The Health Care Blog

PHARMA: Crestor & Statin slight update.

Light blogging today...as other commitments are banging on the door, however, in relation to a couple of readers comments, I need to say a little more following up on my post on The Lancet vs Crestor issue. Public Citizen is...

POLICY: The uninsured--can Pfizer's solution really help?

I stumbled across the web site healthpolitics.com recently while looking for Jeanne Scott's site health-politics.com (you spot the cunning difference!). HealthPolitics with Dr. Magee is a site which does a weekly power-point, talking head (literally!) and transcript presentation. It's neatly...

PHARMA: The Lancet vs Crestor, or why I'm not on statins....yet!

I'm going to start this with a little personal info. I am an ideal candidte for a life-time regimen of statins. I'm 40 years old. I have high-ish cholesterol and have had for a while, and my father had a...

PHARMA: Pharma no longer a safe haven?

Merck, which span off Medco as featured in the previous story on today's THCB, has not been having such a good time as its former subsidiary. It's recent lay-offs of over 4,000 has lead to the now quite widespread belief...

PBMs: PBMs doing well while CaremarkRx/AdvancePCS' deal is still uncertain

The newly independent PBM Medco Health Services' stock has been doing very well since its independence from Merck just a few months ago. In fact if you received Medco stock at the time of the disbursement you'll find that it's...

PHARMA/HEALTH PLANS: Kaiser ends coverage for brands for seniors

Kaiser Permanente, the historic group-model HMO that dominates the California market and has over 650,000 members in its Medicare HMOs, has changed its benefits in response to higher costs. Kaiser has the reputation of being loathe to change its members'...

TECHNOLOGY: More on the Forrester HMO website report (with update)

A few weeks back I posted about a Forrester report about how bad consumers found health plan web sites. The Forrester report is online but only for its clients. Forrester did send out an email that non-members can get by...

INDUSTRY: Merger Mania Monday

This morning two big mergers in the health plan world. The two biggest (ex-)Blues merge (Anthem and Wellpoint), and United buys MAMSI, the big commercial HMO on the mid-Atlantic states. In the Blues case the market has marked down the...

TECHNOLOGY: Physicians like the Internet, eventually

In the old days (well, 1997), there were many reports about physicians annoyed with patients coming to their office with reams of paper printed out off the Internet and asking, for example, if rolling in moose dung reduced blood pressure,...

POLICY: User fees, employer-based insurance and why it won't go away

Suddenly it feels very like 1991 again. Imagine that the 49ers and Joe Montana has suddenly become human and the newspapers are full of stories about how the high cost of health care is the cause of all the world's...

POLICY: Not enough doctors?

I've been sitting on this story about the number of doctors in the future for a week or two but have finally got around to posting it as Jeanne Scott has written about it and I don't want to be...

POLICY: A very tentative deal on drug benefits

Yesterday's reports that a deal has been reached in the Medicare Drug negotiations do not necessarily mean that we're actually going to get a finished bill. There are only 2 Democrats on the negotiating team, and several Senators, led by...

POLICY: Other shoe dropping on employer-based health insurance

Yikes--too much to report today! Two confirmations today about employer health insurance confirm much of what I've posted about before. First, the Commonwealth Fund reports that a growing share of uninsured workers are employed by large firms. More noticeably, low-income...

POLICY: Medical privacy-what happens when private data leaves the country

And in news from San Francisco, UCSF the biggest teaching hospital in the Bay Area was threatened with release of some of its patients' data on to the Internet. The wrinkle is that the threat came from a transcriptionist who...

TECHNOLOGY: CPR use-- review of state of the nation report from CHCF

Continuing with its excellent work as a trailblazer in research into health care IT arena, the California HealthCare Foundation (CHCF) has put out an interesting summary report on the adoption of Computerized Patient Records (CPR) written by David Brailer and...

POLICY: Medpundit's concerns--too much coverage

Medpundit has responded to my queries about her stance on MSAs, coverage and all that. Go read her piece here, then come back. Medpundit's very concerned that many of the patients she's seeing are coming in for expensive diagnostic tests...

PHARMA: Does Lipitor cause memory loss?

While I was (very worthily) working out at the gym last night I noticed that November's Smart Money had an article on Lipitor. Given that Lipitor is the single biggest product in health care, currently at $8 billion in revenue,...

POLICY: Support for "Medicare-for-all" high, perhaps?

This topic comes your way via the always interesting Medpundit. Medpundit is a doc who doesn't want a single payer system, and reading between the lines of her views sounds like she is in the "MSA's for all" camp. (Even...

PHARMA: US attorney cracking down on drug companies, by Matt Quinn

From THCB's legal office, Matt Quinn is back on the track of health care fraud once again. This time he's turned his attention from Medi-Cal to big pharma: The new edition of "Fortune" (the one with, as I remember, Andy...

POLICY: Medicare drug coverage issue hurts Bush

Today's New York Times reports with data what most of us following along at home have suspected for a while--seniors don't like what they are hearing about the Medicare drug bill, and the blame is shifting towards the President. A...

INDUSTRY: Slow progress on HBOC indictments

If you think back to late 1998 you may remember that stodgy drug distributor McKesson bought hospital software company HBOC. HBOC had grown into being the biggest HIT software supplier, mostly through a series of acquisitions through the 1990s. At...

INDUSTRY: The ever-growing power of Wal-Mart

There's been plenty written elsewhere about the influence of Wal-Mart in America's economy. For instance, this about Wal-Mart and the recording industry and this critical view of its influence on local communities. Somewhat under the radar Wal-Mart has been growing...

INDUSTRY: Major healthcare M&A deals this year

This Reuters report shows major healthcare M&A deals this year. I found this after looking at GE's further incursions into the health care business. Most recently GE last week bought Amersham. Amersham makes reagents and fits in with GE's MRI...

TECHNOLOGY: Physician IT use--New Zealand leads the way

I mentioned anecdotally a while back that GPs in New Zealand and the UK are very advanced in their in-office IT use. A GP I stayed with there last March was using a computer to type his patient notes while...

QUALITY QUICKIE: Design in HC--IDEO's take

Famed Palo Alto industrial design firm IDEO is taking on the challenge of designing a more-patient friendly hospital process. Many of the ideas they are talking about are similar to the quality circles that the Japanese used to successfully destroy...

INDUSTRY: Employer health costs moderating slightly

Hewitt Associates report on their annual survey on health costs for employers. They found that the 2004 premiums will be up an average of 12.6% next year as opposed to 14.7% in 2003. They also note that HMO costs continue...

HEALTH PLANS--Using OTC as a lever for pushing costs onto members

Health plans and their PBMs failed in their mission to control drug costs in the 1990s. One option that has proved somewhat successful is to get members to use OTC versions of previously popular prescription drugs. Wellpoint in particular waged...

QUALITY QUICKIE: Blue Cross' Pay for Performance strategy

California Blue Cross (Wellpoint) is one of the plans participating in the California wide Pay for Performance (P4P) scheme, which rewards physician groups for improving a variety of quality scores. The scheme is administered by the IHA, a provider/payer talking...

TECHNOLOGY: Customer service on health plan web sites--Now I'm mad! (with new UPDATE)

I tend not to let my personal feelings come out in this blog (as I have a couple of others for that) but I find myself pretty grumpy when I read the following passage in Today in E-HealthNews. Health-plan Web...

DISEASE MANAGEMENT: Health-e-technologies Initiative launches

At the tail end of last week the RWJ-funded Health-e-technologies Initiative organization gave out its first round of grants. Many of the subjects looked familiar to those of us who've spent time in the (nominally) for-profit eHealth sector. For instance,...

POLICY: Fraud in Medi-Cal, by Matt Quinn

Guest contributor Matt Quinn reports from THCB's Sacramento Bureau. After reading his article, cogitate on this question. D'you think that a newcomer to the California political scene, elected Governor on a "platform" of cutting government bureaucracy, might find this information...

UPCOMING: Clinical wireless and PDA use

This is the first in an occasional post to let you know what I'm working on behind the scenes. I'm trying to get to grips with the huge topic of wireless computer use by clinicians. If you have access either...

TECHNOLOGY: What's behind WebMD missing its numbers?

This morning WebMD, the de facto giant of the transaction processing and physician office software markets, announced that its earnings and revenues for the next two quarters will be below expectations. The stock price traded down about 10% in early...

INDUSTRY: Healthsouth--Scrushy speaks out

I've commented (perhaps too much) about the Healthsouth affair and how the vagaries of Medicare reimbursement led many different types of for-profit (and probably also non-profit) providers to go well over the top in attempting to cash in. The difference...

POLICY & PHARMA: Opposing drug re-importation is political loser for big Pharma

All that you need to know is in today's Harris Poll. 77% of Americans think that it's unreasonable for pharma companies to try to make it impossible for American consumers to buy drugs from Canadian pharmacies over the Internet. Yet...

TECHNOLOGY: Tim Oren's analysis of Sili valley development

As healthcare person connected to Silicon Valley by geography and osmosis, I'm always amazed why I don't quite "get it" and hence why I'm not driving a Porsche, owning 6 houses and lying on the beach like some folks I...

QUALITY QUICKIE: Another study on medical errors

AHRQ, the Agency for Healthcare Research and Quality has put out another study on medical errors This one has a slightly different methodology than the IOM's 1999 "To Err is Human" study. The researchers estimated that the study's findings mean...

PHARMA: The orphan blockbuster costs $800m

Forbes is pumping out a lot of interesting articles on the pharma market these days. In an article called The Diagnosis For Medical Diagnostics they raise the issue of pairing diagnostics with drugs. The basic problem is that as drug...

PHARMA: Follow up to the Pipeline Post

Health care expert and all-round wonderful person Jane Sarasohn-Kahn of Think-Health has some added thoughts about what's likely to be happening inside the pharma industry to deal with the "pipeline problem" discussed in this recent post. Jane suggests you keep...

TECHNOLOGY: Follow up to Wireless Vulnerability

I've been having a background email conversation with Lisa Williams who covers many medical blogs as part of her blog Learning the Lessons Of Nixon and kindly refers back to me. (Lisa does seem to think this is a blog...

TECHNOLOGY: A surgeon as a futurist?

Speaking as an ex-real and current hack futurist, this title disturbs me. However, jumbled up in this interview with ex-Yale surgeon Richard Satava are a bunch of very interesting concepts. He discusses the potential impact of smart dust, radio-tagging (RFID)...

QUALITY QUICKIE: Follow up to Kentucky nurse dismissals

A cardiologist wrote to me about my post concerning the nurses fired for administering drugs without physician approval. The response suggests that there should have been standing orders, which sounds logical to me: In regards to intubated patients, 1) almost...

TECHNOLOGY: Dump the stent, have a by-pass

You may recall that when I wrote about the market for drug-coated stents, I made an off-hand remark about a Canadian health services researcher who told me that stents were a waste of money because, from a health services research...

PHARMA: The pipeline needs filling

There's been substantial worry in the pharma business about the future of the pipeline--and rightfully so. More than any other business, pharma companies tend to rely on one huge hit, and the spin-offs from it, rather than a steady stream...

TECHNOLOGY: Wireless vulnerability

According to AIS' Business News wireless networks can create major HIPAA vulnerabilities. This seems obvious but if the network is not secure and doesn't require authentication, anyone within range can get on the network and with a tiny amount of...

QUALITY QUICKIE: Kentucky hospital dismisses 14 nurses

I am deeply puzzled by this one. Apparently patients on respirators sometimes try to pull their tubes out of their throats in a panic, and administering such patients Diprivan immediately calms them and potentially saves their lives. A hospital in...

QUALITY QUICKIE: Managed care works in California (according to Managed Care)

While the managed care industry generally has more or less given up the concept of trying to manage the way physicians practice, it's not quite so in California. The CCHRI, a mostly payer/provider funded group, albeit with representation from organized...

POLICY: Pay or Play in California signed into law

In what may be one of his last acts in office depending on how tomorrow's recall vote goes, yesterday Gray Davis signed SB2. I've written more extensively about what SB2 is and more importantly what it isn't in this post....

Friday Funny

So I'm a very messy guy who's insensitive to what's happening around me and likes using the TV remote control -- a massive P rather than a J on the Myers-Briggs scale. I have had several girlfriends who are extreme...

PBMs: The very, very begining of the end for PBMs?

You may remember my post somewhat facetiously titled The End of Managed Care. The concept was that managed care plans had stopped trying to manage physician behavior and had given up in the face of aggressive class action lawsuits from...