Today’s Top Story
Landscape may be shifting on off-label promotion.
An article in The Washington Post outlines efforts to lift restrictions on off-label marketing of pharmaceuticals. The writer notes that the state of Arizona recently enacted a law allowing manufacturers to share with providers certain information regarding off-label uses of drugs and medical devices, and in two recent court cases, federal district courts ruled that the First Amendment does not allow the U.S. Food and Drug Administration (FDA) to prevent manufacturers from providing truthful information about their products to physicians. A libertarian think tank that devised the Arizona legislation is currently promoting similar laws in other states. In addition, the current FDA commissioner has previously advocated loosening restrictions on off-label promotion. Read more…
     An article in the October issue of AAOS Now looks at some of the issues surrounding physician-directed (off-label) use. Read more…

Other News

Providers offer strategies for success in BPCI.
An article in Modern Healthcare looks at the Medicare Bundled Payments for Care Improvement (BPCI) program. The writer profiles several organizations that have received payment bonuses under BPCI and offers several strategies for participants, including:

  • Obtaining strong involvement from physician leaders
  • Identifying utilization and cost issues
  • Gain-sharing agreements and negotiation
  • Patient education
  • Potential involvement of nurse navigators

Read more…(registration may be required)

Study: APS may reduce pain and improve function in patients affected by knee OA.
Findings from a study published online in The American Journal of Sports Medicine suggest that a single injection of autologous protein solution (APS) may help reduce pain for patients with knee osteoarthritis (OA). The authors conducted a randomized controlled trial of 46 patients with unilateral knee OA, of whom 31 were treated with APS and 15 were treated with a single saline injection. At 1-year follow-up, they found that improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score was 65 percent in the APS cohort and 41 percent in the saline group. Compared with the saline cohort, the APS cohort also displayed improvement in Short Form-36 Bodily Pain and Role Emotional Health subscales as well as Clinical Global Impression of Change values. Read the abstract…

Study: What factors affect biomechanical properties of allograft tissue for ACL reconstruction?
A study published online in the journal Clinical Orthopaedics and Related Research examines factors that may influence the biomechanical properties of allograft tissue for anterior cruciate ligament (ACL) reconstruction. The researchers conducted a systematic review of 48 studies and identified graft tissue type, sterilization methods (irradiation and chemical processing), graft preparation, donor parameters, and biologic adjuncts as the primary factors. The findings suggest that for better load to failure and graft stiffness values, surgeons should prefer the use of central-third patellar tendon or looped soft-tissue grafts, maximize graft cross-sectional area, and prefer grafts from donors aged younger than 40 years, while avoiding grafts subjected to radiation doses of greater than 20 kGy, chemical processing, or more than eight freeze-thaw cycles. Read the abstract…

Study: Ibuprofen may be preferential first-line option for pediatric patients after minor orthopaedic surgery.
Data from a study published in the October issue of Canadian Medical Association Journal suggest that ibuprofen may be preferred to morphine for pain relief in pediatric patients who have undergone minor outpatient orthopaedic surgery. The authors conducted a randomized controlled trial of 132 children aged 5 to 17 years, of whom 65 received morphine and 67 received ibuprofen. They found no significant difference in pain score across cohorts. However, they noted adverse events in 45 (69 percent) of patients given morphine and 26 (39 percent) of patients given ibuprofen. Read more…
Read the abstract…

CMS to host webcast on 2016 Annual QRURs.
The U.S. Centers for Medicare & Medicaid Services (CMS) will host a webcast on Oct. 19 to provide an overview of the 2016 Annual Quality and Resource Use Reports (QRURs) and explain how to interpret and use the information. Other topics include an overview of the 2018 Value Modifier, how to access the 2016 Annual QRUR, and how to request an informal review of one’s 2018 Value Modifier. Register for the webcast…
Learn more about obtaining a QRUR…

Call for volunteers: Council on Research and Quality.
Oct. 20, 2017, is the last day to submit applications for a position on the Council on Research and Quality (one opening—Communications Cabinet liaison). The liaison is responsible for representing the Council on Research and Quality’s issues and concerns to the Communications Cabinet. Applicants for this position must be active fellows with interest in member communications, public relations, and issues related to research and quality. Learn more and submit your application…(member login required)