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First Murder By Propofol Reported By Leading Anesthesia Journal
Recent questions about the death of Michael Jackson have focused media attention on the commonly used intravenous anesthetic propofol. In the April 2009 issue of Anesthesia & Analgesia, the leading clinical journal for anesthesiologists, Robert R. Kirby, James M. Colaw and Michael M. Douglas reported on a 24-year-old woman whose 2005 death was attributed to propofol toxicity.
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Pledges To Reduce Health Care Costs, Spending Growth Could Violate Antitrust Laws, Lawyers Say
U.S. antitrust laws could affect health care industry groups" efforts to work together to rein in health care costs, the New York Times reports (Pear, New York Times, 5/27). In a letter sent to President Obama on May 10, a coalition of groups -- the American Medical Association, the American Hospital Association, Pharmaceutical Research and Manufacturers of America, the Advanced Medical Technology Association, America"s Health Insurance Plans and the Service Employees International Union -- pledged to reduce the annual health care spending growth rate by 1.5%. The groups did not elaborate on what specific measures they would use to achieve such reductions, but the Obama administration has requested specific plans from the groups by June 1 (Kaiser Daily Health Policy Report, 5/26). According to the Times, many of the plans being considered by the health care industry would require greater cooperation across health care providers. Robert Leibenluft, a former Federal Trade Commission official, said, "Any agreement among competitors with regard to prices or price increases -- even if they set a maximum -- would raise legal concerns." In addition, while Obama is asking for specific plans from the health care industry, the administration has not offered any relief from antitrust laws, the Times reports. Furthermore, during his campaign Obama pledged to increase enforcement of antitrust laws, according to the Times.Antitrust laws have had a negative effect on previous health reform efforts, the Times reports. In 1993, the drug industry established a voluntary cost control plan that limited each drug company"s annual increase in the average price of prescription drugs to the increase in the Consumer Price Index, but the Department of Justice ruled that the proposal would violate antitrust laws. DOJ officials said that the U.S. Supreme Court made it clear that setting price maximums was akin to setting price minimums, which is illegal. In a letter to the Senate Finance Committee, AHA wrote that uncertainty regarding the enforcement of antitrust laws "makes it difficult for a hospital and doctors to collaborate to improve care" and reduce costs. AMA has asked Congress to amend antitrust laws to allow physicians to collectively negotiate with insurers over fees and other concerns, but FTC repeatedly has designated the practice illegal price-fixing, according to the Times. FTC officials said that consumers could benefit from cooperation among health care industry groups but that cooperation also could lead to increased bargaining power for physicians and hospitals, making it easier for them to set prices and eliminate competition (New York Times, 5/27). Reform Developments
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Micronics Receives Patent On Rapid Thermocycling Methodology For Molecular Diagnostics
Micronics, Inc. announced that it has been issued a letters patent from the United States Patent and Trademark Office (USPTO) for a system and method for performing rapid thermocycling on a microfluidic device. The new patent has broad utility across the life sciences sector with particular application in point of care molecular diagnostics.
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Agencies And Health Departments Prepare For Swine Flu

Governments and drug companies are struggling with efforts to prepare for a possible resurgence of swine flu in the fall as well as questioning who should receive swine flu vaccines as they ramp up production. The Boston Globe reports on low stockpiles as disease trackers prepare for the fall to see how the swine strain develops. The paper reports: "The arrival of swine flu in the United States exposed gaps in the supply chain that delivers medication, masks, and even testing swabs to hospitals and doctors" offices - shortcomings that could prove vastly more worrisome if a deadlier strain returns in the fall, officials say. In Massachusetts, where the state health agency had to tap its emergency cache of flu-relief pills to supplement dwindling private supplies, the administration of Governor Deval Patrick is asking the Legislature to spend $1 million more to bolster the state stockpile, a request that is pending." The paper also notes: "The experience with swine flu has underscored how the agencies responsible for corralling dangerous germs often have no way of assuring whether pharmaceutical and medical supply companies have stocks sufficient to satisfy demand." Later this month, five dozen health officers will convene in Massachusetts to analyze the handling of swine flu. Massachusetts health authorities have noted that supply shortages tended to be localized and that nation"s health system didn"t experience major upheaval. The Boston Globe also notes: "Disease specialists fear that the appearance of twin flu strains could sorely tax the nation"s healthcare system, which faced episodic supply shortages since the first cases of swine flu were diagnosed. In the early days of the epidemic, Massachusetts doctors reported that some patients had trouble getting prescriptions filled for Tamiflu - the main medication used to treat the novel virus - as drug-store reserves ran low. As a result, the state Department of Public Health distributed enough antiviral medication from its stockpile to treat the flu or prevent it in 53,000 patients. Some hospitals said shelves usually brimming with surgical masks, used to slow the virus" transmission, turned barren - and suppliers proved unable to replenish supplies in the standard 24-hour timeframe. Hospitals sometimes found themselves in competition with each other for supply reinforcements, and there were instances when departments within the same medical center raced to get their orders in first" (Smith, 6/15). The Wall Street Journal reports that "the world"s biggest drug companies have started producing vaccines against the H1N1 virus and expect the first doses to be available by the fall. Many Western countries have ordered millions of doses, at a cost of more than $1 billion. But they have yet to figure out who should be first in line to get the shots, or to what extent they are even needed, given that the virus has so far proved less deadly than feared." The paper reports on the dilemma of dealing with a high-risk health care challenge like swine flu: "If they move to produce too much vaccine, they could find themselves wasting taxpayer money and using up scarce capacity that could be producing other life-saving vaccines. But not getting enough vaccine -- or not vaccinating the right people -- could expose them to trouble if the pandemic worsens. The World Health Organization, which formally declared swine flu a pandemic Thursday, has yet to offer guidelines on how many people should be vaccinated and who should be first. But some governments are moving ahead with their own plans." Meanwhile, "U.S. officials are gathering more information on the virus and waiting to see the results of clinical trials on the safety and efficacy of the shots before making any decisions" (Whalen, 6/15). The Associated Press reports that Health Secretary Kathleen Sebelius says production of a swine flue vaccine is being set up and production could start as early as late summer and be ready in fall. Meanwhile, the government is working with governors and health and schools officials in case a major vaccination program is needed. The AP also noted: "Nearly 18,000 cases of swine flu have been reported across the United States, with 45 confirmed deaths" (6/15). In a separate article, the Boston Globe reports on training for other emergency and public health scares through an examination of Boston"s DelValle Institute for Emergency Preparedness, which was set up in 2003 by the city"s Emergency Medical Service and the Public Health Commission. The institute "has won praise from national antiterrorism specialists" with nearly 13,000 nurses, doctors, police officers, ambulance teams and other emergency personnel having received training there. The Globe reports that experts from countries targeted by recent mass-casualty terror attacks will meet at DelValle this week to connect with their local and national counterparts (Smith, 6/15). This information was reprinted from kaiserhealthnews.org with kind permission from the Henry J. Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives and sign up for email delivery at kaiserhealthnews.org. © Henry J. Kaiser Family Foundation. All rights reserved.


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