A Fool’s Potpourri XIV

Brand-name drug supporters have tried to claim that generics may have lower efficacy and other issues.  Researchers looked at whether this might be reflected in any difference in discontinuation rates.  The study focused on two common anti-depressant classes and found that brand-names had a 47% discontinuation rate after 180 days and generics a 44% rate, a non-significant difference.  But overall health care costs over six months were about $3,660 for generic users and $4,587 for brand users, which was much more than the drug cost difference of $174 versus $309.  So generic drugs not only cost less, but their users have lower overall health costs and perhaps lower discontinuation rates.  (AMCP Article)

We aren’t normally inclined to push a particular company’s proprietary products, but there is good material in these at times.  IMS Health, the large collector and analyzer of prescription drug data, started a group called the Institute for Healthcare Informatics.  It intends to conduct and publish research and where it may have a particular advantage is in its access to the IMS database.  The Institute’s work apparently will primarily be published through something called Health IQ Insights and the initial volume contains articles on diffusion of innovative products; medication adherence techniques and comparative effectiveness research.  (IMS Site)

A new report from the Department of Health and Human Services indicates that in its first year the new health reform law has been successful beyond initial expectations.  Overall health spending in the last year declined by 5% according to HHS, the number of people with coverage climbed to 88% of the population and health insurance premiums declined by 3%, the first decline in decades.  In addition, the overall health of the nation’s citizens improved.  HHS expects even more dramatic changes for the better as more provisions of the law are implemented.  (HHS Report)

The American Medical Association hired the Lewin Group to prepare a report on the economic effects of local physician practices, both direct and indirect.  According to Lewin, the physicians in this country generate $1.4 trillion in net economic activity and 4 million jobs.  Now, the Lewin Group is actually very reputable and is a part of the Ingenix subsidiary of UnitedHealth Group, so we have to assume the numbers are close to accurate.  What might be more useful, however, is for Lewin to give us the facts on what it costs the country and local communities for all the money spent on health care delivered by physicians, especially the wasteful, unnecessary part.  Health care spending doesn’t necessarily always have a net economic benefit, quite the contrary, like defense spending on military equipment that gets destroyed, it may have, in fact almost certainly does have, a net negative effect.   A lot better economic good might be done by spending a lot of those health dollars that go to physicians in other ways.  (AMA Report) (I know this seems like it might be the bogus item, but trust me, its not.)

The Hospital Clinic of Barcelona, in Spain, has been a leader in looking at telemedicine use.  It recently released a study on its experience in running a virtual HIV treatment clinic.  The clinic saw 200 patients over five years.  The outcomes were reported to be as good as those for traditionally treated patients, and wait times were reduced for patients, as were overall costs.  The virtual clinic also allowed for much more efficient use of health care professionals.  (Telemed Study Release)

As part of its analysis of the effect of the Administration’s proposed budget for 2012, which itself shows a horrendous increase over the previous baseline debt and deficit, the Congressional Budget Office updated its analysis of the fiscal impact of the “reform” law.  Here’s another shock, the expanded coverage is going to cost more than originally projected, about $100 billion more.  The CBO is sticking to its projection that overall the legislation will reduce the budget deficit over the next ten years, primarily because of the revenue it raises, but again, one big item that CBO acknowledges makes this unlikely is the Medicare physician payment issue, which conveniently got left out of the reform bill.  When the likely outcome of that contentious problem is included, the deficit increases.  (CBO Estimate)