Mid-week miscellany

• The Hill newspaper featured a report on a U.S. Chamber of Commerce conference on electronic health information technology (HIT). Rep. Jon Porter (R Nev.) announced there that he is "devising legislation to test electronic medical records in the Federal Employees Health Benefits Program."

• The New York Times reported on a new HIT product called SmartSource that Aetna is beginning to roll out to its health plan members after testing the product on its 35,000 employees. The report explains that
  

  Using a medical search engine developed by Healthline, a medical database software developer, Aetna is piecing together medical profiles that are based on records of each insured member’s illnesses and diagnostic tests and that also make assumptions about their health concerns as reflected in their search topics.

  Andrea Rosenberg, a quality supervisor in an Aetna call center in Phoenix, said she had used the system to conduct research about her 5-year-old daughter Hayley’s ear infections and her own allergy symptoms.

  Like the millions of working mothers — a segment who are major online searchers for health information — Ms. Rosenberg said she had searched other health Web sites but found that the Aetna site provided information that was “more specific” to her situation. After looking it over, she took Hayley to see the family pediatrician. As for her allergies, she decided to stick with nonprescription medicines from the drugstore.

  Health plan members have been slow to add their information to personal health records offered by many insurers, at least until a family member gets sick. But Aetna and some other health insurers, including UnitedHealth and WellPoint, have made an end run around this obstacle by creating rudimentary health profiles based on medical claims data.

  Aetna says it has gone further by using the profile to help tailor the SmartSource searches.

• The Washington Post reports that a European study recommends against prescribing antibiotics for sinus infections because doctors have a difficult time distinguishing between bacterial infections that can be treated with antibiotics and viral infections that can't. I have had a sinus condition throughout my life, and I can distinguish between a bacterial and sinus infection in myself, without HIT. I think this illustrates my opinion that medicine remains as much an art as a science and efforts to remove the art from the practice of medicine may be counterproductive. It also points out why it is so difficult to control health care costs.
  

• And speaking of costs, the AP reported that

  Sales growth in the U.S. prescription drug market slowed to the lowest rate in 46 years in 2007 as more brand-name drugs lost their exclusivity to generics and new product approvals declined, according to a report issued Wednesday.

  Sales came to $286.5 billion in 2007, up 3.8 percent, IMS Health said in its annual U.S. Pharmaceutical Market Performance Review. The rate of growth was the lowest since 1961, when sales increased by 3.3 percent.

  The IMS Health press release describes the "Primary Factors Contributing to 2007 Market Slowdown"
  

  • Loss of exclusivity – Branded drugs representing $17 billion in sales lost exclusivity in 2007, helping to drive prescription volume growth of 10 percent for unbranded generics. In 2007, generics continued to replace branded prescriptions in the major therapeutic classes, increasing their share of total dispensed prescriptions to 67.3 percent.
  • Uptake of new products – Uptake of new, innovative medicines represented just $441 million of total sales in 2007, reflecting both the fewest new product launches in the past three decades and slower adoption by physicians of these products.
  • Medicare Part D contribution – Prescriptions dispensed through the Medicare Part D program accounted for 19 percent of retail prescriptions at the end of last year, a modest increase over 2006, and reflective of a maturing program. Today, 65 percent of U.S. citizens age 65 and older are enrolled in the Medicare Part D program.
  • Safety issues – Sales growth in 2007 also was affected by a significant number of “black box” warnings and product withdrawals, as well as safety concerns raised by the FDA for products in the erythropoietins, diabetes and antidepressant therapy classes. Safety issues contributed to significantly lower- than-expected sales for products accounting for approximately 10 percent of the total prescription market.