Healthcare Innovations

Burning to Innovate

Boston Globe: 16 area scientists awarded NIH grants for innovative study. 2007-Sep-19, by Elizabeth Cooney

Jeremy M. Berg, director of the National Institute of General Medical Sciences, runs two grant programs under an NIH initiative intended to support bold and unconventional research that could have a big payoff but also has a higher than usual risk of failure and is therefore less likely to receive approval through the traditional grant process.

While the Pioneer awards go to researchers at any point in their careers, the New Innovator awards are limited to scientists who are within 10 years of finishing their doctoral degrees or clinical training and who have not yet won NIH grants for their independent research.

Younger scientists have been waiting longer to get their first grants, from an average age of mid-30s about 10 years ago to their 40s in recent years, a sign of increased competition for government funding for science that has been declining in real dollars. The NIH budget doubled from 1998 to 2003 but has been flat since.

The New Innovator competition drew 2,200 applications, Berg said, compared with 450 for the Pioneer awards.

"We expected there would be a strong response, but not this strong," he said, adding that the number of applicants demonstrates the need for a program that supports riskier work.

Good Hospital Data Hasn't Arrived

Ivanhoe's Medical Breakthroughs: Can You Believe Hospital Comparison Web sites?. 2007-Sep-19 (original source: Archives of Surgery, 2007; 142:863-869)

Can you really believe what you read on those hospital comparison Web sites? Not completely, report University of California, Los Angeles researchers who analyzed information available on six leading sites -- one run by the government, two by non-profit groups, and three by proprietary companies. Their results suggest these sites display inconsistent findings and often use inappropriate or incomplete standards to measure hospital quality.

Healthcare Access Key to Stopping Cancer

MediaPost Publications - Cancer Society Launches Largest Single-Issue Ad Campaign - 09/19/2007. by Karl Greenberg

Amercian Cancer Society's message: Health care must be a priority in the next election because lack of--and inadequate--health coverage for Americans is the second-biggest hurdle (after tobacco use) to improving cancer statistics in the U.S.

The effort, which includes TV ads on cable and network TV, print ads in a range of consumer publications, the organization's largest-ever Internet campaign, argues that quality, affordable health care for all Americans is a prerequisite for lowering cancer mortality. [emphasis added]

Prizes for Ideas for Cures

WSJ: Will Sharing Ideas Advance Cancer Research?. 2007-Sep-18, by Amy Dockser Marcus (paid subscription required)

Avichai Kremer, a 32-year-old who has ALS, the neurodegenerative illness also known as Lou Gehrig's disease, is co-founder of the Prize4Life, which is awarding a $1 million prize for ALS biomarker discovery. The National Institutes of Health announced this year a program called the New Innovator Award offering grants of up to $1.5 million over five years for innovative research projects that don't have extensive preliminary data.

In addition, the National Cancer Institute is helping companies find a way to collaborate in drug testing without worrying about intellectual-property issues. The medical journal the Oncologist is encouraging the publication of failed medical trials in order to bring the ideas behind these trials -- which otherwise would never see the light of day -- to a broader audience. And Mr. Goldstein's father, Alfred, with help from the family's other son, Mark, also developed a venture that aims to improve idea-sharing: Through "Project Hope," named for his late wife, Alfred Goldstein guarantees certain funding for specific projects and requires the researchers share results with each other on a regular basis.

The Gotham Prize is a particularly ambitious project that is attracting attention. The foundation of the Ira Sohn Investment Research Conference, which runs the conference as a benefit to raise money for cancer, will fund an additional $250,000 prize for the best pediatric-cancer idea submitted to the Gotham site. Ephraim Gildor, founder of Axiom Investment Advisors, is also providing financial support for the prize.

More Drug Usage, More Dangers

The FDA is tap dancing furiously over this. They say it could be caused by a lot of things other than inadequate oversight on their part.

Archives of Internal Medicine: Serious Adverse Drug Events Reported to the Food and Drug Administration, 1998-2005, 2007-Sep-10, by Thomas J. Moore, AB; Michael R. Cohen, RPh, MS, ScD; Curt D. Furberg, MD, PhD (via USA Today)

From 1998 through 2005, reported serious adverse drug events increased 2.6-fold from 34,966 to 89,842, and fatal adverse drug events increased 2.7-fold from 5,519 to 15,107. Reported serious events increased 4 times faster than the total number of outpatient prescriptions during the period. In a subset of drugs with 500 or more cases reported in any year, drugs related to safety withdrawals accounted for 26% of reported events in that group in 1999, declining to less than 1% in 2005. For 13 new biotechnology products, reported serious events grew 15.8-fold, from 580 reported in 1998 to 9181 in 2005. The increase was influenced by relatively few drugs: 298 of the 1489 drugs identified (20%) accounted for 407 394 of the 467 809 events (87%).

Systemic Research Problems

Even if a drug does well on its Phase II trials, we may have little hope it will get a shot at Phase III (large scale, double-blind). Some researchers say the amount of work at the Phase II is 'inflated' and should be scaled back so more 'Phase III' will be funded. But why can't we get more Phase III funded? Insufficient money to risk?

HealthDay: Study Questions Dead-End Cancer Clinical Trials. 2007-Sep-10, E. J. Mundell

Dr. Bruce Hillner, a professor of medicine at Virginia Commonwealth University, has researched the issue on a global scale. In a study published in 2003 in the Journal of Clinical Oncology, Hillner found that phase II trials are much more common in the United States than Europe, where more resources are poured into practice-changing phase III trials. "One of the pressures may be the 'publish-or-perish' that's disproportionately felt by American junior faculty," he said. "The other is the depth of financial entanglements with the pharmaceutical industry." In some cases, Hillner said, drug companies use promising results from small phase II trials to encourage doctors to use an already FDA-approved drug 'off-label' for another purpose. In this way, he said, the company boosts drug sales while sparing itself the expense of the multimillion-dollar phase III trial that's required for new agency approvals. Hillner also believes that, in many cases, phase II trials simply aren't presented well enough to garner the wider interest that's needed to take them to the next level.

Bridges to Excellence expands national presence

Link: COLLOQUY: Covering the world of loyalty marketing, reward programs and customer retention, 2007-Aug-22

Bridges to Excellence (BTE), the nation’s largest effort to reward physicians for delivering high- quality care, has reached a milestone with more than 100 employers and all national health plans working together throughout most of the East Coast to transform the way health care is delivered. There are a total of 19 regional areas, the majority along the East Coast but also including California, Minnesota, Ohio, Kentucky, Colorado and Arkansas. For consumers, the number of patients benefiting from improved and more cost-effective care as a result of seeing recognized physicians is more than 5 million.