Health Business Blog

I’m in Montreal this week, so have a chance to catch up on Canadian topics.

Not so socialist?

The Canadian government pays about 70% of health care costs, which is lower than other Western countries including UK (83%), Germany (78%), and France (76%). The US number is getting close to 50%, so it’s not as though the systems are as different as people think. The Canadian number is relatively low because consumers bear a high proportion of drug costs. The government virtually monopolizes hospital and physician services, though. The US acts as a relief valve. (From the National Post)

Cross-province capacity balancing

The Canadian Medical Association is calling for provinces to pool resources to reduce patient wait times. Some provinces have excess capacity, others are short. The proposal is to allow patients from a constrained province to travel to another province for treatment and have the government pay the bill. The article doesn’t mention it but it’s likely that the excess-capacity provinces might like to hold on to some of that capacity to prevent waiting lists from building up for their own residents. (From Canwest News Service)

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FDA is planning to make prescription drug labels easier to read and capable of being updated quickly on the Internet, according to iHealthBeat. FDA is responding to complaints that the current system is too slow and inflexible.

It currently can take months for new warnings to be added to drug labels, but beginning next month, drug makers will be required to electronically submit
changes to their product labels… The FDA also is considering releasing regular – possibly weekly – updates on side effects of drugs on the market..

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FDA reports that Toprol, Topamax and Tergetol have been mixed up with one another. The names are similar and doctors’ bad handwriting on prescriptions is notorious. Any e-prescribing tool will solve the legibility problem.

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From the Wall St. Journal:

“A California hospital suspended its liver program after finding a Saudi man who paid a premium jumped to the front of the transplant queue.”

Sound like we need the Monty Python troupe to come by and ask, “Can we have your liver?”

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Guidant is under fire for paying doctors $100 to fill out a survey providing their feedback on defibrillators and pacemakers. I haven’t seen the survey but if it’s asking legitimate questions that Guidant needs answers to in order to develop products then it seems reasonable to pay doctors for their time.

One aspect of the survey program does seem a little suspect, though. Apparently doctors are allowed to fill out multiple surveys.

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Employers expect to pay about 6.4% more for health care in 2006 than 2005 according to a survey by Mercer. The increase would have been 10% if benefit design had stayed the same. But instead employers continue to shift costs to employees.

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The conventional wisdom is that health care is mainly a local business, with hundreds or thousands of local markets, each with its own dynamics. But that’s changing as commercial health insurers consolidate, Medicare becomes ever more prominent, and evidence based medicine and pay for performance become the norm. Today brings another step in that evolution as WellPoint announced its acquisition of WellChoice, creating a plan with 33 million members.

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A popular restaurant in my neighborhood recently converted to an outpatient MRI/CT clinic.

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A new poll shows that at least half of Americans are at least somewhat concerned that they will be over-treated when they are sick. Many say they have foregone recommended tests, treatments and prescriptions that they thought were unneeded. Does this indicate that Americans are overtreated overall? Not necessarily.

Some treatments and tests that patients feel are unneeded may actually be important, but doctors don’t always explain them well or provide enough reinforcement. Sometimes doctors don’t bother to tell patients about all the treatment options, in some cases mistakenly assuming a patient won’t be interested or won’t be a good candidate. Although there are often financial incentives for over-treatment, these are often at least partially offset by incentives to restrain utilization.

I’d be interested to see the results of a similar poll in Canada, where in my experience undertreatment is the norm.

See here for details.

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The phenomenon of Viagra and crystal meth abuse among gay men wanting to “party and play” is well known among HIV researchers. Crystal meth reduces inhibitions and also sexual performance. Viagra more than offsets the performance effects of crystal meth. The result of this drug abuse is more dangerous sexual activity and the spread of HIV. The last thing Viagra’s maker Pfizer wants is to be associated with this problem, but unfortunately it’s not easy to stop.

Drug companies –including the makers of Cialis and Levitra in addition to Viagra– are meeting with the FDA this week to discuss what to do. There’s an article about it in the Boston Globe.

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