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THT's One-hour 'Fastest' Service Aims To Reduce Undiagnosed HIV In Brighton & Hove
In a bid to reduce levels of undiagnosed HIV in Brighton & Hove, HIV and sexual health charity Terrence Higgins Trust (THT) is encouraging gay and bisexual men who may have been at risk to attend a local service offering one-hour HIV testing. One in four people who have HIV in the UK are undiagnosed, and there are now more people living with the condition than ever before.
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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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Sixteen States, DOJ Join Whistle-Blower Lawsuits Alleging Wyeth Defrauded Medicaid Programs
The U.S. Department of Justice and 16 states have joined two whistle-blower lawsuits filed in federal District Court in Massachusetts alleging that Wyeth defrauded the government by not offering the same discounts on two medications to Medicaid that it offered to hospitals, the Wall Street Journal reports. The lawsuits were initiated following a grand-jury investigation by the U.S. Attorney"s Office in Massachusetts (Johnson, Wall Street Journal, 5/19). The other states included in the lawsuits are California, Delaware, Florida, Illinois, Indiana, Louisiana, New York, Michigan, Nevada, New Hampshire, Tennessee, Texas, Virginia, Wisconsin and the District of Columbia (Barrett, AP/Austin American-Statesman, 5/18).According to the lawsuits, Wyeth from 2000 to 2006 sold hospitals a bundled package called the Protonix Performance Agreement, which included its acid-reflux drugs Protonix Oral and Protonix IV. The suits allege that Wyeth gave hospitals up to a 94% discount for the oral version under the deal, with the understanding that when patients were released from hospitals they would be switched from the intravenous version of the drug to the oral version. According to the complaint, Wyeth hoped to gain an edge in a competitive market for acid-reflux pills by taking advantage of its standing as the only company offering an IV acid-reflux drug. The Journal reports that Wyeth charged hospitals $20 per vial for the IV version of Protonix and $3 for the oral version.Medicaid rules stipulate that the program is entitled to the lowest price on prescription drugs, and drugmakers are required to pay states rebates if they offer discounts to any other entities. The lawsuits state that Wyeth avoided paying hundreds of millions of dollars to state Medicaid programs because it did not offer the programs the same discounts or provide rebates (Wall Street Journal, 5/19).The lawsuits are seeking financial penalties against Wyeth of up to three times the amount lost by Medicaid. Assistant Attorney General Tony West said, "By offering massive discounts to hospitals, but then hiding that information from the Medicaid program, we believe Wyeth caused Medicaid programs throughout the country to pay much more for these drugs than they should have." Wyeth spokesperson Doug Petkus said that Wyeth "believes that its pricing calculations were correct and intends to defend itself vigorously in these actions" (AP/Austin American-Statesman, 5/18).
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RDAA Survey Shows Widespread Support For Medicare Loading For Rural And Remote Doctors

Over 80% of rural and remote doctors recently surveyed by the Rural Doctors Association of Australia (RDAA) believe adding a significant rural and remote loading on Medicare items would assist in recruiting and retaining doctors in their communities. The online poll conducted by RDAA during April and May backs RDAA"s ongoing call for an extra loading to be added to Medicare fees paid to rural and remote doctors. RDAA President Dr Nola Maxfield said the poll showed rural Australia needed "better incentives that demonstrate to doctors currently working in the bush they are valued, and shows those considering a move to the bush that it is an attractive option". "We have to do something significant, and urgently, to turn around the declining number of doctors in the bush," Dr Maxfield said. "Incentives would be calculated as a loading on rural doctors" Medicare billings or as a special payment for salaried rural doctors. The loading would increase the more remote the location the doctors worked in. "The Federal Government must look seriously at building a rural loading into Medicare." The RDAA survey paints a clear picture of the existing rural medical workforce crisis and the significant concerns over the sustainability of the workforce. When asked if their rural town or community had enough doctors to service the health and medical needs of its residents nearly 60% of respondents described their towns as "underserviced" and 9% said they were "severely underserviced". One respondent drolly remarked, "clone the doctors!" A considerable number of the rural and remote medical workforce polled reported overwhelming on-call demands, with 17% on call seven days a week. Nearly 30% of the workforce was on-call at least one day a week. The average weekly hours worked by the doctors surveyed, was a staggering 47.4 hours. This compares with the national weekly hours worked of 34.7 hours. Much of the feedback received as part of the survey reflected these views, with comments such as this one common, "...until rural and remote work is reclassified as a specialty nothing will change." Along with calling for a rural loading on Medicare items as a remedy for the current workforce shortage, the survey found doctors want a range of other supports, including improved after-hours and on-call arrangements, better education and professional supports, better locum availability, capital funding to improve practice infrastructure and nearly 100% of respondents reported family friendly working arrangements as important or very important. Feedback provided as part of the survey also reflects frustrations with health and hospital administration, with comments such as this: "...sack the bureaucrats and replace them with clinicians who understand healthcare delivery ..." and this: "...anaesthetists should run hospitals, plan theatres - not accountants or business men who do not actually work in health care." The comments also reflect dissatisfaction at the loss of rural health facilities, in comments like this "...replace lost maternity service." Rural Doctors Association of Australia


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