Associated Press
Roland Burris has criticized drug-company profits, though the subject wasn’t exactly at the top of the agenda at yesterday’s news conference.

Who knows if Roland Burris, former Illinois attorney general, will ultimately fill Barack Obama’s Senate seat. But since embattled Illinois Gov. Rod Blagojevich made Burris the man of the moment, we figured we’d take a look at his stances on health care.

When Burris was running for Illinois governor in 2002, before the advent of the Medicare drug benefit, he didn’t show much love for the drug industry. In a Chicago Tribune article we found (sorry, no link) about the gubernatorial candidates’ views on seniors’ health costs, Burris said the federal government needed to address “disproportionately high profit margins associated with the pharmaceutical industry.”

There was also a piece from Burris’s earlier run for governor back in 1994. Burris and another candidate favored universal coverage and wanted to sharpen the state’s focus on preventive care and to boost the number of primary care physicians. (Wait, so they were talking about the same problems 25 years ago? The Health Blog just got a little glum.)

For our final post of 2008, we couldn’t resist hitting one of our favorite subjects: deals on generic drugs.

In this case, they’re free — at least for now. Giant Food is giving away generic antibiotics from Jan. 2 to March 21, including amoxicillin, penicillin and ciprofloxacin. Details are here. The program will also be available at Giant’s sister chain, Stop & Shop.

Since Wal-Mart started its four-dollar program a couple of years ago, cheap generics have become almost a necessity to bring in customers.

“We have a lot more competition these days,” Robin Michel, EVP and general manager at Giant, told the Baltimore Business Journal. “And there’s no way you can be more competitive than free.”

Some folks who talked to the Washington Post hadn’t heard about free antibiotics before. We hereby offer them our post from last year about Publix’s free antibiotics program. Others that have gotten in the game include Schnucks and Martin’s supermarkets.

Photo by katmere via Flickr

With some data showing that the anti-clotting medicine Plavix may not work well in almost a third of patients with a genetic variant, the FDA may look for changes to the instructions for the drug.

The WSJ reports on talks between the agency and Bristol-Myers Squibb over a revision to the label for Plavix, the second-biggest seller in the world behind Pfizer’s Lipitor. But the mixed bag of information make it hard to predict what the changes, if any come to pass, might look like.

Two studies, published in the New England Journal of Medicine and the Lancet last week, suggested Plavix was less effective in about 30% of the population that has the mutated gene from one parent. A third in NEJM indicated the drug is less effective only in the 5% of the population that has the gene from both parents.

The results underscore the tough road ahead for the growing field of personalized medicine, which aims to tailor use of drugs to patients’ genetic traits.

“What I think we’re struggling with is what is the label going to say in light of all the ambiguous data out there,” said Larry Lesko, director of the FDA’s office of clinical pharmacology.

Doctors, we warned you: The days of free office supplies courtesy of drug companies are ending.

After the ball drops in Times Square tonight, the pharmaceutical industry’s new ban on pens, staplers, mugs and other giveaways to doctors will be official around here. More than 40 companies have signed on, including Eli Lilly, Johnson & Johnson and Pfizer, the New York Times reports this morning.

The FDA is going to get some expert help as it decides whether to finally approve prasugrel, Eli Lilly’s powerful anti-clotting drug and would-be competitor to blockbuster Plavix.

Lilly and partner Daiichi Sankyo said this morning that the FDA’s Cardiovascular and Renal Drugs Advisory Committee would meet Feb. 3. The companies didn’t offer any details about what’s on the agenda, but Lilly said it has “full confidence in the data submitted to the FDA and the overall benefit-risk profile of prasugrel.”

Early this year, lots of folks were brimming with anticipation for prasugrel, a more powerful clot-fighter than Plavix. But the Lilly medicine also carried a higher risk for life-threatening bleeding. Perhaps no surprise then that there was a three-month delay in FDA’s review earlier this year, then another with a less clear timetable for action, as the agency weighed what to do.

Controversial Harvard psychiatrist Joseph Biederman has agreed to stop working on clinical trials funded by industry until Massachusetts General Hospital finishes looking into allegations that he didn’t adequately report the funding he has received from drugmakers.

Sen. Charles Grassley (R., Iowa) has accused Biederman of failing to disclose more than $1.6 million in payments he received from companies including Johnson & Johnson and Eli Lilly. Biederman is also taking fire over a research institute at the hospital that J&J, maker of antipsychotic Risperdal, allegedly helped fund to support sales of the drug.

Mass General said yesterday that Biederman (pictured) would stop industry-funded activities at the hospital until its review was completed, the WSJ reports. Hospital spokeswoman Peggy Slasman said that would mean he’d stop his participation in several industry-funded clinical trials there. The hospital wouldn’t describe the studies, which it said would continue under a different doctor.

You can get an idea of the studies that might be affected by checking out Clinicaltrials.gov. A search this morning shows several active industry-supported trials, including one using J&J’s Concerta to curb smoking in youngsters with ADHD.

Abbott’s been selling its blockbuster drug Humira since 2002. But it was just a few days ago that Bayer sued Abbott in federal court, arguing that Humira infringes on a patent granted to Bayer in 1997.

Here’s a copy of the complaint, filed in the Eastern District of Texas; here’s the Bayer patent.

There’s a simple logic to the filing: Bayer’s patent is on monoclonal antibodies that bind to a protein called TNF-alpha, and Humira is a monoclonal antibody that binds to TNF-alpha. The company wants to be awarded damages.

But an Abbott spokesman told Dow Jones Newswires that “Humira does not infringe Bayer’s patent and Abbott believes that Bayer’s patent is invalid.”

Humira is approved to treat rheumatoid arthritis and Crohn’s disease, among other ailments. Abbott sold more than $3 billion of the drug in the first nine months of this year.

Richard Daines, the MD who runs the New York State Health Department, has rounded up a few props and grabbed himself a video camera to support a proposed state tax on sugary sodas.

The video, which feels like something we saw on a cable access channel in 1989, has been watched about 16,000 times since it was posted it to YouTube a few days ago.

The basic argument: Each New Yorker now drinks the equivalent of 11 cans of soda a week, up from five cans a week in 1970. Three of the six additional sodas per capita are sweetened with sugar.

Three cans per week adds up to “13 more pounds of straight sugar” a year, he says as he hauls out a giant jar of sugar to illustrate the point. (That’s about 21,000 calories worth of sugar, by the way.) Daines also points out that 34% of NY children are overweight or obese.

Gov. David Paterson recently proposed adding an 18% tax on sugar-sweetened drinks as part of a package of spending cuts and tax hikes aimed at closing the state’s yawning budget gap. A health department spokeswoman told the Daily News that Daines shot the video in response to a poll that found New Yorkers opposed to the new tax by a margin of 60% to 37%.

The WSJ’s Melinda Beck devotes this week’s Health Journal column to odd ailments. One that caught our attention: foreign accent syndrome.

We’d never heard of it before, but as it turns out the medical literature is full of case reports. The problem typically follows a stroke or head injury, and is the result of brain damage that changes the speed and stresses of speech. The patient doesn’t adopt a particular foreign accent, but winds up speaking his or her native language like someone who learned it as a second language.

A few before-and-after examples are available online. Researchers at the University of Texas at Dallas took “before” clips from a recording of a family reunion, and then had the patient record “after” clips in a studio. She goes from a bit twangy to vaguely French (at least, that’s how it sounds to our ear).

In this ABC News video a Michigan native’s accent goes from Upper-Midwest nasal to something more Germanic. “I go grocery shopping and the clerk will say, ‘You’re not from around here are you?’ she tells the interviewer. “Well, yes. As a matter of fact I am.”

Image: iStockphoto

Five … Four … Three … Two … Say, is there time for me to get that hip replacement before my deductible resets?

The end-of-year health-care boom is upon us, as legions of the insured rush in for care before 2008 runs out.

The rush is driven by largely patients who’ve already paid their deductible for the year, which means insurance will cover most of the cost of approved elective procedures, the Minneapolis Star-Tribune reports.

Flexible spending accounts that set aside pre-tax dollars for health-related expenses also expire with the new year, adding another incentive for health-care shoppers.

“The wave of last-minute surgeries rode on top of a busy acute illness period for us,” a local hospital exec told the paper. “Surgeons are operating later into the night.”

Year-End Flashback: Last December, country doc Ben Brewer described how the year-end rush reveals the flaws in our insurance system.

Photo: Associated Press

Federal tobacco policy could soon be in for some big changes. High on the list: increasing cigarette taxes to fund health insurance for children, and giving the FDA the power to regulate cigarettes.

Both have been topics of debate for years; this morning’s New York Times has an update that says Democrats’ control of the White House and Congress will likely be enough to push the changes through.

Sen. Ted Kennedy (D., Mass.) has long been pushing a bill (cosponsored by then-Senator Obama) that would give the FDA power to regulate tobacco. Even Philip Morris backs the bill. Obama hasn’t taken an official stance on the measure as president-elect, but its passage is likely this year, the NYT says.

The Dems have also been pushing a legislation that would raise cigarette taxes by 61 cents, to $1 a pack, and use the money to fund an expansion of SCHIP, the State Children’s Health Insurance Program. A version of that bill passed Congress twice in recent years but was vetoed by President Bush. Dems in Congress are so eager to act on the bill, the NYT says, that it may be waiting for Obama when he takes office later this month.

Photo by Bloomberg News/Landov

The recession is hitting insurance giant Cigna coming and going. The company said late yesterday that it’s cutting 1,100 jobs, or 4% of its workers.

As the WSJ reminds us, the company took a nasty hit last year on investments related to its variable-annuity death-benefits business — a small unit that doesn’t even sell policies anymore. But the losses were big enough to make the company trim its 2008 earnings forecast.

On top of that, Cigna is forecasting a decline in health-plan enrollment in 2009 — a problem that’s growing common in the industry as employers faced with the economic pinch cut back on employees and benefits. Aetna said last month that it was cutting 1,000 jobs.

About 1,000 of Cigna’s cuts will be in the U.S. The company will take a fourth-quarter charge of $30 million to $40 million related to cutting jobs and closing down some offices.

Image: iStockphoto

It’s a tough time to be in the drug business — lots of generic competition, and plenty of scrutiny from regulators wary of approving new drugs too quickly.

But those same forces are slowing the rise in health-care spending. A paper published today in Health Affairs found that in 2007, total U.S. health care spending grew by 6.1% — the slowest rate since 1998.

The main reason for the overall slowdown was the 4.9% growth in prescription drug spending, the lowest rate in decades. In recent years, cheap generics of some of the industry’s biggest sellers have become available, including copycats of Merck’s cholesterol-fighter Zocor, Johnson & Johnson’s antipsychotic Risperdal and Pfizer’s antidepressant Zoloft.

Still, spending on health care continued to grow faster than the economy as a whole in 2007, reaching 16.2% of GDP. Total bill: $2.2 trillion, or $7,421 per person.

The complete numbers for 2008 aren’t in yet. But in October, IMS Health estimated that prescription drugs sales growth for the year could be 2% or lower, as the recession added to the industry’s existing woes.

Health Blog (Alleged) Medicaid Scam of the Week: Offer prospective “patients” beer if they’ll agree to enter your detox program.

Seven hospitals in New York State are accused of bilking Medicaid of some $50 million. Lawsuits filed by the state attorney general and U.S. attorney say the hospitals paid patients kickbacks (allegedly including beer in some instances) to enroll in drug treatment programs and billed Medicaid for services that weren’t standard or necessary and lacked state certification.

The New York Post broke the story yesterday; here’s more coverage from the Associated Press and Newsday. Today, the Post reports that two whistleblowers helped authorities uncover the alleged scam.

New York has a gargantuan Medicaid program — the biggest in the country at more than $44 billion as of FY ‘06, according to one source — so it’s not surprising that something like this should spring up in the weeds. Still, the details are pretty striking.

More than 14,000 fraudulent claims were filed, according to the lawsuits. At least one hospital allegedly paid people to search homeless shelters and for patients to enter a three-day stay detox in exchange for cigarettes, beer, food, and other items.

All of the hospitals accused in the suits worked with Special Care Hospital Management, based in Missouri. The hospitals and the management company have denied the charges and filed motions to have the cases dismissed.

Photo by mrmatt via Flickr

Voting is now opened for the 2008 Weblog Awards, and we would kindly ask you to take a minute and vote for World of Psychology today (no registration required):

Best Medical/Health Issues Blog

We are the only blog listed in this category that represents the broad topic area of mental health and psychology. Thank you for your continued support and appreciation!

One more warning about the status of hospitals in the US, and she gets right to the point, the first statement pretty much says it all below, and the comment about Medicare makes sense too, making a larger crowd and a varied mix of patients, if 55 were a starting point, it would add younger and healthier patients to the entire mix, thus making it perhaps easier to spread the cost as well.  I can see why she is searched for speaking and opinion statements relative to hospital care.  BD 

“There are only three ways to save money in the healthcare system -- you serve fewer people, you provide fewer services, or you pay less for the services you provide.”

“For 2009, the biggest challenge will be getting paid. Like the rest of the economy, hospitals are not recession proof.”

“And then I think 65 is too old as a entry point for Medicare. I think if they let people participate starting at 55, you'd add a much healthier group of people, so the price would go down.”

On many occasions, Linda Quick is the voice for healthcare in the region. As president of the South Florida Hospital and Healthcare Association, she represents more than 100 entities in an area that stretches from Key West to St. Lucie County. When a television station needs a comment, a reporter has even gone so far as to track her down at the association's annual golfing event.

Ailing economy affects hospitals' health - Business - MiamiHerald.com

Technorati Tags: Hospitals,Healthcare,Recession,Medicare,Florida

MedGadget has announced this blog as a finalist for the the 2008 (fifth annual) Medical Weblog Award in the Health Policy and Ethics category.

Please vote here.

Long before Dana Jennings blogged about prostate cancer, he wrote about it for himself.

The stakes cannot be higher for Boston's Tufts Medical Center.

Over the past few weeks, we've been reading how rival Partners HealthCare, comprised of powerhouse hospitals Massachusetts General and Brigham and Women's Hospitals, have bullied health insurers into disproportionally higher payments.

I have argued it is because patients demand their services.

Now, Tufts Medical Center is attempting to play the same game, announcing they are no longer accepting the state's largest insurer, Blue Cross Blue Shield HMO.

As always, patients will determine whether this gambit is successful. If they continue to demand Tufts care, they will switch insurers, forcing Blue Cross' hand. If not, then the hospital will lose and acquiesce to the lower payments. It's as simple as that, and this is the beginning of a public relations war that will be decided by advertising dollars.

Does Tufts have the cachet of a MGH or Brigham? My gut says no, since they don't have the name appeal of the Partners brand.

Endocrinologists are puzzled over the Apple chief executive's medical condition.

Steve Jobs disclosed a cryptic letter today detailing his health condition. It reads, "As many of you know, I have been losing weight throughout 2008. The reason has been a mystery to me and my doctors. A few weeks ago, I decided that getting to the root cause of this and reversing it needed to become my #1 priority.

Fortunately, after further testing, my doctors think they have found the cause -- a hormone imbalance that has been "robbing" me of the proteins my body needs to be healthy. Sophisticated blood tests have confirmed this diagnosis.

The remedy for this nutritional problem is relatively simple and straightforward, and I've already begun treatment. But, just like I didn't lose this much weight and body mass in a week or a month, my doctors expect it will take me until late this Spring to regain it."

It is known that Jobs underwent a modified Whipple procedure in 2004 to remove a pancreatic neuroendocrine tumor.

MedPage Today talked with several prominent endocrinologists who did little to clarify the situation.

Said Yale's Elizabeth Holt, "My best guess is that he was not absorbing nutrients from his diet because he lacked the necessary pancreatic enzymes to digest his food. That can happen if a large portion of the pancreas is removed at surgery."

The Mayo Clinic's Adrian Vella adds, "Deficiencies in digestive enzymes make patients vulnerable to changes in diet, impairing nutrient absorption and potentially leading to weight loss." He also considers that "the pancreatic remnant may have failed."

The WSJ Health Blog also discusses the case with Michael D. Jensen, another Mayo endocrinologist, and speculates that "it's possible that the tumor has recurred, perhaps on the pancreas or the liver, and is upsetting hormonal signals involved in digestion."

Other possibilities include a thyroid disorder, says Bernard A. Roos of the University of Miami. He also considers "low levels of growth hormone due to a chronic illness."

Endocrinologists are getting their time in the medical punditry limelight, but the bottom line is that no one really knows what's wrong with Steve Jobs.