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Insurers Underpaid 'Billions' In Health Claims
The Senate Commerce Committee has found that a flawed payment database produced by a UnitedHealth subsidiary and distributed to other major insurance companies has led insurers to underpay millions of out-of-network claims, forcing patients to make up the difference of health care providers" fees, the Wall Street Journal reports. Aetna, Cigna, WellPoint, and other large insurers used the data to calculate their "reasonable and customary" charges. They also provided UnitedHealth"s subsidiary, Ingenix, with historic data about their payments, which became the foundation of ongoing versions of the flawed payment models.
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ACCP Position Paper On Genetic Tests Advertised Directly To The Consumer
Genetic testing services have recently begun to be advertised directly to the patient, and the results of the consumers" response can affect public health, as well as the future adoption of pharmacogenetic/genomic testing, according to a position paper from the American College of Clinical Pharmacology (ACCP) to be published in the August 2009 issue of the Journal of Clinical Pharmacology. The journal is published on behalf of the ACCP by SAGE.
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Swine Flu Expected To Continue Through The Summer, US
Health officials said on Thursday that it looks like the novel H1N1 swine flu virus will continue to spread in the US through the summer months,
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The Dawn Of A New Era In Cancer Treatment

A new article in Scrip World Pharmaceutical News highlights enormous change in cancer medicine with highly personalised treatments, patient top-up payments in some markets, response-related payments and even refunds when there is no response to a treatment, all driving the future of cancer care worldwide. The article - written by Karol Sikora, professor of cancer medicine at Imperial College, London - cites an increasingly informed and consumerist society as one of the key drivers in this critical and evolving competitive marketplace. "Denying the existence of innovative drugs is no longer acceptable to democracies where patients can access all the information they require. The internet is a great equaliser," explains Professor Sikora. "Patient knowledge and understanding in terms of what is available has led to the growing use of top-up payments to break access barriers to innovative cancer drugs." "An ethically-driven top-up system is the only sustainable solution for the current challenge of cancer care and carries the best chance of sustaining a high-quality core service for all," adds Professor Sikora. "It could drive a new, patient-led, competitive marketplace which will create greater efficiency throughout cancer care." At the same time - as in other therapy areas - cancer treatments will become much more personalised. "The days of marketing cancer drugs like a supermarket commodity are over," continues Professor Sikora. "This is the dawn of a new era of rational cancer drug use, where oncologists avidly seek logical ways to get the right drug to the right patient thanks to a personalised diagnostics programme." "All of this means that investment now - in diagnostics, new technologies, new delivery systems and, of course, in new drugs - is vital if pharma companies are to avoid financial meltdown and the tragedy of efficacious drugs falling by the wayside because organisations like the National Institute for Health and Clinical Excellence (NICE) turn them down due to lack of companion diagnostics." "Within 20 years, cancer will be a chronic disease, joining conditions such as diabetes, heart disease and asthma. These conditions impact on the way people live and do not inexorably lead to death. The model of prostate cancer, where many men die with it rather than from it, will be common for most cancers. The greatest progress will be made in understanding the myriad causes of cancer, leading to new prevention strategies for which scientific advances will be able to provide effective risk reduction." Scrip World Pharmaceutical News


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