Health Highlights: April 28, 2014

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Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:

Psychiatric Side Effects of Chantix to be Reviewed in Fall: FDA

The mental health risks associated with the anti-smoking drug Chantix will be reviewed at a public meeting scheduled for October, the U.S. Food and Drug Administration says.

The meeting will feature a panel of experts who will discuss the psychiatric and behavioral side effects of the pill and how best to manage them, the agency announced Friday, The New York Times reported.

In 2009, the FDA ordered drug maker Pfizer to add a black box label — the strongest safety warning — to Chantix after it was linked to hostility, aggression, depression and suicidal thoughts. There were dozens of reports of suicide and suicidal behavior among people taking the drug.

Pfizer was also told to conduct further studies to assess the extent of these side effects. The company recently provided the FDA with new data about the anti-smoking drug.

“Pfizer has proposed an update to the Chantix labeling based on these new data, which, we believe, would better reflect the product’s safety profile as it pertains to neuropsychiatric symptoms,” company spokeswoman Victoria Davis said in a statement, The Times reported.

The findings submitted to the FDA include data from a number of Pfizer studies, as well as findings from two studies conducted by the U.S. Department of Defense and the Department of Veterans Affairs.

The government studies were released in 2011 and found that Chantix users did not have a higher rate of psychiatric hospitalizations than those who used nicotine patches or other treatments to help them stop smoking. However, the study authors said only mental health problems that resulted in hospitalization were included, which means many such problems likely went unreported, the Times said.

U.S. sales of Chantix began in 2006 and the FDA began investigating the drug’s potential side effects in 2007. The pill’s labeling tells patients to stop using it if they develop agitation, depression, suicidal thinking and other behavioral changes.

Chantix works by blocking nicotine from binding to certain locations in the brain and triggering the release of the “feel-good” chemical dopamine.

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Health Care Law Payment Policies Unfair: Report

Hospitals and doctors that treat large numbers of poor Americans are unfairly penalized under payment policies in the federal health care law that reward high-quality health care, a new report says.

The measures of quality in those rules are flawed because they do not take into account that it is often more difficult to successfully treat patients who are poor or have little education, according to the White House-commissioned draft report by a 26-member expert panel, The New York Times reported.

For example, poor people may not be able to afford prescribed medications or transportation to doctor’s offices or clinics. People with low levels of education or literacy may have trouble understanding or following written instructions for home care and medication use.

The expert panel added that hospitals and clinics used by these patients may not have the resources or equipment needed to properly diagnose and treat health problems, The Times reported.

The current payment policies inadvertently widen health disparities between poor and rich Americans by shifting money away from doctors and hospitals that care for low-income patients, the document said.

The panel recommended that measures of health care quality of performance be adjusted for various “sociodemographic factors,” The Times reported.

The panel was created by the nonprofit, nonpartisan National Quality Forum, which endorses health care standards.

“Factors far outside the control of a doctor or hospital — patients’ income, housing, education, even race — can significantly affect patient health, health care and providers’ performance scores,” said Dr. Christine Cassel, president of the forum, The Times reported.

“The administration’s current policy on adjustments for socioeconomic status are quite inadvertently exacerbating disparities in access to medical care for poor people who live in isolated neighborhoods. I’m sure that’s not what President Obama intended with the Affordable Care Act,” panel member Steven Lipstein, president of BJC HealthCare in St. Louis, said.

One change suggested by the panel would be to compare doctors and hospitals who provide care for a similar share of low-income patients, The Times reported.

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Physical Therapists Paid $1.8 Billion by Medicare in 2012

Physical therapists working in offices were paid $1.8 billion by Medicare in 2012, making them the 10th-highest among 74 types of health care specialists, according to an analysis of government data by The New York Times.

The highest paid physical therapist was Wael Bakry of Brooklyn, who received $4.1 million in Medicare payments that year. His practice treated 1,950 Medicare patients in 2012 and was paid by Medicare for 94 separate procedures for each patients.

That works out to a total of about 183,000 treatments a year, 500 a day, 21 an hour, according to The Times.

While Bakry did not dispute the $4.1 million figure, he suggested that the Medicare data could be “deceiving,” and noted that one person could not provide all of that care alone.

“I’m not Superman,” Bakry told The Times.

Medicare has never questioned his billing practices nor denied payments to his practice, he said. Bakry is not listed in a database of providers who are currently excluded from Medicare.

The Medicare data released this month also revealed that Brooklyn was the address listed by half of the 10 physical therapists nationwide who were paid the most by Medicaid in 2012. Two others had addresses on Long Island, one in Queens, one in California, and one in Texas.

Federal officials say that Brooklyn is a national hot bed of Medicare fraud, particularly scams linked to physical therapy. Dishonest members of that profession bill for treatments or procedures they never gave patients. This is often easier for physical therapists to do than specialists in fields such as cardiology or oncology,The Times reported.

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