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CMS rules contribute to drug shortages, hospital pharmacists say
Federal guidance requiring strict adherence to manufacturer labels for inject-able drugs has forced hospitals to throw away perfectly good drugs that are in short supply, according to a survey of pharmacy directors and managers. The Institute for Safe Medication Practices, based in Horsham, Pa., has called on the Centers for Medicare & Medicaid Services to review its policies involving stability and beyond-use dating of medicines. The institute surveyed 715 hospital pharmacists and managers who reported that following manufacturer directions has contributed to national drug shortages. CMS requires pharmacists to be compliant with Food and Drug Administration-approved labels to avoid the use of expired drugs. But pharmacists who were surveyed said some labels are not current and that newer, evidence-based research supports a longer shelf life in certain circumstances. Those studies have shown that diluted drugs remain stable beyond their stated expiration dates, said Allen J. V [Read more]
Sleeping pills pose added death risk for obese patients
The mortality rate for obese patients who regularly take sleeping pills is nine times higher than the death risk for similar patients who do not use the drugs, said a study presented at an American Heart Assn. scientific meeting in March. Researchers examined the medical records of more than 34,000 patients treated in the Geisinger Health System in Pennsylvania. After controlling for sex, age, smoking status, alcohol use, marital status and ethnicity, the obese patients who took hypnotic medicines regularly — at least 132 pills annually — were 9.3 times likelier to die than patients with similar health who did not. Even obese patients who took 18 pills or fewer annually had a death rate eight times higher. The added risk of sleeping pills for obese patients also applied to drugs such as zolpidem, marketed as Ambien by Sanofi-Aventis, which is thought to be less problematic than older, longer-acting sedatives. Obese patients using zolpidem regularly had an eightfold higher dea [Read more]
National health information network soon will stand on its own
A once-conceptual “network of networks” that evolved into the Nationwide Health Information Network Exchange is leaving the direct oversight of the Health and Human Services’ Office of the National Coordinator of Health Information Technology to stand as its own nonprofit organization. The ONC is making the newly coined “NwHIN Exchange” into an independent, nonprofit, public-private partnership that includes the Dept. of Defense, the Social Security Administration, the Dept. of Veterans Affairs, the Centers for Medicare & Medicaid Services and a host of non-federal hospitals and health care organizations, as well as local health information exchanges. Details of the new business model are being worked out, including a sustainability plan. The network is expected to continue evolving as new technologies are introduced and new partners come aboard. The planning process and transfer of power are expected to be complete by the fall. Physicians who use a health information e [Read more]
HHS says insurance rate reviews are working
The Dept. of Health and Human Services says its authorization under the health system reform law to review double-digit premium increases by insurers has led to fewer such rate hikes being proposed in the first place. HHS Secretary Kathleen Sebelius announced March 22 that the department had undertaken 186 reviews of health plans that had proposed raising premiums on subscribers by 10% or more. After the reviews, HHS determined that two insurers had proposed unreasonable rate hikes as high as 24% on enrollees in nine states — Arizona, Idaho, Louisiana, Missouri, Montana, Nebraska, Virginia, Wisconsin and Wyoming. The two insurers named in the reviews were John Alden Life Insurance Co. and Time Insurance Co., both Assurant Health plans that are based in Milwaukee. “Thanks to the Affordable Care Act, consumers are no longer in the dark about their health insurance premiums,” Sebelius said. “Now insurance companies are required to justify rate increases of 10% or higher. It [Read more]
Congress told more prescription drug monitoring programs are needed
More monitoring programs are needed to counter the abuse of prescription drugs in Medicaid and Medicare programs, physicians told lawmakers during a March 22 Senate hearing. An epidemic of prescription drug use for non-medical purposes has hurt families and communities across the country, said Sen. Jay Rockefeller (D, W.Va.), chair of the Senate Finance health subcommittee. He called for the hearing after concerns about abuse of medications in his home state. Problems such as misunderstanding the strength of addictive painkillers also can lead to unintentional misuse by elderly patients and tragic overdoses. “Patients need better education so they are sure how to use powerful prescription drugs correctly,” Rockefeller said. Taking multiple prescriptions is not uncommon for seniors, said internist and geriatrician Timothy C. Schwab, MD. He’s the chief medical officer of SCAN Health Plan, a private Medicare plan in Long Beach, Calif. Different medications, prescribed by di [Read more]
Women need more intensive chlamydia screening, CDC says
Annual chlamydia screening alone is not enough to stem the tide of new infections among the nation’s young, sexually active women each year, according to the Centers for Disease Control and Prevention. The agency recommends that physicians also retest patients 25 and younger three months after treatment for chlamydia to ensure that the person has not been reinfected. On average, between 10% and 25% of women treated for the disease will be reinfected within three months, said Gail Bolan, MD, director of the CDC’s Division of Sexually Transmitted Disease Prevention. Young, sexually active women have an increased risk of developing chlamydia, in part, because their cervix is not fully matured and is more susceptible to infections, the CDC said. But physicians often overlook chlamydia screening among these women, according to data released March 13 at the CDC’s National STD Prevention Conference in Minneapolis. The conference focused on advances and challenges in efforts to hal [Read more]
IOM report identifies ways to measure improvements in HIV care
People continue to be diagnosed with advanced stages of HIV/AIDS despite tools that enable health professionals to detect the condition early and federal recommendations that encourage doctors to do so, infectious diseases experts say. Primary care physicians can help remedy the problem by testing all patients between age 13 and 64 for the virus and making sure those diagnosed with the condition start treatment, said Carlos del Rio, MD, a professor of medicine and global health at Emory University Rollins School of Public Health in Atlanta. Dr. Del Rio also is co-director of the Emory Center for AIDS Research. “To get them into care, you have to diagnose them,” he said. In July 2010, the Obama administration issued the first-ever national strategy on combating and preventing HIV and AIDS. The plan’s goals are clear, but the question has been how to determine whether the strategy is making strides in the right direction, Dr. Del Rio said. To address that uncertainty, t [Read more]
GOP Medicare reform bill would let seniors tap into government employee plan
Medicare seniors would be offered the choice of signing up for the same health care plans that cover lawmakers, their staffs and other federal employees under legislation introduced by Republican senators. Starting in 2014, Medicare-eligible beneficiaries would have the option to enroll in the Federal Employees Health Benefits Plan if lawmakers were to approve the Congressional Health Care for Seniors Act of 2012. The legislation was introduced by Sens. Rand Paul, MD (R, Ky.), Lindsey Graham (R, S.C.), Mike Lee (R, Utah) and Jim DeMint (R, S.C.) on March 15. The legislation would give seniors access to hundreds of health plans while phasing out the traditional Medicare program. It also would gradually increase the age for Medicare eligibility to 70 over the course of 20 years. The bill's sponsors said that if the federal workers' plan is good enough for lawmakers, it should be good enough for the seniors they represent. "To get our nation's fiscal house in order, we must ad [Read more]
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