Report Shows Questionable Billing by Thousands of U.S. Pharmacies
About $5.6 billion was paid by Medicare in 2009 to 2,600 pharmacies with questionable billings, according to a report released Thursday by the inspector general of the U.S. Health and Human Services department.
That included a Kansas drugstore that submitted more than 1,000 prescriptions each for two patients in that year, the Associated Press reported.
The analysis of more than 1 billion prescriptions submitted by the nation's 59,000 retail pharmacies in 2009 found that they're vulnerable to fraud. Part of the problem is that Medicare does not require private insurers that deliver prescription benefits to seniors to report suspicious billing patterns, the inspector general's report said.
"While some pharmacies may be billing extremely high amounts for legitimate reasons, all warrant further scrutiny," according to the document, which called for improved oversight, the AP reported.
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FDA Should OK New Rheumatoid Arthritis Pill: Panel
A new rheumatoid arthritis pill called tofacitinib should be approved for sale in the United States, a Food and Drug Administration advisory panel recommended Wednesday.
However, several members of the panel expressed concerns about the drug's safety and urged the FDA to require Pfizer to conduct rigorous follow-up studies, The New York Times reported.
In an 8-2 vote, the panel decided that tofacitinib could provide patients with an alternative to injectable medicines already on the market and that it offered enough benefits to offset potential safety risks, including higher rates of lymphoma and other cancers, and serious infections.
"The observation of malignancy rates increasing over time was unexpected and is of major concern," said panel member Dr. Nikolay P. Nikolov, The Times reported.
The FDA, which is expected to make a decision by August, typically follows the advice of its advisory panels.
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FDA Questions Long-Term Benefits of Bone Drugs
Bisphosphonate bone-strengthening drugs used to treat and prevent osteoporosis in older women may provide little long-term benefit, according to a U.S. Food and Drug Administration analysis of two previous studies that included more than 2,300 post-menopausal women.
The FDA found that the women "showed little benefit of continued bisphosphonate treatment beyond five years," Bloomberg News reported.
The agency didn't propose specific guidelines for doctors, but suggested that continued treatment with the drugs may provide some benefit to women with low bone-mineral density who have the highest risk of fractures.
The report, published in the New England Journal of Medicine, renews debate about whether taking bisphosphonates for longer than three to five years provides any protection against the risk of fractures, Bloomberg reported.
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Health Care Costs Top $240,000 for Retired Couples: Report
American couples retiring this year can expect their medical bills throughout retirement to cost about $240,000, which is about four percent more than the $230,000 needed by those who retired last year, says an annual projection released Wednesday by Fidelity Investments.
The new estimate is based on a 65-year-old couple retiring with Medicare coverage, and factors in the federal program's premiums, co-payments, deductibles and out-of-pocket prescription drug costs, the Associated Press reported.
The projection assumes the couple does not have insurance from their former employers and is based on a life expectancy of 85 for women and 82 for men. It doesn't include the costs of dental services or long-term care, such as the expense of living in a nursing home.
The most recent estimate could change significantly depending on the U.S. Supreme Court's ruling next month on whether to strike down part or all of the 2010 health care law. Depending on the ruling, Fidelity may update its estimate, the AP reported.
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Two Proposed Diagnoses Dropped From Psychiatric Diagnostic Manual
Two controversial proposals that would have expanded the number of people diagnosed with psychotic or depressive disorders have been scrapped by an expert panel revising an influential psychiatric diagnostic manual.
The panel working to complete the fifth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders said the two proposed diagnoses were not supported by evidence, The New York Times reported.
The two rejected diagnoses were: attenuated psychosis syndrome, proposed to identify people at risk of developing psychosis; and mixed anxiety depressive disorder, a hybrid of anxiety and depression.
The panel also refined their proposed definition of depression so that the normal sadness a person experiences after the loss of loved one, marriage or job would not be mistaken for a mental health problem, The Times reported.
However, the panel did not back down from another widely criticized move to streamline the definition of autism. Critics say the new definition could greatly reduce the number of people diagnosed with autism, but panel members say evidence from a newly completed study shows that's not the case.
The changes to the diagnostic manual -- which plays a major role in research, treatment and insurance decisions -- are being debated this week at the psychiatric association's annual meeting, The Times reported.
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