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Experts To Assess Impacts And Policy Barriers To Improving Proper Medication Adherence
Health reform may succeed in creating better coverage and access for Americans, but until we reduce the barriers to proper medication adherence, many patients will not experience improved health, according to experts meeting today to discuss the challenges of adherence.
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New Analysis Examines Fraud In Both Private And Public Health Insurance Markets
A new report from The George Washington University School of Public Health and Health Services, Department of Health Policy challenges the notion that fraud is a problem only in public health insurance markets and finds that fraud is a system-wide problem affecting private and public health insurance alike. The report finds that some of the most striking examples of fraud come from fraud committed directly by the private insurance industry itself. In 2007, when the U.S. spent nearly $2.3 trillion on health care and public and private insurers processed more than 4 billion health insurance claims, fraud was estimated to reach as much as 10 percent of annual health care spending. At this rate, the losses in 2007 alone over $220 billion would have been enough to cover the uninsured. The National Health Care Anti-Fraud Association (NHCAA) has estimated conservatively that 3 percent of all health care spending or $68 billion is lost to health care fraud.
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'Consumer-Directed' Plans Rise In Popularity As Businesses Scramble To Cut Health Costs
High-deductible health insurance plans coupled with health savings accounts (tax-advantaged funds for covering medical costs), are becoming the plan of choice for Connecticut"s small businesses newly offering insurance to employees, Hartford Business reports. The plans, called "consumer-directed health plans," make up 60 percent of the insurance company Aetna"s new small business sales. Nationally, the number of people with these plans rose from 3.2 million in 2006 to eight million this year.
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Controling Concurrent Hepatitis B Infection By Focusing HIV Treatment

Prolonged use of highly active antiretroviral therapy (HAART) to treat people infected with both HIV and hepatitis B (HBV) helps to better control the hepatitis B infection and could delay or prevent liver complications, according to a new study by researchers at Wake Forest University School of Medicine. Researchers also found that patients who had higher levels of a common liver enzyme upon beginning treatment for HIV-HBV co-infection were at an increased risk of being diagnosed with cirrhosis within the first few years of follow-up. Cirrhosis is a disease that scars the liver, progressively shutting it down. The enzyme is one released into the bloodstream after liver damage. "One of the most interesting findings was the confirmation that a simple marker, such as transaminase levels before treatment, is useful in identifying patients at higher risk of developing HBV-related complications in a few years," said lead researcher Marina N̙̱ez, M.D., Ph.D., an assistant professor in the Section on Infectious Diseases, in the Department of Internal Medicine at the School of Medicine. The study is appears in the May/June issue of HIV Clinical Trials. HBV is a contagious liver disease, contracted in the same way as HIV - through intravenous drug use, sexual contact or mother-to-newborn transmission. Left untreated, it can lead to fatal liver disease or liver cancer. HIV increases the activity of HBV, speeds the progression of related liver disease and might decrease the effectiveness of treatments for HBV. But N̙̱ez and Tsan Lee, a medical student at the School of Medicine, found that prolonged use of highly active antiretroviral therapy, including one or more drugs active against HBV, can lead to clearance of the HBV infection in co-infected patients. HAART is the treatment for HIV infection, consisting of a combination of drugs commonly known as the "cocktail." For the study, researchers reviewed medical records of patients seen in an adult HIV clinic between 1990 and 2008. They included in the study all patients with positive HIV antibody, hepatitis B and at least three months of follow-up care on record. Of the 72 patient charts reviewed - primarily black males with a median age of 39 and advanced HIV disease at the time of diagnosis - 64 of the patients received HAART that included drugs effective in treating HBV, for a median duration of one year. The researchers were looking for whether the patients were diagnosed with liver complications such as cirrhosis and liver cancer over the course of treatment, and whether the chronic HBV infection improved. Analysis showed that receiving HAART combined with HBV treatment for a longer period of time was significantly associated with reduced and, in some cases cleared, chronic HBV infection. N̙̱ez said these findings "stress the importance of good control of the HIV and HBV infections through maintained compliance with HAART including drugs to treat HBV. "In HBV-HIV patients with the elevated enzyme levels that signal liver damage, it is even more important to control the HBV infection in an attempt to decrease the risks of complications. Those patients should also be more closely screened for liver complications." Jessica Guenzel Wake Forest University Baptist Medical Center


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