Cosmetics for Calif. Oral Surgeons
California Governor Arnold Schwarzenegger (R) has signed a bill that will grant new privileges to oral and maxillofacial surgeons. The governor vetoed a similar bill in 2005. Board-certified and licensed dentists who have completed an oral and maxillofacial surgery residency will be able to apply for and receive a 2-year, $500 permit to perform elective facial cosmetic surgery. Every 6 years, the permit holder has to submit evidence of competence to a credentialing committee. Procedures such as facial rejuvenation and contouring must be done at licensed and accredited hospitals or outpatient surgical facilities. The privileges do not extend to reconstructive surgery. The bill was supported by the California Association of Oral and Maxillofacial Surgeons, and opposed by the California Medical Association and the American Association of Plastic and Reconstructive Surgery.
Specialty Drug Demand Is Inelastic
Patients who need expensive specialty drugs will keep using the products even if they have to pay moreand that can drive up the cost of health care, said RAND Corp. researchers, who argued against tight restrictions and higher patient cost-sharing for such drugs. The researchers used 20032004 data covering 1.5 million beneficiaries from 55 health plans to gauge private coverage for patients with four conditionscancer, kidney disease, rheumatoid and/or psoriatic arthritis, and multiple sclerosis. They included drugs administered at physicians' offices and other nonhospital health care facilities. Health plan spending ranged from $3,200 per user for Lupron (leuprolide acetate), to $10,000 per user for Enbrel (etanercept), to $100,000 per user for recombinant factor VIII. Patients spent between $3,301 and $8,878 out of pocket on these four conditions. Writing in the September/October issue of Health Affairs, the researchers said their data showed that even if a plan doubled the patient's share, overall spending on specialty drugs by insurers would drop by only 1%21%, depending on diagnosis. They concluded that increasing patient copays only transfers more of the burden to the patient and will do little to cut overall spending. The study was supported by Amgen, the National Institute on Aging, and United Healthcare.
Psoriatic Arthritis Resources
The National Psoriasis Foundation has partnered with Abbott to provide psoriatic arthritis patients with online tools to manage their symptoms. The Web site, found at
Coalition Seeks More FDA Funds
A coalition of strange bedfellows has joined together to call on the White House and Congress to increase funding for the Food and Drug Administration, saying that the agency's mission and responsibilities have expanded hugely while its appropriations have failed to keep up with inflation or with the growing largess going to other agencies like the National Institutes of Health. That NIH investment will likely result in a large number of new products, all of which the FDA will have to regulate, according to the Coalition for a Stronger FDA. The agency also needs help coping with growing pharmaceutical, medical device, and food safety issues, the group said. The Coalition includes the Consumer Federation of America, the Center for Science in the Public Interest, the Grocery Manufacturers Association, the Biotechnology Industry Organization, and the Advanced Medical Technology Association, among others. Serving as cochairs of the Coalition are the last three secretaries of the Department of Health and Human Services: Tommy G. Thompson, Donna E. Shalala, and Louis Sullivan.
Low Physician E-Mail Use
Physicians rarely use 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 20042005, a 4% increase from the previous study period of 20002001. 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 other reasons for not using e-mail: lack of reimbursement for consultations, cost of implementing a secure system, and fears that e-mail would add to workload. 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.