A study published recently in the New England Journal of Medicine concludes that the diagnostic effectiveness of a colonoscopy depends on the doctor’s techniques. An article in the New York Times today gives advice on how a prospective patient can question a doctor about his or her technique. I have always thought that medicine is as much an art as it is a science, a consideration which complicates quality transparency initiatives in my opinion.
Reuters reports that CVS filed a registration statement today with the Securities and Exchange Commission concerning its proposed acquisition of Caremark (which is available on the SEC’s EDGAR system). According to Reuters, “there is a $675 million breakup fee if either it or Caremark terminates the deal under certain circumstances.”
Meanwhile the stock market continues to respond favorably to Express Script’s higher offer for Caremark, pushing Express Script’s stock price up 3.3% today. According to Businessweek.com analysts predict that the debt load associated with Express Script’s leverage buyout proposal is “manageable.” Time will tell.
Caremark and CVS responded to Express Script’s competing bid for Caremark with measured press releases describing their agreement as “definitive” and stating that Caremark’s board of directors will take the ESI proposal under advisement. The stock market responded by boosting Caremark’s common stock price from $50.30 per share to $55.28 per share as investors expect a bidding war over Caremark.
The Wall Street Journal reported overnight that “Pharmacy benefit manager Express Scripts is preparing to launch a $26 billion cash and stock offer for rival Caremark Rx, in an effort to break up the company’s existing takeover deal with drug chain CVS.” Express Scripts this morning confirmed the bid in a press release. According to Bloomberg.com, “Caremark investors would receive $58.50 in cash and stock for each share, 15 percent more than the Dec. 15 closing price, St. Louis, Missouri-based Express Scripts said in an e-mailed statement. CVS agreed to buy Caremark for $48.53 a share on Nov. 1, offering shareholders no premium.” Caremark shares closed at $50.30 on Friday.
The Daily Mail of London reports that “Oversize clothes should have obesity helpline numbers sewn on them to try and reduce Britain’s fat crisis, a leading professor [Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow] said today.”
HHS maintains a web based Hospital Compare tool which “provides you with information on how well the hospitals in your area care for all their adult patients with certain medical conditions.” The tool is based principally on information provided by the Hospital Quality Alliance (HQA): Improving Care Through Information.
The Associated Press reports that researchers from the University of Pennsylvania have published a study in the AMA Journal that analyzed the death rates at the 3,657 hospitals evaluated by Hospital Compare. “The study examined three conditions that often lead to hospitalization — heart attacks, heart failure and pneumonia — and found that death rates for patients with those diseases were only slightly lower at top-rated hospitals in 2004 than at the lowest-rated hospitals.” The researchers contend that HHS needs to develop better quality measures. An HHS rebuts that “researchers likely would have found bigger differences among hospitals if they’d examined all 22 quality measures used on Hospital Compare.”
In yesterday’s Federal Register, the Labor Department, the Internal Revenue Service, and the Health and Human Services Department published a final regulation on non-discrimination and wellness programs in the group insurance market as required by the Health Insurance Portability and Accountability Act of 1996 (fondly known as HIPAA). The rules replace interim final rules that were published in 2001. The changes will be effective for FEHB plans on January 1, 2008.
The Government Accountability Office today recommended in report GAO-07-54 that the Food and Drug Administration (FDA) should improve its oversight of direct to consumer prescription drug marketing. A Wall Street Journal article explains that the advertising media for prescription drugs widely vary.
GlaxoSmithKline PLC manufactures a genital herpes treatment called Valtrex, which is a billion dollar seller. According to the Wall Street Journal, while Glaxo does not market the drug to pregnant women and the drug is not FDA labelled for treatment of neonatal herpes, Glaxo is providing funding for doctors who speak at continuing medical education seminars on the benefits of screening all pregnant women for genital herpes.
What makes this interesting is that the Government does not support testing all pregnant women for genital herpes. To the contrary,
The CDC earlier this year said that “insufficient evidence exists to recommend routine” herpes screening of pregnant women, although it said testing should be offered to those whose sexual partners have the disease. A government-appointed panel of experts called the Preventive Services Task Force concluded last year that “there are no benefits associated with screening” asymptomatic women. It said, “The potential harm to many low-risk women and fetuses from the side effects of antiviral therapy may be great.”
The new Congress is expected to take up drug safety issues.
On December 13, the Blue Cross and Blue Shield Association and America’s Health Insurance Plans announced a model format for a computerized personal health record. “The industry model PHR is a private, secure web-based tool maintained by an insurer that contains a consumer’s claims and administrative information. PHRs enable individual patients and their designated caregivers to view and manage health information and play a greater role in their own health care.” Full details on the format are available on the AHIP website.
HHS Secretary Leavitt announced yesterday that in 2007 HHS will support trial implementations of the National Health Information Network, which will be the backbone of the Nation’s electronic health records system.
[In 2006] NHIN activities included “prototype architectures” developed by four consortia of health care and health information technology organizations through contracts with HHS. This “prototype architecture” work included developing functional requirements, security approaches and identifying needed standards for creating secure health information exchange in different health care markets. In January 2007, the four existing consortia will present the prototype architectures at the American Health Information Community and the third NHIN forum to be held in Washington, D.C. A summary report capturing key findings from this past year will be published in early 2007.