Comp Medical News for February

Welcome to this month’s edition of Comp Medical News, an essential update series. Employee wellness woes, drug prices and a local scientist working on a non-addictive painkiller are your headlines heading into February 2016.

First, employee wellness programs remain under scrutiny for reasons related to both potential discrimination and effectiveness:

When are Employee Wellness Programs No Longer Voluntary?

A high profile challenge of an employee wellness program has stoked the fires of discriminatory concern surrounding incentives for healthy habits. In a case filed by the Equal Employment Opportunity Commission, the U.S. government argued that Flambeau, a plastics maker, had a wellness program that didn’t comply with the Americans with Disabilities Act, which limits companies from requiring medical exams or personal health information from workers. The suit was the result of a complaint from a worker who was denied health coverage entirely after refusing to submit to testing. He was instead directed to purchase coverage through the government’s COBRA plan. The EEOC contended that denying employer-sponsored coverage crosses the line from voluntary to coercive. However, a federal judge ruled on December 31st that employers can deny coverage without violating the ADA as long as the data gleaned from the wellness program is used for purposes of overall health coverage. Such decisions against the EEOC have prompted new definitions of what “voluntary” means in the age of “wellness.”

Read more via Insurance Journal here.

Incentive Worth $550 Did Not Motivate Workers to Lose Weight

A recent study published in Health Affairs found that premium-based incentives worth about $550 did not result in meaningful weight loss among obese employees enrolled in an employer-based wellness program. At the end of a year, obese workers had lost less than 1.5 pounds on average, statistically no different than the minute average gain of a tenth of a pound for workers who weren’t offered a financial incentive to lose weight. The study reported the results of a year-long randomized controlled trial of 197 obese employees of the University of Pennsylvania system.

Participants were asked to lose 5 percent of their weight. Each was assigned to one of four study groups. The control group wasn’t offered any financial rewards. The three other groups were offered an incentive valued at $550. One group was told they would begin receiving health insurance premium discounts on a bi-weekly basis immediately after reaching their weight loss goal, while another was told they would receive bi-weekly premium adjustments the following year if they reached their goal. The final group was eligible for a daily lottery payment if they met their daily weight loss goal and weighed in the previous day. At year’s end, no group had met the 5 percent weight-loss target. Participants’ average weight was virtually unchanged, whether or not they had a financial incentive to lose pounds. Nineteen percent of participants did meet the 5 percent target, but they weren’t concentrated in any particular group. Study authors suggested that the results display the need for aggressively structured wellness programs if employers want them to meaningfully change outcomes.

Read more via MedPage Today here.

Next, medical devices and drugs are in the news:

Major Drugmakers Fight Public Perception of Price Increases

Top executives from Eli Lilly and Co., Merck & Co. and Biogen Inc. told Reuters in a series of interviews that the massive backlash against overnight increases in the average wholesale price of drugs should be tempered by the fact that “most people don’t pay retail.” They explained that the actual prices paid by prescription benefit managers, insurers and other large purchasers are reduced through negotiated discounts. However, a couple of dramatic price hikes in 2015 exposed the whole industry to ongoing scrutiny in Congress and on Wall Street. Turing Pharmaceuticals raised the price of a generic anti-infective drug called Daraprim by 5,000 percent, and the larger Valeant Pharmaceuticals International raised the price on a heart drug Isuprel by more than 200 percent. The largest drugmakers quickly portrayed those cases as outliers. But the industry practice of raising prices each year for treatments used by millions of people is attracting new attention.

Read the full report from Reuters here.

Case Report on Replacing Intrathecal Pain Devices

Pain Medicine News contributors Dr. Timothy Deer and Dr. Jason Pope provided the news site with a case report on a patient that has an intrathecal pain pump as part of his treatment regimen. Because such devices have been in use for over 20 years, management of patients at end of the generator’s life is becoming increasingly commonplace. They discuss the troubleshooting associated with intrathecal therapy at end of device life and cost concerns in the analysis.

Read the report here.

Finally, opioids, the national issue heavy on the minds of comp professionals and increasingly in the spotlight, continue to plague researchers and the public alike:

New Research Review Suggests Link Between Painkillers and Heroin is Not as Strong as Once Thought

Almost 19,000 people died from overdoses of prescription painkillers in 2014, the most recent year for which statistics are available, according to the CDC. That same year, about 10,600 died from heroin overdoses — more than five times the number of fatalities from them in 2000. A new review of current research published in the New England Journal of Medicine seeks to provide guidance on the problem. The review of recent studies examines the often cited link between abuse of prescription painkillers and heroin use. That consequence, the researchers say, fuels the need for better treatment and prevention of prescription drug abuse. They noted, however, that “although the majority of current heroin users report having used prescription opioids non-medically before they initiated heroin use, heroin use among people who use prescription opioids for nonmedical reasons is rare, and the transition to heroin use appears to occur at a low rate.”

Read more via Kaiser Health News here.

NPR Analyzes “Anatomy of Addiction” and How Opioids are Unique

Told through the story of Jack O’Connor, a young former opioid addict and alcoholic, NPR recruited experts to explain how opioids work and why drugs within that class create such profound addictions compared to other substances. The report also assesses detox programs and how, despite an absence of physical dependence, relapse is common.

Listen/read the story here.

Tulane Scientist Working on a Non-Addictive Painkiller

Scientists at Tulane University and the Southeast Louisiana Veterans Health Care System may be on the brink of creating a new painkiller that would not be addictive and would have fewer side effects. The drug, which would be used as an alternative to morphine and other opioids, has the potential to prevent overdoses by lowering the body’s penchant for increasing tolerance and addiction. According to a New Orleans Advocate report, data from the Louisiana Department of Health and Hospitals show that from 2010 to 2013, heroin deaths in the state skyrocketed from 15 to 117, an eightfold increase. The majority of the deaths were in Orleans and Jefferson parishes, followed by East Baton Rouge.

Read the full story from The Advocate here.


Image Credit: Wilkes University

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