AHA Merges Guidelines
The American Heart Association has combined its quality improvement programs on cardiopulmonary resuscitation and postresuscitation care. The melding of the association's National Registry of CardioPulmonary Resuscitation program with its Get With the Guidelines effort was spurred by recently released recommendations on CPR and emergency cardiovascular care (ECC). The registry is a database of resuscitation events in 500 hospitals that have used the data to improve outcomes, according to an AHA statement. Get With the Guidelines has offered in-hospital quality improvement modules for heart failure, stroke, and outpatient care. Incorporating CPR quality improvement, the new product is called Get With the Guidelines–Resuscitation.
Women's Stroke Survival Lags
Although in-hospital stroke death is falling for both men and women, it is declining faster for men, according to the Agency for Healthcare Research and Quality. The death rate per 1,000 admissions for men with stroke declined from 123 in 2000 to 87 in 2007. For women, deaths declined from 127 per 1,000 in 2000 to 96 per 1,000 in 2007. The death rate from heart failure fell by 52% for men and 46% for women, but they were equally as likely to die in-hospital. Women's death rate from heart attack declined slightly more than did men's but still showed the former much more likely to die as inpatients: In 2007, 77 women died per 1,000 admissions, compared with only 58 men per 1,000 admissions. The data come from the agency's Trends in Hospital Risk-Adjusted Mortality for Selected Diagnoses by Patient Subgroups, 2000-2007.
Red Flag for A Fib Drug
The Institute for Safe Medication Practices reported that the Food and Drug Administration has been receiving increasing numbers of reports that dronedarone (Multaq) may cause or worsen heart failure or trigger irregular heartbeats. There were also incidents of kidney failure or impairment, according to the watchdog group, which analyzes case reports submitted to the FDA. The review of dronedarone identified 387 serious adverse events associated with the drug since its approval in 2009, including 24 deaths. The group also flagged the patient medication guide for dronedarone, saying that it contains a misleading reassurance about the drug's potential as a teratogen, even though it was included in the FDA's Category X for pregnant women. “We have seldom seen a drug with so many issues in so many areas of its safety profile,” the institute noted in its QuarterWatch report.
Glaxo Pays Huge Fine
GlaxoSmithKline pled guilty to charges that it manufactured and distributed adulterated drugs. The company will pay $750 million to settle federal and state government claims. The drugs in question were manufactured in Puerto Rico between 2001 and 2005 and included the antinausea drug Kytril, the antidepressant Paxil CR, the diabetes medication Avandamet, and the anti-infection ointment Bactroban. The complaint alleged that the drugmaker failed to prove that Bactroban and Kytril were not contaminated with microorganisms. GlaxoSmithKline will pay the federal government $600 million, and a whistle-blower will receive $96 million for having tipped the federal government to the manufacturing issues. The states are eligible to receive up to $163 million from GSK. The complaint alleged that the company knowingly caused false claims to be submitted to state Medicaid programs.
Top Fraud Cases All Involve Health
Pharmaceutical companies paid large fines in 8 of the top 10 fraud cases settled by the Department of Justice in 2010, according to the Taxpayers Against Fraud Education Fund. An insurer and a hospital rounded out the top 10 largest fine payers, making all 10 of the top settlements health care related, the advocacy group said. Allergan Inc., which in September settled allegations that it had marketed Botox (onabotulinumtoxinA) for off-label uses, accounted for the largest settlement ($600 million). AstraZeneca International came in second with its $520 million payment for illegally marketing the antipsychotic Seroquel (quetiapine). About 80% of all fraud recoveries under the False Claims Act occur in the health care area, the group said.
Wired Practices Make More Money
Medical practices that have adopted electronic health records perform better financially than do practices that still use paper, according to the Medical Group Management Association. The group looked at the technology's impact on revenue, costs, and staffing and found that it correlated with $50,000 more net revenue per full-time physician in practices that were not owned by hospitals or integrated delivery systems. The wired practices reported $105,591 higher expenses per full-time physician, but had significantly more revenue per physician, the association said. “These data indicate that there are financial benefits to practices that implement an EHR system,” Dr. William Jessee, the association's president and CEO, said in a statement.