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04-11-2012 | Article

The week in review, October 28 - November 3, 2012

medwireNews: This week's stories include a second pharmacy under Food and Drug Administration (FDA) scrutiny relating to the fungal meningitis outbreak; two Michigan health systems announcing a merger; workplace clinics going underused; analysis of US healthcare costs; and Medtronic's relationship with the physicians reviewing its products coming under question.

Second Mass pharmacy recall

Ameridose LLC, a Massachusetts pharmacy owned and operated by the team that runs the compounding pharmacy at the center of the fungal meningitis outbreak, is voluntarily recalling all of its unexpired products in circulation.

"Out of an abundance of caution, we are undertaking this recall to assure customers that when Ameridose products are shipped, they are fully in conformance with all of the FDA's recommendations," the company said in a "Dear Customer" letter.

Ameridose is a "sister" pharmacy to the New England Compounding Center (NECC) in Framingham, Massachusetts, which has been linked to the nationwide fungal meningitis outbreak.

As of October 31, 377 fungal meningitis cases and 28 deaths have been reported in 19 states, according to the Centers for Disease Control and Prevention.

The outbreak has been traced to three contaminated lots of methylprednisolone acetate and possibly other products produced by the NECC.

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Michigan healthcare systems get engaged

Michigan-based Beaumont Health System and Henry Ford Health system have signed a letter of intent to merge into a single, non-profit entity worth approximately $ 6.4 billion.

The merger is a response to the growing trend toward consolidation among US healthcare providers, the companies say.

"Both systems recognize that the way health care is provided today ‑ where it is offered, how it is paid for, how it is measured ‑ is changing dramatically," Steve Howard, chairman of the Beaumont Health System board of directors, said in a statement.

"Our shared vision is to form a new organization that will develop improved approaches to patient care that will lead the nation in quality outcomes, service, access and reliability," said Henry Ford chief executive officer Nancy Schlichting.

The hospitals cite a national survey of healthcare leaders conducted earlier in 2012, which found that three-fourths of US healthcare systems were pursuing or considering some kind of partnership or alliance with another system.

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Workplace clinics underused

Employees are not taking advantage of workplace health clinics, making them unlikely to provide a broad solution to rising healthcare costs, according to a report by the Center for Study Health System Change.

The main focus of workplace clinics is to offer primary care, prevention, and wellness services in order to reduce the need for specialty referrals, urgent care visits, and hospitalizations.

Just 4% of US families reported taking advantage of such clinics, however, the same percentage as in 2007.

Reasons cited for using a workplace clinic included convenience, better hours, and not having to make an appointment.

But most (63.7%) employees cited vaccinations as their primary reason for visiting workplace clinics rather than care for chronic conditions.

"Workplace clinics are typically only viable for large employers with low employee turnover and high concentrations of workers, which means they are unlikely to provide a broad solution for controlling health care spending or improving care delivery," say authors Ellyn Boukus and Ha Tu.

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Fee-for-service model drives up US healthcare costs

The fee-for-service (FFS) model of care is among the most significant determinants of rising US healthcare expenditures, suggests a report from the Bipartisan Policy Center.

This model encourages clinicians to perform tests and procedures regardless of their effect on the quality of care; it also contributes to another cost driver ‑ care fragmentation.

"The economic incentives are particularly strong for services with high fixed costs, typically those making extensive use of medical equipment, such as imaging services. Moreover, FFS does not pay for many services perceived to be increasingly important for the management of serious illnesses, especially chronic disease, such as patient education and coordination of care with other providers," Paul Ginsburg and colleagues from the Center note.

In 2010, the USA spent approximately 18% of its gross domestic product on healthcare, which is double that spent by the UK and Japan.

Other cost drivers include increases in chronic health problems such as obesity and economic factors such as the current tax treatment of healthcare benefits.

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Medtronic's influence over studies of InFuse questioned

Medtronic employees have come under scrutiny regarding their influence over publications regarding the company's bone graft product InFuse in a report from the US Senate Committee on Finance.

The report alleges that a Medtronic employee recommended against publishing a complete list of adverse events possibly associated with the product in a 2005 paper published in the Journal of Bone and Joint Surgery, and that in one study Medtronic officials promoted InFuse as clinically superior to an alternative by emphasizing the pain associated with the alternative.

"Medical journal articles should convey an accurate picture of the risks and benefits of drugs and medical devices, but patients are at serious risk when companies distort the facts the way Medtronic has," said Finance Committee Chairman Max Baucus (D-Montana).

Medtronic told the press that the company "vigorously disagrees with any suggestion that the company improperly influenced or authored any of the peer-reviewed published manuscripts discussed in the report, or that Medtronic intended to under-report adverse events."

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By Peter Sergo, medwireNews Reporter