Vytorin Marketing Investigated
Merck and Schering-Plough's problems with Vytorin are continuing. The companies had already disclosed that marketing of the cholesterol-lowering drug was being investigated by the New York, New Jersey, and Connecticut attorneys general. Now, in its third-quarter filing with the Securities and Exchange Commission, Merck says that it has received inquiries from 35 state attorneys general looking into whether Vytorin marketing violated state consumer protection laws. In addition, Merck has received a letter from the Department of Justice stating that it, too, is investigating the promotion of Vytorin, which contains ezetimibe and simvastatin, to Medicare beneficiaries. The companies are cooperating with the investigations, according to the filing, which also noted that 140 civil class action lawsuits have been filed.
Smoke-Free Law Cuts MI Deaths
Heart attack deaths have been reduced by as many as 600 in Massachusetts in each of the 4 years since smoking was banned in restaurants and bars, according to an analysis by the state department of public health and the Harvard School of Public Health, Boston. Data were analyzed on heart attack deaths from 1999 to 2006 for 351 Massachusetts cities and towns. In areas with weak laws or no laws before the state law was enacted in 2004, there was a relatively slow decrease in deaths. After the law was enacted, there was a much sharper decrease. Areas with strong laws already had seen a fairly big decline in deaths, according to the study. The researchers concluded that reduced exposure to secondhand smoke had a “significant effect in reducing heart attack deaths.”
Inquiries Into AtriCure
West Chester, Ohio-based AtriCure has revealed that the Department of Justice is investigating its marketing practices. The company said that it received a letter in late October stating that Justice is looking into whether AtriCure illegally marketed its surgical ablation system off-label to treat atrial fibrillation. The federal agency is also investigating whether the company committed fraud by urging hospitals to use incorrect billing codes for the ablation procedures. AtriCure said in a statement that it intended to cooperate with the investigation.
Unspecified Chest Pain in Women
Women are diagnosed and hospitalized for unspecified chest pain more often than men, according to the Agency for Healthcare Research and Quality. In 2006, 379,000 men were admitted for unspecified chest pain, and 477,000 women were hospitalized with the same diagnosis. Interestingly, however, men are admitted much more frequently for coronary artery disease—747,000 in 2006, compared with 451,000 women. Men also account for 60% of admissions for heart attacks. Admissions for heart failure and irregular heart beat are similar for both genders. The data come from the 2006 Nationwide Inpatient Sample.
Resuscitation Practices Ineffective
An overwhelming majority of emergency physicians believe that resuscitation practices in the United States are not very effective, according to a survey released by the American College of Emergency Physicians. In addition, more than half of emergency physicians surveyed believe that poor survival rates from sudden cardiac arrest are related to the aging population, while one-quarter of respondents said that obesity has contributed most to poor survival rates. Increased bystander CPR, faster patient-to-doctor time, improved data collection and sharing, and greater use of technology all are critical to improving resuscitation, the survey concluded. “It is necessary for communities to encourage more CPR trainings, offer more access to a broader range of critical life-saving technologies, and report sudden cardiac arrest cases more consistently,” said ACEP President Nick Jouriles.
Poor Marks for PQRI
Most physicians who participated in Medicare's 2007 Physician Quality Reporting Initiative found the program at least moderately difficult, according to a survey conducted by the American Medical Association. Only 22% of respondents to the online survey were able to successfully download their feedback report. Of those who downloaded the report, less than half found it helpful. In an open-ended question about their experience with the program, nearly all the responses were negatives, according to the association. The results are based on responses from 408 physicians. The AMA plans to work with Congress and the administration to alter the program to provide physicians with interim feedback reports an appeals process. A recent survey from the Medical Group Management Association reported similar problems in accessing feedback reports.