Chronic Disease: $1 Trillion a Year
Seven chronic diseases—cancer, diabetes, hypertension, stroke, heart disease, pulmonary conditions, and mental illness—have a total impact on the economy of $1.3 trillion annually, including $1.1 trillion in lost productivity, according to a study by the Milken Institute. That figure could be nearly $6 trillion by midcentury, the report said. “By investing in good health, we can add billions of dollars in economic growth in the coming decades,” said Ross C. DeVol, the institute's director of regional economics and principal author of the report. He noted that much of this cost was avoidable. “With moderate improvements in prevention and early intervention … the savings to the economy would be enormous.” West Virginia, Tennessee, Arkansas, Kentucky, and Mississippi have the highest rates of chronic disease. Utah, Alaska, Colorado, New Mexico, and Arizona have the lowest.
Senate Committee Knocks GSK Actions on Avandia
The Senate Finance Committee has issued a report criticizing GlaxoSmithKline for its alleged efforts to tone down one of the more prominent critics of its drug rosiglitazone (Avandia). The report referred to “what appears to be an orchestrated plan to stifle the opinion of Dr. John Buse,” the current president of the American Diabetes Association. The report looked back to 1999, when Dr. Buse raised the possibility that rosiglitazone could have the potential to increase cardiovascular events in those who took it. GlaxoSmithKline eventually had Dr. Buse sign a letter clarifying some of his earlier statements. The committee called the company's behavior “less than stellar” and said that the public good “would have been better served” if Dr. Buse had been allowed to continue voicing his concerns. In a statement, the company said it disagreed with the committee's findings and said that it did not require Dr. Buse to sign a legal document restricting his comments. Instead, the company said it was “trying to correct inaccuracies about data on Avandia in a continuing medical education presentation by Dr. Buse. … Ultimately, GSK staff communicated their concerns to Dr. Buse and his supervisor. Dr. Buse clarified and corrected his statements, which the company appreciated.” The statement noted that “GSK understands that there is a fundamental difference between engaging in scientific debate to ensure the accuracy of public statements, and trying to inappropriately influence or silence a critic…. The company does not support or condone efforts to silence critics.”
Heart Drugs Skewing Younger
More people aged 20–44 years are taking prescription medications for cardiac conditions—and their ranks are growing faster than those aged 45 or older who use the therapies, according to Medco Health Solutions. Extrapolating data from 2.5 million Medco drug benefit users, the company estimated that nationally 4.2 million patients aged 20–44 years took lipid-lowering drugs in 2006—a 68% increase from 2001—and 8.5 million took antihypertensives, a 21% rise from 2001. The rate of increase for new users of lipid-lowering drugs was 37% higher for those younger than 45 years than for patients 45–64 years. “The bad news is that these conditions are showing up in patients at younger ages,” Medco chief medical officer Dr. Robert Epstein said in a statement.
Low Health Literacy Is Costly
Researchers found that 87 million adults, or 36% of the adult U.S. population, have basic or below basic health literacy skills. Using data from the 2003 Department of Education National Assessment of Adult Health Literacy, they estimated that low health literacy costs the U.S. economy between $106 billion and $236 billion a year. “Our findings suggest that low health literacy exacts enormous costs on both the health system and society,” lead author John A. Vernon, Ph.D., said in a statement. The report, “Low Health Literacy: Implications for National Health Policy,” was supported by a grant from Pfizer Inc.
Medicare Out-of-Pocket Spending Rises
The percentage of income that Medicare beneficiaries spend on out-of-pocket health care costs is rising, according to a study published in the November/December issue of Health Affairs. The median amount of income that Medicare beneficiaries spent out of pocket was 12% in 1997, but rose to 16% in 2003. Study authors Patricia Neuman, Sc.D., of the Henry J. Kaiser Family Foundation, and colleagues noted that in 2003, the 25% of beneficiaries with the highest out-of-pocket expenses spent at least 30% of their income on health care, while the top 10% spent at least 58%. “Our findings suggest that giving elderly and disabled Medicare beneficiaries more 'skin in the game' could make health care less affordable and accessible for all but the highest-income beneficiaries,” the researchers said.