MedWorm provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest medical blog items that have been tagged with 'effectiveness'. Sat, 03 Sep 2011 01:56:08 +0100 http://www.medworm.com/index.php?rid=5181736&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F09%2F01%2Fberwick-to-keynote-health-affairs-briefing%2F Don Berwick, the Administrator of the Centers for Medicare and Medicaid Services, will keynote Health Affairs’ September 8 briefing on controlling health care costs. At the briefing, Health Affairs will release its September 2011 issue, “The New Urgency To Lower Costs.” Topics to be discussed include chronic disease costs and opportunities for savings through prevention; who bears [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5181736 Thu, 01 Sep 2011 14:09:50 +0100 5181736 http://www.medworm.com/index.php?rid=5174618&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fplastic-surgeon-discusses-safety-and-effectiveness-of-new-anti-wrinkle-product%2F2011.08.28 The FDA has granted a license to the maker of laViv which is said to improve the appearance of smile lines without freezing the muscles of your face. Have you heard of this new drug? Does it work like it claims? Are there any side effects that are worrisome? Source: dailymail.co.uk/femail/article-2028456/New-biological-wrinkle-cure-touted-alternative-Botox-frozen-face.html Maybe. As we have discussed before, FDA approval is not a stamp of approval that a drug is effective. It just means that as far as current studies show, it is not harmful. Some drugs are FDA approved for years until later the FDA reconsiders and removes them from the market. Look at the relatively recent removal of Darvocet from the market after many years of FDA approval. LaViv is an interesting concept. (more…) ... Better Health blogs http://www.medworm.com/rss/comments.php?id=5174618 Sun, 28 Aug 2011 16:35:43 +0100 5174618 http://www.medworm.com/index.php?rid=5139888&cid=t_126797_109_f&fid=34761&url=http%3A%2F%2Ffeeds.feedblitz.com%2F%7E%2F26782953%2F0%2Fneuromarketing%7EFrom-Soup-To-ARF.htm There’s a new Executive Vice President of Advertising Effectiveness at the Advertising Research Foundation (ARF), according to a Mediapost report. It’s Robert Woodard, former VP of Global Consumer and Customer Insights at Campbell Soup Co. The soup firm received quite a bit of publicity when they redesigned their iconic cans using neuromarketing analysis, among other [...] CommentsCommentsRelated StoriesARF on Neuromarketing: Not So FastNeuromarketing Standards ProposedTurning Browsers into Buyers at SXSW (Source: Neuromarketing) Neuromarketing blogs http://www.medworm.com/rss/comments.php?id=5139888 Thu, 18 Aug 2011 15:54:48 +0100 5139888 http://www.medworm.com/index.php?rid=5139674&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F16%2Fthe-legal-battle-over-health-reform-analyzing-the-11th-circuit-opinions%2F Editor’s Note: Below, William Sage analyzes Friday’s federal appellate court decision regarding the Affordable Care Act. See Timothy Jost’s earlier post for more on this decision. On August 12, a divided three-judge panel of the US Court of Appeals for the Eleventh Circuit ruled in State of Florida v. Sibelius that the individual mandate contained [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5139674 Tue, 16 Aug 2011 19:40:18 +0100 5139674 http://www.medworm.com/index.php?rid=5118647&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fexpensive-medications-is-the-benefit-worth-the-cost%2F2011.08.10 The concept of cost-effectiveness in medicine is elastic. One’s view on this issue depends upon who is paying the cost. Of course, this is true in all spheres of life. When you’re in a fine restaurant, you order differently when the meal will be charged to someone else. Under these circumstances, the foie gras appetizer and the jumbo shrimp cocktail are no longer luxuries, but are considered as essential amino acids that are necessary to maintain life. In the marketplace, except in the medical universe, goods and services are priced according to what the market will bear. If an item is priced too high, then the seller will have fewer sales and a bloated inventory. Consumers will not pay absurd prices for common items, regardless of supernatural claims of quality. Would you pay $100 fo... Better Health blogs http://www.medworm.com/rss/comments.php?id=5118647 Wed, 10 Aug 2011 16:00:00 +0100 5118647 http://www.medworm.com/index.php?rid=5107477&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F08%2F09%2Fjulys-most-read-ha-blog-posts%2F Timothy Jost’s series of posts on proposed new federal rules for state health insurance exchanges leads July’s list of most-read Health Affairs Blog posts. Jon Kingsdale’s article on Massachusetts’ efforts to control health care costs is also featured on the list, as are Jeff Goldsmith’s discussion of the effect of health reform on employer-based health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5107477 Tue, 09 Aug 2011 13:44:43 +0100 5107477 http://www.medworm.com/index.php?rid=5050500&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F21%2Fthe-womens-preventive-services-report-and-the-role-of-evidence%2F Section 1001 of the Affordable Care Act establishes women’s preventive health benefits as a new mandatory coverage class for all insurance products sold in the individual and group markets, self insured employer-sponsored health plans, and benchmark plans enrolling newly eligible Medicaid beneficiaries.  In implementing the Act in accordance with the tight deadlines established under the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5050500 Thu, 21 Jul 2011 18:59:57 +0100 5050500 http://www.medworm.com/index.php?rid=5050506&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F07%2F18%2Fpatient-advocates-flies-in-the-ointment-of-evidence-based-care%2F The women recounted how their lives had been saved as they pleaded for the Food and Drug Administration not to withdraw approval for Avastin as a treatment for advanced breast cancer. They did so even without evidence that it provides benefit and with evidence that it confers risks. Their efforts were ultimately not successful: the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=5050506 Mon, 18 Jul 2011 18:07:44 +0100 5050506 http://www.medworm.com/index.php?rid=4997503&cid=t_126797_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2011%2F07%2Fblogscan-forensic-statistics.html Several interesting points are raised in the newsletter of the American Association of Physicians and Surgeons (AAPS) in a post entitled "Forensic Statistics" in their July 2011 newsletter headlined "Numbers." Healthcare Renewal is cited:Forensic StatisticsWhile claims from RCTs fail to replicate about 20% of the time, the problem with epidemiology is so bad as to constitute a crisis, writes S. Stanley Young (“Everything Is Dangerous: a Controversy,” National Institute of Statistical Sciences, June 2008, www.niss.org). Fewer than 20% of nonrandomized trials [e.g., observational studies - ed.] replicate; i.e. 80%-90% of epidemiologists’ claims are false.More than $1 billion in grant/tax money flows to institutions with reproducibility problems, Young states. A fundamental flaw in the... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=4997503 Sun, 03 Jul 2011 14:13:00 +0100 4997503 http://www.medworm.com/index.php?rid=4992681&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Fwww.changehealthcare.com%2Fdownloads%2Fhcti%2FHCTI_Q42010.pdf My mama told me you’d better shop around, as Smokey Robinson also told us. We now know it pays to shop the prices for digital imaging. The price of an MRI of the brain ranges from a low of $825 to a high of $3,600 within the Southeast region of the U.S. In the Northeast, the low is $1,540 and the high, $3,500. There are similar price “spreads” in other regions of the country for the same imaging study, and across other imaging modalities such as PET and CT. The greatest regional variances by service type are for MRI scans of the brain, varying 747% between a low price of $425 in the Southwest to a high of $3,600 in the Southeast, based on an analysis from change: healthcare‘s Q2 2011 Healthcare Transparency Index. USA Today reported on this study on June 30, 2011. Christopher Park... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=4992681 Fri, 01 Jul 2011 15:47:47 +0100 4992681 http://www.medworm.com/index.php?rid=4893368&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F06%2F03%2Fpost-on-health-reform-and-medicare-tops-mays-ha-blog-most-read-list%2F Thomas Saving’s and John Goodman’s post on the implications of the Affordable Care Act for Medicare leads the list of most-read Health Affairs Blog posts for May. On the list as well are posts on the hazards of ignoring the lessons of the Clinton years; the opportunities offered by clinical registries; and the implications of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4893368 Fri, 03 Jun 2011 15:40:41 +0100 4893368 http://www.medworm.com/index.php?rid=4813229&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F11%2Fclinical-registries-the-opportunity-for-the-nation%2F In the early 1970s, the Cystic Fibrosis Foundation began tracking the health of patients with cystic fibrosis.  What began as a modest data collection effort is today a comprehensive clinical registry of 26,000 patients.  Caregivers and researchers use the registry to identify new trends in outcomes; recognize the most effective treatments; and design clinical trials [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4813229 Wed, 11 May 2011 16:22:36 +0100 4813229 http://www.medworm.com/index.php?rid=4813232&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F10%2Fhow-to-make-comparative-effectiveness-work%2F Comparative effectiveness research has been the target of recurrent criticism in some political circles, with opponents claiming it’s the “gateway to rationing” or it encourages “cookbook medicine.” But the conversation on Capitol Hill needs to evolve beyond the rhetoric so it can address the reality of medical care today: doctors and patients lack access to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4813232 Tue, 10 May 2011 13:53:37 +0100 4813232 http://www.medworm.com/index.php?rid=4803519&cid=t_126797_150_f&fid=34889&url=http%3A%2F%2Fpharmamkting.blogspot.com%2F2011%2F05%2Fedetailing-technology-spells-death-of.html "You can't eat the orange and throw the peel away - a man is not a piece of fruit," says Willy Loman in Act 2 of Death of a Salesman. After reading this article in today's Wall Street Journal, many pharma sales reps may be feeling like tossed peeled fruit."Big pharmaceutical companies have found replacements for the army of sales representatives they've laid off in recent years: digital sales tools that seek to sell doctors on drugs without the intrusion of an office visit," says the WSJ."Tens of thousands of pharmaceutical sales reps have been eliminated in the U.S., creating a void that drug makers are now increasingly filling with websites, iPad apps and other digital tools to interact with doctors who prescribe their treatments."Let's refer to "digital sales tools that seek to sell doc... Pharma Marketing Blog blogs http://www.medworm.com/rss/comments.php?id=4803519 Tue, 10 May 2011 12:33:00 +0100 4803519 http://www.medworm.com/index.php?rid=4794832&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F06%2Fto-ipab-or-not-to-ipab-is-that-the-question%2F The Independent Payment Advisory Board (IPAB) has been touted as an important tool to control Medicare costs. The President supports it. But many members of Congress and provider groups do not. Can the IPAB survive in this political environment? Should the health policy community take a stand? (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4794832 Fri, 06 May 2011 23:36:36 +0100 4794832 http://www.medworm.com/index.php?rid=4794833&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F05%2F06%2Fnew-answers-on-macular-degeneration-important-questions-for-comparative-effectiveness-research%2F On April 28th, the New England Journal of Medicine published the results of a study that compared two drugs head-to-head for the treatment of age-related macular degeneration (AMD), the leading cause of legal blindness in the United States.  The two drugs, Ranibizumab (Lucentis) and Bevacizumab (Avastin), are very similar molecules and are both meant to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4794833 Fri, 06 May 2011 15:45:32 +0100 4794833 http://www.medworm.com/index.php?rid=4780485&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FU_8pduWA8bk%2F How soon might comparative effectiveness offer significant change? And which entities will guide these changes when they begin? Inside the nation’s capitol, CER has become something of a mantra among those hoping to drive down health care costs. But beyond the Beltway, CER appears not to be nearly as potent a concept, for now anyway. To gauge the extent to which CER is perceived, the National Pharmaceutical Council, a policy and research organization supported by pharma, surveyed 111 people from federal agencies, consumer and trade groups, insurers and academics, among others. And NPC found nearly 60 percent are “very familiar” with CER, but only 30 percent believe CER will lead to moderate improvements in health care decision-making in the next year. One reason for the lack... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4780485 Tue, 03 May 2011 13:36:25 +0100 4780485 http://www.medworm.com/index.php?rid=4723782&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F18%2Fcomparative-effectiveness-research-how-can-it-change-practice%2F The Patient Protection and Affordable Care Act (ACA)  is designed to increase the number of U. S. citizens with access to health insurance.  Along with augmented access to health insurance and hopefully health care for millions of the currently uninsured, as well as some degree of overall health care cost containment,  the ultimate success of [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4723782 Mon, 18 Apr 2011 13:59:19 +0100 4723782 http://www.medworm.com/index.php?rid=4676746&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F04%2F04%2Flook-carefully-medicares-provenge-national-coverage-decision%2F Editor’s Note: The authors of the post below, Dan Mendelson and Tanisha Carino, also wrote an earlier post on the initial decision of the Centers for Medicare and Medicaid Services to undertake a national coverage review of the cancer drug Provenge. In one of its most anticipated national coverage decisions (NCD), issued on March 30, [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4676746 Mon, 04 Apr 2011 16:48:13 +0100 4676746 http://www.medworm.com/index.php?rid=4658617&cid=t_126797_150_f&fid=34889&url=http%3A%2F%2Fpharmamkting.blogspot.com%2F2011%2F03%2Fnew-phrma-survey-of-physicians-are.html "New Survey Emphasizes Value of Biopharmaceutical Company Engagement With Healthcare Providers" is the main point PhRMA (Pharmaceutical Research and Manufacturing Association - the industry trade association) emphasized in its press release (here) regarding a survey of physicians it sponsored. PhRMA also pointed out that nearly 9 out of 10 physicians considered company-sponsored peer education programs to be "up-to-date, useful and reliable."That's good news for pharmaceutical marketers who spent $24 billion between October 2009 and September 2010 on physician-targeted promotional spending, not including nearly $1 billion on continuing medical education (more data on promotional spending will appear in a Pharma Marketing News article to be published later today). It's good news because the... Pharma Marketing Blog blogs http://www.medworm.com/rss/comments.php?id=4658617 Wed, 30 Mar 2011 12:12:00 +0100 4658617 http://www.medworm.com/index.php?rid=4642566&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F03%2F28%2Fmedicares-embedded-ethics-the-challenge-of-cost-control-in-an-aging-society%2F The challenge of reining in the rising costs of the Medicare Program is particularly thorny because it confronts a recalcitrant societal tension between the necessity for cost control and the value of open-ended technology use for life extension in the later years. That tension is becoming more deeply entrenched because a growing number of older [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4642566 Mon, 28 Mar 2011 20:02:43 +0100 4642566 http://www.medworm.com/index.php?rid=4626886&cid=t_126797_113_f&fid=34625&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FNeilVerselsHealthcareItBlog%2F%7E3%2FuP93TL-iZGE%2F The slams on Dr. Donald Berwick, frankly, are getting pathetic. Today, Fox News medical contributor Dr. Marc Siegel dismissed Berwick as a “basically a policy wonk” who “hasn’t really practiced since 1989.” Siegel tried to score points with sound bites. “This guy has more quotes than Yogi Berra, and let me tell you something, these quotes are an indictment on people that want clinicians to make decisions,” Siegel said on Fox this afternoon. Watch the latest video at video.foxnews.com According to Siegel, comparative effectiveness “doesn’t work in the real world.” Well, sure, that’s the point of clinical decision support. Best practices are for common conditions, and clinical decision support is to help physicians either foll... Neil Versel's Healthcare IT Blog blogs http://www.medworm.com/rss/comments.php?id=4626886 Wed, 23 Mar 2011 22:11:49 +0100 4626886 http://www.medworm.com/index.php?rid=4622245&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbreast-cancer-breakthrough-less-is-more%2F2011.03.21 Recently, every newspaper in the country reported on a landmark development in breast cancer treatment. It is now clear that certain breast cancer women do not need to undergo removal of lymph nodes from the armpit as part of their treatment. This would spare them from the risk and discomfort of an unnecessary procedure. It is welcome news, particularly for those of us who argue that in medicine, less is more. This is an example of the benefit of comparative effectiveness research, a tool that can separate what patients truly need from what the medical profession believes they must have. Let’s hope that breast cancer breakthrough metastasizes across the medical profession. Here’s what it accomplished. It spares women from unnecessary surgery. It saves money. It demonstrates that physi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4622245 Mon, 21 Mar 2011 20:00:00 +0100 4622245 http://www.medworm.com/index.php?rid=4566304&cid=t_126797_136_f&fid=37846&url=http%3A%2F%2Fhealthinfoispower.wordpress.com%2F2011%2F03%2F08%2Fohio-state-university-reports-that-ovarian-cancer-drug-bevacizumab-is-not-cost-effective%2F An analysis conducted by Ohio State University cancer researchers found that adding the targeted therapy bevacizumab to the first-line treatment of patients with advanced ovarian cancer is not cost effective. An analysis conducted by Ohio State University cancer researchers found that adding the targeted therapy bevacizumab [Avastin®] to the first-line treatment of patients with advanced [...] (Source: Libby's H*O*P*E*) Libby's H*O*P*E* blogs http://www.medworm.com/rss/comments.php?id=4566304 Wed, 09 Mar 2011 00:51:51 +0100 4566304 http://www.medworm.com/index.php?rid=4560251&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FLizuL3o0-Bs%2F By Michael F. CannonIn a column for Kaiser Health News, Michael L. Millenson, President of Health Quality Advisors LLC, laments that conservatives in the U.S. House are approaching ObamaCare like, well, conservatives.  He cites comments by unnamed House GOP staffers at a recent conference: The Innovation Center at the Centers for Medicare & Medicaid Services? "An innovation center at CMS is an oxymoron," responded a  Republican aide..."Though it's great for PhDs who come to Washington on the government tab." There was also no reason the government should pay for "so-called comparative effectiveness research," another said. "Everything's on the chopping block," said yet another. No government-funded comparative-effectiveness research?  The horror!  For my money, those staffers (and... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=4560251 Mon, 07 Mar 2011 15:26:48 +0100 4560251 http://www.medworm.com/index.php?rid=4549937&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fakf6ENsJfZk%2F How is this for timing? The UK’s NICE has rejected Roche’s Lucentis med for treating diabetic macular oedema because of insufficient value for the price. And the decision comes shortly before the US National Eye Institute releases results of a trial of 1,200 patients with age-related macular degeneration given Lucentis or Avastin, another Roche drug that costs less to treat eye problems. The rejection by the UK agency underscores the difficulties Roche has encountered with Lucentis, a newer medication the drugmaker has marketed for different eye ailments. And price has been a big issue. There are “reservations about the cost effectiveness estimates provided in the manufacturer‟s submission,” stated the UK’s National Institute for Health and Clinical Excellen... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4549937 Fri, 04 Mar 2011 15:44:41 +0100 4549937 http://www.medworm.com/index.php?rid=4477684&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F14%2Fa-valentine-to-shared-decision-making%2F Shared decision making is hot right now. Research.  Surveys.  Tools.  Training.  Conferences.  Policies. The current model of shared decision making consists of providing patients with evidence that allows them to compare the risks and side effects of different treatments or preventive services when more than one option is available. After studying the evidence, the theory [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4477684 Mon, 14 Feb 2011 16:38:29 +0100 4477684 http://www.medworm.com/index.php?rid=4428980&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F02%2Fcomparative-effectiveness-research-and-medicare-gail-wilenskys-view%2F Editor’s Note: In the October issue of Health Affairs, Steven Pearson and Peter Bach proposed a new Medicare payment model incorporating comparative effectiveness research. Under the model, services offering greater health benefits than an existing alternative would receive cost-based reimbursement, but services offering benefits only comparable to an existing alternative would receive a “reference price” equal to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4428980 Wed, 02 Feb 2011 19:25:15 +0100 4428980 http://www.medworm.com/index.php?rid=4428981&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F02%2Fcomparative-effectiveness-research-and-medicare-sean-tunis-view%2F Editor’s Note: In the October issue of Health Affairs, Steven Pearson and Peter Bach proposed a new Medicare payment model incorporating comparative effectiveness research. Under the model, services offering greater health benefits than an existing alternative would receive cost-based reimbursement, but services offering benefits only comparable to an existing alternative would receive a “reference price” equal to [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4428981 Wed, 02 Feb 2011 19:23:27 +0100 4428981 http://www.medworm.com/index.php?rid=4428982&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F02%2F02%2Fcomparative-effectiveness-research-and-medicare-kathy-butos-view%2F Editor’s Note: In the October issue of Health Affairs, Steven Pearson and Peter Bach proposed a new Medicare payment model incorporating comparative effectiveness research. Under the model, services offering greater health benefits than an existing alternative would receive cost-based reimbursement, but services offering benefits only comparable to an existing alternative would receive a “reference price” equal to the reimbursement [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4428982 Wed, 02 Feb 2011 19:20:28 +0100 4428982 http://www.medworm.com/index.php?rid=4399465&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2011%2F01%2F26%2Fnursing-times-2010-vol-107-no-1%2F Fade Fave: What is the effect of discharge planning? Fade Skinny: This Cochrane Review investigates whether discharge planning improved the use of acute care and patient outcomes. It also looked at whether discharge planning reduced overall costs of healthcare. Follow this link to access the full Cochrane Review report or contact the Library for a copy of the Nursing Times summary of the review. Filed under: Journals Tagged: Cost Effectiveness, Discharge Planning, Health Economics, Health Outcomes (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=4399465 Wed, 26 Jan 2011 11:35:38 +0100 4399465 http://www.medworm.com/index.php?rid=4382734&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2011%2F01%2F21%2Femployers-as-doctors%2F If you don’t keep up with the latest twists and turns in healthy policy, you probably don’t know what value-based health insurance benefits are. A Health Affairs article takes a focused look at it. Here is my layman’s summary: If you are like most people, you are not a very good consumer of health care. [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4382734 Fri, 21 Jan 2011 13:12:00 +0100 4382734 http://www.medworm.com/index.php?rid=4318331&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fcomparative-effectiveness-research-more-can-be-less%2F2011.01.06 Discussion About Comparative Effectiveness Research When the public turns its attention to medical effectiveness research, a discussion often follows about how this research might restrict access to new medical innovations. But this focus obscures the vital role that effectiveness research will play in evaluating current medical and surgical care. I am now slogging through chemotherapy for stomach cancer, probably the result of high doses of radiation for Hodgkin lymphoma in the early 1970s, which was the standard treatment until long-term side effects (heart problems, additional cancers) emerged in the late 80s. So I am especially attuned to the need for research that tracks the short and long-term effectiveness — and dangers — of treatments.  Choosing a surgeon this Septembe... Better Health blogs http://www.medworm.com/rss/comments.php?id=4318331 Thu, 06 Jan 2011 22:00:53 +0100 4318331 http://www.medworm.com/index.php?rid=4294633&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fabout-scar-prevention-and-treatment%2F2010.12.27 I saw a Scarguard product on sale at a drugstore locally. The claims on the packaging were over the top as usual: 1. “Guards against new scars forming” – Difficult to prove. 2. “Flattens and shrinks old scars” – Not really. 3. “Scarguard is the #1 choice of plastic surgeons” – Really? Nobody asked me. Scar treatment is pretty simple. Avoid wounding if you can. If you have plastic surgery, seek a skilled surgeon who will spend the time to do the best. After surgery avoid sunlight and smoking, and consider scar massage as directed by your surgeon. This “Scarguard” product is not going to make a bad scar much better unless it is applied early, and even then the results are debatable. - John Di Saia, M.D. *This blog post was originally published at Trut... Better Health blogs http://www.medworm.com/rss/comments.php?id=4294633 Mon, 27 Dec 2010 15:00:30 +0100 4294633 http://www.medworm.com/index.php?rid=4294603&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F27%2Ffree-access-to-health-affairs-papers-on-imaging-self-referral-boom%2F In the December issue, Health Affairs published a series of papers on the effects of self-referral by physicians for imaging services. Princeton economist Uwe Reinhardt spotlighted the set of papers in a Christmas Eve blog post in the New York Times’ Economix blog: A fascinating narrative on how private health insurers and Medicare have both [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4294603 Mon, 27 Dec 2010 12:39:20 +0100 4294603 http://www.medworm.com/index.php?rid=4245276&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F09%2Fregional-quality-initiatives-expanding-the-partnership%2F If you’re looking for a transformation in health care, look first to America’s cities, towns and communities. That’s where it happens, among local men and women who deliver and receive care, and the employers and consumers who pay for it. That’s why the Robert Wood Johnson Foundation (RWJF) and the U.S. Department of Health and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4245276 Thu, 09 Dec 2010 15:58:37 +0100 4245276 http://www.medworm.com/index.php?rid=4245257&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F12%2Fmore-can-also-be-less-we-need-a-more-complete-public-discussion-about-comparative-effectiveness-rese.html By JESSIE GRUMAN, PhD Media coverage of the government’s new investment in comparative effectiveness research leans heavily toward the effects of such research on new drugs and technologies: Will such evaluations lead to restricted access to the latest innovations? Will... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4245257 Thu, 09 Dec 2010 00:00:00 +0100 4245257 http://www.medworm.com/index.php?rid=4241697&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F12%2F08%2Fstudies-puncture-arguments-about-benefits-of-imaging-self-referral%2F When physicians who aren’t radiologists refer patients to imaging facilities they own or lease—known as self-referral—their patients don’t always benefit. In fact, these self-referrals lead to overuse of services, escalate spending, and rarely shorten the duration of illness, according to a series of studies in the December issue of Health Affairs. The findings challenge what [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4241697 Wed, 08 Dec 2010 16:24:00 +0100 4241697 http://www.medworm.com/index.php?rid=4230157&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fpatient-centered-outcomes-research-will-patients-be-involved%2F2010.12.05 A year ago Gangadhar Sulkunte shared his story here about how he and his wife became e-patients of necessity, and succeeded, resolving a significant issue through empowered, engaged research. As today’s guest post shows, he’s now actively engaged in thinking about healthcare at the level of national policy, as well – and he calls for all patients to speak up about this new issue. – Dave I recently came across a Pauline Chen piece in the New York Times, “Listening to Patients Living With Illness.” It refers to a paper by Dr. Wu et al, ”Adding The Patient Perspective To Comparative Effectiveness Research.” According to the paper and the NY Times article, Dr. Wu and his co-authors propose: Making patient-reported outcomes a more routine part of clinical studi... Better Health blogs http://www.medworm.com/rss/comments.php?id=4230157 Sun, 05 Dec 2010 19:00:34 +0100 4230157 http://www.medworm.com/index.php?rid=4225661&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FNannBzcrm6Q%2F Health care reform may eventually solve some problems, but the price of medications may not be on the list. Consequently, drug pricing is likely to remain a contentious topic for the forseeable future. Consider that prices may continue to rise, even though drugmakers are required to offer new discounts and pay a new tax, prices may well continue to rise. In the 12-month run-up to passage of The Patient Protection and Affordable Care Act, there was a 9.7 percent average price hike on widely used meds. Then there’s the steep cost of so-called specialty drugs - those bank-account draining biologics. In 1995, just eight cost more than $10,000 annually; now, there are 48. And what is really known about behind-the-scenes rebates? And so the deep thinkers at Deloitte, the consulting firm, a... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=4225661 Thu, 02 Dec 2010 16:49:32 +0100 4225661 http://www.medworm.com/index.php?rid=4200548&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F24%2Fthoughtful-purchasing-at-cms%2F Recent press reports on Medicare’s decision to evaluate coverage policy for the new cancer therapy Provenge were highly critical of the Centers for Medicare and Medicaid Services (CMS) and its role in examining the evidence behind FDA-approved products.  Let’s take a step back. In fact, this is exactly what CMS should be doing – carefully [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4200548 Wed, 24 Nov 2010 14:21:49 +0100 4200548 http://www.medworm.com/index.php?rid=4190149&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fthe-federal-coordinating-council-for-comparative-effectiveness-research-what-is-it%2F2010.11.22 What is the Federal Coordinating Council for Comparative Effectiveness Research?  The mission of the Federal Coordinating Council for Comparative Effectiveness Research will be to decide on best practices and most cost effective practices. The council will recommend cost effective treatments for diseases to the National Coordinator for Health Information Technology (NCFHIT). The NCFHIT will determine treatment at the time and place of care. It is charged with deciding the course of treatment for the diagnosis given by the doctor.  The U.S. Department of Health and Human Services (HHS) announced the formation and membership of the Federal Coordinating Council for Comparative Effectiveness Research that will be funded by President Obama’s stimulus program the American Recovery and Reinv... Better Health blogs http://www.medworm.com/rss/comments.php?id=4190149 Mon, 22 Nov 2010 23:00:58 +0100 4190149 http://www.medworm.com/index.php?rid=4151691&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F11%2Fhit-trends-summary-for-october-2010.html By MICHAEL LAKE This is a summary of the HIT Trends Report for October 2010. You can get the current issue or subscribe here. The evolving health information exchange market. The HIE segment was center-stage this month with a game-changing... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4151691 Wed, 10 Nov 2010 00:00:00 +0100 4151691 http://www.medworm.com/index.php?rid=4151733&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F08%2Fcomparing-treatments-judging-health-reform-top-ha-blog-most-read-list%2F A look at Health Affairs‘ October issue on comparative effectiveness research tops the list of most-read Health Affairs Blog posts for last month. Next on the list is Tim Jost’s look at the debate over the Affordable Care Act’s constitutionality, followed by John Goodman’s analysis of whether the new legislation will ”bend the cost curve.” Here’s the entire [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4151733 Mon, 08 Nov 2010 17:00:02 +0100 4151733 http://www.medworm.com/index.php?rid=4133647&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F11%2F02%2Fnew-health-affairs-issue-value-based-insurance-design%2F Having insurance coverage that requires consumers to pay less out of pocket for certain medications— for example, those they must take regularly to combat chronic illness— makes it more likely that they will adhere to their medication regimens.  But the jury is still out on whether this strategy will dramatically reduce the rate of growth [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4133647 Tue, 02 Nov 2010 11:34:09 +0100 4133647 http://www.medworm.com/index.php?rid=4119218&cid=t_126797_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D75 I have been waiting patiently for the Comparative Effectiveness Research program to get into full swing.  Now, we are finally starting to see the first results of the $1.1 billion provided through The American Recovery and Reinvestment Act of 2009 (ARRA) for comparative effectiveness research, and what a wealth of knowledge! Technology is constantly evolving, and determining what is the most effective in terms of costs and outcomes can be a challenge.  Let me save you from reading the full 381-page MedPAC 2010 report to congress and summarize a portion of it for you.  According to the report, new technology is a primary factor causing the rising healthcare costs because it increases demand.  But, on the other hand, improved outcomes resulting from the new technologies can provide long-... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4119218 Fri, 29 Oct 2010 13:59:46 +0100 4119218 http://www.medworm.com/index.php?rid=4118856&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F28%2Freminder-health-affairs-briefing-on-value-based-insurance-design%2F On November 2, 2010, Health Affairs will welcome policy experts at a briefing to discuss key topics in value-based insurance design. VBID is the primary focus of the journal’s November issue, published with the support of the California HealthCare Foundation. Areas to be discussed will include: the evidence supporting the impact of value-based insurance design; the effectiveness of value-based insurance design in getting [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4118856 Thu, 28 Oct 2010 16:28:24 +0100 4118856 http://www.medworm.com/index.php?rid=4118804&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F10%2Fhow-come-comparative-effectiveness-research-is-all-the-rage.html By KENT BOTTLES, MD Comparative Effectiveness Research (CER) is suddenly a hot topic at all the health care conferences. How come? Everybody agrees that we have to decrease per-capita cost and increase quality. Why? Government programs like Medicare and Medicaid... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4118804 Tue, 26 Oct 2010 23:00:00 +0100 4118804 http://www.medworm.com/index.php?rid=4118859&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F26%2Fsimpson-to-take-reins-at-academyhealth%2F AcademyHealth, a professional society for health services researchers and health policy analysts, today announced that Lisa Simpson would be the new president and CEO of the organization and its advocacy arm, the Coalition for Health Services Research. Simpson is currently the director of the Child Policy Research Center at Cincinnati Children’s Hospital Medical Center and [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4118859 Tue, 26 Oct 2010 17:19:21 +0100 4118859 http://www.medworm.com/index.php?rid=4086243&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F20%2Fhealth-affairs-briefing-value-based-insurance-design%2F The November issue of Health Affairs,with the support of the California HealthCare Foundation, focuses on the growing interest in and adoption of value-based insurance design.  Value-based insurance design is based on the simple concept that incentives matter – and if insurance coverage is an obvious set of incentives for both provider and patient, it should be [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4086243 Wed, 20 Oct 2010 15:52:28 +0100 4086243 http://www.medworm.com/index.php?rid=4082053&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F19%2Fwatch-health-affairs-comparative-effectiveness-briefing%2F The Affordable Care Act and last year’s economic stimulus legislation have launched a major new initiative in comparative effectiveness research, the topic of Health Affairs‘ October issue and the journal’s October 5 briefing at the National Press Club. You can watch the briefing and download speaker materials on the Health Affairs web site. Among the [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4082053 Tue, 19 Oct 2010 16:31:47 +0100 4082053 http://www.medworm.com/index.php?rid=4077245&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fmedicare-should-it-pay-less-for-less-effective-care%2F2010.10.18 From its inception, Medicare has been agnostic about the effectiveness of different treatments when it sets payment rates. Once a treatment is found to be “reasonable and necessary,” Medicare establishes a payment rate that takes into account complexity and other “inputs” that go into delivering the service. But it is prohibited by law from varying payments based on how well an intervention works. This would change under a “dynamic pricing” approach proposed by two experts in this month’s issue of Health Affairs. The article itself is available only to Health Affairs subscribers, but the Wall Street Journal health blog has a good summary. The researchers propose that Medicare pay more for therapies with “superior” results and the same f... Better Health blogs http://www.medworm.com/rss/comments.php?id=4077245 Mon, 18 Oct 2010 13:00:00 +0100 4077245 http://www.medworm.com/index.php?rid=4065460&cid=t_126797_113_f&fid=39278&url=http%3A%2F%2Fblogsite.mdbuyline.com%2F%3Fp%3D58 At about the time when the when the Wright brothers first flew, advanced medical technology consisted of a microscope, an X-ray machine, and a sterilizer.  Now, providers purchase almost $70 Billion worth in high tech Lab, patient monitoring, imaging, IT, radiation therapy, and robotic technology each year.  While gathering background information for one of my papers, I found a common concern facing administrators with the capital budget process, which can be summed up by a comment from Ms. Kim Capps, CFO of Green-Breach Memorial Hospital in Charlotte, MI.  She stated, “Most of the time, we have more requests than we have capital; therefore, we have to set priorities, but how we set priorities varies from year to year.”  Hospitals are then left wondering if there is a more effectiv... MD Buyline blogs http://www.medworm.com/rss/comments.php?id=4065460 Wed, 13 Oct 2010 14:15:30 +0100 4065460 http://www.medworm.com/index.php?rid=4036612&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F06%2Fmore-from-health-affairs-on-comparative-effectiveness%2F Health Affairs this week released a Health Policy Brief and two Web First articles about comparative effectiveness research, to complement the information in its October edition,     The Health Policy Brief, produced in conjunction with the Robert Wood Johnson Foundation (RWJF), examines some of the key issues concerning comparative effectiveness research. This area of scientific inquiry, which has been carried out [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4036612 Wed, 06 Oct 2010 16:10:57 +0100 4036612 http://www.medworm.com/index.php?rid=4031203&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F05%2Fnew-health-affairs-issue-comparative-effectiveness-research%2F A national push on comparative effectiveness research is under way as a result of federal stimulus and health reform legislation.  The research, which is aimed at answering critical questions about what works—and what doesn’t—in health care, is the subject of the October issue of Health Affairs.  The issue explores the myriad challenges inherent in making [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4031203 Tue, 05 Oct 2010 11:36:08 +0100 4031203 http://www.medworm.com/index.php?rid=4027161&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fbias-in-clinical-research-is-inevitable%2F2010.10.03 DrRich has said many times that clinical science is among the least exact of the sciences, and therefore, the results of clinical research are particularly susceptible to “spinning” by various interested parties, in order to yield the kind of results they would prefer to see. Until recent times in American medicine, the parties who have been most interested in spinning clinical research have been the people who run drug companies and medical device companies (who need clinical research which supports the use of their products), and the medical specialists (who are more likely to be paid for performing medical procedures that are supported by clinical research). In writing about such data-spinning abuses, DrRich has particularly targeted his own Cardiology Guild, but only because he kno... Better Health blogs http://www.medworm.com/rss/comments.php?id=4027161 Sun, 03 Oct 2010 12:00:16 +0100 4027161 http://www.medworm.com/index.php?rid=4031508&cid=t_126797_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Faa-na-help-youth-sobriety%2F CONCLUSIONS: Results suggest that, similar to findings comparing adult outpatients to inpatients, AA/NA participation is less common among less severe adolescent outpatients. Nonetheless, attendance appears to strengthen and extend the benefits of typical community outpatient treatment. Given the dramatic increase in rates of substance use among same-aged peers in the population at this life-stage, and the relative dearth of abstainers and recovery-specific supports, these resources may provide a concentrated cost-effective social recovery resource for young people. Drug Alcohol Depend. 2010 Jul 1;110(1-2):117-25. Epub 2010 Mar 24. Can 12-step group participation strengthen and extend the benefits of adolescent addiction treatment? A prospective analysis. Kelly JF, Dow SJ, Yeterian JD, Kah... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=4031508 Sat, 02 Oct 2010 15:02:00 +0100 4031508 http://www.medworm.com/index.php?rid=4022884&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F10%2F01%2Freminder-health-affairs-briefing-on-comparative-effectiveness-research%2F The October issue of Health Affairs focuses on comparative effectiveness research. On October 5, Health Affairs will hold a release briefing for the issue. WHEN:   Tuesday, October 5, 2010, 8:30 a.m. – 2:00 p.m. WHERE:       Hyatt Regency Capitol Hill, 400 New Jersey Avenue, NW [Union Station], Washington, D.C. 20001 RSVP:     RSVP for [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=4022884 Fri, 01 Oct 2010 13:20:25 +0100 4022884 http://www.medworm.com/index.php?rid=4003216&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F09%2Fconsumer-groups-shut-out-of-comparative-effectiveness-board.html By MERRILL GOOZNER The Government Accountability Office last week appointed two “faster cures” patient advocates and a former insurance company executive now on the AARP board to the three slots reserved for patient and consumer representatives on the Patient-Centered Outcomes... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=4003216 Sun, 26 Sep 2010 23:00:00 +0100 4003216 http://www.medworm.com/index.php?rid=3994342&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FlEBBvNl8zQw%2F That’s the issued raised in an editorial in The New England Journal of Medicine, which praised a new study of a bloodthinner, but carped that there was a lack of information about the cost. In doing so, the editorial writers underscored the growing debate about the cost effectiveness of medicines and the extent to which this issue should play in treatment decisions. To wit, the study of 3,002 people found that Arixtra, which is sold by GlaxoSmithKline for dealing with deep vein thrombosis and embolism, helped people with superficial-vein thrombosis in the legs. The condition worsened in 1.3 percent of those on a placebo for 45 days but just 0.2 percent of those on the med. The upshot: Arixtra prevented one in 88 patient froms having a more dangerous, but rarely fatal clot (see the ab... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3994342 Thu, 23 Sep 2010 12:43:51 +0100 3994342 http://www.medworm.com/index.php?rid=3987026&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F20%2Fhealth-affairs-briefing-comparative-effectiveness-research%2F A major new national initiative in comparative effectiveness research is under way, thanks to the Affordable Care Act and 2009 stimulus legislation. The research is aimed at giving patients, health care providers and those paying the bill for health care far better information than ever on which to base health care decisions, as well as [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3987026 Mon, 20 Sep 2010 19:13:55 +0100 3987026 http://www.medworm.com/index.php?rid=3976487&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2F-Sb79C4_7uY%2F By Michael F. CannonI must be losing my touch. I’ve let nearly two months pass without responding to Ezra Klein’s defense of RomneyCare, ObamaCare, and other centrally planned health care systems.  (For those who want to get up to speed: his original post, my reply, and his response.)  So here goes. Klein notes that he and I had each used flawed measures of RomneyCare’s impact on health insurance premiums in Massachusetts.  Fair enough.  But Klein ignores the study I cited by John Cogan, Glenn Hubbard, and Dan Kessler, which estimates that RomneyCare increased premiums in Massachusetts by 6 percent.  The CHK study has limitations, but it is the best estimate available.  I hope Klein addresses it. Klein’s fallback position is that even if RomneyCare increases p... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3976487 Thu, 16 Sep 2010 15:50:05 +0100 3976487 http://www.medworm.com/index.php?rid=3965384&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F09%2F13%2Ffighting-antibiotic-resistance-by-paying-for-appropriate-use%2F The world faces a public health crisis: growing numbers of bacteria are becoming resistant to available antibiotics, and there are few new antibiotics in the drug development pipeline. Writing in the September issue of Health Affairs, Aaron Kesselheim and Kevin Outterson propose an innovative approach to this dilemma. Their  proposal is designed to both increase [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3965384 Mon, 13 Sep 2010 12:29:29 +0100 3965384 http://www.medworm.com/index.php?rid=3885312&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F08%2F19%2Fconference-comparative-effectiveness-and-personalized-medicine%2F Susan Dentzer, Health Affairs editor-in-chief, will lead a discussion with speakers and audience in the opening session of ECRI Institute’s 17th annual conference, entitled “Comparative Effectiveness and Personalized Medicine: An Essential Interface.” The conference will be held on the campus of the National Institutes of Health, in Bethesda, MD, October 19 and 20, 2010. Health [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3885312 Thu, 19 Aug 2010 17:55:30 +0100 3885312 http://www.medworm.com/index.php?rid=3802349&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F29%2Fviable-and-reliable-alternatives-to-colonoscopies%2F According to the American College of Gastroenterology, colorectal cancer is currently the third leading cause of cancer-related deaths in the United States. The colonoscopy is considered the “gold standard” for colon cancer detection. However, a new Health Affairs Web First study by researchers from RTI International demonstrates that for screening programs with limited budgets, using fecal [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3802349 Thu, 29 Jul 2010 12:57:09 +0100 3802349 http://www.medworm.com/index.php?rid=3798522&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F07%2F28%2Fend-of-life-savings-the-fools-gold-of-reform%2F Just over 1 in 4 dollars spent by the Medicare program last year was spent on someone who was in their last year of their life.  This is nothing new–the basic proportion has not changed since it was first noted in the 1970s.  Other nations that spend much less on health care nevertheless spend a similar [...] (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3798522 Wed, 28 Jul 2010 20:12:46 +0100 3798522 http://www.medworm.com/index.php?rid=3757852&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FsaYXyH9Fags%2F By Michael F. CannonChristopher Weaver of Kaiser Health News has an excellent article in today’s Washington Post on the various government agencies that will now be deciding what health insurance coverage you must purchase, and how many of those decisions will ultimately fall to lobbyists and politicians: For years, an obscure federal task force sifted through medical literature on colonoscopies, prostate-cancer screening and fluoride treatments, ferreting out the best evidence for doctors to use in caring for their patients. But now its recommendations have financial implications, raising the stakes for patients, doctors and others in the health-care industry. Under the new health-care overhaul law, health insurers will be required to pay fully for services that get an A or B recomm... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3757852 Thu, 15 Jul 2010 15:32:20 +0100 3757852 http://www.medworm.com/index.php?rid=3753759&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F07%2F14%2Finvolving-users-in-commissioning-local-services%2F Title: Involving users in commissioning local services Skinny: Study by Age Concern London brought commissioners and diverse service users together to discuss how service users can be involved in shaping local services. The project reflected on what is actually happening and provided pointers to how user involvement in commissioning could work in practice. Publisher: Joseph Rowntree Foundation Size of Publication: 58p Published: 18/05/2010 Filed under: Community Services, Grey Literature, Practice Based Commissioning Tagged: Best Practice, Commisioning, Cost Effectiveness, Joseph Rowntree Foundation, Service Users, Social Care, World Class Commissioning (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3753759 Wed, 14 Jul 2010 13:41:52 +0100 3753759 http://www.medworm.com/index.php?rid=3746739&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Ffor-patients-does-the-fda-play-fair%2F2010.07.12 They have a tough job, those government doctors, scientists, and bureaucrats who are charged with assessing the safety and effectiveness of proposed new medical products. As you know, they rely largely on studies presented by the applicants. The Food and Drug Administration (FDA) has the power to not approve a new drug or product or even pull it off the market. Right now it is considering limiting or pulling GlaxoSmithKline’s (GSK) diabetes drug, Avandia, because of newly discovered data that it may have caused heart attack in some patients –- data mysteriously not shown in GSK’s own studies. If the drug is pulled it will cost GSK billions of dollars in lost revenue but, from the FDA’s point-of-view, it will be protecting the public. And, after all, there are safer diabetes drugs ... Better Health blogs http://www.medworm.com/rss/comments.php?id=3746739 Mon, 12 Jul 2010 18:00:41 +0100 3746739 http://www.medworm.com/index.php?rid=3740583&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FgrmO7Lh-tHQ%2F By Michael F. CannonI just came across this doozy in a 2009 report by MedPAC, the government agency that advises Congress on how to adjust Medicare’s price and exchange controls: In broad terms, we must … invest in better information on the effectiveness of treatment options so it might guide the decisions of patients, health care providers, and public and private insurers.  Our nation spends over $2 trillion on health care, yet we know far too little about the comparative effectiveness of alternative treatments.  Such information is a public good, which has not—and will not—be [sic] spontaneously produced by the private market. Except: the private market has spontaneously produced comparative-effectiveness information, as I documented in this study released one m... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3740583 Fri, 09 Jul 2010 19:58:01 +0100 3740583 http://www.medworm.com/index.php?rid=3714139&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F30%2Fis-the-impact-of-comparative-effective-reports-being-evaluated%2F Conclusion In this study we were unable to document a single instance where the impact of a traditional evidence review was evaluated and made publicly available.  Additionally, no known systematic effort has been made to document whether such evaluations have occurred; thus this study can serve as a call for such efforts to take place.  The scope of this study was to determine whether impact evaluations existed in the public domain.  A useful next step might be to conduct research that surveys plans and providers for how they use and/or implement evidence reviews, such as those conducted by AHRQ and the Drug Effectiveness Review Project, the BCBS TEC, and other private and public organizations. Comparative effectiveness research remains a cornerstone of public policy efforts to improve... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3714139 Wed, 30 Jun 2010 14:34:51 +0100 3714139 http://www.medworm.com/index.php?rid=3710528&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F29%2Frapid-learning-cancer-care-getting-serious-about-implementation%2F Editor’s Note: Below, Amy Abernethy discusses the potential of a rapid learning system to improve the quality and efficiency of cancer care. Lynn Etheredge also addresses this subject in a another Health Affairs Blog post published today. With respect to rapid learning healthcare, it’s time to get serious about implementation.  National entities, such as the Institute of Medicine and the Robert Wood Johnson Foundation, have helped shape a growing consensus that this new model can help bridge the chasm between research and clinical care, and have convened thought leaders to define it. As a practicing oncologist and clinical researcher, I see rapid learning healthcare as starting from patient care itself, which is provided individually, patient-by-patient. In the rapid learning... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3710528 Tue, 29 Jun 2010 14:29:12 +0100 3710528 http://www.medworm.com/index.php?rid=3710529&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F29%2Frapid-learning-and-cancer-care-time-to-move-forward%2F Editor’s Note: Below, Lynn Etheredge discusses the potential of a rapid learning system to improve the quality and efficiency of cancer care. Amy Abernethy also addresses this subject in another Health Affairs Blog post published today. Cancer is among the most complicated group of diseases to research and treat. The progress in the federal government’s “war on cancer” launched in the 1970s has been frustratingly slow. A rapid-learning (RL) cancer system is now possible — using the potential of “in silico” research. Traditional health research has relied on “in vitro” and “in vivo” methods – bench science and experiments. In silico research would add large computerized registries and databases, with many millions of records, Internet-connected research netwo... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3710529 Tue, 29 Jun 2010 14:26:25 +0100 3710529 http://www.medworm.com/index.php?rid=3706623&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2010%2F06%2Fcomparative-effectiveness-research-removing-the-barriers.html By DAVID E. WILLIAMS Writing in the New England Journal of Medicine (Identifying and Eliminating the Roadblocks to Comparative-Effectiveness Research) three authors share their experience in running a head-to-head trial of Avastin (bevacizumab) versus Lucentis (ranibizumab) for wet age-related macular... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=3706623 Sun, 27 Jun 2010 23:00:00 +0100 3706623 http://www.medworm.com/index.php?rid=3699703&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FqmL_7AMPh1Q%2F This may be a bad break for drugmakers. Wellpoint is using comparative effectiveness to make it more difficult for its members to use the Boniva osteoporosis drug after its own research found greater fractures, lower compliance and higher costs than other meds, according to Dow Jones. The insurer studied 26,000 members on osteo meds, comparing Boniva, which is marketed by Roche and GlaxoSmithKline with Actonel, which is sold by Sanofi-Aventis and Warner Chilcott, and Merck’s Fosamax. Although randomized clinical trials suggest the drugs should be equivalent, WellPoint data found differences. Now, WellPoint other drugs must be tried before Boniva is approved. The drug remains where on Tier 3, or non-preferred level, on the formulary. WellPoint actually made the change last year, Dow J... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3699703 Fri, 25 Jun 2010 13:57:57 +0100 3699703 http://www.medworm.com/index.php?rid=3648474&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FFjc9Jk-ceC4%2F By Michael F. CannonOver at CongressDaily, Julie Rovner has a great piece on the difficulties involved in generating and using comparative-effectiveness research (read: evidence that can improve the quality and reduce the cost of medical care). Rovner cites a recent New England Journal of Medicine article about the obstacles to conducting CER, and a recent article from Health Affairs that finds consumers tend to trust their doctor’s judgment more than evidence-based treatment guidelines. In a paper titled, “A Better Way to Generate and Use Comparative-Effectiveness Research,” I explain how a string of government interventions — from state licensing of medical professionals and health insurance, to the tax preference for job-based health insurance, to Medicare and Me... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3648474 Thu, 10 Jun 2010 14:27:03 +0100 3648474 http://www.medworm.com/index.php?rid=3633620&cid=t_126797_147_f&fid=39202&url=http%3A%2F%2Fnicolaziady.wordpress.com%2F2010%2F06%2F05%2Ffree-search-engine-ranking-checkers%2F These tools are used to track your site rankings in the SERPs for important keywords, tracking that information against competing sites to gauge SEO effectiveness. * Note: search rankings are not the only measure of success. SEO Book Google Rank Checker: Free tool searches Google with 100 results per page to show you where your site ranks for a particular term DigitalPoint Search Engine Keyword Tracker & Keyword Ranking Tool: Free tool checks Google Yahoo and MSN for search engine rankings and tracks those rankings historically (Source: Nicola Ziady) Nicola Ziady blogs http://www.medworm.com/rss/comments.php?id=3633620 Sat, 05 Jun 2010 23:45:32 +0100 3633620 http://www.medworm.com/index.php?rid=3629599&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F06%2F04%2Fwhy-dont-consumers-embrace-evidence-based-care%2F Misconceptions and a lack of knowledge have caused many Americans with health insurance to be at odds with policy makers when it comes to embracing the tenets of evidence-based health care. These conclusions, documented by focus groups, interviews, and an online survey, are contained in a Web first article published yesterday in Health Affairs. Kristin Carman of the American Institutes for Research and coauthors collected data between August 2006 and December 2007  using a mixed-methods approach. Qualitative methods included four focus groups involving thirty-four consumers and one-on-one interviews with fifty-seven individuals. In addition, the authors conducted interviews with forty “employer intermediaries” who regularly communicate about health care—for example, human resou... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3629599 Fri, 04 Jun 2010 11:45:06 +0100 3629599 http://www.medworm.com/index.php?rid=3607500&cid=t_126797_87_f&fid=39187&url=http%3A%2F%2Fgetbetterhealth.com%2Fhave-we-killed-clinical-research%2F2010.05.27 “…I have always depended on the kindness of strangers.”  — Blanche DuBois in Tennessee Williams’ play A Streetcar Named Desire Years ago when I began my medical training, I recall enrolling patients for clinical research. In cardiology, there were a myriad of questions that needed to be answered, especially in the area of defining which medications were best to limit the damage caused by a heart attack. Patients routinely participated in large, multi-center prospective randomized trials to answer these questions. It was routine for them not to charged for participating in the trial — the drug(s) and additional testing would be funded by the company whose drug was being studied. Patients enrolled willingly, eager to help advance science and perhaps, in s... Better Health blogs http://www.medworm.com/rss/comments.php?id=3607500 Thu, 27 May 2010 16:00:00 +0100 3607500 http://www.medworm.com/index.php?rid=3603876&cid=t_126797_151_f&fid=35805&url=http%3A%2F%2Ftwelvestepfacilitation.com%2Fadolescents-12-step-group-participation%2F Conclusions Results suggest that, similar to findings comparing adult outpatients to inpatients, AA/NA participation is less common among less severe adolescent outpatients. Nonetheless, attendance appears to strengthen and extend the benefits of typical community outpatient treatment. Given the dramatic increase in rates of substance use among same-aged peers in the population at this life-stage, and the relative dearth of abstainers and recovery-specific supports, these resources may provide a concentrated cost-effective social recovery resource for young people. Can 12-step group participation strengthen and extend the benefits of adolescent addiction treatment? A prospective analysis. John F. Kelly, Sarah J. Dow, Julie D. Yeterian and Christopher W. Kahle. Drug and Alcohol Dependence S... Twelve Step Facilitation.com blogs http://www.medworm.com/rss/comments.php?id=3603876 Wed, 26 May 2010 11:24:02 +0100 3603876 http://www.medworm.com/index.php?rid=3581551&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F05%2F20%2Forganising-quality-and-effective-spinal-services-for-patients-a-report-for-local-health-communities-by-the-spinal-taskforce%2F Title: Organising quality and effective spinal services for patients: a report for local health communities by the Spinal Taskforce Skinny: Report  intended to assist the NHS in developing and delivering effective spinal services, creating a set of productive services that deliver quality, timely and clinically appropriate care that meets patients’ needs and expectations. It looks at the effective organisation of spinal services for a wide population to support those planning and commissioning services across an SHA, PCTs and clinical and managerial teams within provider units. The document describes the main types of patients being referred for spinal treatment and advises on how to organise services to meet the needs of these groups, paying particular attention to quality, clinical ou... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3581551 Thu, 20 May 2010 04:32:13 +0100 3581551 http://www.medworm.com/index.php?rid=3573718&cid=t_126797_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2010%2F05%2Fhow-weve-killed-clinical-research.html "I have always relied on the company of strangers."- Blanche DuBois in Tennessee William's play, A Streetcar Named DesireYears ago when I began my medical training, I recall enrolling patients for clinical research. In cardiology, there were a myriad of questions that needed to be answered, especially in the area of defining which medications were best to limit the damage caused by a heart attack. Patients routinely participated in large, multi-center prospective randomized trials to answer these questions. It was routine for them not to charged for participating in the trial: the drug(s) and additional testing would be funded by the company whose drug was being studied. Patients enrolled willingly, eager to help advance science and perhaps, in some small way, their fellow man.It never daw... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=3573718 Tue, 18 May 2010 10:14:00 +0100 3573718 http://www.medworm.com/index.php?rid=3560498&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F6PUQzXUi6TE%2F Pontificators are having a field day deciphering healthcare reform and PricewaterhouseCoopers is no exception. The consulting firm has just released a report concluding that, despite expanded coverage that will increase revenue, overall drug sales will decline by 4.3 percent from what they would have been otherwise between 2010 and 2019. The bill increases Medicaid rebates, expands discounts to 340b hospitals, requires Medicare Part D discounts and adds a big fees over 10 years. Specifially, a typical big pharma should see a 4 percent drop in revenue, and a large generic drugmaker should see a 2 percent boost. Meanwhile, a medium-size drugmaker with low government sales should expect only a 1 percent decline, but a large drugmaker with lots of government sales can expect a 7 percent drop. ... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3560498 Thu, 13 May 2010 11:16:46 +0100 3560498 http://www.medworm.com/index.php?rid=3505155&cid=t_126797_167_f&fid=38576&url=http%3A%2F%2Fwww.drbriffa.com%2Fblog%2F2010%2F04%2F26%2Fmy-advice-for-those-looking-to-have-an-energised-and-productive-afternoon%2F Apparently, it’s 30 years ago that Marks and Spencer (a UK-based food, clothing and home goods retailer) started selling pre-prepared sandwiches. Other retail outlets followed suit, and the end result is that sandwiches now are the prime lunch fodder for workers up and down the land. But do they represent prime fuel for those with [...] (Source: Dr John Biffa's Blog) Dr John Biffa's Blog blogs http://www.medworm.com/rss/comments.php?id=3505155 Mon, 26 Apr 2010 07:16:57 +0100 3505155 http://www.medworm.com/index.php?rid=3468021&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2Fx5kKBxgumFg%2F Top of the morning to you. Another shiny day here on the Pharmalot corporate campus and our spirits are high. And why not? Once again, we would like to share a favorite saying of the Morning Mayor: ‘Every brand new day should be unwrapped like a precious gift.’ So go ahead and tug on the ribbon. Meanwhile, here are a few items to help you along. Have a great day, everyone… Buy Bullish Dendreon Options Says Analyst (Bloomberg News) Canada Made ‘Value Judgment’ In Dropping HIV Plant (InPharmaTechnologist) Harvard’s Avorn Hires Faculty To Test Comparative Effectiveness (Bloomberg News) Orexigen Revises Obesity Drug Data (Reuters) Sanofi-Aventis Shifts PR Chief To Global Responsibility Role (PR Week) Teva Strikes Deal For Mersana Cancer Drug (PharmaTimes) Me... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3468021 Wed, 14 Apr 2010 11:14:44 +0100 3468021 http://www.medworm.com/index.php?rid=3443981&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2F2paLZUJkPhc%2F The cost-per-QALY (Quality-Adjusted Life years) pricing model is a trick used by drugmakers to raise prices, and as a pricing instrument it is “going completely the wrong way,” because the benefits to patients cannot be quantified, according to a German health insurance expert, PharmaTimes writes. Drugmakers, instead, need to demonstrate why prices are so high, Thomas Mueller, head of the pharmaceuticals department at the Federal Joint Committee (G-BA) - the lead decision-making body of Germany’s statutory health insurance system – told a conference in London. “Give us a dossier which justifies the price,” he said, noting that studies submitted to the G-BA is at a very low rate. “We have communicated our frustration about this to the government. You cannot have a free market... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3443981 Wed, 07 Apr 2010 12:16:46 +0100 3443981 http://www.medworm.com/index.php?rid=3440755&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F04%2F06%2Fcomputerized-physician-order-entry-accomplishments-and-remaining-challenges%2F A few weeks ago I toured a hospital that had recently adopted computerized physician order entry (CPOE). We visited a patient room on the Med-Surge floor, where a nurse explained what happens in an emergency. Before they adopted CPOE, nurses would run 300 feet down the hall to find the patient’s paper record during a code, and race back, flipping frantically through the chart to find what medications the patient was on. Now that they had adopted CPOE, one touch of a keyboard at the bedside was all it took for clinicians to immediately access the patient’s current medications and vital signs. According to the nurse leading the tour, the CPOE system reduced errors and saved time and lives.  This is the kind of triumphant advancement in quality, efficiency, and safety The Leapfrog Group ... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3440755 Tue, 06 Apr 2010 15:56:18 +0100 3440755 http://www.medworm.com/index.php?rid=3432930&cid=t_126797_109_f&fid=34750&url=http%3A%2F%2Fpsychcentral.com%2Fblog%2Farchives%2F2010%2F04%2F02%2Fintroducing-dialectical-behavior-therapy-understood%2F I’m pleased to introduce you to Dialectical Behavior Therapy Understood, a blog about DBT by Christy Matta. What the heck is dialectical behavior therapy (DBT), and why does it have such a weird name? DBT is a specific type of therapy invented in the early 1990s by Marsha Linehan, a psychologist at the University of Washington in Seattle, to treat borderline personality disorder. Its primary focus is providing a validating environment for someone with this disorder, and helping them view the therapist as an ally in growth and change. Linehan also recognized that people with borderline personality disorder often lacked certain skills that most of us learn intrinsically, which made their lives even more difficult. The skills are taught in four parts and include Mindfulness, Interpersonal e... World of Psychology blogs http://www.medworm.com/rss/comments.php?id=3432930 Fri, 02 Apr 2010 14:10:36 +0100 3432930 http://www.medworm.com/index.php?rid=3424811&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F03%2F30%2Fmoving-toward-a-robust-comparative-effectiveness-research-enterprise%2F Editor’s Note: Most health policy analysts believe that better evidence about quality and value, obtained through comparative effectiveness research (CER), can drive better clinical decision making and could potentially slow the rate of growth in health care spending.  But the success of any national CER initiatives will depend on how evidence is developed, whether it is trusted, and how is used by patients, providers, and payers. Last fall,  the Health Industry Forum of Brandeis University hosted a roundtable in Washington DC, bringing together policymakers from HHS, AHRQ, NIH, and CMS with representatives from the Health Industry Forum’s Advisory Board to discuss how public and private investments in CER can be focused to achieve maximum value. Chaired by Professor Stuart Altman,... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3424811 Tue, 30 Mar 2010 18:48:26 +0100 3424811 http://www.medworm.com/index.php?rid=3408364&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fsrr9nu0Bzcc%2F By Christopher PrebleSecretary Gates’s new guidelines for “don’t ask, don’t tell” are consistent with the Obama administration’s plan to alter—and eventually reverse—the misguided policy. Both the guidelines and their ultimate goal deserve broad public support. In the nearly 17 years since it was enacted, DADT has impeded military effectiveness by prohibiting motivated and well-qualified individuals from serving their country. A new generation of military leaders, both officers and enlisted, has seen the harm and injustice done by this policy, and is ready for change. As this cohort advances through the ranks, and as an earlier generation that was not willing to change retires from service, we should anticipate a relatively smooth transition to a pol... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3408364 Thu, 25 Mar 2010 17:51:43 +0100 3408364 http://www.medworm.com/index.php?rid=3403828&cid=t_126797_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F03%2Fhealth-care-reform-bill-and-health-care.html I have not written much about the seemingly endless health care reform debate in the US, because much of it has not been relevant to the issues we discuss on Health Care Renewal.  Now that the current phase of the debate is done, and legislation has been passed, let me offer my opinions on the few aspects that do seem relevant to this blog.The Sunshine ActFor Health Care Renewal readers, the most important part of the legislation is that containing the provisions of the Sunshine Act, championed by Senators Grassley and Kohl.  (See this summary on Postscript, the Prescription Project blog.)  The act requires that all drug, device, biologic, and medical supply manufacturers report essentially all payments to physicians or teaching hospitals to the goverment, and on the in... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3403828 Wed, 24 Mar 2010 21:42:00 +0100 3403828 http://www.medworm.com/index.php?rid=3366137&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F15%2Fjournal-of-the-american-medical-association-2010-vol-303-no-10%2F This article examines the characteristics of recently published CE studies evaluating medications. An NHS Athens password is required to access this article. Filed under: Current Awareness, E-Journals Tagged: Comparative Effectiveness, Medication, Research (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3366137 Mon, 15 Mar 2010 13:51:29 +0100 3366137 http://www.medworm.com/index.php?rid=3359213&cid=t_126797_150_f&fid=35777&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FPharmalot%2F%7E3%2FORFn2VZ8BVg%2F An analysis of comparative effectiveness studies finds that only 32 percent, which were published in leading medical journals, compared the effectiveness of existing drugs. Instead, few compared meds with non-pharmacologic interventions, while only 19 percent examined safety and 2 percent eyed cost effectiveness, according to the study in this week’s Journal of the American Medical Association (here is the abstract). The analysis examined 328 studies, of which 104 were CE studies, and discoved that only 11 percent compared existing drugs with existing therapies not involving drugs, such as surgery or lifestyle changes. Also worth noting - 87 percent were funded by nonprofit or government institutions, not drugmakers. And of the 212 randomized trials analyzed, 46 percent used an acti... Pharmalot blogs http://www.medworm.com/rss/comments.php?id=3359213 Fri, 12 Mar 2010 13:41:25 +0100 3359213 http://www.medworm.com/index.php?rid=3354250&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F03%2F11%2Ftackling-problem-drug-use%2F Title: Tackling problem drug use (Executive Summary) Skinny: National Audit Office report that identifies good progress in a number of areas, including an increasing number of problem drug users in effective treatment and an increasing number leaving treatment free from dependency. Without an evaluative framework for the Strategy as a whole, the NAO is not able to conclude positively on value for money. Nevertheless, the NAO note that the Drug Treatment Outcomes Research Study (DTORS) has estimated the benefit-cost ratio for drug treatment, the largest element of spending, at 2.5 to 1 and that the programme has delivered some significant successes. There are an estimated third of a million problem drug users in England. As part of an increased emphasis on drug treatment, funding rose from ... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3354250 Thu, 11 Mar 2010 04:32:50 +0100 3354250 http://www.medworm.com/index.php?rid=3350270&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FORzKd2YOkW0%2F Editor’s note: The Disruptive Women in Health Care blog recently compiled an ebook exploring the issue of Comparative Effectiveness Research (CER) from a variety of viewpoints and perspective. We invite you to download the ebook or read the original posts. By Liz Scherer. Comparative effectiveness research (CER): it’s the buzzword of the new decade.  In fact, Congress recently passed legislation to provide more than $1B to support CER  in hopes of improving utilization of existing therapies while simultaneously holding down healthcare costs. The ultimate goal of CER goes even further and paints a rosy vision of patient-centered care and personalized medicine. However, perhaps these goals are loftier than originally imagined.  Newly- published data appearing in this week’s JAMA... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3350270 Wed, 10 Mar 2010 13:31:25 +0100 3350270 http://www.medworm.com/index.php?rid=3246856&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2010%2F02%2F06%2Fheart-2009-vol-96-no-3%2F Heart 2010 (Vol. 96 No. 3) Contents page Fade Fave: Comparison of mass and targeted screening strategies for cardiovascular risk: simulation of the effectiveness, cost-effectiveness and coverage using a cross-sectional survey of 3921 people Fade Skinny: Suggests that cardiovascular primary prevention should be targeted at those with the highest global risk. This studies aim was to compare mass and targeted screening strategies in terms of effectiveness, cost effectiveness and coverage. It finds targeted screening strategies are less costly than mass screening, and can identify up to 84% of high-risk individuals. Additional resources required for mass screening may not be justified. (NHS Athens is required to access this article online) Filed under: Athens Password, Current Awareness, E-J... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3246856 Sat, 06 Feb 2010 08:12:42 +0100 3246856 http://www.medworm.com/index.php?rid=3185296&cid=t_126797_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2010%2F01%2Fnot-just-american-disease.html We have written about attacks on rigorous evidence-based medicine, and particularly on comparative effectiveness research from those with vested interests in having clinical research come out a certain way (e.g., see this most recent relevant post). Those who see such research primarily as a marketing opportunity tend to be offended by the notion of rigorous, unbiased research that may not be so easily turned to marketing purposes. Since I, like the other current Health Care Renewal bloggers, am based in the US, we tend to focus on local examples. But it turns out that the American malady described above has spread to Germany.From the Science blog, ScienceInsider:A long-running feud between pharmaceutical companies and the German institute that evaluates the effectiveness of medical treatm... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3185296 Mon, 18 Jan 2010 21:05:00 +0100 3185296 http://www.medworm.com/index.php?rid=3167083&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2010%2F01%2F12%2Fthe-mammograpy-guidelines-and-evidence-based-medicine%2F As someone who has spent the last several years promoting the development of a comparativeness effectiveness center that would encourage the production of more objective information about what works medically, for whom, and under what circumstances, it is hard not to feel discouraged by the reaction to the breast cancer screening guidelines recently announced by the U.S. Preventive Services Task Force.  To be sure, there are a variety of lessons that should be learned from this experience about how to present to the public information that goes against current “conventional wisdom, ” how to explain why current recommendations may differ from past recommendations or current practice, how to reach out to the media, and how to handle issues of  timing, task force composition and so fort... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3167083 Tue, 12 Jan 2010 18:45:29 +0100 3167083 http://www.medworm.com/index.php?rid=3100767&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F17%2Fhealth-care-costs-and-imaging-technology-adoption%2F Conclusion In summary, close examination of the two papers suggests that adoption and use of high-tech imaging is probably more rational than the papers describe it to be, particularly for acquisition of 64-slice CT.  On the other hand, one wonders about MRI, for the U.S. has 26 MRI machines per million population and keeps these units fairly busy, while the typical OECD country has 5-10 MRIs per million (OECD, Health Data 2009). Copyright © 2009 Health Affairs Blog. This Feed is for personal non-commercial use only. All material published on Health Affairs blog, excluding links, is covered under a Creative Commons Attribution - NonCommercial - No Derivs 2.5 license.Plugin by Taragana (Source: Health Affairs Blog) Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3100767 Thu, 17 Dec 2009 18:14:55 +0100 3100767 http://www.medworm.com/index.php?rid=3096788&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F17%2Farchives-of-general-psychiatry-2009-vol-66-no-12%2F content page Fade Fave: Clinical Effectiveness of Individual Cognitive Behavioral Therapy for Depressed Older People in Primary Care Fade Skinny: Major depression often becomes a chronic disorder in older people, with up to 74% of people in the community remaining depressed 1 year after detection.1 Physical ill health may make conventional pharmacotherapy less desirable, and factors such as bereavement and social isolation make psychological interventions more relevant. NHS Athens is required to access this article online Posted in Athens Password, Current Awareness, E-Journals, Journals Tagged: Athens Password, Clinical Effectiveness, Cognitive Behavioural Therapy, Current Awareness, Depression, E-Journals, Older People, Primary Care (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3096788 Thu, 17 Dec 2009 13:46:45 +0100 3096788 http://www.medworm.com/index.php?rid=3089214&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F15%2Fbritish-journal-of-healthcare-management-2009-volume-15-issue-12%2F Contents Page Fade Fave: Productive, efficient cost savings Fade Skinny: Professor John Appleby, chief economist of the King’s Fund, discusses productively efficient cash-releasing cost minimising savings, or the jargon that no-one understands. (Print copy held at the Fade Library) Posted in Current Awareness, Journals Tagged: Cost Effectiveness, Current Awareness, Health Economics, Jargon, Journals (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3089214 Tue, 15 Dec 2009 12:30:30 +0100 3089214 http://www.medworm.com/index.php?rid=3089225&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F14%2Fgmc-affiliates-pilots-final-report-of-the-kpmg-evaluation%2F Title: GMC affiliates pilots: final report of the KPMG evaluation Skinny: Independent evaluation of two pilots introducing a system of GMC Affiliates aimed at closing the regulatory gap between local workplace management of doctors and national professional regulation. The purpose of this evaluation is to produce feedback and provide an assessment of the feasibility, potential benefits, costs and wider impacts of the introduction of GMC Affiliates at a national level. Publisher: DH Size of Publication: 63p. Published: 30/11/2009 Posted in Clinical Governance, Ethics, Grey Literature, NHS, Primary Care, Quality Tagged: Clinical Governance, Cost Effectiveness, Ethics, Grey Literature, Professional Discipline, Regulation (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3089225 Mon, 14 Dec 2009 19:00:37 +0100 3089225 http://www.medworm.com/index.php?rid=3089227&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F14%2Fnhs-2010-2015-from-good-to-great-preventative-people-centred-productive%2F Title: NHS 2010 – 2015: from good to great: preventative,people-centred,productive Skinny: Five-year plan to reshape the NHS to meet the challenge of delivering high quality health care in a tough financial environment. The report describes practical measures to meet the demands of an aging population and the increased prevalence of lifestyle diseases. The vision is for an NHS that is organised around patients whether at home, in a community setting or in hospital. There will be a renewed focus on prevention with the ambition of delivering cost-effective high quality care across the service Publisher: DH Size of Publication: 64p. Published: 10/12/2009 Posted in Clinical Governance, Corporate Governance, Economics, Financial Management, Governance, Grey Literature, Management, NHS, Pr... Fade Library blogs http://www.medworm.com/rss/comments.php?id=3089227 Mon, 14 Dec 2009 18:00:45 +0100 3089227 http://www.medworm.com/index.php?rid=3084714&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F14%2Fbirth-and-beyond-a-review-of-the-evidence-about-antenatal-education%2F Title: Birth and beyond: a review of the evidence about antenatal education Skinny: Synthesises published evidence concerning the cost and effectiveness of antenatal education, alongside evidence about stakeholder perspectives. Publisher: DH Size of Publication:65p. Published: 08/12/2009 Posted in Antenatal Care, Grey Literature, Midwifery, Obstetrics Tagged: Antenatal Education, Cost Effectiveness, Evidence Based Practice, Grey Literature, Midwifery, Obstetrics, Stakeholder Engagement (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3084714 Mon, 14 Dec 2009 16:00:32 +0100 3084714 http://www.medworm.com/index.php?rid=3084734&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F12%2F14%2Fheart-2009-vol-95-no-22%2F Contents page Fade Fave: Potential survival gains in the treatment of myocardial infarction Fade Skinny: Evaluates the potential impact of complete implementation of guideline recommendations in myocardial infarction (MI) care, and contrast this with new innovations. Finds that potential gains from improved clinical effectiveness in MI care are likely to compare favourably with benefits achieved though innovations, and should inform priorities in research and implementation strategies for improving MI outcomes. (NHS Athens is required to access this article online) Posted in Athens Password, Current Awareness, E-Journals Tagged: Athens Password, Clinical Effectiveness, Current Awareness, E-Journals, Guidelines, Myocardial Infarction (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=3084734 Mon, 14 Dec 2009 08:30:17 +0100 3084734 http://www.medworm.com/index.php?rid=3052113&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F12%2F02%2Forszag-on-health-reform-at-health-affairs-breakfast%2F At a Health Affairs reporters breakfast this morning, White House Office of Management and Budget Director Peter Orszag defended the ability of the health reform bill being debated in the Senate to “bend the cost curve” of health care costs. “The bill that is currently on the Senate floor contains more cost-containment and delivery system reforms, in its current form, than any bill that’s ever been considered on the Senate floor, period,” he said. Orszag said the Senate bill meets the four pillars of cost control laid out in a recent letter to President Obama by 23 noted economists: no increases in federal government deficits; an excise tax on high-cost health plans; a Medicare commission to ensure continuing flexibility and reform; and delivery system reforms such as inc... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3052113 Wed, 02 Dec 2009 18:28:32 +0100 3052113 http://www.medworm.com/index.php?rid=3026636&cid=t_126797_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F11%2Fno-free-speech-for-comparative.html We have repeatedly argued why comparative effectiveness research, under ideal circumstances, would be a good idea.  As I said before:Physicians spend a lot of time trying to figure out the best treatments for particular patients' problems. Doing so is often hard. In many situations, there are many plausible treatments, but the trick is picking the one most likely to do the most good and least harm for a particular patient. Ideally, this is where evidence based medicine comes in. But the biggest problem with using the EBM approach is that often the best available evidence does not help much. In particular, for many clinical problems, and for many sorts of patients, no one has ever done a good quality study that compares the plausible treatments for those problems and those patients. Wh... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=3026636 Tue, 24 Nov 2009 22:22:00 +0100 3026636 http://www.medworm.com/index.php?rid=3023236&cid=t_126797_113_f&fid=35746&url=http%3A%2F%2Fblog.criticalmassconsulting.com%2F%3Fp%3D15 Check out this WSJ piece on the falloff of participation in Wikipedia: http://online.wsj.com/article/SB125893981183759969.html?mod=WSJ_hps_MIDDLESecondNews.   Since a medical- and health-oriented wiki would advance the democratization of care, the notion of such a crowd-sourced compendium of relevant knowledge is appealing, at least in principle.  But now I’m thinking the odds are stacked against the idea, for at least four reasons:   ·         Lack of first-mover advantage.  The original Wikipedia benefitted enormously from sheer originality, which led to its having little or no competition in its formative years.  The situation of medical and healthcare wikis seems quite different.  Today, if you Google healthcare wiki, you get roughly 19 million hits.  Medica... Critical blogs http://www.medworm.com/rss/comments.php?id=3023236 Tue, 24 Nov 2009 02:02:51 +0100 3023236 http://www.medworm.com/index.php?rid=3023118&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2F9BgVPJIVN08%2F The following post represents my personal opinion and not that of any groups or organizations with which I am affiliated. Okay, it’s enough already! Why is it that women are always the target? First it’s abortions, then mammograms, pap smears following closely, behind and now cosmetic surgery (although that’s not only women!) It looks like the Congress is desperate to find any savings anywhere. Why not tell it like it is, it’s raising taxes. Whether it is through so called elective procedures or levying taxes on devices and diagnostics, to be passed on to the patients, it’s a tax. Instead of rewriting the rules on mammograms which will cost lives, maybe not that many, but if it is your life that’s all that matters and focusing on false positives and unnecessary screening, ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=3023118 Mon, 23 Nov 2009 18:05:21 +0100 3023118 http://www.medworm.com/index.php?rid=3012345&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F11%2Fso-much-for-comparative-effectiveness.html By MERRILL GOOZNER The Obama administration's commitment to cost control in health care can now be summed up in four words: Not on our watch. Health and Human Services Secretary Kathleen Sebelius told American women this week that they have... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=3012345 Fri, 20 Nov 2009 00:00:00 +0100 3012345 http://www.medworm.com/index.php?rid=3012364&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FSxuNPIhmoN8%2F A report released today by the federal government’s non-partisan General Accounting Office finds deficits in the Department of Education’s financial and program oversight. According to the GAO, “These shortcomings can lead to weaknesses in program implementation that ultimately result in failure to effectively serve the students, parents, teachers, and administrators those programs were designed to help.” The GAO’s findings are consistent with the longstanding pattern: for forty years, Americans have steadily increased spending on public schools without any resulting improvement in student performance by the end of high school (see the figures here and here). The Obama administration has touted its $100 billion in education stimulus spending as a key to long term economic growth.... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=3012364 Thu, 19 Nov 2009 22:06:51 +0100 3012364 http://www.medworm.com/index.php?rid=3003716&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F11%2F17%2Fthe-battle-over-rewarding-efficient-providers%2F Editor’s Note: In the post below, John Wennberg and Shannon Brownlee discuss the controversy over a proposed study of regional variations in Medicare spending. Wennberg and Brownlee rebut claims that spending and utilization variations among academic medical centers are due to differences in patient income, race, and health status. In another post coming next week, Wennberg and Brownlee will rebut claims that academic medical centers with higher utilization and spending produce better outcomes. To the casual observer of health care reform legislation, the reaction from several prominent medical centers to a modest provision in the House health reform bill might seem perplexing. The bill provides funding for a two-year study by the Institute of Medicine (IOM) looking at regional vari... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=3003716 Tue, 17 Nov 2009 22:39:02 +0100 3003716 http://www.medworm.com/index.php?rid=2995703&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F16%2Finternational-journal-of-health-technology-assessment-in-health-care-2009-vol-25-no-4%2F This article assesses the role of MEDLINE and EMBASE in identifying economic evaluations. (Print subscription held at Fade Library) Posted in Journals Tagged: Contingent Valuation, Cost Effectiveness, Databases, Embase, Medline, Technology Assessment (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2995703 Mon, 16 Nov 2009 14:08:22 +0100 2995703 http://www.medworm.com/index.php?rid=2993725&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F15%2Fbristol-myers-squibb-pharmaceuticals-ltd-r-on-the-application-of-v-national-institute-for-health-and-clinical-excellence-2009%2F Title: Bristol-Myers Squibb Pharmaceuticals Ltd, R (on the application of) v National Institute for Health and Clinical Excellence [2009] The Skinny: Challenges of the decision of the defendant, the National Institute for Health and Clinical Excellence (NICE) refusing to recommend the use of abatacept (ABA) for treatment in connection with rheumatoid arthritis in the National Health Service in the United Kingdom. Publisher: Bailii Size of Document: Webpage Case No.:EWHC 2780 (Admin) (06 November 2009) Posted in Jurisprudence Tagged: Arthiritis, Cost Effectiveness, Drug Therapy, Evidence Based Practice, Jurisprudence (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2993725 Sun, 15 Nov 2009 12:11:20 +0100 2993725 http://www.medworm.com/index.php?rid=2989109&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F11%2F13%2Fmore-for-less-are-productivity-and-efficiency-improving-in-the-nhs%2F Title: More for less: Are productivity and efficiency improving in the NHS? Skinny: Analytical briefing from the Audit Commission considering how NHS money has been spent, whether primary care trusts have been successful in keeping more patients out of hospital, and whether hospitals have become more efficient. Findings are that the NHS is treating more patients at lower cost and trusts are starting to meet the challenges of the future. It suggests NHS trusts are increasing productivity and reducing unit costs. But overall, there is no sign yet that primary care trusts have been successful in moving care from hospitals closer to patients’ homes. Publisher: Audit Commission Size of Publication: 12p Published: 12/11/2009 Posted in Change, Financial Management, Grey Literature, Hospit... Fade Library blogs http://www.medworm.com/rss/comments.php?id=2989109 Fri, 13 Nov 2009 08:33:21 +0100 2989109 http://www.medworm.com/index.php?rid=2970240&cid=t_126797_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F11%2Freading-fine-print-of-government-run.html This week, the New England Journal of Medicine published the comparative effectiveness research trial "ROOBY" comparing conventional cardiac bypass surgery to off-pump bypass surgery. The study was conducted at VA medical centers and randomly enrolled 2203 patients between conventional bypass and off-pump bypass surgeries. The study concluded "At 1 year of follow-up, patients in the off-pump group had worse composite outcomes and poorer graft patency than did patients in the on-pump group. No significant differences between the techniques were found in neuropsychological outcomes or use of major resources." Excellent reviews of the trial (with associated surgeon commentary) are provided at theHeart.org and at MedPageToday.com.What I found interesting was the fact that over half of the oper... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2970240 Fri, 06 Nov 2009 18:08:00 +0100 2970240 http://www.medworm.com/index.php?rid=2934738&cid=t_126797_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F10%2Fdefibrillators-and-video-pill.html A radiofrequency interference myth debunked:A new Mayo Clinic study suggests that video capsule endoscopy (CE), a procedure that uses wireless technology in diagnosing intestinal disease, is safe for patients with heart devices. Wireless electrical gadgets, such as cell phones, have been shown to interfere with implanted heart devices, including pacemakers and defibrillators. This risk has led medical experts to speculate that capsule endoscopy could similarly cause heart devices to fail. As a result, the noninvasive procedure has been contraindicated by the U.S. Food and Drug Administration (FDA) for patients with cardiac devices. Contraindication means an increased risk may be involved.Generally, the topic has remained in the subject of speculation, although several small studies have fo... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2934738 Tue, 27 Oct 2009 21:24:00 +0100 2934738 http://www.medworm.com/index.php?rid=2930930&cid=t_126797_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F10%2Fwho-should-sponsor-comparative.html We have tried to argue why comparative effectiveness research is a good idea. To cut and paste what I wrote in a previous post,Physicians spend a lot of time trying to figure out the best treatments for particular patients' problems. Doing so is often hard. In many situations, there are many plausible treatments, but the trick is picking the one most likely to do the most good and least harm for a particular patient. Ideally, this is where evidence based medicine comes in. But the biggest problem with using the EBM approach is that often the best available evidence does not help much. In particular, for many clinical problems, and for many sorts of patients, no one has ever done a good quality study that compares the plausible treatments for those problems and those patients. When the only... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2930930 Mon, 26 Oct 2009 18:34:00 +0100 2930930 http://www.medworm.com/index.php?rid=2908581&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2FF4OyERJiqJM%2F If the goal is to improve health, then the answer is clearly no. Ironically, even though universal coverage is presumably about helping the sick, the Democrats’ pursuit of universal coverage demonstrates not how much, but how little they care about their neighbors’ health. Economists Helen Levy and David Meltzer explain, in a book published by the Urban Institute, “There is no evidence at this time that money aimed at improving health would be better spent on expanding insurance coverage than on…other possibilities,” such as clinics, hypertension screening, nutrition campaigns, or even education.  In the Annual Review of Public Health, they explain further: The central question of how health insurance affects health, for whom it matters, and how much, remains largely unanswered ... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2908581 Mon, 19 Oct 2009 15:47:15 +0100 2908581 http://www.medworm.com/index.php?rid=2857430&cid=t_126797_105_f&fid=38964&url=http%3A%2F%2Fdrwes.blogspot.com%2F2009%2F10%2Four-new-era-of-comparative.html I just finished our first day at the Principle Investigator Meeting for the launch of the Catheter Ablation Versus Anti-arrhythmic Drug Therapy for Atrial Fibrillation (CABANA) trial in Philadelphia today. The trial is a 3000-patient patient trial performed at 140 centers around the world and jointly sponsored by the National Heart, Lung, and Blood Institute (NHLBI), a component of the National Institutes of Health (NIH), and industry (St. Jude Medical and Biosense Webster). The trial will randomize 3000 previously untreated or incompletely treated patients at high risk of cardiovascular complications in the trial to two arms: 1500 patients to catheter ablation as primary therapy of atrial fibrillation and the other 1500 patients to conventional medical therapy with rate control or rhythm ... Dr. Wes blogs http://www.medworm.com/rss/comments.php?id=2857430 Sat, 03 Oct 2009 02:21:00 +0100 2857430 http://www.medworm.com/index.php?rid=2800327&cid=t_126797_87_f&fid=35747&url=http%3A%2F%2Fhealthaffairs.org%2Fblog%2F2009%2F09%2F16%2Fhigh-quality-low-cost-care-an-interview-with-gundersen-lutheran-ceo-jeff-thompson%2F Editor’s Note: In terms of “bending the cost curve,” health-care providers in La Crosse, WI., have clearly demonstrated the ability to deliver high-qualty care for comparatively low costs. La Crosse was one of ten communities featured at a July 21 conference in Washington, D.C. titled “How Do They Do That?  Low-Cost, High-Quality Health Care in America.” The conference was organized by four nationally noted health care improvement experts: Don Berwick, Elliott Fisher, Atul Gawande, and Mark McClellan. But that is only part of what has grabbed national headlines for this community that borders on the Mississippi River in Northwest Wisconsin.  La Crosse has become embroiled in a national controversy over end-of-life planning that has swirled around the health-care reform debate.�... Health Affairs Blog blogs http://www.medworm.com/rss/comments.php?id=2800327 Wed, 16 Sep 2009 17:42:47 +0100 2800327 http://www.medworm.com/index.php?rid=2712038&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F19%2Finternational-journal-of-technology-assessment-in-health-care-2009-vol-25-no-3%2F This article looks at a study which investigated the views of UK stakeholders on the current arrangements for implementing “only in research” decisions as well as how improvements might be made. (Print subscription held at Fade Library) Posted in Journals Tagged: Cost Effectiveness, Medical Technology, Policy, Technology Assessment (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2712038 Wed, 19 Aug 2009 11:56:03 +0100 2712038 http://www.medworm.com/index.php?rid=2709095&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F08%2F17%2Fassessing-complementary-practice-building-consensus-on-appropriate-research-methods-report-of-an-independent-advisory-group%2F This report aims to establish a consensus on the ways in which research might be conducted that both the conventional and complementary health care communities can support. Publisher: King’s Fund Size of Publication: 32p Published: 10/08/2009 Posted in Clinical Governance, Complementary Medicine, Grey Literature, Health Economics, Quality Tagged: Complimentary Therapies, Cost Effectiveness, Evidence Based Practice, Grey Literature, Research (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2709095 Mon, 17 Aug 2009 14:59:37 +0100 2709095 http://www.medworm.com/index.php?rid=2695389&cid=t_126797_99_f&fid=35344&url=http%3A%2F%2Fzackarysholemberger.blogspot.com%2F2009%2F08%2Fsaving-money-while-improving-care.html At the Health Care Blog, George Lundberg picks the following sources of savings, where comparative effectiveness research can help save money while guiding us to the most effective treatment. His confidence that screening mammography doesn't improve mortality seems misplaced (the data isn't clear, and the studies are difficult), and his jab at oncologists is impolitic, but otherwise this is a worthwhile list. Intensive medical therapy should be substituted for coronary artery bypass grafting (currently around 500,000 procedures annually) for many patients with established coronary artery disease, saving many billions of dollars annually. The same for invasive angioplasty and stenting (currently around 1,000,000 procedures per year) saving tens of billions of dollars annually.Most non-indic... Zackary Sholem Berger blogs http://www.medworm.com/rss/comments.php?id=2695389 Thu, 13 Aug 2009 10:34:00 +0100 2695389 http://www.medworm.com/index.php?rid=2667427&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F08%2Fsenate-healthcare-bill-amendment-allocates-your-tax-dollars-to-quacks.html By DR. VAL With healthcare costs spiraling out of control, and major rationing efforts under consideration - can we really afford to allow purveyors of pseudoscience to use up scarce Medicare/Medicaid resources? It’s hard to imagine that Obama’s administration would... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2667427 Mon, 03 Aug 2009 23:00:00 +0100 2667427 http://www.medworm.com/index.php?rid=2648996&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fexplaining-runaway-healthcare-costs-on-lunch-clubs-and-lap-choleys-.html By BOB WACHTER Have you found yourself ‘splaining to friends and family why the healthcare system is so damn expensive? I’ve been teaching health policy for a couple of decades, and I’m surprised that my two favorite stories haven’t yet... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2648996 Mon, 27 Jul 2009 23:00:00 +0100 2648996 http://www.medworm.com/index.php?rid=2645294&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fexplaining-runaway-healthcare-costs-on-lunch-clubs-and-lap-choleys-.html By BOB WACHTER Have you found yourself ‘splaining to friends and family why the healthcare system is so damn expensive? I’ve been teaching health policy for a couple of decades, and I’m surprised that my two favorite stories haven’t yet... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2645294 Sun, 26 Jul 2009 23:00:00 +0100 2645294 http://www.medworm.com/index.php?rid=2634334&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FM6f2saN00_A%2F At the end of June 2009, Disruptive Women in Health Care ran a series of posts that explored the issue of Comparative Effectiveness Research (CER) from a variety of viewpoints and perspectives: Patients Providers Innovators Caregivers Policymakers Rare Diseases Minorities Gender While there is tremendous potential in the power of CER, there remain a number of troubling issues and difficult questions.  The promise and the pitfalls are reflected in the new CER ebook we put together, which encapsulates each of the posts.  To download a free copy, please click here. (Source: Disruptive Women in Health Care) Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2634334 Thu, 23 Jul 2009 13:26:50 +0100 2634334 http://www.medworm.com/index.php?rid=2601929&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F15%2Fjournal-of-the-american-medical-association-2009-vol-302-no-3%2F Contents Fade Fave: Integrating clinical care and community health Fade Skinny: Public health professionals generally think about how to improve health at a population level, whereas clinicians generally address the needs of individuals. These streams converge in systems of clinical care and are also embodied in population health principles of measurement, system change, and accountability. Posted in Current Awareness, Journals Tagged: Clinical Care, Clinical Effectiveness, Community Care, Community Health Services (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2601929 Wed, 15 Jul 2009 08:58:29 +0100 2601929 http://www.medworm.com/index.php?rid=2598163&cid=t_126797_86_f&fid=36669&url=http%3A%2F%2Ffadelibrary.wordpress.com%2F2009%2F07%2F14%2Fjournal-of-care-services-management-2009-volume-3-number-4%2F Contents Page Fade Fave: Home healthcare: Emerging evidence for NHS commissioners Fade Skinny: Evidence of the potential for home healthcare to form part of a coherent suite of appropriate, flexible and cost-effective services is emerging. As healthcare budgets come under increasing pressure and demands for care to be delivered in a manner more convenient to patients increase, so interest in this method of care delivery has grown. This paper briefly reviews the evidence base for home healthcare. (Print copy held at the Fade Library) Posted in Current Awareness Tagged: Athens Password, Cancer, Chemotherapy, Commissioning, Cost Effectiveness, Current Awareness, E-Journals, Home Healthcare, Oncology Services, Outreach, Patient Satisfaction (Source: Fade Library) Fade Library blogs http://www.medworm.com/rss/comments.php?id=2598163 Tue, 14 Jul 2009 09:11:10 +0100 2598163 http://www.medworm.com/index.php?rid=2594431&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fby-rahul-parikh-md---when-i-was-a-kid-growing-up-in-los-angeles-there-was-this-local-tv-show-my-dad-used-to-enjoy-watching-c.html By RAHUL PARIKH MD When I was a kid growing up in Los Angeles, there was this local TV show my dad used to enjoy watching called “Fight Back with David Horowitz.” Basically, Horowitz, a TV reporter and consumer advocate,... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2594431 Sun, 12 Jul 2009 23:00:00 +0100 2594431 http://www.medworm.com/index.php?rid=2588173&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FlVMpUf3cD5U%2F The following guest post on Comparative Effectiveness Research comes from Maria L Kirzecky, R.Ph., MBA, who founded The Kirzecky Group, LLC – a strategic healthcare consultancy specializing in leading organizations to enhance their market position through market-focused business direction, innovative strategies, and sound science-based communications. Why aren’t we as health care professionals clamoring for CER? Why shouldn’t we encourage health care policy makers and industries to align themselves to how we make clinical decisions? Perhaps we haven’t taken the time to fully understand the benefits of CER, how it could directly improve our ability to positively affect the lives of our patients, or we see it as something far-off and impossibly complex to implement. If w... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2588173 Thu, 09 Jul 2009 15:00:25 +0100 2588173 http://www.medworm.com/index.php?rid=2570453&cid=t_126797_87_f&fid=34470&url=http%3A%2F%2Fwww.thehealthcareblog.com%2Fthe_health_care_blog%2F2009%2F07%2Fcreative-thinking-about-the-cer-agenda.html By JOSHUA SEIDMAN This week the Institute of Medicine (IOM) released its list of the top 100 topics that should be addressed in comparative effectiveness research (CER) now — thanks to $1.1 billion in the American Recovery & Reinvestment Act... (Source: The Health Care Blog) The Health Care Blog blogs http://www.medworm.com/rss/comments.php?id=2570453 Thu, 02 Jul 2009 23:00:00 +0100 2570453 http://www.medworm.com/index.php?rid=2570354&cid=t_126797_86_f&fid=34445&url=http%3A%2F%2Fwomenshealthnews.wordpress.com%2F2009%2F07%2F02%2Fat-our-bodies-our-blog-research-priorities-and-more-bs-posturing-on-womens-health-for-political-gain%2F Yesterday at Our Bodies Our Blog, I posted about the list of priorities for comparative effectiveness research compiled in an Institute of Medicine report as part of the process for allocating funds for this research from the stimulus package. It’s really more interesting than that sentence makes it sound. Several women’s health and childbirth-related topics made the list. Check it out. Christine has something more urgent today, Trading Women’s Health for Votes: Legislators Call for Excluding Abortion Services from Government Health Plan. Apparently “Nineteen House members sent a letter to House Speaker Nancy Pelosi stating that they will not vote for health care reform legislation ‘unless it explicitly excludes abortion funding from the scope of any government-d... Women's Health News blogs http://www.medworm.com/rss/comments.php?id=2570354 Thu, 02 Jul 2009 21:24:27 +0100 2570354 http://www.medworm.com/index.php?rid=2570357&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FoUfyubZxxAQ%2F Today’s guest post by Julie Murchinson, Executive Director, Health 2.0 Accelerator, is the final installment in the Disruptive Women Comparative Effectiveness Research smackdown. Stay Tuned: We will be creating and widely distributing a CER e-book. The HHS Federal Coordinating Council for CER research posted its report to Congress and the President on Monday describing federal activities on CER. Another report with actual priority suggestions is due to Congress by the end of July. On Tuesday, the Institute of Medicine released their sage advice about the top 100 priorities as well as a report on CER. I found one line, in particular, of extreme importance from the report to Congress: “National Institutes of Health (NIH) diabetes prevention trial demonstrated that lifestyle change ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2570357 Wed, 01 Jul 2009 14:28:21 +0100 2570357 http://www.medworm.com/index.php?rid=2561196&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FoUfyubZxxAQ%2F Today’s guest post by Julie Murchinson, Executive Director, Health 2.0 Accelerator, is the final installment in the Disruptive Women Comparative Effectiveness Research smackdown. Stay Tuned: We will be creating and widely distributing a CER e-book. The HHS Federal Coordinating Council for CER research posted its report to Congress and the President on Monday describing federal activities on CER. Another report with actual priority suggestions is due to Congress by the end of July. On Tuesday, the Institute of Medicine released their sage advice about the top 100 priorities as well as a report on CER. I found one line, in particular, of extreme importance from the report to Congress: “National Institutes of Health (NIH) diabetes prevention trial demonstrated that lifestyle change w... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2561196 Wed, 01 Jul 2009 14:28:21 +0100 2561196 http://www.medworm.com/index.php?rid=2556069&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2Fct_05V7h5lY%2F I don’t think we in health policy really understand how complex our systems are and what manner of challenges – some of which we created – present themselves in clinical care. It was Dr. Christine Sinsky who enlightened me. She said that just five years ago, a patient with a 143/82 blood pressure, 1.4 creatinin, 128 fasting blood sugar and 189 cholesterol was advised to exercise and lose weight. Today, that same person has hypertension, stage 3 kidney disease, diabetes, hyperlipidemia and is a candidate for four medications and ongoing monitoring. Citing data from the New England Journal of Medicine, she added that a Medicare patient with diabetes, hypertension and depression with a complaint of headaches is subject to 56 different quality measures. The complexity of those – and ot... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2556069 Tue, 30 Jun 2009 12:02:44 +0100 2556069 http://www.medworm.com/index.php?rid=2553000&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FJvZlJEPNyj8%2F I’ve been tasked with presenting the genetic and rare disease perspective on comparative effectiveness. I’ll dispense with ‘rare’ right away.  If by rare, we mean single gene disorders, then perhaps it is a useful designation. If by rare, we just mean the equivalent of the US definition of orphan disease, i.e., less than 200,000 people in the US, then we should ask a few questions. In the old model of test and drug development, the ‘block buster, body count’, model, rare was a useful designation.  In a system built for BIG, then rare needed a boost.  In the new age of personalized medicine, all conditions are rare. In fact, they are usually an N of 1 after factoring in the myriad of genes involved, epigenetics, environment and so on.  As we enter new... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2553000 Sun, 28 Jun 2009 19:14:59 +0100 2553000 http://www.medworm.com/index.php?rid=2522819&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FPXIMAhh8eyM%2F The Top headline of FDA News Device Daily today read, “Comparative Effectiveness Research has Benefits, Risks Experts Say”. Why would Device Daily consider comparative effectiveness to be risky? Many obvious concerns come to mind. There are distinct risks that the process imposed on the device industry may stifle growth. Worries abound related to the direction policy makers may employ such as when studies will be required (e.g., at the early stages of development, or later in the cycle of real-world experience), how studies will be conducted (e.g., by the government or a public/private entity), who will determine the type, scope, design and rationale for conducting such studies, what the studies will be used for (e.g., to restrict coverage, to control access). The medical device indus... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2522819 Fri, 26 Jun 2009 14:02:33 +0100 2522819 http://www.medworm.com/index.php?rid=2515170&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2F43WhriHtG7M%2F Caregivers need all the help we can get in navigating the confusing and often conflicting health, medical, and financial decisions required to support a family member with severe or chronic health conditions. My husband, Paul Berger, suffered a severe stroke from a ruptured aneurysm at the young age of 36. Our insurance covered his acute medical needs—brain surgery, hospital care, and even some rehabilitation services. Reimbursement ended when he was discharged from the rehab unit of the hospital, but he still needed—and could benefit from—long term speech, occupational and physical therapy. The first decision was how to continue care. Should we try to coordinate outpatient care through the hospital, or through independent practitioners? Should we sacrifice our savings by spending a ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2515170 Thu, 25 Jun 2009 15:00:26 +0100 2515170 http://www.medworm.com/index.php?rid=2510202&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FLlDHWQOUAhM%2F My organization, the National Hispanic Medical Association, is committed to improving the health of Hispanics and other underserved. We support policies that will reform public health and medical services to decrease health care disparities and improve the health status of vulnerable groups. The National Disparities Report by the Agency for Healthcare Research and Quality found that our community has the worst access and quality care compared to non-Hispanics in the nation. Evidence-based public health and medicine strategies are necessary to decrease variation of service delivery that impacts and rations care to Latinos, especially in our poor neighborhoods. Medical treatment should be based on comparative effectiveness value of treatment strategies that produce the greatest benefit for t... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2510202 Wed, 24 Jun 2009 15:32:09 +0100 2510202 http://www.medworm.com/index.php?rid=2510203&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDisruptiveWomenInHealthCare%2F%7E3%2FjVUwvJSdZlU%2F “$2.5 Billion spent: no alternative medicine cures” screamed the headline two weeks ago. “You expect scientific thinking” one expert was quoted as saying, claiming that it’s become “politically correct to investigate nonsense.” So what’s the real issue here? Better yet, is there a way to bridge the gap between Western and Eastern philosophies so that the constituent that matters most in this paradigm — the patient — wins? I believe that when it comes to comparative effectiveness research (CER, i.e. the efficacy/superiority of one drug or modality compared to another), the heart of the West vs. East battle is two-fold and until we find ways to overcome philosophical barriers, never the twain shall meet. First, we must examine the funding factor. Notably, most Wes... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2510203 Tue, 23 Jun 2009 11:59:19 +0100 2510203 http://www.medworm.com/index.php?rid=2510204&cid=t_126797_87_f&fid=38368&url=http%3A%2F%2Fwww.amplifypublicaffairs.net%2Fharkin-society-letter-on-ce.pdf With all the chatter and perhaps now “ twitter” about health care reform, one area has gotten a lot of attention and it is an issue that is near and dear to the Society for Women’s Health Research—that is comparative effectiveness research (CER). Since it is accepted knowledge that women and minorities were not, and are still not, to the degree they should be, included in clinical trials, there is much we are learning and still do not know about sex and ethnic differences in terms of prevention, diagnosis and treatment. My concern with CER, therefore, is how differences in effectiveness and treatment will be determined. Several genetic, hormonal, environmental factors influence health and disease in particularly different ways in women and men. Because of that, CER must study both ... Disruptive Women in Health Care blogs http://www.medworm.com/rss/comments.php?id=2510204 Mon, 22 Jun 2009 11:52:48 +0100 2510204 http://www.medworm.com/index.php?rid=2510436&cid=t_126797_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F06%2Fclear-headed-defense-of-comparative.html We have tried to argue why comparative effectiveness research is a good idea. To cut and paste what I wrote in a previous post,Physicians spend a lot of time trying to figure out the best treatments for particular patients' problems. Doing so is often hard. In many situations, there are many plausible treatments, but the trick is picking the one most likely to do the most good and least harm for a particular patient. Ideally, this is where evidence based medicine comes in. But the biggest problem with using the EBM approach is that often the best available evidence does not help much. In particular, for many clinical problems, and for many sorts of patients, no one has ever done a good quality study that compares the plausible treatments for those problems and those patients. When the only... Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2510436 Wed, 17 Jun 2009 21:18:00 +0100 2510436 http://www.medworm.com/index.php?rid=2441164&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fbz5bpMFLQqA%2F Sen. Edward Kennedy (D-Mass.) has begun circulating drafts of his proposed health care reform legislation. Initial reports, including an op-ed in the Boston Globe by Kennedy himself, suggest that the bill will contain every one of the bad ideas that I outlined in my recent Policy Analysis on what to expect from Obamacare. Among other things, the Kennedy bill will call for: An employer mandate; An individual mandate; A so-called “Public Option,” a Medicare-like plan that will compete with private insurance; The use of comparative-effectiveness/cost-effectiveness research to restrain costs; Subsidies for families earning as much as 500% of the poverty level ($110,250 for a family of four). Insurance regulation, including guaranteed issue and community rating. (He would also establish a... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2441164 Fri, 29 May 2009 18:39:29 +0100 2441164 http://www.medworm.com/index.php?rid=2441178&cid=t_126797_87_f&fid=36438&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FCato-at-liberty%2F%7E3%2Fpp5du9uDC64%2F The New Republic’s Jonathan Cohn accuses Americans for Prosperity (AFP) of “lies” for running an ad that claims “Washington wants to bring Canadian-style healthcare to the U.S.” AFP’s ad is more defensible than Cohn’s criticisms of it. Cohn elides the question of whether Shana Holmes (the woman featured in the ad) was almost killed by Canada’s Medicare system.  For a supporter of single-payer like Cohn, that is tantamount to admitting that, yeah, socialized medicine sometimes kills people. Cohn argues that the ad is unfair because Canada has many advantages over the U.S. health care sector.  That may be true, but the ad doesn’t appear to defend American health care.  It merely says, “government should never come in between your family and your doctor” and “Don’... Cato-at-liberty blogs http://www.medworm.com/rss/comments.php?id=2441178 Thu, 28 May 2009 12:43:07 +0100 2441178 http://www.medworm.com/index.php?rid=2441286&cid=t_126797_87_f&fid=34765&url=http%3A%2F%2Fhcrenewal.blogspot.com%2F2009%2F05%2Fblogscan-comparative-effectiveness.html On the Hooked: Ethics, Medicine and Pharma blog, Dr Howard Brody dissected a campaign to redirect comparative effectiveness research by making it responsible to a new governing board that would include "insurance" and "industry" members. And surprise, surprise, the campaign is run by the Partnership to Improve Patient Care, a group that seems to have multiple connections to PhRMA, the pharmaceutical industry trade organization. More stealth health policy advocacy? (Source: Health Care Renewal) Health Care Renewal blogs http://www.medworm.com/rss/comments.php?id=2441286 Sun, 24 May 2009 15:46:00 +0100 2441286 http://www.medworm.com/index.php?rid=2424392&cid=t_126797_134_f&fid=35187&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDiabetesDaily%2F%7E3%2FVvaZVoE1zs0%2Fwhy-perform-comparative-effectiveness-research.php Comparative Effectiveness Research (CER) answers basic questions about drugs and treatments. Is Treatment A better than Treatment B? Which one costs more over time? Answers to these questions can help doctors and patients choose cheaper and more effective treatments. What Exactly Is Comparative Effectiveness Research? In the latest issue of the New England Journal of Medicine, Jerry Avorn clearly explains why CER is so important. "The contested provisions were designed... (Source: Diabetes Daily) Diabetes Daily blogs http://www.medworm.com/rss/comments.php?id=2424392 Wed, 20 May 2009 16:00:00 +0100 2424392