COPD Exacerbations Increase the Likelihood of Repeat Exacerbations
New research shows that individual exacerbations in chronic obstructive lung disease (COPD) increase the likelihood of repeat exacerbations, even after 5 days of full, asymptomatic recovery.
"This concept that exacerbations are not random has important implication for the analysis of clinical trial data and identifies a specific high-risk period for recurrent exacerbation during which preventative interventions might be targeted," wrote lead author, John Hurst, MD, of the Royal Free and University College Medical School, London.
Prior to this research, exacerbations were assumed to be isolated events unrelated to one another despite observational data that suggested a dependency. In patients with COPD, exacerbations are generally defined as an acute worsening of symptoms, which can decrease lung function, ultimately driving the progression of the disease. Many patients never recover their baseline level of lung function after exacerbations.
To test the validity of this assumption, Hurst and colleagues analyzed daily symptom diaries that were kept for at least one year by 297 patients with COPD, describing nearly 2,000 distinct exacerbation events. Two or more new or worsening symptoms, one of which must be "major" (dyspnea, more sputum, or a change in color of sputum) constituted an exacerbation, and after 5 days of symptoms reverting to baseline severity, the exacerbation was considered to be over. A second exacerbation occurring within an 8-week period was considered to be a recurrent exacerbation. The researchers further analyzed seasonality of exacerbations, comparing their winter (November to January) frequency with their summer (June through August) frequency.
The researchers identified an 8-week period of time during which monitoring and follow-up is crucial to prevent or minimize further exacerbations in the COPD patient. "Our finding of a high-risk period for recurrent exacerbation may be important in guiding patient follow-up," wrote Hurst.
The researchers also found that exacerbations were significantly more common in the winter than the summer. They also noted that "isolated" exacerbations tended on average to be about 25% more severe than the first of serial exacerbations.
"The mechanisms of exacerbation recurrence remain unexplored, and it is unknown whether recurrence is due to persistence of an existing organism or to acquisition of a new one," said Hurst. "The failure to eradicate bacteria with exacerbation therapy has been associated with an incomplete recovery in inflammatory markers and we have recently reported a relationship between elevated C-reactive protein during the recovery period of an initial exacerbation and shorter time to the next."
Results of the study appear in the first issue for March of the American Journal of Respiratory and Critical Care Medicine.
Saturday, February 21, 2009
Sunday, February 15, 2009
Roy Masters demonstrates the hidden hypnotic connection to smoking, and the one simple thing you need to learn and practice to stop permanently.
Smoking-related diseases claim an estimated 430,700 American lives each year. Smoking costs the United States approximately $97.2 billion each year in health-care costs and lost productivity. It is directly responsible for 87 percent of lung cancer cases and causes most cases of emphysema and chronic bronchitis.
Learn how to Quit smoking, cigarettes and other addictions in this simple lesson.
Smoking-related diseases claim an estimated 430,700 American lives each year. Smoking costs the United States approximately $97.2 billion each year in health-care costs and lost productivity. It is directly responsible for 87 percent of lung cancer cases and causes most cases of emphysema and chronic bronchitis.
Learn how to Quit smoking, cigarettes and other addictions in this simple lesson.
Friday, February 13, 2009
Emphasys Medical, maker of a valve that diverts air to only the healthy parts of lungs in emphysema patients, has put itself up for sale after the Food and Drug Administration rejected its lead product in December. This is the second relatively recent defeat for the Redwood City, Calif.-based company, which had to withdraw its IPO filing last May. Since then, all but five of its 50 employees have been laid off.
Tuesday, February 10, 2009
FDA Advisers Recommend Rejection of Airway Valve for Emphysema
By Emily P. Walker, Washington Correspondent, MedPage TodayPublished: December 05, 2008Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
GAITHERSBURG, Md., Dec. 5 -- An FDA advisory panel recommended today against agency approval of a first-of-its-kind one-way airway valve for emphysema patients, a device billed as a noninvasive substitute for lung volume-reduction surgery.
By an 11-2 vote, the Anesthesiology and Respiratory Therapy Device Panel found insufficient evidence of benefit to outweigh the risks of implanting the Zephyr Endobronchial Valve, manufactured by Emphasys Medical of Redwood City, Calif.
The panel was chaired by anesthesiologist David Birnbach, M.D., M.P.H., of the University of Miami. The affirmative votes were from two pulmonologists, Andrew Reis, M.D., of the University of California San Diego, and Philip Marcus, M.D., of the University of Arizona in Tuscan.
Drs. Marcus and Reis argued that the panel should recommend approving the device with some caveats, such as demanding an immediate post-market study, but the panel voted against approving the device with added conditions.
"Once you approve, the cat is out of the bag," said panel member Hugh Cassiere, M.D., director of the cardiothoracic unit at North Shore University Hospital in Manhasset, N.Y. "Approving a product just to continue research is not justified," he said.
But panel members seemed as upset as the company with the decision.
"It kind of breaks my heart to vote against this," said Stephen Li, Ph.D., of the Medical Device Testing and Innovations in Windsor, N.J. "The panel recognized how few options exist for emphysema patients."
"It's an interesting technology that is not ready for prime time," said panel member Thomas Vassiliades, M.D., of Emory in Atlanta, a cardiothoracic surgeon.
The FDA is not obliged to follow an advisory panel's recommendations but it usually does.
The Zephyr device is a removable one-way valve that is implanted by fiberoptic bronchoscopy into the diseased lobe in the lung. The purported mechanism of the valve is to reduce thoracic gas volume by preventing air from entering while still allowing trapped gas to escape.
The device limits the amount of air intake for an emphysema patient, and offers an alternative to the more risky lung volume reduction surgery for some patients, said pulmonologist Frank Sciurba, M.D., of the University of Pittsburgh, who was principal investigator for the key clinical trial, VENT.
For the Endobronchial Valve for Emphysema Treatment Trial (VENT), researchers randomized 221 patients to receive either the Zephyr endobronchial valve, or standard treatment. The tria l was multicenter, prospective, and unblinded.
The primary efficacy endpoint was at least a 15% change from baseline on two respiratory tests. The first test measured how much a patient could breathe out in one second while breathing as fast as possible, and the second tested how far a patient could walk in six minutes. Patients had these two tests at one, three, six and 12 months post-valve implantation.
The trial prespecified the six-month follow-up as the time to use to determine success of the treatment. At six months, the groups receiving the valve performed better on both tests than the control group (P=0.002 for breath test and P=0.019 for walk test), although the difference was much less than the prespecified 15% improvement.
At 12 months, the results of the 6-minute walking test dropped below statistical significance. Other secondary tests, including one to gauge quality of life, were also no different between the two arms at one year.
But perhaps the most striking result, according to pulmonologist Deborah Shure, M.D., Master FCCP, a consultant for the FDA, was the number of deaths in the valve group at six months. While no deaths were reported during that period in the control group, six patients died in the valve group before the half-year mark. All but one of those deaths was COPD-related. Dr. Shure gave a clinical review of the trial before the panel.
The mortality differences between the two groups are not so alarming considering that the valve group had twice the number of patients as the control group, said Armin Ernst, M.D., an interventional pulmonologist at Beth Israel Deaconess Medical Center in Boston, who spoke on behalf of Emphasys Medical. The company determined that there was not an increased mortality in the valve group.
But mortality rates aside (which were similar in the two arms at one year), other serious negative outcomes appeared to hit the valve group harder at the one-year mark.
The valve group had higher rates of serious adverse events related to COPD than the control group (23% versus 10%, P=0.01). They were also more likely to be hospitalized (39.7% versus 25.3%, P=0.024).
Ultimately, the panel agreed that the safety of the device was not the biggest issue.
"The risks are not huge," said Dr. Vassiliades, the panel member. "They are not insignificant either." But "the benefits are inadequate to overcome the risks."
"It's an irreversible disease," said Dr. Marcus. "What else can we really offer these people?"
The lead researcher of the trial said Emphasys likely will not continue on with its research.
"This was an $80 million study," said Dr. Sciurba. "There will be no resources for this company to complete it, and I fear this technology will die."
He said there are several other companies with similar technology, but this was, by far, the farthest along trial. (See: CHEST: Investigational Valve May Help In Emphysema)
"I feel it's a loss for choice in an otherwise bleak situation," Dr. Sciurba said after the vote.
Dr. Sciurba said he received no consultation fees from Emphasys. He is also an investigator on the NIH-sponsored National Emphysema Treatment Trial.
By Emily P. Walker, Washington Correspondent, MedPage TodayPublished: December 05, 2008Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
GAITHERSBURG, Md., Dec. 5 -- An FDA advisory panel recommended today against agency approval of a first-of-its-kind one-way airway valve for emphysema patients, a device billed as a noninvasive substitute for lung volume-reduction surgery.
By an 11-2 vote, the Anesthesiology and Respiratory Therapy Device Panel found insufficient evidence of benefit to outweigh the risks of implanting the Zephyr Endobronchial Valve, manufactured by Emphasys Medical of Redwood City, Calif.
The panel was chaired by anesthesiologist David Birnbach, M.D., M.P.H., of the University of Miami. The affirmative votes were from two pulmonologists, Andrew Reis, M.D., of the University of California San Diego, and Philip Marcus, M.D., of the University of Arizona in Tuscan.
Drs. Marcus and Reis argued that the panel should recommend approving the device with some caveats, such as demanding an immediate post-market study, but the panel voted against approving the device with added conditions.
"Once you approve, the cat is out of the bag," said panel member Hugh Cassiere, M.D., director of the cardiothoracic unit at North Shore University Hospital in Manhasset, N.Y. "Approving a product just to continue research is not justified," he said.
But panel members seemed as upset as the company with the decision.
"It kind of breaks my heart to vote against this," said Stephen Li, Ph.D., of the Medical Device Testing and Innovations in Windsor, N.J. "The panel recognized how few options exist for emphysema patients."
"It's an interesting technology that is not ready for prime time," said panel member Thomas Vassiliades, M.D., of Emory in Atlanta, a cardiothoracic surgeon.
The FDA is not obliged to follow an advisory panel's recommendations but it usually does.
The Zephyr device is a removable one-way valve that is implanted by fiberoptic bronchoscopy into the diseased lobe in the lung. The purported mechanism of the valve is to reduce thoracic gas volume by preventing air from entering while still allowing trapped gas to escape.
The device limits the amount of air intake for an emphysema patient, and offers an alternative to the more risky lung volume reduction surgery for some patients, said pulmonologist Frank Sciurba, M.D., of the University of Pittsburgh, who was principal investigator for the key clinical trial, VENT.
For the Endobronchial Valve for Emphysema Treatment Trial (VENT), researchers randomized 221 patients to receive either the Zephyr endobronchial valve, or standard treatment. The tria l was multicenter, prospective, and unblinded.
The primary efficacy endpoint was at least a 15% change from baseline on two respiratory tests. The first test measured how much a patient could breathe out in one second while breathing as fast as possible, and the second tested how far a patient could walk in six minutes. Patients had these two tests at one, three, six and 12 months post-valve implantation.
The trial prespecified the six-month follow-up as the time to use to determine success of the treatment. At six months, the groups receiving the valve performed better on both tests than the control group (P=0.002 for breath test and P=0.019 for walk test), although the difference was much less than the prespecified 15% improvement.
At 12 months, the results of the 6-minute walking test dropped below statistical significance. Other secondary tests, including one to gauge quality of life, were also no different between the two arms at one year.
But perhaps the most striking result, according to pulmonologist Deborah Shure, M.D., Master FCCP, a consultant for the FDA, was the number of deaths in the valve group at six months. While no deaths were reported during that period in the control group, six patients died in the valve group before the half-year mark. All but one of those deaths was COPD-related. Dr. Shure gave a clinical review of the trial before the panel.
The mortality differences between the two groups are not so alarming considering that the valve group had twice the number of patients as the control group, said Armin Ernst, M.D., an interventional pulmonologist at Beth Israel Deaconess Medical Center in Boston, who spoke on behalf of Emphasys Medical. The company determined that there was not an increased mortality in the valve group.
But mortality rates aside (which were similar in the two arms at one year), other serious negative outcomes appeared to hit the valve group harder at the one-year mark.
The valve group had higher rates of serious adverse events related to COPD than the control group (23% versus 10%, P=0.01). They were also more likely to be hospitalized (39.7% versus 25.3%, P=0.024).
Ultimately, the panel agreed that the safety of the device was not the biggest issue.
"The risks are not huge," said Dr. Vassiliades, the panel member. "They are not insignificant either." But "the benefits are inadequate to overcome the risks."
"It's an irreversible disease," said Dr. Marcus. "What else can we really offer these people?"
The lead researcher of the trial said Emphasys likely will not continue on with its research.
"This was an $80 million study," said Dr. Sciurba. "There will be no resources for this company to complete it, and I fear this technology will die."
He said there are several other companies with similar technology, but this was, by far, the farthest along trial. (See: CHEST: Investigational Valve May Help In Emphysema)
"I feel it's a loss for choice in an otherwise bleak situation," Dr. Sciurba said after the vote.
Dr. Sciurba said he received no consultation fees from Emphasys. He is also an investigator on the NIH-sponsored National Emphysema Treatment Trial.
Saturday, February 7, 2009
from About.com Guide to COPD
Impact of Nutrition on Body Functioning in COPD
Friday February 6, 2009
While it is quite clear that good nutrition leads to better health, many of us wholeheartedly pay no heed to this fact as we joyfully pound down our Big Macs, triple Quarter-Pounders with cheese and 64 ounce Coca-Colas!
The truth is that a sound diet has many benefits, including weight reduction, higher energy levels, and a general improvement in overall well-being. But what about the affects of good nutrition on chronic obstructive pulmonary disease? Can a healthy diet alone actually prevent or somehow alter the course of this and other chronic lung diseases?
A recent study found that indeed, different dietary factors, (dietary patterns, foods, nutrients) do appear to be associated with COPD and its inevitable course. However, the study also found that other factors such as energy imbalance, muscle atrophy (from disuse), hypoxemia, systemic inflammation (inflammation affecting the entire body) and a mechanical disadvantage, are also known to contribute to the compromise of total body function in patients with COPD. Is the key then, to improve nutritional status and reduce these known, comprimising factors?
The study supported this idea, as it concluded that that nutritional intervention makes it possible to change the course and perhaps even the prognosis of COPD, but it MUST be combined with other interventional factors, including pulmonary rehabilitation, combining the use of bronchodilators effectively, controlling infection and exercise.
With this study in mind, here are some links that many help to improve your nutritional status and get you started on a basic, exercise plan:
Nutritional Guidelines for People with COPD
By Deborah Trendel, RN,
Impact of Nutrition on Body Functioning in COPD
Friday February 6, 2009
While it is quite clear that good nutrition leads to better health, many of us wholeheartedly pay no heed to this fact as we joyfully pound down our Big Macs, triple Quarter-Pounders with cheese and 64 ounce Coca-Colas!
The truth is that a sound diet has many benefits, including weight reduction, higher energy levels, and a general improvement in overall well-being. But what about the affects of good nutrition on chronic obstructive pulmonary disease? Can a healthy diet alone actually prevent or somehow alter the course of this and other chronic lung diseases?
A recent study found that indeed, different dietary factors, (dietary patterns, foods, nutrients) do appear to be associated with COPD and its inevitable course. However, the study also found that other factors such as energy imbalance, muscle atrophy (from disuse), hypoxemia, systemic inflammation (inflammation affecting the entire body) and a mechanical disadvantage, are also known to contribute to the compromise of total body function in patients with COPD. Is the key then, to improve nutritional status and reduce these known, comprimising factors?
The study supported this idea, as it concluded that that nutritional intervention makes it possible to change the course and perhaps even the prognosis of COPD, but it MUST be combined with other interventional factors, including pulmonary rehabilitation, combining the use of bronchodilators effectively, controlling infection and exercise.
With this study in mind, here are some links that many help to improve your nutritional status and get you started on a basic, exercise plan:
Nutritional Guidelines for People with COPD
By Deborah Trendel, RN,
Thursday, February 5, 2009
NEW YORK, Feb 05, 2009 (BUSINESS WIRE) -- Reportlinker.com announces that a new market research report related to the Medical devices industry is available in its catalogue.
Home Medical Equipment Market in the US
http://www.reportlinker.com/p0100131/Home-Medical-Equipment-Market-in-the-US.html
US market to approach $8 billion in 2012
The US market for home medical equipment is forecast to increase nearly six percent annually to $7.9 billion in 2012. Growth opportunities will be divided among several groups of therapeutic and patient support products. Respiratory therapy equipment will remain the topselling product group based on the increasing prevalence of chronic obstructive pulmonary disease (COPD) and other conditions that cause breathing difficulties. Ongoing improvements in performance and portability features, coupled with widespread insurance coverage, will broaden the use of breathing-assist devices -- such as oxygen concentrators, liquid oxygen tanks and continuous positive airway pressure (CPAP) machines -- among home patients.
Home mobility devices demand to remain strong
Home mobility devices -- including wheelchairs, scooters, specialized lifts, canes and walkers -- will continue to see robust demand as aging demographic patterns lead to an increasing prevalence of orthopedic impairments. Upward trends in the number of orthopedic patients will also benefit growth opportunities for medical furniture and bathroom safety products. Efforts to control escalating health care costs will promote the transfer of IV drug delivery and dialysis procedures from medical facilities to patient homes, impacting favorably on home sales of IV pumps and accessories and peritoneal dialysis devices. An increasing emphasis on preventive medicine will broaden the home health care market for numerous patient monitors. Based on number of potential patients and potential to reduce health complications, monitors for blood glucose, blood pressure, and heart and respiratory functions will continue to post the largest demand. Additionally, home alert systems will form an attractive, rapidly growing niche in the marketplace as they enable most elderly individuals to live independently without direct supervised care.
More distribution channels, technology to support gains
Advances in technology, coupled with the expansion of distribution channels, represent two additional factors that will contribute to growth opportunities for home medical equipment. Advances in technology will increase the range of therapeutic and patient support equipment available for home applications. The diversification of medical facilities and retail establishments -- such as drug stores and mass merchandisers -- into home health care services is expanding the accessibility of home medical equipment to a widening percentage of the population.
Study coverage
This new industry study, Home Medical Equipment, presents historical demand data (1997, 2002 and 2007) plus forecasts for 2012 and 2017 by product type. The study also assesses key market environment factors, evaluates company market share and profiles 34 competitors in the US industry.
Home Medical Equipment Market in the US
http://www.reportlinker.com/p0100131/Home-Medical-Equipment-Market-in-the-US.html
US market to approach $8 billion in 2012
The US market for home medical equipment is forecast to increase nearly six percent annually to $7.9 billion in 2012. Growth opportunities will be divided among several groups of therapeutic and patient support products. Respiratory therapy equipment will remain the topselling product group based on the increasing prevalence of chronic obstructive pulmonary disease (COPD) and other conditions that cause breathing difficulties. Ongoing improvements in performance and portability features, coupled with widespread insurance coverage, will broaden the use of breathing-assist devices -- such as oxygen concentrators, liquid oxygen tanks and continuous positive airway pressure (CPAP) machines -- among home patients.
Home mobility devices demand to remain strong
Home mobility devices -- including wheelchairs, scooters, specialized lifts, canes and walkers -- will continue to see robust demand as aging demographic patterns lead to an increasing prevalence of orthopedic impairments. Upward trends in the number of orthopedic patients will also benefit growth opportunities for medical furniture and bathroom safety products. Efforts to control escalating health care costs will promote the transfer of IV drug delivery and dialysis procedures from medical facilities to patient homes, impacting favorably on home sales of IV pumps and accessories and peritoneal dialysis devices. An increasing emphasis on preventive medicine will broaden the home health care market for numerous patient monitors. Based on number of potential patients and potential to reduce health complications, monitors for blood glucose, blood pressure, and heart and respiratory functions will continue to post the largest demand. Additionally, home alert systems will form an attractive, rapidly growing niche in the marketplace as they enable most elderly individuals to live independently without direct supervised care.
More distribution channels, technology to support gains
Advances in technology, coupled with the expansion of distribution channels, represent two additional factors that will contribute to growth opportunities for home medical equipment. Advances in technology will increase the range of therapeutic and patient support equipment available for home applications. The diversification of medical facilities and retail establishments -- such as drug stores and mass merchandisers -- into home health care services is expanding the accessibility of home medical equipment to a widening percentage of the population.
Study coverage
This new industry study, Home Medical Equipment, presents historical demand data (1997, 2002 and 2007) plus forecasts for 2012 and 2017 by product type. The study also assesses key market environment factors, evaluates company market share and profiles 34 competitors in the US industry.
Wednesday, February 4, 2009
this story came from the wenatcha wa paper wenatcheeworld
A program for people with chronic illnesses that is being tested at Wenatchee Valley Medical Center could save the federal government billions of dollars if it were used for Medicare patients nationwide, a medical center official said.
The federal government will expand the test program to more patients in Wenatchee and other areas before deciding whether to make it available to all Medicare recipients who have one of three costly diseases.
At the program’s core is the Health Buddy, an electronic device into which patients enter specifics about their disease every day. It helps doctors catch serious problems before they escalate, officials say.
"We keep patients out of the emergency room and the hospital. There’s nothing magic about what we’ve done," said Dr. David Weber, CEO of Wenatchee Valley Medical Center. About 450 Medicare patients have been using the device for the last three years.
The patients all have one of three conditions — diabetes, congestive heart failure or chronic obstructive pulmonary disease, known as COPD.
They are asked to answer a dozen questions daily, including specific information related to their condition, such as blood sugar level, and the results are checked daily by health care professionals. A doctor is alerted if necessary.
Those patients were compared with another group of Medicare patients who didn’t have a Health Buddy. Depending on the illness, hospital admissions and stays dropped by 20 to 30 percent for patients with a Health Buddy, said Derek Newell, CEO of Health Hero, the California company that makes the device.
They’ve had the same kind of success in a four-year study of more than 10,000 veterans through the U.S. Department of Veterans Affairs, he said.
Newell said Health Hero’s goal was to reduce the cost of treating chronic illnesses by 5 percent, and they exceeded it.
Weber said the percentage of savings is in the double digits. "There are potentially billions of dollars to be saved with this kind of model, if we could extend it to the entire Medicare population," he said.
He said it may be difficult for smaller clinics to replicate the success at Wenatchee Valley Medical Center because they may not have sufficient staff to check answers from patients every day or be able to schedule an appropriate appointment when problems arise.
Newell said patients with the three chronic illnesses tested in the Health Buddy program represent only about 10 percent of the Medicare population, but those patients cost the system 50 to 75 percent of total costs.
"Even with a small percent of the patients, you impact a big percentage of the costs," he said.
Medicare wants to expand the number of patients using the Health Buddy at both Wenatchee Valley Medical Center and a clinic in Bend, Ore., and bring it to other clinics that haven’t yet been selected, Newell said.
Lori Smet, nurse case manager at Wenatchee Valley Medical Center who coordinates the Health Buddy program, said they’ll be looking to keep current patients in the study and add about 1,000 more patients from around the region.
Smet said she finds that patients who use the Health Buddy tend to pay more attention to their health.
"Part of the effect is they know somebody is checking in on them on a daily basis, and that really gives them an added incentive to do what they’re supposed to be doing," she said.
Weber said he was in Washington, D.C., last week to meet with lawmakers from Washington state, and told them about the pilot study and the initial success.
He said he’s hoping the program will be included in some of the health care reform legislation that is now being drafted.
"It’s very, very consistent with the new president’s mantra," added Newell. "It has to improve quality and reduce costs, and this dramatically reduces costs and improves quality. It’s one of the very few projects out there that meets that criteria," he said.
K.C. Mehaffey: 997-2512
mehaffey@wenatcheeworld.com
A program for people with chronic illnesses that is being tested at Wenatchee Valley Medical Center could save the federal government billions of dollars if it were used for Medicare patients nationwide, a medical center official said.
The federal government will expand the test program to more patients in Wenatchee and other areas before deciding whether to make it available to all Medicare recipients who have one of three costly diseases.
At the program’s core is the Health Buddy, an electronic device into which patients enter specifics about their disease every day. It helps doctors catch serious problems before they escalate, officials say.
"We keep patients out of the emergency room and the hospital. There’s nothing magic about what we’ve done," said Dr. David Weber, CEO of Wenatchee Valley Medical Center. About 450 Medicare patients have been using the device for the last three years.
The patients all have one of three conditions — diabetes, congestive heart failure or chronic obstructive pulmonary disease, known as COPD.
They are asked to answer a dozen questions daily, including specific information related to their condition, such as blood sugar level, and the results are checked daily by health care professionals. A doctor is alerted if necessary.
Those patients were compared with another group of Medicare patients who didn’t have a Health Buddy. Depending on the illness, hospital admissions and stays dropped by 20 to 30 percent for patients with a Health Buddy, said Derek Newell, CEO of Health Hero, the California company that makes the device.
They’ve had the same kind of success in a four-year study of more than 10,000 veterans through the U.S. Department of Veterans Affairs, he said.
Newell said Health Hero’s goal was to reduce the cost of treating chronic illnesses by 5 percent, and they exceeded it.
Weber said the percentage of savings is in the double digits. "There are potentially billions of dollars to be saved with this kind of model, if we could extend it to the entire Medicare population," he said.
He said it may be difficult for smaller clinics to replicate the success at Wenatchee Valley Medical Center because they may not have sufficient staff to check answers from patients every day or be able to schedule an appropriate appointment when problems arise.
Newell said patients with the three chronic illnesses tested in the Health Buddy program represent only about 10 percent of the Medicare population, but those patients cost the system 50 to 75 percent of total costs.
"Even with a small percent of the patients, you impact a big percentage of the costs," he said.
Medicare wants to expand the number of patients using the Health Buddy at both Wenatchee Valley Medical Center and a clinic in Bend, Ore., and bring it to other clinics that haven’t yet been selected, Newell said.
Lori Smet, nurse case manager at Wenatchee Valley Medical Center who coordinates the Health Buddy program, said they’ll be looking to keep current patients in the study and add about 1,000 more patients from around the region.
Smet said she finds that patients who use the Health Buddy tend to pay more attention to their health.
"Part of the effect is they know somebody is checking in on them on a daily basis, and that really gives them an added incentive to do what they’re supposed to be doing," she said.
Weber said he was in Washington, D.C., last week to meet with lawmakers from Washington state, and told them about the pilot study and the initial success.
He said he’s hoping the program will be included in some of the health care reform legislation that is now being drafted.
"It’s very, very consistent with the new president’s mantra," added Newell. "It has to improve quality and reduce costs, and this dramatically reduces costs and improves quality. It’s one of the very few projects out there that meets that criteria," he said.
K.C. Mehaffey: 997-2512
mehaffey@wenatcheeworld.com
Humidifiers: Moisture in the air eases skin, breathing symptomsHumidifiers can ease problems caused by dry air. But, they need regular maintenance. Here are tips to ensure your humidifier doesn't become a household health hazard. http://www.mayoclinic.com/health/humidifiers/HQ00076
Tuesday, February 3, 2009
Get Everything Done: Live longer, live healthier : Be positive...By IDEAL Emphysema. How to put a positive spin on negative thoughts. Self-talk — the inner monologue sometimes referred to as automatic thinking — can be positive or negative. When the theme of your self-talk is mostly negative, ...Get Everything Done - http://mynameisideal.blogspot.com/ Newly described contaminant sources in Katrina-flooded homes pose ...New research suggests that cadmium is one of the critical ingredients causing emphysema, and even low-level exposure attained through second-hand smoke and other means may also increase the chance of developing lung disease. ...Brightsurf Science News :: Ecology News - http://www.brightsurf.com/ love: caseBy shine Chronic obstructive pulmonary disease (COPD) is a disease state in which airflow is obstructed by emphysema, chronic bronchitis or both. The airflow obstruction is usually progressive, irreversible, and associated with airway ...love - http://love-shine-love.blogspot.com/ Usmagazine.com News - Ashton Kutcher Defends Michael Phelps Over ...By Mandi Illuzzi Marijuana smokers are at a high risk of developing lung cancer, bronchitis, and emphysema. Fact: Moderate smoking of marijuana appears to pose minimal danger to the lungs. Like tobacco smoke, marijuana smoke contains a number of ...Usmagazine.com celebrity_news - http://www.usmagazine.com/celebrity_news medicine , drugs , quizzes , diseases , mcqs and postgraduation ...By doctor c. mediastinal emphysema d. niemann-pick's disease answer: c . mediastinal emphysema. 33q: the organism most frequently related to mediastinal fibrosis ? a. actinomyces b. histoplasma c. hansen bacillus d. staphylococcus ...medicine , drugs , quizzes ,... - http://ourmedicine.blogspot.com/ The Drunken Severed Head: Today is the day The King died.By Max the drunken severed head Karloff's workload was amazing for a man in his 80's, despite crippling, painful arthritis and debilitating emphysema. He seemed to be truly imbued with the immortal life force that Frankenstein's monster was given. ...The Drunken Severed Head - http://drunkenseveredhead.blogspot.com/
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This once a day Google Alert is brought to you by Google.
Scale the Strat!
Thirty-five million Americans are living with chronic lung diseases such as asthma, lung cancer and COPD. We invite you to register for the "Scale the Strat" event to help us fight to end lung disease.
Friday, February 20, 2009, 400 climbers will tackle the 1,455 stairs of the Stratosphere Tower. Saturday, February 21, 2009, the top 50 climbers from Friday will climb off again for fabulous prizes "Scale the Strat" is the American Lung Association in Nevada's competitive stair climb. Individuals and teams will race up the Stratosphere Observation Tower's staircase to raise money to fund lung health research, education, and advocacy in Southern Nevada.
This climb is not for beginners Scale the Strat is a 108- floor vertical ascent that is not for the average couch potato or acrophobic (people who are afraid of heights). The first 26 flights are configured like a typical stairwell, but the upper flights are suspended inside the middle of a hollow tower with open air on each side. Once the climbers are in the tower core, there is no exit point, unless there is a medical emergency. This climb is not for the weak hearted. The unique location of the climb should be considered prior to you registering.
If you would like to register or find out more about SCALE THE STRAT CLICK HERE
If you would like to join Nina Radetich's team and support her climb CLICK HERE
Thirty-five million Americans are living with chronic lung diseases such as asthma, lung cancer and COPD. We invite you to register for the "Scale the Strat" event to help us fight to end lung disease.
Friday, February 20, 2009, 400 climbers will tackle the 1,455 stairs of the Stratosphere Tower. Saturday, February 21, 2009, the top 50 climbers from Friday will climb off again for fabulous prizes "Scale the Strat" is the American Lung Association in Nevada's competitive stair climb. Individuals and teams will race up the Stratosphere Observation Tower's staircase to raise money to fund lung health research, education, and advocacy in Southern Nevada.
This climb is not for beginners Scale the Strat is a 108- floor vertical ascent that is not for the average couch potato or acrophobic (people who are afraid of heights). The first 26 flights are configured like a typical stairwell, but the upper flights are suspended inside the middle of a hollow tower with open air on each side. Once the climbers are in the tower core, there is no exit point, unless there is a medical emergency. This climb is not for the weak hearted. The unique location of the climb should be considered prior to you registering.
If you would like to register or find out more about SCALE THE STRAT CLICK HERE
If you would like to join Nina Radetich's team and support her climb CLICK HERE
The Captain's Journal - http://www.captainsjournal.com/ 60health14: News Briefs Highlight Research In Pulmonary, Critical ...By isabellesxwgilltfir #7214 ESSENTIAL AMINO ACIDS MAY IMPROVE STRENGTH IN COPD PATIENTS (Wednesday, October 29, 1:00 PM EST) Patients beside confirmed obstructive pulmonary bug (COPD) may mix up with to muscle mettle and exert serenity by means of taking ...60health14 - http://60health14.blogspot.com/ COPD Info at COPD-InternationalAs we now know, the face of COPD is changing. It used to be considered an old mans disease, the direct result of smoking. As we also know, it used to be considered a disease that was self inflicted, thus did not "deserve" the attention ...COPD Info at COPD-International - http://www.copd-international.com/COPDInfo/
Monday, February 2, 2009
MedWire News - Respiratory - Gender-specific emphysema phenotypes ...MedWire News Male and female heavy smokers without airflow obstruction exhibit gender-specific differences in the radiologic features of emphysema, research shows. MedWire News.MedWire News - Respiratory - http://www.medwire-news.md/48/Respiratory.html
Can we get Camel Snus here? « Aliyah! Step-by-Step: Making a Life ...By Yael It is a smokeless tobacco product which carries the nicotine of a cigarette but none of the cancer/emphysema/heart attack problems of the jolly old fire sticks. Medical studies have found that it is is approximately 1/1000 as harmful as ...Aliyah! Step-by-Step: Making... - http://olehgirl.com/
It's MY Crisis and I'll Cry if I Need To: If You or Someone You ...By Yojeved Golani Indeed, they might develop chronic bronchitis or even emphysema. What causes COPD in the first place? Many types of air pollution, smoking, chemical fumes, or even excessive dust can cause the narrowed airways of COPD. ...It's MY Crisis and I'll Cry if I Need To - http://itsmycrisisandillcryifineedto.blogspot.com/
What they say and what they mean - scannersI'm only up to 1959 and, despite a lifetime of alcoholism, emphysema, bipolar depression and a host of other physical and mental troubles, Yates survived until 1992. Perhaps the notion of "tragic honesty" is illustrated below, ...scanners - http://blogs.suntimes.com/scanners/
Choosing Obama: Why 4 voters switched from McCain « Fresh News"I just feel that he's emphysema and heart problems. She going to keep spending money the favors Obama's health care plan, wrong way." After doing some which aims for universal coverage research, Miller decided it was without ...Fresh News - http://dolnewsg.com/
This once a day Google Alert is brought to you by Google.
National Institutes of Health grants $1M to BioMarckBizjournals.com - Charlotte,NC,USAIn a statement, the company says it has enough money to complete its current phase II trial of BIO-11006, the experimental COPD treatment. ...See all stories on this topic BioMarck Pharmaceuticals Awarded $990000 Grant by National ...PharmaLive.com (press release) - Newtown,PA,USAThe study is designed to enroll 162 COPD patients with COPD, specifically chronic bronchitis. BioMarck initiated the study in Q3 of 2008 and expects ...See all stories on this topic NC-based BioMarck Pharma gets NIH grant moneyTechJournal South - Research Triangle Park,NC,USAThe grant will support research studies of the company's experimental treatment for chornic obstructive pulmonary disease (COPD). ...See all stories on this topic An interesting July 25, 2008, article from WebMD helps explain the ...Battle Creek Enquirer - Battle Creek,MI,USAfrom the United Kingdom documented from the study of 3 million patient charts that patients with a diagnosis of chronic obstructive pulmonary disease (COPD) ...See all stories on this topic
Can we get Camel Snus here? « Aliyah! Step-by-Step: Making a Life ...By Yael It is a smokeless tobacco product which carries the nicotine of a cigarette but none of the cancer/emphysema/heart attack problems of the jolly old fire sticks. Medical studies have found that it is is approximately 1/1000 as harmful as ...Aliyah! Step-by-Step: Making... - http://olehgirl.com/
It's MY Crisis and I'll Cry if I Need To: If You or Someone You ...By Yojeved Golani Indeed, they might develop chronic bronchitis or even emphysema. What causes COPD in the first place? Many types of air pollution, smoking, chemical fumes, or even excessive dust can cause the narrowed airways of COPD. ...It's MY Crisis and I'll Cry if I Need To - http://itsmycrisisandillcryifineedto.blogspot.com/
What they say and what they mean - scannersI'm only up to 1959 and, despite a lifetime of alcoholism, emphysema, bipolar depression and a host of other physical and mental troubles, Yates survived until 1992. Perhaps the notion of "tragic honesty" is illustrated below, ...scanners - http://blogs.suntimes.com/scanners/
Choosing Obama: Why 4 voters switched from McCain « Fresh News"I just feel that he's emphysema and heart problems. She going to keep spending money the favors Obama's health care plan, wrong way." After doing some which aims for universal coverage research, Miller decided it was without ...Fresh News - http://dolnewsg.com/
This once a day Google Alert is brought to you by Google.
National Institutes of Health grants $1M to BioMarckBizjournals.com - Charlotte,NC,USAIn a statement, the company says it has enough money to complete its current phase II trial of BIO-11006, the experimental COPD treatment. ...See all stories on this topic BioMarck Pharmaceuticals Awarded $990000 Grant by National ...PharmaLive.com (press release) - Newtown,PA,USAThe study is designed to enroll 162 COPD patients with COPD, specifically chronic bronchitis. BioMarck initiated the study in Q3 of 2008 and expects ...See all stories on this topic NC-based BioMarck Pharma gets NIH grant moneyTechJournal South - Research Triangle Park,NC,USAThe grant will support research studies of the company's experimental treatment for chornic obstructive pulmonary disease (COPD). ...See all stories on this topic An interesting July 25, 2008, article from WebMD helps explain the ...Battle Creek Enquirer - Battle Creek,MI,USAfrom the United Kingdom documented from the study of 3 million patient charts that patients with a diagnosis of chronic obstructive pulmonary disease (COPD) ...See all stories on this topic
http://www.chron.com/disp/story.mpl/metropolitan/6241780.html
As Texas scientists stand ready, Obama poised to lift limits onresearchBy TODD ACKERMAN
More than a decade after the discovery of human embryonic stem cells,Texas scientists are poised to finally ramp up research involving thecutting-edge but controversial science.
With President Barack Obama expected to lift federal restrictions onthe field as early as this week, scientists in the Texas Medical Centerand around the state have expressed their delight and predicted along-awaited scientific renaissance will follow.
Opening up the research is going to have an enormous benefit, saidBill Brinkley, a Baylor College of Medicine professor of molecular andcellular biology. After being diminished and pushed to the side for adecade, embryonic stem cell research will become mainstream -- mostevery lab will take advantage of it.
In the minds of many, stem cell research promises nothing less than thefuture of medicine, youthful tissue replacing that which is old ordamaged. From animal studies, scientists tout research suggesting stemcells can replace brain cells lost in Parkinsons disease, restorefunction to defective muscles in muscular dystrophy and regenerateparts of the pancreas that dont work in diabetes.
The question is, how quickly can scientists turn the promise intoreality? The first attempt is about to start in California. A biotechcompany there recently got clearance from the Food and DrugAdministration for the first human trial of a therapy based onembryonic stem cells, injecting them into the spinal cords of paralyzedpeople.
Local stem-cell leaders are Baylor and the University of Texas HealthScience Center at Houston, both of which boast centers dedicated to thescience. The centers have focused mostly on adult stem cells but alsofeature work with embryonic stem cells, work that their leaders saywill mushroom once Obama overturns the policy of former PresidentGeorge W. Bush.
Origins of the debate
Already, teams at Baylor, UT-Houston and Rice University are planninggrant applications to build on their ongoing embryonic stem cellresearch on Parkinsons disease, lung disease and joint replacementcartilage, respectively. Biotechnology industry observers say Texas canbecome a leader if the Legislature adds its support.
The political debate over embryonic stem cells dates to 2001, when Bushagreed to allow the use of federal funds for research but limitedsupport to existing cell lines, which numbered less than two dozen.Most were in far from ideal condition and unsuitable for clinical work.
Essentially, Bushs policy has made us operate with one hand tiedbehind our back, said Robert Lanza, of Massachusetts-based AdvancedCell Technology.
The wonder of embryonic stem cells is that they have the capacity tobecome any sort of tissue the body needs -- nerves, blood, heart, bone,muscle. They morph from microscopic spheres to full body parts, aprocess scientists hope to take control of after retrieving the cellsfrom 5-day-old embryos. So promising is the research that the 1998discovery gave birth to a whole new specialty, regenerative medicine.But the science also raises ethical concerns. Because the embryo iskilled in the retrieval process, it has been called a direct attack oninnocent human life.
Bush objected to further research on those grounds. He prohibited theuse of federal funding on research involving cell lines from anyembryos destroyed after his 2001 policy announcement, calling forresearch to instead emphasize adult stem cells, which pose no ethicalconcerns, because they require no destruction of life.
Some defenders of Bushs policy say it spurred scientists to moreaggressively pursue adult stem cell research, resulting in a 2007breakthrough that could ultimately make the controversy moot. Two teamsof scientists independently reported developing a method of convertinghuman adult stem cells into the equivalent of embryonic stem cells,seemingly capable of becoming any of the 220 cell types of the body.Researchers previously believed adult stem cells lacked the unlimitedability to turn into other types of human tissue.
But scientists, noting the breakthrough would have been impossiblewithout knowledge gained through embryonic stem cell research, saidlast week its too early to assume that the technique is the answer.For one,the method entails the use of genetically engineered viruses,which can trigger tumors.
We still dont know whether that technique, still far from perfected,will be able to faithfully reproduce all of embryonic stem cellproperties in adult stem cells, said Paul Simmons, director ofUT-Houstons Center for Stem Cell Research and an adult stem cellresearcher. Embryonic stem cells are the gold standard to conduct thatstudy and make a determination. It may turn out that adult stem cellsare good for some things and embryonic are better for others.
Legislation is next in line
Obama campaigned on a promise to lift Bushs restrictions and allowresearch on stem cells taken from embryos that otherwise would bediscarded by fertility clinics. Congressional sources said last week heplans to make the change as soon as the economic stimulus package ispassed. Legislation codifying the policy will follow.
The policy should provide the most immediate boost to three teams hereworking with Bushs federally approved cell lines. Their leaders saythey can hardly wait to work with any of the more than 1,000 linescreated with private money since Bushs policy was adopted. Thoselines, expected to be eligible for federally supported research, aremore robust and clinically useful than the currently approved lines.
Advocates of stem-cell research also call for a state investment. Areport commissioned by Texans for the Advancement of Medical Researchsays the state could generate $88 billion in economic activity ifTexas share of U.S. biotechnology spending increases to 6 percent from2.9 percent by 2014.
Obamas new policy will change the game dramatically, said Dr. RayDubois, provost at the University of Texas M.D. Anderson Cancer Center.Texas may not have the state or private money that some states havefor stem-cell research, but the stage could quickly change quite abit.
todd.ackerman@chron.com
Brought to you by the HoustonChronicle.com
As Texas scientists stand ready, Obama poised to lift limits onresearchBy TODD ACKERMAN
More than a decade after the discovery of human embryonic stem cells,Texas scientists are poised to finally ramp up research involving thecutting-edge but controversial science.
With President Barack Obama expected to lift federal restrictions onthe field as early as this week, scientists in the Texas Medical Centerand around the state have expressed their delight and predicted along-awaited scientific renaissance will follow.
Opening up the research is going to have an enormous benefit, saidBill Brinkley, a Baylor College of Medicine professor of molecular andcellular biology. After being diminished and pushed to the side for adecade, embryonic stem cell research will become mainstream -- mostevery lab will take advantage of it.
In the minds of many, stem cell research promises nothing less than thefuture of medicine, youthful tissue replacing that which is old ordamaged. From animal studies, scientists tout research suggesting stemcells can replace brain cells lost in Parkinsons disease, restorefunction to defective muscles in muscular dystrophy and regenerateparts of the pancreas that dont work in diabetes.
The question is, how quickly can scientists turn the promise intoreality? The first attempt is about to start in California. A biotechcompany there recently got clearance from the Food and DrugAdministration for the first human trial of a therapy based onembryonic stem cells, injecting them into the spinal cords of paralyzedpeople.
Local stem-cell leaders are Baylor and the University of Texas HealthScience Center at Houston, both of which boast centers dedicated to thescience. The centers have focused mostly on adult stem cells but alsofeature work with embryonic stem cells, work that their leaders saywill mushroom once Obama overturns the policy of former PresidentGeorge W. Bush.
Origins of the debate
Already, teams at Baylor, UT-Houston and Rice University are planninggrant applications to build on their ongoing embryonic stem cellresearch on Parkinsons disease, lung disease and joint replacementcartilage, respectively. Biotechnology industry observers say Texas canbecome a leader if the Legislature adds its support.
The political debate over embryonic stem cells dates to 2001, when Bushagreed to allow the use of federal funds for research but limitedsupport to existing cell lines, which numbered less than two dozen.Most were in far from ideal condition and unsuitable for clinical work.
Essentially, Bushs policy has made us operate with one hand tiedbehind our back, said Robert Lanza, of Massachusetts-based AdvancedCell Technology.
The wonder of embryonic stem cells is that they have the capacity tobecome any sort of tissue the body needs -- nerves, blood, heart, bone,muscle. They morph from microscopic spheres to full body parts, aprocess scientists hope to take control of after retrieving the cellsfrom 5-day-old embryos. So promising is the research that the 1998discovery gave birth to a whole new specialty, regenerative medicine.But the science also raises ethical concerns. Because the embryo iskilled in the retrieval process, it has been called a direct attack oninnocent human life.
Bush objected to further research on those grounds. He prohibited theuse of federal funding on research involving cell lines from anyembryos destroyed after his 2001 policy announcement, calling forresearch to instead emphasize adult stem cells, which pose no ethicalconcerns, because they require no destruction of life.
Some defenders of Bushs policy say it spurred scientists to moreaggressively pursue adult stem cell research, resulting in a 2007breakthrough that could ultimately make the controversy moot. Two teamsof scientists independently reported developing a method of convertinghuman adult stem cells into the equivalent of embryonic stem cells,seemingly capable of becoming any of the 220 cell types of the body.Researchers previously believed adult stem cells lacked the unlimitedability to turn into other types of human tissue.
But scientists, noting the breakthrough would have been impossiblewithout knowledge gained through embryonic stem cell research, saidlast week its too early to assume that the technique is the answer.For one,the method entails the use of genetically engineered viruses,which can trigger tumors.
We still dont know whether that technique, still far from perfected,will be able to faithfully reproduce all of embryonic stem cellproperties in adult stem cells, said Paul Simmons, director ofUT-Houstons Center for Stem Cell Research and an adult stem cellresearcher. Embryonic stem cells are the gold standard to conduct thatstudy and make a determination. It may turn out that adult stem cellsare good for some things and embryonic are better for others.
Legislation is next in line
Obama campaigned on a promise to lift Bushs restrictions and allowresearch on stem cells taken from embryos that otherwise would bediscarded by fertility clinics. Congressional sources said last week heplans to make the change as soon as the economic stimulus package ispassed. Legislation codifying the policy will follow.
The policy should provide the most immediate boost to three teams hereworking with Bushs federally approved cell lines. Their leaders saythey can hardly wait to work with any of the more than 1,000 linescreated with private money since Bushs policy was adopted. Thoselines, expected to be eligible for federally supported research, aremore robust and clinically useful than the currently approved lines.
Advocates of stem-cell research also call for a state investment. Areport commissioned by Texans for the Advancement of Medical Researchsays the state could generate $88 billion in economic activity ifTexas share of U.S. biotechnology spending increases to 6 percent from2.9 percent by 2014.
Obamas new policy will change the game dramatically, said Dr. RayDubois, provost at the University of Texas M.D. Anderson Cancer Center.Texas may not have the state or private money that some states havefor stem-cell research, but the stage could quickly change quite abit.
todd.ackerman@chron.com
Brought to you by the HoustonChronicle.com
Sunday, February 1, 2009
Health October 16, 2008, 5:00PM EST
Medicare's Doughnut Hole Needs Plugging
A gap in the program's drug coverage is driving senior citizens nuts. Both McCain and Obama are considering reforms
By Arlene Weintraub
For many older Americans, fall is a bitter time of year associated with a deceptively sweet name: the "doughnut hole." Far from a sugary treat, it's a coverage gap in the Medicare Part D drug program.
When Part D was first implemented in 2004 to help elderly patients pay for their prescription drugs, the government imposed a yearly limit on how much it was willing to shell out. Seniors are covered right up until they hit the threshold, which is $2,510 in 2008. From that point until the end of the year, they pay fully out of pocket—unless their costs soar to the point where the senior qualifies for catastrophic coverage, which kicks in at $5,726.
The doughnut hole has always been a source of dread for the elderly. But now, with the financial crisis decimating 401(k)s and other retirement plans, many cash-strapped seniors are simply doing without some of their meds. In August a survey from the Henry J. Kaiser Family Foundation showed that in 2007, 26% of Part D beneficiaries—3.4 million people—landed in the doughnut hole. On average, their monthly out-of-pocket costs doubled, to $196. As a result, 15% of people with chronic illnesses stopped taking their drugs while they were in the coverage gap. "This raises concerns," says Tricia Neuman, vice-president at Kaiser Family Foundation in Menlo Park, Calif.
Larry Kay of Yucaipa, Calif., is having so much trouble fighting his way out of the doughnut hole that he's thinking about coming out of retirement. A hunter and former quality-control inspector for a company that makes fences, the 69-year-old Kay hit the hole in May and is now paying $650 a month for drugs to treat his high cholesterol and a lung condition called chronic obstructive pulmonary disease, or COPD. He has stopped using his COPD inhaler in the morning, even though he's not supposed to skip doses. "If my doctor knew, he'd be very upset," he says.
Health policy experts believe the next Administration will be under pressure to address the doughnut hole, and both candidates have expressed some support for reforming the program. Senator Barack Obama backs the idea of letting the government negotiate drug prices for Part D. (It doesn't have the right to do so now.) Senator John McCain has said that higher-income beneficiaries should pay higher premiums for their Part D plans.
Right now, Wall Street's crisis and the $700 billion bailout plan are drawing attention away from health-care reform. But there is little doubt the next President will place drug benefits for seniors high on his agenda. "There is a growing recognition that the doughnut hole is impairing people's access to medications," says Dr. Carolyn Clancy, director of the Agency for Healthcare Research & Quality in Rockville, Md., a public service agency of the U.S. Health & Human Services Dept.
Meanwhile, the doughnut hole continues to exacerbate financial burdens on seniors. On Sept. 26, health-care advisory firm Avalere Health released a report predicting Part D beneficiaries who joined the 10 most popular Medicare plans would see their premiums rise by 30%. At places like California Health Advocates in Sacramento, which helps Medicare beneficiaries navigate the system, frustration is mounting, says spokeswoman Karen Fletcher. "Seniors go through the deductible, then they fall into the gap, then a new year comes around, and they have to start all over again," she says.
Weintraub is a senior writer for BusinessWeek's science and technology department.
Medicare's Doughnut Hole Needs Plugging
A gap in the program's drug coverage is driving senior citizens nuts. Both McCain and Obama are considering reforms
By Arlene Weintraub
For many older Americans, fall is a bitter time of year associated with a deceptively sweet name: the "doughnut hole." Far from a sugary treat, it's a coverage gap in the Medicare Part D drug program.
When Part D was first implemented in 2004 to help elderly patients pay for their prescription drugs, the government imposed a yearly limit on how much it was willing to shell out. Seniors are covered right up until they hit the threshold, which is $2,510 in 2008. From that point until the end of the year, they pay fully out of pocket—unless their costs soar to the point where the senior qualifies for catastrophic coverage, which kicks in at $5,726.
The doughnut hole has always been a source of dread for the elderly. But now, with the financial crisis decimating 401(k)s and other retirement plans, many cash-strapped seniors are simply doing without some of their meds. In August a survey from the Henry J. Kaiser Family Foundation showed that in 2007, 26% of Part D beneficiaries—3.4 million people—landed in the doughnut hole. On average, their monthly out-of-pocket costs doubled, to $196. As a result, 15% of people with chronic illnesses stopped taking their drugs while they were in the coverage gap. "This raises concerns," says Tricia Neuman, vice-president at Kaiser Family Foundation in Menlo Park, Calif.
Larry Kay of Yucaipa, Calif., is having so much trouble fighting his way out of the doughnut hole that he's thinking about coming out of retirement. A hunter and former quality-control inspector for a company that makes fences, the 69-year-old Kay hit the hole in May and is now paying $650 a month for drugs to treat his high cholesterol and a lung condition called chronic obstructive pulmonary disease, or COPD. He has stopped using his COPD inhaler in the morning, even though he's not supposed to skip doses. "If my doctor knew, he'd be very upset," he says.
Health policy experts believe the next Administration will be under pressure to address the doughnut hole, and both candidates have expressed some support for reforming the program. Senator Barack Obama backs the idea of letting the government negotiate drug prices for Part D. (It doesn't have the right to do so now.) Senator John McCain has said that higher-income beneficiaries should pay higher premiums for their Part D plans.
Right now, Wall Street's crisis and the $700 billion bailout plan are drawing attention away from health-care reform. But there is little doubt the next President will place drug benefits for seniors high on his agenda. "There is a growing recognition that the doughnut hole is impairing people's access to medications," says Dr. Carolyn Clancy, director of the Agency for Healthcare Research & Quality in Rockville, Md., a public service agency of the U.S. Health & Human Services Dept.
Meanwhile, the doughnut hole continues to exacerbate financial burdens on seniors. On Sept. 26, health-care advisory firm Avalere Health released a report predicting Part D beneficiaries who joined the 10 most popular Medicare plans would see their premiums rise by 30%. At places like California Health Advocates in Sacramento, which helps Medicare beneficiaries navigate the system, frustration is mounting, says spokeswoman Karen Fletcher. "Seniors go through the deductible, then they fall into the gap, then a new year comes around, and they have to start all over again," she says.
Weintraub is a senior writer for BusinessWeek's science and technology department.
Hand & Foot Care Tips: Lung Cancer in NonSmokersBy jymyster ... of 140000 breast cancer patients found that there was an increase of lung cancer 5 to 20 years after breast cancer treatment. Suspicion is that radiotherapy in the chest area may have made the lungs more susceptible to the disease. ...Hand & Foot Care Tips - http://woman-handfootcare.blogspot.com/ Stress May Hasten Growth of Melanoma Tumors -Skin Cancer news-The research is showing not only that different forms of cancer react differently to stress hormones but also that those reactions can vary within a specific form of the disease, with the possibility of a more aggressive form of the ...Cancer: Overview, Causes, Risk... - http://www.health.am/cr/ The Role of Nurtition in Cancer Prevention and Treatment ...A cross-sectional study of postoperative non-small cell lung cancer (NSCLC) patients looked at the possible effects of vitamin intake and folate status upon disease-free survival Jatoi et al. (1998). Supplemental vitamin usage, dietary ...lusherthanlife - http://lusherthanlife.wordpress.com/ Study finds genetic link between sleep disorders and depression in ...Asthmatics May Be At Risk for Lung Disease In The FutureNew Guidelines Found To Benefit Cardiovascular TreatmentParents Should Look For Signs Of Children Becoming Overweight Vitamin use in Babies Might Lead to Asthma and Allergies ...Latest Medical News from Bio-Medicine... - http://www.bio-medicine.org/medicine-news-1/ Genome Medicine & Genome Wide Association StudiesWe associate that symptom with lung disease. We already wonder whether he has sickle cell disease and concomitant pneumonia. Even the physical examination is performed by association. We look for a tower skull and prominent maxillae ...Article Summaries - http://ts-si.org/index/article-summaries.html
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