Little Evidence Disease Management Programs Save Money: RAND
While disease management programs may improve quality of care for patients with chronic health problems such as diabetes and congestive heart failure, there's little evidence that such programs save money, according to a study released Monday by the non-profit research organization RAND Corp.
Researchers analyzed previous studies on disease management programs -- which use interventions ranging from telephone reminders to home visits by medical professionals -- and found that the programs can improve health care quality and disease control and, in the case of congestive heart failure, lower hospital admission rates.
But there's little evidence about whether the programs improve patient health outcomes or save money over the long term.
"Disease management is viewed as the silver bullet that can fix two problems of the health care system -- inadequate quality and high costs. Unfortunately, while there is evidence that disease management programs can indeed improve the quality of care, there is no conclusive evidence that they can actually save money," said report lead author Soeren Mattke, a senior natural scientist at RAND.
In 2005, U.S. health insurance plans and employers spent about $1.2 billion on disease management programs.
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Merck Pushes for OTC Sales of Mevacor
For the third time in a decade, Merck & Co. is trying to persuade the U.S. Food and Drug Administration to allow non-prescription sales of the cholesterol-lowering statin drug Mevacor, Bloomberg news reported.
However, the likelihood of the FDA granting such approval appears slim due to opposition from the American Medical Association, Bloomberg said. In a letter to the FDA, the AMA said patients need a physician's help to determine if they have high cholesterol and whether it's safe for them to take Mevacor.
"This is a serious medication, not the kind you want to be taking over-the-counter on your own," Steven Nissen, chief of cardiology at the Cleveland Clinic, told Bloomberg. "Unlike a headache, high cholesterol doesn't have any symptoms, so how do you know you have high cholesterol, or if it has improved, without going to a physician?"
An FDA advisory panel will meet Dec. 13 to hear submissions and make a recommendation about nonprescription sales of Mevacor.
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Many Medicare Enrollees Paying More for Brand Name Drugs
Nearly half of national Medicare Part D drug plans have increased the amount enrollees pay for brand name drugs, says a Kaiser Family Foundation report.
Since 2006, average cost sharing for a 30-day supply of "non-preferred" brand name drugs increased by 29 percent, from $55.36 to $71.31. During the same time, average cost sharing for "preferred" brand name drugs increased by 11 percent, from $26.87 to $29.86. Cost sharing for generic drugs remained fairly stable.
The report also said that in 2008, 41 of the 47 national Medicare drug plans will place some drugs on a specialty tier, about twice the number of plans that had a specialty tier in 2006. Plans are able to charge enrollees more for specialty tier drugs than for preferred and non-preferred drugs.
The Kaiser Foundation said it has updated its online consumer guide, Talking About Medicare, designed to help people understand Medicare coverage. The guide includes detailed information about the Medicare drug benefit.
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More Improvements Needed to Protect Children: UNICEF
While the number of children worldwide who died before they reached age 5 dropped below 10 million in 2006, much more needs to be done to improve children's health and reduce death rates, says a UNICEF report released Monday.
At the beginning of the 1960s, more than 20 million children under age 5 died each year, Agence France-Presse reported.
Despite improvements made over the past decades, UNICEF executive director Ann Veneman said "much more must be done" to "create a better world for boys and girls, and for generations to come."
For example, the report noted that more than 500,000 women die each year from pregnancy- and childbirth-related complications. It also said that lack of basic sanitation, hygiene and drinkable water contributes to the deaths of more than 1.5 million children each year from diarrhea and related problems, AFP reported.
UNICEF said an estimated 158 million children, ages 5 to 14, around the world were engaged in child labor in 2006.
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Increased Cancer Risk For Children Living Near Reactors: Study
Children younger than 5 years old who lived near nuclear power plants were much more likely to develop cancer than those in the general population, a German government study found.
Children who lived less than five kilometers (three miles) from a nuclear power plant had about a 60 percent increased risk of cancer. When investigators looked at leukemia alone, there was a 117 percent increased risk, Agence France-Presse reported.
Researchers analyzed statistics from 1980 to 2003 from areas near 21 operating or former reactors. There were a total of 77 cases of cancer among children younger than 5 years.
Based on current scientific knowledge, the findings can't "be explained by exposure to radiation from a nuclear reaction," German Environment Minister Sigmar Gabriel said in a statement, AFP reported.
"To explain this increased cancer risk, the population would have to be exposed to radiation at least 1,000 times higher than what comes from German nuclear power plants," Gabriel said.
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Brain Area May Filter Irrelevant Input
Swedish scientists believe they've identified a brain area that filters irrelevant/distracting input, leaving more room for things that are important to remember.
The finding may help explain why some people have better memory ability and it could also help improve understanding of attention deficit hyperactivity disorder (ADHD), BBC News reported.
The study of 25 healthy volunteers found that those who were better at memorizing visual images on a computer while coping with distractions showed increased activity in the brain's basal ganglia. Functional MRI was used to scan the participants' brain activity. The study appears in the journal Nature Neuroscience.
"The basal ganglia are very strong candidates for involvement in brain disorders where people have difficulty with attentional control," John Duncan, a scientist with the Medical Research Council in the U.K., told BBC News. "But there will be many brain regions that filter irrelevant information, so it is too early to tell if these findings will have a bearing on conditions such as ADHD."
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