From Staff Reports

Media-Savvy Teens Smoke Less

Teens who know how to detect subliminal prosmoking messages are less likely to smoke, research from the University of Pittsburgh found. Previous studies have shown that adolescents are swayed by glamorous depictions of smoking in advertising, movies, and TV shows. The Pitt researchers surveyed 1,200 students' attitudes and knowledge at a suburban, middle-class, mostly white high school, using a Pitt-developed, validated, smoking media literacy (SML) scale. SML scores were assigned based on responses to 18 statements such as “advertisements usually leave out a lot of important information.” The median SML score was 6.8 (out of 10). Students with scores above the median were half as likely to smoke or to be susceptible to starting in the future. As little as a 1-point decrease in the SML score was associated with a 30% increase in a student's likelihood to smoke or start. Lead author Dr. Brian Primack, assistant professor of general internal medicine, said the study supports the idea that schools and others can target teens for media literacy training. The results might not be generalizable to more diverse groups of students, however, he said. The Pitt paper appeared in the October issue of the Journal of Adolescent Health.

More Opt-Outs Mean More Pertussis

States that make it easier for parents to opt out of vaccinating their children have a much higher incidence of pertussis, according to a study in the Oct. 11 issue of the Journal of the American Medical Association. Forty-eight states allow exemptions for either religious or personal beliefs. It appears that the percentage of children eligible for vaccination but who are granted exemptions for personal issues is growing—rising from 1% in 1991 to 2.5% in 2004. States that made it especially easy to secure an exemption had the highest exemption rates, and a 90% higher incidence of pertussis, according to an unadjusted analysis, the authors reported. Vermont topped the list, with a pertussis incidence of 12.8 per 100,000. Massachusetts, Idaho, New Hampshire, and Wisconsin followed. Even after adjusting for education, urbanization, and income, the results showed that pertussis incidence was associated with states' policies, wrote the authors. “States should examine their exemption policies to ensure control of pertussis and other vaccine-preventable diseases,” they said.

Medicaid Enrollment, Spending Slows

Spending by the states under the Medicaid program increased 2.8% during the state fiscal year 2006, the smallest increase in about a decade, according to the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. Improvements in the economy and the implementation of the Medicare prescription drug benefit in 2006 may have helped to keep costs lower, according to the results of the 50-state survey released by the Kaiser Family Foundation. There was also an enrollment slowdown in the program, with only a 1.6% increase. “When the economy improves, it is natural for Medicaid spending and enrollment growth to subside because fewer people turn to the program for assistance,” Diane Rowland, executive vice president of the Kaiser Family Foundation, said. “But with the continued growth in the uninsured population, Medicaid remains on the front lines for coverage [of] low-income children and adults.”

FCC Changes Children's TV Rules

Officials at the Federal Communications Commission recently clarified the rules regarding requirements for children's television programming. Under the changes, TV broadcasters that have multiple stations must ensure that they air additional children's programming, and only half the shows can be repeats aired in the previous 7 days. The changes also clarify restrictions on the use of Web site addresses in programming. Under the new FCC rules, Internet addresses that do not offer a substantial amount of noncommercial content will be counted against the network's commercial time limits and must be kept separate from its programming. The changes were praised by the American Academy of Child and Adolescent Psychiatry. The new rules revise rules issued by the FCC in 2004 and are based largely on a compromise agreement among the four major broadcast networks, major children's networks, cable operators, advertisers, and a coalition of children's advocacy groups. “Children should have access to educational as well as entertaining television programs. We also need to protect kids from the overinfluence of television advertising, [which] has been linked to childhood obesity and lower academic performance,” said Dr. Michael Brody, chair of the academy's television and media committee.

Media-Savvy Teens Smoke Less

Teens who know how to detect subliminal prosmoking messages are less likely to smoke, research from the University of Pittsburgh found. Previous studies have shown that adolescents are swayed by glamorous depictions of smoking in advertising, movies, and TV shows. The Pitt researchers surveyed 1,200 students' attitudes and knowledge at a suburban, middle-class, mostly white high school, using a Pitt-developed, validated, smoking media literacy (SML) scale. SML scores were assigned based on responses to 18 statements such as “advertisements usually leave out a lot of important information.” The median SML score was 6.8 (out of 10). Students with scores above the median were half as likely to smoke or to be susceptible to starting in the future. As little as a 1-point decrease in the SML score was associated with a 30% increase in a student's likelihood to smoke or start. Lead author Dr. Brian Primack, assistant professor of general internal medicine, said the study supports the idea that schools and others can target teens for media literacy training. The results might not be generalizable to more diverse groups of students, however, he said. The Pitt paper appeared in the October issue of the Journal of Adolescent Health.

More Opt-Outs Mean More Pertussis

States that make it easier for parents to opt out of vaccinating their children have a much higher incidence of pertussis, according to a study in the Oct. 11 issue of the Journal of the American Medical Association. Forty-eight states allow exemptions for either religious or personal beliefs. It appears that the percentage of children eligible for vaccination but who are granted exemptions for personal issues is growing—rising from 1% in 1991 to 2.5% in 2004. States that made it especially easy to secure an exemption had the highest exemption rates, and a 90% higher incidence of pertussis, according to an unadjusted analysis, the authors reported. Vermont topped the list, with a pertussis incidence of 12.8 per 100,000. Massachusetts, Idaho, New Hampshire, and Wisconsin followed. Even after adjusting for education, urbanization, and income, the results showed that pertussis incidence was associated with states' policies, wrote the authors. “States should examine their exemption policies to ensure control of pertussis and other vaccine-preventable diseases,” they said.

Medicaid Enrollment, Spending Slows

Spending by the states under the Medicaid program increased 2.8% during the state fiscal year 2006, the smallest increase in about a decade, according to the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. Improvements in the economy and the implementation of the Medicare prescription drug benefit in 2006 may have helped to keep costs lower, according to the results of the 50-state survey released by the Kaiser Family Foundation. There was also an enrollment slowdown in the program, with only a 1.6% increase. “When the economy improves, it is natural for Medicaid spending and enrollment growth to subside because fewer people turn to the program for assistance,” Diane Rowland, executive vice president of the Kaiser Family Foundation, said. “But with the continued growth in the uninsured population, Medicaid remains on the front lines for coverage [of] low-income children and adults.”

FCC Changes Children's TV Rules

Officials at the Federal Communications Commission recently clarified the rules regarding requirements for children's television programming. Under the changes, TV broadcasters that have multiple stations must ensure that they air additional children's programming, and only half the shows can be repeats aired in the previous 7 days. The changes also clarify restrictions on the use of Web site addresses in programming. Under the new FCC rules, Internet addresses that do not offer a substantial amount of noncommercial content will be counted against the network's commercial time limits and must be kept separate from its programming. The changes were praised by the American Academy of Child and Adolescent Psychiatry. The new rules revise rules issued by the FCC in 2004 and are based largely on a compromise agreement among the four major broadcast networks, major children's networks, cable operators, advertisers, and a coalition of children's advocacy groups. “Children should have access to educational as well as entertaining television programs. We also need to protect kids from the overinfluence of television advertising, [which] has been linked to childhood obesity and lower academic performance,” said Dr. Michael Brody, chair of the academy's television and media committee.

Media-Savvy Teens Smoke Less

Teens who know how to detect subliminal prosmoking messages are less likely to smoke, research from the University of Pittsburgh found. Previous studies have shown that adolescents are swayed by glamorous depictions of smoking in advertising, movies, and TV shows. The Pitt researchers surveyed 1,200 students' attitudes and knowledge at a suburban, middle-class, mostly white high school, using a Pitt-developed, validated, smoking media literacy (SML) scale. SML scores were assigned based on responses to 18 statements such as “advertisements usually leave out a lot of important information.” The median SML score was 6.8 (out of 10). Students with scores above the median were half as likely to smoke or to be susceptible to starting in the future. As little as a 1-point decrease in the SML score was associated with a 30% increase in a student's likelihood to smoke or start. Lead author Dr. Brian Primack, assistant professor of general internal medicine, said the study supports the idea that schools and others can target teens for media literacy training. The results might not be generalizable to more diverse groups of students, however, he said. The Pitt paper appeared in the October issue of the Journal of Adolescent Health.

More Opt-Outs Mean More Pertussis

States that make it easier for parents to opt out of vaccinating their children have a much higher incidence of pertussis, according to a study in the Oct. 11 issue of the Journal of the American Medical Association. Forty-eight states allow exemptions for either religious or personal beliefs. It appears that the percentage of children eligible for vaccination but who are granted exemptions for personal issues is growing—rising from 1% in 1991 to 2.5% in 2004. States that made it especially easy to secure an exemption had the highest exemption rates, and a 90% higher incidence of pertussis, according to an unadjusted analysis, the authors reported. Vermont topped the list, with a pertussis incidence of 12.8 per 100,000. Massachusetts, Idaho, New Hampshire, and Wisconsin followed. Even after adjusting for education, urbanization, and income, the results showed that pertussis incidence was associated with states' policies, wrote the authors. “States should examine their exemption policies to ensure control of pertussis and other vaccine-preventable diseases,” they said.

Medicaid Enrollment, Spending Slows

Spending by the states under the Medicaid program increased 2.8% during the state fiscal year 2006, the smallest increase in about a decade, according to the Kaiser Family Foundation's Commission on Medicaid and the Uninsured. Improvements in the economy and the implementation of the Medicare prescription drug benefit in 2006 may have helped to keep costs lower, according to the results of the 50-state survey released by the Kaiser Family Foundation. There was also an enrollment slowdown in the program, with only a 1.6% increase. “When the economy improves, it is natural for Medicaid spending and enrollment growth to subside because fewer people turn to the program for assistance,” Diane Rowland, executive vice president of the Kaiser Family Foundation, said. “But with the continued growth in the uninsured population, Medicaid remains on the front lines for coverage [of] low-income children and adults.”

FCC Changes Children's TV Rules

Officials at the Federal Communications Commission recently clarified the rules regarding requirements for children's television programming. Under the changes, TV broadcasters that have multiple stations must ensure that they air additional children's programming, and only half the shows can be repeats aired in the previous 7 days. The changes also clarify restrictions on the use of Web site addresses in programming. Under the new FCC rules, Internet addresses that do not offer a substantial amount of noncommercial content will be counted against the network's commercial time limits and must be kept separate from its programming. The changes were praised by the American Academy of Child and Adolescent Psychiatry. The new rules revise rules issued by the FCC in 2004 and are based largely on a compromise agreement among the four major broadcast networks, major children's networks, cable operators, advertisers, and a coalition of children's advocacy groups. “Children should have access to educational as well as entertaining television programs. We also need to protect kids from the overinfluence of television advertising, [which] has been linked to childhood obesity and lower academic performance,” said Dr. Michael Brody, chair of the academy's television and media committee.

U.S. System Gets Failing Grade

The U.S. health care system ranked 15th out of 19 countries in number of preventable deaths, according to a comparison of 37 indicators of health outcomes, quality, access, equity, and efficiency. The United States scored particularly low, compared with other nations, on efficiency, getting an average score of 51 out of 100. The report blames this partly on the lack of electronic medical records—used by only 17% of American physicians, compared with the benchmark, which was 80% in the top-performing three nations in 2000–2001. Scores for quality and equity of access were highest, at 71. “Our purpose in issuing this scorecard is to bring attention to opportunities to improve, with benchmarks to motivate change,” said Dr. James Mongan, chairman of the 18-member commission that conducted the study and CEO of Partners HealthCare in Boston. “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system,” the American Board of Internal Medicine said in a statement. The full report is available at

www.cmwf.org

Target Opens In-House Clinics

Target, the Minneapolis-based retail powerhouse, is opening in-house clinics at 8 of its 1,443 stores. The company is rolling out the concept in its corporate hometown and soon will add at least four more in that region. According to Target, the clinics will feature a private waiting area and exam rooms and will offer services such as flu shots and treatments for strep throat, bronchitis, and skin conditions. Prices for services—most under $50—will be clearly listed. The clinics are staffed by licensed nurse-practitioners and physician assistants. Medcor will provide clinic management, and physicians from Fairview Health Services will provide oversight and consultation. The company said in a statement that it will “meet or exceed the American Medical Association and the American Academy of Family Physicians guidelines for retail healthcare.”

Low Physician E-Mail Use

Physicians are rarely using e-mail to communicate with patients, according to one study, and yet, patients overwhelmingly report that they would like to use e-mail to set appointments, talk with the doctor, and receive test results, according to a separate poll. The Center for Studying Health System Change found that only 24% of physicians said they used e-mail to discuss a clinical issue with a patient in 2004–2005, a 4% increase from the previous study period of 2000–2001. Almost half of physicians in academic settings and staff or group HMO practices use e-mail for clinical discussions, compared with about 20% in practices of 10 or fewer physicians. Physicians in nonmetropolitan areas or who have large numbers of Medicaid and/or Medicare patients say they are less likely to use e-mail, because of patients' lack of access to the technology. Some reasons for not using e-mail are lack of reimbursement for consultations, cost of implementing a secure system, and fears that e-mail will add to workloads. A recent Wall Street Journal-Harris Interactive poll of 2,624 adults found that 74% want to communicate directly with doctors by e-mail, 67% want to receive test results, and 75% want to schedule appointments via the Internet.

Insurance Premiums Continue Rise

Employer-sponsored health insurance premiums rose 7.7% in 2006, outpacing wages and inflation, according to a report from the Kaiser Family Foundation and the Health Research and Educational Trust. The annual survey of employer health benefits found that on average, family health coverage costs $11,480 annually, with workers contributing an average of $2,973 toward their premiums. “We are still losing the race between premiums and workers' earnings, and if that trend persists, employer-based coverage will continue to decline as fewer employers and workers can afford the cost of coverage,” Jon Gabel, coauthor of the study and vice president of the Center for Studying Health System Change, said in a statement. Most individuals opted for coverage through preferred provider organizations (60%), with others choosing HMOs (20%), point-of-service plans (13%), and conventional indemnity plans (3%). About 4% of individuals enrolled in high-deductible plans with a savings option. This year, about 7% of employers—mostly those with 1,000 workers or more—offered some form of high-deductible plan in 2006. The information is from a telephone poll of 3,159 randomly selected public and private employers. Details are available at

www.kff.org/insurance/7527

Reporting on Quality

More than 3,300 hospitals around the country have reported data on quality measures to Medicare and consumers, according to the Centers for Medicare and Medicaid Services. Of the 3,490 acute care hospitals eligible to participate in the federal program that links hospital payments to reporting of quality measures, 99% opted to report data. Under the program, hospitals that submit quality information to CMS are eligible to receive the full 2% payment update for inpatient services in 2007 under Medicare, while those who do not report will see a 2% payment reduction. “This is more evidence that paying for reporting and improving quality can help patients get better care,” Dr. Mark McClellan, outgoing CMS administrator, said in a statement. “Consumers can use this information to evaluate care, and doctors and hospitals can use it to help improve their performance.

U.S. System Gets Failing Grade

The U.S. health care system ranked 15th out of 19 countries in number of preventable deaths, according to a comparison of 37 indicators of health outcomes, quality, access, equity, and efficiency. The United States scored particularly low, compared with other nations, on efficiency, getting an average score of 51 out of 100. The report blames this partly on the lack of electronic medical records—used by only 17% of American physicians, compared with the benchmark, which was 80% in the top-performing three nations in 2000–2001. Scores for quality and equity of access were highest, at 71. “Our purpose in issuing this scorecard is to bring attention to opportunities to improve, with benchmarks to motivate change,” said Dr. James Mongan, chairman of the 18-member commission that conducted the study and CEO of Partners HealthCare in Boston. “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system,” the American Board of Internal Medicine said in a statement. The full report is available at

www.cmwf.org

Target Opens In-House Clinics

Target, the Minneapolis-based retail powerhouse, is opening in-house clinics at 8 of its 1,443 stores. The company is rolling out the concept in its corporate hometown and soon will add at least four more in that region. According to Target, the clinics will feature a private waiting area and exam rooms and will offer services such as flu shots and treatments for strep throat, bronchitis, and skin conditions. Prices for services—most under $50—will be clearly listed. The clinics are staffed by licensed nurse-practitioners and physician assistants. Medcor will provide clinic management, and physicians from Fairview Health Services will provide oversight and consultation. The company said in a statement that it will “meet or exceed the American Medical Association and the American Academy of Family Physicians guidelines for retail healthcare.”

Low Physician E-Mail Use

Physicians are rarely using e-mail to communicate with patients, according to one study, and yet, patients overwhelmingly report that they would like to use e-mail to set appointments, talk with the doctor, and receive test results, according to a separate poll. The Center for Studying Health System Change found that only 24% of physicians said they used e-mail to discuss a clinical issue with a patient in 2004–2005, a 4% increase from the previous study period of 2000–2001. Almost half of physicians in academic settings and staff or group HMO practices use e-mail for clinical discussions, compared with about 20% in practices of 10 or fewer physicians. Physicians in nonmetropolitan areas or who have large numbers of Medicaid and/or Medicare patients say they are less likely to use e-mail, because of patients' lack of access to the technology. Some reasons for not using e-mail are lack of reimbursement for consultations, cost of implementing a secure system, and fears that e-mail will add to workloads. A recent Wall Street Journal-Harris Interactive poll of 2,624 adults found that 74% want to communicate directly with doctors by e-mail, 67% want to receive test results, and 75% want to schedule appointments via the Internet.

Insurance Premiums Continue Rise

Employer-sponsored health insurance premiums rose 7.7% in 2006, outpacing wages and inflation, according to a report from the Kaiser Family Foundation and the Health Research and Educational Trust. The annual survey of employer health benefits found that on average, family health coverage costs $11,480 annually, with workers contributing an average of $2,973 toward their premiums. “We are still losing the race between premiums and workers' earnings, and if that trend persists, employer-based coverage will continue to decline as fewer employers and workers can afford the cost of coverage,” Jon Gabel, coauthor of the study and vice president of the Center for Studying Health System Change, said in a statement. Most individuals opted for coverage through preferred provider organizations (60%), with others choosing HMOs (20%), point-of-service plans (13%), and conventional indemnity plans (3%). About 4% of individuals enrolled in high-deductible plans with a savings option. This year, about 7% of employers—mostly those with 1,000 workers or more—offered some form of high-deductible plan in 2006. The information is from a telephone poll of 3,159 randomly selected public and private employers. Details are available at

www.kff.org/insurance/7527

Reporting on Quality

More than 3,300 hospitals around the country have reported data on quality measures to Medicare and consumers, according to the Centers for Medicare and Medicaid Services. Of the 3,490 acute care hospitals eligible to participate in the federal program that links hospital payments to reporting of quality measures, 99% opted to report data. Under the program, hospitals that submit quality information to CMS are eligible to receive the full 2% payment update for inpatient services in 2007 under Medicare, while those who do not report will see a 2% payment reduction. “This is more evidence that paying for reporting and improving quality can help patients get better care,” Dr. Mark McClellan, outgoing CMS administrator, said in a statement. “Consumers can use this information to evaluate care, and doctors and hospitals can use it to help improve their performance.

U.S. System Gets Failing Grade

The U.S. health care system ranked 15th out of 19 countries in number of preventable deaths, according to a comparison of 37 indicators of health outcomes, quality, access, equity, and efficiency. The United States scored particularly low, compared with other nations, on efficiency, getting an average score of 51 out of 100. The report blames this partly on the lack of electronic medical records—used by only 17% of American physicians, compared with the benchmark, which was 80% in the top-performing three nations in 2000–2001. Scores for quality and equity of access were highest, at 71. “Our purpose in issuing this scorecard is to bring attention to opportunities to improve, with benchmarks to motivate change,” said Dr. James Mongan, chairman of the 18-member commission that conducted the study and CEO of Partners HealthCare in Boston. “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system,” the American Board of Internal Medicine said in a statement. The full report is available at

www.cmwf.org

Target Opens In-House Clinics

Target, the Minneapolis-based retail powerhouse, is opening in-house clinics at 8 of its 1,443 stores. The company is rolling out the concept in its corporate hometown and soon will add at least four more in that region. According to Target, the clinics will feature a private waiting area and exam rooms and will offer services such as flu shots and treatments for strep throat, bronchitis, and skin conditions. Prices for services—most under $50—will be clearly listed. The clinics are staffed by licensed nurse-practitioners and physician assistants. Medcor will provide clinic management, and physicians from Fairview Health Services will provide oversight and consultation. The company said in a statement that it will “meet or exceed the American Medical Association and the American Academy of Family Physicians guidelines for retail healthcare.”

Low Physician E-Mail Use

Physicians are rarely using e-mail to communicate with patients, according to one study, and yet, patients overwhelmingly report that they would like to use e-mail to set appointments, talk with the doctor, and receive test results, according to a separate poll. The Center for Studying Health System Change found that only 24% of physicians said they used e-mail to discuss a clinical issue with a patient in 2004–2005, a 4% increase from the previous study period of 2000–2001. Almost half of physicians in academic settings and staff or group HMO practices use e-mail for clinical discussions, compared with about 20% in practices of 10 or fewer physicians. Physicians in nonmetropolitan areas or who have large numbers of Medicaid and/or Medicare patients say they are less likely to use e-mail, because of patients' lack of access to the technology. Some reasons for not using e-mail are lack of reimbursement for consultations, cost of implementing a secure system, and fears that e-mail will add to workloads. A recent Wall Street Journal-Harris Interactive poll of 2,624 adults found that 74% want to communicate directly with doctors by e-mail, 67% want to receive test results, and 75% want to schedule appointments via the Internet.

Insurance Premiums Continue Rise

Employer-sponsored health insurance premiums rose 7.7% in 2006, outpacing wages and inflation, according to a report from the Kaiser Family Foundation and the Health Research and Educational Trust. The annual survey of employer health benefits found that on average, family health coverage costs $11,480 annually, with workers contributing an average of $2,973 toward their premiums. “We are still losing the race between premiums and workers' earnings, and if that trend persists, employer-based coverage will continue to decline as fewer employers and workers can afford the cost of coverage,” Jon Gabel, coauthor of the study and vice president of the Center for Studying Health System Change, said in a statement. Most individuals opted for coverage through preferred provider organizations (60%), with others choosing HMOs (20%), point-of-service plans (13%), and conventional indemnity plans (3%). About 4% of individuals enrolled in high-deductible plans with a savings option. This year, about 7% of employers—mostly those with 1,000 workers or more—offered some form of high-deductible plan in 2006. The information is from a telephone poll of 3,159 randomly selected public and private employers. Details are available at

www.kff.org/insurance/7527

Reporting on Quality

More than 3,300 hospitals around the country have reported data on quality measures to Medicare and consumers, according to the Centers for Medicare and Medicaid Services. Of the 3,490 acute care hospitals eligible to participate in the federal program that links hospital payments to reporting of quality measures, 99% opted to report data. Under the program, hospitals that submit quality information to CMS are eligible to receive the full 2% payment update for inpatient services in 2007 under Medicare, while those who do not report will see a 2% payment reduction. “This is more evidence that paying for reporting and improving quality can help patients get better care,” Dr. Mark McClellan, outgoing CMS administrator, said in a statement. “Consumers can use this information to evaluate care, and doctors and hospitals can use it to help improve their performance.

U.S. System Gets Failing Grade

The U.S. health care system ranked 15th out of 19 countries in number of preventable deaths, according to a comparison of 37 indicators of health outcomes, quality, access, equity, and efficiency. Compared with other nations, the United States scored particularly low on efficiency, getting an average score of 51 out of 100. The report blames this partly on the lack of electronic medical records—used by only 17% of American physicians, compared with the benchmark, which was 80% in the top-performing three nations in 2000–2001. Scores for quality and equity of access were highest, at 71. “Our purpose in issuing this scorecard is to bring attention to opportunities to improve, with benchmarks to motivate change,” said Dr. James Mongan, chairman of the 18-member commission that conducted the study and CEO of Partners HealthCare in Boston. “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system,” the American Board of Internal Medicine said in a statement. The full report is available at

www.cmwf.org

Target Opens In-House Clinics

Target, the Minneapolis-based retail powerhouse, is opening in-house clinics at 8 of its 1,443 stores. The company is rolling out the concept in its corporate hometown and soon will add at least four more in that region. According to Target, the clinics will feature a private waiting area and exam rooms and will offer services such as flu shots and treatments for strep throat, bronchitis, and skin conditions. Prices for services—most under $50—will be clearly listed. The clinics are staffed by licensed nurse-practitioners and physician assistants. Medcor will provide clinic management, and physicians from Fairview Health Services will provide oversight and consultation. The company said in a statement that it will “meet or exceed the American Medical Association and the American Academy of Family Physicians guidelines for retail healthcare.”

Low Physician E-Mail Use

Physicians are rarely using e-mail to communicate with patients, according to one study, yet patients overwhelmingly report that they would like to use e-mail to set appointments, talk with the doctor, and receive test results, according to a separate poll. The Center for Studying Health System Change found that only 24% of physicians said they used e-mail to discuss a clinical issue with a patient in 2004–2005, a 4% increase from the previous study period of 2000–2001. Almost half of physicians in academic settings and staff or group HMO practices use e-mail for clinical discussions, compared with about 20% in practices of 10 or fewer physicians. Physicians in nonmetropolitan areas or who have large numbers of Medicaid and/or Medicare patients say they are less likely to use e-mail, because of patients' lack of access to the technology. Some reasons for not using e-mail are lack of reimbursement for consultations, cost of implementing a secure system, and fears that e-mail will add to workloads. A recent Wall Street Journal-Harris Interactive poll of 2,624 adults found that 74% want to communicate directly with doctors by e-mail, 67% want to receive test results, and 75% want to schedule appointments via the Internet.

Insurance Premiums Continue Rise

Employer-sponsored health insurance premiums rose 7.7% in 2006, outpacing wages and inflation, according to a report from the Kaiser Family Foundation and the Health Research and Educational Trust. The annual survey of employer health benefits found that family health coverage costs an average of $11,480 annually, with workers contributing an average of $2,973 toward their premiums. “We are still losing the race between premiums and workers' earnings, and if that trend persists, employer-based coverage will continue to decline as fewer employers and workers can afford the cost of coverage,” Jon Gabel, coauthor of the study and vice president of the Center for Studying Health System Change, said in a statement. Most individuals opted for coverage through preferred provider organizations (60%), with others choosing HMOs (20%), point-of-service plans (13%), and conventional indemnity plans (3%). About 4% of individuals enrolled in high-deductible plans with a savings option. This year, about 7% of employers—mostly those with 1,000 workers or more—offered some form of high-deductible plan in 2006. The information is from a telephone poll of 3,159 randomly selected public and private employers. To obtain more information, visit

www.kff.org/insurance/7527

Reporting on Quality

More than 3,300 hospitals around the country have reported data on quality measures to Medicare and consumers, according to the Centers for Medicare and Medicaid Services. Of the 3,490 acute care hospitals eligible to participate in the federal program that links hospital payments to reporting of quality measures, 99% opted to report data. Under the program, hospitals that submit quality information to CMS are eligible to receive the full 2% payment update for inpatient services in 2007 under Medicare, while those who do not report will see a 2% payment reduction. “This is more evidence that paying for reporting and improving quality can help patients get better care,” Dr. Mark McClellan, outgoing CMS administrator, said in a statement. “Consumers can use this information to evaluate care, and doctors and hospitals can use it to help improve their performance.

U.S. System Gets Failing Grade

The U.S. health care system ranked 15th out of 19 countries in number of preventable deaths, according to a comparison of 37 indicators of health outcomes, quality, access, equity, and efficiency. Compared with other nations, the United States scored particularly low on efficiency, getting an average score of 51 out of 100. The report blames this partly on the lack of electronic medical records—used by only 17% of American physicians, compared with the benchmark, which was 80% in the top-performing three nations in 2000–2001. Scores for quality and equity of access were highest, at 71. “Our purpose in issuing this scorecard is to bring attention to opportunities to improve, with benchmarks to motivate change,” said Dr. James Mongan, chairman of the 18-member commission that conducted the study and CEO of Partners HealthCare in Boston. “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system,” the American Board of Internal Medicine said in a statement. The full report is available at

www.cmwf.org

Target Opens In-House Clinics

Target, the Minneapolis-based retail powerhouse, is opening in-house clinics at 8 of its 1,443 stores. The company is rolling out the concept in its corporate hometown and soon will add at least four more in that region. According to Target, the clinics will feature a private waiting area and exam rooms and will offer services such as flu shots and treatments for strep throat, bronchitis, and skin conditions. Prices for services—most under $50—will be clearly listed. The clinics are staffed by licensed nurse-practitioners and physician assistants. Medcor will provide clinic management, and physicians from Fairview Health Services will provide oversight and consultation. The company said in a statement that it will “meet or exceed the American Medical Association and the American Academy of Family Physicians guidelines for retail healthcare.”

Low Physician E-Mail Use

Physicians are rarely using e-mail to communicate with patients, according to one study, yet patients overwhelmingly report that they would like to use e-mail to set appointments, talk with the doctor, and receive test results, according to a separate poll. The Center for Studying Health System Change found that only 24% of physicians said they used e-mail to discuss a clinical issue with a patient in 2004–2005, a 4% increase from the previous study period of 2000–2001. Almost half of physicians in academic settings and staff or group HMO practices use e-mail for clinical discussions, compared with about 20% in practices of 10 or fewer physicians. Physicians in nonmetropolitan areas or who have large numbers of Medicaid and/or Medicare patients say they are less likely to use e-mail, because of patients' lack of access to the technology. Some reasons for not using e-mail are lack of reimbursement for consultations, cost of implementing a secure system, and fears that e-mail will add to workloads. A recent Wall Street Journal-Harris Interactive poll of 2,624 adults found that 74% want to communicate directly with doctors by e-mail, 67% want to receive test results, and 75% want to schedule appointments via the Internet.

Insurance Premiums Continue Rise

Employer-sponsored health insurance premiums rose 7.7% in 2006, outpacing wages and inflation, according to a report from the Kaiser Family Foundation and the Health Research and Educational Trust. The annual survey of employer health benefits found that family health coverage costs an average of $11,480 annually, with workers contributing an average of $2,973 toward their premiums. “We are still losing the race between premiums and workers' earnings, and if that trend persists, employer-based coverage will continue to decline as fewer employers and workers can afford the cost of coverage,” Jon Gabel, coauthor of the study and vice president of the Center for Studying Health System Change, said in a statement. Most individuals opted for coverage through preferred provider organizations (60%), with others choosing HMOs (20%), point-of-service plans (13%), and conventional indemnity plans (3%). About 4% of individuals enrolled in high-deductible plans with a savings option. This year, about 7% of employers—mostly those with 1,000 workers or more—offered some form of high-deductible plan in 2006. The information is from a telephone poll of 3,159 randomly selected public and private employers. To obtain more information, visit

www.kff.org/insurance/7527

Reporting on Quality

More than 3,300 hospitals around the country have reported data on quality measures to Medicare and consumers, according to the Centers for Medicare and Medicaid Services. Of the 3,490 acute care hospitals eligible to participate in the federal program that links hospital payments to reporting of quality measures, 99% opted to report data. Under the program, hospitals that submit quality information to CMS are eligible to receive the full 2% payment update for inpatient services in 2007 under Medicare, while those who do not report will see a 2% payment reduction. “This is more evidence that paying for reporting and improving quality can help patients get better care,” Dr. Mark McClellan, outgoing CMS administrator, said in a statement. “Consumers can use this information to evaluate care, and doctors and hospitals can use it to help improve their performance.

U.S. System Gets Failing Grade

The U.S. health care system ranked 15th out of 19 countries in number of preventable deaths, according to a comparison of 37 indicators of health outcomes, quality, access, equity, and efficiency. Compared with other nations, the United States scored particularly low on efficiency, getting an average score of 51 out of 100. The report blames this partly on the lack of electronic medical records—used by only 17% of American physicians, compared with the benchmark, which was 80% in the top-performing three nations in 2000–2001. Scores for quality and equity of access were highest, at 71. “Our purpose in issuing this scorecard is to bring attention to opportunities to improve, with benchmarks to motivate change,” said Dr. James Mongan, chairman of the 18-member commission that conducted the study and CEO of Partners HealthCare in Boston. “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system,” the American Board of Internal Medicine said in a statement. The full report is available at

www.cmwf.org

Target Opens In-House Clinics

Target, the Minneapolis-based retail powerhouse, is opening in-house clinics at 8 of its 1,443 stores. The company is rolling out the concept in its corporate hometown and soon will add at least four more in that region. According to Target, the clinics will feature a private waiting area and exam rooms and will offer services such as flu shots and treatments for strep throat, bronchitis, and skin conditions. Prices for services—most under $50—will be clearly listed. The clinics are staffed by licensed nurse-practitioners and physician assistants. Medcor will provide clinic management, and physicians from Fairview Health Services will provide oversight and consultation. The company said in a statement that it will “meet or exceed the American Medical Association and the American Academy of Family Physicians guidelines for retail healthcare.”

Low Physician E-Mail Use

Physicians are rarely using e-mail to communicate with patients, according to one study, yet patients overwhelmingly report that they would like to use e-mail to set appointments, talk with the doctor, and receive test results, according to a separate poll. The Center for Studying Health System Change found that only 24% of physicians said they used e-mail to discuss a clinical issue with a patient in 2004–2005, a 4% increase from the previous study period of 2000–2001. Almost half of physicians in academic settings and staff or group HMO practices use e-mail for clinical discussions, compared with about 20% in practices of 10 or fewer physicians. Physicians in nonmetropolitan areas or who have large numbers of Medicaid and/or Medicare patients say they are less likely to use e-mail, because of patients' lack of access to the technology. Some reasons for not using e-mail are lack of reimbursement for consultations, cost of implementing a secure system, and fears that e-mail will add to workloads. A recent Wall Street Journal-Harris Interactive poll of 2,624 adults found that 74% want to communicate directly with doctors by e-mail, 67% want to receive test results, and 75% want to schedule appointments via the Internet.

Insurance Premiums Continue Rise

Employer-sponsored health insurance premiums rose 7.7% in 2006, outpacing wages and inflation, according to a report from the Kaiser Family Foundation and the Health Research and Educational Trust. The annual survey of employer health benefits found that family health coverage costs an average of $11,480 annually, with workers contributing an average of $2,973 toward their premiums. “We are still losing the race between premiums and workers' earnings, and if that trend persists, employer-based coverage will continue to decline as fewer employers and workers can afford the cost of coverage,” Jon Gabel, coauthor of the study and vice president of the Center for Studying Health System Change, said in a statement. Most individuals opted for coverage through preferred provider organizations (60%), with others choosing HMOs (20%), point-of-service plans (13%), and conventional indemnity plans (3%). About 4% of individuals enrolled in high-deductible plans with a savings option. This year, about 7% of employers—mostly those with 1,000 workers or more—offered some form of high-deductible plan in 2006. The information is from a telephone poll of 3,159 randomly selected public and private employers. To obtain more information, visit

www.kff.org/insurance/7527

Reporting on Quality

More than 3,300 hospitals around the country have reported data on quality measures to Medicare and consumers, according to the Centers for Medicare and Medicaid Services. Of the 3,490 acute care hospitals eligible to participate in the federal program that links hospital payments to reporting of quality measures, 99% opted to report data. Under the program, hospitals that submit quality information to CMS are eligible to receive the full 2% payment update for inpatient services in 2007 under Medicare, while those who do not report will see a 2% payment reduction. “This is more evidence that paying for reporting and improving quality can help patients get better care,” Dr. Mark McClellan, outgoing CMS administrator, said in a statement. “Consumers can use this information to evaluate care, and doctors and hospitals can use it to help improve their performance.

Lipoprotein (a) and CV Risk in Women

High levels of lipoprotein (a) are associated with increased cardiovascular risk in healthy women, particularly in those with high levels of LDL cholesterol, according to researchers at Harvard Medical School, Boston.

Dr. Jacqueline Suk Danik and colleagues analyzed data from 27,791 participants in the Women's Health Study, a prospective study of cardiovascular risk in healthy women aged 45 years and older. Blood samples and data on lifestyle and behavioral risk factors were obtained at baseline. Participants were followed up prospectively for 10 years.

First major cardiovascular events occurred in 899 women. Multivariate analysis showed increased cardiovascular risk was linked to high levels of lipoprotein (a), with the association largely attributed to a threshold effect among those with the highest levels (JAMA 2006;296:1363–70).

The adjusted hazard ratio for a cardiovascular event was 1.66 for women with lipoprotein (a) levels in the 90th percentile (at least 65.5 mg/dL) and 1.87 for those in the 95th percentile (at least 83 mg/dL). Although lipoprotein (a) may have clinical importance in select women at high cardiovascular risk, generalized screening is not recommended, Dr. Suk Danik wrote.

Impact of Long QT Syndrome

Factors that predict a high risk of life-threatening events in adolescents with the hereditary long QT syndrome are duration of the QT interval, timing and frequency of recent syncope, and male gender, according to a study by Dr. Jenny B. Hobbs of the University of Rochester (N.Y.) Medical Center and colleagues.

The study included 2,772 patients enrolled in the International Long QT Syndrome Registry who had survived to age 10 years. For inclusion in the study, patients were required to have at least one of the following: QTc of 450 milliseconds or longer, QTc from 420 to 450 milliseconds with syncope before age 10 years, or QTc from 420 to 450 milliseconds plus a long QT syndrome mutation identified on genetic testing.

A total of 81 patients experienced an episode of aborted cardiac arrest, and 54 had sudden cardiac death during the 10 years of follow-up (JAMA 2006;296:1249–54). Nine of the 81 patients who had an aborted cardiac arrest subsequently experienced sudden cardiac death.

Multivariate analysis determined that patients whose QTc interval exceeded 530 milliseconds were more than twice as likely to experience one of these events as were those with shorter intervals.

Syncope significantly contributed to risk of a cardiac event in a time-dependent fashion. The hazard ratio was 2.7 for patients who had one syncopal event in the past 2–10 years and 18.1 for those who had two or more such events in the past 2 years.

The risk associated with male sex also was time dependent. Between the ages of 10 and 12 years, boys had four times the risk of girls, but there were no gender differences after age 13.

The authors also analyzed the effects of β-blocker therapy in these high-risk patients and found a risk reduction of 64% with the drug therapy.

MI Risk Higher in Men With Gout

Men with a history of gouty arthritis have a significantly higher risk of acute myocardial infarction, reported Dr. Eswar Krishnan of the University of Pittsburgh and his associates.

“This study is the first to show that among men with no previous history of coronary artery disease, gouty arthritis is a significant independent correlate of subsequent acute myocardial infarction,” the researchers reported.

The results revealed a significantly greater number of acute MI events in men with gout (odds ratio, 1.26) and showed that hyperuricemia is an independent risk factor for acute MI (OR, 1.11).

The findings were from the Multiple Risk Factor Intervention Trial (MRFIT), a randomized controlled trial of 12,866 men with a mean age of 46 years. They were followed prospectively for about 6.5 years. (Arthritis Rheum. 2006;54:2688–96).

To assess the relationship between MI and gout, the researchers used a two-part definition of gout. Participants had to answer “yes”' when asked if they had ever been told by a physician that they had gout and also had to have a uric acid level greater than 7.0 mg/dL on at least four occasions.

This definition was used because obtaining joint fluid samples from all the participants was not within the scope of the trial. “Defining gout has always been a problem,” Dr. Krishnan said. “Crystal diagnosis is desirable but almost impossible.”

Although researchers have not fully elucidated the pathophysiology of the relationship between gouty arthritis and cardiovascular disease, Dr. Krishnan proposed that the increased inflammation associated with gout and hyperuricemia could lead to increased risk for acute MI.

Lipoprotein (a) and CV Risk in Women

High levels of lipoprotein (a) are associated with increased cardiovascular risk in healthy women, particularly in those with high levels of LDL cholesterol, according to researchers at Harvard Medical School, Boston.

Dr. Jacqueline Suk Danik and colleagues analyzed data from 27,791 participants in the Women's Health Study, a prospective study of cardiovascular risk in healthy women aged 45 years and older. Blood samples and data on lifestyle and behavioral risk factors were obtained at baseline. Participants were followed up prospectively for 10 years.

First major cardiovascular events occurred in 899 women. Multivariate analysis showed increased cardiovascular risk was linked to high levels of lipoprotein (a), with the association largely attributed to a threshold effect among those with the highest levels (JAMA 2006;296:1363–70).

The adjusted hazard ratio for a cardiovascular event was 1.66 for women with lipoprotein (a) levels in the 90th percentile (at least 65.5 mg/dL) and 1.87 for those in the 95th percentile (at least 83 mg/dL). Although lipoprotein (a) may have clinical importance in select women at high cardiovascular risk, generalized screening is not recommended, Dr. Suk Danik wrote.

Impact of Long QT Syndrome

Factors that predict a high risk of life-threatening events in adolescents with the hereditary long QT syndrome are duration of the QT interval, timing and frequency of recent syncope, and male gender, according to a study by Dr. Jenny B. Hobbs of the University of Rochester (N.Y.) Medical Center and colleagues.

The study included 2,772 patients enrolled in the International Long QT Syndrome Registry who had survived to age 10 years. For inclusion in the study, patients were required to have at least one of the following: QTc of 450 milliseconds or longer, QTc from 420 to 450 milliseconds with syncope before age 10 years, or QTc from 420 to 450 milliseconds plus a long QT syndrome mutation identified on genetic testing.

A total of 81 patients experienced an episode of aborted cardiac arrest, and 54 had sudden cardiac death during the 10 years of follow-up (JAMA 2006;296:1249–54). Nine of the 81 patients who had an aborted cardiac arrest subsequently experienced sudden cardiac death.

Multivariate analysis determined that patients whose QTc interval exceeded 530 milliseconds were more than twice as likely to experience one of these events as were those with shorter intervals.

Syncope significantly contributed to risk of a cardiac event in a time-dependent fashion. The hazard ratio was 2.7 for patients who had one syncopal event in the past 2–10 years and 18.1 for those who had two or more such events in the past 2 years.

The risk associated with male sex also was time dependent. Between the ages of 10 and 12 years, boys had four times the risk of girls, but there were no gender differences after age 13.

The authors also analyzed the effects of β-blocker therapy in these high-risk patients and found a risk reduction of 64% with the drug therapy.

MI Risk Higher in Men With Gout

Men with a history of gouty arthritis have a significantly higher risk of acute myocardial infarction, reported Dr. Eswar Krishnan of the University of Pittsburgh and his associates.

“This study is the first to show that among men with no previous history of coronary artery disease, gouty arthritis is a significant independent correlate of subsequent acute myocardial infarction,” the researchers reported.

The results revealed a significantly greater number of acute MI events in men with gout (odds ratio, 1.26) and showed that hyperuricemia is an independent risk factor for acute MI (OR, 1.11).

The findings were from the Multiple Risk Factor Intervention Trial (MRFIT), a randomized controlled trial of 12,866 men with a mean age of 46 years. They were followed prospectively for about 6.5 years. (Arthritis Rheum. 2006;54:2688–96).

To assess the relationship between MI and gout, the researchers used a two-part definition of gout. Participants had to answer “yes”' when asked if they had ever been told by a physician that they had gout and also had to have a uric acid level greater than 7.0 mg/dL on at least four occasions.

This definition was used because obtaining joint fluid samples from all the participants was not within the scope of the trial. “Defining gout has always been a problem,” Dr. Krishnan said. “Crystal diagnosis is desirable but almost impossible.”

Although researchers have not fully elucidated the pathophysiology of the relationship between gouty arthritis and cardiovascular disease, Dr. Krishnan proposed that the increased inflammation associated with gout and hyperuricemia could lead to increased risk for acute MI.

Lipoprotein (a) and CV Risk in Women

High levels of lipoprotein (a) are associated with increased cardiovascular risk in healthy women, particularly in those with high levels of LDL cholesterol, according to researchers at Harvard Medical School, Boston.

Dr. Jacqueline Suk Danik and colleagues analyzed data from 27,791 participants in the Women's Health Study, a prospective study of cardiovascular risk in healthy women aged 45 years and older. Blood samples and data on lifestyle and behavioral risk factors were obtained at baseline. Participants were followed up prospectively for 10 years.

First major cardiovascular events occurred in 899 women. Multivariate analysis showed increased cardiovascular risk was linked to high levels of lipoprotein (a), with the association largely attributed to a threshold effect among those with the highest levels (JAMA 2006;296:1363–70).

The adjusted hazard ratio for a cardiovascular event was 1.66 for women with lipoprotein (a) levels in the 90th percentile (at least 65.5 mg/dL) and 1.87 for those in the 95th percentile (at least 83 mg/dL). Although lipoprotein (a) may have clinical importance in select women at high cardiovascular risk, generalized screening is not recommended, Dr. Suk Danik wrote.

Impact of Long QT Syndrome

Factors that predict a high risk of life-threatening events in adolescents with the hereditary long QT syndrome are duration of the QT interval, timing and frequency of recent syncope, and male gender, according to a study by Dr. Jenny B. Hobbs of the University of Rochester (N.Y.) Medical Center and colleagues.

The study included 2,772 patients enrolled in the International Long QT Syndrome Registry who had survived to age 10 years. For inclusion in the study, patients were required to have at least one of the following: QTc of 450 milliseconds or longer, QTc from 420 to 450 milliseconds with syncope before age 10 years, or QTc from 420 to 450 milliseconds plus a long QT syndrome mutation identified on genetic testing.

A total of 81 patients experienced an episode of aborted cardiac arrest, and 54 had sudden cardiac death during the 10 years of follow-up (JAMA 2006;296:1249–54). Nine of the 81 patients who had an aborted cardiac arrest subsequently experienced sudden cardiac death.

Multivariate analysis determined that patients whose QTc interval exceeded 530 milliseconds were more than twice as likely to experience one of these events as were those with shorter intervals.

Syncope significantly contributed to risk of a cardiac event in a time-dependent fashion. The hazard ratio was 2.7 for patients who had one syncopal event in the past 2–10 years and 18.1 for those who had two or more such events in the past 2 years.

The risk associated with male sex also was time dependent. Between the ages of 10 and 12 years, boys had four times the risk of girls, but there were no gender differences after age 13.

The authors also analyzed the effects of β-blocker therapy in these high-risk patients and found a risk reduction of 64% with the drug therapy.

MI Risk Higher in Men With Gout

Men with a history of gouty arthritis have a significantly higher risk of acute myocardial infarction, reported Dr. Eswar Krishnan of the University of Pittsburgh and his associates.

“This study is the first to show that among men with no previous history of coronary artery disease, gouty arthritis is a significant independent correlate of subsequent acute myocardial infarction,” the researchers reported.

The results revealed a significantly greater number of acute MI events in men with gout (odds ratio, 1.26) and showed that hyperuricemia is an independent risk factor for acute MI (OR, 1.11).

The findings were from the Multiple Risk Factor Intervention Trial (MRFIT), a randomized controlled trial of 12,866 men with a mean age of 46 years. They were followed prospectively for about 6.5 years. (Arthritis Rheum. 2006;54:2688–96).

To assess the relationship between MI and gout, the researchers used a two-part definition of gout. Participants had to answer “yes”' when asked if they had ever been told by a physician that they had gout and also had to have a uric acid level greater than 7.0 mg/dL on at least four occasions.

This definition was used because obtaining joint fluid samples from all the participants was not within the scope of the trial. “Defining gout has always been a problem,” Dr. Krishnan said. “Crystal diagnosis is desirable but almost impossible.”

Although researchers have not fully elucidated the pathophysiology of the relationship between gouty arthritis and cardiovascular disease, Dr. Krishnan proposed that the increased inflammation associated with gout and hyperuricemia could lead to increased risk for acute MI.

Part B Premiums Up 5.6% for 2007

Medicare's Part B premium for outpatient and physician services will go up by 5.6% to $93.50 in 2007, the smallest increase since 2001, and less than what had been projected by the Centers for Medicare and Medicaid Services earlier in 2006, Dr. Mark B. McClellan, outgoing CMS administrator, announced in a briefing with reporters. The Part B deductible will be $131. For the first time in 2007, higher-income beneficiaries—individuals with incomes over $80,000 annually, and couples who make more than $160,000 annually—will pay a larger share of their costs. Spending on Medicare Advantage is flat, but growth continues in the traditional fee-for-service side. The largest contributors to that growth are outpatient hospital services (projected to grow by 12% in 2007), physician-administered drugs, and ambulatory surgery center services. Growth in physician services, such as lab tests and imaging, slowed down significantly from what had been expected, but the volume is still projected to increase 5% in 2007, said Dr. McClellan. Also, if Congress increases physician fees for 2007, as is expected, the Part B premium will have to be adjusted upward in proceeding years to compensate, he warned.

Public Prioritizes Health Care Reform

Most Americans want to see health care as one of the top priorities of Congress and the president, according to a poll commissioned by the American Academy of Family Physicians. About 90% of Americans who were surveyed said that the next Congress must make reforms to the health care system and about two-thirds said they would be upset if lawmakers did not take action in the next two to four years. When asked how best to reform the system, about 40% of respondents said that making health care more affordable should be the goal, and 31% said that providing basic health care coverage for everyone was important. Nearly one-third of respondents say that the current health care system is failing to meet their needs and the needs of their families. The poll of 800 likely voters was conducted by Republican pollster Bill McInturff of Public Opinion Strategies and Democratic pollster Celinda Lake of Lake Research Partners. AAFP officials have also released a “Guide to Health Issues for Voters” at

www.familydoctor.org

Tackling Pay for Performance

Evidence on pay for performance shows that in general payment incentives can improve the quality of care, Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said at the annual Congress of Delegates of the American Academy of Family Physicians. There are some factors that make a difference between success and failure, including the certainty of increased revenue. And for small practices in particular, the cost and difficulty of achieving gain through a program is key, Dr. Clancy said. But there are still gaps in the available research. For example, most studies have omitted key variables and many studies have yet to evaluate the impact of the market share of a program, Dr. Clancy said. In order for these programs to succeed, physicians will need to understand the incentives and what must be done to qualify for them, and evaluate whether the incentives are worth their time and effort. Physicians will also need to have sufficient control over the clinical activities required to achieve the targets, she said.

AAFP Elects New Leadership

Family physicians elected new leadership for the American Academy of Family Physicians last month at the group's annual Congress of Delegates. The AAFP delegates elected Dr. James King, of Tennessee, as president-elect. Dr. King, who previously served for three years on the AAFP's board of directors, said in an interview that his top priority for the year will be fixing the Medicare physician payment system. Dr. King is in private practice in the rural area of Selmer, Tenn., and serves as volunteer faculty at the University of Tennessee Center for Health Sciences in Memphis. AAFP delegates also elected three new members to their board: Dr. David Avery of Vienna, W.V.; Dr. James J. Dearing, D.O., of Phoenix, Ariz.; and Dr. Roland Goertz, of Waco, Texas. Dr. Rick Kellerman assumed the role of president of the AAFP. Dr. Kellerman of Wichita, Kan., was elected as president-elect at the annual meeting in 2005.

U.S. System Gets Failing Grade

A comparison of how the U.S. health care system stacks up against systems in other countries on 37 indicators of health outcomes, quality, access, equity, and efficiency shows that America scores an average 66 out of 100, ranking 15th out of 19 countries in preventable deaths. The United States scored particularly low against other nations on efficiency, getting an average score of 51, which the report blames partly on the lack of electronic medical records, used by only 17% of American physicians. Scores for quality and equity of access were highest, at 71. The American Board of Internal Medicine, which participated in a briefing on the report, said in a statement, “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system.” The scorecard, which will be updated annually, was developed using a quality framework established by the Institute of Medicine and used indicators from the Department of Health and Human Services, the Agency for Healthcare Research and Quality, the National Committee for Quality Assurance and others. The full report is available online at

www.cmwf.org

Part B Premiums Up 5.6% for 2007

Medicare's Part B premium for outpatient and physician services will go up by 5.6% to $93.50 in 2007, the smallest increase since 2001, and less than what had been projected by the Centers for Medicare and Medicaid Services earlier in 2006, Dr. Mark B. McClellan, outgoing CMS administrator, announced in a briefing with reporters. The Part B deductible will be $131. For the first time in 2007, higher-income beneficiaries—individuals with incomes over $80,000 annually, and couples who make more than $160,000 annually—will pay a larger share of their costs. Spending on Medicare Advantage is flat, but growth continues in the traditional fee-for-service side. The largest contributors to that growth are outpatient hospital services (projected to grow by 12% in 2007), physician-administered drugs, and ambulatory surgery center services. Growth in physician services, such as lab tests and imaging, slowed down significantly from what had been expected, but the volume is still projected to increase 5% in 2007, said Dr. McClellan. Also, if Congress increases physician fees for 2007, as is expected, the Part B premium will have to be adjusted upward in proceeding years to compensate, he warned.

Public Prioritizes Health Care Reform

Most Americans want to see health care as one of the top priorities of Congress and the president, according to a poll commissioned by the American Academy of Family Physicians. About 90% of Americans who were surveyed said that the next Congress must make reforms to the health care system and about two-thirds said they would be upset if lawmakers did not take action in the next two to four years. When asked how best to reform the system, about 40% of respondents said that making health care more affordable should be the goal, and 31% said that providing basic health care coverage for everyone was important. Nearly one-third of respondents say that the current health care system is failing to meet their needs and the needs of their families. The poll of 800 likely voters was conducted by Republican pollster Bill McInturff of Public Opinion Strategies and Democratic pollster Celinda Lake of Lake Research Partners. AAFP officials have also released a “Guide to Health Issues for Voters” at

www.familydoctor.org

Tackling Pay for Performance

Evidence on pay for performance shows that in general payment incentives can improve the quality of care, Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said at the annual Congress of Delegates of the American Academy of Family Physicians. There are some factors that make a difference between success and failure, including the certainty of increased revenue. And for small practices in particular, the cost and difficulty of achieving gain through a program is key, Dr. Clancy said. But there are still gaps in the available research. For example, most studies have omitted key variables and many studies have yet to evaluate the impact of the market share of a program, Dr. Clancy said. In order for these programs to succeed, physicians will need to understand the incentives and what must be done to qualify for them, and evaluate whether the incentives are worth their time and effort. Physicians will also need to have sufficient control over the clinical activities required to achieve the targets, she said.

AAFP Elects New Leadership

Family physicians elected new leadership for the American Academy of Family Physicians last month at the group's annual Congress of Delegates. The AAFP delegates elected Dr. James King, of Tennessee, as president-elect. Dr. King, who previously served for three years on the AAFP's board of directors, said in an interview that his top priority for the year will be fixing the Medicare physician payment system. Dr. King is in private practice in the rural area of Selmer, Tenn., and serves as volunteer faculty at the University of Tennessee Center for Health Sciences in Memphis. AAFP delegates also elected three new members to their board: Dr. David Avery of Vienna, W.V.; Dr. James J. Dearing, D.O., of Phoenix, Ariz.; and Dr. Roland Goertz, of Waco, Texas. Dr. Rick Kellerman assumed the role of president of the AAFP. Dr. Kellerman of Wichita, Kan., was elected as president-elect at the annual meeting in 2005.

U.S. System Gets Failing Grade

A comparison of how the U.S. health care system stacks up against systems in other countries on 37 indicators of health outcomes, quality, access, equity, and efficiency shows that America scores an average 66 out of 100, ranking 15th out of 19 countries in preventable deaths. The United States scored particularly low against other nations on efficiency, getting an average score of 51, which the report blames partly on the lack of electronic medical records, used by only 17% of American physicians. Scores for quality and equity of access were highest, at 71. The American Board of Internal Medicine, which participated in a briefing on the report, said in a statement, “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system.” The scorecard, which will be updated annually, was developed using a quality framework established by the Institute of Medicine and used indicators from the Department of Health and Human Services, the Agency for Healthcare Research and Quality, the National Committee for Quality Assurance and others. The full report is available online at

www.cmwf.org

Part B Premiums Up 5.6% for 2007

Medicare's Part B premium for outpatient and physician services will go up by 5.6% to $93.50 in 2007, the smallest increase since 2001, and less than what had been projected by the Centers for Medicare and Medicaid Services earlier in 2006, Dr. Mark B. McClellan, outgoing CMS administrator, announced in a briefing with reporters. The Part B deductible will be $131. For the first time in 2007, higher-income beneficiaries—individuals with incomes over $80,000 annually, and couples who make more than $160,000 annually—will pay a larger share of their costs. Spending on Medicare Advantage is flat, but growth continues in the traditional fee-for-service side. The largest contributors to that growth are outpatient hospital services (projected to grow by 12% in 2007), physician-administered drugs, and ambulatory surgery center services. Growth in physician services, such as lab tests and imaging, slowed down significantly from what had been expected, but the volume is still projected to increase 5% in 2007, said Dr. McClellan. Also, if Congress increases physician fees for 2007, as is expected, the Part B premium will have to be adjusted upward in proceeding years to compensate, he warned.

Public Prioritizes Health Care Reform

Most Americans want to see health care as one of the top priorities of Congress and the president, according to a poll commissioned by the American Academy of Family Physicians. About 90% of Americans who were surveyed said that the next Congress must make reforms to the health care system and about two-thirds said they would be upset if lawmakers did not take action in the next two to four years. When asked how best to reform the system, about 40% of respondents said that making health care more affordable should be the goal, and 31% said that providing basic health care coverage for everyone was important. Nearly one-third of respondents say that the current health care system is failing to meet their needs and the needs of their families. The poll of 800 likely voters was conducted by Republican pollster Bill McInturff of Public Opinion Strategies and Democratic pollster Celinda Lake of Lake Research Partners. AAFP officials have also released a “Guide to Health Issues for Voters” at

www.familydoctor.org

Tackling Pay for Performance

Evidence on pay for performance shows that in general payment incentives can improve the quality of care, Dr. Carolyn Clancy, director of the Agency for Healthcare Research and Quality, said at the annual Congress of Delegates of the American Academy of Family Physicians. There are some factors that make a difference between success and failure, including the certainty of increased revenue. And for small practices in particular, the cost and difficulty of achieving gain through a program is key, Dr. Clancy said. But there are still gaps in the available research. For example, most studies have omitted key variables and many studies have yet to evaluate the impact of the market share of a program, Dr. Clancy said. In order for these programs to succeed, physicians will need to understand the incentives and what must be done to qualify for them, and evaluate whether the incentives are worth their time and effort. Physicians will also need to have sufficient control over the clinical activities required to achieve the targets, she said.

AAFP Elects New Leadership

Family physicians elected new leadership for the American Academy of Family Physicians last month at the group's annual Congress of Delegates. The AAFP delegates elected Dr. James King, of Tennessee, as president-elect. Dr. King, who previously served for three years on the AAFP's board of directors, said in an interview that his top priority for the year will be fixing the Medicare physician payment system. Dr. King is in private practice in the rural area of Selmer, Tenn., and serves as volunteer faculty at the University of Tennessee Center for Health Sciences in Memphis. AAFP delegates also elected three new members to their board: Dr. David Avery of Vienna, W.V.; Dr. James J. Dearing, D.O., of Phoenix, Ariz.; and Dr. Roland Goertz, of Waco, Texas. Dr. Rick Kellerman assumed the role of president of the AAFP. Dr. Kellerman of Wichita, Kan., was elected as president-elect at the annual meeting in 2005.

U.S. System Gets Failing Grade

A comparison of how the U.S. health care system stacks up against systems in other countries on 37 indicators of health outcomes, quality, access, equity, and efficiency shows that America scores an average 66 out of 100, ranking 15th out of 19 countries in preventable deaths. The United States scored particularly low against other nations on efficiency, getting an average score of 51, which the report blames partly on the lack of electronic medical records, used by only 17% of American physicians. Scores for quality and equity of access were highest, at 71. The American Board of Internal Medicine, which participated in a briefing on the report, said in a statement, “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system.” The scorecard, which will be updated annually, was developed using a quality framework established by the Institute of Medicine and used indicators from the Department of Health and Human Services, the Agency for Healthcare Research and Quality, the National Committee for Quality Assurance and others. The full report is available online at

www.cmwf.org

Part B Premiums Up 5.6% for 2007

Medicare's Part B premium for outpatient and physician services will go up by 5.6% to $93.50 in 2007, the smallest increase since 2001, and less than what had been projected by the Centers for Medicare and Medicaid Services earlier in 2006, Dr. Mark B. McClellan, outgoing CMS administrator, announced in a briefing. The Part B deductible will be $131. For the first time in 2007, higher-income beneficiaries—individuals with incomes over $80,000 annually, and couples who make more than $160,000 annually—will pay a larger share of their costs. Spending on Medicare Advantage is flat, but growth continues in the traditional fee-for-service side. The largest contributors to that growth are outpatient hospital services (projected to grow by 12% in 2007), physician-administered drugs, and ambulatory surgery center services. Growth in physician services, such as lab tests and imaging, slowed down significantly from what had been expected, but the volume is still projected to increase 5% in 2007, Dr. McClellan said. Also, if Congress increases physician fees for 2007, the Part B premium will have to be adjusted upward in proceeding years to compensate, he warned.

U.S. System Gets Failing Grade

A comparison of how the U.S. health care system stacks up against systems in other countries on 37 indicators of health outcomes, quality, access, equity, and efficiency shows that America scores an average 66 out of 100, ranking 15th out of 19 countries in preventable deaths. The United States scored particularly low against other nations on efficiency, getting an average score of 51, which the report blames partly on the lack of electronic medical records, used by only 17% of American physicians. Scores for quality and equity of access were highest, at 71. The American Board of Internal Medicine, which participated in a briefing on the report, said in a statement, “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system.” The scorecard, which will be updated annually, was developed using a quality framework established by the Institute of Medicine and used indicators from the Department of Health and Human Services, the Agency for Healthcare Research and Quality, the National Committee for Quality Assurances, and others. The full report is available online at

www.cmwf.org

Easing Insurance Hassles

A group of health care organizations has pledged to ease some of the hassles faced by physicians in verifying patient insurance information and to do so by March 31, 2007. More than 20 organizations, including a number of major insurers, will begin to electronically exchange patient eligibility and benefits information using operating rules developed by the Committee on Operating Rules for Information Exchange (CORE), part of the Council for Affordable Quality Healthcare (CAQH), an industry group. The adoption of the CORE rules by insurers and other health care organizations means that physicians will be able to submit an electronic request to a participating health plan and get a response in 20 seconds or less, according to CAQH. Some of the insurers who have committed to adopting the CORE rules include Aetna Inc., Humana Inc., and Wellpoint Inc. Nearly 70 million Americans are covered by the health plans that have committed to using the CORE rules, according to CAQH. The CORE Phase I rules have been endorsed by the American Academy of Family Physicians, the American College of Physicians, and the Medical Group Management Association.

Wal-Mart Offers Drug Discounts

Retail giant Wal-Mart last month began offering generic medications to pharmacy customers in the Tampa Bay, Fla., area at a cost of $4 per 30-day supply. The program will be expanded to all stores in Florida in January and could be expanded across the country in 2007, the company said. “Competition and market forces have been absent from our health care system, and that has hurt working families tremendously,” Wal-Mart CEO H. Lee Scott Jr. said in a statement. “We are excited to take the lead in doing what we do best—driving costs out of the system—and passing those savings to our customers and associates.” The $4 copay will apply to prescriptions that can be filled with 1 of 291 generic medications from a variety of therapeutic categories including antibiotics, cardiac medications, antidepressants, anti-inflammatory drugs, diabetes medications, analgesics, and vitamins. The program will be available to customers with and without insurance. In an effort to remain competitive with Wal-Mart, Target announced that its Tampa Bay area stores would match the lower prices on generic drugs.

Research on Healthy Aging

More than 90 scientists, research advocates, and other experts are calling on policy makers around the world to make research into healthy aging a priority. The researchers signed on to a statement that calls the slowing of the aging process in humans “scientifically plausible,” providing there is adequate investment. Investing more in understanding the biology of aging is important, the statement said, because of the individual and societal costs associated with debilitating late-in-life illnesses. “A modest deceleration in the rate of biological aging would produce the equivalent of simultaneous major breakthroughs against every single fatal and nonfatal disease and disorder associated with growing older,” said the statement, which was released in September at a symposium on Capitol Hill sponsored by the Alliance for Aging Research.

Part B Premiums Up 5.6% for 2007

Medicare's Part B premium for outpatient and physician services will go up by 5.6% to $93.50 in 2007, the smallest increase since 2001, and less than what had been projected by the Centers for Medicare and Medicaid Services earlier in 2006, Dr. Mark B. McClellan, outgoing CMS administrator, announced in a briefing. The Part B deductible will be $131. For the first time in 2007, higher-income beneficiaries—individuals with incomes over $80,000 annually, and couples who make more than $160,000 annually—will pay a larger share of their costs. Spending on Medicare Advantage is flat, but growth continues in the traditional fee-for-service side. The largest contributors to that growth are outpatient hospital services (projected to grow by 12% in 2007), physician-administered drugs, and ambulatory surgery center services. Growth in physician services, such as lab tests and imaging, slowed down significantly from what had been expected, but the volume is still projected to increase 5% in 2007, Dr. McClellan said. Also, if Congress increases physician fees for 2007, the Part B premium will have to be adjusted upward in proceeding years to compensate, he warned.

U.S. System Gets Failing Grade

A comparison of how the U.S. health care system stacks up against systems in other countries on 37 indicators of health outcomes, quality, access, equity, and efficiency shows that America scores an average 66 out of 100, ranking 15th out of 19 countries in preventable deaths. The United States scored particularly low against other nations on efficiency, getting an average score of 51, which the report blames partly on the lack of electronic medical records, used by only 17% of American physicians. Scores for quality and equity of access were highest, at 71. The American Board of Internal Medicine, which participated in a briefing on the report, said in a statement, “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system.” The scorecard, which will be updated annually, was developed using a quality framework established by the Institute of Medicine and used indicators from the Department of Health and Human Services, the Agency for Healthcare Research and Quality, the National Committee for Quality Assurances, and others. The full report is available online at

www.cmwf.org

Easing Insurance Hassles

A group of health care organizations has pledged to ease some of the hassles faced by physicians in verifying patient insurance information and to do so by March 31, 2007. More than 20 organizations, including a number of major insurers, will begin to electronically exchange patient eligibility and benefits information using operating rules developed by the Committee on Operating Rules for Information Exchange (CORE), part of the Council for Affordable Quality Healthcare (CAQH), an industry group. The adoption of the CORE rules by insurers and other health care organizations means that physicians will be able to submit an electronic request to a participating health plan and get a response in 20 seconds or less, according to CAQH. Some of the insurers who have committed to adopting the CORE rules include Aetna Inc., Humana Inc., and Wellpoint Inc. Nearly 70 million Americans are covered by the health plans that have committed to using the CORE rules, according to CAQH. The CORE Phase I rules have been endorsed by the American Academy of Family Physicians, the American College of Physicians, and the Medical Group Management Association.

Wal-Mart Offers Drug Discounts

Retail giant Wal-Mart last month began offering generic medications to pharmacy customers in the Tampa Bay, Fla., area at a cost of $4 per 30-day supply. The program will be expanded to all stores in Florida in January and could be expanded across the country in 2007, the company said. “Competition and market forces have been absent from our health care system, and that has hurt working families tremendously,” Wal-Mart CEO H. Lee Scott Jr. said in a statement. “We are excited to take the lead in doing what we do best—driving costs out of the system—and passing those savings to our customers and associates.” The $4 copay will apply to prescriptions that can be filled with 1 of 291 generic medications from a variety of therapeutic categories including antibiotics, cardiac medications, antidepressants, anti-inflammatory drugs, diabetes medications, analgesics, and vitamins. The program will be available to customers with and without insurance. In an effort to remain competitive with Wal-Mart, Target announced that its Tampa Bay area stores would match the lower prices on generic drugs.

Research on Healthy Aging

More than 90 scientists, research advocates, and other experts are calling on policy makers around the world to make research into healthy aging a priority. The researchers signed on to a statement that calls the slowing of the aging process in humans “scientifically plausible,” providing there is adequate investment. Investing more in understanding the biology of aging is important, the statement said, because of the individual and societal costs associated with debilitating late-in-life illnesses. “A modest deceleration in the rate of biological aging would produce the equivalent of simultaneous major breakthroughs against every single fatal and nonfatal disease and disorder associated with growing older,” said the statement, which was released in September at a symposium on Capitol Hill sponsored by the Alliance for Aging Research.

Part B Premiums Up 5.6% for 2007

Medicare's Part B premium for outpatient and physician services will go up by 5.6% to $93.50 in 2007, the smallest increase since 2001, and less than what had been projected by the Centers for Medicare and Medicaid Services earlier in 2006, Dr. Mark B. McClellan, outgoing CMS administrator, announced in a briefing. The Part B deductible will be $131. For the first time in 2007, higher-income beneficiaries—individuals with incomes over $80,000 annually, and couples who make more than $160,000 annually—will pay a larger share of their costs. Spending on Medicare Advantage is flat, but growth continues in the traditional fee-for-service side. The largest contributors to that growth are outpatient hospital services (projected to grow by 12% in 2007), physician-administered drugs, and ambulatory surgery center services. Growth in physician services, such as lab tests and imaging, slowed down significantly from what had been expected, but the volume is still projected to increase 5% in 2007, Dr. McClellan said. Also, if Congress increases physician fees for 2007, the Part B premium will have to be adjusted upward in proceeding years to compensate, he warned.

U.S. System Gets Failing Grade

A comparison of how the U.S. health care system stacks up against systems in other countries on 37 indicators of health outcomes, quality, access, equity, and efficiency shows that America scores an average 66 out of 100, ranking 15th out of 19 countries in preventable deaths. The United States scored particularly low against other nations on efficiency, getting an average score of 51, which the report blames partly on the lack of electronic medical records, used by only 17% of American physicians. Scores for quality and equity of access were highest, at 71. The American Board of Internal Medicine, which participated in a briefing on the report, said in a statement, “We applaud the commission for providing us with a comprehensive, comparative set of measures to use as a basis for improving the performance of our nation's health care system.” The scorecard, which will be updated annually, was developed using a quality framework established by the Institute of Medicine and used indicators from the Department of Health and Human Services, the Agency for Healthcare Research and Quality, the National Committee for Quality Assurances, and others. The full report is available online at

www.cmwf.org

Easing Insurance Hassles

A group of health care organizations has pledged to ease some of the hassles faced by physicians in verifying patient insurance information and to do so by March 31, 2007. More than 20 organizations, including a number of major insurers, will begin to electronically exchange patient eligibility and benefits information using operating rules developed by the Committee on Operating Rules for Information Exchange (CORE), part of the Council for Affordable Quality Healthcare (CAQH), an industry group. The adoption of the CORE rules by insurers and other health care organizations means that physicians will be able to submit an electronic request to a participating health plan and get a response in 20 seconds or less, according to CAQH. Some of the insurers who have committed to adopting the CORE rules include Aetna Inc., Humana Inc., and Wellpoint Inc. Nearly 70 million Americans are covered by the health plans that have committed to using the CORE rules, according to CAQH. The CORE Phase I rules have been endorsed by the American Academy of Family Physicians, the American College of Physicians, and the Medical Group Management Association.

Wal-Mart Offers Drug Discounts

Retail giant Wal-Mart last month began offering generic medications to pharmacy customers in the Tampa Bay, Fla., area at a cost of $4 per 30-day supply. The program will be expanded to all stores in Florida in January and could be expanded across the country in 2007, the company said. “Competition and market forces have been absent from our health care system, and that has hurt working families tremendously,” Wal-Mart CEO H. Lee Scott Jr. said in a statement. “We are excited to take the lead in doing what we do best—driving costs out of the system—and passing those savings to our customers and associates.” The $4 copay will apply to prescriptions that can be filled with 1 of 291 generic medications from a variety of therapeutic categories including antibiotics, cardiac medications, antidepressants, anti-inflammatory drugs, diabetes medications, analgesics, and vitamins. The program will be available to customers with and without insurance. In an effort to remain competitive with Wal-Mart, Target announced that its Tampa Bay area stores would match the lower prices on generic drugs.

Research on Healthy Aging

More than 90 scientists, research advocates, and other experts are calling on policy makers around the world to make research into healthy aging a priority. The researchers signed on to a statement that calls the slowing of the aging process in humans “scientifically plausible,” providing there is adequate investment. Investing more in understanding the biology of aging is important, the statement said, because of the individual and societal costs associated with debilitating late-in-life illnesses. “A modest deceleration in the rate of biological aging would produce the equivalent of simultaneous major breakthroughs against every single fatal and nonfatal disease and disorder associated with growing older,” said the statement, which was released in September at a symposium on Capitol Hill sponsored by the Alliance for Aging Research.

Mandating HPV Vaccination

Under a proposal gaining momentum in Michigan, vaccination against human papillomavirus (HPV) would be required for all girls entering the sixth grade beginning next school year. Two pieces of legislation introduced in the Michigan state senate last month would require the HPV vaccine to be added to the roster of required immunizations for the state's public and private schools. While the vaccine would be required, parents could choose to opt out for medical, religious, or philosophical reasons. If this legislation is passed by the legislature and signed by the governor, Michigan would be the first state to require the HPV vaccine for school entry, according to state Sen. Beverly Hammerstrom, a Republican, who introduced the bills. “Recent studies have shown that cervical cancer may be one of the few cancers that is actually preventable. This new vaccine will serve as our most effective tool in the fight against cervical cancer,” she said in a statement. “For the first time in history, we have an opportunity to finally eliminate this deadly disease.” The bills have the support of all of the women in the Michigan senate, according to Sen. Hammerstrom. The FDA approved one HPV vaccine (Gardasil) for girls and women aged 9–26 in June. Also in June, the Advisory Committee on Immunization Practices, which advises officials at the Centers for Disease Control and Prevention, recommended routine vaccination in girls 11–12 years old and permissive use in individuals aged 9–26.

Exclusivity Data Not Reaching Doctors

Results from a huge number of trials undertaken specifically to investigate dosing, safety, or efficacy of pharmaceuticals in children are not reaching clinicians, researchers from the FDA and the Duke Clinical Research Institute reported. They examined studies conducted from 1998 to 2004 by manufacturers seeking patent extensions under the FDA's pediatric exclusivity rule. During that time, 253 studies were submitted to the FDA—125 evaluating efficacy, 51 on multidose pharmacokinetics, 34 on single-dose pharmacokinetics, and 43 on safety. For half (127), the results indicated a label change, but only 113 were published. Studies that showed efficacy or had results that gave rise to a positive labeling change were more likely to be published, wrote the authors in the Sept. 13 issue of the Journal of the American Medical Association. Of 100 trials associated with a key labeling change—that is, one that would show substantive dosing changes, new safety information, or lack of efficacy in phase III—only 37 were published. While the pediatric exclusivity rule has promoted new research, “the research has not been consistently disseminated into the peer-reviewed medical literature”—a crucial step to educating and notifying the prescriber, said the authors.

Gaps in Mental Health Knowledge

Clinicians now have better information on the short-term efficacy of medications for children with mental illnesses and behavioral problems, but there is a need for more evidence on the long-term impact and safety of these therapies, according to a report from the American Psychological Association. More research also needs to be conducted in practice settings to show the benefits of therapies under real-life conditions, the report said. The report, which was produced by the APsA Working Group on Psychotropic Medications for Children and Adolescents, provides a review of the current literature on the use, sequencing, and integration of psychotropic medications and psychosocial interventions in children and adolescents. The group found that evidence for treatment efficacy is “uneven” across disorders, with most of the research attention focused on childhood ADHD, adolescent depression, and anxiety disorders. But there is less information on treatment efficacy available for some of the most severe conditions, including bipolar disorder and schizophrenia, the report noted.

FDA Brings on New Ethicist

Dr. Robert M. Nelson, who has served as the chairman of the Food and Drug Administration's Pediatric Advisory Committee for the last 2 years, is joining the agency full-time as an ethicist in the Office of Pediatric Therapeutics. Dr. Nelson is an associate professor of anesthesiology and critical care at the Children's Hospital of Philadelphia; he will keep his faculty appointments at the University of Pennsylvania, Philadelphia. Dr. Nelson is also a former chairman of the American Academy of Pediatrics' Committee on Bioethics. At the Office of Therapeutics, he will guide the agency on issues related to pediatric clinical trials and products that may have an impact on children. “His expertise and experience further bolster our ability to ensure the highest level of scientific and ethical rigor in pediatric clinical research,” said FDA acting commissioner Dr. Andrew von Eschenbach in a statement.

Mandating HPV Vaccination

Under a proposal gaining momentum in Michigan, vaccination against human papillomavirus (HPV) would be required for all girls entering the sixth grade beginning next school year. Two pieces of legislation introduced in the Michigan state senate last month would require the HPV vaccine to be added to the roster of required immunizations for the state's public and private schools. While the vaccine would be required, parents could choose to opt out for medical, religious, or philosophical reasons. If this legislation is passed by the legislature and signed by the governor, Michigan would be the first state to require the HPV vaccine for school entry, according to state Sen. Beverly Hammerstrom, a Republican, who introduced the bills. “Recent studies have shown that cervical cancer may be one of the few cancers that is actually preventable. This new vaccine will serve as our most effective tool in the fight against cervical cancer,” she said in a statement. “For the first time in history, we have an opportunity to finally eliminate this deadly disease.” The bills have the support of all of the women in the Michigan senate, according to Sen. Hammerstrom. The FDA approved one HPV vaccine (Gardasil) for girls and women aged 9–26 in June. Also in June, the Advisory Committee on Immunization Practices, which advises officials at the Centers for Disease Control and Prevention, recommended routine vaccination in girls 11–12 years old and permissive use in individuals aged 9–26.

Exclusivity Data Not Reaching Doctors

Results from a huge number of trials undertaken specifically to investigate dosing, safety, or efficacy of pharmaceuticals in children are not reaching clinicians, researchers from the FDA and the Duke Clinical Research Institute reported. They examined studies conducted from 1998 to 2004 by manufacturers seeking patent extensions under the FDA's pediatric exclusivity rule. During that time, 253 studies were submitted to the FDA—125 evaluating efficacy, 51 on multidose pharmacokinetics, 34 on single-dose pharmacokinetics, and 43 on safety. For half (127), the results indicated a label change, but only 113 were published. Studies that showed efficacy or had results that gave rise to a positive labeling change were more likely to be published, wrote the authors in the Sept. 13 issue of the Journal of the American Medical Association. Of 100 trials associated with a key labeling change—that is, one that would show substantive dosing changes, new safety information, or lack of efficacy in phase III—only 37 were published. While the pediatric exclusivity rule has promoted new research, “the research has not been consistently disseminated into the peer-reviewed medical literature”—a crucial step to educating and notifying the prescriber, said the authors.

Gaps in Mental Health Knowledge

Clinicians now have better information on the short-term efficacy of medications for children with mental illnesses and behavioral problems, but there is a need for more evidence on the long-term impact and safety of these therapies, according to a report from the American Psychological Association. More research also needs to be conducted in practice settings to show the benefits of therapies under real-life conditions, the report said. The report, which was produced by the APsA Working Group on Psychotropic Medications for Children and Adolescents, provides a review of the current literature on the use, sequencing, and integration of psychotropic medications and psychosocial interventions in children and adolescents. The group found that evidence for treatment efficacy is “uneven” across disorders, with most of the research attention focused on childhood ADHD, adolescent depression, and anxiety disorders. But there is less information on treatment efficacy available for some of the most severe conditions, including bipolar disorder and schizophrenia, the report noted.

FDA Brings on New Ethicist

Dr. Robert M. Nelson, who has served as the chairman of the Food and Drug Administration's Pediatric Advisory Committee for the last 2 years, is joining the agency full-time as an ethicist in the Office of Pediatric Therapeutics. Dr. Nelson is an associate professor of anesthesiology and critical care at the Children's Hospital of Philadelphia; he will keep his faculty appointments at the University of Pennsylvania, Philadelphia. Dr. Nelson is also a former chairman of the American Academy of Pediatrics' Committee on Bioethics. At the Office of Therapeutics, he will guide the agency on issues related to pediatric clinical trials and products that may have an impact on children. “His expertise and experience further bolster our ability to ensure the highest level of scientific and ethical rigor in pediatric clinical research,” said FDA acting commissioner Dr. Andrew von Eschenbach in a statement.

Mandating HPV Vaccination

Under a proposal gaining momentum in Michigan, vaccination against human papillomavirus (HPV) would be required for all girls entering the sixth grade beginning next school year. Two pieces of legislation introduced in the Michigan state senate last month would require the HPV vaccine to be added to the roster of required immunizations for the state's public and private schools. While the vaccine would be required, parents could choose to opt out for medical, religious, or philosophical reasons. If this legislation is passed by the legislature and signed by the governor, Michigan would be the first state to require the HPV vaccine for school entry, according to state Sen. Beverly Hammerstrom, a Republican, who introduced the bills. “Recent studies have shown that cervical cancer may be one of the few cancers that is actually preventable. This new vaccine will serve as our most effective tool in the fight against cervical cancer,” she said in a statement. “For the first time in history, we have an opportunity to finally eliminate this deadly disease.” The bills have the support of all of the women in the Michigan senate, according to Sen. Hammerstrom. The FDA approved one HPV vaccine (Gardasil) for girls and women aged 9–26 in June. Also in June, the Advisory Committee on Immunization Practices, which advises officials at the Centers for Disease Control and Prevention, recommended routine vaccination in girls 11–12 years old and permissive use in individuals aged 9–26.

Exclusivity Data Not Reaching Doctors

Results from a huge number of trials undertaken specifically to investigate dosing, safety, or efficacy of pharmaceuticals in children are not reaching clinicians, researchers from the FDA and the Duke Clinical Research Institute reported. They examined studies conducted from 1998 to 2004 by manufacturers seeking patent extensions under the FDA's pediatric exclusivity rule. During that time, 253 studies were submitted to the FDA—125 evaluating efficacy, 51 on multidose pharmacokinetics, 34 on single-dose pharmacokinetics, and 43 on safety. For half (127), the results indicated a label change, but only 113 were published. Studies that showed efficacy or had results that gave rise to a positive labeling change were more likely to be published, wrote the authors in the Sept. 13 issue of the Journal of the American Medical Association. Of 100 trials associated with a key labeling change—that is, one that would show substantive dosing changes, new safety information, or lack of efficacy in phase III—only 37 were published. While the pediatric exclusivity rule has promoted new research, “the research has not been consistently disseminated into the peer-reviewed medical literature”—a crucial step to educating and notifying the prescriber, said the authors.

Gaps in Mental Health Knowledge

Clinicians now have better information on the short-term efficacy of medications for children with mental illnesses and behavioral problems, but there is a need for more evidence on the long-term impact and safety of these therapies, according to a report from the American Psychological Association. More research also needs to be conducted in practice settings to show the benefits of therapies under real-life conditions, the report said. The report, which was produced by the APsA Working Group on Psychotropic Medications for Children and Adolescents, provides a review of the current literature on the use, sequencing, and integration of psychotropic medications and psychosocial interventions in children and adolescents. The group found that evidence for treatment efficacy is “uneven” across disorders, with most of the research attention focused on childhood ADHD, adolescent depression, and anxiety disorders. But there is less information on treatment efficacy available for some of the most severe conditions, including bipolar disorder and schizophrenia, the report noted.

FDA Brings on New Ethicist

Dr. Robert M. Nelson, who has served as the chairman of the Food and Drug Administration's Pediatric Advisory Committee for the last 2 years, is joining the agency full-time as an ethicist in the Office of Pediatric Therapeutics. Dr. Nelson is an associate professor of anesthesiology and critical care at the Children's Hospital of Philadelphia; he will keep his faculty appointments at the University of Pennsylvania, Philadelphia. Dr. Nelson is also a former chairman of the American Academy of Pediatrics' Committee on Bioethics. At the Office of Therapeutics, he will guide the agency on issues related to pediatric clinical trials and products that may have an impact on children. “His expertise and experience further bolster our ability to ensure the highest level of scientific and ethical rigor in pediatric clinical research,” said FDA acting commissioner Dr. Andrew von Eschenbach in a statement.

Role of International Medical Grads

Family physicians who are international medical graduates provide an important access point for Medicare and Medicaid patients, according to a study published in the online journal Human Resources for Health. The study compared practice patterns between family physicians who are international medical graduates (IMGs) and those graduated from U.S. medical schools. More IMGs accepted all new Medicare and Medicaid patients, compared with their U.S.-trained counterparts, according to the study. About 67% of IMGs reported accepting all new Medicare patients, compared with 60% of U.S. medical graduates. Forty-nine percent of IMGs said they accepted all new Medicaid patients, compared with 40% among U.S. medical graduates. The researchers also found that IMGs earned a greater percentage of their revenue from these federal health programs than did U.S. medical graduates working in family medicine. The analysis is based on 1996–1997 data from a nationally representative survey of physicians. The survey included 2,726 family physicians, of whom 2,360 graduated from U.S. medical schools and 366 graduated from international medical schools.

DEA Reverses Pain Rx Restrictions

A new proposal from the U.S. Drug Enforcement Administration would allow physicians to issue up to a 90-day supply of schedule II controlled substances in a single visit. The notice of proposed rule making, which was issued in September, is open for public comment until Nov. 6. If finalized, the proposal would reverse the agency's previous position that physicians must write new prescriptions each month. Instead, physicians would be able to issue three monthly prescriptions at once, specifying the fill date for each prescription. The agency also issued a policy statement aimed at answering physician questions about dispensing pain medications. “Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards,” DEA Administrator Karen P. Tandy said in a statement. “Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged for prescribing all appropriate pain medications.” The American Academy of Pain Medicine (AAPM) praised the proposal, noting in a statement that it could help eliminate the burden on cancer patients and others with chronic pain who have been forced to visit their physician every month for a new prescription.

Medicare Risk Reduction Demo

Officials at the Centers for Medicare and Medicaid Services are seeking proposals for a new demonstration project that will test the effectiveness of health promotion programs in the Medicare population. The Medicare Senior Risk Reduction Demonstration will target multiple risk factors for chronic diseases including physical inactivity, obesity, smoking, depression, high blood pressure, high cholesterol, and high blood sugar. Officials will also look at underuse of Medicare preventive benefits. CMS officials plan to select up to five organizations to participate in a 3-year demonstration project; participants will be announced next spring. Officials plan to invite about 85,000 Medicare fee-for-service beneficiaries to take part. Beneficiaries will complete a risk assessment, receive information on their specific health risk factors, and receive referrals to community resources that can help them to make lifestyle changes. “This demonstration can support doctors and other health professionals by providing support in their efforts to help seniors make important changes, such as starting an exercise program and using recommended preventive care,” the agency said in a statement.

Fueling the Rise in Medicare Costs

The rapid growth in spending for Medicare beneficiaries is largely because of the increasing portion of those beneficiaries receiving treatment for five or more conditions in a year, according to a study published in an online edition of Health Affairs. Between 1987 and 2002, the number of beneficiaries who sought care for five or more conditions rose from about 9 million to 19.8 million. In 2002, beneficiaries with five or more conditions accounted for more than 75% of health spending, according to the study. And Medicare beneficiaries with three or more conditions accounted for 92.9% of health care spending in 2002. “One of the biggest challenges we face is that the Medicare system makes it very difficult for physicians to effectively treat people with multiple chronic illnesses,” Kenneth E. Thorpe, the study's lead author and chair of the department of health policy management at Emory University, Atlanta, said in a statement. “Medicare's fee-for-service structure does not reimburse for services critical to medically managing chronic illness—preventative measures, monitoring medication intake and blood sugar.” The researchers received support from the Pharmaceutical Research and Manufacturers of America.

Access to Mammography

The national capacity to provide mammography services is adequate, despite a 6% drop in the number of mammography facilities from 2001 to 2004, according to a recent report from the U.S. Government Accountability Office. In addition to the decrease in the number of facilities, the GAO reported a 4% drop in the number of machines, a 3% drop in the number of radiologic technologists, and a 5% drop in the number of physicians who interpret mammograms. Experts interviewed by the GAO said that the capacity nationwide is likely adequate to meet the current demand for screening and diagnostic mammograms but cautioned that there could be access problems in the future. The report was requested by Sen. Arlen Specter (R-Pa.) and Sen. Barbara Mikulski (D-Md.).

Role of International Medical Grads

Family physicians who are international medical graduates provide an important access point for Medicare and Medicaid patients, according to a study published in the online journal Human Resources for Health. The study compared practice patterns between family physicians who are international medical graduates (IMGs) and those graduated from U.S. medical schools. More IMGs accepted all new Medicare and Medicaid patients, compared with their U.S.-trained counterparts, according to the study. About 67% of IMGs reported accepting all new Medicare patients, compared with 60% of U.S. medical graduates. Forty-nine percent of IMGs said they accepted all new Medicaid patients, compared with 40% among U.S. medical graduates. The researchers also found that IMGs earned a greater percentage of their revenue from these federal health programs than did U.S. medical graduates working in family medicine. The analysis is based on 1996–1997 data from a nationally representative survey of physicians. The survey included 2,726 family physicians, of whom 2,360 graduated from U.S. medical schools and 366 graduated from international medical schools.

DEA Reverses Pain Rx Restrictions

A new proposal from the U.S. Drug Enforcement Administration would allow physicians to issue up to a 90-day supply of schedule II controlled substances in a single visit. The notice of proposed rule making, which was issued in September, is open for public comment until Nov. 6. If finalized, the proposal would reverse the agency's previous position that physicians must write new prescriptions each month. Instead, physicians would be able to issue three monthly prescriptions at once, specifying the fill date for each prescription. The agency also issued a policy statement aimed at answering physician questions about dispensing pain medications. “Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards,” DEA Administrator Karen P. Tandy said in a statement. “Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged for prescribing all appropriate pain medications.” The American Academy of Pain Medicine (AAPM) praised the proposal, noting in a statement that it could help eliminate the burden on cancer patients and others with chronic pain who have been forced to visit their physician every month for a new prescription.

Medicare Risk Reduction Demo

Officials at the Centers for Medicare and Medicaid Services are seeking proposals for a new demonstration project that will test the effectiveness of health promotion programs in the Medicare population. The Medicare Senior Risk Reduction Demonstration will target multiple risk factors for chronic diseases including physical inactivity, obesity, smoking, depression, high blood pressure, high cholesterol, and high blood sugar. Officials will also look at underuse of Medicare preventive benefits. CMS officials plan to select up to five organizations to participate in a 3-year demonstration project; participants will be announced next spring. Officials plan to invite about 85,000 Medicare fee-for-service beneficiaries to take part. Beneficiaries will complete a risk assessment, receive information on their specific health risk factors, and receive referrals to community resources that can help them to make lifestyle changes. “This demonstration can support doctors and other health professionals by providing support in their efforts to help seniors make important changes, such as starting an exercise program and using recommended preventive care,” the agency said in a statement.

Fueling the Rise in Medicare Costs

The rapid growth in spending for Medicare beneficiaries is largely because of the increasing portion of those beneficiaries receiving treatment for five or more conditions in a year, according to a study published in an online edition of Health Affairs. Between 1987 and 2002, the number of beneficiaries who sought care for five or more conditions rose from about 9 million to 19.8 million. In 2002, beneficiaries with five or more conditions accounted for more than 75% of health spending, according to the study. And Medicare beneficiaries with three or more conditions accounted for 92.9% of health care spending in 2002. “One of the biggest challenges we face is that the Medicare system makes it very difficult for physicians to effectively treat people with multiple chronic illnesses,” Kenneth E. Thorpe, the study's lead author and chair of the department of health policy management at Emory University, Atlanta, said in a statement. “Medicare's fee-for-service structure does not reimburse for services critical to medically managing chronic illness—preventative measures, monitoring medication intake and blood sugar.” The researchers received support from the Pharmaceutical Research and Manufacturers of America.

Access to Mammography

The national capacity to provide mammography services is adequate, despite a 6% drop in the number of mammography facilities from 2001 to 2004, according to a recent report from the U.S. Government Accountability Office. In addition to the decrease in the number of facilities, the GAO reported a 4% drop in the number of machines, a 3% drop in the number of radiologic technologists, and a 5% drop in the number of physicians who interpret mammograms. Experts interviewed by the GAO said that the capacity nationwide is likely adequate to meet the current demand for screening and diagnostic mammograms but cautioned that there could be access problems in the future. The report was requested by Sen. Arlen Specter (R-Pa.) and Sen. Barbara Mikulski (D-Md.).

Role of International Medical Grads

Family physicians who are international medical graduates provide an important access point for Medicare and Medicaid patients, according to a study published in the online journal Human Resources for Health. The study compared practice patterns between family physicians who are international medical graduates (IMGs) and those graduated from U.S. medical schools. More IMGs accepted all new Medicare and Medicaid patients, compared with their U.S.-trained counterparts, according to the study. About 67% of IMGs reported accepting all new Medicare patients, compared with 60% of U.S. medical graduates. Forty-nine percent of IMGs said they accepted all new Medicaid patients, compared with 40% among U.S. medical graduates. The researchers also found that IMGs earned a greater percentage of their revenue from these federal health programs than did U.S. medical graduates working in family medicine. The analysis is based on 1996–1997 data from a nationally representative survey of physicians. The survey included 2,726 family physicians, of whom 2,360 graduated from U.S. medical schools and 366 graduated from international medical schools.

DEA Reverses Pain Rx Restrictions

A new proposal from the U.S. Drug Enforcement Administration would allow physicians to issue up to a 90-day supply of schedule II controlled substances in a single visit. The notice of proposed rule making, which was issued in September, is open for public comment until Nov. 6. If finalized, the proposal would reverse the agency's previous position that physicians must write new prescriptions each month. Instead, physicians would be able to issue three monthly prescriptions at once, specifying the fill date for each prescription. The agency also issued a policy statement aimed at answering physician questions about dispensing pain medications. “Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards,” DEA Administrator Karen P. Tandy said in a statement. “Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged for prescribing all appropriate pain medications.” The American Academy of Pain Medicine (AAPM) praised the proposal, noting in a statement that it could help eliminate the burden on cancer patients and others with chronic pain who have been forced to visit their physician every month for a new prescription.

Medicare Risk Reduction Demo

Officials at the Centers for Medicare and Medicaid Services are seeking proposals for a new demonstration project that will test the effectiveness of health promotion programs in the Medicare population. The Medicare Senior Risk Reduction Demonstration will target multiple risk factors for chronic diseases including physical inactivity, obesity, smoking, depression, high blood pressure, high cholesterol, and high blood sugar. Officials will also look at underuse of Medicare preventive benefits. CMS officials plan to select up to five organizations to participate in a 3-year demonstration project; participants will be announced next spring. Officials plan to invite about 85,000 Medicare fee-for-service beneficiaries to take part. Beneficiaries will complete a risk assessment, receive information on their specific health risk factors, and receive referrals to community resources that can help them to make lifestyle changes. “This demonstration can support doctors and other health professionals by providing support in their efforts to help seniors make important changes, such as starting an exercise program and using recommended preventive care,” the agency said in a statement.

Fueling the Rise in Medicare Costs

The rapid growth in spending for Medicare beneficiaries is largely because of the increasing portion of those beneficiaries receiving treatment for five or more conditions in a year, according to a study published in an online edition of Health Affairs. Between 1987 and 2002, the number of beneficiaries who sought care for five or more conditions rose from about 9 million to 19.8 million. In 2002, beneficiaries with five or more conditions accounted for more than 75% of health spending, according to the study. And Medicare beneficiaries with three or more conditions accounted for 92.9% of health care spending in 2002. “One of the biggest challenges we face is that the Medicare system makes it very difficult for physicians to effectively treat people with multiple chronic illnesses,” Kenneth E. Thorpe, the study's lead author and chair of the department of health policy management at Emory University, Atlanta, said in a statement. “Medicare's fee-for-service structure does not reimburse for services critical to medically managing chronic illness—preventative measures, monitoring medication intake and blood sugar.” The researchers received support from the Pharmaceutical Research and Manufacturers of America.

Access to Mammography

The national capacity to provide mammography services is adequate, despite a 6% drop in the number of mammography facilities from 2001 to 2004, according to a recent report from the U.S. Government Accountability Office. In addition to the decrease in the number of facilities, the GAO reported a 4% drop in the number of machines, a 3% drop in the number of radiologic technologists, and a 5% drop in the number of physicians who interpret mammograms. Experts interviewed by the GAO said that the capacity nationwide is likely adequate to meet the current demand for screening and diagnostic mammograms but cautioned that there could be access problems in the future. The report was requested by Sen. Arlen Specter (R-Pa.) and Sen. Barbara Mikulski (D-Md.).

Medicare Risk Reduction Demo

Officials at the Centers for Medicare and Medicaid Services are seeking proposals for a new demonstration project that will test the effectiveness of health promotion programs in the Medicare population. The Medicare Senior Risk Reduction Demonstration will target multiple risk factors for chronic diseases, including physical inactivity, obesity, smoking, depression, high blood pressure, high cholesterol, and high blood sugar. Officials will also look at underuse of Medicare preventive benefits. CMS officials plan to select up to five organizations to participate in a 3-year demonstration project; participants will be announced next spring. Officials plan to invite about 85,000 Medicare fee-for-service beneficiaries to take part. Beneficiaries will complete a risk assessment, receive information on their specific health risk factors, and receive referrals to community resources that can help them to make lifestyle changes. They will have the option of sharing the information with their physicians. “This demonstration can support doctors and other health professionals by providing support in their efforts to help seniors make important changes, such as starting an exercise program and using recommended preventive care,” the agency said in a statement.

DEA Reverses Pain Rx Restrictions

A new proposal from the U.S. Drug Enforcement Administration would allow physicians to issue up to a 90-day supply of schedule II controlled substances in a single visit. The notice of proposed rule making, which was issued in September, is open for public comment until Nov. 6. If finalized, the proposal would reverse the agency's previous position that physicians must write new prescriptions each month. Instead, physicians would be able to issue three monthly prescriptions at once, specifying the fill date for each prescription. The agency also issued a statement aimed at answering physician questions about dispensing pain medications. “Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards,” DEA Administrator Karen P. Tandy said in a statement. “Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged for prescribing all appropriate pain medications.” The American Academy of Pain Medicine (AAPM) praised the proposal, noting that it could help to eliminate the burden on cancer patients and others with chronic pain who have been forced to visit their physician every month for a new prescription, an AAPM statement said.

Fueling the Rise in Medicare Costs

The rapid growth in spending for Medicare beneficiaries is largely because of the increasing portion of those beneficiaries receiving treatment for five or more conditions in a year, according to a study published in an online edition of Health Affairs. Between 1987 and 2002, the number of beneficiaries who sought care for five or more conditions rose from about 9 million to 19.8 million. In 2002, beneficiaries with five or more conditions accounted for more than 75% of health spending, according to the study. And Medicare beneficiaries with three or more conditions accounted for 92.9% of health care spending in 2002. “One of the biggest challenges we face is that the Medicare system makes it very difficult for physicians to effectively treat people with multiple chronic illnesses,” Kenneth E. Thorpe, the study's lead author and chair of the department of health policy management at Emory University, Atlanta, said in a statement. “Medicare's fee-for-service structure does not reimburse for services critical to medically managing chronic illness—preventative measures, monitoring medication intake and blood sugar.” The researchers received support from the Pharmaceutical Research and Manufacturers of America.

Mammography Access 'Adequate'

The national capacity to provide mammography services is adequate, despite a 6% drop in the number of mammography facilities from 2001 to 2004, according to a recent report from the U.S. Government Accountability Office. In addition to the decrease in the number of facilities, the GAO reported a 4% drop in the number of machines, a 3% drop in the number of radiologic technologists, and a 5% drop in the number of physicians who interpret mammograms. Experts interviewed by the GAO said that the capacity nationwide is likely adequate to meet the current demand for screening and diagnostic mammograms but cautioned that there could be access problems in the future. The report was requested by Sen. Arlen Specter (R-Pa.) and Sen. Barbara Mikulski (D-Md.).

U.S. Cancer Deaths Decreasing

The rate of new cancers was stable from 1992 to 2003, but deaths from malignancies continued to decline, according to the “Annual Report to the Nation on the Status of Cancer” in the Oct. 15 issue of Cancer, published online in September. The cancer incidence for men was stable from 1995 to 2003, but the incidence for women increased from 1979 to 2003. Death rates decreased for 11 of the 15 most common cancers for men and for 10 of the 15 most common cancers for women. Incidence rates for breast cancer stabilized from 2001 to 2003, but it's not clear if that is a true trend, according to the report. Women saw a decrease in new cancers of the colon, uterus, ovaries, stomach, and cervix and an increase in non-Hodgkin's lymphoma, melanoma, leukemia, and lung, bladder, and kidney cancers. Men saw a decrease in colon, stomach, oral, and lung cancers but an increase in prostate, liver, kidney, and esophageal cancers, and in leukemia and myeloma.

Medicare Risk Reduction Demo

Officials at the Centers for Medicare and Medicaid Services are seeking proposals for a new demonstration project that will test the effectiveness of health promotion programs in the Medicare population. The Medicare Senior Risk Reduction Demonstration will target multiple risk factors for chronic diseases, including physical inactivity, obesity, smoking, depression, high blood pressure, high cholesterol, and high blood sugar. Officials will also look at underuse of Medicare preventive benefits. CMS officials plan to select up to five organizations to participate in a 3-year demonstration project; participants will be announced next spring. Officials plan to invite about 85,000 Medicare fee-for-service beneficiaries to take part. Beneficiaries will complete a risk assessment, receive information on their specific health risk factors, and receive referrals to community resources that can help them to make lifestyle changes. They will have the option of sharing the information with their physicians. “This demonstration can support doctors and other health professionals by providing support in their efforts to help seniors make important changes, such as starting an exercise program and using recommended preventive care,” the agency said in a statement.

DEA Reverses Pain Rx Restrictions

A new proposal from the U.S. Drug Enforcement Administration would allow physicians to issue up to a 90-day supply of schedule II controlled substances in a single visit. The notice of proposed rule making, which was issued in September, is open for public comment until Nov. 6. If finalized, the proposal would reverse the agency's previous position that physicians must write new prescriptions each month. Instead, physicians would be able to issue three monthly prescriptions at once, specifying the fill date for each prescription. The agency also issued a statement aimed at answering physician questions about dispensing pain medications. “Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards,” DEA Administrator Karen P. Tandy said in a statement. “Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged for prescribing all appropriate pain medications.” The American Academy of Pain Medicine (AAPM) praised the proposal, noting that it could help to eliminate the burden on cancer patients and others with chronic pain who have been forced to visit their physician every month for a new prescription, an AAPM statement said.

Fueling the Rise in Medicare Costs

The rapid growth in spending for Medicare beneficiaries is largely because of the increasing portion of those beneficiaries receiving treatment for five or more conditions in a year, according to a study published in an online edition of Health Affairs. Between 1987 and 2002, the number of beneficiaries who sought care for five or more conditions rose from about 9 million to 19.8 million. In 2002, beneficiaries with five or more conditions accounted for more than 75% of health spending, according to the study. And Medicare beneficiaries with three or more conditions accounted for 92.9% of health care spending in 2002. “One of the biggest challenges we face is that the Medicare system makes it very difficult for physicians to effectively treat people with multiple chronic illnesses,” Kenneth E. Thorpe, the study's lead author and chair of the department of health policy management at Emory University, Atlanta, said in a statement. “Medicare's fee-for-service structure does not reimburse for services critical to medically managing chronic illness—preventative measures, monitoring medication intake and blood sugar.” The researchers received support from the Pharmaceutical Research and Manufacturers of America.

Mammography Access 'Adequate'

The national capacity to provide mammography services is adequate, despite a 6% drop in the number of mammography facilities from 2001 to 2004, according to a recent report from the U.S. Government Accountability Office. In addition to the decrease in the number of facilities, the GAO reported a 4% drop in the number of machines, a 3% drop in the number of radiologic technologists, and a 5% drop in the number of physicians who interpret mammograms. Experts interviewed by the GAO said that the capacity nationwide is likely adequate to meet the current demand for screening and diagnostic mammograms but cautioned that there could be access problems in the future. The report was requested by Sen. Arlen Specter (R-Pa.) and Sen. Barbara Mikulski (D-Md.).

U.S. Cancer Deaths Decreasing

The rate of new cancers was stable from 1992 to 2003, but deaths from malignancies continued to decline, according to the “Annual Report to the Nation on the Status of Cancer” in the Oct. 15 issue of Cancer, published online in September. The cancer incidence for men was stable from 1995 to 2003, but the incidence for women increased from 1979 to 2003. Death rates decreased for 11 of the 15 most common cancers for men and for 10 of the 15 most common cancers for women. Incidence rates for breast cancer stabilized from 2001 to 2003, but it's not clear if that is a true trend, according to the report. Women saw a decrease in new cancers of the colon, uterus, ovaries, stomach, and cervix and an increase in non-Hodgkin's lymphoma, melanoma, leukemia, and lung, bladder, and kidney cancers. Men saw a decrease in colon, stomach, oral, and lung cancers but an increase in prostate, liver, kidney, and esophageal cancers, and in leukemia and myeloma.

Medicare Risk Reduction Demo

Officials at the Centers for Medicare and Medicaid Services are seeking proposals for a new demonstration project that will test the effectiveness of health promotion programs in the Medicare population. The Medicare Senior Risk Reduction Demonstration will target multiple risk factors for chronic diseases, including physical inactivity, obesity, smoking, depression, high blood pressure, high cholesterol, and high blood sugar. Officials will also look at underuse of Medicare preventive benefits. CMS officials plan to select up to five organizations to participate in a 3-year demonstration project; participants will be announced next spring. Officials plan to invite about 85,000 Medicare fee-for-service beneficiaries to take part. Beneficiaries will complete a risk assessment, receive information on their specific health risk factors, and receive referrals to community resources that can help them to make lifestyle changes. They will have the option of sharing the information with their physicians. “This demonstration can support doctors and other health professionals by providing support in their efforts to help seniors make important changes, such as starting an exercise program and using recommended preventive care,” the agency said in a statement.

DEA Reverses Pain Rx Restrictions

A new proposal from the U.S. Drug Enforcement Administration would allow physicians to issue up to a 90-day supply of schedule II controlled substances in a single visit. The notice of proposed rule making, which was issued in September, is open for public comment until Nov. 6. If finalized, the proposal would reverse the agency's previous position that physicians must write new prescriptions each month. Instead, physicians would be able to issue three monthly prescriptions at once, specifying the fill date for each prescription. The agency also issued a statement aimed at answering physician questions about dispensing pain medications. “Today's policy statement reaffirms that DEA wants doctors to treat pain as is appropriate under accepted medical community standards,” DEA Administrator Karen P. Tandy said in a statement. “Physicians acting in accordance with accepted medical practice should be confident that they will not be criminally charged for prescribing all appropriate pain medications.” The American Academy of Pain Medicine (AAPM) praised the proposal, noting that it could help to eliminate the burden on cancer patients and others with chronic pain who have been forced to visit their physician every month for a new prescription, an AAPM statement said.

Fueling the Rise in Medicare Costs

The rapid growth in spending for Medicare beneficiaries is largely because of the increasing portion of those beneficiaries receiving treatment for five or more conditions in a year, according to a study published in an online edition of Health Affairs. Between 1987 and 2002, the number of beneficiaries who sought care for five or more conditions rose from about 9 million to 19.8 million. In 2002, beneficiaries with five or more conditions accounted for more than 75% of health spending, according to the study. And Medicare beneficiaries with three or more conditions accounted for 92.9% of health care spending in 2002. “One of the biggest challenges we face is that the Medicare system makes it very difficult for physicians to effectively treat people with multiple chronic illnesses,” Kenneth E. Thorpe, the study's lead author and chair of the department of health policy management at Emory University, Atlanta, said in a statement. “Medicare's fee-for-service structure does not reimburse for services critical to medically managing chronic illness—preventative measures, monitoring medication intake and blood sugar.” The researchers received support from the Pharmaceutical Research and Manufacturers of America.

Mammography Access 'Adequate'

The national capacity to provide mammography services is adequate, despite a 6% drop in the number of mammography facilities from 2001 to 2004, according to a recent report from the U.S. Government Accountability Office. In addition to the decrease in the number of facilities, the GAO reported a 4% drop in the number of machines, a 3% drop in the number of radiologic technologists, and a 5% drop in the number of physicians who interpret mammograms. Experts interviewed by the GAO said that the capacity nationwide is likely adequate to meet the current demand for screening and diagnostic mammograms but cautioned that there could be access problems in the future. The report was requested by Sen. Arlen Specter (R-Pa.) and Sen. Barbara Mikulski (D-Md.).

U.S. Cancer Deaths Decreasing

The rate of new cancers was stable from 1992 to 2003, but deaths from malignancies continued to decline, according to the “Annual Report to the Nation on the Status of Cancer” in the Oct. 15 issue of Cancer, published online in September. The cancer incidence for men was stable from 1995 to 2003, but the incidence for women increased from 1979 to 2003. Death rates decreased for 11 of the 15 most common cancers for men and for 10 of the 15 most common cancers for women. Incidence rates for breast cancer stabilized from 2001 to 2003, but it's not clear if that is a true trend, according to the report. Women saw a decrease in new cancers of the colon, uterus, ovaries, stomach, and cervix and an increase in non-Hodgkin's lymphoma, melanoma, leukemia, and lung, bladder, and kidney cancers. Men saw a decrease in colon, stomach, oral, and lung cancers but an increase in prostate, liver, kidney, and esophageal cancers, and in leukemia and myeloma.

Part D Premiums Hold Steady

Premiums under Medicare's Part D drug benefit will remain stable in 2007, according to figures released last month by the Centers for Medicare and Medicaid Services. Officials at CMS estimate that the average monthly premium paid by Medicare Part D beneficiaries will be around $24 in 2007, about the same as in 2006. “Competition and choice in health care are working,” Dr. Mark McClellan, CMS administrator, said during a press conference. In addition to holding consumer costs steady, CMS officials reported that the national benchmark that determines Medicare's subsidy of drug coverage will decline next year. The competitive bids for both the stand-alone drug plans and the Medicare Advantage managed-care prescription drug plans came in with lower-than-expected bids, according to CMS. The open enrollment period for 2007 will begin on Nov. 15.

Mixed Reviews for Merck

The most recent Vioxx court cases have produced mixed results for the drugmaker Merck & Co., Inc. In August, a Los Angeles jury ruled in the company's favor, finding that the Vioxx (rofecoxib) was not responsible for the heart attack of Stewart Grossberg, who had been taking the drug intermittently. Merck argued successfully that Vioxx was not responsible for Mr. Grossberg's heart attack because he has high cholesterol levels, atherosclerosis, and a family history of cardiac problems. But about 2 weeks later, a federal jury in New Orleans found Merck liable for $51 million in damages in the 2002 heart attack of Gerald Barnett, a 62-year-old retired special agent of the FBI. The company is currently exploring grounds for appeal including insufficient evidence and the application of incorrect legal standards, according to Merck. The company was also dealt another blow in August, when a New Jersey judge decided to set aside a 2005 jury verdict that had been in the Merck's favor. The judge ordered a new trial to take place early next year. The judge cited a December 2005 New England Journal of Medicine editorial expressing concerns about Vioxx-related study data as the basis for throwing out the jury verdict (N. Eng. J. Med. 2005;353:2813–4).

In the Dark on EC

Despite the controversy surrounding the proposal to provide Plan B emergency contraception without a prescription, only about one-quarter of Americans in a recent survey said they had heard a lot about the debate. And nearly an equal number said they had heard nothing about the politically charged issue. The survey was commissioned by the Pew Research Center for the People & the Press and the Pew Forum on Religion & Public Life. The survey also found that about 48% of those surveyed favored selling emergency contraception without a prescription, whereas about 41% opposed the idea. The national telephone survey was conducted in July among more than 2,000 U.S. adults.

Uninsured Figures Climb

The number of people in the United States without health insurance edged higher in 2005, fueled in part by a drop in employer-sponsored health insurance, according to figures released in August from the U.S. Census Bureau. In 2005, 46.6 million people were uninsured, up from 45.3 million the year before. The percentage of people covered by employer-sponsored health insurance dropped from 59.8% to 59.5% between 2004 and 2005, while the percentage covered by government insurance stayed the same, according to the Census figures. The new figures, compiled as part of the Current Population Survey, showed that the number of uninsured children also increased. Between 2004 and 2005, the number of uninsured children rose from 7.9 million to 8.3 million. And children living in poverty were the most likely to be uninsured, with the uninsured rate at 19% for children living in poverty compared with 11.2% of children overall in 2005. The American Medical Association issued a statement calling for action to address the uninsured problem. “The AMA plan for reducing the number of the uninsured advocates expanded coverage and choice through a system of refundable tax credits based on income, individually selected and owned health insurance, and market reforms that will enhance new, affordable insurance options,” Dr. Ardis Hoven, an AMA board member, said in a statement.

Drug Code Directory Incomplete

The Department of Health and Human Services' Office of Inspector General has found that the Food and Drug Administration's National Drug Code Directory is incomplete and inaccurate, largely as a result of drug companies' failure to submit required data, though the FDA shares some blame. The NDC Directory is supposed to be a current compendium of marketed drug products. The FDA relies on internal reports and on submissions from pharmaceutical manufacturers, which must report when a new product is introduced or withdrawn. The OIG report is a snapshot of the NDC Directory as of February 2005. At that time, there were 123,856 products with unique NDCs. The OIG found that the FDA's listing left off just more than 9,000 drug products. For about 16%, the drug maker either had not submitted required forms or the agency had not appropriately processed them. Listings for about 5,100 products had been held up because the companies had failed to provide needed information. Finally, the OIG found that 34,000 products listed were either no longer marketed or their entries contained erroneous information, mostly because drug makers had not told the FDA that the products were discontinued. In a comment submitted with the report, the FDA acknowledged many of the failures, but also said there was a decrease in the percentage of missing products since 1990.

Part D Premiums Hold Steady

Premiums under Medicare's Part D drug benefit will remain stable in 2007, according to figures released last month by the Centers for Medicare and Medicaid Services. Officials at CMS estimate that the average monthly premium paid by Medicare Part D beneficiaries will be around $24 in 2007, about the same as in 2006. “Competition and choice in health care are working,” Dr. Mark McClellan, CMS administrator, said during a press conference. In addition to holding consumer costs steady, CMS officials reported that the national benchmark that determines Medicare's subsidy of drug coverage will decline next year. The competitive bids for both the stand-alone drug plans and the Medicare Advantage managed-care prescription drug plans came in with lower-than-expected bids, according to CMS. The open enrollment period for 2007 will begin on Nov. 15.

Mixed Reviews for Merck

The most recent Vioxx court cases have produced mixed results for the drugmaker Merck & Co., Inc. In August, a Los Angeles jury ruled in the company's favor, finding that the Vioxx (rofecoxib) was not responsible for the heart attack of Stewart Grossberg, who had been taking the drug intermittently. Merck argued successfully that Vioxx was not responsible for Mr. Grossberg's heart attack because he has high cholesterol levels, atherosclerosis, and a family history of cardiac problems. But about 2 weeks later, a federal jury in New Orleans found Merck liable for $51 million in damages in the 2002 heart attack of Gerald Barnett, a 62-year-old retired special agent of the FBI. The company is currently exploring grounds for appeal including insufficient evidence and the application of incorrect legal standards, according to Merck. The company was also dealt another blow in August, when a New Jersey judge decided to set aside a 2005 jury verdict that had been in the Merck's favor. The judge ordered a new trial to take place early next year. The judge cited a December 2005 New England Journal of Medicine editorial expressing concerns about Vioxx-related study data as the basis for throwing out the jury verdict (N. Eng. J. Med. 2005;353:2813–4).

In the Dark on EC

Despite the controversy surrounding the proposal to provide Plan B emergency contraception without a prescription, only about one-quarter of Americans in a recent survey said they had heard a lot about the debate. And nearly an equal number said they had heard nothing about the politically charged issue. The survey was commissioned by the Pew Research Center for the People & the Press and the Pew Forum on Religion & Public Life. The survey also found that about 48% of those surveyed favored selling emergency contraception without a prescription, whereas about 41% opposed the idea. The national telephone survey was conducted in July among more than 2,000 U.S. adults.

Uninsured Figures Climb

The number of people in the United States without health insurance edged higher in 2005, fueled in part by a drop in employer-sponsored health insurance, according to figures released in August from the U.S. Census Bureau. In 2005, 46.6 million people were uninsured, up from 45.3 million the year before. The percentage of people covered by employer-sponsored health insurance dropped from 59.8% to 59.5% between 2004 and 2005, while the percentage covered by government insurance stayed the same, according to the Census figures. The new figures, compiled as part of the Current Population Survey, showed that the number of uninsured children also increased. Between 2004 and 2005, the number of uninsured children rose from 7.9 million to 8.3 million. And children living in poverty were the most likely to be uninsured, with the uninsured rate at 19% for children living in poverty compared with 11.2% of children overall in 2005. The American Medical Association issued a statement calling for action to address the uninsured problem. “The AMA plan for reducing the number of the uninsured advocates expanded coverage and choice through a system of refundable tax credits based on income, individually selected and owned health insurance, and market reforms that will enhance new, affordable insurance options,” Dr. Ardis Hoven, an AMA board member, said in a statement.

Drug Code Directory Incomplete

The Department of Health and Human Services' Office of Inspector General has found that the Food and Drug Administration's National Drug Code Directory is incomplete and inaccurate, largely as a result of drug companies' failure to submit required data, though the FDA shares some blame. The NDC Directory is supposed to be a current compendium of marketed drug products. The FDA relies on internal reports and on submissions from pharmaceutical manufacturers, which must report when a new product is introduced or withdrawn. The OIG report is a snapshot of the NDC Directory as of February 2005. At that time, there were 123,856 products with unique NDCs. The OIG found that the FDA's listing left off just more than 9,000 drug products. For about 16%, the drug maker either had not submitted required forms or the agency had not appropriately processed them. Listings for about 5,100 products had been held up because the companies had failed to provide needed information. Finally, the OIG found that 34,000 products listed were either no longer marketed or their entries contained erroneous information, mostly because drug makers had not told the FDA that the products were discontinued. In a comment submitted with the report, the FDA acknowledged many of the failures, but also said there was a decrease in the percentage of missing products since 1990.

Part D Premiums Hold Steady

Premiums under Medicare's Part D drug benefit will remain stable in 2007, according to figures released last month by the Centers for Medicare and Medicaid Services. Officials at CMS estimate that the average monthly premium paid by Medicare Part D beneficiaries will be around $24 in 2007, about the same as in 2006. “Competition and choice in health care are working,” Dr. Mark McClellan, CMS administrator, said during a press conference. In addition to holding consumer costs steady, CMS officials reported that the national benchmark that determines Medicare's subsidy of drug coverage will decline next year. The competitive bids for both the stand-alone drug plans and the Medicare Advantage managed-care prescription drug plans came in with lower-than-expected bids, according to CMS. The open enrollment period for 2007 will begin on Nov. 15.

Mixed Reviews for Merck

The most recent Vioxx court cases have produced mixed results for the drugmaker Merck & Co., Inc. In August, a Los Angeles jury ruled in the company's favor, finding that the Vioxx (rofecoxib) was not responsible for the heart attack of Stewart Grossberg, who had been taking the drug intermittently. Merck argued successfully that Vioxx was not responsible for Mr. Grossberg's heart attack because he has high cholesterol levels, atherosclerosis, and a family history of cardiac problems. But about 2 weeks later, a federal jury in New Orleans found Merck liable for $51 million in damages in the 2002 heart attack of Gerald Barnett, a 62-year-old retired special agent of the FBI. The company is currently exploring grounds for appeal including insufficient evidence and the application of incorrect legal standards, according to Merck. The company was also dealt another blow in August, when a New Jersey judge decided to set aside a 2005 jury verdict that had been in the Merck's favor. The judge ordered a new trial to take place early next year. The judge cited a December 2005 New England Journal of Medicine editorial expressing concerns about Vioxx-related study data as the basis for throwing out the jury verdict (N. Eng. J. Med. 2005;353:2813–4).

In the Dark on EC

Despite the controversy surrounding the proposal to provide Plan B emergency contraception without a prescription, only about one-quarter of Americans in a recent survey said they had heard a lot about the debate. And nearly an equal number said they had heard nothing about the politically charged issue. The survey was commissioned by the Pew Research Center for the People & the Press and the Pew Forum on Religion & Public Life. The survey also found that about 48% of those surveyed favored selling emergency contraception without a prescription, whereas about 41% opposed the idea. The national telephone survey was conducted in July among more than 2,000 U.S. adults.

Uninsured Figures Climb

The number of people in the United States without health insurance edged higher in 2005, fueled in part by a drop in employer-sponsored health insurance, according to figures released in August from the U.S. Census Bureau. In 2005, 46.6 million people were uninsured, up from 45.3 million the year before. The percentage of people covered by employer-sponsored health insurance dropped from 59.8% to 59.5% between 2004 and 2005, while the percentage covered by government insurance stayed the same, according to the Census figures. The new figures, compiled as part of the Current Population Survey, showed that the number of uninsured children also increased. Between 2004 and 2005, the number of uninsured children rose from 7.9 million to 8.3 million. And children living in poverty were the most likely to be uninsured, with the uninsured rate at 19% for children living in poverty compared with 11.2% of children overall in 2005. The American Medical Association issued a statement calling for action to address the uninsured problem. “The AMA plan for reducing the number of the uninsured advocates expanded coverage and choice through a system of refundable tax credits based on income, individually selected and owned health insurance, and market reforms that will enhance new, affordable insurance options,” Dr. Ardis Hoven, an AMA board member, said in a statement.

Drug Code Directory Incomplete

The Department of Health and Human Services' Office of Inspector General has found that the Food and Drug Administration's National Drug Code Directory is incomplete and inaccurate, largely as a result of drug companies' failure to submit required data, though the FDA shares some blame. The NDC Directory is supposed to be a current compendium of marketed drug products. The FDA relies on internal reports and on submissions from pharmaceutical manufacturers, which must report when a new product is introduced or withdrawn. The OIG report is a snapshot of the NDC Directory as of February 2005. At that time, there were 123,856 products with unique NDCs. The OIG found that the FDA's listing left off just more than 9,000 drug products. For about 16%, the drug maker either had not submitted required forms or the agency had not appropriately processed them. Listings for about 5,100 products had been held up because the companies had failed to provide needed information. Finally, the OIG found that 34,000 products listed were either no longer marketed or their entries contained erroneous information, mostly because drug makers had not told the FDA that the products were discontinued. In a comment submitted with the report, the FDA acknowledged many of the failures, but also said there was a decrease in the percentage of missing products since 1990.