Headlines: May 3, 2011
by Meg Larkin
Recently, there has been a lot of talk in political circles about the future of the Medicare program. As part of the new health care law, Medicare is offering a number of preventive services free of charge, but early surveys show that seniors aren’t taking advantage of those services. Part of the problem may be that many doctors and patients don’t know which services are free under the new program. Also, although a particular service or test may be free, seniors might still have to pay for the cost of the office visit when the test is administered. The confusion has led the American Medical Association to issue a two-page guide for doctors detailing what benefits are free for patients under the new law. Another reason that seniors may not be lining up for preventive care procedures is the procedures themselves. Many seniors are hesitant to undergo procedures that could be uncomfortable or could lead to bad news about their health. These trends could be changing in the coming years as awareness of the benefits offered and knowledge of the value of preventive care rises. The Washington Post reported that, “In just the first three months of this year, almost 300,000 seniors nationwide received the new free wellness exam.”
In other wellness news, researchers are looking into the benefits of group checkups for patients with chronic disease. Group checkups last for approximately 90 minutes and allow patients to interact with each other and their physician in order to address questions and concerns about managing their condition. The checkups are being studied for use in patients with conditions like Parkinson’s disease and diabetes. The longer time frame and group setting allows doctors to observe patients’ condition over the course of the visit and through patients’ interactions with one another, which can provide a more accurate assessment of the patient’s well being than a regular 15 minute office visit. In addition, the group dynamic can encourage patients to ask more questions about their condition, and peer pressure can increase compliance with the doctor’s recommendations. A small but increasing number of physicians are using the group checkup model, with the American Academy of Family Physicians reporting that about 10 percent of its members in 2009 – up from 6 percent in 2005 -- used group checkups. A few studies have been done comparing the effectiveness of group visits with that of individual visits, and the evidence is mixed. For the moment, Medicare is reimbursing doctors per patient for group visits that meet specified guidelines.
In research news, a much anticipated study on the effectiveness of Avastin to treat Age-related Macular Degeneration has been released. The study compared Avastin with Lucentis, and found that the two drugs were equally effective in treating macular degeneration. Avastin and Lucentis are both made by Genentech, and Avastin, which is approved by the FDA as a cancer treatment, has been used off-label to treat macular degeneration at a much lower cost per dose than Lucentis. Genentech has argued that Lucentis has a lower risk of side effects and is more suited for use in the eye because it was designed and approved for that purpose. The results of the study are pretty much what researchers, doctors and regulators had expected. While patients in the Avastin arm of the trial had a slightly higher rate of adverse events, it is unclear whether those were related to the drug because they did not correspond to any known side effects. Genentech is funding a separate study that evaluates the risks of the two drugs. In addition, the company pointed out that Lucentis may need to be taken less often than Avastin, which could generate cost savings.
Finally, in wellness news, researchers have found that a questionnaire can detect autism at a young age. The questionnaire was found to detect autism and other cognitive difficulties in 1 year olds, but it also generated a high number of false positives. The study followed 184 children identified using the questionnaire. According to the New York Times, “Of those, 184 infants were evaluated and tracked, including 32 who subsequently were found to have autism spectrum disorder, 56 with language delays, 9 with developmental delays and 36 with other problems. Another 46 were subsequently found to be developing normally, meaning the checklist’s false-positive rate was 25 percent.” Currently, most pediatricians don’t screen young children for autism, but there is growing support for the position that early intervention can be beneficial for patients. The study was published on Thursday in the journal Pediatrics.
Meg Larkin is a third year law student at Boston University. Please feel free to email her with questions, comments, suggestions or concerns.