Tag: "cancer"

How ObamaCare is Hurting Cancer Patients

Scott Gottlieb writing in the Wall Street Journal:

[E]ligible hospitals are buying private oncology practices so they can book more of the expensive cancer drug purchases at the discount rates. More than 400 oncology practices have been acquired by hospitals since ObamaCare passed. Acquiring a single oncologist and moving the doctor’s drug prescriptions under a hospital’s 340B program can generate an additional profit of more than $1 million for a hospital.

Because the overhead for a hospital is higher than for a doctor’s office, a patient treated in a hospital clinic incurs $6,500 more in costs than the same person treated in a private medical office, according to data from the Community Oncology Alliance. Patients who get chemotherapy at a hospital also face an additional $650 in co-pays and other out-of-pocket expenses.

Aug 01, 2013 | 11 comments | by

Redefining Cancer, and Other Links

One way to cut costs: redefine “cancer.”

Medicare patients’ chances of being admitted to the hospital or kept for observation depend on what hospital they go to ― even when their symptoms are the same.

Is psychotherapy over the Internet better than face-to-face counseling?

Jul 31, 2013 | 11 comments | by

Is There Too Much Screening For Cancer?

There’s a simply fantastic Viewpoint in this week’s JAMA that addresses that issue. The basic premise is that over the last 30 years there’s been a real emphasis on “awareness” of and screening for cancer. The idea has always been that this will lead to earlier detection and fewer deaths from cancer. I have argued here repeatedly that this has often led to a much larger increase in diagnosis (and therefore treatment) relative to any declines in mortality.

This is mainly because not all cancer is the same. Some of it might never progress to becoming dangerous. Screening, therefore, picks up cancer that really didn’t need detection. This leads to treatment, and all its negative consequences, without any actual gains in mortality.

Entire post by Aaron Carroll worth reading.

Jul 31, 2013 | 11 comments | by

The Race Divide in Medicare

Using data from Medicare patients, researchers analyzed 107,273 breast cancer cases. The findings were striking. Overall, whites with breast cancer lived three years longer than black women. Of those studied, nearly 70 percent of white women lived at least five years after diagnosis, while 56 percent of black women were still alive five years later.

The researchers found a troubling pattern in which black women were less likely to receive a diagnosis when their cancer was at an early stage and most curable. In addition, a significant number of black women also receive lower-quality cancer care after diagnosis. (New York Times)

Jul 30, 2013 | 10 comments | by

About 1.4 Million Americans Have Mini-Med Health Insurance

And that may not change according to a report in Politico:

Skinny plans will have to cover preventive services like vaccines and cancer screenings without any cost-sharing — a requirement of all insurance under the health law. They can’t put a cap on annual benefits, as limited benefit, or mini-med, plans typically do now. But the lack of a cap is largely symbolic because the plans don’t cover the services that run up medical bills…

And those who want more comprehensive coverage can still go to the exchanges, where they may be eligible for subsidies depending on their income.

“That may be a better option for employees who need better coverage,” Stover said. For those employees who do receive subsidies on the exchange, their employers would have to pay a $3,000 penalty, but it’s likely to be a smaller subset of the workforce, Stover said…

A Treasury Department official confirmed that properly designed skinny plans meet the requirements of the health care law.

Jul 18, 2013 | 12 comments | by

The Whole Idea of a Clinical Trial is Inconsistent with Personalized Medicine

…even after some 400 completed clinical trials in various cancers, it’s not clear why Avastin works (or doesn’t work) in any single patient. “Despite looking at hundreds of potential predictive biomarkers, we do not currently have a way to predict who is most likely to respond to Avastin and who is not,” says a spokesperson for Genentech, a division of the Swiss pharmaceutical giant Roche, which makes the drug.

That we could be this uncertain about any medicine with $6 billion in annual global sales — and after 16 years of human trials involving tens of thousands of patients — is remarkable in itself. And yet this is the norm, not the exception. We are just as confused about a host of other long-tested therapies: neuroprotective drugs for stroke, erythropoiesis-stimulating agents for anemia, the antiviral drug Tamiflu — and, as recent headlines have shown, rosiglitazone (Avandia) for diabetes, a controversy that has now embroiled a related class of molecules. Which brings us to perhaps a more fundamental question, one that few people really want to ask: do clinical trials even work? Or are the diseases of individuals so particular that testing experimental medicines in broad groups is doomed to create more frustration than knowledge?

Researchers are coming to understand just how individualized human physiology and human pathology really are. On a genetic level, the tumors in one person with pancreatic cancer almost surely won’t be identical to those of any other. Even in a more widespread condition like high cholesterol, the variability between individuals can be great, meaning that any two patients may have starkly different reactions to a drug.

More at the NYT.

Jul 18, 2013 | 12 comments | by

The A.M.A. on Obesity, and Other Links

Is obesity a disease?

Study: patients with caregivers are more likely to be readmitted.

Chris Jacobs fact checks the ObamaCare ads.

One more reason to take an aspirin a day: cancer.

70% of Americans are on prescription drugs.

Jun 20, 2013 | 17 comments | by

Not Enough Spending on Cancer Drugs, and Other Links

Scott Gottlieb: We’re not spending enough on cancer drugs.

Is this an argument for forced sterilization?

Unauthorized immigrants account for only 1.4 percent of U.S. medical spending.

Report overstates the economic benefits of the human genome project: It counts inputs as outputs.

Jun 13, 2013 | 12 comments | by

The FDA Cannot Handle Personalized Medicine

The current regime was built during a time of pervasive ignorance when the best we could do was throw a drug and a placebo against a randomized population and then count noses. Randomized controlled trials are critical, of course, but in a world of limited resources they fail when confronted by the curse of dimensionality. Patients are heterogeneous and so are diseases. Each patient is a unique, dynamic system and at the molecular level diseases are heterogeneous even when symptoms are not. In just the last few years we have expanded breast cancer into first four and now ten different types of cancer and the subdivision is likely to continue as knowledge expands. Match heterogeneous patients against heterogeneous diseases and the result is a high dimension system that cannot be well navigated with expensive, randomized controlled trials. As a result, the FDA ends up throwing out many drugs that could do good.

Alex Tabarrok on Peter Huber. See our previous posts on personalized medicine here and here.

Jun 12, 2013 | 11 comments | by

How Half the Newly Insured Are Going To Be Insured

Medicaid patients experience significantly more deaths, longer hospitalizations and more serious complications from major surgery, cancers, heart disease, interventional procedures, transplants and AIDS than equivalent patients with the same illnesses and same health status but with private insurance ― objective data-based conclusions proven by medical scientists in the world’s top peer-reviewed medical journals like Annals of Surgery, Cancer, Journal of Heart and Lung Transplantation and the American Journal of Cardiology. Medicaid outcomes are so shamefully poor that, when comparing patients with the same risk factors and same health status, Medicaid patients at times even fared worse than those with no insurance at all.

Scott Atlas from USA Today.

May 30, 2013 | 16 comments | by
« Previous Page — Next Page »