Psych Disorders in Young People
Almost half of Americans aged 18–24 could be diagnosed with a psychiatric disorder in a given 12-month period, according to an analysis of the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions. The face-to-face survey found that alcohol use disorder was more prevalent in college students, affecting 20% of the 2,188 respondents in this group, compared with 16% of the 2,904 respondents who had not attended college. Nicotine dependence was more common in noncollege youths (21% vs. 15%), as was personality disorder (22% vs. 18%). Few of the young people had sought treatment, especially for alcohol and drug disorders, reported researchers at Columbia University and the National Institute on Alcohol Abuse and Alcoholism. Only 5% of college students and 10% of nonstudents with alcohol or drug disorders had sought treatment in the past year. The researchers published their analysis in the December issue of the Archives of General Psychiatry.
Project Examines Early-Onset AD
Researchers are recruiting the adult children of individuals diagnosed with inherited Alzheimer's disease. The volunteers will undergo genetic analysis, cognitive testing, and neuroimaging, and will provide blood and cerebral spinal fluid samples for an international database. The Dominantly Inherited Alzheimer's Network study is a 6-year, $16 million effort aimed at identifying the sequence of brain changes in the early-onset form of the disease before symptoms occur. Funded by the National Institutes of Health, researchers in the United States, England, and Australia will participate. “By sharing data within the network, we hope to advance our knowledge of the brain mechanisms involved in Alzheimer's,” Dr. Richard J. Hodes, director of the NIH's National Institute of Aging, said in a statement. More information about the study is at
IOM Sets Health Indicators
The Institute of Medicine said that policy makers, the media, and the public should focus on 20 “health indicators” for Americans. In a report issued last month, the IOM proposed the indicators and said that the new nonprofit organization, State of the USA Inc., would use them to monitor the nation's progress. The measures include such usual gauges as life expectancy, infant mortality, and smoking, but also some departures such as unhealthy days, serious psychological distress, excessive drinking, and condom use. The IOM also suggested monitoring Americans' insurance coverage and their unmet medical, dental, and prescription drug needs. Copies of the report are available from the IOM, and the monitoring project may be followed at
Generic Growth Slowed
The market research company IMS reported that the worldwide sales growth of generic drugs slowed to 3.6% in the year ended in September. In the previous year, ending September 2007, generic sales grew 11.4%. In a statement, IMS Senior Vice President Murray Aitken attributed the slowdown to price competition among generic companies. The year's $78 billion worth of generics was sold largely in the United States, Germany, France, the United Kingdom, Canada, Italy, Spain, and Japan. Sales were actually down 2.7% in the United States, which accounts for 42% of global sales. On the other hand, generics made up about two-thirds of the U.S. pharmaceutical market, with about $33 billion in sales in the 12 months ending Sept. 30. In the next few years, generics can go after $139 billion in sales of products losing their patents, said IMS.
Incentive Exception May Reappear
Under current Medicare and Medicaid rules governing patient referrals, physicians can't share incentive payments for quality improvement. But a proposal to make an exception may reappear, a Centers for Medicare and Medicaid Services official told the Practicing Physicians Advisory Council in December. The CMS proposed an exception under the physician payment rules for 2009, but opposition–mainly from medical device manufacturers–killed it, said Lisa Ohrin, acting director of the division of technical payment policy at the CMS's Center for Medicare Management. She said, however, that allowing incentive payments is a priority for the CMS, so the agency will again propose allowing physicians to share the payments.
RAC Program Is Heavily Criticized
Medicare's effort to recover overpayments made to physicians and hospitals and to make good on underpayments–dubbed the Recovery Audit Contractor program–was lambasted by members of the Practicing Physicians Advisory Council in December. The program is on hold while the Government Accountability Office studies whether the CMS has properly implemented it. During a demonstration project, however, RAC auditors found $1 billion in improper payments among $317 billion worth of claims, a CMS official reported to PPAC. But as of July 2008, about 7% of those determinations were overturned on appeal. Once the program is restarted–expected to occur by February–there will be limitations on the number of years of claims an auditor can examine and how many records can be requested from practices of various sizes. Even with those plans, PPAC panelists recommended further limits and suggested that the CMS require auditors to reimburse providers for fulfilling records requests.