class III devices, which requires the highest level of data submission and review before approval.  They include such things as the capability to store and forward blood pressure or temperature readings.  The new approach will lessen the regulatory burden on manufacturers, without likely increasing patient risk.  The change should also give a boost to mobile and wireless devices.   (FDA Rule Release)

The Principal Financial Group periodically releases components of its Principal Financial Well-Being Index, which includes health care items.  The most recent online survey of about 1160 consumers found that the reasons for participating in wellness programs include achieving better health, 43%, reducing health costs, 33%, and living longer and healthier, 31%.  According to the survey, 53% of employees take advantage of weight reduction programs offered by their employers, and there is increased use of other wellness programs.  Wellness programs led to fewer missed days according to 28% of respondents, and to increased productivity for 38%.   (Principal Survey)

The American Medical Association sent a letter to the Food and Drug Administration regarding direct-to-consumer genetic testing, which has been a source of recent controversy, given its current largely unregulated status.  The AMA recommended that all genetic testing should be done only under the supervision of a physician.  The AMA points out that these tests are complex and patients need adequate information to assess their clinical validity and utility and that the companies offering the tests have often done so in a misleading manner.  One problem with the AMA’s suggestion is that most physicians acknowledge that they are not informed enough themselves to provide good guidance for patients.   (AMA Letter)

Researchers at the University of Texas Medical Branch published an article in the American Journal of Public Health describing what they call the Inverse Benefits Law in regard to use of drugs.  According to their research, the more widely a drug is marketed, the more likely it won’t be effective for a significant number of the patients using it and the more likely many of those patients will suffer side effects.  They cite examples of drugs which are used beyond the intended indications and which have large direct-to-consumer marketing expenditures.  In several of these cases, the drugs end up leading to large lawsuit payouts and even regulatory withdrawal.  Good documentation of the need to eliminate DTC and limit off-label prescribing.   (Press Release)

Cigna released results from a study of its integrated disability and health care coverage program.  According to the study, people in the integrated study were absent from work 20% less than those who had only the disability coverage and had an 11 percent better return to work rate.  For an employer with 5000 employees, the program would save 2500 days of disability and $397,000.  For those with chronic conditions, the integrated program enrollees miss four fewer days of work.  While the study is obviously done to help with Cigna’s marketing, it does have some methodological rigor and indicates the value of dealing with a person’s health needs in one program.   (Cigna Study)

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