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Health Highlights: May 7, 2005

Implantable Defibrillator Use Recommended for Certain Recently Diagnosed Heart Patients States Pushing for Employers to Assume More Health Care Costs World Health Officials Unveil Drug Monitoring System U.S. Considers Plan to Track All Livestock Merck Sales Reps Told to Downplay Vioxx Risks: Report

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Implantable Defibrillator Use Recommended for Certain Recently Diagnosed Heart Patients

A patient who has just been diagnosed with cardiomyopathy, a disease that affects the heart muscle's ability to pump, would benefit from an implantable defibrillator, a study has concluded.

The research was presented over the weekend to members of the Heart Rhythm Society's Annual Scientific Sessions in New Orleans and was based on previous studies showing that implantable cardiac defibrillators (ICDs) were effective in controlling cardiac myopathy.

But the U.S. government's Center for Medicare and Medicaid Services had established payment guidelines based on cardiac myopathy diagnoses of about nine months, the lead researcher said in a news release.

Dr. Alan Kadish, associate chief of Cardiology and associate director of the Bluhm Cardiovascular Institute at Northwestern Memorial Hospital, said the study was designed to see if those diagnosed with cardiac myopathy would benefit from an earlier ICD implant.

The government "... established guidelines that limited ICD use in patients with recently diagnosed cardiomyopathy," Kadish said. "However, our study found that patients who have a recent cardiomyopathy diagnosis appear to get just as good a survival benefit from ICD implantation as those with a remote diagnosis. Therefore, these findings could help expand the number of patients who benefit from this life-saving therapy."


States Pushing for Employers to Assume More Health Care Costs

Government figures show that an alarming number of U.S. residents have jobs but no health insurance, and some state governments are considering requiring employers to provide more health care coverage.

The Robert Wood Johnson Foundation recently reported that more than 20 million working adults in the United States don't have health insurance. And according to a story in the New York Times, more than 45 million Americans -- employed and unemployed -- have no health insurance at all.

This has placed a heavy financial burden on individual states, the Times reports, causing state governments to consider shifting the burden of providing the minimal health coverage for the uninsured to employers.

The names of some of these companies the newspaper cited is surprising, including Dunkin' Donuts, Wal-Mart and Stop & Shop, a large Northeast supermarket chain. These companies supply so little in health benefits, the state claims, that many employees are on Medicaid or some other form of state assistance for those below the poverty level.

Massachusetts has already ordered these and other employers to pick up the cost of additional health coverage. Wal-Mart is challenging the order, the Times says, while Dunkin' Donuts claims individual franchises are responsible for health insurance decisions for their employees.

At least two dozen states are now considering some sort of law requiring employers to pick up health care costs, which until now was not required anywhere in the United States. Maryland may be a key state. "The focus of the debate is whether there should be an employer mandate," the Times quotes Ellen Valentino, Maryland director for the National Federation of Independent Business, as saying. Her group of small Maryland businesses is opposing the legislation.


World Health Officials Unveil Drug Monitoring System

The World Health Organization (WHO) has unveiled the world's first Internet-based system to track fake drugs, BBC News Online reported Friday.

As much as 10 percent of the global prescription drug market is comprised of phony concoctions, amounting to $35 billion a year, WHO officials said at a news conference in the Philippines.

The problem is most critical in developing nations, where up to 25 percent of medicines are fake or substandard, the BBC quoted WHO officials as saying. The Rapid Alert System initially will track counterfeit drugs in Asia, and theoretically could be expanded globally, the organization said.

Given a lack of universal Internet access and other logistical concerns, no one expects the issue to be resolved instantly, a WHO regional official cautioned. "Of course this will not solve the problem overnight," he told the BBC.


U.S. Considers Plan to Track All Livestock

The U.S. government is considering a plan to force farmers, feedlots, and packinghouses to track every cow, pig, and chicken from birth to slaughter by 2009, the Associated Press reported.

The plan was prompted by discovery of the brain-wasting condition dubbed "mad cow" disease in a Washington state Holstein cow in December 2003. The goal of the new system would be to identify an exposed animal within 48 hours, U.S. Agriculture Secretary Mike Johanns told a news conference on Thursday.

Johanns said the proposal wasn't written in stone and could be changed based on response from the livestock industry and others, the AP reported.

Meat producers, concerned about privacy issues, have resisted a mandatory government-run identification system, the wire service said. They prefer the idea of a voluntary database to which state and federal officials have limited access.

Another sticking point may be who pays for the program. A U.S. Agriculture Department official said states and the livestock industry should split the cost, the wire service said.


Merck Sales Reps Told to Downplay Vioxx Risks: Report

Sales representatives for drug maker Merck & Co. were told to play down the heart risks of the painkiller drug Vioxx when they met with doctors, according to documents released Thursday during Congressional testimony, the Associated Press reported.

The company's 3,000 sales team members were instructed on how to aggressively push Vioxx and boost sales before it was pulled from the market last fall, the AP said.

A Feb. 9, 2001, memo warned sales representatives not to bring up heart risks linked to Vioxx. If doctors asked about such risks, the Merck sales reps were instructed to refer to a "cardiovascular card" that contained data suggesting that Vioxx could be safer than other anti-inflammatory drugs, the news service reported.

However, that card did not include data from the study that first raised concerns about the heart risks posed by Vioxx, the AP reported.

The documents were released at a House Government Reform Committee hearing, the news service said.

Merck Vice President Dennis Erb defended the company's handling of Vioxx, noting that it promptly released details of studies that first raised the possibility of heart damage -- and followed up by performing the study that ultimately led to the drug's demise, the AP said.


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