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Medication Adherence and Medicare’s Part D Prescription Drug Program

October 29, 2009
11:12 am

Below is my blog post which was featured today on Disruptive Women In Health Care:

If only it were an urban legend that senior citizens in the United States were cutting their physician-prescribed pills in half or ignoring their medications altogether in order to have enough money for food and utilities, but one doesn’t need academic studies to know that this kind of economically-forced non-adherence has too often been the case in our country.

After Congress passed the Medicare Modernization Act (MMA), creating the Part D prescription drug program, the Healthcare Leadership Council – an advocacy group comprised of chief executives of healthcare companies and organizations from all health sectors – literally took its show on the road.  Having worked for passage of the MMA, we felt a responsibility to ensure that the new Part D program was implemented successfully and that seniors knew how to take advantage of the new benefit.

In community meetings across the country, I met with scores of elderly men and women who told me heart-wrenching stories of the hard choices they had to make between medications and other necessities, knowing they were putting their health at risk.

Has the Medicare Part D prescription drug program made a difference in drug adherence within this vulnerable population?  The results are quite positive but they also show that further improvements remain necessary.

The impact of Part D on drug adherence among the elderly is unquestionable.  A survey in April of this year by KRC Research (commissioned by Medicare Today, a coalition of local and national organizations we founded to provide reliable Part D information to seniors) found that three of every 10 Medicare beneficiaries reported that they are now taking medications that they had previously either skipped or rationed. Read more

The Battle Against Obesity: Hope on the Horizon?

October 26, 2009
8:24 am

An upcoming edition of the British medical journal The Lancet will feature the results of research into a new diabetes drug that is demonstrating significant progress in helping obese patients lose weight and reduce their blood pressure.

The drug liraglutide, developed by Novo Nordisk, has been the subject of testing by the department of human nutrition at the University of Copenhagen, Denmark.  Weight loss of more than five percent, over a 20-week timeframe, occurred in 76 percent of the patients taking the drug.  Additional studies are now needed to investigate the long-term benefits and risks of the medications, the study’s authors wrote.

Pharmaceutical progress in this arena is critical in the drive to boost societal health and control healthcare costs.  Almost 75 cents of every healthcare dollar is spent to fight chronic disease, with obesity being a leading driver of chronic illnesses like diabetes, diabetes and heart disease.  The Lancet  study noted that about half of Europeans and two-thirds of U.S. citizens are currently overweight. Read more

Heads or Tails?

October 23, 2009
12:25 pm

“Support for Public Option Grows In House and Senate”
 Headline, Washington Post, October 23

“Pelosi Lacks Votes For Most Sweeping Public Option”
 Headline, Politico, October 23

Bold Headline, Questionable Substance: Understanding That Washington Post Poll

October 20, 2009
2:22 pm

Advocates of a government-run health insurance plan are calling today’s published Washington Post/ABC News poll a game-changer, placing the impetus on Congress to give the public what it ostensibly wants.  According to the poll, 57 percent say they want a government-run plan while 40 percent oppose the idea.

But is the Post poll everything government plan supporters make it out to be?  Taking a closer look, some flaws and quirks in the survey become apparent.

•      In June, a Post poll showed even greater support for the government option – 62 percent – but when a subsequent question asked respondents if they would still support the concept even if it would reduce private sector coverage choices because of unfair competition, support for the government plan plummeted to 37 percent.  Even though the slanted playing field issue is still a valid concern, the Post didn’t ask the follow-up question this time around.  One has to wonder why. Read more

The O.K. Corral It’s Not

October 14, 2009
3:55 pm

Hollywood movie producers love what are known as “high concept” film ideas.  These are plotlines that are so simple – “aliens invade Earth”, “teenage vampires take on mortals” – they can be summarized in a single line.

The news media also likes “high concept” and tries to apply it whenever it can, even when complex issues are involved.  We’re seeing that right now in the ongoing health reform deliberations.  When America’s Health Insurance Plans (AHIP) issued a PricewaterhouseCoopers study this weekend showing that family health insurance premiums would rise if the Senate Finance Committee bill becomes law, stories began to emerge immediately about a clenched-fist showdown between insurers and the Obama White House/congressional Democrats.

It would be a compelling storyline if it were true, but the reality is that multiple health sectors have qualms with different aspects of health reform legislation and are working diligently to improve the final product.

•       Witness various hospital leaders pointing out that the watered-down individual mandate provisions in the Finance bill will still leave too many Americans without health insurance.

•       Witness the nation’s medical device manufacturers making the case that the bill’s excise tax provisions could have a severe impact on healthcare innovation and place the United States at a competitive disadvantage to its global counterparts.

•       Witness healthcare leaders like Delos Cosgrove, the CEO of the Cleveland Clinic, telling the media that the developing health reform bills don’t do enough in the arenas of payment and delivery reform.

It’s a sexy story to think of the insurance lobby and the Congress having a duel at sunrise, but the fact is this isn’t a one-on-one contest.  The health reform bills making their way through Capitol Hill need improving, and it’s not just the health insurers saying so.