Whither Comprehensive Care?
The American Board of Internal Medicine's draft proposal on a new maintenance of certification module on comprehensive care could potentially be just another hoop to jump through, without any validated value to the internist—according to comments the American College of Physicians' Board of Regents submitted to the ABIM. The comments were not all negative, Regents chairman Joel Levine told INTERNAL MEDICINE NEWS. The Regents found much to like—for instance, the draft endorses traditional internists who coordinate and deliver care to most adults, said Dr. Levine, professor of medicine at the University of Colorado at Denver. Another point of agreement: The proposal emphasizes the importance of the medical home. But there were some concerns that such a module might not bring more recruits into internal medicine, and that it doesn't discuss how such a certification would work in a variety of different practice settings, said Dr. Levine, adding that much work still needs to be done. “I don't think this is a done deal,” he said. The ABIM board will next meet in February to discuss comments.
More Action Needed on MRSA
U.S. health care facilities are not doing enough to protect patients from methicillin-resistantStaphylococcus aureus (MRSA) infections, according to an online poll conducted by the Association for Professionals in Infection Control. A majority of infection control professionals (59%) responded that their health care facilities have stepped up efforts to curb MRSA in the past 6 months. But half said their facilities were “not doing as much as [they] could or should” to stop the transmission of MRSA. “MRSA could be beaten if the leadership at hospitals moved more aggressively to adopt strategies proven to protect patients from these virulent infections,” said Lisa McGiffert, director of Consumers Union's Stop Hospital Infections campaign. “We need to require hospitals to report their infection rates so the public can see if they are achieving results.” Consumers Union has worked to help pass laws in 20 states requiring hospitals to report their patient infection rates, and it supports a federal infection reporting law. The Centers for Disease Control and Prevention estimates that nearly 95,000 patients developed MRSA infections in 2005—most of which were acquired in health care facilities—and almost 19,000 people died.
Generics Could Save States Money
Increasing access to generic medicines would help states lower health care costs, which are putting pressure on state government budgets, according to the Generic Pharmaceutical Association (GPhA). The National Governors Association and the National Association of State Budget Officers said in December that “steadily rising health care costs” are contributing to deteriorating state fiscal conditions, and that states face many challenges in providing health care in Medicaid and other state programs. The GPhA noted in its own report that a 1% increase in the use of generics could save $4 billion annually off the total U.S. health care bill. The group advocates creating a workable pathway to approving generic biopharmaceutical medicines and preventing state governments from barring generic substitution for various therapeutic classes of medicines.
Part D Plans Not Tracking Costs
Medicare drug plans have not met all requirements for tracking out-of-pocket spending by beneficiaries in the Medicare Part D prescription drug program, according to a report from the Health and Human Services Department Office of Inspector General. Tracking out-of-pocket costs is necessary to determine when each beneficiary has reached the required spending threshold at which Medicare's catastrophic drug coverage starts. “Implementing the program has been a large undertaking for [the Centers for Medicare and Medicaid Services], its contractors, and the private Part D plans,” HHS Inspector General Daniel Levinson said in a statement. Medicare “should place more emphasis on conducting Part D oversight.” The report found that 29% of Part D plans did not submit required information to the CMS on enrollees' additional drug coverage data. And 34% of Part D plans—covering nearly half of Part D enrollees—did not submit prescription drug event data to CMS in the required time frames. In addition, the limited oversight the CMS has conducted so far on Part D plans' tracking of out-of-pocket costs relied on plans' self-reported data. And even then, about half of the plans were not in compliance with one or more of four CMS requirements in this area. The full report is available at
FDA Sets User Fees for DTC Ads
The Food and Drug Administration is charging pharmaceutical companies about $40,000 to review each of their direct-to-consumer television advertisements, according to a notice issued by the agency in December. Last September, Congress authorized the FDA to create a user-fee program for the advisory review of DTC prescription-drug television advertisements. The program is voluntary; drug sponsors can choose whether to seek FDA advisory review of their ads before broadcast. However, if they seek review by the agency, they must pay the fee. The $41,390 fee established for fiscal year 2008 is based on the number of ads slated for review and is expected to generate $6.25 million in total revenues during the first year of the program.