Buck for the bang: Premium med-tech pricing

The following originally was featured as a  blog post on Medical Device Daily on October 31st. It is written by Adi Renbaum, senior VP for health policy and reimbursement, Neocure Group.

Cook Medical’s Zilver PTX is likely to become the first peripheral drug-eluting stent (DES) to be approved in the U.S., after an FDA advisory panel voted unanimously in favor of the device on Oct. 13. Approval would give the sponsor, Cook Medical (Bloomington, Indiana) access to a peripheral arterial disease (PAD) market valued at $1 billion, depending on whose figures one relies.

I attended the Oct. 13 advisory committee hearing for the device and observed the panel members comment that this was among the best submissions they had seen in some time. Cook presented a clear study that met all primary endpoints and showed improvement over percutaneous transluminal angioplasty, the current standard of care. To non-FDA experts like myself, it seemed as though Cook was recognized for setting a new bar for conducting clinical trials and collaborating with the FDA.

I imagine that Cook Medical’s leadership was able to make all the right clinical trial investments necessary for the long-term viability of the product’s market value, not just the ones that were on display at the advisory panel meeting. (more…)

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Breast, Colon and Ovarian Cancer Apps are HERE

The breast and colon cancer app are designed to provide newly diagnosed breast and colon cancer patients with personalized information about their diagnosis and are based on the My Breast Cancer Coach and My Colon Cancer Coach online tools. Basically, patients answer just a few simple questions and then get an individualized treatment guide that addresses their specific tumor type and diagnosis –leading to a more empowered patient and a informed dialogue between patients and their healthcare providers. You can check out or download the free app for iPhone here: http://goo.gl/ql1Wd or here for the Android: http://goo.gl/CMLrM.

The Ovarian Cancer Symptom Diary App will help you learn about the risks, signs and symptoms of ovarian cancer. This first-of-its-kind application allows a woman to track symptoms that could indicate ovarian cancer, and alerts her if she should make an appointment with her doctor for further testing. To download app click here.

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A Disruptive Woman Turns 125 Today: Happy Birthday to Lady Liberty

Robin Strongin

By Robin Strongin.  Some women are not afraid to celebrate their age.  Today, our nation has something, and someone, wonderful to celebrate.  The Statue of Liberty, ‘Liberty Enlightening the World,’ was a gift of friendship from the people of France to the people of the United States and was dedicated on October 28, 1886. The celebration theme selected by the National Park Service (think of them as Lady Liberty’s Accountable Care Organization) to mark this auspicious anniversary is ‘Honor History, Envision the Future.’

This got me thinking about the Disruptive Women in Health Care – past and present and how their vision of the future has also enlightened our world.  Here is a snapshot of my list. Who is on your list?

  • Marie Curie—a contemporary of Lady Liberty, the original poster-child for STEM having discovered radioactivity, winner of not one but two Nobel prizes (for physics and chemistry) and, in her spare time, she became the first woman professor at the Sorbonne.
  • Hillary Clinton—architect of health reform 1.0, and oh yes, a Senator and Secretary of State, who continues to champion the rights of women and girls, and
  • Florence Nightingale—the original health services researcher who laid the foundation for today’s field of nursing; not only do new nurses take the Nightingale Pledge but International Nurses Day is celebrated around the world on her birthday. And, oh yes, she too is known as the Lady with the Lamp.
  • My Mother. Enough said.

For her birthday, Lady Liberty is getting  a high-tech uplift: Internet-connected cameras on her torch that will let viewers gaze out at New York Harbor or see visitors on the grounds below. For more information on the birthday celebration or the webcams click here.

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An Interview with Kerry Kennedy, President of the RFK Center for Justice and Human Rights, on the Launch of Health eVillages

Robin Strongin

The following ran on Forbes on October 19th.  I found this to be interesting and relevant to Health in Place (HIP) which we will launch on December 6th. For more information on HIP click here.

Recently, I interviewed Kerry Kennedy, President of the Robert F. Kennedy Center for Justice and Human Rights, about the recent launch of Health eVillages. This initiative aims to bring mobile medical reference and decision support technology to clinicians fighting to save lives in underserved regions worldwide.

Kennedy is the author of The New York Times best seller “Being Catholic Now: Prominent Americans talk about Change in the Church and the Quest for Meaning,” published by Crown Books/Random House in September 2008, and “Speak Truth to Power: Human Rights Defenders Who Are Changing Our World,” (Random House, 2000). Ms. Kennedy started working in the field of human rights in 1981, when she investigated abuses committed by U.S. immigration officials against refugees from El Salvador. Since then, her life has been devoted to the pursuit of justice, to the promotion and protection of basic rights, and to the preservation of the rule of law. She established the Robert F. Kennedy Center for Human Rights in 1988. She has led over 50 human rights delegations around the globe.

Rahim Kanani: What is Health eVillages?

Kerry Kennedy: Health eVillages is an amazing new coalition of healthcare and human rights advocacy groups that’s dedicated to bringing adequate healthcare to poor, remote and underserved areas around the globe through the latest mobile device technology.

Through contributions, we secure new and refurbished mobile phone and handheld devices, load them with the latest in clinical decision support technology, and get these devices to healthcare professionals who are on the ground providing public health services where it’s most desperately needed. These devices allow them to quickly access the latest information on every disease in common medical texts, for example, to assist in diagnosing and treating patients in even in the most remote regions.

The Health eVillages consortium is made up of leading international healthcare advocacy organizations, mobile healthcare solutions providers, health information technology companies, communications providers, and public health foundations. The RFK Center is part of this contsortium because our organization has been working for four decades on the cutting-edge of social change with human rights activists around the world, and the Health eVillages initiative brings the latest technology to our efforts to ensure that the neediest people around the globe have access to adequate healthcare, a fundamental human right. (more…)

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Putting the IT in TransITions

Today’s post is by guest blogger, Shannah Koss

Dear Colleagues,

Health Information Technology and the substantial HITECH investment are a critical part of putting the U.S. health care industry and the U.S. consumer population on the 21st century path to improved health and health care. The investment however is almost exclusively focused on enabling the provider infrastructure. We need a mirrored infrastructure that will help patients and caregivers navigate, access and understand the growing health information universe and what it means to them.

The newly announced “Putting the IT in TransITions” initiative is a critical opportunity to help consumers better access and use their own healthcare information, but only if it is put in context and made truly consumer friendly. This means not just plain language but with tools, translation and interpretation resources that make it actionable.

The two-page project summary “Patients and Caregivers the 1st Step Not the Last Mile” describes an initiative that would explore how to enable a parallel consumer-facing infrastructure that complements and readily connects to the provider-facing infrastructure. Although ultimately there will be one shared infrastructure the timing and challenges of the emerging provider connectivity runs the risk of leaving consumers as the last mile.

We are stepping up to the IT in TransITions two-week challenge with a deadline of October 28, 2011 by seeking broad support for the project and its goals. We have many committed partners and we need your help in emphasizing to HHS and the industry leadership the critical importance of the consumer component to their efforts.

If you can lend your name and/or your organization’s name to this letter of support please email kossoncare@starpower.net by Thursday October 27th.

Your information, exactly as you provide it, will appear after the following statement: We the undersigned agree that successful care transitions need increased consumer IT support and focus consistent with the goals of the Patient and Caregiver Gateway project.

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More U.S. health citizens embrace digital personal health information: the topline of Manhattan Research’s Cybercitizen Health survey

Jane Sarasohn-Kahn

By Jane Sarasohn-Kahn. “56 million U.S. Consumers Access Medical Information from Electronic Health Records,” asserted Manhattan Research’s press release of October 12, 2011. This statistic, fresh out of the firm’s 2011 Cybercitizen Health survey, is among several stunning numbers that demonstrate a growing trend: U.S. health citizens’ embrace of their personal health information in digital formats, via electronic channels.

To kick the tires on the survey a bit, I spent time on the phone with the “3 M’s” of Manhattan Research — Meredith Ressi, President; Monique Levy, VP of Research; and, Maureen Malloy, Senior Healthcare Analyst who can recite the survey data backwards and forwards. Together, they guided me through the topline on digital health information use among U.S. adults in 2011.

The 56 million US adults who access data via electronic health records (EHRs) was a surprise to me, and to this trio, as well — so much so that they revisited the study methodology and samples to ensure that this was not a statistical anomaly. It’s not. But as with all numbers, it’s insightful to know what lies beneath the raw stat.

The big number to consider here is 24% of U.S. adults who are accessing their personal health information (PHI) from their physicians’ EHRs. In this case, the 56 million tend to be younger, better educated (more with college education), higher internet adoption, and more likely to own smartphones and tablet computers. They are also more likely to observe a physician doing digital activities during the consult – such as seeing the doctor entering information into the EHR.

What’s common among those consumers interacting with their EHR-borne health information is that they are more frequent online health information seekers than people who are non-users of their EHR data: three times more likely. (more…)

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No Kidding Around on Wellness

Mary R. Grealy

By Mary Grealy. This past Sunday, Ezra Klein had a fascinating piece on the Washington Post website regarding the Cleveland Clinic (a Healthcare Leadership Council member) and its efforts to achieve a higher degree of wellness within its workforce.

In Cleveland, Clinic CEO Delos Cosgrove has essentially declared war against preventable chronic disease.  Smoking is completely banned anywhere on the campus (and, in fact, physicians have been fired for violating this prohibition), deep fryers and sugared sodas have been removed from the Clinic premises, and Clinic employees pay higher health insurance premiums if they don’t take part in some form of fitness or stress management classes.  Employees’ health conditions – blood pressure, blood sugar, weight and other measurable – are monitored to make sure they are being proactive in improving their health.

The results, as Klein writes, are indisputable.  The Clinic has reduced its employee healthcare costs.  Smoking rates and blood pressure are way down.  Employees have lost a collective 125 tons of weight since 2005. (more…)

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Using Your Mobile Phone To Change Behavior Patterns

The following is a guest post by Dr. Jessie Gruman and ran on the Better Health on October 14th.

There is excitement in the air about how mobile phones are the breakthrough technology for changing health behavior.  Last Saturday, I was convinced this must be true. In two short hours, I:

  • Skimmed the NYTimes op-ed, You Love your iPhone. Literally, that (questionably) claimed that functional MRIs show that our brains react to our iPhones the same way they do to the proximity of someone we love.
  • Received an email on my iPhone from NYC Health Business Leaders inviting me to come to a meeting: Is Mobile Health the Next Killer App?
  • Came across this podcast on how mobile technology is going to vastly change care for seniors with chronic conditions.
  • Read a beautiful review of the behavior change literature that asks the question Is Mobile the Prescription for Sustained Behavior Change?
  • Received a text about the highly anticipated release of the iPhone 5.
  • And came across the entire kitchen crew of a fancy restaurant staring into/talking on their mobile phones.

Now I’m sure that the seductive power of our mobile phones hasn’t escaped your notice. Certainly, if you are concerned about people engaging more fully in their health and health care, you have seen the thousands of apps that intend to exploit the combination of widely available mobile phones with advances in Web-enabled technology as the new best way to spark and sustain health behavior change.

I love the optimism that has driven the development of these apps to date.  The theoretical reasoning of the behavioral scientists that finds mobile apps to be a potential game-changer – this is why this technology is different and what it offers above all other technologies and approaches — is subtle and compelling. And I love imagining the personalized guidance and support that will be possible to deliver to us once these theories are transformed into more sophisticated apps for our mobile devices. (more…)

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100,000 Steps…What color should we wear?

The following is a guest post by Janice Lynch Schuster who  works at the Altarum Institute, a new voice in the field of aging and end of life issues.

By Janice Lynch Schuster. Sunday night, simultaneously tired and wired from my participation in a 39-mile fundraising walk for breast cancer, I attended my daughter’s one-year anniversary meeting to celebrate her achievement: She has one year of drug-free living. The ceremony was moving and painful, joyful and sad. She talked about her struggle, her journey and moments of arrival, insights into her addiction and awareness of ways to overcome it. She talked about people in the room who had helped her along the way, who had called her on it when she tried to bamboozle them, who had loved and supported her as she worked to find other ways to cope with a world in which she had trouble living by the rules. Others in the room testified about their experiences with her—her determination to stay sober had inspired theirs; the fact that she had made it for a year gave them hope to reach similar goals; her enthusiasm and dedication, they said, was electrifying. To other teens in the meeting, she was a role model. She was—and is—a beloved part of this community of addicts and alcoholics. The outpouring of love and affection these people have for my daughter made me understand more fully and deeply just what it means to be on a journey with a community of like-minded people, and how important it is to be surrounded by such people when the journey is long and difficult, when there are barriers to be overcome and milestones to reach.

This time last year, we were in a very different place.  Aware that my daughter was self-destructing, I admitted her to a rehab facility; she was furious with me and told me our relationship was over, that I was not her mother, and she would never be my daughter again. She was livid and, until I stopped answering the phone, would call me daily with her fury. I was heartbroken—my beautiful girl, so smart and talented and funny—had been waylaid by a disease that has plagued our family for generations. She was 17, at the end of her junior year in high school, and at a time when I had expected her to be visiting colleges, studying for the SATs, buying her class ring, we were sitting in a locked room, crying and angry and overwhelmed by what was happening. The weekend I checked her in to the rehab facility coincided with the annual 39-mile walk, and despite my sorrow, I felt obligated to walk. So many people had donated so much money to me, and although the funds were committed whether I showed up or not, I felt compelled to go along with my plan. (more…)

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Americans’ new normal in health: paying attention and responding to costs

Jane Sarasohn-Kahn

By Jane Sarasohn Kahn. The passage of health reform in the U.S. has not enhanced peoples’ confidence in the American health system. In fact, U.S. health consumers’ high confidence level in the future of employer-sponsored health benefits has eroded over the past ten years, according to the Employee Benefit Research Institute‘s (EBRI) 2011 Health Confidence Survey: Most Americans Unfamiliar with Key Aspect of Health Reform.

Most people are dissatisfied with the U.S. health system overall, with 27% of U.S. adults rating the system as “poor” and 29% giving a rating of “fair.”

High costs may be at the root of peoples’ dissatisfaction with the U.S. health system. Only 18% of people are satisfied with the cost of health insurance; only 15% satisfied with the cost of health services not covered by insurance.

EBRI looked into peoples’ health-consumer behaviors, detailed in the chart. Most people who have visited doctors ask them to explain why a test is needed, as well as inquire about risks of treatments and medications and their success rates. Nearly one-half of people ask about less costly treatment options often or always.

Consumers also adjust their health care utilization when facing higher health care costs:

  • 74% of U.S. adults try to take better care of themselves
  • 69% choose generic drugs when available
  • 64% talk to the doctor more carefully about treatment options and costs
  • 59% go to the doctor only for more serious conditions or symptoms
  • 44% delay going to the doctor
  • 36% switch to over-the-counter (OTC) drugs
  • 34% look for cheaper health insurance
  • 31% look for cheaper health providers
  • 25% skip medication doses or don’t fill prescriptions.

Health care costs are eating into peoples’ savings contributions: 56% of people say they have decreased contributions to other savings due to health cost increases, and 33% have difficulty paying for other bills beyond health care.

The Health Confidence Survey interviewed 1,001 U.S. adults over age 21 in May and June 2011 via telephone. (more…)

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In Honor of Breast Cancer Awareness Month

Robin Strongin

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An Apple a Day: What the iPhone and Steve Jobs Can Teach Us About Health Care

Robin Strongin

By Robin Strongin. The passing of Steve Jobs, though not unexpected, is still stunning news.  Disruptive Women in Health Care is proud to call Steve Jobs our October 2011 Man of the Month.  I have often thought with his legendary vision and astonishing understanding of consumer behavior, he could help reform health care.  The explosion in mobile health is just one example.  We have much to learn from this genious in the black turtleneck. I am rerunning a post that invokes his brilliance.  RIP.

Steve Jobs 1955-2011

The day before my daughter Elise’s 15th birthday, the new iPhone went on sale.  My birthday was 4 days later.  So Elise figured out we should buy each other an iPhone to mark our big days.  She planned (and saved) for months.  She spent weeks talking to friends, researching apps on line, planning for such accessories as protective covers, and educating herself on how to maximize her minutes.

When the big day came, we made our way to the Apple store and stood shoulder to shoulder with hundreds of others waiting on a very long line.  Two and a half hours later we were invited, actually escorted, in to the store by an extremely friendly, knowledgeable young man who stayed with us during the entire purchase transaction.

He answered tons of questions (mine, not Elise’s…she already knew everything), politely reviewed various functions with me (Elise was extremely patient during this process), and made great suggestions about which plan was best for us.

While we were waiting on line, I looked around at the people waiting with us–we were an extremely diverse group–and wondered (a) Why in the world were we all willing to wait hours to buy a telephone, a very expensive telephone?  (b) How did the folks at Apple get us to this point? and (c) What lessons could we take away and apply to health care? (more…)

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USA Today and Medicare: The Hits, the Misses and the Absences

Mary R. Grealy

By Mary Grealy. Yesterday, USA Today devoted its front page to a topic many of us have been discussing intensely for some time – how to address Medicare’s escalating costs. 

The newspaper listed five ways to “squeeze” Medicare spending and then discussed the political arguments for and against each.  Some, such as gradually raising the Medicare eligibility age from 65 to 67 and requiring higher-income beneficiaries to pay full premiums for their Medicare Part B (physician services) and Part D (prescription drug) coverage are recommendations that the Healthcare Leadership Council has made to the congressional deficit reduction “super committee.”

But, in a number of ways, the USA Today article missed the mark:

In discussing cutbacks to Medicare providers, including physicians, hospitals and pharmaceutical companies, the newspaper expanded on the likelihood that those health sectors would strenuously argue against any cuts, but there was no reporting on the impact those reductions would have upon beneficiaries.

This is a pet peeve of mine, as I’ve noted previously.  Too often, both politicians and commentators speak of the value of cutting providers instead of patients, obscuring the fact that reduced payments to providers has an impact on both the accessibility and quality of healthcare.  If, as the Obama Administration has proposed, pharmaceutical companies are required to send over $100 billion in rebates back to the government, can there be any other outcome besides higher prices for consumers and less money available for research and development of new innovative medicines? (more…)

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Disruptive Women Celebrates 3 Years of Blogging With a HIP New Initiative

Robin Strongin

By Robin Strongin.  Three years ago, in September 2008, Disruptive Women in Health Care launched with an exciting program at the National Press Club (take a look at our media page to see what we had to say at the time.)

I know, I know it’s October…but hey, we are disruptive so celebrating on the exact day seems so well, ordinary.  And the past three years have been anything but ordinary.  We all had something to say about the new health reform debate and ultimate passage.  We still have much to say about the new law, as well as a multitude of other topics.

One area that I have been thinking a lot about is the exploding area of mhealth (mobile health), remote monitoring, and telehealth.  Technology alone is not the answer of course.  But technology, coupled with innovative care delivery models (think health reform), and patients, caregivers and clinicians more comfortable with smartphones, apps, data sharing and online connectivity have all contributed to a new framework of health and wellness.  Aging in Place, staying connected, eICUs, PHRs and EHRs.  Exciting stuff.

But, like most solutions in health care, success must look beyond the health sector.  Here’s what I mean by that: staying healthy can’t just take place in a health setting or even in your home.  Maintaining your health and wellness or managing your chronic disease or disability requires a connection where ever you are — in other words, Health In Place.  Young people with epilepsy and diabetes still attend school, go on vacation and use public transportation.  Elderly individuals aging in place still travel to visit gradnchildren. And, adults maintaining exercise and nutrition regimens who travel for work need to stay connected to maintain wellness.  The Health In Place concept takes this broad view and will be bringing together thought leaders from not only the health field, but the telecom, travel, automobile and real estate sectors as well. 

The organizers of the 2011 mHealth Summit were so taken with this idea that they invited Disruptive Women to launch the Health In Place or HIP initiative with a reception on December 6th–we couldn’t be more thrilled or more flattered. So SAVE THE DATE:


Health In Place (HIP)™ — Disruptive Women in Health Care is Launching a New Initiative

Tuesday, December 6, 2011, 5:00–7:00 PM
Location: Pose Ultra Lounge & Nightclub–at the Gaylord Hotel in National Harbor (Washington DC)

Overview: The concept of Health In Place™ is built around the idea that our homes are more than just homes, our offices are more than just workplaces, our schools are more than just places of learning, and even our cars are more than just modes of transportation. Thanks to wireless communications and emerging technologies, each of these venues has become potential health and wellness centers or HIP. No matter where we are or what we’re doing, we can be protecting and enhancing our well-being. For this facet of 21st century health care to achieve its full potential — for more Americans to have the tools to link to their caregivers, to protect against and manage illness, while monitoring their well-being — a number of public policy issues are involved, cutting across multiple disciplines from health care regulations and benefit structures to tax policy to technology incentives. That’s why Amplify Public Affairs and the Disruptive Women in Health Care® blog (along with our media partenr, The Hill) have formed the Health In Place™ Initiative — to bring together policymakers and change agents from multiple industries.

 Please join us as we unveil this new initiative.


  • Robin Strongin, President & CEO, Amplify Public Affairs & Creator, Disruptive Women in Health Care — Moderator
  • John Marttila, President, Marttila Strategies (a national polling expert)
  • John C. (Jack) Lewin, MD, Chief Executive Officer, American College of Cardiology
  • Pamela Cipriano, PhD, RN, NEA-BC, FAAN, Professor, University of Virginia School of Nursing, Editor-in-Chief, American Nurse Today, 2010-11 Institute of Medicine Nurse Scholar-In-Residence (and a Disruptive Woman blogger)
  • Halle Tecco, Founder & Managing Director of Rock Health (and a Disruptive Woman blogger)

Stay tuned for more information.  And by all means, please come out on December 6th and celebrate with us.

At three years of age, we are not only Disruptive, we are also HIP.

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  • October 3rd, 2011 Your Kids Needs Medication? Be Careful on School Days
    By Glenna Crooks