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Health Policy

New Orleans, LA—According to the American Medical Association (AMA) and many oncologists, the International Classification of Diseases, Tenth Revision (ICD-10) diagnostic coding system will be a needless and expensive burden to oncology practices, without enhancing patient care. ICD-10 is being developed by the World Health Organization. The Centers for Medicare & Medicaid Services (CMS) ordered the switch in 2009 as part of carrying out the Health Insur ance Portability and Accountability Act.

American adults would be willing to pay a median of $263 for a perfect prostate cancer prediction test and $232 for a perfect breast cancer prediction test, according to a recent survey (Neumann PJ, et al. Health Econ. 2012;21:238-251). This is even when—according to this hypothetical scenario presented to participants in the survey—respondents were told that if the test results were positive the disease could not be prevented, but the person could access treatments when the disease occurred.

Miami, FL—Direct-to-consumer (DTC) marketing of genetic tests represents personalized medicine in evolution. High-throughput genetic technologies have made it possible to evaluate individuals at a relatively affordable price, but a number of technologic, social, regulatory, and ethical issues must first be settled before DTC genetic testing takes personalized medicine to new heights.

At the 2011 Best of ASCO meeting, Gary H. Lyman, MD, MPH, Director of Comparative Effectiveness and Outcomes Research, Duke University School of Medicine, Durham, NC.

On November 30, 2011, the Office of the Inspector Gen­eral (OIG) of the US Depart­ment of Health and Human Services issued an advisory opinion (No. 11-18) to the web-based physician practice service provider athenahealth, tacitly approving the company’s new online service athenaCoordinator. The athenaCoordinator is a cloud-based physician referral tool that monetizes, in some instances, the “referral transaction” between a referring physician and a “trading partner.”

Medical practices in the United States spend much more money and time dealing with third-party payers than do Canadian practices, according to a recent report (Morra D, et al. Health Aff. 2011;30:1443-1450).

The study showed that medical staff in the United States spend nearly 21 hours weekly dealing with insurance issues—addressing drug coverage, prior approvals, and other reimbursement issues—while their Canadian counterparts spend less than 3 hours weekly.

Adear friend recently recanted to me some stories about her recent trip to Italy. One of her more memorable moments was bearing witness to a couple of young Gypsies slipping the wallets out of the pockets of some unsuspecting tourists. Within a nanosecond, cash and credit cards were gone. Thankfully, my friend saved the day by hurriedly calling attention to the heist, and theItalian polizia were quickly in pursuit.

On July 29, 2011, a 3-judge panel from the US Court of Appeals for the Federal Circuit invalidated some patents held by Myriad Genetics and the University of Utah Research Foundation for methods of analyzing individuals’ gene sequences for the presence of BRCA1 and BRCA2 mutations, but upheld other related patents in a reversal of a lower court ruling. The decision has left the door open to many questions.

In September 2011, the American Association of Cancer Research (AACR) issued a new report, “AACR Cancer Progress Report 2011” (www.aacr.org/Uploads/Document Re pository/2011CPR/2011_AACR_CPR_ Text_web.pdf) on the current state of cancer research and the implications of recent cuts in funding for the National Institutes of Health (NIH) and the National Cancer Institute (NCI). These cuts in NIH and NCI funding are already adversely affecting the progress made in cancer research in the United States.

The decision this month (October 2011) by the US Preventive Services Task Force (USPSTF) to recommend against a prostate-specific antigen (PSA)-based screening for prostate cancer in healthy men1 has caused quite a stir both in and outside of medical circles, reminding many people of the task force’s 2009 recommendation against routine breast cancer screenings for women under age 50 years.
Accountable care organizations (ACOs) are a prominent part of the Patient Protection and Affordable Care Act (ACA), better known as the healthcare reform.
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