The program created to provide Medicare recipients with prescription drug benefits exceeded expectations during its first two years, extending pharmacy coverage to most seniors while reducing their overall spending on drugs, according to a new RAND Corporation study.

Although Medicare Part D generated confusion when it was introduced in January 2006, the program has worked well for most seniors and is comparable to other nonMedicare drug plans that cover large groups of seniors, according to the report published in the August edition of the American Journal of Managed Care.

“In the beginning there was a lot of concern about Medicare Part D, but we found convincing evidence that it has exceeded expectations and generally has been successful,” said Geoffrey Joyce, the studys lead author and a senior economist at RAND, a nonprofit research organization. “Most seniors now have prescription drug coverage that allows them to buy drugs at a reasonable cost.”

Researchers estimate that during its first year in 2006, Medicare Part D resulted in a 16 percent drop in outofpocket spending among seniors for prescription medication and a 7 percent increase in the number of prescriptions filled. The savings appears to have been concentrated among the poor and disabled.

“It appears that Medicare Part D has been particularly successful in lowering costs for the poor and the disabled, which is an important finding since initially there was concern these groups would be particularly vulnerable under a privately administered benefit,” Joyce said.

Researchers from RAND Health used administrative records to examine seniors participation in the Medicare Part D program, including how the program has affected seniors access to medications, their use of prescription drugs and their financial risk. They also compared the 10 largest Part D plans in 2006 to seven nonMedicare drug plans often cited as examples of lowcost or generous pharmacy benefits.

After two years, about 90 percent of seniors have drug coverage at least as generous as the standard Part D benefit. Medicare recipients in most states could choose from more than 50 different Part D plans in 2008, a sign of competition among the private companies that provide the coverage.

The number of covered drugs in the 10 largest Medicare Part D plans compared favorably with the coverage provided by other prescription drug plans that insure seniors, such as those offered by Kaiser Permanente, the Veterans Administration and the California Public Employees Retirement System.

Among the 300 prescription drugs most often used by seniors, about half were covered under the lowest copayment tiers provided by the 10 largest Medicare Part D plans, according to the study. The number of drugs not covered varied from four to 41 among the largest Part D plans. In contrast, Kaiser Permanente and the Veterans Administration excluded 75 and 84 medications, respectively.

Although the program has exceeded initial expectations, researchers say problems remain with Medicare Part D.

A substantial number of predominantly lowincome seniors still need to be better educated that enrolling in the program is in their interest and given instruction about how to evaluate the many plans offered to choose the one that best meets their prescription drug needs.

In addition, the annual spending caps included in the plans leave too many seniors without pharmacy coverage for a portion of each year, according to researchers. Recent work suggests that 3 million seniors reached the so called “donut hole” or gap in Part D coverage during 2007, with about 20 percent of seniors stopping their medications after their coverage lapsed for the year.

Funding for the study was provided by the California HealthCare Foundation, the National Institute on Aging through its support of the RAND Roybal Center for Health Policy Simulation and the Bing Center for Health Economics. Other authors of the study are Dana Goldman and William B. Vogt of RAND, and Eric Sun and Anupam B. Jena of RAND and the University of Chicago.

Source
Warren Robak

The American Pharmacists Association (APhA) advises consumers to take acetaminophen products as recommended on the labeling and seek guidance from pharmacists or other healthcare providers on evaluating medication options. This recommendation comes as the Food and Drug Administration (FDA) convened a public advisory committee meeting on June 29 and June 30, 2009 regarding acetaminophen use in both overthecounter (OTC) and prescription (Rx) products, the potential for liver injury, and potential interventions to reduce the incidence of liver injury.

The committee recommended a range of options for the FDA to consider from putting warning labels on products to pulling certain medicines from the market. The FDA will take the recommendations into consideration before taking any action and is not obligated to follow the recommendations of the advisory committee.

“Acetaminophen is an effective, long utilized medication in relieving patient pain and fever, and is considered safe when used according to the directions on product labeling,” said Ed Hamilton, PharmD, FAPhA, and APhA President. “As the FDA considers the recommendations made by the committee, we urge consumers not to panic, but to take acetaminophen containing products and any other medicines as directed by the product label or prescription label. Consumers are also encouraged to ask questions. Pharmacists are here to answer consumers questions about medications and can help them identify which ones may have acetaminophen.”

What should consumers do?

If taking acetaminophen containing products (commonly referred to as Tylenol® or APAP), always take according to current directions and dosing instructions.

Healthy adults should not exceed 4 grams (4000mg) of acetaminophen per day. Others should seek advice from their pharmacist or other health care provider for appropriate dosing limits.

Always read OTC and Rx medication labels before each use, follow the directions, and if you have questions, ask the pharmacist or other health care provider.

If a dosing device is included with a specific medication, use only that device for that medication.

Check the active ingredients of OTC and Rx medications to ensure that multiple products do not contain acetaminophen. Generally, taking multiple products containing acetaminophen is not advisable due to the risk of exceeding the maximum daily dose and liver damage.

Store all medications appropriately, keep all medications out of the reach of children, and always return medications to a proper storage location following each use.

Seek medical advice immediately if you or someone you know may have taken too much acetaminophen.

Advise your health care providers of all Rx, OTC, herbal and dietary supplement products taken regularly or on an as needed basis.

Source

Elsevier, the worldleading publisher of scientific, technical and medical information products and services, has announced the launch of the online version of the Chinese Journal of Natural Medicines (CJNM). Established in 2003, the Chinese Journal of Natural Medicines is now available for the first time in English on ScienceDirect.

This peerreviewed journal is for pharmaceutical and medical scientists interested in the advancement of traditional Chinese medicines, and publishes papers on a broad spectrum of bioactive natural products, leading compounds and materials derived from traditional Chinese medicines.

Until now, much of Chinese research was only available in Chinese, but with the Chinese Journal of Natural Medicines now available in English, new findings in the field of traditional Chinese medicine are accessible to a wider and more international audience.

Zheng Xiaonan, the director of the editorial office, said “The publication of the Chinese Journal of Natural Medicineson ScienceDirect will help us spread the latest scientific achievements and highlight Chinese research articles in this field to the global pharmaceutical community.”

CJNM is one of several journals published by the Chinese Pharmaceutical University, one of the top Chinese universities in this field. The Chinese Pharmaceutical University provides strong academic and financial support to CJNM.

China recognizes the importance of investing in local medical developments and has made efforts to increase the visibility and use of Chinese Traditional Medicines. As part of these efforts, the Chinese central government has invested in Chinese hospitals and the State Council issued a policy to further support and develop the Chinese medical industry. The increased publication of Chinese focused medical research plays an important role in this overall effort.

Hugo Zhang, Managing Director of Elseviers Science & Technology division in China, commented “We expect to see a growing number of quality research articles in this area published in the future. By offering the Chinese Journal of Natural Medicines online and in English, we add unique content to our existing journal collection. Having this journal available in English will be a new and important way to share research developments to the international science community and help them get a better understanding of Chinese medical research and policy. “

Source
Shira Tabachnikoff

Since 2000, nearly 1,000 “retail clinics” offering routine care like sports physicals and immunizations and treatment for minor illnesses like strep throat have opened their doors inside pharmacies and grocery stores across the United States. Retail chain operators proposed that the new clinics would improve access to medical care among uninsured or underserved populations. However, these clinics have been opened more often in higherincome areas that are less likely to be classified as medically underserved, according to a new study from the University of Pennsylvania School of Medicine published in the May 25 issue of Archives of Internal Medicine.

“There has been a rapid rise in the number of retail clinics across the United States, but this growth is not evenly distributed across communities,” says Craig E. Pollack, MD, MHS, an internist and Robert Wood Johnson Clinical Scholar at Penn. “Poorer neighborhoods are less likely to have access to these clinics.”

By combining mapping software with Census data and a listing of nearly 1,000 retail clinics across the nation, Pollack and his coauthor, Katrina Armstrong, MD, MSCE, an associate professor of Medicine and Epidemiology and chief of the division of General Internal Medicine, found that census tracts with retail clinics had a lower population of black residents, lower poverty rates, and higher median incomes than census tracts without retail clinics.

Housed in stores including WalMart, Target and chain pharmacies like CVS and Kerr Drugs, retail clinics offer walkin appointments, often on weekends and evenings, and the visits generally cost less than paying out of pocket for similar services at a doctors office or emergency department. But the Penn authors say these “convenience” factors may not help disadvantaged populations if clinics are located too far away to be reached easily.

“We know that people living in poorer areas are less likely to have health insurance, less likely to have a regular source of medical care, and may have transportation problems that keep them from getting to the doctor,” Pollack says. “By tending to locate in richer neighborhoods, retail clinics may not be meeting their full potential to help address these problems.”

Previous research shows that a third of retail clinic patients pay for their visits out of pocket, and more than 60 percent of patients report not having a primary care provider. Some opt to pay for afterhours, nowait care because its more convenient, even if they have insurance. The new findings suggest that instead of filling an unmet medical need, placement of clinics in more advantaged neighborhoods may act as an adjunct to existing, more traditional medical care perhaps by staying open later than nearby doctors offices.

The authors say that to further expand their reach, municipalities should consider offering incentives to store operators to open clinics in underserved areas where they already operate retail outlets. Currently, nearly a third of all chain stores are located in medically underserved areas.

“There may be a real opportunity to put up clinics in underserved areas where theres already supermarkets and drug stores” Armstrong says.

PENN Medicine is a $3.6 billion enterprise dedicated to the related missions of medical education, biomedical research, and excellence in patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nations first medical school) and the University of Pennsylvania Health System.

Penns School of Medicine is currently ranked #3 in the nation in U.S.News & World Reports survey of top researchoriented medical schools; and, according to the National Institutes of Health, received over $366 million in NIH grants (excluding contracts) in the 2008 fiscal year. Supporting 1,700 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physicianscientists and leaders of academic medicine.

The University of Pennsylvania Health System (UPHS) includes its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nations top ten “Honor Roll” hospitals by U.S.News & World Report; Pennsylvania Hospital, the nations first hospital; and Penn Presbyterian Medical Center, named one of the nations “100 Top Hospitals” for cardiovascular care by Thomson Reuters. In addition UPHS includes a primarycare provider network; a faculty practice plan; home care, hospice, and nursing home; three multispecialty satellite facilities; as well as the Penn Medicine at Rittenhouse campus, which offers comprehensive inpatient rehabilitation facilities and outpatient services in multiple specialties.

“Origins and Strategies for Addressing Ethnic and Racial Disparities in Pharmaceutical Therapy The HealthCare System, the Provider, and the Patient,” National Minority Quality Forum The report by Richard Levy, a health care consultant and former vice president of the National Pharmaceutical Council; Robert Like, professor and director of the Center for Healthy Families and Cultural Diversity of the UMDNJRobert Wood Johnson Medical School; and Harry Shabsin, a privatepractice psychologist looks at how appropriate medications for a variety of diseases often are underprescribed, overprescribed, or misprescribed among minorities. The report looks at disparities in treatment of minority patients with cardiovascular disease, asthma, psychiatric illness, pain and other conditions and finds disparities in access to medications through insurance programs, in the prescribing of medications and in adherence to medication regimens. The report offers ways to improve prescribing and use of medications among diverse communities (National Minority Quality Forum release, 5/12).

Reprinted with kind permission from kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

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