Enlarge Mark Lennihan/AP

Later this year, if all goes as expected, a generic version of Lipitor will become available in the U.S.

Mark Lennihan/AP

Later this year, if all goes as expected, a generic version of Lipitor will become available in the U.S.

Chances are very good that the next prescription you fill will get you a generic medicine.

Three-quarters of prescriptions these days are filled with a generic. And the proportion keeps climbing.

Later this year, if all goes according to plan, the biggest generic switch in the history of the pharmaceutical industry will go down. Cholesterol-fighter Lipitor, the best-selling prescription medicine in the world, will lose U.S. patent protection, clearing the way for legal, inexpensive copies.

The wave of generics to treat conditions ranging from depression to high blood pressure can save consumers plenty of dough.

 

If your health insurance covers prescription drugs, you'll have a lower copay for a generic versus a brand-name drug. The exact savings would depend on the particulars of the plan, but could easily hit $20 or $30 a month.

If you have to pay for your medicines yourself, some big-box retailers and drugstore chains sell generics for rock-bottom prices.

Over the next couple of years lots of other big-selling brands will also go generic. Think Plavix, a blood thinner, and Actos, for diabetes, just to name two.

Why are there so many generics all of a sudden? Well, the wave actually got rolling a few years ago. Now, though, some of the biggest brands are involved.

The reason for all the action is that patents are expiring on medicines launched during the 1990s, which is looking more and more like a golden era of productivity for the pharmaceutical industry.

Typically the patents for prescription pills last about a dozen years or so. And as the clock runs out, the generics makers rush in.

How do American feel about generics? We asked more than 3,000 people last year in a survey conducted with Thomson Reuters. Eight-five of people said generics are as safe and effective as brand-name drugs. And 90 percent said they're willing to take a generic when one is available.

By DAVID E. WILLIAMS

Over the last decade, the United States has intentionally made itself less attractive to immigrants, forgetting that immigration has been a huge driver of the country’s economic success. In a recent article (America needs a 21st century immigration policy), leading entrepreneurs, executives and investors including Steve Case and Sheryl Sandberg said:

To some, the link between immigration reform and economic growth may be surprising.  To America’s most innovative industries, it is a link we know is fundamental.

The global economy means companies that drive U.S. job creation and economic growth are in a worldwide competition for talent.  While other countries are aggressively creating policies and incentives to attract a highly educated workforce, America has stagnated.  Once a magnet for the world’s top minds, America now faces a “reverse brain drain” and is no longer the first choice for many entrepreneurs creating new companies and jobs.

America needs a pro-growth immigration system that works for U.S. workers and employers in today’s global economy.  And we need it now.

Openness and encouragement of immigration is vital for the success of health care reform. Why?

Immigrants innovate and create economic growth. This growth is how the country gets wealthier and better able to support health care expenses without raising tax rates

Immigrants tend to be younger, so they mitigate the overall aging of the population, making it easier for the country to afford its commitments to older citizens

Immigrants can use their intellectual capital and training â€"whether acquired abroad or hereâ€" to fill health care jobs such as primary care physician, pharmacist, nurse that would otherwise go unfilled

President Obama actually understands this dynamic, but has to tread carefully since immigrant bashing is so popular on the right. But unfriendliness to immigration is all over in the place. For example in Massachusetts the state has decided â€"for short-sighted financial reasonsâ€" to exclude legal immigrants from subsidized health insurance. With luck, that decision will be overturned as unconstitutional by the state’s Supreme Judicial Court.

I agree with the Republican rhetoric of the need for a “pro-growth agenda.” Low taxes and limited regulation can certainly play a part. But policies that encourage immigration, especially of younger, well educated people, are absolutely essential. We need it for the economy as a whole and for the health care economy in particular.

David E. Williams is co-founder of MedPharma Partners LLC, strategy consultant in technology enabled health care services, pharma,  biotech, and medical devices. Formerly with BCG and LEK. He writes regularly at Health Business Blog, where this post first appeared.

Filed Under: THCB

Tagged: David Williams, health care reform, Immigration May 25, 2011

If you or your child or any member of your family gets infected with common cold, you may decide to consult your doctor/pediatrician/family doctor. As most doctors are busy and appointment with your doctor may be brief, it is wise to know and learn the topics you need to discuss with your doctor, regarding common cold anyone of your family member may be suffering. Prepare for your appointment with your doctor and know what questions to ask your doctor and what to expect from your doctor.

You should be prepared for appointment before seeing your doctor. Write down the symptoms you or your child or any member of your family may have and for how long you may have the symptoms. Write down if there is any medical information or any medication being received for other medical ailment, about the patient of common cold worth mentioning to your doctor. Mention any recent exposure to people with similar symptoms. Finally write down what questions you might ask your doctor during appointment. You should also ask you doctor about the ways to prevent common cold.

You may ask the following questions:

• What is/are the causes of the symptoms?
• How long it may take for symptomatic improvement?
• What medications or foods to be avoided during treatment?
• Is there any need for tests?
• Am I contagious?
• When it is safe to return to work or school?
• Is there any home remedy or steps taken at home that will be helpful?

Your doctor may ask following questions before writing treatment for you:

• What are your symptoms and for how long they are present? Did all symptoms start at the same time?
• Is there any change in the symptoms severity (improved or worsened)?
• Do you have fever?
• Did you closely interact with any individual recently with similar symptoms?
• What medications/supplements you (patient) are taking at present?
• Do you at present have any illness (acute or chronic)?

You may be asked some other questions by your doctor based on different patient setting. Your doctor may ask different set of question to different patients with similar illness. Be prepared to answer the above mentioned questions accurately.

Related posts:

How to Prepare Yourself for Cold Sores, for Appointment with Doctor

How to Prepare for Doctor’s Appointment for Ringworm?

Reduce Common Cold by Reducing Risk Factors

What is Common Cold?

Symptomatic Treatment of Common Cold

Symptoms of Common Cold

Prevention of Common Cold

Prepare yourself for Appointment with your Doctor for Nail Fungus Infection

Treatment of Common Cold

Global impact of Common Cold

By JOE FLOWER

[Note to the reader: Anything that is in italics and square brackets (such as this note) is addressed to you, personally. Yes, you. Try it on, see if it fits.]

Healthcare has, right now, the greatest opportunity we have seen in our lifetimes to make a big change, to rebuild itself in a hundred ways to become better for everyone, and cheaperâ€"to get cheaper by getting better. We’re not talking “bending the cost curve,” cutting a few points off the inflation chart. We’re not talking a little cheaper, a little less per capita, a few percentage points off the cut of GDP that healthcare sucks up. We’re talking way cheaper. Half the cost. You know, like in normal countries.

We’re not talking a little better, skipping a few unnecessary tests, cutting the percentage of surgical infections a few points. No. Don’t even think about it. We’re talking way better. Save the children, help the people who should know better, nobody dies before their time, no unnecessary suffering. Seriously.

I don’t know how high you want to aim, but personally, I think we should aim at least as high as the cutting-edge programs and facilities that are already out there, in the system as it exists today, cutting real healthcare expenses of real people, even “frequent fliers,” by 10, 20, even 30 percent, while making them healthier, much healthier. At least. To me, that’s a wimpy goal, just doing as well as some other people are already doing. Because these programs are just getting off the ground. They’re in the first few iterations. The stretch goal, the goal we can take seriously, is to cut real costs by 50 percent, by making people healthier. There is at least that much potential out there.

All the Ways the System Doesn’t Work

You want a little convincing? Here’s an easy little exercise: You know how the system actually works. [Note: Yes, you do. You’ve been around the block, right?] Pull up an empty notes page on the laptop, iPad, Blackberry, iPhone, whatever, and just start writing a list of all the frustrations you can think of, the thousand and one ways that the system does not drive toward the best health at the least cost for the people it servesâ€"the missed handoffs, the wrong person/wrong drug mistakes, the lack of engagement with the patient’s life, all that. [Note: My guess? You can come up with a better and longer list than I can. Every person I talk to who actually works in health care has buckets of this stuff for me, every time I talk to them.]

Now do a little imagination exercise: Go down that list, stop at each item, and imagine some way in which the system eliminated it. Imagine that there was some systemic change that made it nearly impossible to give the wrong person the wrong drug, some change that meant that everybody got good health coaching, nobody ever got an operation that actually won’t help them, whatever is the inverse of each frustration on the list. Imagine what each of those changes would mean to the effectiveness and cost of healthcare.

Now imagine that somebody, somewhere, has done just that. Somebody is solving that problem, in ways that can be duplicated where you are. Because that is what I am seeing happen all across healthcare, and it’s a breathtaking story.

A Word about Systems

Do you know how many people died in car crashes in the United States in 2010? 32,000. That’s the lowest number since 1949. That’s impressive, but wait: It’s far more impressive than it sounds at first, because people in the United States drove about 10 times as many vehicle miles in 2010 as they did in 1949. In other words, if you drove a car or truck in 2010, you were 10 times more likely to live through each mile you drove than your father or grandfather was 60 years ago.

Why? Are we better drivers? Nah. Seatbelts, airbags, tougher DUI laws, breathalyzers, graduated licensing for teenagers, anti-lock braking systems, better highway designs, crash barriers, rumble strips, median barriers, steel-belted radial tires that don’t blow out, crumple zones, better bumpers…system tweaks that work, that make it 10 times as hard for even a terrible driver to kill himself or you.

It’s the system, not the individuals. We have only started on the thinnest little wedge of that kind of thinking about healthcare. That kind of thinking will take us way beyond “evidence-based medicine” to what is coming to be called “evidence-based health.” Evidence-based medicine does everything necessary to stabilize diabetic shock patients, gets their blood sugar under control, gives them the right prescriptions and sends them home. Evidence-based health goes home with them, if necessary, does whatever it takes to find out why they were in shock in the first place, what it takes to make sure that they fill the prescriptions, eat better, get good advice and don’t end up back in the ER in a month.

The Reform Is Not the Change

The federal healthcare reform law is a catalyst, and enabler, and an accelerator of the change we are going through. It is not the change itself, and is not even the cause of it, because the change is driven by much larger economic and demographic factors, especially by the crushing cost of healthcare. If the reform law were to go away, the change would not go away.

Here’s why the change is actually happening: As all these factors have come together, everybody in the business has come to believe that their usual way of doing business is crumbling under them. Doctors, hospitals, home health agencies, insurers, employersâ€"everyone is desperate to find a new footing. And no one has found a certain footing yet.

Eight Methods for Screwing This Up

So this is, as the sportscasters say, our game to lose. It’s our change to screw up. And we can screw it up, big time. In case you are interested in helping that happen, here are eight ways to go about it:

Pretending it’s not there. Denial. A few tweaks. Business as usual. Same-old. Flavor of the week. Hey, it’s not my problem. I can squeak through to retirement anyway. [Note: Hello.]

Pretending it’s there and we know exactly what it is. We know its address and its measurements, the forms to fill out and the boxes to tick off. It’s all execution. Trust me, I’ve done this before. [Note: Actually, you haven’t. Nobody has.]

Fending off risk. Going for the safe choice. Pulling up the drawbridge. Hunkering down. We can’t afford to extend ourselves in this budget cycle. If we try that, it’ll just piss off the doctors. Better wait until this whole thing settles out. [Note: Let us know how that works out for you. From here, it looks like the waters are rising really fast.]

Grabbing an answer. Downloading a package. Not recognizing the edge of panic in your voice when you say reassuringly, “This is what works. This is the solution.” [Note: When the problem is not simple or static, the solution is not unitary.]

Mistaking it for an opportunity for empire. Building ACOs as regional monopolies to push up our compensation and grab market share. [Note: Consider this. How would your answer change if the question was not “How do we grow the enterprise and make our careers safer?” but instead was truly (truly nowâ€"be brutally honest, at least with yourself) “How do we help the people we serve better? How do we ease the suffering? How can we do that for more people? Cheaper? Earlier?”]

Making it a turf war. Grabbing territory. Knocking out the other guy.

Pretending it’s not a turf war, and losing it. Standing by while the other guy eviscerates your hold on the market. [Note: Of course people are going to treat it like a turf war. When everyone’s livelihood is threatened and their value is challenged, that’s what they do. That doesn’t mean you have to. In some games, the only way to win is to not play.]

Gaming the system. Figuring the angles. Making “What’s in it for me? What’s in it for us?” the only questions worth asking. [Note: Here’s the invitation: Play a bigger game. The author Harriet Rubin said a marvelous thing. She said, “Freedom is a bigger game than power. Power is about what you can control. Freedom is about what you can unleash.”]

Consider This

“Since death alone is certain, and the time of death is uncertain, what shall I do?” Yes, I’m quoting somebody. Never mind who. No, don’t write it down. Don’t Facebook it, Tweet it, stick it in Evernote, e-mail it to someone. In fact, don’t even think about it. Don’t think it through, generate options, prioritize. Stop. Just sit with it, just for this one moment: “Since death alone is certain, and the time of death is uncertain, what shall I do?”

Whoever you are, however you have defined yourself so far, you have your hands on some portion of this great rambling chaotic sacred Grand Guignol parade we call healthcare. You have some influence. You can nudge it, poke and prod it, re-shape it, help it grow, make new connections, try new skills. Healthcare is where we bring our suffering, and our tricks to defeat suffering.

We can do this. It is as if the sky has opened up, a break in the pattern; there is an urgency, a swiftness to events, a tide, a moment, a momentum. Let’s roll.

With nearly 30 years’ experience, Joe Flower has emerged as a premier observer on the deep forces changing healthcare in the United States and around the world. As a healthcare speaker, writer, and consultant, he has explored the future of healthcare with clients ranging from the World Health Organization, the Global Business Network, and the U.K. National Health Service, to the majority of state hospital associations in the U.S.  He has written for a number of healthcare publications including, the Healthcare Forum Journal, Physician Executive, and Wired Magazine.  You can find more of Joe’s work at his website, imaginewhatif.com, where this post first appeared.

This piece was first published in the May 19, 2011 Hospitals and Health Networks Daily, from the American Hospital Association.

Filed Under: THCB

Tagged: Healthcare system, Joe Flower, Methodology May 21, 2011

Common cold is a very common health problem around the world and nobody is immune to common cold. Old and young, all are affected by common cold, although the severity and frequency of common cold infection may be different among different age group individuals. Younger age groups of individuals are more prone to get infected by common cold causing virus in compare to older individuals. As individuals age, they become immune to common viruses which cause common cold.

The economic impact of common cold is huge. Although the disease is not serious, it can reduce work capacity in the sufferer for approximately a week during every attacks of common cold. Given the fact that, most individuals (healthy as well as unhealthy individuals suffer from common cold) suffer a few attacks of common cold every year the economic burden for individuals and the world is enormous. The work capacity reduces due to common cold and there is also expense for treatment of common cold, both of which takes a huge toll in the finance of individuals as well as to the State.

Common cold scenario in United States:

It is estimated that in United States alone approximately 100 million visits to doctors (which is only the tip of an iceberg, as most individuals suffering from common cold do not visit doctors) for common cold and estimated cost of which is approximately 8 billion dollars a year. Of approximately 100 million doctor visits for common cold, approximately a third receive antibiotics (although most doctors and health experts know that antibiotics are not indicated for treatment of common cold), which is one of the major reason for development of antibiotic resistance due to overuse and unnecessary use of antibiotics. Americans also spent more than 3 billion dollars a year on OTC (over the counter) medication for symptomatic relief of common cold.

It is estimated that approximately 100 to 200 million school days are missed by school age children every year and as a result, to care for the children parents also miss equal number of workdays (100 to 200 million) every year. In addition to this, workers miss approximately 150 million workdays a year due to common cold, the total value of this is estimated to be over 20 billion dollars a year. This statistics explain the enormity of the health and economic impact of a mild and common disease such as common cold.

This is the scenario of common cold only in United States, the global impact of common cold can be easily guessed from this.

Related posts:

The Global Burden of Diarrhea

What is Common Cold?

Causes of Common Cold

Symptoms of Common Cold

Treatment of Common Cold

Risk Factors of Common Cold

Global Scenario of Herpes Zoster

How common is ringworm?

How common is Retinal Detachment?

Alternative Medicine in Treatment of Common Cold

Enlarge Mark Lennihan/AP

Later this year, if all goes as expected, a generic version of Lipitor will become available in the U.S.

Mark Lennihan/AP

Later this year, if all goes as expected, a generic version of Lipitor will become available in the U.S.

Chances are very good that the next prescription you fill will get you a generic medicine.

Three-quarters of prescriptions these days are filled with a generic. And the proportion keeps climbing.

Later this year, if all goes according to plan, the biggest generic switch in the history of the pharmaceutical industry will go down. Cholesterol-fighter Lipitor, the best-selling prescription medicine in the world, will lose U.S. patent protection, clearing the way for legal, inexpensive copies.

The wave of generics to treat conditions ranging from depression to high blood pressure can save consumers plenty of dough.

 

If your health insurance covers prescription drugs, you'll have a lower copay for a generic versus a brand-name drug. The exact savings would depend on the particulars of the plan, but could easily hit $20 or $30 a month.

If you have to pay for your medicines yourself, some big-box retailers and drugstore chains sell generics for rock-bottom prices.

Over the next couple of years lots of other big-selling brands will also go generic. Think Plavix, a blood thinner, and Actos, for diabetes, just to name two.

Why are there so many generics all of a sudden? Well, the wave actually got rolling a few years ago. Now, though, some of the biggest brands are involved.

The reason for all the action is that patents are expiring on medicines launched during the 1990s, which is looking more and more like a golden era of productivity for the pharmaceutical industry.

Typically the patents for prescription pills last about a dozen years or so. And as the clock runs out, the generics makers rush in.

How do American feel about generics? We asked more than 3,000 people last year in a survey conducted with Thomson Reuters. Eight-five of people said generics are as safe and effective as brand-name drugs. And 90 percent said they're willing to take a generic when one is available.

By DAVID WILLIAMS

I often hear from hospitals that they’re being squeezed greatly on cost and not getting paid enough by government and private payers. I have some sympathy for this argument, but on the other hand somehow this country outspends every other country by at least two to one, and hospitals are a big part of the reason.

So what gives?

An article in yesterday’s Wall Street Journal (One Way for Hospitals to Cut Costs of Tests), reporting on an Archives of Surgery study, provides part of the answer.

Making physicians aware of the costs of blood tests can lower a hospital’s daily bill for those tests by as much 27%, a new study suggests.

Researchers simply told the doctors what things cost.

“There was no telling anyone when, or when not, to order a particular test,” says Elizabeth Stuebing, a study co-author…

But she says it shows what can happen merely by giving physicians information they don’t usually have. “We never see the dollar amount of anything,” Dr. Stuebing says. “The first week I stood up and said that in the previous week we’d charged $30,000 on routine blood work and I could hear gasps from the audience.”

The situation doctors are in today is sort of like being sent to a store and told to get what they need, but not paying for the goods and not  knowing the prices of the items or even which items are expensive and which are cheap. That’s certainly a formula to run up the bill, even if inadvertently â€"which is what the “gasps from the audience” indicate.

The experiment was analogous to putting prices on the items in the store, but still letting the shopper buy whatever they thought they needed. That’s a step in the right direction but not exactly draconian from a cost control standpoint! (Of course there are some cost control measures hospitals impose centrally, which is different from my shopping analogy.)

I have mixed views on whether physicians should be exposed to what things cost. Pricing in hospitals is not like pricing in stores, because “charges” are often a small fraction of what’s ultimately reimbursed. I don’t know that I want doctors making tradeoffs based on faulty data or an incomplete understanding of patient preferences.

Still, letting doctors know what’s cheap, moderately priced and expensive is a good idea. In this case it seems to have held physicians back from ordering things that weren’t needed. And it does give a peek at how bloated expenditures in medicine are today.

It also underlines the fact that we are far from the point where consumers can control costs by having “skin in the game.” Do we expect patients to challenge daily blood draws on the basis of their cost and medical necessity? I don’t.

Filed Under: THCB

May 19, 2011