Consumer Health Digest #16-27

Your Weekly Update of News and Reviews
July 17, 2016

Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.

OIG spotlights high drug costs. The U.S. Office of the Inspector General is alarmed by the accelerating cost of Medicare Part D, the optional prescription drug program that has 40 million beneficiaries. The report, which focuses on opioid painkillers and drugs produced by compounding pharmacies, concludes:

Nearly 1 in 3 beneficiaries received commonly abused opioids in 2015 and Part D spending for these drugs exceeded $4 billion. . . . Opioid use can be appropriate in some cases. However, misuse of opioids not only has serious financial costs but also human costs, including deaths from overdoses. Moreover, these continuing high rates provide further evidence of this crisis facing our Nation.

Although not as high as opioid spending, the spending for compounded drugs is just as striking. . . . Part D spending for compounded drugs has grown more than 600 percent since 2006, while spending for compounded topical drugs increased more than 3,400 percent. The extremely high rate of growth raises questions as to whether all of the drugs were medically necessary or even dispensed to the beneficiary. These concerns are buttressed by a growing number of fraud cases. Together, the spending trends and cases involving compounded drugs signal the need for action.

[High part D spending on opioids and substantial growth in compounded drugs raise concerns. Office of the Inspector General Report OEI-02-16-00290, June 21, 2016]

AMA expresses concern about the use of "smart drugs." The American Medical Association House of Delegates has voted to discourage the prescribing and use of prescription drugs for cognitive enhancement in healthy individuals. These products, referred to as nootropics or "smart drugs," include prescription drugs, dietary supplements, and other substances that are claimed to improve brain functions such as executive function, memory, learning, and/or intelligence. [AMA confronts the rise of nootropics. AMA news release, June 14, 2016] The new policy statement noted:

Consumers Union gives more misguided advice about chiropractors. Consumer Reports on Health has published another unhelpful statement about chiropractic. [Hands on help for necks and backs. Consumer Reports on Health, Aug 2016, pp 6-7] The report mentions (unidentified) studies that it says indicate that chiropractic treatment may be useful. But it fails to note that patient management in chiropractic offices is likely to be far less appropriate than the care received in research settings. In 1975 and 1993, Consumer Reports published penetrating reports about the risks and pitfalls of the chiropractic marketplace. Since that time, however, the magazine's editors have treated widespread wrongdoing by chiropractic as though it does not exist.

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