Essential Updates: Comp Medical News for April

Welcome to this month’s edition of Comp Medical News, an essential update series. Each update features stories from around the country, with special focus on medical treatment guidelines and emergent issues related to medical management in workers’ comp.

First, medical technology has made moves in both chronic disease and mental health:

Spider venom shows promise for the development of new painkillers

Researchers have identified seven new chemical compounds in spider venom that block a key step in the body’s ability to send pain signals to the brain. The scientists focused on 206 species of spider and searched for molecules in the venom that block nerve activity via “Nav1.7 channels.” The knowledge could one day lead to a new class of potent painkillers. Experts estimate that as many as one in five people worldwide suffer from chronic pain and existing pain treatments often fail to give sufficient or long-term relief. The economic burden of chronic pain is also huge, with chronic pain estimated to cost $600 billion a year in the United States alone.

Read full coverage from Reuters here.

National Institute of Mental Health advocates for brain scans to diagnose mental illness before major symptoms

NIMH released a new five year strategic plan that emphasizes new research methods of detection for mental illness that allow clinicians to discover problematic brain activity prior to outward drastic symptoms. The plan signals investment to figure out the genes associated with mental illness, develop new treatments based on those findings, make sure research findings are eventually implemented into practice, and find brain patterns for a range of disorders. Experts believe that beginning treatment earlier in the disease process will improve quality of life for patients who might already be suffering from diminished social or emotional competence without understanding the reason. Al Guida, the president of Guide Consulting Services, a Washington-based government relations firm that specializes in behavioral health, told MedPage Today, “Just as brain tumors are detected through CAT scans and diabetes is diagnosed through blood sugar testing, NIMH is focused on employing brain imaging to detect common mental disorders and severe mental illnesses before full-blown clinical presentation.”

Read full coverage from MedPage Today here.

Chronic disease maintenance apps target Apple users for new data opportunities

The ResearchKit software tool, an open source platform, allows researchers to design applications that use built-in sensors on the iPhone along with data from other wearable devices to gather real-time health data. Scientists from Stanford University School of Medicine and Weill Cornell Medical College are among the first to offer apps for diseases like diabetes and heart disease. Researchers claim that ResearchKit simplifies their recruiting work and that volunteers can decide how much data to share directly; data does not go to Apple.

Read more from Reuters here.

Second, a potential formulary is in the spotlight in California:

Formulary bill ready to be discussed in Committee in California

If AB 1124, introduced by Assemblyman Henry Perea of Fresno, is passed, California will become the fifth state in the nation to adopt a pharmaceutical formulary for workers’ comp. Estimates of potential savings for the state system are around $500 million. The bill includes no deadline for the production or implementation of the formulary, leaving the measure open for debate amongst stakeholders on both sides. Workers’ advocates have argued that new restrictions on medical care, in addition to the independent medical review processes created under SB 863 in 2012, would be misguided. Supporters of a formulary cite major savings reported by such institutions as the WCRI, plus the possibility that pre-approved medications in a closed formulary could increase overall system efficiency. AB 1124 was passed to the Committee on Insurance in the California Legislature last week.

Read more details from WorkCompCentral (paid content) here and here. Read full details on the progress of the bill here.

Third, the FDA made a major move that could open the door for quicker approvals of similar medications:

FDA approves “biosimilar” drug for the first time ever

In a decision Kaiser Health News identifies as “uncharted territory,” the U.S. Food and Drug Administration (FDA) approved Novartis’ Zarxio, a cancer drug that is “biosimilar” to Amgen’s Neupogen. “Biosimilarity” is the term used to describe biotech medications that are essentially the same as their original counterparts. How biosimilar drugs differ from generics is that they’re copycats of more complex medicines called biologics, made with living cells. The approval is important because biologics comprise a small but very expensive portion of the U.S. pharmaceutical market; more biosimilar approvals could drive prices down for these specialty drugs and thus assist financially strapped patients. Biosimilars have been on the market in Europe for almost a decade and decreased the costs for some medications as much at 20-30 percent.

Read further coverage from Kaiser Health News here.

Lastly, Medicare continues to be a popular topic of conversation:

U.S. House approves updated reimbursement bill for Medicare doctors

The U.S. House approved a long-awaited bill last week that will update payments to Medicare doctors from the current 1990s levels. The measure is a bipartisan effort spearheaded by top Democrat Nancy Pelosi and House Speaker John Boehner and was overwhelmingly approved in a 392-37 vote. The Senate will not be able to vote on the bill until after the Easter/Passover recess in two weeks, but President Obama has expressed his strong support of the bill and the bipartisan accomplishment. The old formula linked doctor pay to economic growth, the new proposed one focuses on quality of care. It also would require means-testing of Medicare beneficiaries so that higher income people pay higher premiums. The legislation was designed to spare Medicare doctors a 21 percent pay cut effective today (April 1st, 2015) under the existing payment formula. Though the Senate will not act until mid-April, doctors might still be able to avoid pay cuts because Medicare doctors’ claims generally take at least 14 days to be paid.

Read full coverage from Reuters here.

Medicare celebrates its 50th anniversary: a doctor’s retrospective

In this first in a six-part series, Neil Brooks, MD, a family physician in Vernon, Connecticut and former president of the American Academy of Family Physicians (AAFP), addresses the origins of Medicare and the phrase “reasonable and necessary” medical treatment. Brooks was in medical school at the time Medicare was implemented and he offers his perspective on the evolution of the “experiment.”

Read on via MedPage Today here.


Image Credit: Boomer Benefits

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