Study Insurers may save on heart drugs

Tue, 09 Jan 2007 05:26:30 GMT
By KEVIN FREKING, Associated Press Writer
WASHINGTON - Picking up the tab for certain medications taken by people who had suffered a heart attack could save insurance companies money in the long run, a new study says.
A combination of heart medications and cholesterol-lowering drugs has been estimated to reduce the risk of death from heart disease by 80 percent compared with a placebo. Yet, the medications continue to be greatly underused.

One answer to that problem would be to provide full coverage of the heart medicines to those who had a previous heart attack, instead of requiring the patient to pick up a share of that costs. Often the extra coverage could be entirely offset by the savings generated when health problems are averted, said researchers at Harvard Medical School.

Under conservative assumptions, compliance with a medication regimen would increase from 50 percent to 63 percent among patients when they bear none of the cost for the medicine.

The extra coverage would cost insurers an average of $550 per patient, but that would lead to fewer deaths and nonfatal heart attacks and strokes, saving $1,731 in costs per heart-related event.

"If insurers can both boost compliance rates and prevent secondary heart disease events by shouldering these out-of-pocket costs, it's worth the investment," said Niteesh K. Choundry, an assistant professor at Harvard.

The researchers said that some 423,000 Americans with insurance for their medicine will have their first heart attack in 2006. They calculated that providing the patients with complete coverage for their heart medications could save 4,736 lives annually and save insurers more than $2.5 billion annually.

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On the Net:

http://www.healthaffairs.org

Industry money may bias drink studies

Tue, 09 Jan 2007 00:47:48 GMT
By MARILYNN MARCHIONE, AP Medical Writer
Does milk lower blood pressure? Does juice prevent heart disease? Beverage studies were four to eight times more likely to reach sweet conclusions about health effects when industry was footing the bill, a new report contends.
Its authors claim to have done the first systematic analysis of such studies published from 1999 through 2003 in hundreds of journals around the world.

"We found evidence that's strongly suggestive of bias," said Dr. David Ludwig, an obesity specialist at Children's Hospital Boston who led the work, which was published Monday in the online science journal PLoS Medicine. The consumer advocacy group Center for Science in the Public Interest also participated.

Biased science can affect consumer behavior, doctor recommendations and even federal regulation of marketing claims for such products, Ludwig said.

"I don't blame researchers for this problem. I think most are highly ethical and dedicated to science. The problem is that when government underfunds nutrition research, industry money becomes hard to resist," he said.

However, beverage industry folks say the authors have a slant, too.

"This is yet another attack on industry by activists who demonstrate their own biases in their review by looking only at the funding source and not judging the research on its merits," says a statement by Susan Neely, president of the American Beverage Association. "The science is what matters — nothing else."

Public health experts who promote dietary guidelines are biased toward their own advice, said Greg Miller, a nutrition biochemist who heads research for the National Dairy Council. The council requires its funded researchers to publish results in journals that require review by outside scientists and to disclose who pays for their work.

"Everybody brings a point of view to the table, and in the long run, that's probably a good thing," Miller said.

But the authors say this point of view appears to influence results.

They used Medline, a compendium of scientific literature, to identify 538 studies about soda, milk or juice involving people, not animals. They targeted 206 that made a health claim directly related to the drink being studied — for example, bone fractures related to calcium and milk intake, or immune system benefits from antioxidants in juice.

Of the 206 studies, only 111 gave information on funding: 22 percent were fully funded by industry and 32 percent got some industry money.

One group of reviewers analyzed study conclusions and classified them as favorable, neutral or unfavorable to the beverage in question. Another independent group of reviewers determined whether a study would help, harm or have no effect on the finances of the study sponsor.

For example, a negative finding about soda would harm a soda sponsor but could help a dairy producer.

Overall, studies funded entirely by industry were four to eight times more likely to be favorable to their sponsors.

None of the experiments fully funded by industry that tested beverages with a control group found fault with the drinks.

The authors' work was paid for by a grant from the Charles H. Hood Foundation, which finances research on children's issues at Ludwig's hospital. Co-author Dr. Lenard Lesser also had funding from a fellowship at the Rochester School of Medicine and Dentistry.

The beverage association complained that Ludwig is on the editorial board of the journal that published his study. However, Ludwig noted that the board has more than 100 scientists on it, and said his study went through an independent review.
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On the Net:
Medical journal: http://www.plosmedicine.org

Heart group kicks off fitness campaign

Tue, 09 Jan 2007 00:40:04 GMT
By JAMIE STENGLE, Associated Press Writer
DALLAS - With an eye on Americans who spend too much time sitting behind computer screens and not enough time getting exercise, the http://www.americanheart.org/start

Overweight 9yearold girls at heart risk study

Mon, 08 Jan 2007 20:15:12 GMT

NEW YORK - Girls as young as age 9 who are overweight are at heightened risk for serious short-term and long-term health problems that put them at increased risk for developing heart disease, a study released today indicates. For example, overweight girls are more likely to have elevated blood pressure and cholesterol compared with their normal-weight counterparts.
As part of the National Heart, Lung and Blood Institute's Growth and Health Study, 1,166 Caucasian and 1,213 African American girls ages 9 and 10 years were tracked for more than 10 years. Researchers measured the girls' height, weight, blood pressure, and cholesterol annually through age 18. They also obtained self-reported measures at ages 21 to 23 years.

According to the report of the study published in the Journal of Pediatrics, overweight rates increased through adolescence from 7 to 10 percent in the Caucasian girls and from 17 to 24 percent in African American girls. Girls were 1.6 times more likely to become overweight between 9 and 12 years of age than in later adolescence.

"Girls who were overweight during childhood were 11 to 30 times more likely to be obese in young adulthood," Dr. Douglas R. Thompson from Maryland Medical Research Institute, Baltimore, and colleagues report.

What's particularly concerning, the authors report, is that young girls who were overweight were 3 to 10 times more likely to have unhealthy blood pressure levels, HDL cholesterol (the good cholesterol), and triglyceride levels. They were also 3-times more likely to have high levels of LDL cholesterol (the bad cholesterol).

These data indicate that a relationship between cardiovascular disease risk factors and overweight is already present at age 9 and "suggest that pediatricians should address the health correlates of overweight during childhood."

"The challenge for clinicians, community leaders, researchers, and public health officials will be to develop effective innovative obesity prevention interventions that can be widely generalized and disseminated, so that the dire prediction that deaths related to obesity will soon become the leading cause of mortality in the United States does not come to pass," Thompson and colleagues conclude.

SOURCE: Journal of Pediatrics, January 2007.

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