Drugs/Medical Archive

Shopping the best Health Insurance deal? Maybe you can’t

February 26th, 2010. By AbiK

On the heels of posting about the recent WellPoint/Anthem health insurance rate hikes, an American Medical Association (AMA) report on competition in the health insurance industry came out this week.

Guess what? AMA President Dr. J. James Rohack summed it up as: “The near total collapse of competitive and dynamic health insurance markets has not helped patients. As demonstrated by proposed rate hikes in California and other states, health insurers have not shown greater efficiency and lower health care costs. Instead patient premiums, deductibles and co-payments have soared without an increase in benefits in these increasingly consolidated markets.”

The report, Competition in Health Insurance: A Comprehensive Study of US Markets, looked at data from 43 states. Interestingly, in 24 of the states, the two largest insurers had a combined market share of 70% or more. Not a consumer packaged goods company out there that wouldn’t love to be sitting in that position.

Also according to the report:

• In 54% of the metro markets, at least one insurer had a market share of 50% or more
• In 92% of metro markets, at least one insurer had a 30% or more market share

The best quote from the Rohack news release is this though—in reference to the lack of competition within the health insurance industry—it “is clearly not in the best economic interest of patients”.

No kidding.

Tags: Anthem Blue Cross, health insurance, WellPoint
Posted in Drugs/Medical | No Comments »

If the FDA Wore a Uniform

February 25th, 2010. By Hunter West

You gotta love the good ol’ FDA (US Food and Drug Administration) for its renewed stance on oversight on things such as drug advertising. Four months into the Obama Administration, the FDA gets a new leader—Margaret Gamburg—and all of a sudden things start happening.

Among other crackings of the whip, the FDA issued draft guidelines designed to clarify what is appropriate in drug ads. You know, things like upping the music volume when all those nasty, ‘adverse reaction’ bits appear. Or the use of distracting images and visuals to take the focus away from what you are hearing. 

The renewed focus on what consumers are seeing in medicinal TV ads—which seem to take center sponsor stage on the major network television newscasts each night—stems from a few well-placed cat calls from John Dingell and Bart Stupak. Back in 2008 the two congressmen openly questioned if drug advertising properly presented product benefits and risks. 

Among other complaints, Stupak criticized Pfizer for using the inventor of an artificial heart, Robert Read the rest of this entry »

Tags: Dingell, DUI, FDA, Gamburg, OxyContin, Stupak, Trasylol
Posted in Drugs/Medical | 1 Comment »

Hospital Website says Reglan “safe” for Infants: that’s news to us…

February 18th, 2010. By AbiK

Use of Reglan for babies with GERD issues—particularly premature babies—as well as using Reglan to stimulate milk production for breastfeeding are hot topics on mommy message boards all over the internet. Boards about colic, GERD, low milk production, premature births, and even morning sickness debate the pro’s and con’s of using Reglan to provide relief—or help things get moving properly.

But it’s also a well-known fact that Reglan can only be prescribed off label for the above uses, and that no studies have been done on the effects of Reglan on infants. All we know is that Reglan carries a black box warning for Tardive Dyskinesia and that there’s a mixed bag of anecdotal experiences on all the mommy message boards and forums out there.

So why is this what’s written about Reglan use in infants with regurgitation, reflux or GER on the California Pacific Medical Center’s website?…

Medications
When basic measures fail to control symptoms, medication may be indicated. Usually, two types of medication are used. Acid-blocking medications (famotidine/Pepcid, ranitidine/Zantac, cimetidine/Tagamet, omeprazole/Prilosec and lansoprazole/ Prevacid) suppress stomach acid and prevent it from doing damage to the esophagus and lungs. Pro-motility agents (bethanechol, metoclopramide/Reglan, cisapride/ Propulsid) help to strengthen the tone of the lower sphincter and increase gastric emptying. For children these medications are by prescription only.

All of these medications are safe in infants and children [my bolding] and have only minor side effects. If your child experiences side effects, we will adjust the dose or change medication.

No qualifying statements or footnotes. No references to use of Reglan in this capacity being off-label. No mentions of the info you’ll see on rxlist.com (run by webmd.com) for Reglan use in children, which reflects Reglan’s monograph:

Pediatric Use

Safety and effectiveness in pediatric patients have not been established (see OVERDOSAGE).

Care should be exercised in administering metoclopramide to neonates since prolonged clearance may produce excessive serum concentrations (see CLINICAL PHARMACOLOGY – Pharmacokinetics). In addition, neonates have reduced levels of NADH-cytochrome b5 reductase which, in combination with the aforementioned pharmacokinetic factors, make neonates more susceptible to methemoglobinemia (see OVERDOSAGE).

The safety profile of metoclopramide in adults cannot be extrapolated to pediatric patients. Dystonias and other extrapyramidal reactions associated with metoclopramide are more common in the pediatric population than in adults. (See WARNINGS and ADVERSE REACTIONS – Extrapyramidal Reactions.)

 What gives California Pacific Medical Center?

Tags: Breastfeeding, GERD, Reglan
Posted in Drugs/Medical | 1 Comment »

Fluoride in Water Debate Continues

February 17th, 2010. By AbiK

As the debate on fluoride in water continues to rage in towns across America, it’s interesting to go back and watch this clip from the US Senate Hearing on Safe Drinking Water Act (June 29, 2000); yes, it’s ten years old now, but it’s still relevant; case in point, the current debate going on in Watsonville, CA where on the one hand, health officials note a dental decay epidemic and opponents to fluoridation refer to studies linking it to bone cancer, thyroid problems, kidney malfunction, fetal damage, and of course, fluorosis.

If you’re wondering whether your own water supply has fluoride in it, check with your local water company. Ask what the level of fluoride—it’ll be in parts-per-million (ppm)—in the water is. According to the ADA, the optimal level of fluoride in drinking water that has been proven to help reduce tooth decay is 0.7 – 1.2 ppm. While the ADA supports community water fluoridation, the ADA website also notes:

Naturally occurring fluoride may be below or above these levels [0.7-1.2 ppm] in some areas. Under the Safe Drinking Water Act, the U.S. Environmental Protection Agency requires notification by the water supplier if the fluoride level exceeds 2 parts per million. People living in areas where naturally occurring fluoridelevels in drinking water exceed 2 parts per million should consider an alternative water source or home water treatments to reduce the risk of fluorosis for young children.

Tags: Drinking Water, EPA, Fluoride, Fluorosis
Posted in Drugs/Medical, Environment | No Comments »

WellPoint, Anthem Blue Cross rate hikes: Bloodless Economics?

February 16th, 2010. By Hunter West

The mind-boggling increase in healthcare premiums promoted to policyholders of WellPoint Inc. and its subsidiary, Anthem Blue Cross comes down to a central question, according to a story today in the New York Times… 

Is this the bloodless economics of risk, or a corporate culture of greed? 

In Los Angeles Bernhard Punzet opened up his envelope from Anthem Blue Cross and saw that Anthem intended to increase his insurance premiums by 34 percent. His partner’s would rise by 36 percent. 

Joshua Needle, a trial lawyer in Santa Monica, got a similar shock when he saw that Anthem intended to increase his premium by 33 percent.  “I have no problem with profits,” he said in comments published this morning in the New York Times, “but they’re maximizing profits without any concern that they have a captive audience.” 

He is not alone. About 700,000 Anthem Blue Cross clients are reeling with the news that they may be facing increases averaging 25 percent. That’s the average. A full 25 percent of policyholders are facing premium increases of anywhere from 35 to 39 percent. 

That’s four times the rate of medical inflation. 

Needless to say, consumers are screaming bloody murder, while advocates of public healthcare are using the issue as fodder for a renewed push behind President Obama’s universal health care reform. 

The increase has been delayed by two months, at the request of the insurance commissioner in California, in order Read the rest of this entry »

Tags: Anthem Blue Cross, health insurance, WellPoint
Posted in Drugs/Medical, Emerging Issues, Insurance | 1 Comment »