- Big Pharma Payments for High Prescribing Doctors (news.yahoo.com)
In an ideal world, doctors avoid outside influence and commit to ethical practice. However, they are also huge influencers in a for-profit pharmaceutical industry. This creates a breeding ground for potential conflicts of interest…In order to make relationships between health care providers and pharmaceutical companies more transparent, the Physician Payments Sunshine Act was enacted into law…Open Payments is the program that collects this information…Within this data, a pattern emerges: doctors who prescribe a lot of drugs tend to get more money from pharmaceutical companies…this data…identifies doctor and pharma relationships, it still does not determine causation. It only brings up certain questions: Are doctors prescribing specific drugs more because a pharmaceutical company is paying them? Or do pharma companies pay certain doctors because they prescribe a lot of their drugs? Further complicating the analysis is the knowledge that some physicians prescribe certain drugs in high volumes simply because they’re the best for their patients…While some argue that physicians should have nothing to do with drug marketing, others believe that collaboration between doctors and pharmaceutical companies is critical to improving the health and quality of life for patients. Not all doctors work simultaneously as drug prescribers and drug marketers, but those who do must strike a careful balance.
- 7 ways hospitals can rebuild community trust (fiercehealthcare.com)Community perception: How does a hospital regain trust? (beckershospitalreview.com)
Transparency is key, expert says…Any number of incidents can erode a community's trust in a hospital, from a nasty disease outbreak to a slow corrosion of the hospital-community relationship over time. But both types of lost trust can be repaired…suggestions for rebuilding community trust, including:
- Be transparent and communicate to show hospital leaders take the situation seriously when incidents such as infectious-disease outbreaks occur
- Acknowledge mistakes and show strong support for staff while correcting those errors
- Share stories of the good work the hospital is doing
- Engage and partner with community groups to host events such as safety fairs and community walks/runs
- Encourage hospital leaders to blog to engage the community with health-oriented information
- Listen to what community members say in informal settings and be willing to respond
- Research community needs, such as access to dental care, and work to serve those needs
- Indian health officials slam Lancet editor’s comments (fiercepharmaasia.com)
Recent comments by the editor of The Lancet, Richard Horton, have stirred the ire of Indian health officials who called them derogatory and not borne out by evidence…the country's government…failed to make the health sector a priority…a joint secretary in the Ministry of Health, said in a letter to Horton…the country has made great strides in reducing infant and maternal mortality through its immunization programs…as well as increased efforts to control drug-resistant tuberculosis and HIV…government has spent more than $4 billion at 10 centers for medical science and at 58 district hospitals that will be converted to medical schools…Indian officials...said the respected journal (The Lancet)…must not become a tool in the hands of people with their own agenda for generating political controversies…
- Specialty Pharmaceuticals for Hyperlipidemia — Impact on Insurance Premiums (nejm.org)
Food and Drug Administration recently approved…PCSK9 inhibitors…These novel biologic agents offer the promise of reductions in blood cholesterol levels. This broad indication sets the practice of cardiology on a collision course with specialty pharmaceutical pricing models…At its core, the current pricing model for these products is driven by a transformation in the pharmaceutical industry, whereby 84% of prescriptions are filled with generic products and follow-on biologics have the potential to disrupt many established markets and firms…for most firms, future revenue expectations hinge on novel therapies…without the potential for outsized returns, capital might not be available for early innovation in biotechnology. Pricing pressure on innovative products would drive a fundamental restructuring of the industry and further increase the financial challenges of bringing scientific innovations to the market. It is important that we manage these downside risks carefully as we work toward a more sustainable pricing model in this market.
- Martin Shkreli just reminded us why we need Martin Shkreli (vox.com)Martin Shkreli, the Bad Boy of Pharmaceuticals, Hits Back (nytimes.com)
Martin Shkreli thinks he made a mistake: He didn't hike the price of his drug enough…And that willingness to say something so awful, so off-putting, is just one reason why he's so darn useful to have around…Shkreli styles himself as a truth teller, saying the hard things that no one else is brave enough to reveal about health care. And in some ways, he's right! Major insurers, drugmakers, and hospital systems collect billions of dollars in annual earnings…but cloak many profit-driven decisions by defending them as beneficial for patients. By being brutally honest about his motives, Shkreli is a rare exception. His comments may be odious, but they're not baseless…That doesn't make them morally right, though. One reason we need Martin Shkreli is to protect against other Martin Shkrelis, who find ways to exploit the system and turn patients into profit centers.
- DEA chief says smoking marijuana as medicine “is a joke” (cbsnews.com)
DEA chief Chuck Rosenberg on Wednesday rejected the notion that smoking marijuana is "medicine," calling the premise a "joke."…"What really bothers me is the notion that marijuana is also medicinal -- because it's not," Rosenberg said in a briefing to reporters. "We can have an intellectually honest debate about whether we should legalize something that is bad and dangerous, but don't call it medicine -- that is a joke."…Rosenberg said that people shouldn't conflate the issue of legalizing recreational marijuana with medicinal marijuana…"There are pieces of marijuana -- extracts or constituents or component parts -- that have great promise" medicinally, he said. "But if you talk about smoking the leaf of marijuana -- which is what people are talking about when they talk about medicinal marijuana -- it has never been shown to be safe or effective as a medicine."
- Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine (nejm.org)
…complaints might be dismissed as growing pains, born of resistance to change. But transitional chaos must be distinguished from enduring harm…the EHR's limitations and why they've been largely ignored, one key barrier is that physicians who voice reservations are labeled "technophobic, resistant, and uncooperative." But in fact…most physicians recognize the potential of EHRs and appreciate such features as the ability to view data remotely. Nevertheless, the researchers found remarkable EHR-induced distress. They conclude, "No other industry, to our knowledge, has been under a universal mandate to adopt a new technology before its effects are fully understood, and before the technology has reached a level of usability that is acceptable to its core users."...What this surgeon and the rest of us need are patient records that communicate meaning and foster understanding of the particular patient in question. The blanks on our screens can be filled with words, but the process of understanding cannot be auto-populated. Perhaps life without the EHR will soon be unimaginable. But the technology will support and improve medical care only if it evolves in ways that help, rather than hinder, us in synthesizing, analyzing, thinking critically, and telling the stories of our patients.
- We have met the enemy, and he is us (drugtopics.modernmedicine.com)
The Cynical Pharmacist lays it on the line..
- Back in the day - Not long ago, pharmacists were respected. We went out of our way to help people in every imaginable situation…What is the upshot of all this kindness today? Patients berate and complain about us unless or until we accede to their every demand.
- Think about what you’re doing…If a prescriber forgets anything on a prescription, what do pharmacists do? We call.
- Whose job is it?...What do we do? What should we do?...What happens when I send prescriptions back with a patient?
- Do the rules apply?...prescribers as well as pharmacists. I believe that both groups of people have to read, understand, and follow the same set of rules…Somehow it has become our job to fill in the blanks for the prescribers…How about a big fat “no”?
- Who ends up on the hook?...But what about the poor patients? Don’t put them in the middle of a pissing contest between you and the prescriber. It’s not their fault their prescriber was in a hurry/forgot/is a moron.”
- Stand up for pharmacy…I’ve done it. It’s amazing how quickly physician offices change their tune when facing legal repercussions.
- Just stop…we are great complainers. We also shy away from conflict. Patients yell at and abuse us all day long and we complain — after they’ve gone…Stop permitting abuse.
Better yet…just send them back.
- The 7 Organizations That Will Turn Healthcare Upside Down In 2016 (forbes.com)
When I wrote Healthcare’s Trillion Dollar Disruption, I recounted how a collection of senior executives assembled by Oliver Wyman representing every sector of healthcare foresaw a radical reshaping of the industry. They predicted that over the course of ten years major winners and losers would be created as one-third of the annual revenues of the industry shifted from one set of players to another…More important than the revenue shift is who would be the catalysts for a much higher performing system as measured by the Quadruple Aim. In this list, I highlight the game-changers. Some may also be big revenue winners but that isn’t the point of this list. After all, there are plenty of organizations profiting from today’s wasteful system, so revenue is only one metric of success. Rather, the actions of the organization are putting the wheels in motion for a massive transformation of the industry.
- MassMutual will slow healthcare’s heist of retirement accounts
- Collective Health will turn employers fully into the insurance companies they already are
- Rosen Hotels will show how employers can transform the lives of their employees and their community with a great benefits plan
- Iora Health will prove primary care is the linchpin to a consumer-centric health future and achieving the Quadruple Aim
- Surgery Center of Oklahoma will be replicated to overcome severe price failure of healthcare services ranging from surgeries to chronic disease management
- Oscar will demonstrate that their data science expertise will deliver a superior health plan package that is about more than just consumer-friendly packaging
- Geisinger Health System will raise awareness of the massive over-investment in hospital infrastructure at the expense of community health
- The 21st Century Cures Act – To the Editor: (nejm.org)H.R.6 — 114th Congress (2015-2016) (congress.gov)
In their Perspective article…Avorn and Kesselheim argue that the 21st Century Cures Act, which is currently being debated in Congress, would lower the regulatory standards of the Food and Drug Administration by giving it greater discretion to approve drugs on the basis of less rigorous data…the legislation would authorize the FDA to "rely" on observational analyses, which are less rigorous than randomized controlled trials. But the Cures Act does not diminish the FDA's standards for requiring that new medical products are safe and effective. Rather, it recognizes that recent developments in genomics, systems biology, electronic data systems, and other fields can provide additional tools and resources to support better premarketing and postmarketing regulation and more efficient development of drugs and medical devices…Better evidence and up-to-date regulatory science are the best foundation for regulatory decisions and meaningful progress in biomedical innovation. They are also the best way to avoid turning back the clock on new opportunities to develop safe and effective treatments for unmet medical needs...