Your Weekly Update of News and Reviews
May 10, 2015
Consumer Health Digest is a free weekly e-mail newsletter edited by Stephen Barrett, M.D., with help from William M. London, Ed.D., M.P.H. It summarizes scientific reports; legislative developments; enforcement actions; news reports; Web site evaluations; recommended and nonrecommended books; and other information relevant to consumer protection and consumer decision-making.
TRICARE cracking down on compounded scar and pain creams. As of May 1, 2015, TRICARE, a government program that provides civilian health benefits for military personnel, military retirees, their dependents, and some reservists, will no longer pay for compounded products that contain ingredients that lack FDA approval. [Bushatz A. TRICARE to no longer cover some prescription pain killers. Military Times, March 16, 2015] The change is intended to reduce the cost of medications that TRICARE considers unsafe or ineffective. The TRICARE Web site defines compounded drugs as combinations of two or more drugs prepared by a pharmacist for an individual patient’s needs. Last year, the Government Accountability Office questioned TRICARE payments for 465,000 compounded prescriptions and noted that the average price for the 25 most expensive products ranged from $848 to $9,961 per prescription. [Compounded drugs: TRICARE payment practices should be more consistent with its regulations. GAO-15-64, Oct 2014] TRICARE officials have noted:
- Although compounded drugs make up only 0.5% of all TRICARE prescription volume, they account for 20% of drug costs.
- In recent months, Military Health System costs for compounded drugs have skyrocketed from about $54 million in August 2014 to more than $330 million in March 2015.
- Some compounded drugs—including many expensive skin creams that were prescribed for pain—contained ingredients that had not been proven safe and effective.
- In March and April, TRICARE received growing numbers of reports from beneficiaries that they have been targeted by unsolicited marketing efforts trying to collect personal information and send them unwanted prescriptions that would be billed at great cost to the program. [TRICARE revises compound drug coverage. TRICARE Web site, accessed May 10, 2015]
The situation exploded into public view when CBS Evening News showed how a producer who filled out an online form received a product prescribed by a physician with whom he had never communicated. The doctor—Paul Bolger, M.D., of Davenport Iowa—admitted on camera that he should not have written the prescription. CBS subsequently reported that federal agencies are investigations 90 compounding pharmacies and doctors and that payments to Bolger, three other doctors, and four compounders have been suspended. [Feds open investigations into compounding pharmacies. CBS Evening News, May 7, 2015]
Yoga complications reported. A survey of 2508 people taking yoga classes and 271 yoga therapists conducting the classes has found that about 30% of class attendees had experienced some type of adverse event. [Matsushita M, Takakazu O. A large-scale survey of adverse events experienced in yoga classes. Biosocial Medicine 9(9), 2015] The average age of the participants was 58.5 years. The most common problems were muscular pain, joint pain, and muscle cramps that the therapists thought were related to overexertion. Although the majority had mild symptoms, the survey indicated that attendees with chronic diseases were more likely to experience adverse events that were associated with their disease. The authors advised giving special attention when yoga is introduced to patients with stress-related, chronic diseases. The full text of the article is available online free of charge.
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