|Selected news articles which highlight important policy issues.||
News: Weekly Archives
News for the week of 05-18-2005
The Informed Patient: Web Grows as Health-Research Tool
The Pew Research Center released a study this week showing that more and more Americans are using the Internet to access health-care information:
Increasingly, Americans…are using the Web to find the right doctor or research the quality of care at their local hospitals: last year 42% of Internet users with a college degree reported that they have looked for information about a particular doctor or hospital, a sharp increase from just 27% who sought information in 2002. …
By reflecting Americans’ shifting priorities in health care, the Pew findings may help provide a road map for employers, health plans, and patient advocates looking to provide better health information for consumers in the future. But the survey also raises concerns about a new digital divide, between more educated and affluent Internet users with high-speed broadband access—about half of all Internet users at home—and less educated or older health consumers with slower dial-up connections who are less likely to have searched for information about various kinds of health information online.
Worries about a digital divide, however, are probably overblown. Market pressure from savvy consumers drives consumer gains in other markets, and health care should be no exception to this rule.
What is needed to make health care markets work is more information on patient-level outcomes (for instance, risk-adjusted infection rates for every hospital) and a reimbursement system that targets financial gains at the best providers.
Insurance Option Has Workers Pay More
Health savings accounts linked to high-deductible insurance plans are spreading among employers and employees who are trying to rein in high health care costs and premiums.
Now, as medical costs keep climbing, those high-deductible plans are spreading to the giant corporations that have long been the backbone of traditional job-related, low-deductible health insurance. And if the trend continues, it could reshape the medical insurance landscape and sharply redistribute costs, risks and responsibilities for many of the 160 million Americans with private coverage.
A number of large employers, including defense contractor Northrop Grumman Corp., the Wendy's hamburger chain, high-tech conglomerate Fujitsu and office supply retailer Staples Inc., are adding what they call consumer-directed health plans to their menus of insurance options.
In a recent survey, 26% of large employers said they would offer such plans in 2006, up from 14% this year. Another survey found that about half of large companies were considering adding them. …
Over the past sixty years, employers have shifted more compensation to employee health insurance and away from direct income because of an IRS ruling dating from WWII that shields employer-purchased health insurance from income taxes.
Basically, the HMO that your boss pays for is disguised income. Sound good? Or would you rather have more cash in your pocket and lower health insurance premiums?
HSAs encourage consumer responsibility and help employers lower their health care costs. At the same time, unspent income in these accounts can build up an employee nest egg for retirement, and can be used to cover routine health expenses. Employees are still covered for truly catastrophic injuries by traditional insurance, often with lower monthly premiums. Overall, HSAs are a win-win for most employers and employees.
Will HSAs cut down overall health care costs for the small fraction of Americans who are chronically ill? The jury is still out. But the current health care system is now unsustainable—and over-regulated—and HSAs deserves every chance to prove themselves.
Drug Helps to Reverse Vision Loss
Age-related macular degeneration (AMD) “is the leading cause of irreversible vision loss among the elderly,” and until now, there have been few good treatments available. A new drug from Genentech called Lucentis, however, is giving fresh hope to AMD patients with the most aggressive form of the disease.
An experimental drug from Genentech Inc. improved vision, on average, for patients with a degenerative eye condition, the first time any therapy has appeared to reverse the malady in a large clinical trial.
In a test of 716 patients with a particular form of age-related macular degeneration, Genentech's injectable drug Lucentis produced an average improvement in vision for the patients getting the drug. Patients who received sham injections during the study, by contrast, showed a decline in visual acuity, on average. Overall, Genentech said, fully 95% of patients who received Lucentis saw their vision stabilize or improve, compared with 62% in the control group.
The results exceeded expectations at the company and among eye specialists, who have long sought a way to treat AMD more effectively. "That is huge," said Elias Reichel, a researcher at Tufts University who participated in the study. "This is going to benefit large numbers of patients."
Ironically, Lucentis is actually a “modified form of Genentech's cancer drug Avastin,” proving that innovations in one area of medicine often have spillover benefits unrelated to their original use.
Crestor has higher incidence of side effects; A new analysis showed that certain important side effects are more common with Crestor than with other cholesterol drugs. But doctors said most users should stay on the drug. SCIENCE & MEDICINE
The consumer group Public Citizen has called for the withdrawal of a widely used cholesterol-lowering statin called Crestor, on the grounds that it is significantly more dangerous than other drugs in its class. However, a new report actually makes the case that Crestor “should [still] be considered safe for long-term use.”
The new findings suggest that Crestor, whose generic name is rosuvastatin, probably should be reserved for patients who have a hard time lowering their overall cholesterol levels with other statins, said Dr. Richard H. Karas of the Tufts-New England Medical Center in Boston, who led the study. …
Comparing the number of reported events to the number of prescriptions written, the Karas team concluded that Crestor was responsible for 2.2 times as many reports as simvastatin, sold by Merck under the brand name Zocor, and 6.8 times as many as atorvastatin, sold by Pfizer under the brand name Lipitor.
The relative risk makes Crestor sound pretty dangerous—until you read that the absolute risk from Crestor was small: 145 complications out of over 5 million prescriptions. This translates into “an absolute risk of one in 35,862.”
Getting information about the relative risks and benefits of medicines is critical—but it is also important that those risks are put in context and that doctors and patients have a wide variety of treatment options.
For instance, patients at high risk for heart attack who aren’t responding to other statins should have the option of taking a one in 36,000 risk of a rare complication.
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