News

Consumers tend to seek the best combination of price, features and quality when shopping for medical services, just as in other market transactions. Today, employers are relying on health plans to fill the value-information void with Web-based decision support tools.

The benefits of Health Information Exchanges (HIEs) are obvious, and have been for decades. And what better time than now, well into the Information Age, for HIEs to realize their full potential using real-time electronic communications over the Internet? As grant money to fund HIE startups and a national health information network begins to dry up, sustainability has become paramount.

Clinical depression is a major problem in the United States, affecting an estimated 5% to 10% of all adults. Costs for medical care and lost productivity related to depression are estimated at more than $40 billion per year.

As patients take more ownership of their disease management regimens, hospitals are beginning to re-evaluate their processes-clinically, administratively and culturally.

National reports-Marketing and distribution of health insurance products continue to evolve, as does the movement toward creating flexible, innovative products to attract new members.

Managed Healthcare Executive recently surveyed readers and gathered your predictions for some of managed care's biggest issues in 2008, including drug safety, technology integration and competition. Answers from the more than 500 respondents indicate that an increasing number of you are uncertain about what the next year will bring, but you remain optimistic about your opportunities and your core capabilities. Comprehensive indicators suggest that the industry is becoming more granular, that is, more customized and more focused on one-off strategies, further stratified populations and differentiation in the market. Preparing for another year of regulatory changes, political influence and industry self-governance will clearly call for greater collaboration, which is another recurring theme throughout this Special Report. We've also included in-depth analysis from an authoritative panel of experts to help you forecast the turning points for 2008.

Disease management-or, what we have known as disease management-stands at a crossroads, as changing demands in the marketplace and a growing emphasis on wellness and prevention recast our thinking on chronic care. Can DM survive?

Health plans are looking for a more integrated approach to managing specialty therapies so they can effectively and efficiently manage the quality of care for the member, as well as the cost to the plan sponsor, say industry experts.

There are as many as 75 million Americans who are either uninsured or underinsured, and the rate will continue to grow. Access to healthcare for all Americans was a hot topic during the early years of the Clinton administration, and has resurfaced recently in anticipation of the 2008 presidential election.

There has been a lot of good news about the Medicare drug benefit lately. Surveys show a substantial increase in coverage, particularly among low-income seniors. Costs are less than expected; employers continue to offer retiree benefits; major insurers are sticking with the program; and product coverage remains fairly broad. Beneficiaries seem generally satisfied with the program, and the much-feared "donut hole" appears less lethal than anticipated.

Every time I look through the sales fliers in the Sunday newspaper, I'm amazed by all the stuff we can buy. Toys, such as satellite radios and video game systems, are just the beginning. Today, you can even buy high-end cleaning products for your bath or shower at more than 10 times the price of a simple sponge and some cleanser.

Washington, D.C-Employer-sponsored health-insurance plan premiums increased only 6% in 2007, less than the last four years. However, insurance costs are rising much faster than inflation and wages, according to a leading survey of employer health benefits. Premiums now average more than $12,000 for family coverage (almost $4,500 for individuals), pricing many workers out of the market.

Denver-A UnitedHealthcare initiative underway in Colorado and a handful of other states allows high-deductible PPO plan members to cut their deductibles as much as $4,000 by meeting certain wellness benchmarks. Called Vital Measures, the program launched June 1 in Colorado, Pennsylvania, Ohio and Rhode Island, and is drawing employer interest, says Cheryl Randolph, UnitedHealthcare spokesperson.

Washington, D.C.-House legislation that proposed to fund expanded coverage for children by cutting payments to Medicare Advantage (MA) plans was put on hold last month in an effort to reach a speedy compromise for reauthorizing the State Children's Health Insurance Program (SCHIP). The legislators agreed to adopt the less-costly Senate proposal, which increases tobacco taxes to expand SCHIP into a $60 billion program over five years. The House bill sought $75 billion for SCHIP and proposed to cut payments to MA plans to offset a lower increase in cigarette taxes. Both plans are much more costly than the $30 billion program proposed by the White House.

Washington, D.C.-House and Senate leaders finally agreed on compromise legislation to renew prescription user fees late last month, just a few days before the funding program was set to expire. The Food and Drug Administration legislation increases drug user fees by $225 million over five years, in addition to adopting user fee agreements negotiated with pharmaceutical, biotech and medical device companies that already raised fees considerably. There's also a new fee program to support FDA pre-review of DTC television ads.

Washington, D.C.-Democratic presidential hopeful Sen. Hillary Clinton scored points with the business community in pledging to retain the nation's public-private healthcare system while promising universal coverage, improved quality and lower costs. In an effort to distance herself from previous efforts to establish a single-payer system, Clinton offered a more centrist plan that touts the "share responsibility" of all parties and builds on the existing employer-based system. There is a mandate for large employers to provide health coverage, which most already do, along with a tax credit for small employers (fewer than 25 workers possibly) to offset premium costs.

Agents in late-stage development for the treatment of allergic rhinitis and sinusitis/rhinosinusitis

Telavancin is a novel semisynthetic lipoglycopeptide antibiotic undergoing FDA review for complicated skin and skin-structure infections; this agent is also in phase 3 clinical trials for the treatment of hospital-acquired pneumonia caused by methicillin-resistant Staphylococcus aureus (MRSA) or multidrug-resistant Streptococcus pneumoniae. Telavancin exerts its antibacterial action via a dual mode of action involving both inhibition of peptidoglycan synthesis and disruption of the bacterial cell membrane; the latter of these effects is believed to improve the rate of killing observed with telavancin compared with other glycopeptides. In vitro, telavancin exhibits good activity against a variety of gram-positive organisms, including drug-resistant S pneumoniae, MRSA, vancomycin intermediate-susceptible and vancomycin-resistant S aureus, and vancomycin-resistant enterococci. Clinical data have demonstrated that telavancin is at least as effective as comparator agents for a variety of infectious processes...

In response to the recent FDA warnings about an increased risk of suicidal ideation/suicide attempt among children and adolescents using antidepressants, investigators performed a meta-analysis to assess the efficacy and risk associated with antidepressants among pediatric patients.

Legislation to reauthorize the Prescription Drug User Fee Act (PDUFA) IV has been expanded, as expected, via a host of provisions designed to shape drug development and ensure the safe use of medications.

Initial combination therapy with sitagliptin and metformin is more effective than either agent alone in lowering glucose values in patients with type 2 diabetes, according to the results of a recently published study.

Splitting statin tablets does not negatively affect patient satisfaction, medication adherence, or lipid level control, according to the authors of a randomized, controlled study

In a randomized, placebo-controlled trial, topiramate was demonstrated to be an effective add-on treatment to lifestyle changes in obese patients with type 2 diabetes.

Children who receive broad-spectrum antibiotics during their first year of life are at increased risk of developing childhood asthma.That was the conclusion of researchers who conducted a large, longitudinal, case-control study.

Proton-pump inhibitor (PPI) use moderately increases the risk of community-acquired pneumonia (CAP), particularly among younger patients and those who recently initiated treatment, according to the results of a population-based, case-control study.

Parkinson disease (PD) is a chronic progressive neurodegenerative disorder that affects >1 million people in the United States. PD causes both motor and nonmotor disturbances; common symptoms include resting tremor, rigidity, and bradykinesia. The current goals of treatment are to slow disease progression and to reduce disability without inducing long-term complications. The classes of agents currently approved for the treatment of PD include levodopa/carbidopa, dopamine agonists, catechol-O-methyl-transferase (COMT) inhibitors, monoamine-oxidase type B (MAO-B) inhibitors, anticholinergics, and agents/ combinations from other drug classes. Newer agents, such as rasagiline and rotigotine, offer additional treatment options to healthcare professionals. Despite these advances in the treatment of PD symptoms, current therapies do not prevent neuron degeneration. Research into new treatments is focused on neuroprotective drugs, new dopamine agonists, and nondopaminergic agents; the goal of these investigative..

In the large cohort study referred to as the "The Million Women Study," the use of hormone replacement therapy (HRT) in postmenopausal women was demonstrated to increase the risk of ovarian cancer and death from ovarian cancer by 20% and 23%, respectively, compared to nonuse of HRT.

Briefs of FDA actions/approvals of drugs, doses, and indications

First-time generic approvals: fosphenytoin for injection; pantoprazole delayed-release tablets; cefotetan for injection; cefepime for injection.

The latest FDA action (through September 2007) related to satraplatin, ropinirole (Requip CR), sumatriptan/naproxen (Trexima,) desvenlafaxine (Pristiq), eprodisate (Kiacta,) raloxifene (Evista), natalizumab (Tysabri), bifeprunox, fluticasone/salmeterol inhalation powder (Advair Diskus 500/50), LX211, TZP-101, Alferminogene tadenovec, Ad5FGF-4 (Generx), tramiprosate (Alzhemed), rilonacept, aripiprazole (Abilify), sapropterin (Kuvan), oral topotecan (Hycamtin), mifepristone (Corlux), vitiligo-derived IgG (VitiGam)