TBI Costs Almost $6 Billion Yearly
Traumatic brain injury was the most frequent cause of death in the hospital among Americans 44 years and younger, according to data from the Agency for Healthcare Research and Quality. More than 5,500 people in this age range died from traumatic brain injury (TBI) in 2002; most of these injuries were related to falls (38%) and motor vehicle accidents (35%). Another 8% of TBI cases involved being struck by or against something. Respiratory intubation and mechanical ventilation were among the most common procedures performed in TBI patients; those who had these procedures done had a 38% mortality, according to the researchers. The aggregate charge billed for all TBI patients nationwide was $5.8 billion.
Patients Allege Gambling Addiction
Patients in the United States and Canada have filed class action suits against Boehringer Ingelheim, maker of pramipexole dihydrochloride (Mirapex), claiming that the Parkinson's disease drug caused them to become gambling addicts. In Canada, lead plaintiff Gerard Schick of Midland, Ontario, alleged that whereas before taking the drug, he had gambled only infrequently and risked small sums of money, once he started taking Mirapex he gambled away more than $100,000, withdrew all available cash from his bank accounts, and mortgaged his house to pay for his addiction. “At no time … did Gerard Schick receive any warning about the risk of compulsive behavior and in particular an addiction to gambling that could result from the use of Mirapex,” notes the lawsuit, which seeks $3 million for each plaintiff and $50 million in punitive damages. Boehringer Ingelheim does not comment on pending litigation, a spokeswoman said.
Medicare AED Drug Benefit Explained
The Centers for Medicare and Medicaid Services is requiring all health plans serving Medicare patients to include all antiepileptic drugs (AED) on their formularies starting in 2006, when the new Medicare drug benefit takes effect. In a document released in early June, the agency noted that in earlier guidance on the Medicare drug plan, it stated that “a majority” of drugs in the AED group and five other categories—antidepressants, antipsychotics, anticancer drugs, immunosuppressants, and HIV/AIDS drugs—would have to be on plan formularies and that beneficiaries should have uninterrupted access to all drugs in that class. But in training sessions and in answering user calls, “CMS has consistently explained that this meant that access to 'all or substantially all' drugs in these specific categories needed to be addressed by plan formularies,” the document stated. “This is because the factors described in our formulary guidance indicated that interruption of therapy in these categories could cause significant negative outcomes to beneficiaries in a short timeframe.”
U.S. Is High-Tech Imaging Champ
The United States ranks highest in utilization of high-tech imaging compared with other countries, according to data presented at the American Roentgen Ray Society meeting in New Orleans last month. The study of high-tech imaging use in 15 countries by Mark Schweitzer, M.D., of the Hospital for Joint Diseases in New York, and his colleagues, found that although Germany, Singapore, and South Korea had the highest per capital x-ray utilization, the United States had the highest per capita use of MRI and CT, almost 10 times greater than Singapore or Germany. India had the lowest MRI usage, the authors noted. “Not surprisingly, the most capital intensive countries more often used CT and MRI,” Dr. Schweitzer said in a statement. Although reasons for the usage differences were not examined, “who is paying for the studies may be a driving force in image utilization,” he added.
The OxyContin Wars: DEA vs. MDs
The federal Drug Enforcement Administration's efforts to stop illegal use of the prescription painkiller OxyContin have “cast a chill over the doctor-patient candor necessary for successful treatment,” Ronald T. Libby, Ph.D., a political science professor at the University of North Florida, wrote in a policy analysis for the Cato Institute, a libertarian think tank. The DEA's campaign includes elevating OxyContin to the status of other schedule II substances and using “aggressive undercover investigation, asset forfeiture, and informers, he notes.” By demonizing physicians as drug dealers and exaggerating the health risks of pain management, the federal government has made physicians scapegoats for the failed drug war,” Dr. Libby wrote. When asked for comment, a DEA spokeswoman referred to a statement by DEA Administrator Karen Tandy. “We employ a balanced approach that recognizes both the unquestioned need for responsible pain medication, and the possibility … of criminal drug trafficking,” Ms. Tandy said, noting that physicians “are an extremely small part of the problem.”