Makeover for Medicare Payments
As members of Congress consider comprehensive health reform this year, the American Academy of Neurology is urging lawmakers to include a complete overhaul of the Medicare physician payment system. In testimony to the House Committee on Energy and Commerce Subcommittee on Health last month, Dr. Bruce Sigsbee, a member of the board of directors of the American Academy of Neurology, said the current Medicare payment system is so fundamentally flawed that it should be thrown out entirely. In its place, he suggested, Congress should consider a blended payment method that would include a base salary for physicians but put as much as 35% of the compensation at risk based on factors such as productivity, quality performance, and patient satisfaction. “For this type of system to work, it would have to provide incentives for coordinating the care of Medicare beneficiaries, especially those with chronic disease that incur a large percentage of Medicare resources,” Dr. Sigsbee said in testimony to Congress. “The result will be that physicians will be encouraged to provide high quality care that reduces the use of unnecessary care and improves the quality of life of the patient.”
FDA Warns on Internet Ads
The Food and Drug Administration has warned 14 drug makers against using brief Internet ads to promote drugs, saying the ads are misleading because they fail to provide full information about risks and indications. The ads typically appear on search engines, such as Google, as “sponsored links” when patients search for information on medical conditions. The ads cited by the Food and Drug Administration include promotions for the multiple sclerosis drug Tysabri (natalizumab), the cardiovascular drug Plavix (clopidogrel), and the diabetes treatment Avandia (rosiglitazone). The sponsored links generally contain only a dozen or so words—not enough to convey detailed treatment or risk information, according to the FDA. The Pew Prescription Project, a nonprofit drug-safety group, has asked the FDA to articulate the rules regulating online advertising and to advise manufacturers on where risk disclosures may appear in Internet ads.
Vt. Neurologists Make Pharma List
Neurologists were among the top recipients of pharmaceutical industry funding in the state of Vermont, according to an annual report compiled by the state's attorney general. The data are from drug manufacturers' public disclosures between July 2007 and June 2008. The disclosures include consulting and speaking fees, travel, gifts, and other payments to physicians, nurses, physician assistants, hospitals, and universities. In the report, neurologists received the third highest amount of industry funding, with about $185,000 going to eight neurologists. Psychiatry topped the list with about $479,000 in industry funds and internal medicine was second with about $333,000. The top five 2007-2008 spenders were Eli Lilly & Co.—the leaders for 3 years consecutively in the report—Pfizer Inc., Novartis Pharmaceuticals, Merck & Co., and Forest Pharmaceuticals.
Reloxin Approval Delayed
Ipsen and its marketing partner Medicis announced in mid-April that its botulinum type A (Reloxin, known as Dysport in Europe) would not be approved at that time, as had been expected. Instead, the companies reported in a statement that they were “in active labeling and risk evaluation and mitigation strategy discussions” with the FDA for both the therapeutic—cervical dystonia—and the aesthetic indications. Galderma owns European marketing rights for aesthetic uses and Medicis owns the U.S., Canadian, and Japanese rights. The companies did not say when they expect final approval.