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Grassley Digs Into Biederman

Sen. Chuck Grassley (R-Iowa) has tenaciously gone after what he sees as conflict of interest in the medical field, focusing closely on psychiatry. In the latest volley in his investigation into Dr. Joseph Biederman of Harvard University, Sen. Grassley said he was provided documents as part of ongoing litigation that appear to demonstrate that Dr. Biederman was acting in tandem with Johnson & Johnson to promote Concerta and other psychopharmacologics for off-label uses. Sen. Grassley sent a 63-page missive to the presidents of Harvard and the Massachusetts General Hospital outlining numerous apparent conflicts, including that Dr. Biederman was receiving $500,000 in grant money from the National Institutes of Health while he was running J&J's Center for Pediatric Psychopathology Research. Separately, in a letter to the New Jersey judge overseeing the litigation that peripherally involves Dr. Biederman, the psychiatrist's attorneys are seeking an order to prevent public disclosure of his deposition. Among other things in that deposition, when asked what rank followed full professor at Harvard, Dr. Biederman answered “God.”

Dementias Three Times as Costly

The latest report on Alzheimer's disease and other dementias from the Alzheimer's Association finds that Medicare pays out three times as much for beneficiaries with brain diseases, averaging $15,000 annually, compared with about $5,000 for those with no dementias. The 2009 report also found that 5.3 million Americans are living with AD. The organization expects 500,000 new cases a year in 2010, and a million per year by 2050. From 2000 to 2006, Alzheimer's disease deaths rose 47%, whereas deaths from other major diseases declined. The disease is also taking a toll on family members, who provide care for 70% of those with Alzheimer's. More states are querying caregivers about the impact. In Washington state, 48% of caregivers said stress was their greatest difficulty.

Painkiller Admissions on Rise

The Substance Abuse and Mental Health Services Administration (SAMHSA) is reporting that prescription painkiller misuse admissions have risen from 1% of total admissions in 1997 to 5% in 2007. The data come from the Treatment Episode Data Set 2007 Highlights report, which also found that alcohol-related admissions still account for the largest portion, but that they declined from 50% to 40% over the 10-year period. Heroin admissions have remained steady for a decade, at 14%, and methamphetamine admissions hit 8% in 2007, up from 4% in 1997. The dataset is not comprehensive, because it comes only from state-licensed treatment facilities.

Group Wants Ban on Industry CME

The consumer watchdog group Public Citizen has asked the American Medical Association to support a ban on commercial support of continuing medical education. In a letter to the chairs of the AMA's ethical and CME councils, Public Citizen's Health Research Group said that it wants the ban “because the consequences of any corrupting influence of commercial support on CME are so significant.” The group said that “physician-supported CME” is a viable alternative to commercial funding. The Pharmaceutical Research and Manufacturers of America said in a statement that a ban on commercial support of CME could prevent physicians from accessing critical information about treatments.

CNS Drugs Rank High in Cost

Medications that affect the central nervous system accounted for about $28 billion of the $208 billion American adults spent on prescription drugs in 2006, said the Agency for Healthcare Research and Quality. Metabolic drugs topped the list at $38 billion, cardiovascular drugs cost $33 billion, psychotherapeutic drugs cost more than $17 billion, and hormones cost $14 billion. The agency also found spending for outpatient prescription analgesics rose from about $4 billion in 1996 to more than $13 billion in 2006.

Boston Limits Tobacco Sales

Boston has banned tobacco-product sales at pharmacies and on college campuses. The Boston Public Health Commission's board of health also banned new permits for smoking bars, such as hookah and cigar bars, and prohibited the sale of blunt wraps, a tobacco leaf often used to roll marijuana. The board said it was working to increase access to smoking cessation resources. Last year, San Francisco imposed the first municipal ban on cigarette sales by pharmacies. Many college campuses already ban tobacco.

Physicians Postponing Retirement

Fewer physicians left group practices in 2008 than in 2007, and most group practice leaders believe that this change reflects more physicians' postponement of retirement because of the poor economy, said the American Medical Group Association. The group's annual survey of AMGA members reported about a 6% turnover of group practice physicians in 2008, compared with nearly 7% in 2007. The top reasons cited for leaving a group included poor fit with one's practice and the need to relocate to be closer to family. Flexibility can keep physicians in a practice, according to respondents, nearly half of whom said that part-time options encourage physicians either to stay while meeting personal needs, or to delay retirement.

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FYI