June 2010

Bay State Rate Battle

Massachusetts the Site of Latest Clash over Premiums

Although 4 of the state’s largest health insurers posted first-quarter losses that they attributed mostly to Governor Deval Patrick’s efforts to slow premium growth rates for individuals and small businesses, the Massachusetts Division of Insurance is holding firm on its decision to deny insurers’ requests for premium increases. Insurers challenging the rejections assert that premium increases are a direct and necessary result of the rising cost of medical care and say the denials amount to arbitrary price contro



Reports Document Growth of HSAs

Increases in Enrollment and Assets Continue

Led by growth among large-group insurers, enrollment in high-deductible health plans (HDHPs) and associated health savings accounts (HSAs) exceeded 10 million this year. Separate research projects recently conducted by America’s Health Insurance Plans (AHIP) and the Employee Benefit Research Institute (EBRI) quantify expansion in both the number and value of HSAs. After several years of increases, the continued expansion of HDHP/HSA arrangements may depend on how new regulations issuing from national healthcare reforms influe



Aspirin versus Placebo Does Not Result in Significant Reduction in Vascular Events

In an intention-to-treat, double-blind, randomized controlled trial, researchers found that the administration of aspirin compared with placebo did not result in a significant reduction in vascular events among participants without clinical cardiovascular disease. Those participants were identified as having a low ankle-brachial index (ABI) based on screening a general population. The authors claimed the trial was the first to report on the effectiveness of aspirin in reducing major cardiovascular and cerebrovascular events in individuals from the general population who



End-of-Life Decision Making and the Role of Advance Directives

Discussions prior to passage of recent healthcare reform laws raised awareness of the use of advance directives to direct end-of-life care. Advance directives document a patient’s wishes regarding life-sustaining treatment, choice of a surrogate decision maker, or both. In 1990, Congress passed the Patient Self-Determination Act mandating that all Medicare-certified institutions provide written information about a patient’s right to formulate an advance directive. Recently, according to researchers, concerns were generated by some of the provisions in the new law that reimbursing provid



Pneumococcal Vaccine Does Not Reduce Risk of MI, Stroke in Men

Pneumococcal vaccination does not reduce the risk of acute myocardial infarction (MI) or stroke in men ≥45 years of age, according to a study published in the Journal of the American Medical Association [2010;303(17):1699-1706].

A prospective cohort study was performed with data collected by the California Men’s Health Study, which is a multiethnic cohort of men enrolled in Kaiser Permanente Northern California and Kaiser Permanente Southern California health plans. The analysis included 84,170 participants between the ages of 45 and 69 years, recruited from January



Xifaxan (rifaximin)

Xifaxan (rifaximin) is a rifamycin antibiotic that is gut selective with negligible systemic absorption and broad-spectrum activity in vitro against both gram-positive and gram-negative pathogens. The drug is minimally absorbed and concentrates in the gastrointestinal tract.

Rifaximin was recently approved for reduction in risk of overt hepatic encephalopathy recurrence in patients ≥18 years of age. The product is also indicated for treatment of patients ≥12 years of age with travelers’ diarrhea caused by noninvasive strains of Escherichia coli.

Hepatic encephalopathy



Long-Term Treatment with Asenapine Safe and Effective for Schizophrenia and Schizoaffective Disorder

New Orleans—An extension study that looked at the safety and efficacy of asenapine to treat patients with schizophrenia or schizoaffective disorder found that asenapine remains well tolerated and effective for up to 3 years of treatment. The study, presented in a poster at the recent APA meeting by Joep Schoemaker, MSc, of Merck Sharp & Dohme, confirmed previously published results that showed the safety and efficacy of asenapine for schizophrenia or schizoaffective disorder after 1 year of treatment.

The 1-year, double-blind,



Outcomes Compared for Patients with Alzheimer’s and Non-Alzheimer’s Dementia

Atlanta—A review of records from the National Alzheimer Coordinating Center’s Uniform Data Set (NACC-UDS) found that patients with Alzheimer’s disease (AD) transition more quickly to states of more severe dementia as measured by the Mini-Mental State Examination (MMSE) than patients with non-AD dementia. Patients with non-AD dementia, however, were more likely to be institutionalized or die.

The NACC-UDS is a large, longitudinal dataset funded by the National Institute of Aging that includes AD and non-AD dementia patients, and



Product Updates

News

New Treatment for Late-Onset Pompe Disease
The FDA approved alglucosidase alfa (Lumizyme) for patients ≥8 years of age with late-onset, noninfantile Pompe disease, a rare genetic disorder. Alglucosidase alfa, marketed by Genzyme Corporation, is believed to work by replacing the deficient acid alpha-glucosidase necessary for proper muscle functioning, thereby reducing the accumulated glycogen in heart and skeletal muscle cells.

Alglucosidase alfa is being approved with a Risk Evaluation and Mitigation Strategy. It will only