The number-one cosmetic treatment is now poised to become even more popular. In April, the FDA granted approval for botulinum toxin type A (Botox Cosmetic) to be used as a temporary treatment for moderate to severe glabellar lines in men and women aged 65 or younger. Already, this treatment has enjoyed wide popularity. Since 2000, Botox Cosmetic procedures were up by 46%, and this type of treatment was rated the most popular among the 8.5 million surgical and non-surgical cosmetic procedures performed in 2001, according to Roberta Sengelmann, M.D., who is assistant professor of dermatology and otolaryngology at Washington University in St. Louis. “With the FDA approval,” says Nadine Tosk, spokesperson for the American Society for Dermatologic Surgery, “I think you’ll now see a lot of interest in this procedure among the second wave of consumers — the group following the early adopters. With the increase in procedures, we also expect to see more competition as more providers will offer this procedure.” A look at the data Results from a 12-month study, which consisted of 537 patients who underwent repeated treatments during a 4-month, double-blind time period, were clinically significant for improving the appearance of glabellar lines. Following the initial 4-month treatment time, patients were observed for 8 months to evaluate safety of the procedure. Of the patients who participated, 405 received Botox Cosmetic and 132 who received placebo. The maximum response rate occurred at day 30. Results showed: • When investigators assessed patient results, they reported that 80.2% of patients treated with Botox Cosmetic experienced a reduction in frown lines at maximum frown, compared with only 3% of patients who received a placebo. • When patients assessed their results, 89.4% of patients who underwent treatment with Botox Cosmetic said they saw an improvement in frown lines, as compared with 6.8% of the placebo group. The most frequently reported adverse reactions included headache (about 13% treated with Botox Cosmetic, compared with a little more than 17% treated with placebo), respiratory infection (about 3% for each group), temporary eyelid droop (3% vs. 0% of the placebo group) nausea (3% vs. 2% with patients who received placebo) and flu-like symptoms (2% vs. 1.5% of the placebo group). Less-frequent adverse events were facial pain, injection-site erythema and muscle weakness. Botox is also presently under investigation for treating hyperhidrosis. Ambulatory Surgery Centers Exponential Growth Opportunities If you’re thinking of opening an ambulatory surgical center, your timing couldn’t be better. Growth of physician-owned surgery centers was in the double digits last year, according to a recent article in American Medical News. Some of the biggest reasons for the growth are that surgery in these outpatient settings was less expensive and more efficient. The trend toward outpatient surgery has been increasing for years. Within the last 20 years, outpatient surgeries in the United States have increased by 55%. In 2000, 70% of all surgeries in the United States were outpatient, compared with only 15% in 1980. Subsequently, the number of procedures has jumped. In 1990, 2.3 million surgeries were performed in outpatient settings. Ten years later that number skyrocketed to 6.7 million — an increase of 191%.Medicare is presently considering a proposal that would increase the reimbursement rate for procedures performed in the office, which could further fuel the growth of ambulatory surgical centers (ASCs). According to one company that builds and manages ASCs, the market for physician-owned ASCs is “not even 10% built-out.”The fastest-growing areas for ASCs are orthopedics (9.8% of procedures performed in outpatient settings) and ear, nose and throat (6.9% of procedures done on an outpatient basis). Online Care Diagnosing Via the Internet Imagine treating a patient without ever even seeing them. Could speaking with some patients through e-mail be the closest you come to meeting them? If one Internet company has its way, this may be a form of practice you’ll be seeing soon. The Indianapolis-based MyDoc.com is opening its site for business and targeting busy professionals and their family members suffering from minor conditions who can’t take off from work for an office visit to their doctor because they’ve had the same symptoms in the past, and think they know the cause. According to MyDoc.com, owned by Roche Diagnostics, patients will be able to get a diagnosis and treatment recommendation within 15 to 20 minutes, 24 hours a day. Each “visit” costs $39.95, or consumers can sign up for a 1-year subscription for $15 a month, which covers six online consults. As a subscriber, each additional visit after the first six would cost $19.95. Right now the site is only hiring board-certified primary care physicians, who are being paid an average of $45 to $65 per hour and working 2- to 12-hour shifts. How It Works The site uses software that’s similar to what many telephone-based nurse call centers have been using for years. Patients go online and answer questions about their symptoms. Each answer generates another set of questions. Once the patient completes the questionnaire, the software generates an assessment that’s reviewed by a physician. If the case seems serious, the system informs the patient to seek emergency care. Doctors can prescribe medications, as long as they aren’t narcotics or lifestyle drugs, such as those for weight loss or baldness. So for now, although this is only something primary care physicians may be doing, it may not be too far off in the future that you’re faced with the possibility of practicing on the Net. What do you think about this practice? Would you consider treating patients without ever seeing them? How do you think this would affect standards of care? Would this put your patients at too great a risk for misdiagnosis? Write to us at stuleya@hmpcommunications.com and let us know what you think. Prompt Payment Problems Florida HMOs Violate Law At least 27 states have adopted prompt payment laws, requiring insurance companies to reimburse within a reasonable timeframe. In Georgia and Nebraska, the state’s with the toughest laws, this means payers must pay or deny a claim within 15 days — and request additional information within 15 days before downcoding. But in Florida, a recent look at the prompt pay report card has many HMOs getting a flunking grade. Two-thirds of Florida’s HMOs violated the state’s prompt-payment law, according to regulators. Of the state’s 24 HMOs, 16 were charged with not paying claims promptly — the law mandates that HMOs pay clean claims within 35 calendar days with a 10% fee for late payers, and insurers must reimburse disputed claims within 120 days. The notices were sent after the insurance department began a review of payment information in October 2001. Medical Malpractice Awards on the Rise Liability Insurance Reaching Crisis Proportions According to a report issued by the Jury Verdict Research Data in late March, medical malpractice awards rose nearly 43% between 1999 and 2000. In 2000, the median award reached the $1 million mark. Medical malpractice cases are approaching a nationwide crisis status due to lower interest rates, highly competitive insurance markets and bigger awards presented to plaintiffs. Insurers have pulled out of markets or narrow guidelines have been set that define what type of physicians the companies are willing to insure. For many doctors, finding insurance will become a problem as liability insurance rates continue to increase. The reason that liability insurance continues its ascent can be blamed in part on the low interest rates of the 1990s. Throughout the 90s, lower interest rates translated into a lower return on the investments insurers made to cover claims. Rate increases were also implemented to compensate for the market realities of the day. At that time, rates were underpriced and in a highly competitive market, insurers who did not understand the market, priced their product incorrectly. The result culminated in a pullout of insurance carriers because of the haste in which they expanded their businesses without full knowledge of pricing in that market. States such as Pennsylvania, West Virginia, Mississippi and Nevada, where the malpractice debacle has hit the hardest, have been the most affected by the 90s pullout. Some states, such as Pennsylvania, don’t provide a limit as to how much a jury can award the plaintiff — another factor contributing to the crisis. A solution to this problem would call for a damage cap to limit the damage juries can award. Physician organizations such as the AMA are urging states to enact laws limiting the amount of damages a jury can award. More results from the Jury Verdict Research Data showed the number of diagnosis error cases that plaintiffs won also increased. In 2000, plaintiffs won 37% of diagnosis failure cases — up from 31% in 1999. Between 1999 and 2000, median settlement figures fell 16% from $590,000 to $500,000. With no immediate long-term solution to the medical malpractice battle, physicians can be assured this headache will continue. Physician Bonuses Patients Still Trusting If you were to let your patients know that you received a bonus from an HMO as incentive for keeping healthcare costs down, do you think your patients would trust you more, or less? Possibly more. At least that’s what researchers at Wake Forest University recently found, according to a report in Reuters Health. Wake Forest University professor Mark Hall led the study, which focused on 1,918 participants in two health plans. One of the plans paid on a capitated basis, the other on a discounted fee-for-service schedule. Physicians in both plans received bonuses based on a formula that included meeting budgetary goals, maintaining patient satisfaction levels and meeting certain preventive care performance measures. Researchers questioned all the participants on trust issues and previous interactions with their doctors and HMOs. Then, participants were randomly assigned to one of two groups — either they received explicit written and verbal disclosures of their HMO’s financial incentive measures, or they received no additional information. After 1 month, researchers repeated another round of questioning patients on trust. Of the capitated plan members who received disclosures, their trust increased by 1.4% — a small increase but one that’s still statistically significant. Among the subgroup of participants who demonstrated a greater understanding of the disclosed incentives, trust rose by 3%. Tick Time Lyme Disease Vaccine off the Market Spring is here and so is tick season. Patients spend more time outdoors at this time of year, particularly in the northeastern, Mid-Atlantic and north-central areas of the country where Lyme disease is most prevalent. But as patients start to present with signs and symptoms of Lyme, you’ll be without the vaccine that may have helped prevent the disease in the first place. Poor sales made GlaxoSmithKline, the manufacturer of the only existing Lyme vaccine, which had a reported efficacy rate of 80%, pull it from the market. And with the number of cases of Lyme reported to the Center for Disease Control continuing to rise each year (17,730 cases were reported in 2000), preventative tools are very much needed. The vaccine, Lymerix, was under investigation after patients argued it made them sick and filed suits against the manufacturer and asked the government to restrict sales. The FDA investigated and found no proof of any danger. GlaxoSmithKline didn’t pull the vaccine because of any problems with the FDA, only because sales predictions were low. The company projected 10,000 doses this year — down from about 1.5 million doses in 1999, the first year it was available. Some reason for the fall in sales could be: • consumer misconception about the side effects • an efficacy rate of only 80% • the low fatality of Lyme disease • effective antibiotic treatment if caught early • the prescribed dosage must be taken three times Other Options The only prevention available now for Lyme disease is controlling tick populations, convincing patients to avoid tick-loving habitats and to use repellents. But for patients who get bitten by a tick, early detection is a must. But, although most patients believe that the “bull’s-eye” rash is the most common symptom to look for when checking for Lyme, a new report indicates that most patients actually have homogeneous lesions. The research was done by Robert P. Smith, M.D., of the Main Medical Center Research Institute in Portland and published in the March 19 issue of the Annals of Internal Medicine. They characterized early Lyme disease in 118 patients with microbiologically confirmed erythema migrans. They found that patients typically presented 3 days after symptoms started, and only 9% had the classic bull’s-eye rash, while 59% had rashes with homogeneous pattern and 32% had rashes with dense central erythema. The most common symptoms were non-specific flu-like symptoms. Be sure to educate your patients about symptoms other than the bull’s-eye rash so they know what to look for. Research Shorts Comparing Cost- Effective Psoriasis Therapies Assessing the cost of therapeutic regimens in these healthcare conscious times allows you to provide your patients with the best treatment program with regard to the its cost effectiveness. In a study published in the February issue of the Journal of the American Academy of Dermatology, researchers assessed two cost-effective strategies for treating psoriasis. One group received the treatment, methotrexate, while the second treatment group received a rotational schedule of modified cyclosporine with methotrexate. The researchers developed a computerized decision analytic model with stimulated patients with moderate to severe psoriasis. The stimulation ran in 1-year cycles throughout a 10-year period with patients randomly assigned to receive one of the two treatments. The results indicated that methotrexate cost $33,000 over a 10-year period and cleared psoriasis for 2 years. The rotational strategy of cyclosporine and methotrexate cost approximately $38,000 over the 10-year study period and had a 4-year clearance rate. While the rotational strategy cost more, it was also more effective. Researchers concluded that with the current problems of cost control, consideration of the clinical and economic consequences should be accounted for in addition to patients’ treatment needs and preferences. -- J. Am Acad. Dermatol., February 2002 Treating Lichen Sclerosus with Low-Dose UVA1 Phototherapy While numerous therapies have been used to treat lichen sclerosus, they’ve had limited success. In a recent study in the Journal of the American Academy of Dermatology, researchers treated patients with extragenital LS with low–dose UVA1 phototherapy, a treatment shown to be effective for localized scleroderma. Extragenital LS (lichen sclerosus) is a chronic and somewhat rare inflammatory skin disease that produces plaques and lesions on the skin. A clinical trial was conducted in Bochum, Germany, on 10 patients suffering from extragenital LS. Patients were treated with low-dose UVA1 phototherapy four times a week with single UVA1 doses of 20J/cm2. Within 10 weeks, 40 treatment sessions were performed for a cumulative UVA1 dose of 800 J/cm2. According to the results, a marked reduction was reported as patients demonstrated a softening and repigmentation of former affected skin. A softening of sclerotic plaques was observed after the tenth session. Researchers concluded that low-dose UVA1 phototherapy can reduce and clear extragenital LS. – J. Am Acad. Dermatol., February 2002 Melasma Treatment Effectiveness Demonstrated Following the completion of recent studies, Medicis Pharmaceutical Corp. released data on the treatment of melasma using its hydroquinone USP 4% cream, Alustra. The results showed Alustra was twice as effective as the topical tretinoin in treating patients with melasma. In a 16-week, randomized, blind study of 44 female patients, patients were randomly divided into two groups. Participants in Group A received Alustra and those in Group B received tretinoin cream. The study evaluated the efficacy and tolerance of a hydroquinone and a retinol topical product such as Alustra versus the topical tretinoin 0.05% emollient cream to treat photodamaged skin and hyperpigmentation. The patients were evaluated at 4, 8, 12 and 16 weeks — researchers looked for skin irritation, overall me-lasma severity, the appearance of fine lines and wrinkles, mottled pigmentation and tactile roughness. The study revealed the following results: • the Alustra group indicated a 74.8% reduction in the melasma area versus a 32.0% reduction seen in patients who used tretinoin • the Alustra group noted a 59.6% improvement in tactile roughness compared to tretinoin users who saw a 4.3% roughness increase at 16 weeks. The study concluded that Alustra can be used as a first- line, long-term treatment for melasma. Physician-Generated Revenue New Study Tracks the Most Profitable Doctors C ardiovascular surgeons generate the most money each year for hospitals, according to a new survey. These surgeons topped the list of physicians, generating an annual $3.1 million for their respective hospitals, reported a survey conducted by the physician search firm Merritt, Hawkins & Associates. While cardiovascular surgeons came in first, pediatricians were the lowest revenue-producing physicians at $690,104. However, the study only summarized res-ponses from CFOs at 153 hospitals — the number of hospitals that responded to the 4,000 surveys sent to hospitals around the country. Most respondents came from not-for-profit hospitals (85%) and from hospitals with less than 100 beds (47%). Also, most of these hospitals served a patient base of 50,000 people or fewer. The table above gives you a look at how other physician specialties fixed into the mix. Treating Vitiligo Tacrolimus ointment may be the answer. The recently FDA–approved topical immunomodulator, Protopic (tacrolimus ointment), has indicated a positive response in treating patients with vitiligo. In research presented at the AAD’s annual conference in New Orleans, researchers presented data showing Protopic’s effectiveness among vitiligo patients. The drug, which was approved in December 2000 to treat moderate to severe eczema, displayed varying degrees of repigmentation in patients ranging from 7 to 38 years old. Patients’ affected areas were treated with tacrolimus twice daily for 1 to 5 months. Different degrees of repigmentation were achieved in all patients. In Brief... Phase I Trial To Begin… Phase I trial has begun in Halifax, Nova Scotia for the peptide vaccine, Cytovaxine. Manufactured by Cytovax Biotechnologies, the vaccine prevents infections caused by Pseudomonas aeruginosa, a leading cause of hospital-acquired infections. Potential New Psoriasis Drug Fails in Trial… In a recent Phase II trial, results indicated the drug, Zenaphax (daclizumab) in conjunction with cyclosporine, did not prolong the recurrence of moderate to severe psoriasis. The drug, developed by Protein Design Labs did not meet its treatment goals but the company hopes to pursue other options with it. New Study Results Announced on Propecia… Recently released study results from Merck & Co. and the Live Surgery Workshop found new data on the effects of the hair restoration drug, Propecia, in a double-blind, placebo-controlled study of 66 mean. The research indicated an increase in hair mass of 34% among men after 2 years and in 4 years there was an approximate 40% hair mass increase. In a 96-week period, a 36% mean hair weight difference was noted among men taking Propecia and those taking a placebo. New Elidel Cream Effective for Eczema ... Data published in the April issue of the Journal of the American Academy of Dermatology showed the non-steroid prescription cream Elidel (pimecrolimus) Cream 1% effectively treated eczema particularly among the head and neck regions. Developed by Novartis, Elidel treats mild to moderate eczema in patients 2 years or older. In data analysis, half of Elidel-treated patients indicated their eczema to be in good or complete control versus 20% of placebo treated patients. New Technology Benefits Hair Transplant Patients… A new technology that delivers controlled local anesthesia with an ergonomically designed handpiece to patients has been found effective in a recent study at the Scholl College of Podiatric Medicine. Developed by Milestone Scientific, the CompuMed system will be installed into the surgery centers of Medical Hair Restoration (MHR) to reduce patient discomfort and pain. The study indicated 80% of patients preferred the CompuMed system compared to the traditional syringe technique. A greatly reduced level of discomfort was noted among patients.
FDA ApprovalsBotox: Cosmetic Indication Approved
The number-one cosmetic treatment is now poised to become even more popular. In April, the FDA granted approval for botulinum toxin type A (Botox Cosmetic) to be used as a temporary treatment for moderate to severe glabellar lines in men and women aged 65 or younger. Already, this treatment has enjoyed wide popularity. Since 2000, Botox Cosmetic procedures were up by 46%, and this type of treatment was rated the most popular among the 8.5 million surgical and non-surgical cosmetic procedures performed in 2001, according to Roberta Sengelmann, M.D., who is assistant professor of dermatology and otolaryngology at Washington University in St. Louis. “With the FDA approval,” says Nadine Tosk, spokesperson for the American Society for Dermatologic Surgery, “I think you’ll now see a lot of interest in this procedure among the second wave of consumers — the group following the early adopters. With the increase in procedures, we also expect to see more competition as more providers will offer this procedure.” A look at the data Results from a 12-month study, which consisted of 537 patients who underwent repeated treatments during a 4-month, double-blind time period, were clinically significant for improving the appearance of glabellar lines. Following the initial 4-month treatment time, patients were observed for 8 months to evaluate safety of the procedure. Of the patients who participated, 405 received Botox Cosmetic and 132 who received placebo. The maximum response rate occurred at day 30. Results showed: • When investigators assessed patient results, they reported that 80.2% of patients treated with Botox Cosmetic experienced a reduction in frown lines at maximum frown, compared with only 3% of patients who received a placebo. • When patients assessed their results, 89.4% of patients who underwent treatment with Botox Cosmetic said they saw an improvement in frown lines, as compared with 6.8% of the placebo group. The most frequently reported adverse reactions included headache (about 13% treated with Botox Cosmetic, compared with a little more than 17% treated with placebo), respiratory infection (about 3% for each group), temporary eyelid droop (3% vs. 0% of the placebo group) nausea (3% vs. 2% with patients who received placebo) and flu-like symptoms (2% vs. 1.5% of the placebo group). Less-frequent adverse events were facial pain, injection-site erythema and muscle weakness. Botox is also presently under investigation for treating hyperhidrosis. Ambulatory Surgery Centers Exponential Growth Opportunities If you’re thinking of opening an ambulatory surgical center, your timing couldn’t be better. Growth of physician-owned surgery centers was in the double digits last year, according to a recent article in American Medical News. Some of the biggest reasons for the growth are that surgery in these outpatient settings was less expensive and more efficient. The trend toward outpatient surgery has been increasing for years. Within the last 20 years, outpatient surgeries in the United States have increased by 55%. In 2000, 70% of all surgeries in the United States were outpatient, compared with only 15% in 1980. Subsequently, the number of procedures has jumped. In 1990, 2.3 million surgeries were performed in outpatient settings. Ten years later that number skyrocketed to 6.7 million — an increase of 191%.Medicare is presently considering a proposal that would increase the reimbursement rate for procedures performed in the office, which could further fuel the growth of ambulatory surgical centers (ASCs). According to one company that builds and manages ASCs, the market for physician-owned ASCs is “not even 10% built-out.”The fastest-growing areas for ASCs are orthopedics (9.8% of procedures performed in outpatient settings) and ear, nose and throat (6.9% of procedures done on an outpatient basis). Online Care Diagnosing Via the Internet Imagine treating a patient without ever even seeing them. Could speaking with some patients through e-mail be the closest you come to meeting them? If one Internet company has its way, this may be a form of practice you’ll be seeing soon. The Indianapolis-based MyDoc.com is opening its site for business and targeting busy professionals and their family members suffering from minor conditions who can’t take off from work for an office visit to their doctor because they’ve had the same symptoms in the past, and think they know the cause. According to MyDoc.com, owned by Roche Diagnostics, patients will be able to get a diagnosis and treatment recommendation within 15 to 20 minutes, 24 hours a day. Each “visit” costs $39.95, or consumers can sign up for a 1-year subscription for $15 a month, which covers six online consults. As a subscriber, each additional visit after the first six would cost $19.95. Right now the site is only hiring board-certified primary care physicians, who are being paid an average of $45 to $65 per hour and working 2- to 12-hour shifts. How It Works The site uses software that’s similar to what many telephone-based nurse call centers have been using for years. Patients go online and answer questions about their symptoms. Each answer generates another set of questions. Once the patient completes the questionnaire, the software generates an assessment that’s reviewed by a physician. If the case seems serious, the system informs the patient to seek emergency care. Doctors can prescribe medications, as long as they aren’t narcotics or lifestyle drugs, such as those for weight loss or baldness. So for now, although this is only something primary care physicians may be doing, it may not be too far off in the future that you’re faced with the possibility of practicing on the Net. What do you think about this practice? Would you consider treating patients without ever seeing them? How do you think this would affect standards of care? Would this put your patients at too great a risk for misdiagnosis? Write to us at stuleya@hmpcommunications.com and let us know what you think. Prompt Payment Problems Florida HMOs Violate Law At least 27 states have adopted prompt payment laws, requiring insurance companies to reimburse within a reasonable timeframe. In Georgia and Nebraska, the state’s with the toughest laws, this means payers must pay or deny a claim within 15 days — and request additional information within 15 days before downcoding. But in Florida, a recent look at the prompt pay report card has many HMOs getting a flunking grade. Two-thirds of Florida’s HMOs violated the state’s prompt-payment law, according to regulators. Of the state’s 24 HMOs, 16 were charged with not paying claims promptly — the law mandates that HMOs pay clean claims within 35 calendar days with a 10% fee for late payers, and insurers must reimburse disputed claims within 120 days. The notices were sent after the insurance department began a review of payment information in October 2001. Medical Malpractice Awards on the Rise Liability Insurance Reaching Crisis Proportions According to a report issued by the Jury Verdict Research Data in late March, medical malpractice awards rose nearly 43% between 1999 and 2000. In 2000, the median award reached the $1 million mark. Medical malpractice cases are approaching a nationwide crisis status due to lower interest rates, highly competitive insurance markets and bigger awards presented to plaintiffs. Insurers have pulled out of markets or narrow guidelines have been set that define what type of physicians the companies are willing to insure. For many doctors, finding insurance will become a problem as liability insurance rates continue to increase. The reason that liability insurance continues its ascent can be blamed in part on the low interest rates of the 1990s. Throughout the 90s, lower interest rates translated into a lower return on the investments insurers made to cover claims. Rate increases were also implemented to compensate for the market realities of the day. At that time, rates were underpriced and in a highly competitive market, insurers who did not understand the market, priced their product incorrectly. The result culminated in a pullout of insurance carriers because of the haste in which they expanded their businesses without full knowledge of pricing in that market. States such as Pennsylvania, West Virginia, Mississippi and Nevada, where the malpractice debacle has hit the hardest, have been the most affected by the 90s pullout. Some states, such as Pennsylvania, don’t provide a limit as to how much a jury can award the plaintiff — another factor contributing to the crisis. A solution to this problem would call for a damage cap to limit the damage juries can award. Physician organizations such as the AMA are urging states to enact laws limiting the amount of damages a jury can award. More results from the Jury Verdict Research Data showed the number of diagnosis error cases that plaintiffs won also increased. In 2000, plaintiffs won 37% of diagnosis failure cases — up from 31% in 1999. Between 1999 and 2000, median settlement figures fell 16% from $590,000 to $500,000. With no immediate long-term solution to the medical malpractice battle, physicians can be assured this headache will continue. Physician Bonuses Patients Still Trusting If you were to let your patients know that you received a bonus from an HMO as incentive for keeping healthcare costs down, do you think your patients would trust you more, or less? Possibly more. At least that’s what researchers at Wake Forest University recently found, according to a report in Reuters Health. Wake Forest University professor Mark Hall led the study, which focused on 1,918 participants in two health plans. One of the plans paid on a capitated basis, the other on a discounted fee-for-service schedule. Physicians in both plans received bonuses based on a formula that included meeting budgetary goals, maintaining patient satisfaction levels and meeting certain preventive care performance measures. Researchers questioned all the participants on trust issues and previous interactions with their doctors and HMOs. Then, participants were randomly assigned to one of two groups — either they received explicit written and verbal disclosures of their HMO’s financial incentive measures, or they received no additional information. After 1 month, researchers repeated another round of questioning patients on trust. Of the capitated plan members who received disclosures, their trust increased by 1.4% — a small increase but one that’s still statistically significant. Among the subgroup of participants who demonstrated a greater understanding of the disclosed incentives, trust rose by 3%. Tick Time Lyme Disease Vaccine off the Market Spring is here and so is tick season. Patients spend more time outdoors at this time of year, particularly in the northeastern, Mid-Atlantic and north-central areas of the country where Lyme disease is most prevalent. But as patients start to present with signs and symptoms of Lyme, you’ll be without the vaccine that may have helped prevent the disease in the first place. Poor sales made GlaxoSmithKline, the manufacturer of the only existing Lyme vaccine, which had a reported efficacy rate of 80%, pull it from the market. And with the number of cases of Lyme reported to the Center for Disease Control continuing to rise each year (17,730 cases were reported in 2000), preventative tools are very much needed. The vaccine, Lymerix, was under investigation after patients argued it made them sick and filed suits against the manufacturer and asked the government to restrict sales. The FDA investigated and found no proof of any danger. GlaxoSmithKline didn’t pull the vaccine because of any problems with the FDA, only because sales predictions were low. The company projected 10,000 doses this year — down from about 1.5 million doses in 1999, the first year it was available. Some reason for the fall in sales could be: • consumer misconception about the side effects • an efficacy rate of only 80% • the low fatality of Lyme disease • effective antibiotic treatment if caught early • the prescribed dosage must be taken three times Other Options The only prevention available now for Lyme disease is controlling tick populations, convincing patients to avoid tick-loving habitats and to use repellents. But for patients who get bitten by a tick, early detection is a must. But, although most patients believe that the “bull’s-eye” rash is the most common symptom to look for when checking for Lyme, a new report indicates that most patients actually have homogeneous lesions. The research was done by Robert P. Smith, M.D., of the Main Medical Center Research Institute in Portland and published in the March 19 issue of the Annals of Internal Medicine. They characterized early Lyme disease in 118 patients with microbiologically confirmed erythema migrans. They found that patients typically presented 3 days after symptoms started, and only 9% had the classic bull’s-eye rash, while 59% had rashes with homogeneous pattern and 32% had rashes with dense central erythema. The most common symptoms were non-specific flu-like symptoms. Be sure to educate your patients about symptoms other than the bull’s-eye rash so they know what to look for. Research Shorts Comparing Cost- Effective Psoriasis Therapies Assessing the cost of therapeutic regimens in these healthcare conscious times allows you to provide your patients with the best treatment program with regard to the its cost effectiveness. In a study published in the February issue of the Journal of the American Academy of Dermatology, researchers assessed two cost-effective strategies for treating psoriasis. One group received the treatment, methotrexate, while the second treatment group received a rotational schedule of modified cyclosporine with methotrexate. The researchers developed a computerized decision analytic model with stimulated patients with moderate to severe psoriasis. The stimulation ran in 1-year cycles throughout a 10-year period with patients randomly assigned to receive one of the two treatments. The results indicated that methotrexate cost $33,000 over a 10-year period and cleared psoriasis for 2 years. The rotational strategy of cyclosporine and methotrexate cost approximately $38,000 over the 10-year study period and had a 4-year clearance rate. While the rotational strategy cost more, it was also more effective. Researchers concluded that with the current problems of cost control, consideration of the clinical and economic consequences should be accounted for in addition to patients’ treatment needs and preferences. -- J. Am Acad. Dermatol., February 2002 Treating Lichen Sclerosus with Low-Dose UVA1 Phototherapy While numerous therapies have been used to treat lichen sclerosus, they’ve had limited success. In a recent study in the Journal of the American Academy of Dermatology, researchers treated patients with extragenital LS with low–dose UVA1 phototherapy, a treatment shown to be effective for localized scleroderma. Extragenital LS (lichen sclerosus) is a chronic and somewhat rare inflammatory skin disease that produces plaques and lesions on the skin. A clinical trial was conducted in Bochum, Germany, on 10 patients suffering from extragenital LS. Patients were treated with low-dose UVA1 phototherapy four times a week with single UVA1 doses of 20J/cm2. Within 10 weeks, 40 treatment sessions were performed for a cumulative UVA1 dose of 800 J/cm2. According to the results, a marked reduction was reported as patients demonstrated a softening and repigmentation of former affected skin. A softening of sclerotic plaques was observed after the tenth session. Researchers concluded that low-dose UVA1 phototherapy can reduce and clear extragenital LS. – J. Am Acad. Dermatol., February 2002 Melasma Treatment Effectiveness Demonstrated Following the completion of recent studies, Medicis Pharmaceutical Corp. released data on the treatment of melasma using its hydroquinone USP 4% cream, Alustra. The results showed Alustra was twice as effective as the topical tretinoin in treating patients with melasma. In a 16-week, randomized, blind study of 44 female patients, patients were randomly divided into two groups. Participants in Group A received Alustra and those in Group B received tretinoin cream. The study evaluated the efficacy and tolerance of a hydroquinone and a retinol topical product such as Alustra versus the topical tretinoin 0.05% emollient cream to treat photodamaged skin and hyperpigmentation. The patients were evaluated at 4, 8, 12 and 16 weeks — researchers looked for skin irritation, overall me-lasma severity, the appearance of fine lines and wrinkles, mottled pigmentation and tactile roughness. The study revealed the following results: • the Alustra group indicated a 74.8% reduction in the melasma area versus a 32.0% reduction seen in patients who used tretinoin • the Alustra group noted a 59.6% improvement in tactile roughness compared to tretinoin users who saw a 4.3% roughness increase at 16 weeks. The study concluded that Alustra can be used as a first- line, long-term treatment for melasma. Physician-Generated Revenue New Study Tracks the Most Profitable Doctors C ardiovascular surgeons generate the most money each year for hospitals, according to a new survey. These surgeons topped the list of physicians, generating an annual $3.1 million for their respective hospitals, reported a survey conducted by the physician search firm Merritt, Hawkins & Associates. While cardiovascular surgeons came in first, pediatricians were the lowest revenue-producing physicians at $690,104. However, the study only summarized res-ponses from CFOs at 153 hospitals — the number of hospitals that responded to the 4,000 surveys sent to hospitals around the country. Most respondents came from not-for-profit hospitals (85%) and from hospitals with less than 100 beds (47%). Also, most of these hospitals served a patient base of 50,000 people or fewer. The table above gives you a look at how other physician specialties fixed into the mix. Treating Vitiligo Tacrolimus ointment may be the answer. The recently FDA–approved topical immunomodulator, Protopic (tacrolimus ointment), has indicated a positive response in treating patients with vitiligo. In research presented at the AAD’s annual conference in New Orleans, researchers presented data showing Protopic’s effectiveness among vitiligo patients. The drug, which was approved in December 2000 to treat moderate to severe eczema, displayed varying degrees of repigmentation in patients ranging from 7 to 38 years old. Patients’ affected areas were treated with tacrolimus twice daily for 1 to 5 months. Different degrees of repigmentation were achieved in all patients. In Brief... Phase I Trial To Begin… Phase I trial has begun in Halifax, Nova Scotia for the peptide vaccine, Cytovaxine. Manufactured by Cytovax Biotechnologies, the vaccine prevents infections caused by Pseudomonas aeruginosa, a leading cause of hospital-acquired infections. Potential New Psoriasis Drug Fails in Trial… In a recent Phase II trial, results indicated the drug, Zenaphax (daclizumab) in conjunction with cyclosporine, did not prolong the recurrence of moderate to severe psoriasis. The drug, developed by Protein Design Labs did not meet its treatment goals but the company hopes to pursue other options with it. New Study Results Announced on Propecia… Recently released study results from Merck & Co. and the Live Surgery Workshop found new data on the effects of the hair restoration drug, Propecia, in a double-blind, placebo-controlled study of 66 mean. The research indicated an increase in hair mass of 34% among men after 2 years and in 4 years there was an approximate 40% hair mass increase. In a 96-week period, a 36% mean hair weight difference was noted among men taking Propecia and those taking a placebo. New Elidel Cream Effective for Eczema ... Data published in the April issue of the Journal of the American Academy of Dermatology showed the non-steroid prescription cream Elidel (pimecrolimus) Cream 1% effectively treated eczema particularly among the head and neck regions. Developed by Novartis, Elidel treats mild to moderate eczema in patients 2 years or older. In data analysis, half of Elidel-treated patients indicated their eczema to be in good or complete control versus 20% of placebo treated patients. New Technology Benefits Hair Transplant Patients… A new technology that delivers controlled local anesthesia with an ergonomically designed handpiece to patients has been found effective in a recent study at the Scholl College of Podiatric Medicine. Developed by Milestone Scientific, the CompuMed system will be installed into the surgery centers of Medical Hair Restoration (MHR) to reduce patient discomfort and pain. The study indicated 80% of patients preferred the CompuMed system compared to the traditional syringe technique. A greatly reduced level of discomfort was noted among patients.
The number-one cosmetic treatment is now poised to become even more popular. In April, the FDA granted approval for botulinum toxin type A (Botox Cosmetic) to be used as a temporary treatment for moderate to severe glabellar lines in men and women aged 65 or younger. Already, this treatment has enjoyed wide popularity. Since 2000, Botox Cosmetic procedures were up by 46%, and this type of treatment was rated the most popular among the 8.5 million surgical and non-surgical cosmetic procedures performed in 2001, according to Roberta Sengelmann, M.D., who is assistant professor of dermatology and otolaryngology at Washington University in St. Louis. “With the FDA approval,” says Nadine Tosk, spokesperson for the American Society for Dermatologic Surgery, “I think you’ll now see a lot of interest in this procedure among the second wave of consumers — the group following the early adopters. With the increase in procedures, we also expect to see more competition as more providers will offer this procedure.” A look at the data Results from a 12-month study, which consisted of 537 patients who underwent repeated treatments during a 4-month, double-blind time period, were clinically significant for improving the appearance of glabellar lines. Following the initial 4-month treatment time, patients were observed for 8 months to evaluate safety of the procedure. Of the patients who participated, 405 received Botox Cosmetic and 132 who received placebo. The maximum response rate occurred at day 30. Results showed: • When investigators assessed patient results, they reported that 80.2% of patients treated with Botox Cosmetic experienced a reduction in frown lines at maximum frown, compared with only 3% of patients who received a placebo. • When patients assessed their results, 89.4% of patients who underwent treatment with Botox Cosmetic said they saw an improvement in frown lines, as compared with 6.8% of the placebo group. The most frequently reported adverse reactions included headache (about 13% treated with Botox Cosmetic, compared with a little more than 17% treated with placebo), respiratory infection (about 3% for each group), temporary eyelid droop (3% vs. 0% of the placebo group) nausea (3% vs. 2% with patients who received placebo) and flu-like symptoms (2% vs. 1.5% of the placebo group). Less-frequent adverse events were facial pain, injection-site erythema and muscle weakness. Botox is also presently under investigation for treating hyperhidrosis. Ambulatory Surgery Centers Exponential Growth Opportunities If you’re thinking of opening an ambulatory surgical center, your timing couldn’t be better. Growth of physician-owned surgery centers was in the double digits last year, according to a recent article in American Medical News. Some of the biggest reasons for the growth are that surgery in these outpatient settings was less expensive and more efficient. The trend toward outpatient surgery has been increasing for years. Within the last 20 years, outpatient surgeries in the United States have increased by 55%. In 2000, 70% of all surgeries in the United States were outpatient, compared with only 15% in 1980. Subsequently, the number of procedures has jumped. In 1990, 2.3 million surgeries were performed in outpatient settings. Ten years later that number skyrocketed to 6.7 million — an increase of 191%.Medicare is presently considering a proposal that would increase the reimbursement rate for procedures performed in the office, which could further fuel the growth of ambulatory surgical centers (ASCs). According to one company that builds and manages ASCs, the market for physician-owned ASCs is “not even 10% built-out.”The fastest-growing areas for ASCs are orthopedics (9.8% of procedures performed in outpatient settings) and ear, nose and throat (6.9% of procedures done on an outpatient basis). Online Care Diagnosing Via the Internet Imagine treating a patient without ever even seeing them. Could speaking with some patients through e-mail be the closest you come to meeting them? If one Internet company has its way, this may be a form of practice you’ll be seeing soon. The Indianapolis-based MyDoc.com is opening its site for business and targeting busy professionals and their family members suffering from minor conditions who can’t take off from work for an office visit to their doctor because they’ve had the same symptoms in the past, and think they know the cause. According to MyDoc.com, owned by Roche Diagnostics, patients will be able to get a diagnosis and treatment recommendation within 15 to 20 minutes, 24 hours a day. Each “visit” costs $39.95, or consumers can sign up for a 1-year subscription for $15 a month, which covers six online consults. As a subscriber, each additional visit after the first six would cost $19.95. Right now the site is only hiring board-certified primary care physicians, who are being paid an average of $45 to $65 per hour and working 2- to 12-hour shifts. How It Works The site uses software that’s similar to what many telephone-based nurse call centers have been using for years. Patients go online and answer questions about their symptoms. Each answer generates another set of questions. Once the patient completes the questionnaire, the software generates an assessment that’s reviewed by a physician. If the case seems serious, the system informs the patient to seek emergency care. Doctors can prescribe medications, as long as they aren’t narcotics or lifestyle drugs, such as those for weight loss or baldness. So for now, although this is only something primary care physicians may be doing, it may not be too far off in the future that you’re faced with the possibility of practicing on the Net. What do you think about this practice? Would you consider treating patients without ever seeing them? How do you think this would affect standards of care? Would this put your patients at too great a risk for misdiagnosis? Write to us at stuleya@hmpcommunications.com and let us know what you think. Prompt Payment Problems Florida HMOs Violate Law At least 27 states have adopted prompt payment laws, requiring insurance companies to reimburse within a reasonable timeframe. In Georgia and Nebraska, the state’s with the toughest laws, this means payers must pay or deny a claim within 15 days — and request additional information within 15 days before downcoding. But in Florida, a recent look at the prompt pay report card has many HMOs getting a flunking grade. Two-thirds of Florida’s HMOs violated the state’s prompt-payment law, according to regulators. Of the state’s 24 HMOs, 16 were charged with not paying claims promptly — the law mandates that HMOs pay clean claims within 35 calendar days with a 10% fee for late payers, and insurers must reimburse disputed claims within 120 days. The notices were sent after the insurance department began a review of payment information in October 2001. Medical Malpractice Awards on the Rise Liability Insurance Reaching Crisis Proportions According to a report issued by the Jury Verdict Research Data in late March, medical malpractice awards rose nearly 43% between 1999 and 2000. In 2000, the median award reached the $1 million mark. Medical malpractice cases are approaching a nationwide crisis status due to lower interest rates, highly competitive insurance markets and bigger awards presented to plaintiffs. Insurers have pulled out of markets or narrow guidelines have been set that define what type of physicians the companies are willing to insure. For many doctors, finding insurance will become a problem as liability insurance rates continue to increase. The reason that liability insurance continues its ascent can be blamed in part on the low interest rates of the 1990s. Throughout the 90s, lower interest rates translated into a lower return on the investments insurers made to cover claims. Rate increases were also implemented to compensate for the market realities of the day. At that time, rates were underpriced and in a highly competitive market, insurers who did not understand the market, priced their product incorrectly. The result culminated in a pullout of insurance carriers because of the haste in which they expanded their businesses without full knowledge of pricing in that market. States such as Pennsylvania, West Virginia, Mississippi and Nevada, where the malpractice debacle has hit the hardest, have been the most affected by the 90s pullout. Some states, such as Pennsylvania, don’t provide a limit as to how much a jury can award the plaintiff — another factor contributing to the crisis. A solution to this problem would call for a damage cap to limit the damage juries can award. Physician organizations such as the AMA are urging states to enact laws limiting the amount of damages a jury can award. More results from the Jury Verdict Research Data showed the number of diagnosis error cases that plaintiffs won also increased. In 2000, plaintiffs won 37% of diagnosis failure cases — up from 31% in 1999. Between 1999 and 2000, median settlement figures fell 16% from $590,000 to $500,000. With no immediate long-term solution to the medical malpractice battle, physicians can be assured this headache will continue. Physician Bonuses Patients Still Trusting If you were to let your patients know that you received a bonus from an HMO as incentive for keeping healthcare costs down, do you think your patients would trust you more, or less? Possibly more. At least that’s what researchers at Wake Forest University recently found, according to a report in Reuters Health. Wake Forest University professor Mark Hall led the study, which focused on 1,918 participants in two health plans. One of the plans paid on a capitated basis, the other on a discounted fee-for-service schedule. Physicians in both plans received bonuses based on a formula that included meeting budgetary goals, maintaining patient satisfaction levels and meeting certain preventive care performance measures. Researchers questioned all the participants on trust issues and previous interactions with their doctors and HMOs. Then, participants were randomly assigned to one of two groups — either they received explicit written and verbal disclosures of their HMO’s financial incentive measures, or they received no additional information. After 1 month, researchers repeated another round of questioning patients on trust. Of the capitated plan members who received disclosures, their trust increased by 1.4% — a small increase but one that’s still statistically significant. Among the subgroup of participants who demonstrated a greater understanding of the disclosed incentives, trust rose by 3%. Tick Time Lyme Disease Vaccine off the Market Spring is here and so is tick season. Patients spend more time outdoors at this time of year, particularly in the northeastern, Mid-Atlantic and north-central areas of the country where Lyme disease is most prevalent. But as patients start to present with signs and symptoms of Lyme, you’ll be without the vaccine that may have helped prevent the disease in the first place. Poor sales made GlaxoSmithKline, the manufacturer of the only existing Lyme vaccine, which had a reported efficacy rate of 80%, pull it from the market. And with the number of cases of Lyme reported to the Center for Disease Control continuing to rise each year (17,730 cases were reported in 2000), preventative tools are very much needed. The vaccine, Lymerix, was under investigation after patients argued it made them sick and filed suits against the manufacturer and asked the government to restrict sales. The FDA investigated and found no proof of any danger. GlaxoSmithKline didn’t pull the vaccine because of any problems with the FDA, only because sales predictions were low. The company projected 10,000 doses this year — down from about 1.5 million doses in 1999, the first year it was available. Some reason for the fall in sales could be: • consumer misconception about the side effects • an efficacy rate of only 80% • the low fatality of Lyme disease • effective antibiotic treatment if caught early • the prescribed dosage must be taken three times Other Options The only prevention available now for Lyme disease is controlling tick populations, convincing patients to avoid tick-loving habitats and to use repellents. But for patients who get bitten by a tick, early detection is a must. But, although most patients believe that the “bull’s-eye” rash is the most common symptom to look for when checking for Lyme, a new report indicates that most patients actually have homogeneous lesions. The research was done by Robert P. Smith, M.D., of the Main Medical Center Research Institute in Portland and published in the March 19 issue of the Annals of Internal Medicine. They characterized early Lyme disease in 118 patients with microbiologically confirmed erythema migrans. They found that patients typically presented 3 days after symptoms started, and only 9% had the classic bull’s-eye rash, while 59% had rashes with homogeneous pattern and 32% had rashes with dense central erythema. The most common symptoms were non-specific flu-like symptoms. Be sure to educate your patients about symptoms other than the bull’s-eye rash so they know what to look for. Research Shorts Comparing Cost- Effective Psoriasis Therapies Assessing the cost of therapeutic regimens in these healthcare conscious times allows you to provide your patients with the best treatment program with regard to the its cost effectiveness. In a study published in the February issue of the Journal of the American Academy of Dermatology, researchers assessed two cost-effective strategies for treating psoriasis. One group received the treatment, methotrexate, while the second treatment group received a rotational schedule of modified cyclosporine with methotrexate. The researchers developed a computerized decision analytic model with stimulated patients with moderate to severe psoriasis. The stimulation ran in 1-year cycles throughout a 10-year period with patients randomly assigned to receive one of the two treatments. The results indicated that methotrexate cost $33,000 over a 10-year period and cleared psoriasis for 2 years. The rotational strategy of cyclosporine and methotrexate cost approximately $38,000 over the 10-year study period and had a 4-year clearance rate. While the rotational strategy cost more, it was also more effective. Researchers concluded that with the current problems of cost control, consideration of the clinical and economic consequences should be accounted for in addition to patients’ treatment needs and preferences. -- J. Am Acad. Dermatol., February 2002 Treating Lichen Sclerosus with Low-Dose UVA1 Phototherapy While numerous therapies have been used to treat lichen sclerosus, they’ve had limited success. In a recent study in the Journal of the American Academy of Dermatology, researchers treated patients with extragenital LS with low–dose UVA1 phototherapy, a treatment shown to be effective for localized scleroderma. Extragenital LS (lichen sclerosus) is a chronic and somewhat rare inflammatory skin disease that produces plaques and lesions on the skin. A clinical trial was conducted in Bochum, Germany, on 10 patients suffering from extragenital LS. Patients were treated with low-dose UVA1 phototherapy four times a week with single UVA1 doses of 20J/cm2. Within 10 weeks, 40 treatment sessions were performed for a cumulative UVA1 dose of 800 J/cm2. According to the results, a marked reduction was reported as patients demonstrated a softening and repigmentation of former affected skin. A softening of sclerotic plaques was observed after the tenth session. Researchers concluded that low-dose UVA1 phototherapy can reduce and clear extragenital LS. – J. Am Acad. Dermatol., February 2002 Melasma Treatment Effectiveness Demonstrated Following the completion of recent studies, Medicis Pharmaceutical Corp. released data on the treatment of melasma using its hydroquinone USP 4% cream, Alustra. The results showed Alustra was twice as effective as the topical tretinoin in treating patients with melasma. In a 16-week, randomized, blind study of 44 female patients, patients were randomly divided into two groups. Participants in Group A received Alustra and those in Group B received tretinoin cream. The study evaluated the efficacy and tolerance of a hydroquinone and a retinol topical product such as Alustra versus the topical tretinoin 0.05% emollient cream to treat photodamaged skin and hyperpigmentation. The patients were evaluated at 4, 8, 12 and 16 weeks — researchers looked for skin irritation, overall me-lasma severity, the appearance of fine lines and wrinkles, mottled pigmentation and tactile roughness. The study revealed the following results: • the Alustra group indicated a 74.8% reduction in the melasma area versus a 32.0% reduction seen in patients who used tretinoin • the Alustra group noted a 59.6% improvement in tactile roughness compared to tretinoin users who saw a 4.3% roughness increase at 16 weeks. The study concluded that Alustra can be used as a first- line, long-term treatment for melasma. Physician-Generated Revenue New Study Tracks the Most Profitable Doctors C ardiovascular surgeons generate the most money each year for hospitals, according to a new survey. These surgeons topped the list of physicians, generating an annual $3.1 million for their respective hospitals, reported a survey conducted by the physician search firm Merritt, Hawkins & Associates. While cardiovascular surgeons came in first, pediatricians were the lowest revenue-producing physicians at $690,104. However, the study only summarized res-ponses from CFOs at 153 hospitals — the number of hospitals that responded to the 4,000 surveys sent to hospitals around the country. Most respondents came from not-for-profit hospitals (85%) and from hospitals with less than 100 beds (47%). Also, most of these hospitals served a patient base of 50,000 people or fewer. The table above gives you a look at how other physician specialties fixed into the mix. Treating Vitiligo Tacrolimus ointment may be the answer. The recently FDA–approved topical immunomodulator, Protopic (tacrolimus ointment), has indicated a positive response in treating patients with vitiligo. In research presented at the AAD’s annual conference in New Orleans, researchers presented data showing Protopic’s effectiveness among vitiligo patients. The drug, which was approved in December 2000 to treat moderate to severe eczema, displayed varying degrees of repigmentation in patients ranging from 7 to 38 years old. Patients’ affected areas were treated with tacrolimus twice daily for 1 to 5 months. Different degrees of repigmentation were achieved in all patients. In Brief... Phase I Trial To Begin… Phase I trial has begun in Halifax, Nova Scotia for the peptide vaccine, Cytovaxine. Manufactured by Cytovax Biotechnologies, the vaccine prevents infections caused by Pseudomonas aeruginosa, a leading cause of hospital-acquired infections. Potential New Psoriasis Drug Fails in Trial… In a recent Phase II trial, results indicated the drug, Zenaphax (daclizumab) in conjunction with cyclosporine, did not prolong the recurrence of moderate to severe psoriasis. The drug, developed by Protein Design Labs did not meet its treatment goals but the company hopes to pursue other options with it. New Study Results Announced on Propecia… Recently released study results from Merck & Co. and the Live Surgery Workshop found new data on the effects of the hair restoration drug, Propecia, in a double-blind, placebo-controlled study of 66 mean. The research indicated an increase in hair mass of 34% among men after 2 years and in 4 years there was an approximate 40% hair mass increase. In a 96-week period, a 36% mean hair weight difference was noted among men taking Propecia and those taking a placebo. New Elidel Cream Effective for Eczema ... Data published in the April issue of the Journal of the American Academy of Dermatology showed the non-steroid prescription cream Elidel (pimecrolimus) Cream 1% effectively treated eczema particularly among the head and neck regions. Developed by Novartis, Elidel treats mild to moderate eczema in patients 2 years or older. In data analysis, half of Elidel-treated patients indicated their eczema to be in good or complete control versus 20% of placebo treated patients. New Technology Benefits Hair Transplant Patients… A new technology that delivers controlled local anesthesia with an ergonomically designed handpiece to patients has been found effective in a recent study at the Scholl College of Podiatric Medicine. Developed by Milestone Scientific, the CompuMed system will be installed into the surgery centers of Medical Hair Restoration (MHR) to reduce patient discomfort and pain. The study indicated 80% of patients preferred the CompuMed system compared to the traditional syringe technique. A greatly reduced level of discomfort was noted among patients.
