Archive for September, 2008

Mayo Care for Wyoming Miners

September 30th, 2008 | No Comments | Source: Bloomberg

In 2001, Foundation Coal Holdings Inc. and Peabody Energy Corp. asked retired surgeon Derrell Crowder to help reduce their health care expenditures.

Crowder set out to negotiate price reductions with local providers in Wyoming, where most employees lived. He figured the providers would listen to a pitch from two companies that employed nearly 20% of the population in their towns.

The providers blew him off. They thought they had a monopoly on medical services in the area.

Crowder was unfazed. “Even if I got a discount” he told Bloomberg, “Bad care at a discount is still bad care and it’ll be more expensive in the long run” due to costs associated with avoidable complications, unnecessary tests and longer hospital stays.

Crowder then prepared a list of the top hospitals based on national quality indicators and determined how they stacked up on costs. He found among other things that the Mayo Clinic received very high quality ratings and charged approximately $67,000 for coronary bypass surgery, whereas the coal companies’ local hospital received low ratings and charged $98,000 for the same.

Now mine workers at the two companies can choose to undergo certain elective procedures at a national center of excellence. Their employers pay all travel and lodging costs, and reduce co-payments as well.

In the 3 years since the mining companies instituted Crowder’s plan, their health care costs have dropped 5% per year. Nationally, corporate spending on health rose 7% per year during the same period.


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Cell Phone Study Flaws

September 30th, 2008 | No Comments | Source: Economist

No one knows whether cell phones cause brain cancer, and it may be awhile before anyone does.

Many had hoped the Interphone Study would answer the question. Interphone enrolled 14,000 people from 13 countries. It began in 2000, involved 50 scientists and cost $30 million.

Unfortunately, Interphone scientists are now struggling to interpret its data, which has been badly compromised by flaws in study design. The acrimony has pushed back the release date for the final paper from this month to next year.

It hasn’t helped that some Interphone scientists have already published preliminary studies that are based on samples of the Interphone data. Some of these studies contain bizarre conclusions such as a protective effect against certain brain cancers for mobile cell phone users.

The study design flaws are gaping. For example “regular mobile-phone use” was defined to include people who use a phone once each week as well as heavy users. This assures that any moderate adverse effect of regular mobile phone use will be masked.  As well, its retrospective design forces participants to recall specifics of their cell phone 10 years earlier. Do you recall how much you used your phone in 1998?

It remains to be seen whether the data scrubbers can make sense of it all. Meanwhile in the absence of clarity, Interphone scientists have staked out every conceivable position on the matter.


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China’s Poisonous Milk

September 30th, 2008 | No Comments | Source: CNN, Economist

Tainted milk produced in China has sickened 53,000 children and tarnished the nation’s reputation as a food exporter. And the scandal isn’t going away soon.

Toxic melamine, a nitrogen-rich product used to make plastics and by scoundrels to drive up apparent protein concentrations in watered-down milk, has now been detected in yogurt, cake and sweets. Several countries in Africa and Asia have banned diary imports from China after receiving shipments of affected milk. European chocolate-maker Cadbury recalled its China-produced products as well.

A month ago, China’s government did an abrupt about-face on the matter. In the run-up to the Olympics, government-controlled Internet portals squelched stories about the scandal. After the Olympics, the government made a showy effort to get out front. It detained the chairwoman of Sanlu, one of the dairy concerns at the heart of the scandal.  It arrested some milk distributers and detained others. The mayor and local Communist Party leader of Sanlu’s home city have resigned, as has the head of China’s national quality control bureau.

It’s unlikely these steps will fix China’s food-processing systems. Local party leaders are responsible for quality control, and many enjoy cozy relations with food producers.

Foreign companies have known the Chinese system was suspect. Unilever ended joint ventures with local producers years ago. McDonald’s developed a closed supply chain for its signature offerings, and Coca-Cola monitors suppliers with enormous vigor.


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Rivals Win Anthrax Contracts

September 29th, 2008 | No Comments | Source: Washington Post

Emergent BioSolutions of Rockville, Maryland has been the government’s only provider of anthrax vaccine ever since it secured a half billion dollar sole source deal several years ago to stockpile 19 million doses of its version, known as BioThrax.

BioThrax has limitations though. It must be refrigerated for example. Inoculated conscripts have reported serious complications, and 6 injections over 18 months are needed to produce a sufficient immune response.

The US government has thus just awarded development contracts to two companies, Emergent and its rival PharmAthene, to create improved vaccines.

Emergent Biosystems secured $29.7 million to develop an improved version of BioThrax that will require fewer injections. It will still require refrigeration, however.

The government’s decision was a coup for PharmAthene. It received $83.9 million to create a vaccine that requires only 1 or 2 injections and can be stored at room temperature.

The split decision heightens anticipation for the announcement later this fall of the big prize, a contract (or contracts) to supply 25 million doses of recombinant (genetically engineered) anthrax vaccine to the US Strategic National Stockpile. 

The agency that awarded the two contracts is the Biomedical Advanced Research and Development Authority (BARDA). It sits within the Office of the Assistant Secretary for Preparedness and Response in the U.S. Department of Health and Human Services. According to the HHS web site, BARDA’s mission is “to provide an integrated, systematic approach to the development and purchase of the necessary vaccines, drugs, therapies, and diagnostic tools for public health medical emergencies.”


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Career Networking Sites Thrive

September 29th, 2008 | No Comments | Source: Economist

Few companies are benefiting from the financial crisis, but business networking sites such as LinkedIn and Xing are doing just that. These sites have grown rapidly as economic conditions have soured. In the last several weeks, an unprecedented number of LinkedIn members updated their profiles, preparing themselves perhaps for the possibility they may lose their jobs.

LinkedIn and Xing provide platforms allowing business professionals to get their names out there, keep track of peers and industry leaders, establish new contacts and form groups with common interests.

LinkedIn is a privately held, Silicon Valley based company that has 29 million members. It was started in 2002 and is now valued at $1 billion on revenues of approximately $100m. LinkedIn’s revenues derive from members as well as headhunters and companies that pay to troll their databases.

Xing is a German company that has 6 million members. It was founded in 2003 and went public in 2006. It had revenues $24m in the first half of this year. Xing’s revenues derive primarily from subscription fees, because the site emphasizes networking rather than job search.

Their business concept now proven, these two companies now must fend off competition. Facebook has the capacity to play in this space, for example. Even the venerable Wall Street Journal and New York Times have nascent professional networking features on their sites.


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China Shoots for the Moon

September 29th, 2008 | No Comments | Source: Economist, Washington Post

America hasn’t had landed a man on the moon in 36years and it has no immediate plans to return there. Meanwhile, China can now boast it has the moon in its sights.

This after three Chinese astronauts parachuted to Earth yesterday following an error-free mission which included China’s first spacewalk. Crowds gathered before outdoor TV monitors across China to cheer the spectacle.

China’s leaders are riding a wave of nationalism following the Olympics. There is no public opposition to their space program, and they face few of the budgetary constraints that have plagued NASA for decades.

China plans to construct a space station within 5-10 years and land an unmanned probe on the moon shortly after that. It is a matter of time before China announces plans to put a man on the moon.

China’s latest space success created less angst in the US than its last one, in which it blew up a failed weather satellite with an anti-satellite missile some 21 months ago. China’s space program is run by the military, but China insists its program is peaceful.

With many nations’ economies in tatters, those who are still inspired by human space exploration will be gazing up at red flags for the foreseeable future.


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Medtronic Spine Product Lawsuit

September 26th, 2008 | 1 Comment | Source: Wall Street Journal

Medtronic’s spinal devices unit has been in bunker mode since the FDA alerted surgeons about serious complications associated with off-label use of its products. Yesterday, the medical device giant received more bad news when sealed documents from a 2002 lawsuit were leaked to the Wall Street Journal.

The suit was filed by a former Medtronic lawyer. It alleges that the spinal devices unit provided surgeons incentives to use its products. The incentives included entertainment at a Memphis strip club, fishing expeditions to Alaska, free rides on Mardi Gras parade floats and royalties on inventions they didn’t develop.

The federal government does not allow companies to provide incentives that encourage physicians to use products covered by Medicare and Medicaid.

The spinal devices unit is already under investigation by Sen. Charles Grassley (R-IA) who wants to know whether incentives like the ones alleged in this lawsuit have driven widespread off-label use of Infuse, a growth factor that promotes healing following lower back surgery. Medtronic had refused to provide documents from the case to Sen. Grassley’s staff.

Medtronic denies engaging in improper behavior of any kind and added that it is “committed to reform and transparency in the industry.”


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NICE on Drugs for ADHD

September 26th, 2008 | No Comments | Source: Medical News Today, Wall Street Journal

Britain’s National Institute for Health and Clinical Excellence (NICE) new treatment guidelines for attention-deficit hyperactivity disorder (ADHD) suggest that drugs should be used as first line therapy only for those who are severely impaired.

British physicians are strongly encouraged to implement the NICE recommendations, but they are not obligated to do so. Widespread adoption of the new guidelines would result in dramatic reductions in the use of Ritalin (Novartis) Concerta (Johnson & Johnson) and Strattera (Eli Lilly).

The NICE recommendations call for group-based parent education and training programs as the first line intervention for children with mild or moderate impairment due to ADHD. These behavioral/social interventions are also recommended, along with drug therapy, for severe cases.

NICE also stated that primary care physicians should neither diagnose ADHD nor start drug treatment on their own. These decisions should be left with psychiatrists, pediatricians or those having expertise in ADHD.

Approximately 3% of all school aged children are thought to have ADHD, but only a small percentage of them are severely impaired. In the US, more than 2.5 million children take drugs for ADHD.


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The Big Digg

September 26th, 2008 | No Comments | Source: Wall Street Journal

Digg Inc., a social-networking site where users share their favorite content from anywhere on the web, plans to double its staff to 150 in the next year, expand into international markets and move into spiffy new, uh, digs.

A $28.7 million investment led by Highland Capital partners of Lexington, Massachusetts will fund the expansion. As part of the fresh funding, Highland’s Richard de Silva will sit on Digg’s board.

Digg was founded in 2004 and now claims to have 30 million visitors to its site each month, twice as many as one year ago. Its expansion comes at a time when traditional media companies are struggling as readership and advertising revenues shift to the Internet.

At the time of this post, the three most popular items on Digg were:  You liberals could put a negative spin on anything (a comment exchange from Flickr), Craig Ferguson on McCain suspending his campaign (a YouTube video), and Listen to yourself (a web comic).



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Sarah Palin: Seeing is Believing

September 26th, 2008 | No Comments | Source: CBS News

Couric Grills Palin on Foreign Policy



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