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Prescription Opioid Analgesic Use Among Adults: United States, 1999–2012

March 4, 2015 Comments off

Prescription Opioid Analgesic Use Among Adults: United States, 1999–2012
Source: National Center for Health Statistics

Key findings

Data from the National Health and Nutrition Examination Survey

  • From 1999–2002 to 2003–2006, the percentage of adults aged 20 and over who used a prescription opioid analgesic in the past 30 days increased from 5.0% to 6.9%. From 2003–2006 to 2011–2012, the percentage who used an opioid analgesic remained stable at 6.9%.
  • From 1999–2002 to 2011–2012, the percentage of opioid analgesic users who used an opioid analgesic stronger than morphine increased from 17.0% to 37.0%.
  • During 2007–2012, the use of opioid analgesics was higher among women (7.2%) than men (6.3%).
  • During 2007–2012, the use of opioid analgesics was higher among non-Hispanic white adults (7.5%) compared with Hispanic adults (4.9%).
  • There was no significant difference in use between non-Hispanic white adults and non-Hispanic black adults (6.5%).

Patient Responses to Incentives in Consumer-directed Health Plans: Evidence from Pharmaceuticals

February 26, 2015 Comments off

Patient Responses to Incentives in Consumer-directed Health Plans: Evidence from Pharmaceuticals
Source: National Bureau of Economic Research

Prior studies suggest that consumer-directed health plans (CDHPs) -characterized by high deductibles and health care accounts- reduce health costs, but there is concern that enrollees indiscriminately reduce use of low-value services (e.g., unnecessary emergency department use) and high-value services (e.g., preventive care). We investigate how CDHP enrollees change use of pharmaceuticals for chronic diseases. We compare two large firms where nearly all employees were switched to CDHPs to firms with conventional health insurance plans. In the first firm’s CDHP, pharmaceuticals were subject to the deductible, while in the second firm pharmaceuticals were exempt. Employees in the first firm shifted the timing of drug purchases to periods with lower cost sharing and were more likely to use lower-cost drugs, but the largest effect of the CDHP was to reduce utilization. Employees in the second firm also reduced utilization, but did not shift the timing or use of low cost drugs.

Innovation for Healthier Americans: Identifying Opportunities for Meaningful Reform to Our Nation’s Medical Product Discovery and Development

February 26, 2015 Comments off

Innovation for Healthier Americans: Identifying Opportunities for Meaningful Reform to Our Nation’s Medical Product Discovery and Development (PDF)
Source: Sen. Lamar Alexander (R-TN) and Sen. Richard Burr (R-NC)
From press release:

Senators Lamar Alexander (R-Tenn.) and Richard Burr (R-N.C.) today released a report on the challenges to getting safe treatments, devices and cures to patients more quickly and effectively, examining what is working, and what isn’t, at the Food and Drug Administration and the National Institutes of Health.

The senators are soliciting feedback on their report as Chairman Alexander and Ranking Member Patty Murray (D-Wash.) begin a major initiative in the Senate health committee —including a bipartisan working group and a series of hearings—to examine the time and cost currently involved with the drug and medical device discovery and development process, and how to better align public policies to support medical innovation.

In the executive summary, the senators write: “This report aims to examine the current process of drug and device development and identify the inefficiencies that stand in the way of a modern development and review process. We take a close and honest look at what is, and is not, working well at the NIH and FDA. We want to know what successes we can replicate, and what failures must be learned from and fixed.”

Prescription Cholesterol-lowering Medication Use in Adults Aged 40 and Over: United States, 2003–2012

February 23, 2015 Comments off

Prescription Cholesterol-lowering Medication Use in Adults Aged 40 and Over: United States, 2003–2012
Source: National Center for Health Statistics

Key findings

Data from the National Health and Nutrition Examination Survey

  • During 2003–2012, the percentage of adults aged 40 and over using a cholesterol-lowering medication in the past 30 days increased from 20% to 28%.
  • The use of statins increased from 18% to 26%. By 2011–2012, 93% of adults using a cholesterol-lowering medication used a statin.
  • Cholesterol-lowering medication use increased with age, from 17% of adults aged 40–59 to 48% of adults aged 75 and over.
  • About 71% of adults with cardiovascular disease and 54% of adults with hypercholesterolemia used a cholesterol-lowering medication.
  • Adults aged 40–64 with health insurance were more likely than those without health insurance to use a cholesterol-lowering medication.

FDA issues new draft documents related to compounding of human drugs

February 18, 2015 Comments off

FDA issues new draft documents related to compounding of human drugs
Source: U.S. Food and Drug Administration

Today, the U.S. Food and Drug Administration issued five draft documents related to drug compounding and repackaging that will help entities comply with important public health provisions. The draft documents are applicable to pharmacies, federal facilities, outsourcing facilities and physicians.

The new category of outsourcing facilities was created under the Drug Quality and Security Act (DQSA), enacted by Congress in November 2013 in response to a deadly fungal meningitis outbreak that was linked to contaminated sterile compounded drug products. Drugs compounded in an outsourcing facility that meet certain conditions may be entitled to exemptions from certain provisions of the Federal Food, Drug, and Cosmetic Act (FD&C Act), including the new drug approval requirements and the requirement to label drug products with adequate directions for use. Outsourcing facilities are subject to current good manufacturing practice requirements and inspections by the FDA according to a risk-based schedule.

Drugs produced by compounders that are not registered as outsourcing facilities must meet certain other conditions described in the FD&C Act, or they will be subject to all of the requirements applicable to drugs produced by conventional drug manufacturers.

Affordable Access to Medicines: A Prescription for Canada

February 5, 2015 Comments off

Affordable Access to Medicines: A Prescription for Canada
Source: Canadian Centre for Policy Alternatives

This report reviews research detailing the financial and social impacts of national pharmacare implementation abroad, and shifts in policy in Canada. It finds that implementing pharmacare for at least the 80 most commonly prescribed generic drugs would save governments almost a quarter of a billion dollars annually, while allowing everyone who needs those medicines to access them at little or no cost.

Using Drugs to Discriminate — Adverse Selection in the Insurance Marketplace

February 4, 2015 Comments off

Using Drugs to Discriminate — Adverse Selection in the Insurance Marketplace
Source: New England Journal of Medicine

Eliminating discrimination on the basis of preexisting conditions is one of the central features of the Affordable Care Act (ACA). Before the legislation was passed, insurers in the nongroup market regularly charged high premiums to people with chronic conditions or denied them coverage entirely. To address these problems, the ACA instituted age-adjusted community rating for premiums and mandated that plans insure all comers. In combination with premium subsidies and the Medicaid expansion, these policies have resulted in insurance coverage for an estimated 10 million previously uninsured people in 2014.

There is evidence, however, that insurers are resorting to other tactics to dissuade high-cost patients from enrolling. A formal complaint submitted to the Department of Health and Human Services (HHS) in May 2014 contended that Florida insurers offering plans through the new federal marketplace (exchange) had structured their drug formularies to discourage people with human immunodeficiency virus (HIV) infection from selecting their plans. These insurers categorized all HIV drugs, including generics, in the tier with the highest cost sharing.

Insurers have historically used tiered formularies to encourage enrollees to select generic or preferred brand-name drugs instead of higher-cost alternatives. But if plans place all HIV drugs in the highest cost-sharing tier, enrollees with HIV will incur high costs regardless of which drugs they take. This effect suggests that the goal of this approach — which we call “adverse tiering” — is not to influence enrollees’ drug utilization but rather to deter certain people from enrolling in the first place.

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