BOSTON (Reuters) – Three adults in the northeastern U.S. state of Maine were diagnosed on Wednesday with H1N1 swine flu and are recovering in their homes, the governor’s office said.

“It is important for the citizens of Maine to prepare for this as they would any other emergency situation,” Governor John Baldacci said in a statement.

(Reporting by Jason Szep)

APhA provides useful summary as number of cases jumps to 40.

The number of reported cases of swine influenza A (H1N1) has doubled to 40, CDC officials said during a news conference today. While more cases and involvement of more states are expected, agency personnel emphasized that these 20 new cases are the result of testing among students in a New York school who recently went to Cancun, Mexico, for spring break and not additional outbreaks of infection. APhA has compiled a useful summary of CDC announcements and clinical advice.

In response to the cases reported thus far in California, Texas, Kansas, Ohio, and New York, the CDC has mobilized 25% of its reserve of antiviral medications. A total of 11 million courses of agents for preventing and treating influenza are being shipped to those states and any others that report cases, CDC explained.

Over the weekend, CDC also issued several updates and recommendations to governmental authorities and clinicians. Patients with swine influenza are infectious from 1 day before to 7 days after onset of symptoms, CDC advised, and human-to-human transmission of the virus appears to be occurring. The possibility of swine influenza should be considered in those developing acute respiratory illness (defined as recent onset of at least two these symptoms—rhinorrhea or nasal congestion, sore throat, cough [with or without fever or feverishness]) after close contact with an identified case of swine influenza or after travel to affected areas (currently Mexico, southern California, San Antonio, Kansas, New York City) within 7 days of disease onset.

In infected patients, zanamivir (Relenza—GlaxoSmithKline) or oseltamivir (Tamiflu—Roche) can be used for 5 days of treatment. Those with suspected cases can receive either zanamivir alone or oseltamivir plus amantadine or rimantadine. Chemoprophylaxis with oseltamivir or zanamivir is recommended for health care workers with unprotected close contact with a case and several categories of patients who are at high risk of influenza complications, including close contacts and schoolmates of cases, those traveling to Mexico, and workers on the Mexican border.

CDC is recommending the usual common-sense precautions for Americans to take in stemming the transmission of this virus (cover nose and mouth with tissue during coughing and sneezing; throw tissue in trash after using; wash hands; avoid close contact with sick people; stay home when sick; and avoid touching eyes, nose, and mouth). It might be good time to skip the kiss and the handshake when greeting others, one CDC official said half-jokingly during the news conference, if people want to decrease their chances of getting swine influenza.

Reckitt Benckiser filed suit against Watson on April 20, 2009 in the U.S. District Court for the Southern District of New York seeking to prevent Watson from commercializing its products prior to expiration of U.S. patent numbers 6,372,252 and 6,955,821. Reckitt Benckiser’s suit was filed under the provisions of the Hatch Waxman Act, resulting in a stay of final FDA approval of Watson’s ANDAs for up to 30 months or until final resolution of the matter before the court, whichever occurs sooner. Based on available information, Watson believes it may be the first applicant to file an ANDA for a generic version of Mucinex DM(R) and, should its product be approved, may be entitled to 180 days of generic market exclusivity.

For the twelve-months ended December 31, 2008, Mucinex(R) and Mucinex(R) DM products had total U.S. sales of approximately $106 million and $85 million respectively, according to IMS Health data.

Freedom 55 is a thing of the past, and many Canadians aren’t banking on Freedom 65, either.

This means a shift to an older workforce, and while it is creating challenges for everyone involved the trend is also benefiting employers by staving off an anticipated shortage of skilled workers as boomers age.

“That is really going to revolutionize the workforce,” says Barbara Jaworski, CEO of the Toronto-based Workplace Institute, which provides consultation and training on mature worker issues. “The challenge for employers is to accommodate new sorts of issues that perhaps they’ve never had to deal with in the past.”

The oldest baby boomers showed little interest in leaving the workforce even before the economic crisis gutted their investments and pension plans, she says. Financial necessity has made the option to stop working even less attractive.

Still, Jaworski and other experts believe deferred retirement is more about baby boomers wanting to stay engaged.

“While the financial impact is negative, the positive side is that 60 is the new 40, or whatever number you want to pick,” says Jim Thomson, vice-president human resources operations of Ceridian, a human resources services firm. “They feel like they can add value to companies, add value to society.”

Jean Brock took early retirement from the federal government in 1995 to look after her husband while he battled cancer. After his death in 2001, she moved from southern Ontario to Ottawa to help care for her grandchildren, but Brock, now 66, says she didn’t feel like she was giving back to society, so she applied for a job in the floral department of a grocery store.

“I really enjoy people and I help a lot of older ladies like myself select flowers for different occasions, and I make floral arrangements,” she says of her new career. “It’s just great, I’d never done anything like that in my life.”

The 10 hours a week she devotes to her job – between volunteering at the Legion, ballroom dance lessons and dart games – keeps her young, she says, and despite a stroke and two heart attacks, her 74-year-old partner continues to work as a stone mason for the same reason.

“I fully intend to work until I’m 90 if I last that long,” Brock says, laughing.

The “war for talent” among companies hoping to lure or retain experienced older workers will be waged not with higher salaries, Thomson says, but with fringe benefits like flexible scheduling and time off.

Experts agree flexibility will be the biggest demand of boomers staying on the job, whether it means telecommuting from the cottage or vacation property, working mornings only, flex-hours or a few months at a time as consultants.

“There’s a lot of tailoring you want to do to keep people engaged and productive,” says Lynn Palmer, CEO of the Canadian Council of Human Resources Associations.

That will require some pragmatic changes, she says, such as discarding the usual Monday morning meeting for a time when everyone is in the office and using technology to connect workers via teleconferencing and video.

HSBC Bank Canada got a “wake-up call” in 2005 when they realized 72 per cent of their senior managers would be eligible for retirement within a decade, says Pat Brosseau, vice-president human resources. In an effort to retain some of them, the company introduce a phased retirement program that lets experienced workers pass along their knowledge to younger successors, she says, as well as a roster of “returning retirees” who are hired for special projects.

“Most of the people we interviewed were interested in continuing to work or coming back to work after retirement, so the notion that at 55 they’d pack up their desk and start golfing really wasn’t there anymore,” Brosseau says.

But an older workforce could mean more health problems and higher benefit costs, says Jaworski, and employers may be compelled to confront the “very delicate” issue of dementia on the job. She recently worked with a company facing that situation with an employee who thought he was coming to work when he wasn’t, she says. The human resources manager ended up acting as “a bit of a social worker” because the man had no close family to help.

“Ideally, what you want is someone who’s got enough money to retire but wants to continue to work for you,” Jaworski says. “You don’t want an individual that just can’t afford to retire but can no longer do the job. That’s not going to be pretty.”

More people working later in life will also mean managing a workforce with an age gap of 40 years or more between the youngest employee and the oldest, says Palmer.

Boomers who are accustomed to working long hours may look askance at younger colleagues who dart out the door at 5 p.m. to play sports or otherwise guard their work-life balance, she says, but Thomson at Ceridian believes the older cohort will have more in common with their Millennial coworkers as time goes on.

“They’ve worked very hard for a long time and now it’s time to enjoy life,” he says.

MADRID – Young people largely drove the early stages of Internet growth but in recent years the sharpest rise in Web use in developed nations has been amongst people aged 70 and over, experts said Monday.

“Older adults are the fastest growing demographic on the Internet,” said Professor Vicki Hanson of the School of Computing at Scotland’s University of Dundee on the opening day of a global World Wide Web conference in Madrid.

While just over one-fourth, or 26 per cent, of 70-75 year olds went online in the United States in 2005, the proportion was 45 per cent last year, according to data from the Pew Internet & American Life Project, she said.

The percentage of those aged 76 years and over who surf the Web rose during the same period from 17 per cent to 27 per cent.

Britain has experienced similar sharp gains in Internet use by people in this age group, said Andrew Arch of the World Wide Web Consortium (W3C), the main international standards organization for the Web.

“They are basically doing the same things as everyone else. Using the Web for communication, then quickly moving to other activities like information seeking, online banking, shopping,” said Arch who works to boost Web accessibility for older and disabled users.

Sending and receiving e-mail is the most popular online activity for Internet users age 64 and older, according to the Pew study.

But older Internet users are less likely than younger Web surfers to do online banking and shopping — and far less likely to use social networking sites, it found.

“They are not on Twitter,” said Hanson, referring to the microblogging Web site whose popularity got a huge boost last week as U.S. talk show diva Oprah Winfrey became the latest big name celebrity to join the craze.

With the percentage of the population aged 60 and over expected to reach 20 per cent by 2050, experts said the numbers of older Web browsers is set to continue to rise.

And with many countries increasing the retirement age, being able to use the Web will become a requirement for an increasing number of older workers.

But the physical problems that come with old age still act as a barrier to getting online. Poor vision can make reading text on the screen a challenge. Arthritis and motor control problems can make manoeuvring a mouse difficult.

Web sites can make it easier for older surfers by using larger fonts, higher contrast and extra spaces at the end of sentences, said Arch.

“The typical web developer does not really understand that the world is aging the way it is,” he said, adding the changes he is suggesting would make it easier for people of all ages to use the Internet.

“It is like footpaths. They were initially set up for the disabled but then everyone found them very useful,” he said.

The number of people going online has surpassed one billion for the first time, according to online metrics company comScore.

It counts only unique users above the age of 15 and excludes access in Internet cafes and through mobile phones.

“Over the last 20 years, drugs have consistently remained one of the major cost drivers in health care,” says Michael Hunt, Manager of Pharmaceutical Programs at CIHI. “Spending on pharmaceuticals has more than doubled over the past 10 years, outpacing growth in health spending by hospitals, physicians and other health professionals.” 

Spending on prescribed drugs growing faster in the private sector 

For the third consecutive year, private-sector spending on prescribed drugs grew at a faster rate than that in the public sector. Private-sector prescribed drug expenditure reached $12.6 billion in 2007, and is forecast to have reached $14.0 billion in 2008, representing annual growth rates of 11.4% and 11.0%, respectively. Public-sector expenditure on prescribed drugs reached $10.5 billion in 2007, and is forecast to have hit $11.2 billion in 2008, representing annual growth rates of 7.6% and 6.7%, respectively. 

The public-private split for total prescribed drug spending remained relatively stable over the past 20 years, with approximately 45% financed by the public sector and 55% financed by the private sector. However, among private-sector spending on prescribed drugs, the share of spending shifted from out-of-pocket spending to private insurers. Spending by private insurers is estimated to have accounted for 67% of private-sector drug spending in 2008, compared to 55% in 1989. 

“The economic downturn is resulting in many Canadians losing their jobs. Since many Canadians have private health insurance through their employment it may also mean a loss of private health insurance,” says Hunt. “In light of this situation, it will be important to document what the impact will be on both the public sector as well as out-of-pocket drug spending over the next few years.” 

Variation among provinces on prescribed drug spending 

Prescribed drug expenditure per person varies across Canada. In 2008, prescribed drug spending per person is estimated to have ranged from $651 in Alberta and $652 in British Columbia to $841 in Quebec and $865 in Nova Scotia. 

There is also variation among the provinces in terms of the source of funding for drugs. On average across Canada in 2008, 44% of total spending on prescribed drugs was publicly financed. The proportion of public spending on prescribed drugs ranged from 32% in New Brunswick and 34% in Prince Edward Island to 50% in Quebec and 54% in Saskatchewan. Public-sector spending per person on prescribed drugs ranged from $236 in B.C. and $253 in P.E.I. to $377 in Saskatchewan and $420 in Quebec. 

International comparison in drug spending 

When comparing 23 countries in the Organisation for Economic Co-operation and Development (OECD) with similar health-reporting systems as Canada’s in 2006 (latest available information), Canada had the second-highest level of total per capita drug spending (including prescribed and non-prescribed drugs). The United States had the highest level of 2006 per capita spending ($1,015) followed by Canada ($770) and Belgium ($703)-the position of Canada has been stable over the past few years. 

In 2006, Canada was below the OECD median in terms of what proportion of total drug spending was publicly financed. The public share of total drug spending in Canada was 39%, compared to the OECD median of 59%. Among the 23 OECD comparator countries, the share of total drug spending funded by the public sector ranged from 15% in Mexico to 84% in Luxembourg. 

Source
Angela Allain-LeVasseur
Administrative Assistant, Communications
CIHI, Ottawa
Canada

Prescription drug advertisements “have surged” since 1997 when FDA relaxed restrictions on direct-to-consumer drug advertising, according to the Journal. Spending on such ads reached a high of $4.8 billion in 2007, compared with less than $1 billion in 1997, according to IMS data. 

The reduction in advertising spending can be attributed to fewer new drugs and heightened congressional scrutiny of drug marketing practices, experts said. For example, Merck and Schering-Plough, which jointly market the cholesterol drug Vytorin, reduced their overall consumer ad spending in 2008 to $47 million from $114 million following criticism from Reps. John Dingell (D-Mich.) and Bart Stupak (D-Mich.) over ads for Vytorin that ran while the companies delayedunfavorable study results, the Journal reports. 

According to IMS, which consults for drugmakers and investors, pharmaceutical companies went too far on print and TV advertising spending reductions. IMS researcher John Busbice said, “They should optimally be pushing back up again” (Winstein/Vranica, Wall Street Journal, 4/16). 

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery athttp://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation. 

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