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Understanding Vitamin D

More than half of women aged over 50 years reported that they have not discussed vitamin D with their physicians, according to a national survey released by the Society for Women's Health Research. The society also found that women over 50 may lack an overall understanding of the importance of vitamin D to bone health. About 46% said they felt vitamin D was “extremely important” for maintaining bone health, compared with 72% who said they felt that way about calcium. One in six women (16%) said they thought vitamin D was “somewhat important” or “not important at all” for bone health, compared with 4% for calcium. The nationwide survey was conducted in February and included responses from 492 women aged 50 years and older. “These survey results should serve as a wake-up call for women over 50 to talk to their doctors about the importance of vitamin D as it relates to overall bone health due to the impact of vitamin D insufficiency on calcium absorption, bone loss, and fracture risk,” said Felicia Cosman, M.D., clinical director of the National Osteoporosis Foundation.

Risk Minimization Guidance

The Food and Drug Administration has released three guidance documents to help industry improve its methods of assessing and monitoring the risks associated with drugs and biologic products in clinical development and general use. One document addresses risk minimization action plans (RiskMAPs) that industry could use to address specific risk-related goals and objectives. How the new guidance protocols would specifically address a drug with red safety flags such as Vioxx (rofecoxib), “is hard to speculate,” Paul J. Seligman, M.D., director of the Office of Pharmacoepidemiology and Statistical Science with the FDA's Center for Drug Evaluation and Research, said at a press conference. “It would be difficult for us to come up with a drug that would allow us to walk through the guidances,” as all drugs need to be evaluated on a case-by-case basis, Dr. Seligman said.

Top 'Fortified' Cities

Bethesda, Frederick, and Gaithersburg, Md., have the distinction of being at the top of a list of the most “fortified” cities in a new ranking from the General Nutrition Centers (GNC) based on vitamin intake and other nutritional factors. GNC, a global retailer of nutritional supplements, determined its rankings by looking at fruit and vegetable intake in 94 sampled markets, along with per capita GNC multivitamin sales in those areas. Wichita and Topeka in Kansas topped the list of least fortified cities. “One trend we noticed is that participating markets in the East seemed to rank high, while the Midwest and Southern markets ranked toward the bottom,” said Susan Trimbo, Ph.D., senior vice president of scientific affairs at GNC. “The results seem to indicate that people in the East consume more fruits, vegetables, and multivitamins.” A complete ranking of the 94 markets is available online at

www.gnc.com

Trading Choice for Savings

More patients are willing to limit their choice of physicians and hospitals to save on out-of-pocket medical costs, the Center for Studying Health System Change (HSC) reported. Between 2001 and 2003, the proportion of working-age Americans with employer health coverage willing to make this trade-off increased from 55% to 59%—after the rate had been stable since 1997, the study found. Low-income consumers were the most willing to give up provider choice in return for lower cost. In addition, the proportion of chronically ill working-age adults with employer coverage who are willing to trade choice for lower costs rose from 51% in 2001 to 56% in 2003. The study's findings were based on HSC's Community Tracking Household Survey. In 2003, the survey included 20,500 adults aged 18-64 with employer-sponsored health coverage; in 2001, it included 28,000 working-age adults with employer coverage.

Part B Costs Expected to Rise

Payments for Medicare Part B services—coverage for physician visits and outpatient services—are expected to grow at an annual average rate of about 6.9% over the next 10 years, the program's trustees announced in their annual report. More use of services like office visits and lab and diagnostic tests account for the accelerated growth in Part B costs—and needs further detailed examination, said Mark McClellan, M.D., administrator of the Centers for Medicare and Medicaid Services. Medicare's hospital fund in the meantime isn't expected to dry out until 2020, 1 year later than estimated in last year's report. “However, if you look at historical projections, President Bush has presided over an unprecedented drop in solvency,” countered Rep. Pete Stark (D-Calif.), ranking Democrat on the House Ways and Means health subcommittee, in a statement.

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