NIDDK Director Search Continues
The application deadline has come and gone for the position of director of the National Institute of Diabetes and Digestive and Kidney Diseases. The last director of the institute, Dr. Allen M. Spiegel, left in March to become dean of the Albert Einstein College of Medicine in New York. Dr. Spiegel became director of the institute in 1999; Dr. Griffin Rodgers is serving as acting director until a new director is found. Dr. Spiegel will be sorely missed, according to Dr. Elias Zerhouni, director of the National Institutes of Health. “Allen Spiegel does whatever he does with grace, insight, and an analytical mind,” Dr. Zerhouni said at Dr. Spiegel's farewell reception. “He has the highest degree of intellectual rigor and integrity of anyone I've met.” Applications for the director's job were due July 31; the agency expects to begin reviewing and rating candidates this month, a spokeswoman said.
Report Faults Wound Payment
Medicare needs to improve the way it pays for wound management, according to a new report by AdvaMed, a trade association for medical device companies. “Coverage and reimbursement policies in the nation's Medicare system currently do not reflect technological advances in wound care management, are too comprehensive, and can cause disruptions in delivering appropriate care to patients,” the report's authors said. “Medicare often focuses narrowly on a specific unit cost or the cost of wound care at a specific site, while not considering the long-term costs of caring for patients.” AdvaMed urged the Centers for Medicare and Medicaid Services (CMS) to increase the amount of money the agency pays for wound care supplies used by hospitals, nursing homes, and outpatient clinics. The group also recommended that CMS “revise the [payment] for skilled nursing facilities to reflect the incremental cost for the necessary treatment and therapy of a wound when it is not the primary diagnosis.” The recommendations also included prevention: AdvaMed suggested the agency provide coverage as part of Medicare's surgical dressing benefit for “preventive and early intervention technologies for tissue damage.”
Diabetes Guide for Schools
The Department of Health and Human Services has released a guide to help school personnel, parents, and students manage diabetes in the school setting. “Studies show diabetes management and control can help prevent or delay diabetes-related complications,” the department noted in a press release. “However, students with diabetes need a supportive environment to help them take care of their diabetes through the school day during school-sponsored activities.” The guide includes a diabetes primer, copier-ready action plans, and a review of school responsibilities under federal laws. It is available from the department's National Diabetes Education Program at
www.ndep.nih.gov/resources/school.htm
Postmarketing Follow-Up
The Food and Drug Administration is doing a poor job of ensuring that pharmaceutical companies live up to postmarketing study commitments, according to a new report by the Department of Health and Human Services' Office of Inspector General (OIG). Among the findings: that the FDA can't easily identify if the studies are progressing or what stage they are in; and that monitoring postmarketing studies “is not a top priority at FDA.” The OIG reviewed new drug applications from 1990–2004; 48% of those applications had at least one postmarketing study commitment. Drug makers are required to submit annual status reports. The OIG found that 35% of the reports that should have been submitted in fiscal 2004 were missing or had no information on the study commitments. Even complete reports provide limited useful information, and on top of that, the FDA's information system for monitoring those reports doesn't glean much, either, said the OIG. The Office noted that the FDA has limited enforcement power in this area, but suggested that the agency require more, and more relevant, information from drug makers in the reports. In a response to the OIG, the agency said it could not do that without additional regulations, but agreed that it needed to do more to improve its monitoring and to ensure that commitments are honored and that annual reports are thorough.
Rhode Island Health Care Bills
Rhode Island Governor Donald L. Carcieri (R) signed legislation in early July to address rising health insurance costs and the uninsured problem in the state. One bill creates a reinsurance program to help pay the health insurance premiums for low- and moderate-income wage earners, as well as to help low-wage small businesses pay health insurance costs. Another bill creates a new benefit plan for individual policyholders and businesses with 50 or fewer workers. The plan will have a target cost of 90% of the standard plan premium or, in the case of individual insurance, no more than 10% of the total statewide average wage. A third bill will expand the current state reports on the quality of hospital care to also include community-based care, and will link the quality data to cost data “As long as health care costs continue to grow, there are going to be ways we can work to improve the system to help Rhode Islanders get the health care they need at a price they can afford,” said state Rep. Steven Costantino (D-Providence), cochair of the state legislature's Joint Committee on Health Care Oversight, which developed some of the bills.