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Beating Back Opioids – Now What?

July 8, 2015

opioidsWorkComp Central published a new report,“We’re Beating Back Opioids — Now What?” this past June, by Peter Rousmaniere in cooperation with CompPharma. It narrates a 20-year story and poses some provocative recommendations, noting that we are at a turning point in treating chronic pain though the statistics remain daunting. Every workday, some 5,000 workers sustain injuries which disable them for at least a week; on any given day in the U.S. 500,000 injured workers are treated for chronic pain. The majority of treatments includes opioids, and for individuals with chronic pain, care and wage replacement can reach $1,000,000 in cost per claim.

Per the study’s author: “This report does two things. First, it chronicles the two decade-long story of how opioid use greatly expanded in workers’ comp, then halted and began to retreat in the face of fierce criticism. Workers’ comp professionals can use this story to tell their friends about a war they still are fighting.”

Rousmanier also credits several organizations in the detection and reporting on trends and solutions. They include the California Workers’ Compensation Institute, CompPharma, the National Council for Compensation Insurance, Washington State, and the Workers’ Compensation Research Institute. Read more…

 

Hepatitis C: Who Can Afford to Be Cured?

June 26, 2015

hep_c_global_prevalence_mapIn October U.S. Food and Drug Administration approved a new pill, Harvoni, that can cure hepatitis C, which afflicts about 170 million people worldwide and annually kills 350,000 people.

The price on the new treatment will be a hard pill to swallow for most: $94,500 for a 12-week treatment course with Harvoni, manufactured by Gilead Sciences.

Hepatitis C is a chronic blood-borne infection that attacks the liver, eventually causing cirrhosis or liver cancer and leading to death if not treated. The US Centers of Disease Control and Prevention believes 3.2 million people in the United States could be infected.

Patients who receive these treatments almost never see the total cost, but their insurers do. More than two dozen state Medicaid programs for low-income patients, as well as for-profit insurers, have restricted coverage for the treatment to only those with severe liver damage. While researching the subject for this blog post, we found such distressing – and sadly accurate – soundbites as “The $84,000 Cure – Cheaper than a Liver Transplant.” Last July two members of the Senate Finance Committee, including Ron Wyden, Committee Chair, Democrat from Oregon, asked the manufacturer to defend the cost. They are not alone.

“Never before have drugs been priced so high to treat such a large population,” says Steve Miller, chief medical officer at Express Scripts, the country’s largest manager of drug benefits for employers and insurers. In December, Express Scripts announced it would reject coverage for one-pill-a-day Harvoni and instead steer patients to a less pricey rival drug that requires four to six pills a day.

Just how profitable are drugs like Harvoni and Sovaldi, a Hepatitis C medication released last year? In 2014 Sovaldi, also manufactured by Gilead,  generated $10.3 billion in sales, making it one of the most lucrative pharmaceutical launches ever. Harvoni sales totaled more than $2.1 billion in the last 3 months of the year. Gilead’s market capitalization has soared from $29 billion to $167 billion in five years. The net worth of its chief executive officer, John Martin, exceeds $1 billion. “For a long time we’ve had innovation after innovation,” Martin noted. For many patients, Gilead’s drugs are indeed miraculous. But is the U.S. health-care system paying too much for them? And with 170 million carriers worldwide, what will the impact of this transmittable disease be on governments and citizens with much less spending power?

The Age of Oblivobesity

June 22, 2015

what-to-do-if-your-childs-overweight

by Jen Jenkins, Market Analyst, MCN

It’s never a good sign when a health condition prompts new buzz words, in this case “oblivobesity.”  This latest addition to the national discussion on the childhood obesity epidemic introduces this term while shedding some light on the series of (mis)conceptions and (mis)communications that have led to this problem and are continuing to compound it.

Just what is “oblivobesity” referring to? It is a term coined by Dr. David L. Katz, Director of Yale’s Prevention Research Center, to indicate parents’ inability to identify that their children are overweight. A grave review of recent studies published in Childhood Obesity showed some shocking results: Percentages of parents who inappropriately perceived their overweight child as just about the right weight was 96.6% and 94.9% for the [two studies in question]. As high as 78.4% of parents perceived their obese child as just about the right weight in the recent survey. This information helped bring this term to life taking special note of the fact that comparing this 2012 study to a similar study done in 1994 children are not only significantly heavier now but parents are also 30% less likely to notice that there is a problem.

The reasoning behind these revelations spans from the idea that children generally being heavier is considered the “new normal” to, in the words of Dr. Katz, “willful, genuine denial” on the part of the parents. The scary thing is that there is no hope of fixing the issue if the serious health threats that accompany obesity are being ignored or denied. Many different factors come into play when this discussion arises but the important takeaway here is that this growing issue is being swept under the rug in the very place that it must be addressed: American homes.

 

New Webseries Features MCN Star Jeremy Behrens

June 18, 2015

Jeremy_BehrensMCN’s Market Analysis Team Lead, Jeremy Behrens, appears in a new webseries, CRAVE. The show was produced in collaboration with the production company Honey Toad, whose own webseries, WRECKED, garnered acclaim from TubeFilter and other reviewers, and received thirteen nominations and four wins from the Indie Series Awards.

The pilot was shot in May, with Ms. Aneesh Sheth directing and Liz Ellis running the set. Nathaniel Buechler and Ben Goldsmith, also of Honey Toad, directed photography. The show stars Sheth with Jeremy Behrens, Angela DiMarco (Chop Socky Boom, Grimm, The Device) Sarbani Hazra (Blissville, Jane Don’t Date,) Amalya Benhaim and DeRon Brigdon (Orange Is The New Black, Grimm). A Kickstarter campaign has been launched to fund the rest of the season.

Medicine is a Science, Medicine is an Art

June 11, 2015

FWPeabodyby Jen Jenkins, MCN Market Analyst

An address first delivered in 1926 at Harvard Medical School, The Care of the Patient by Francis W. Peabody, MD explores a topic that seems to remain relevant in the practice of medicine today. Dr. Peabody (1881-1927) was renowned for setting himself apart from his colleagues throughout his career by treating each patient as a real person and not just according to their disease or disorder. The premise of this essay is the belief that “One of the essential qualities of the clinician is interest in humanity, for the secret of the care of the patient is in caring for the patient.” 

As science and technology improved then, and continue to improve now, the practice of medicine puts a greater emphasis on the science and less on the actual care of patients. Students are exiting medical school with excellent knowledge where medicine is concerned but the actual practice of medicine has been somewhat neglected.  Dr. Peabody believed caring for patients is something learned over time, not necessarily in the 4 to 5 years it takes to complete medical school, but he also believed it to be the medical institution’s job to provide the foundation for this type of care. The pressure to effectively diagnose and treat often overlooks the necessity of conversation and the vital importance of creating a personal relationship with the patient. The fundamental sciences will always be imperative but intimately knowing a patient as a human being and not just as a sick individual is the practice of medicine in the broadest sense.

The diagnosis and treatment of disease is a very limited aspect of practicing medicine. A quote that stood out was “The art of medicine and the science of medicine are not antagonistic but supplementary to each other.” Oftentimes, it is not just the disease that needs treating but the individual who needs to be treated. This takes time, which more now than ever is a commodity difficult to obtain in most settings, and it also takes compassion and understanding. The practice of medicine is intensely personal and the more impersonal and clinical the profession becomes the further we stray from the main objective of it all – the actual care of the patient.

See the related 1984 commentary in the Journal of the American Medical Association (JAMA) on this article.

MCN Softball – Meet the Team!

June 3, 2015

SQUADby Jen Jenkins, MCN Market Analyst

For the first time in MCN history we are excited to introduce our very own softball team! Dedicated players from both the Corporate and Seattle offices are banding together to compete at Maplewood Playfield on Thursdays. The first game takes place tomorrow 6/4 and the season will run through 7/30, giving teams the opportunity to play six regular season games plus playoff games if/when we  qualify.

Yesterday marked the very first practice for some team members that were able to attend (photo proof provided above left). They’re looking pretty fierce out there! Lea Dilling remarked that there were a handful of them that had never played softball before but by the end of the practice were looking like really promising players. Oh what practice can do! One of the team’s original founders Russell Blount deserves special thanks for organizing the practice and has been officially coined “The Softball Man.” Another big thank you goes out to Albert Jennings for coaching the team like it was a paid gig. Based on how #PracticeOne went some highlights to look out for are: Kyle Brady and Dave Tucker tearing up the outfield; Lea Dilling diving for grounders; Amy Belete taking balls for the sake of the team; and Brianna Bean (former softball champion), Kierra Neher and Caitlin Jacques doing whatever it takes to get that win.

Along with the aforementioned players the roster for this season includes:  Jeremy Behrens, Barbara Bulichi, Jacob Burger, Ryan Clarry, Raul Gutierrez, Erik Madrid, Oscar Meza, Evan Shustoff, and Heather Vasquez. 

We are looking forward to bringing you updates about the team and the standings as the season progresses. Details for tomorrow’s game are below and we encourage anyone not playing and in the area to come out and help root our team on! Go Marmots!

Game I Details: 

Date: 6/4/2015

Time: 7:30 PM

Location:  Maple Wood Playfield – 4801 Corson Ave S, Seattle – Field 1

 

A Changing Landscape: America’s Opiate Epidemic

June 1, 2015

by Jen Jenkins, MCN Market Analyst

A group of drug traffickers have devised a system resembling pizza delivery for selling heroin across the US.

A group of drug traffickers have devised a system resembling pizza delivery for selling heroin across the US.

Many Americans have developed an expectation for something that on the surface appears harmless but in reality has proven rather dangerous: the quick fix. This expectation falls into a variety of categories but the dangers here tend to lurk around seemingly magical solutions that directly involve our health.

During the 1990’s there was a surge in pain medication being prescribed freely as an easy fix for chronic pain sufferers over the use of other types of rehabilitation. Prescribers were outspoken about their belief that these drugs were not addicting when used in these scenarios and pain medication was not only being freely prescribed but done so in enormous excess. Between 1999 and 2010 the US saw sales quadruple for opioids such as Percocet, Vicodin and OxyContin. These names probably sound familiar as they have readily become household names, yet we are only more recently being warned about the dangers of using these drugs.

On the other hand, heroin is widely known to be illegal and highly addictive. Fatal heroin overdoses in this country have almost tripled in the past three years, claiming the lives of more than 8,250 people per year. As horrifying as that is, it may not be all that surprising since the dangers of heroin are so well known.  In a shocking comparison, around double that number of people are dying every year from prescription opioid painkillers, which are molecularly similar to heroin. If that statistic is news to anyone it’s probably because overdoses due to prescription medications are far less scrutinized and rarely publicized. The victims of these overdoses are overwhelmingly white, financially well-off, and young; a very different demographic from what we have come to know in relation to other types of drug abuse.

This article in The New York Times provides a snapshot of the new heroin landscape and why it is more dangerous than ever before. Use of this addictive drug had been on decline since the 1980’s but was revitalized thanks to prescription opioid addicts who are more readily turning to heroin as a less expensive and more accessible alternative for a similar high. The article goes on to look at how this change of demographic has also brought about a new kind drug dealer, in particular highlighting the business practices of the group of traffickers dubbed “The Xalisco Boys.”

Although low-profile and anti-violent, The Xalisco Boys are drug dealers to fear because they are going after their customers instead of the old standby of waiting for customers to come to them. They also rely on marketing instead of perpetuating street crime and have devised a system resembling pizza delivery for selling heroin across the United States. Interestingly, they even keep business hours between 7am and 7pm to instill a “safe” sort of atmosphere along with reliable delivery and balloons of heroin that have been properly dosed out by weight and potency. Free samples given out at methadone clinics, discount pricing, and free hits delivered to customers showing signs of quitting are cited all examples of their entrepreneurial take on drug sales.

So what do we do in this ever-changing landscape?  Do we look for resolution on the street or in our clinics and hospitals? Especially now that “street crime is no longer the clearest barometer of our drug problem; corpses are.”

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