Type 2 diagnoses propel diabetes epidemic
WASHINGTON —Diabetes quickly has grown into one of the top disease epidemics in the United States, with the American Diabetes Association estimating it to affect close to 24 million Americans. Growth mostly has occurred among those with Type 2 diabetes.
A report by the Agency for Healthcare Research and Quality helped show what the epidemic looks like on the ground. According to the report, released last month, there were more than 7.7 million hospital stays for patients with diabetes in 2008, resulting in $83 billion in hospital costs, or 23% of total hospital costs.
Class and geography had a lot to do with hospitalization rates, according to the report. When broken down by ZIP code, rates were higher in low-income areas than in high-income areas, with 3,232 hospitalizations per 100,000 people in the lowest-income areas, compared with 1,762 per 100,000 people in those areas with the highest incomes.
Among U.S. regions, the South had the highest rates, with 2,829 per 100,000 people hospitalized, while the West had the lowest, with 1,866 per 100,000 hospitalized. Not surprisingly, according to the Centers for Disease Control and Prevention, the South and West also have the highest and lowest rates of obesity, respectively, a major factor in the rise of Type 2 diabetes. Eight-of-the-9 states with obesity rates more than 30% as of 2009 are in the South, while 9-of-the-17 states with rates less than 25% are in the West, including Colorado, the only state in which fewer than 20% of residents are obese.
Top 10 most common principal reasons for hospitalization among patients with diabetes in 2008
|RANK||PRINCIPAL DIAGNOSIS||#OF HOSPITAL STAYS AMONG PATIENTS WITH DIABETES*||%OF HOSPITAL STAYS WITH DIABETES AS A COEXISTING CONDITION†|
|2||Congestive heart failure (nonhypertensive)||424,147 (5.5%)||41.6%|
|3||Coronary atherosclerosis (hardening of the arteries)||346,054 (4.5%)||37.7|
|6||Acute myocardial infarction (heart attack)||220,760 (2.9%)||34.2|
|7||Chronic obstructive pulmonary disease and bronchiectasis||219,743 (2.8%)||30.7|
|8||Nonspecific chest pain||212,706 (2.8%)||29.3|
|9||Cardiac dysrhythmias||196,293 (2.5%)||24.6|
|10||Complication of device, implant or graft||194,516 (2.5%)||28.4|
Pittsburgh Business Group on Health’s LivingMyLife program to expand
PITTSBURGH The Pittsburgh Business Group on Health’s LivingMyLife program, which helps diabetes patients with disease management through the use of “coach pharmacists,” will soon do the same for those with other diseases, according to published reports.
The Pittsburgh Tribune-Review reported Friday that LivingMyLife also would help patients with asthma and heart disease. The program, which began in 2006, allows patients to manage their disease with visits to pharmacies, mostly Giant Eagle, Kmart and some independents.
The announcement was made at the annual healthcare symposium of the group and involved more than 100 attendees, the newspaper reported.
Appeals court upholds decision to OK ‘pay-for-delay’ deals
NEW YORK The federal government got a kick in the face Thursday as an appeals court ruled in favor of patent litigation settlements between branded and generic drug companies.
The U.S. Second Circuit Court of Appeals in New York decided not to reconsider a ruling it made earlier this year in the case of Arkansas Carpenters Health and Welfare Fund vs. Bayer AG. The case concerned the legality of a settlement between Bayer and Teva Pharmaceutical Industries subsidiary Barr Labs over the anthrax treatment Cipro (ciprofloxacin), but the court ruled that the deal between the two companies did not violate antitrust laws.
The appeals court’s decision is a major setback for the efforts of the Federal Trade Commission and members of Congress who have sought to ban such settlements.
In most cases, a generic drug company that wishes to market its version of a drug before the branded drug company’s patents expire will file an approval application with the Food and Drug Administration with a paragraph IV certification, a legal assertion that the patents covering the branded drug are invalid, unenforceable or won’t be infringed by the generic drug. In response, the branded drug company usually will sue, but cases frequently result in settlements whereby the generic drug company agrees to hold off launching its drug in exchange for payment of some sort by the branded drug company.
This often comes in the form of an agreement not to use an authorized generic, essentially the branded drug marketed under its generic name, to compete with the generic drug company during its customary six-month market exclusivity period. Legally, the generic company must launch before the patents expire or as soon as they do, and delaying launch after patent expiry would be illegal, though critics such as the FTC and The New York Times’ editorial board have often derided the settlements as “pay-for-delay” deals, with the FTC contending that they cost consumers billions of dollars a year. Nevertheless, most cases that are settled result in launch of the generic drug ahead of patent expiry. In the case of Bayer and Barr, Bayer paid Barr $400 million to hold off launching its version of Cipro.
“Patents, issued by the government, are given the presumption of validity,” read a statement from the Generic Pharmaceutical Association, the generic drug industry’s main lobby. “Any market entry of a generic drug before the brand patent expires –– whether as the result of a finding that the generic product does not infringe the patent, that the patent is not enforceable or through a patent settlement agreement with the brand company –– is a positive, cost-saving event for consumers.”