AAFP News Now: AFP Edition
Policy and Health Issues in the News
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Am Fam Physician. 2010 Jun 1;81(11):1311-1312.
Thousands of Physicians Eligible for Settlement from UnitedHealth Group
Family physicians could be among the thousands of physicians entitled to money from a class-action settlement with UnitedHealth Group. According to the American Medical Association (AMA), the settlement involves payments to physicians for health care services provided by out-of-network health care professionals. The class-action suit asserted that for more than a decade, UnitedHealth Group used a flawed database to determine its out-of-network payment rates. According to the AMA, use of the flawed database increased insurers’ profits at the expense of patients and physicians. Although UnitedHealth Group did not claim responsibility in the case, the company settled out of court and agreed to pay $350 million to physicians and patients whose payments may have been affected. Notices to potential members of the settlement should have been mailed no later than May 28, 2010. According to the United Healthcare Settlement Web site, physicians have until July 27, 2010, to opt out of the class-action settlement or file objections to the settlement, and October 5, 2010, to file a proof-of-claim to share in the settlement fund. For more information, visit http://www.aafp.org/news-now/practice-management/20100428unitedsettlement.html, and http://www.uniteducrsettlement.com/.
Med Watch McNeil Recalls Pediatric Products; Infusion Pumps Also Recalled
McNeil Consumer Healthcare said in an April 30, 2010, news release that it is recalling all lots of certain brand-name, over-the-counter children’s and infants’ liquid medications, including more than 40 variations of Tylenol, Motrin, Zyrtec, and Benadryl products. McNeil said the products were being recalled because of manufacturing deficiencies that could affect quality, purity, or potency. In a May 1, 2010, news release, U.S. Food and Drug Administration (FDA) officials said that some of the recalled products may contain higher concentrations of active ingredients than specified, whereas others contain foreign particles or inactive ingredients that may not meet internal testing requirements. The FDA said generic versions of the products are not affected by the recall and are considered safe to use. In another recall, The FDA has ordered Baxter Healthcare Corp. to recall and destroy all of its Colleague Volumetric Infusion Pumps. In addition, Baxter must reimburse customers for the value of the recalled pumps and assist them in finding replacement devices. The FDA estimates that there are as many as 200,000 Colleague pumps currently in use. Colleague pumps have been the subject of Class I recalls—the FDA’s most severe recall status, signifying there is a potential for serious injury or death associated with a product—because of battery swelling, inadvertent power loss, service data errors, and other issues. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20100504mcneil--recall.html, http://www.fda.gov/Safety/Recalls/ucm210443.htm, http://www.aafp.org/news-now/health-of-the-public/20100505baxter-recall.html, and http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm210664.htm.
FDA Evaluating Safety of Certain Drugs for the Treatment of Prostate Cancer
The FDA is evaluating whether gonadotropin-releasing hormone (GnRH) agonists increase the risk of diabetes mellitus and certain cardiovascular diseases in men who receive these medications to treat prostate cancer. The drugs are used in androgen deprivation therapy, which has been shown to slow the growth of prostate cancer and shrink prostate tumors by suppressing testosterone. The FDA advises physicians to carefully weigh the benefits and risks of prescribing GnRH agonists and to manage patients’ cardiovascular risk factors (e.g., smoking; increases in blood pressure, cholesterol, blood sugar, and weight) according to current clinical practice. Patients receiving GnRH agonists should not stop their treatment unless told to do so by their physicians. For more information, visit http://www.aafp.org/news-now/health-of-the-public/20100504gnrh-agonists.html, and http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm210549.htm.
AHRQ Posts Summary Guides on Cholesterol Treatment and Reducing Breast Cancer Risk
The Effective Health Care Program of the Agency for Healthcare Research and Quality (AHRQ) recently posted summary guides on the treatment of high cholesterol and medications to reduce the risk of primary breast cancer. “Treating Cholesterol With Combination Therapy: Clinician’s Guide” summarizes current clinical evidence on using combinations of lipid-lowering medications to treat high cholesterol. It covers the major classes of lipid-lowering medications, but it does not discuss dietary and lifestyle changes. Evidence was insufficient to draw conclusions about the rates of clinical events and mortality; reduction in cholesterol levels; and rates of adverse events in combination therapy compared with statin monotherapy. “Medications to Reduce the Risk of Primary Breast Cancer in Women: Clinician’s Guide” summarizes the safety and effectiveness of the medications tamoxifen and raloxifene (Evista) for breast cancer prevention. According to the guide, both medications are effective at reducing the risk of primary invasive breast cancer in women 35 to 70 years of age, and both reduce the likelihood of a woman developing breast cancer by a similar amount. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20100427ahrq-guides.html, and http://www.effectivehealthcare.ahrq.gov/index.cfm/guides-for-clinicians/.
Study Finds That Following Breastfeeding Recommendations Saves Money and Lives
A study published online April 5, 2010, by Pediatrics estimates that if 90 percent of American mothers complied with recommendations to breastfeed exclusively for the first six months of a child’s life, the United States would save $13 billion per year and prevent more than 900 infant deaths. A 2001 study by the U.S. Department of Agriculture (USDA) estimates that $3.6 billion could be saved if breastfeeding rates increased to the more modest goals established by the Healthy People 2010 initiative, which calls for 75 percent of mothers to breastfeed in the early postpartum period, 50 percent at six months postpartum, and 25 percent at one year postpartum. The USDA study examined the economic impact of breastfeeding for three diseases: necrotizing enterocolitis, otitis media, and gastroenteritis. The recent Pediatrics study went further, examining nearly all childhood diseases for which the AHRQ had reported risk ratios that favored breastfeeding in a 2007 evidence report: necrotizing enterocolitis; otitis media; gastroenteritis; hospitalization for lower respiratory tract infections; atopic dermatitis; sudden infant death syndrome; childhood asthma; childhood leukemia; type 1 diabetes; and childhood obesity. The American Academy of Family Physicians (AAFP), the American Academy of Pediatrics, the U.S. surgeon general, and the World Health Organization all advocate that mothers breastfeed their infants exclusively for the first six months of life. For more information, visit http://www.aafp.org/news-now/clinical-care-research/20100422breastfeeding-peds.html, and http://pediatrics.aappublications.org/cgi/content/abstract/peds.2009-1616v1.
Survey Evaluates Whether Subspecialist Practices Can Serve as PCMHs
A recent telephone survey funded by The Robert Wood Johnson Foundation explored the extent to which subspecialist physician practices function as patient-centered medical homes (PCMHs). The survey results were published online April 21, 2010, by the New England Journal of Medicine. The survey included respondents from 207 cardiology practices, 58 endocrinology practices, and 108 pulmonology practices. Results indicated that endocrinologists were significantly more likely to serve as primary care physicians than physicians in the other two subspecialties surveyed. Small practices (i.e., having no more than two physicians) in all three subspecialties were more likely than large group practices to consider their practice a PCMH. Researchers point out that the recently passed health care reform legislation refers to medical homes as practices that provide primary care, and the authors question whether policymakers should encourage some medical subspecialty practices to serve as PCMHs. The authors concluded that subspecialty practices that want to serve as PCMHs should be allowed to do so, but should be held to the same standards as primary care–based medical homes. For more information, visit http://www.aafp.org/news-now/professional-issues/20100428nejmpcmhstudy.html, and http://healthcarereform.nejm.org/?p=3348.
AFP Launches New Online Feature: AFP By Topic
American Family Physician (AFP) recently launched a new online feature, “AFP By Topic: Editors’ Choice of Best Current Content,” available at http://www.aafp.org/afp/topics. This new resource provides in one place the best content from AFP Online for 30 core clinical topics, such as asthma, coronary artery disease, diabetes, and hypertension. The main categories for each topic include diagnosis, treatment, prevention, and complications.
NCSC Delegates Discuss AAFP Board Representation and Consumer Alliance
The AAFP National Conference of Special Constituencies (NCSC) took place in Kansas City, Mo., from April 30 to May 1, 2010. NCSC delegates encouraged the AAFP to broaden their representation by asking for a seat on the AAFP Board of Directors. In addition, they voted for a resolution that asks the AAFP to support legislation that would allow balance billing of patients. However, NCSC delegates decided not to support a resolution calling on the AAFP to rescind its Consumer Alliance Program contract with The Coca-Cola Company. Other resolutions adopted by the delegates include asking the AAFP to support the development of a comprehensive health disparities curriculum and to create a local database of state-sponsored student recruitment initiatives. For more information, visit http://www.aafp.org/news-now/inside-aafp/20100506ncsccap.html.
— AFP and AAFP NEWS NOW staff
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Copyright © 2010 by the American Academy of Family Physicians.
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