Diet and Nutrition. Natural Health, and Healthy Living

Yesterday we tried to put EHRs into perspective. They're important, and we can't effectively move health care forward without them. But they're only one of many important health IT functions. EHRs and health IT alone won't fix health care. So developing a comprehensive but effective national health IT plan is a huge undertaking that requires broad, non-ideological thinking.

As we've learned so painfully elsewhere in the economy, the danger we face now in developing health care solutions is throwing good money after bad. We don't merely need a readjustment of how health IT dollars are spent. We need to reboot the entire conversation about how health IT relates to health, health care, and health care reform. To get there, we need to take a deep breath and start from well-established and agreed-upon principles.

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AstraZeneca appears set to follow Merck into the market for “bio-similars.” (See AstraZeneca may join generic rush.) Congress and the media tend to portray biosimilars are analogous to generic chemistry-based pharmaceuticals, and therefore believe that they will lead to much lower prices as a result of the commoditization of these products. If all goes according to plan, that should cut the price of biologics by 50 to 95 percent as has been the case for generic versions of traditional pharmaceuticals.

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As we inevitably do this time of year, we prognosticate about the new year. This time around, it's a toughie: there are too many uncertainties that preclude us from doing a straight-line forecast for 2009, especially in health and health care.

Here are some trends and wild cards to keep in mind for 2009: the year of managing risks.

How will the macroeconomy play out against health care in the new year? Keep in mind the Kaiser Family Foundation's metric on unemployment: an increase of 1% unemployment leads to 1.1 million uninsured, and 1 million more people added to Medicaid. This was the math that worked in 2007-8. The metric will probably change in 2009 as Governors struggle to balance budgets while providing medical services, education, and safe streets to citizens. The National Governors Association, and the individual state heads, have all warned that Governors will inevitably cut services in 2009 and into 2010 if tax receipts continue to decline.

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Patient advocacy groups, most of them drug industry-funded, have asked President-elect Barack Obama to appoint a Food and Drug Administration commissioner who won't cave in to pressure from lawmakers or the news media, according to the Wall Street Journal.

It is news to me that the news media has much say about decisions at FDA. There are reporters who highlight problems, especially safety problems, in the nation's food and drug supply. And there are reporters who highlight every study suggesting the next miracle cure is just around the corner. Large news organizations like the New York Times have both. For every Gardiner Harris, there is a Gina Kolata. The news media are megaphones. They are not, to use someone else's phrase, the decider.

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This is open enrollment season for those workers fortunate enough to (1) still be employed and (2) still be offered a health benefit.

It’s also the season of economic decline. These workers are making different health and benefit decisions in this fiscally-constrained era, according to Watson Wyatt's 2008 report, Employee Perspective on Health Care. Some of the most dramatic health behavior changes this year include:

Only 19% of employees are willing to pay higher premiums to keep deductibles and copayments lower. In 2007, 38% were willing to do so.66% of employees are trying to take better control of their health, an increase from 62%.

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Recently, a somewhat starry-eyed op-ed in the New York Times suggested that a $100 billion annual investment in universal health care is just the medicine that our economy needs. The goal, declared Jonathan Gruber, a professor of economics at the Massachusetts Institute of Technology: “Covering every American.”

It is an appealing proposition. But let me suggest that we cannot blindly invest billions in an already bloated health care system. We need to think through where we want the reform dollars to go. Which sectors of a $2.3 trillion health care economy should we stimulate to insure that patients receive the safest, most effective care at a price that they can afford?

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Ten plus years ago I was giving talks suggesting that at some point relatively soon the EMR was going to become a reality. In 1999 at Harris Interactive I actually got the chance to launch a study which I hoped was going to soon show a relatively steep growth in EMR use in physicians’ practices. (The study was called Computing in the Physician’s Practice). Sadly because the study wasn’t a huge financial success and because I wandered off to do other things the study was only fielded in late 1999 and early 2001.

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It seems like everyone in the Pharma Blogosphere and the press is recommending who president-elect Barack Obama should nominate as the new FDA Commissioner to replace Dr. Andrew von Eschenbach.

A few weeks ago, I created the “Who Should Obama Nominate for FDA Commissioner?” online survey to determine who readers of Pharma Marketing News think should be the next FDA Commissioner. I received many interesting comments and decided to open the survey up to as many stakeholders as possible, including consumers, healthcare professionals, former FDA and other government officials, pharmaceutical employees, and others.

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Half of people over 45 said in a recent AARP survey they've taken a generic drug or over-the-counter (OTC) medication instead of a prescription drug due to the current economic situation.

The AARP's report, "Impact of the Economy on Health Behaviors," analyzes the survey responses of 820 Americans 45 years of age and older polled in October 2008.

Asked what health behaviors they may done as a result of the declining economy, the most common reactions among 45+ Americans were:

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The New York Times published a story this month about one of the biggest medical trials ever organized by the federal government, a study that showed that the newest, most expensive drugs used to treat high blood pressure (a.k.a. hypertension) work no better than inexpensive diuretics—water pills that flush excess fluid and salt from the body. Moreover, the research revealed that the pricier drugs increase the risk of heart failure and stroke.

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