Hospital Quality Measures: Value Based Purchasing 2.0 (The Funny Version).
For years, hospital quality measures have been tracked by private and government insurance programs to try and improve the healthcare services received by their beneficiaries. The most recent example is the Value-Based Purchasing Program (VBP) initiative by The Centers For Medicare & Medicaid Services (CMS). How does CMS describe VBP?"Under the Program, CMS will make value-based incentive payments to acute care hospitals, based either on how well the hospitals perform on certain quality measures or how much the hospitals' performance improves on certain quality measures from their performance during a basel...
Source: The Happy Hospitalist - March 14, 2014 Category: Internists and Doctors of Medicine Authors: Tamer Mahrous Source Type: blogs
Pharmaceutical Companies Drastically Cut Speaker Payments for Doctors
A number of large pharmaceutical companies have greatly reduced payments to healthcare professionals for promotional speeches. ProPublica reports that GlaxoSmithKline and Pfizer have dropped their speaking payments by over 60% from 2011 to 2012. Eli Lilly reduced their spending by 55%, from $47.9 million in 2011 to $21.6 million in 2012. During the same period, Novartis reduced their spending from $24.8 million to $14.8 million.
ProPublica states that the sharp drop in payments coincides with the large settlement figures pharmaceutical companies have forked over to the government for their marketing practices, including ...
Source: Policy and Medicine - March 7, 2014 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
As Full Disclosure Nears, Doctors’ Pay for Drug Talks Plummets
Some of the nation’s largest pharmaceutical companies have slashed payments to health professionals for promotional speeches amid heightened public scrutiny of such spending, a new ProPublica analysis shows.Eli Lilly and Co.’s payments to speakers dropped by 55 percent, from $47.9 million in 2011 to $21.6 million in 2012.Pfizer’s speaking payments fell 62 percent over the same period, from nearly $22 million to $8.3 million.And Novartis, the largest U.S. drug maker as measured by 2012 sales, spent 40 percent less on speakers that year than it did between October 2010 and September 2011, reducing payments from $24.8 m...
Source: PharmaGossip - March 4, 2014 Category: Pharma Commentators Authors: insider Source Type: blogs
Cardiovascular and Diabetes Outcomes Among Those taking Novel Antipsychotics
I remember from medical school and the early days of my residency when the only medications available to treat psychosis were the neuroleptics. Patients hated taking them: the high potency medicines like Haldol and Prolixin left people rigid; they had pill-rolling movements with their fingers, cogwheeling in their joints, and they walked liked zombies. The lower potency medications like Mellaril left people drooling and sedated. I once heard these medications described as like having molasses poured into your brain. We'd cajole people in to taking them, and like all medications, there were some peop...
Source: Shrink Rap - January 20, 2014 Category: Psychiatrists and Psychologists Authors: Dinah Source Type: blogs
Notes to myself – 2
Pentobarb coma – BIS should be 10-20 and SR (suppression ratio) should be 70-80
Consider lev albuterol
Should give vaccines after coiling of spleen or before if possible
No calcium channel blockers post MI definitely and post op in general
Toradol inhibits spine healing
Don’t do endoscopes with patients in supine position
don’t ambulate patients with known dvt’s. wait 2-3 days until clots get stuck.
dvt’s even with filter get heparin as much as possible for post phlebitic syndrome and to retard new clot formation
diffuse alveolar hemorrhage – secondary to chemo, goodpasture’s, wege...
Source: Inside Surgery - December 31, 2013 Category: Surgeons Authors: Editor Tags: General Source Type: blogs
Impacts of Pharmaceutical Marketing and Healthcare Services in the District of Columbia: Focus on Antipsychotics in the Elderly
In April of last year, we wrote about Washington, DC's AccessRX Act, which requires pharmaceutical companies that market products in the District to file annual reports on marketing expenditures.
In 2011, 158 pharmaceutical companies reported spending a total of $83.7 million on marketing activities in DC, including $57.9 (69.2%) million on employee and contractor expenses, $18.9 (22.5%) million on gifts and payments, and $6.9 (8.2%) million on advertising. A 2009 report addressed pharmaceutical marketing and healthcare services more broadly in DC. Additional reports were then published in for 2010 and 2011.
Hos...
Source: Policy and Medicine - October 29, 2013 Category: Health Medicine and Bioethics Commentators Authors: Thomas Sullivan Source Type: blogs
Investigating the fallout of a suicide - BMJ
This study was a comparison of atypical antipsychotics for the treatment of first episodes of schizophrenia (the CAFE study). The study’s structure was that of a Phase 4 randomized, double blind trial comparing the effectiveness of three different atypical antipsychotic drugs: Zyprexa (olanzapine), Risperdal (risperidone) and Seroquel (quetiapine), with each patient to be treated for a year.After about two weeks on study treatment in the hospital, Markingson was discharged to a halfway house. His mother, Mary Weiss, raised repeated concerns about his condition, questioning his involvement in the trial, but he eventually ...
Source: PharmaGossip - October 9, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Eli Lilly promises major cost cuts
U.S. drugmaker Eli Lilly, which is trying to rebound from painful patent expirations on its medicines, said it would have to cut costs to achieve its financial goals through 2014, but would buy back $5 billion of its stock over time.
Lilly said that slowing growth in emerging markets and the devaluation of Japan's yen were hurting its results. These "headwinds" will make it challenging for the company to meet its minimum revenue goal of $20 billion in 2014, Chief Financial Officer Derica Rice said in a release.
Rice said Lilly was looking for appropriate ways to reach the revenue goal and would reduce costs to meet its obj...
Source: PharmaGossip - October 3, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Vanity Came Knocking: Being Safe with My Bipolar
I nearly checked myself into the mental ward recently. I’ve been once, and it is no vacation.
But, one ordinary day in September, I was in that much pain. And I didn’t trust myself enough to be safe — all over some vanity and pride.
For the most part, over the years, my bipolar disorder has been tamped down with medication, therapy and stress reduction. And, until that day, I thought I was in remission.
But I was wrong.
Remission for me meant experiencing episodes that weren’t much worse than having a bad cold. I didn’t have any mixed episodes, full-blown mania or crushing depression.1 I like the idea ...
Source: World of Psychology - September 15, 2013 Category: Psychiatrists and Psychologists Authors: Meaghan Tags: Bipolar Brain and Behavior Depression Disorders General Mania Medications Mental Health and Wellness Personal Treatment Arrogance Blah Bp Breadwinner Chantix Daily Basis Day In September Ego Failed Attempt Medication Source Type: blogs
A $500 Million Brawl: Lilly, Canada And Invalidated Patents
In the latest twist in the brawl between Eli Lilly and the Canadian government over invalidated patents, the drugmaker has filed for arbitration and is seeking nearly $500 million in damages as part of an effort to force Canada to alter the way patent rights are administered. The case was filed yesterday under the rules of the North American Free Trade Agreement.
The drugmaker is pursuing what is known as an investor-state dispute which, under provisions of international trade treaties, allows companies to initiate disputes against foreign governments. In this case, Lilly maintains that court decisions violated Canadian ob...
Source: Pharmalot - September 13, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
Deadly Medicines and Organized Crime by Peter Gøtzsche
'The main reason we take so many drugs is that drug companies don't sell drugs, they sell lies about drugs. This is what makes drugs so different from anything else in life...Virtually everything we know about drugs is what the companies have chosen to tell us and our doctors...the reason patients trust their medicine is that they extrapolate the trust they have in their doctors into the medicines they prescribe. The patients don't realise that, although their doctors may know a lot about diseases and human physiology and psychology, they know very, very little about drugs that hasn't been carefully concocted and...
Source: PharmaGossip - September 1, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Antipsychotics Can Triple The Risk That Children Develop Diabetes
In a disturbing finding, children prescribed several widely prescribed antipsychotics face a threefold risk of developing type 2 diabetes within the first year of usage compared with other medications that are available for the same disorders the medicines are used to treat. Originally prescribed for schizophrenia, the pills are now used to treat bipolar disorder, ADHD and mood disorders, such as depression.
“It’s well known that antipsychotics cause diabetes in adults, but until now the question hadn’t been fully investigated in children,: Wayne Ray, one of the study authors and director of the division of pharmacoe...
Source: Pharmalot - August 22, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
Feds Probe Antipsychotic Prescriptions For Children In Medicaid
In response to the rising rate at which antipsychotics are prescribed to children, the Office of Inspector General at the US Department of Health & Human Services is investigating the trend and asked the states to tighten prescribing oversight, The Wall Street Journal writes. The move comes amid ongoing that the drugs are used too freely to children to curb violent or aggressive behavior.
The issue, in fact, has been contentious for several years, especially before drugmakers won FDA approval to market their antipsychotics, which are approved to treat schizophrenia, bipolar disorder and autistic disorder, to increasing...
Source: Pharmalot - August 12, 2013 Category: Pharma Commentators Authors: esilverman Source Type: blogs
At Last! - U.S. Probes Use of Antipsychotic Drugs on Children
By LUCETTE LAGNADO
Federal health officials have launched a probe into the use of antipsychotic drugs on children in the Medicaid system, amid concern that the medications are being prescribed too often to treat behavioral problems in the very young.
The inspector general's office at Department of Health and Human Services says it recently began a review of antipsychotic-drug use by Medicaid recipients age 17 and under. And various agencies within HHS are requiring officials in all 50 states to tighten oversight of prescriptions for such drugs to Medicaid-eligible young people.
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The effort applies to a newe...
Source: PharmaGossip - August 12, 2013 Category: Pharma Commentators Authors: insider Source Type: blogs
Breakthroughs in Bipolar Treatment
"We should continue to repurpose treatments and to recognise the role of serendipity" (Geddes & Miklowitz, 2013).That quote was from a recent review article in The Lancet, which did not hint at any impending pharmacological breakthroughs in the treatment of bipolar disorder. In other words, the future of bipolar treatment doesn't look much different from the present (at least in the immediate term). Bipolar disorder, an illness defined by the existence of manic or hypomanic highs, alternating with depressive lows, can be especially difficult to treat. And the mood episode known as a mixed state, where irritability, ex...
Source: The Neurocritic - August 2, 2013 Category: Psychiatrists and Psychologists Authors: The Neurocritic Source Type: blogs
