Study Finds Cost of Diabetes in the United States Exceeds $217 Billion

• Author: Health Informer
• Filed under: Health News
• Date: Nov 18,2008

Current Cost Figures Only Include Diagnosed Patients

According to findings from a National Diabetes Economic Barometer study, undiagnosed, pre-diabetes and diabetes cost the United States an estimated $217.5 billion in 2007 due to higher medical expenditures and lost productivity.

The research shows that beyond the estimated $174 billion that is widely-accepted as the cost of diagnosed diabetes in 2007, an additional $18 billion was spent on 6.3 million people with undiagnosed diabetes; $25 billion for 57 million American adults with pre-diabetes; and $623 million for the 180,000 pregnancies where gestational diabetes is diagnosed.

The National Diabetes Economic Barometer research was conducted by The Lewin Group and commissioned by the National Changing Diabetes(R) Program (NCDP), an initiative created by Novo Nordisk to improve the lives of people with diabetes.

“In individuals with pre-diabetes, we observed a significant increase in ambulatory visits for a wide variety of medical conditions, including hypertension, endocrine, metabolic and kidney complications,” said Tim Dall, vice president at The Lewin Group. “Additionally, the data show that during the two years before diagnosis people exhibit an increase in ambulatory and hospital-based care for diabetes-related complications.”

As the leading source of health insurance, covering about 158 million non-elderly people in America(1), employers are beginning to feel the financial sting. However, businesses can take steps to help reduce these negative consequences by focusing efforts on diabetes prevention and detection.

“We encourage businesses to take action to reduce the devastating economic consequences of this disease by learning about their workforce, engaging their employees, and making purchasing decisions that will encourage better health choices,” said Dana Haza, senior director of the National Changing Diabetes(R) Program. “If companies can help their employees learn how to better manage their health, businesses can potentially cut down on their own healthcare spending while improving the quality of life of those who work for them.”

At a Forbes Innovation in Healthcare forum sponsored by Novo Nordisk’s National Changing Diabetes(R) Program today, top executives from large employers in the U.S. discussed the critical role of business in addressing the diabetes crisis and protecting the health of our nation’s current and future workforce.

“Novo Nordisk is committed to defeating diabetes, but we can’t do it alone. We started the National Changing Diabetes(R) Program to bring together the many different groups and organizations it will take to beat this disease,” said Jerzy Gruhn, president of Novo Nordisk Inc., the world leader in diabetes care. “As the leading source of healthcare for Americans, businesses have the ability to change the direction of diabetes by tailoring benefits toward prevention, education and access to treatment.”

The National Diabetes Economic Barometer is the second in a series of studies that comprise NCDP’s National Diabetes Triple Barometer, a research program to benchmark the current societal, economic and clinical state of diabetes in the United States.

More information about the National Diabetes Economic Barometer and the National Changing Diabetes(R) Program is available online at www.ncdp.com.

National Diabetes Triple Barometer

Diabetes is an escalating health crisis in the United States. More than 20 million Americans suffer from diabetes and that number is projected to double by 2025. In 2007, the National Changing Diabetes(R) Program undertook a multi-phase initiative — the National Diabetes Triple Barometer — designed to evaluate the current state of diabetes in America in three critical indicators: societal, economic and clinical. After all three barometers are complete, they will be packaged and serve as a comprehensive, authoritative national benchmark and measurement system to create behavior change, drive policy change and catalyze momentum for further strategic system improvements.

(1) Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured, Health insurance Coverage in America, 2005 Data Update, May 2007. Available at www.kff.org/uninsured/upload/2005dataupdate.pdf

Source: Novo Nordisk

New National Poll: Medicare Coverage Gap Confounds Majority of Seniors

• Author: Health Informer
• Filed under: Health News
• Date: Nov 18,2008

Medco Launches National Campaign to Educate Enrollees About the Gap

Nearly two-thirds of enrollees don’t fully understand the Medicare Part D Coverage Gap

Millions of Medicare Part D beneficiaries may not understand a key part of their prescription plan, which can lead to unexpected prescription costs.

According to a new national poll titled “What’s Your Gap? Seniors Struggling with the Medicare Coverage Gap,” nearly two-thirds of enrollees don’t fully understand the Medicare Part D Coverage Gap — the portion of Part D plans in which beneficiaries must cover the full cost of their prescriptions.

In fact, even after three years since the introduction of the Medicare Part D program, and with 56 percent of the eligible population enrolled in the program, more than one in four beneficiaries either don’t understand the Coverage Gap at all, or simply don’t know what the Coverage Gap is. And in spite of the lack of knowledge, nearly one-third of survey respondents have not looked for information on the Coverage Gap to better understand it.

“Seniors are in the dark about the Coverage Gap,” says Dr. Richard Dupee, president of the Massachusetts Geriatric Society and chief of geriatrics at Tufts Medical Center. “Without knowing how the Coverage Gap works, it’s simply impossible to take steps to push off or prevent it.”

To address this issue, Medco unveiled today a multi-level initiative aimed at educating retirees about the Coverage Gap, and what steps they can take to stave off or even prevent them from falling into the “doughnut hole.” The program, “What’s Your Gap?” provides retirees with information about prescription drug savings opportunities, where to look for hidden savings, and clarifies many misconceptions about the Coverage Gap. For example, Part D beneficiaries can save up to 38 percent and delay entering the Coverage Gap by an average of two and a half months by choosing both generics and mail order.

As part of the initiative, Medco has developed a free consumer’s guide called “What’s Your Gap? Three simple steps to make the most of your Medicare Part D coverage and delay the Coverage Gap.” The free guide presents easy-to-understand information on savings tools that are largely unknown or underutilized by beneficiaries and how to track your drug costs against the Coverage Gap. The guide is available free to consumers in a downloadable version at www.whatsyourgap.com, or by sending a postcard requesting the guide to “What’s Your Gap?”, PO Box 8007 Parsippany, NJ 07054-8007.

The poll, a national survey of 1,000 Medicare Part D program participants conducted for Medco Health Solutions, Inc. by Directive Analytics, is one of the first national polls to attempt to uncover some of the underlying reasons that so many beneficiaries end up in the “doughnut hole.” Key findings include:

Gap Hits Those with Chronic Diseases: Among respondents who are already in the Coverage Gap in 2008, more than three out of four regularly take medications to treat more than one chronic condition; among respondents, 43 percent indicated they had reached the Coverage Gap before June of 2008.

Missing Out on Savings: Nearly 28 percent of survey respondents have not used any lower-cost options to reduce their prescription price tag to delay entering the gap. Furthermore, fewer than one in four (23 percent) enrollees have discussed ways to reduce their prescription drugs costs with their physicians. Only 19 percent of respondents indicated they have used a mail-order pharmacy to reduce their drug costs.

In 2008, once Medicare enrollees spend a total of more than $2,510 on prescription drugs in the initial phase of coverage, they enter the Coverage Gap and become responsible for the full cost of their medications. In 2009, the Coverage Gap shifts to total drug costs exceeding $2,700.

Beneficiaries Don’t Know What Costs Count Toward the Gap

According to the survey, one of the root causes of confusion is that Medicare beneficiaries simply don’t know what parts of a prescription’s price count towards the Coverage Gap. Only one-quarter of enrollees polled correctly stated that the total cost of a drug ? both their out-of-pocket cost and the health plan’s portion of the drug price ? count towards the Coverage Gap.

“It’s one of the great Medicare myths ? that only copays or out-of-pocket costs count towards the doughnut hole,” says Dr. Dupee. “This misunderstanding gives many seniors a false sense of security that the Coverage Gap is months away, when in reality, it could hit them with their next refill.”

Bridging the Communication Gap

Recognizing the significance of educating enrollees about the specifics of the Coverage Gap, Medco has implemented an integrated Coverage Gap communications program that alerts its Prescription Drug Plan (PDP) members and specific health plan beneficiaries through mailings and outbound phone calls of their proximity to the Gap long before they reach it. Additionally, any time one of these members contacts a customer service representative for any reason, that member can be provided with a real-time Coverage Gap status update. To promote increased use of generics in order to help members delay entry into the Coverage Gap, Medco also offers members prescription forms that they can bring to their physician or will contact the doctor on their behalf to discuss generic alternatives that can lower the patient’s medication costs.

Source: Medco Health Solutions, Inc.

Is There Really Such a Thing as Hope in a Jar?

• Author: Health Informer
• Filed under: Health Advices, Health News
• Date: Nov 17,2008

Dermatologists help consumers sort through the cosmeceutical conundrum

When it comes to cosmeceuticals, consumers are bombarded by marketing claims that often fail to live up to their hype. Banking on promises that a product can “reverse the aging process” or “deliver the results of a facelift” leads consumers to spend billions of dollars each year to try an array of anti-aging skin care products. Their hope is that one day they will find a product that actually lives up to its claims.

Speaking today at the American Academy of Dermatology’s SKIN academy (Academy), dermatologist Patricia K. Farris, MD, FAAD, clinical associate professor of dermatology at Tulane University School of Medicine in New Orleans, discussed how to separate fact from fiction when evaluating cosmeceuticals and tips for gauging the validity of product claims.

“When consulting with our patients, dermatologists can suggest skin care products that have strong science behind them and that have been proven to be safe and effective in human studies,” said Dr. Farris. “The biggest problem with cosmeceuticals is not that they don’t work, but that their benefits are greatly exaggerated.”

Cosmeceuticals can be divided into categories based on their active ingredients. Anti-oxidants represent the largest category. They are followed by peptides (small proteins that stimulate the production of collagen and thicken the skin) and growth factors (compounds that act as chemical messengers between cells and play a role in cell division, new cell and blood vessel growth, and the production and distribution of collagen and elastin). More recently, Dr. Farris noted that the new trend is toward combination products. For example, cosmeceuticals with multiple anti-oxidants, retinol plus anti-oxidants, growth factors plus vitamin C and other unique combinations that are now being mass marketed. Consumers tend to favor combination products, embracing the philosophy that if one ingredient is good, then two must be better.

“The important thing to understand about combination products is that often the individual ingredients have been studied, but the combination of active ingredients has not,” said Dr. Farris. “More rigorous scientific studies are necessary to assure that biologic activity is maintained when ingredients are formulated together, and clinical studies should be done to determine if combination products really offer any added benefit.”

Consumer demand is high for cosmeceuticals containing “natural” or “organic” ingredients. However, Dr. Farris advised that the notion that these ingredients are safer than synthetic ones is a common misconception. In reality, there is no data to support the notion that natural or organic ingredients — derived from the root, stem, leaves, flowers and fruit of plants — are safer or even more effective than their synthetic counterparts.

“The problem with cosmeceuticals labeled ‘natural’ is that the labels themselves don’t mean anything because these products are not regulated by the Food and Drug Administration (FDA),” said Dr. Farris. “In fact, ‘natural’ skin care products are less tested and scrutinized than synthetic products and pharmaceuticals.”

Dr. Farris noted that most compounds as they exist in their natural state cannot be formulated into skin care products. They must be chemically altered before they can be incorporated into cosmetics. For instance, compounds including retinol, vitamin C, and soy are among those that require chemical alteration — after which they are referred to as enhanced natural ingredients. Enhanced natural ingredients tend to be more stable, penetrate better and have more long-lasting effects on the skin than unaltered plant extracts, which is the reason why most cosmeceuticals contain chemically-altered ingredients.

“There are a number of cosmeceutical ingredients that are completely synthetic, such as collagen-boosting peptides and synthetic forms of vitamin A,” explained Dr. Farris. “These compounds are among the most potent anti-aging ingredients and have been used extensively by dermatologists. So, it’s important for consumers to understand that synthetic ingredients are not necessarily bad and, in fact, skin care products containing these ingredients are probably among the most effective in the marketplace.”

Dr. Farris explained that the key to evaluating the effectiveness of cosmeceuticals is understanding how they are tested. After an active ingredient has been identified, it is evaluated using polymerase chain reaction (PCR) testing, which is used to characterize biologic activity and determine if the ingredient is an anti-oxidant or anti-inflammatory. PCR testing also can tell if an ingredient increases collagen production or reduces collagen breakdown. Although PCR testing is a valuable part of the testing process, many of the claims made as a result of PCR testing are not substantiated by human studies.

“For dermatologists, the gold standard for confirming a product’s efficacy remains the double-blind, vehicle-controlled study,” said Dr. Farris. “In this type of objectively designed study, the product containing the key ingredients is tested against the vehicle, or the product formulation that is similar to the product being tested but without the key active ingredients.” Dr. Farris explained that even though a compound may stimulate collagen production in PCR testing, it does not mean that the ingredient will cause any visible improvement in fine lines and wrinkles.

“Since cosmeceuticals are not subject to the FDA’s rigorous approval process, most cosmetic manufacturers do not perform double-blind, vehicle-controlled studies,” said Dr. Farris. “Instead, they rely on what are called open-label user studies where subjects apply test creams for a few weeks and then assess their improvement over baseline. Unfortunately, these types of studies are of no real value in determining product efficacy because they do not assess the vehicle’s effect and there are no objective measures. People participating in these studies want to believe that they look better after using the product, but that does not necessarily mean it works.”

Dr. Farris offered these tips when purchasing cosmeceuticals:

• Ask yourself what the product claims to do and what kinds of studies have been performed.
• Trust your instincts. If it sounds too good to be true, then it probably is.
• Stick with products and brands that you know to be reputable. Well-known manufacturers have more money behind their active ingredients and product testing.
• Beware of Web site claims, as many are biased even if they say they are objective.
• For day, use products containing anti-oxidants, as they have sun-protection properties. At night, use products containing retinoids, peptides or growth factors for their repair properties.
• Talk to your dermatologist about the best options for your skin care needs.

For more information on aging skin, go to the “AgingSkinNet” section of http://www.skincarephysicians.com/, a Web site developed by dermatologists that provides patients with up-to-date information on the treatment and management of disorders of the skin, hair and nails.

Headquartered in Schaumburg, Ill., the American Academy of Dermatology (Academy), founded in 1938, is the largest, most influential, and most representative of all dermatologic associations. With a membership of more than 15,000 physicians worldwide, the Academy is committed to: advancing the diagnosis and medical, surgical and cosmetic treatment of the skin, hair and nails; advocating high standards in clinical practice, education, and research in dermatology; and supporting and enhancing patient care for a lifetime of healthier skin, hair and nails. For more information, contact the Academy at 1-888-462-DERM (3376) or http://www.aad.org/.

New Data, New Directions in the Management of Mood and Anxiety Disorders

• Author: Health Informer
• Filed under: Health News
• Date: Nov 17,2008

8th International Forum for Mood and Anxiety Disorders Congress Roundup

Clinicians and researchers from around the world attended this week’s 8th International Forum on Mood and Anxiety disorders in Vienna, Austria to discuss the latest advances in the treatment of mood disorders.

A wide range of topics were included in this year’s programme, highlighting the position of IFMAD in the congress calendar as a forum for breaking news, original thinking and debate.

Highlights from the meeting included the latest new treatments for depression and anxiety disorders. There was the first comprehensive presentation of data demonstrating that quetiapine has clear cut efficacy in major depressive disorder (MDD), including a study in the elderly, a difficult to treat and under-researched patient population. It is also the first time that an antidepressant has shown consistent early efficacy at one week in both MDD and bipolar depression. Delegates were excited at the announcement at IFMAD of the first EU licence within the EU for a treatment for bipolar depression.

This year’s IFMAD reflected the rapid pace in which new discoveries are being made to improve our understanding of the mechanisms of mood disorders, the underlying neurobiology and the role of antidepressant treatment. Data evaluating a wide range of potential treatment directions were presented, including studies on the antidepressant agomelatine which targets melatonin and serotonin receptors in the brain. Other new data were presented showing that as much as 30 percent of unipolar depression has genetic or symptomatic predictors for the development of bipolar disorder and the delegates agreed that this was an important area for further research and the targeting of new treatments.

“We are living in exciting times for the treatment of mood disorders with new approaches and new targets being discovered and explored all of the time,” said Professor Siegfried Kasper, IFMAD Chairman and Professor of Psychiatry, Head of the Department of Psychiatry and Psychotherapy at the Medical University of Vienna, Austria. “The breadth of data presented at this year’s IFMAD has really demonstrated this, providing delegates with a comprehensive update of cutting edge advances in the field.”

Other elements of the meeting included an important debate on the relationships between pain, anxiety and depression and the continuing problem of under-diagnosis of GAD despite its prevalence and significant burden to society. The vital need to ensure patient concordance in the treatment of depression and anxiety was discussed, including the roles of patient education, monitoring and the selection of treatments with minimal side effects.

“The format of IFMAD allows informal debate and brings together leaders in the field of mood and anxiety disorders to discuss the most pressing topics and issues of the moment,” said Professor Stuart Montgomery, IFMAD Co-Chairman and Emeritus Professor of Psychiatry, Imperial College of Medicine, University of London, UK. “What sets IFMAD apart is that the meeting is friendly and small enough to allow that informal exchange of new and emerging data from around the world.”

This year’s meeting also marked the launch of the new IFMAD website, providing an online forum to ensure that clinicians and researchers can access the latest developments in mood disorders throughout the year. A full roundup of the 8th IFMAD meeting, including the final abstract book, will be available shortly on the new website, http://www.ifmad.org.

Source: IFMAD