The slowdown in elective procedures and reduced demand for costly drugs

Updated May 7, 2013- The demand for prescription drugs and medical devices is continuing to slow down, as new forms of employer-provided health insurance require greater out-of-pocket expenses for costly drugs or procedures. After the first quarter of earnings, almost all drug companies reported slower than expected sales. The Healthcare Channel was the first to bring up this issue back in 2010.

October 29, 2010

In Part 5 of the Weekly Summary show, Frank Eismont, MD, Chairman of The Department of Orthopaedics at The University of Miami Miller School of Medicine, leads the roundtable discussion on the slowdown in elective procedures such as orthopedic implants and spine fusion caused by the high unemployment and fewer insured. The same factors are also causing reductions in what would seem to be non-elective therapies, such as branded diabetes drugs and coronary stenting.

William O’Neill, MD: The CoreValve trials and AGA medical

October 29, 2010

In Part 3 of the Weekly Summary show, William O’Neill, Executive Dean for Clinical Affairs and cardiologist, University of Miami Health System, leads the discussion about the FDA approval for Medtronic to begin clinical trials of its CoreValve TAVI. The AGA medical products to close PFO and left atrial appendage are also overviewed.

Mark G. McKenney, M.D.: Advances in trauma care

Tremendous advances have been made over the last two decades in the way that trauma patients are handled in the OR and ICU. The ongoing wars have contributed much. Survival rates in the theater are now approaching 90%, compared to 70% decades ago. Mark G. McKenney, M.D., Chief of Trauma at the University of Miami and Co-Director of the Ryder Trauma Center discusses some of the most important developments in sepsis care, artery embolization, fluid resuscitation, and medical imaging using portable ultrasound.

Steven E. Lipshultz, M.D.: Treating pediatric obesity

Produced and interviewed by Steven Greer, MD

Steven E. Lipshultz, M.D.: Professor and Chairman of Pediatrics, University of Miami Miller School of Medicine, Chief of Staff, Holtz Children’s Hospital, discusses therapies for pediatric obesity, including bariatric surgery, diet and exercise, cholesterol lowering agents such as statins, and other topics.

Thomas Brott, MD: Review of the CREST trial of carotid stenting

The CREST trial, published earlier this year, was the latest large-scale, randomized, controlled trial to test the safety and efficacy of carotid artery stenting versus standard open CEA surgery. Divisions of the HHS and medical societies might next make changes to reimbursement and clinical guidelines based on the trial. The PI and lead author, Thomas Brott of the Mayo Clinic in Florida, discussed the paper. Topics discussed include:

• The results which met the primary endpoint: a composite of death, stroke, or MI
• Were the periprocedural minor strokes caused by the stents releasing debris
• Were the greater number of myocardial infractions seen in the CEA surgery group significant Q-wave MI’s or just enzyme bumps?
• The other carotid stenting trial from the ICSS group that showed in a subset of patients MRI evidence of stroke more often with the stent group than CEA

Stacy Ardoin, MD, Carlos Lozada, MD: Benlysta (belimumab) for lupus

Lupus has been a challenging disease with little clinical progress for decades. This may change soon if a new drug branded as Benlysta (belimumab) is approved. The series of BLISS trials met the primary endpoints. CurrentMedicine.TV moderated a roundtable discussion with two lupus experts, Carlos Lozada and Stacy Ardoin, to discuss the strengths and limitations of the trials, and whether safety concerns might arise.

New Therapies to treat acute spinal cord injury

Interviewed by Steven Greer, MD

W. Dalton Dietrich, Ph.D., Scientific Director of the Miami Project to Cure Paralysis discusses two therapies to treat acute spinal cord injury (SCI). First, he discusses the trial recently allowed to proceed by the FDA, funded by company Geron, to use stem cells to treat SCI. It will be the first human trial of its kind in the U.S. In the second part of the interview, he discusses the pioneering work from Miami that uses hypothermia to treat acute SCI.

William O’Neill, MD: Minimally invasive replacement of the aortic valve

William O’Neill, MD, interventional cardiologist and investigator for the PARTNER trial, just released online in the New England Journal of Medicine, discusses this landmark trial investigating vascular routes for replacing worn out aortic valves. Current methods require chest splitting open-heart surgery. As this trans-catheter aortic vascular implantation (TAVI) evolves and the devices get smaller and better, traditional surgery may become less necessary. However, significant safety hurdles must be overcome before that is a reality.

Kottil Rammohan, MD: The new MS drug Gilenya (fingolimod)

Interviewed by Steven Greer, MD

Kottil Rammohan, MD, Director of the Multiple Sclerosis Division of Neurology at the University of Miami Miller School of Medicine, discusses the newly approved drug for first-line therapy of MS branded as Gilenya (fingolimod). He addresses the efficacy of the drug and whether the cost of more than $40,000 per year will limit the usage to second-line therapy.

Richard Isaacson, MD: Surrogate markers for Alzheimer’s

August 29, 2010

Since the ICAD meeting in July, the topic of surrogate markers to diagnose Alzheimer’s in younger patients decades before noticeable onset of dementia has received considerable mainstream press. We interviewed Alzheimer specialist Richard Isaacson of Miami about how these new markers will change current therapy or speed drug development.