AppId is over the quota
AppId is over the quota

Generic Lipitor Approval: Indian drug company Ranbaxy, a unit of Japan’s Daiichi Sankyo, has received FDA approval for its generic version of Pfizer’s Lipitor, the WSJ reports. (Ranbaxy will share profits from the drug during the first 180 days with Teva, according to the company.) The FDA says Ranbaxy’s atorvastatin calcium tablets will be manufactured by Ohm Laboratories in New Jersey. Meantime, Watson Pharmaceuticals yesterday began selling a version of generic Lipitor authorized by, and in partnership with, Pfizer.

Counseling About Weight Loss: Medicare’s decision to cover screening and counseling for weight loss is being hailed as positive news for obese Americans, but experts are also warning that physicians and other health-care providers lack training and time to help patients with weight loss, USA Today reports. One physician tells the paper he thinks weight-loss counseling could be delivered via the telephone and Internet to save money, and hopes Medicare will consider reimbursing for that option.

Quorn Controversy: The Center for Science in the Public Interest is warning consumers about the rare possibility of severe allergic reactions to Quorn, a meat substitute made from a fermented fungus mixed with other ingredients, and has asked the FDA to remove the product from the market, the WSJ reports. CSPI cites 500 complaints about the food that it’s received in the U.S. over the last decade; the FDA says it’s received only seven over seven years and that it hasn’t been able to confirm that life-threatening allergic reactions were involved. The manufacturer says that “one [person] in between 100,000 and 200,000 may have a sensitivity” to Quorn.

NYC Recommendations for HIV Patients: New York City Health Commissioner Thomas Farley says people infected with HIV should be offered antiretroviral drugs at the time of diagnosis rather than waiting until the virus takes its toll on the immune system, the Associated Press reports. Experts told the AP the science backs up Farley’s recommendation, but that the high cost of the drugs remains a potential obstacle. Other issues include side effects of the drugs and the worry that patients who start the medications but don’t take them consistently can develop resistance, the AP says.

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AppId is over the quota
AppId is over the quota

The health-care overhaul law includes a provision requiring insurers to spend a certain proportion of premium dollars on patient care and quality-improvement programs.

It all sounds straightforward enough — large-group plans must spend at least 85% and individual and small-group plans, 80% — but the devil is always in the details.

And insurance agents and brokers have been hoping that HHS would revise those details to remove their commissions from the administrative-cost bucket. Their argument: insurers seeking to meet the MLR targets will squeeze commissions, hurting agents and brokers as well as the customers they serve.

But commissions were classified as an administrative cost when the Obama administration issued its rule on the MLR last year. And revisions made to the rule issued by HHS today made no change to that policy.

The National Association of Insurance Commissioners, which represents state insurance regulators, recently voted to support a resolution urging Congress to amend the law “in order to preserve consumer access to agents and brokers.” It also suggested that HHS could take a variety of actions to help agents, including counting some agent activities and compensation as quality-related for purposes of MLR calculations. (Here’s the resolution, which passed by a narrow margin.)

In an emailed statement, the president of the National Association of Insurance and Financial Advisors, Robert Miller, says the group “is disappointed that the Administration rejected the NAIC recommendation to take action that would ensure continued consumer access to professional health insurance agents” in its final rule. But the group “remains hopeful that Congress will join the NAIC in recognizing the harm caused to consumers and make the necessary changes to the law.”

One modification that was made to the law: the rebates that consumers will get if their plan doesn’t adhere to the MLR requirements will be tax-free.

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AppId is over the quota
AppId is over the quota

Our personal handwashing rules: use hot water and soap, do it after potentially touching something yucky and sing “Happy Birthday” to be sure you’re scrubbing long enough.

Physicians, though, need to know a lot more. And a small study of third-year medical students in Germany finds that they aren’t entirely clear on when handwashing is indicated.

The study, published in the American Journal of Infection Control, covered 85 third-year students at Hannover Medical School, most of whom said they’d had at least some clinical experience. Researchers asked the students whether handwashing was indicated in seven situations:

Before contact with a patientBefore preparing IV fluidsBefore touching a urine-drainage systemDuring regular nursingAfter removing glovesAfter contact with a patient’s bedAfter contact with vomit

Was handwashing indicated? In order: Yes, Yes, No, No, Yes, Yes, Yes.

How’d you do? Among the students, 21% correctly identified all the true and false indications, while 67% correctly identified the five conditions under which handwashing is appropriate. (That means a third missed at least one.)

Most commonly missed were the need for handwashing before preparing IV fluids and after removing gloves. (Though the majority of students did get those right.)

Depressingly, the students perceived that compliance with basic handwashing guidelines declines as physicians progress and move up the career ladder. They also perceived that their own compliance, as students, would be better than that of nurses — though other research has suggested nursing students are better at hand hygiene than med students.

Some limitations to this study: it doesn’t necessarily reflect the experience of med students in the U.S. or elsewhere, and it’s not clear whether students’ knowledge will improve during the rest of their medical education.

Handwashing bonus: Changing One Word to Get Health-Care Workers to Wash Their Hands

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