(Circulation. 2001;104:e9001.)
© 2001 American Heart Association, Inc.
Cardiovascular News
US Department of Health and Human Services Will Improve Drug Access to Safety-Net Patients
Health and Human Services Secretary Tommy Thompson announced changes that he said should make it easier for community health centers and other safety-net providers to make drugs available to their medically indigent patients.
"Through this initiative, organizations will be able to stretch scarce resources and buy more of the drugs their patients need," said Secretary Thompson. "The initiative responds to proposals from local safety-net providers, and it exemplifies our commitment to support grass-roots efforts that improve primary care services for uninsured and underserved Americans."
Groups that participate in demonstration projects can:
- Participate in single
purchasing and dispensing systems that serve the networks in
question.
- Contract with many pharmacy service providers.
- Use contracted pharmacy services to supplement in-house pharmacy services.
- Contract with many pharmacy service providers.
Secretary Thompson said the new plans would allow the safety-net providers to benefit from economies of scale, allowing the center to purchase more drugs without increasing total expenditures. Contracting with multiple pharmacy providers to supplement in-house pharmacies could improve the patients’ access to drugs.
A description of the proposal and requirements for participation can be found at http://www.hrsa.gov/odpp.
Development of Artificial Blood Is in the Final Lap
More than half-a-dozen blood substitutes are in development in the United States, according to the Los Angeles Times in a June 18, 2001, article. The "artificial blood" is a long-time "holy grail" of scientists seeking to find a safe, readily available substitute for human blood.
According to the Times, the first generation of blood substitutes should hit the market in the next 2 years. These substitutes should ease the chronic blood shortages that plague the United States. They would also reduce the risk of infections, which have become increasingly apparent in the past 2 decades.
Although the artificial blood now under development would take the place of only red blood cells, they are intended mainly for emergency, life-threatening situations in which human blood is unavailable. The artificial substitutes are designed to have a long shelf life at room temperature.
National Research Organizations Call for Better Care at the End of Life
The Institute of Medicine, in a report released June 19, 2001, called for national leadership in improving pain control and end-of-life care for the 550 000 Americans who will die from cancer each year.
Approximately half of those who die from cancer suffer needlessly from "pain, breathing difficulties, and depression," according to the report. The report also noted that most research and training focuses on treatment designed to cure, not on palliative care that can relieve symptoms. It calls for more research in the area of pain control and treating patients at the end of life and for insurers to pay for such care. The report noted that many members of minority groups and those who live in inner cities have less access to palliative care for cancer than their white and suburban counterparts. In addition, it called for more attention to symptom relief of dying children, who frequently do not receive adequate pain relief.
The Cleveland Clinic Foundation’s Joanne Hilden, founder of the Children’s Oncology Group’s end-of-life care task force, told the Washington Post in a June 20, 2001, article, "The discussions are hard. Are we going to do experimental chemo for leukemia? Or shall we stop? Do you want to go on or off the ventilator? That’s the down-and-dirty stuff. That’s not a 10-minute conversation."
Consumer Group Exposes High HMO Executive Compensation
A report issued June 21, 2001, by the consumer advocacy group Families USA revealed that a top HMO executive received more than $54 million in compensation in the year 2000 and had $358 million in unexercised stock options.
The report, which was released at the time that debate began on the McCain-Edwards-Kennedy patients’ rights bill, revealed that William W. McGuire, CEO of UnitedHealth Group Corporation, was the highest paid executive in the industry in the year 2000. However, the advocacy group said he is not alone. The report noted that top-level executives of major managed care companies such as Aetna, CIGNA, Oxford Health, and WellPoint Health Networks received multimillion dollar compensation packages and held unexercised stock options in the tens of millions of dollars.
"While the managed care industry decries the pennies needed for important patient protections, it is glad-handing many millions of dollars into the pockets of its top executives," said Ron Pollack, Families USA’s executive director. "Clearly, the industry has a double standard about costs: a very generous standard for its executives and a miserly one for America’s consumers and patients."
The compensation-related data for the report is based only on the information provided by those companies to the Securities Exchange Commission (SEC). The full report can be found at http://www.familiesusa.org/html/whatsnew/whatsnew.htm.
Food Fortification Decreases Neural Tube Defects
Neural tube defects decreased by 19% after the decision to fortify US foods with folic acid, according to a report in the June 20, 2001, issue of the Journal of the American Medical Association (2001;285:2981–2986).
For the past decade, the US Centers for Disease Control and the US Public Health Service have recommended that all women of childbearing age consume 400 µg of folic acid each day to decrease the risk of neural tube defects such as spina bifida and anencephaly; this recommendation came in the wake of research that demonstrated that the vitamin reduces such birth defects.
"This reduction is an excellent step and represents the work of many partners in the fight against these serious birth defects, but it is not enough," said Jeffrey P. Koplan, MD, MPH, director of the Centers for Disease Control. "We must continue the momentum to have a nation of healthy babies born without neural tube defects. We must stay vigilant and continue to work together to educate women of child-bearing age, their families, and their healthcare professionals about the contributions of folic acid and fortification of our foods."
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