Popularity of Biologics
Spending on injectable biologic drugs increased 34% in 2005, according to a report from Express Scripts, one of the country's largest pharmacy benefit managers. The report looked at spending through the pharmacy benefit for four injectable biologics—Enbrel (etanercept), Humira (adalimumab), Kineret (anakinra), and Remicade (inifliximab)—but excluded spending on drugs administered in physician offices. The biggest factor in the increased spending was increased use of the drugs, such as earlier treatment of rheumatoid arthritis and longer duration of treatment. Utilization in this class was up nearly 25%, according to Express Scripts. In addition, uses for other indications, such as psoriasis, also drove up the utilization and spending.
Disparities Among Children
Children with juvenile rheumatoid arthritis who were covered by Medicaid had significantly lower health-related quality of life and higher levels of disability than children with the disease who had private insurance, according to a new study. The study, which was published in the June issue of Arthritis & Rheumatism, evaluated patients with juvenile rheumatoid arthritis being treated at the Cincinnati Children's Hospital Medical Center between July 2003 and March 2004. Of the 295 juvenile rheumatoid arthritis patients treated during that time, 40 (14%) were covered by Medicaid. Children in the two groups had about the same level of health care utilization, the researchers wrote. However, children with Medicaid received significantly fewer MRIs and were nearly twice as likely to visit the emergency department. The differences in disability and health-related quality of life may be due to nonadherence and poverty since patients had similar levels of health care utilization, the researchers wrote.
Harvard Launches Stem Cell Project
Scientists at Harvard University and Children's Hospital Boston have been given the green light to begin research using somatic cell nuclear transfer in an effort to develop treatments for diabetes, blood disorders, and neurodegenerative diseases. The research, which will involve human embryonic stem cells, will be privately funded because the federal government will not provide money for research using human embryonic stem cells derived after Aug. 9, 2001. The efforts were praised by the Coalition for the Advancement of Medical Research, which advocates for federal funding of stem cell research. “In the absence of federal support for and oversight of this type of research, CAMR is pleased that institutions like Harvard have taken the necessary steps to ensure that therapeutic cloning research happens in a manner fully consistent with the ethics and scientific standards in place for all research involving human subjects and tissues,” CAMR President Sean Tipton said.
Women as Medical Subjects
More than 60% of women aged 50 years and older who have participated in a medical research study would “definitely” or “probably” do it again, according to a survey released by the Society for Women's Health Research. The group commissioned the national telephone survey of more than 1,000 women aged 50 years and older. A similar survey was conducted in 2003. Overall, 10% of women aged 50 years and older have participated in some type of medical research, the 2006 survey found, down slightly from 12% in 2003. However, a growing number of women said they aren't interested or don't believe in medical research in the 2006 survey. Nearly 16% of women surveyed cited lack of interest as a reason for not wanting to participate, compared with about 9% in the 2003 survey.
Survey: FDA Influenced by Politics
A majority of Americans—82%—believe the Food and Drug Administration is greatly influenced by politics when making decisions about the safety and efficacy of new prescription drugs, according to a Wall Street Journal online Harris Interactive poll. The finding was similar across parties, with 87% of Democrats, 77% of Republicans, and 88% of Independents saying they thought that politics outweighed science greatly or to some extent in decision making. The survey of more than 2,300 adults was conducted in mid-May. In addition, almost 60% said the agency is doing a fair or poor job in ensuring the safety and efficacy of new drugs. Only 36% said the FDA was doing an excellent or good job. That is a reversal from 2 years ago, when 56% had a positive view and 37% a negative view of the FDA. Opinions have not changed much on the agency's performance in bringing innovative drugs to market quickly. In 2004, 62% said the FDA was not doing well on that front, compared with 70% in the latest poll.
ICD-10 Fraud Concerns
The Blue Cross and Blue Shield Association and the Medical Group Management Association are among those objecting to the planned implementation of ICD-10, the newest version of the comprehensive list of diagnostic billing codes used by health care providers. A bill currently being considered in the House would require payers to switch from the current ICD-9 codes to ICD-10 by Oct. 1, 2009. Blue Cross/Blue Shield argued in a statement that the deadline should be pushed back to 2012 “because much has to be done before a switch to ICD-10 can be started … and providers need time to automate their offices and be trained.” The Blues are particularly concerned because the switch comes at the same time that Medicare is shrinking the number of its claims processors—many of which are Blues plans—from 50 to 15.