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Hospitalization Varies by Income

Diabetes patients living in areas where the average annual income is less than $37,000 are 80% more likely to be hospitalized for treatment of diabetes or its complications than are those who live where the average income is $61,000 or more, according to 2005 data from the Agency for Healthcare Research and Quality. In that year, there were nearly 2,800 diabetes-related hospitalizations per 100,000 people in the lowest-income communities, compared with 1,561 per 100,000 people from higher-income communities. Admissions for patients with diabetes increased by 85% between 1993 and 2005; diabetes admissions accounted for 17% of all hospital cases. Among patients 65 years and older, 10,000 per 100,000 patients—roughly five times the national average—were hospitalized for diabetes or diabetes complications. Regional rates also varied, with the diabetes hospitalization rate in the West at 1,585 per 100,000 people, nearly 40% lower than the rate for all other regions of the country.

Lawmakers OK Rx Rule Delay

Coming down to the wire on a new federal mandate requiring the use of tamper-resistant prescription pads for all Medicaid prescriptions as of Oct. 1, lawmakers in the House and the Senate passed legislation in late September that would delay the mandate's start until March 31, 2008. At press time, President Bush was expected to sign the legislation, although it was not clear whether he would sign it by Oct. 1, National Community Pharmacists Association spokesman John Norton told this newspaper. The tamper-proof prescription pad mandate delay was bundled with extensions on several programs due to expire Sept. 30, including an abstinence education initiative that the Bush administration supports, Mr. Norton said. The original mandate, passed as part of war funding legislation earlier this year, requires all Medicaid prescriptions be written on “tamper resistant” paper to be eligible for federal reimbursement. Even though many states have similar requirements, pharmacists' organizations have maintained that most physicians do not currently use these types of pads, nor are supplies readily available.

WHI Results Still Confusing

Just 18% of physicians say they have “no confusion at all” regarding the results of the Women's Health Initiative study, according to an online survey of more than 400 physicians conducted for The Hormone Foundation. The survey also found only 15% of physicians say they believe their patients accurately understand the risks of hormone therapy. “The results of this survey underscore the importance of physicians' role in educating patients and calls for more public education on menopause management,” said Hormone Foundation director Paula Correa. But Dr. Nanette Santoro, director of the division of reproductive endocrinology at the Albert Einstein College of Medicine/Montefiore Medical Center, New York, said that the complexity of the study's results “has been a blessing in disguise. Physicians are spending more time than ever discussing the risks and benefits of hormone therapy with their patients and are focused on individualizing the hormone therapy regimen to the specific needs of the patient.” The survey, which was sponsored by Novogyne Pharmaceuticals, also found that 74% of physicians still consider hormone therapy as a first-line treatment for menopause symptoms. Novogyne manufactures the hormone therapy patches, Vivelle-Dot, Vivelle, and CombiPatch.

Medco Buys Diabetes Supplier

Pharmacy benefit management company Medco Health Solutions announced in August that it was buying PolyMedica, a supplier of blood glucose testing materials, for $1.5 billion in cash. The market for diabetes care, estimated at $25 billion annually, is one of the fastest-growing segments of the health care market, and is expected to overtake cholesterol medications as the fastest-growing therapeutic category by 2009, Medco, based in Franklin Lakes, N.J., noted in a statement. “Combining Medco's clinical care solutions with our patient-centric service model enables us to deliver a gold standard of care to patients with diabetes,” said Patrick T. Ryan, PolyMedica's chief executive officer.

Rise in Adverse Drug Event Reports

The number of serious and fatal adverse drug events (ADEs) reported to the Food and Drug Administration more than doubled between 1998 and 2005, according to a report in the Sept. 10 issue of Archives of Internal Medicine. The agency defines a serious adverse event as an event resulting in death, a birth defect, disability, hospitalization, or that requires intervention. During the 8-year period, 467,809 serious events met the inclusion criteria. The number of reported serious ADEs increased from 34,966 in 1998 to 89,842 in 2005, a 2.6-fold increase; the number of reported deaths during that time increased 2.7-fold, from 5,519 to 15,107.

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