Rocket Fuel and Thyroid Deficiency
Environmental trace sources of perchlorate may be contributing to lower thyroid hormone levels in women, according to a study by the National Institute of Environmental Health Sciences. Perchlorate is used to make a variety of products including road flares, explosives, and rocket fuel. Researchers looked at urinary levels of perchlorate and serum levels of thyroid-stimulating hormone and total thyroxine in 2,200 males and females aged 12 years and older. They found that although perchlorate was not a significant predictor of T4 or TSH levels in men, it was a significant predictor for levels of both in women. “These associations of perchlorate with T4 and TSH are coherent in direction … but are at perchlorate exposure levels unanticipated based on previous studies,” the authors wrote. The Environmental Working Group, a nonpartisan environmental research organization funded largely by foundations, called the report “alarming” and noted that its own analysis suggests that 44 million American women who are pregnant or thyroid deficient, or who have low iodine levels, are at heightened risk from exposure to the chemical.
Diabetic Nephropathy Genotype?
The Foundation for the National Institutes of Health has awarded the Joslin Diabetes Center one of its first six grants under the Genetic Association Information Network. GAIN is a public-private partnership among the foundation, Pfizer Inc., Affymetrix Inc., Harvard University, and several other companies and institutions aimed at finding the genetic causes of common diseases. Under the project, researchers will use biologic samples already collected from previous studies to evaluate the differences between the genomes of 1,000–2,000 patients with particular conditions and those of 1,000–2,000 healthy volunteers. In the Joslin study, Dr. James Heber Warram and colleagues will analyze the genomes of patients with type 1 diabetes and nephropathy. Pfizer is contributing $5 million to cover the cost of overhead for GAIN, with part of those funds designated to establishing a GAIN database at the National Library of Medicine. Other studies funded in the first round of GAIN include those focussing on psoriasis, attention-deficit hyperactivity disorder, schizophrenia, bipolar disorder, and depression.
Nearly Free Humatrope, Forteo
The Health and Human Services Office of Inspector General has approved a request by Eli Lilly and Co. to provide three drugs—including the growth hormone Humatrope and the osteoporosis drug Forteo—free to beneficiaries enrolled in the Medicare Part D program who are experiencing gaps in their prescription coverage. The other drug covered by the program is Zyprexa, a drug to treat schizophrenia and bipolar disorder. To be eligible for the program, beneficiaries must have an income below 200% of the federal poverty level. To cover some of the administrative costs, patients will be charged a $25 fee for a 30-day supply of the medication, which will be shipped directly to the patient. The company said it expects to begin enrolling patients in the program as early as December. The program “meshes with Medicare Part D, allowing the drug benefit to be successful while still meeting the needs of low-income patients who require more sophisticated medications,” said Deirdre Connelly, Lilly's president of U.S. operations. Patients interested in the program can find information online at
Low Adoption of EMRs
Only about one-fourth of office-based physicians are currently using electronic medical records in their offices, according to a study by researchers at Massachusetts General Hospital, Harvard University, and George Washington University. The study, which was funded by the Robert Wood Johnson Foundation and the federal National Coordinator for Health Information Technology, looked at dozens of studies and surveys done by information technology experts. “We are pitifully behind where we should be,” said study coauthor Dr. David Blumenthal of Massachusetts General Hospital. “We must find ways to get more physicians to embrace this technology if we are to make major strides in improving health care quality.” Barriers to EMR adoption include the high cost of systems, uncertainty regarding the return on investment, and the perceived legal burden of compliance with privacy regulations, according to the report.
CMS Curbs Improper Claims
Medicare's on track in 2006 to further reduce the number of fraudulent and inappropriate claims being submitted. CMS is reporting that 4% of claims were improper in 2006, down from 5% the previous year and from 14% in 1996, leading to $11 billion less in improper payments over the last 2 years. To determine the error rate, CMS randomly sampled 160,000 claims submitted from April 2005 to March 2006. Since it has been able to more closely identify errors, CMS has been providing more accurate information to contractors, resulting in improved system edits and updated coverage policies, said the agency in a statement. In a statement, Sen. Chuck Grassley (R-Iowa), chairman of the committee charged with Medicare oversight, said, “I welcome the news that the government's increased attention to oversight of Medicare payments has paid off.” But he added that CMS has work to do, as it is “still paying for medically unnecessary services and undocumented or poorly documented services.”