September 5
IN THIS ISSUE / September 5, 2018
- CMS values virtual appointments
- AMA House of Delegates votes on critical health policy resolutions
- High drug costs send patients seeking foreign medications
- FDA approves tretinoin lotion for acne
- Brief dermatologist intervention increases sunscreen use, patient satisfaction
CMS values virtual appointments
While dermatologists have long been among the physician leaders in adopting telemedicine technology to meet patient care demands, payment has been a lot slower to catch up. CMS made a major move to address that gap in the proposed 2019 Medicare Physician Fee Schedule.
Related Links:
- Making teledermatology work – Dermatology World (August 2017)
- AADA web: Teledermatology Toolkit
- Steps to teledermatology – Dermatology World (April 2015)
- Volunteer: Join AccessDerm
- Slow progress on teledermatology reimbursement could accelerate – Dermatology World (April 2015)
- AADA Position Statement on Teledermatology
AMA House of Delegates votes on critical health policy resolutions
By Cyndi Yag-Howard, MD
The American Medical Association (AMA) held its Annual Meeting of the House of Delegates (HOD) June 9-13, 2018, in Chicago. During the meeting, the Dermatology Section Council (DSC) contributed to policy discussions and voted on numerous critical health policy and AMA governance matters, many of which are relevant to dermatology.
This year, the DSC authored two resolutions and co-authored a third resolution. All of these resolutions were adopted, referred for study, or reaffirmed by the HOD. Learn more about the resolutions below.
Private equity firms: The DSC introduced a resolution that called on the AMA to study the positive and negative effects of private equity firms acquiring physician practices. The House of Medicine voted to expand the resolution to include corporate ownership of physician practices beyond venture capital/private equity firms. The AMA will present the report in June 2019.
Vector-borne diseases: The second resolution called on the AMA to 1) study the emerging epidemic of vector-borne diseases, including an analysis of currently available testing and treatment standards and their effectiveness; 2) issue a white paper on vector-borne diseases to increase awareness of the epidemic; and 3) advocate for local, state, and national research, education, reporting, and tracking on vector-borne diseases. The HOD adopted the policy that the AMA begin immediately advocating to local, state, and national authorities on the issue. However, the study and white paper were referred to the Board of Trustees in order to give the AMA more time to collect data on the issue and report back to the HOD.
Handling of hazardous drugs: The DSC cosponsored a resolution that calls on the AMA to work with United States Pharmacopeia (USP) to revisit the requirements in General Chapter <800> of the USP Compounding Compendium and review Chapters <795> and <797> to ensure that the requirements are not onerous to physicians and prohibitive to their ability to provide medications to patients. The resolution was reaffirmed, which means that the sunset clock for this policy will be reset, and the AMA will continue to advocate on this issue.
Representation in the House of Medicine
Last year, the AMA passed a resolution requiring the same number of physicians representing the states as there are physicians representing the specialties so that neither interest outweighs the other. Each member can either represent their state or their specialty, but not both.
Unfortunately, this change meant that the AAD lost one delegate and one alternate delegate for 2018. Starting in June 2018, the AAD was able to increase its membership numbers in order to have a chance at regaining the fourth delegate for 2019. As the final delegate allocation is calculated based on year-end membership numbers, we ask for your continued support in promoting AMA membership.
Help the AAD keep dermatology’s voice strong by joining the AMA at www.ama-assn.org/membership.
Related Links:
- Pulling back the curtain on private equity – Dermatology World (January 2018)
- Exploring dermatology’s role in identifying and treating public health trends – Dermatology World (July 2018)
- For your patients: Signs of Lyme disease that appear on your skin
High drug costs send patients seeking foreign medications
As drug prices soar and medication costs become unsustainable, some are crossing borders or traveling abroad to obtain more affordable drugs, reports the Philadelphia Inquirer. One man makes a six-hour journey to Canada every three months to obtain tofacitinib for his teenage son who has alopecia areata. The drug would cost the family about $50,000 a year in the U.S. because it isn’t covered by their insurance plan. In Canada, a year’s supply costs $15,000. The U.S has the highest drug prices among all the developed countries. In fact, drugs cost an average of 56% less in other high-income countries, according to an IHS Markit report.
A 2016 poll found that 19 million adults, or 8% of the U.S. population, imported medication from Canada or other countries. The U.S. Food and Drug Administration (FDA) prohibits importing prescription medication as it can’t vouch for the safety or efficacy of foreign medications. If the agency intercepts packages from foreign pharmacies, it will return or destroy them.
Learn more about what’s happening with drug prices and what’s being done to bring costs down in Dermatology World.
Related Links:
- The price (is not) right – Dermatology World (September 2017)
- What’s happening with drug shortages and what’s being done to resolve the issue? – Dermatology World (September 2018)
FDA approves tretinoin lotion for acne
The U.S. Food and Drug Administration (FDA) has approved once-daily tretinoin 0.05% lotion (Altreno™) by Ortho Dermatologics for the treatment of acne vulgaris in patients nine years and older. In clinical trials, the tretinoin lotion resulted in significant reductions in both inflammatory and noninflammatory lesions compared to the vehicle. Patient satisfaction and quality-of-life assessment were also higher with patients using the tretinoin lotion. Nearly all patients (90%) were satisfied with the treatment, and this satisfaction rate rose by 53% by week 12 of treatment. The company expects the lotion to be available later this year.
Learn more about acne as experts address isotretinoin and pregnancy, and other hot topics in Dermatology World.
Related Links:
- Overusing acne antibiotics? – Dermatology World (August 2015)
- AADA web: Acne clinical guideline
- What do you ask your acne patients at follow-up visits? – Dermatology World (November 2017)
- For your patients: All about acne
Brief dermatologist intervention increases sunscreen use, patient satisfaction
In a recent JAMA Dermatology study, the authors evaluated the effects of a standardized sun protection intervention delivered by a dermatologist versus the usual standard of care. The dermatologists attended a one-hour training session on how to perform the brief intervention using the Addressing Behavior Change (ABC) technique, which consisted of assessing an individual’s risk of sun exposure, willingness to use sunscreen, barriers to using sunscreen, and offering additional options for sun protection. The ABC intervention took less than three minutes and was delivered during a routine skin exam.
The intervention and control groups were questioned on sunscreen use, rate of sunburns, and satisfaction of their interaction with the dermatologist at three- and six-month follow-up intervals. While both groups had relatively high scores, those who received the ABC intervention had higher satisfaction with their communication with their dermatologist and also reported a 12% to 15% increase in use of sunscreen and 50% fewer sunburns at the one-month follow-up.
The Academy has many resources you can recommend to your patients to help educate them about being sun safe, including PSAs, quizzes, stories of skin cancer survivors, handouts and infographics, and more!
Related Links:
- Do European sunscreens outperform those in the U.S.? – Dermatology World (October 2017)
- Profiling sunscreen ingredients not approved for use in the U.S. – Dermatology World (May 2016)
- AAD infographic: What’s the difference between physical and chemical sunscreens?
- For your patients: Is sunscreen safe?
