When marketing trumps medicine: MedCity Morning Read, Feb. 15, 2010

The runaway popularity of robotic prostate surgery is a case study in the triumph of marketing over medicine, and for that reason, it could be a glimpse into the future.

Highlights of the important and the interesting from the world of health care:

When marketing trumps medicine: The runaway  popularity of robotic prostate surgery is a case study in the triumph of marketing over medicine, and for that reason, it could be a glimpse into the future, according to a report in the New York Times. Last year, an overwhelming 86 percent of the 85,000 U.S. men who had prostate surgery chose robot-assisted procedures despite scant evidence that those operations have proven to be safer or produce better long-term outcomes than traditional prostate surgeries. Oh yeah, robot-assisted prostate surgeries cost $1,500 to $2,000 more per patient than traditional variety, which involve surgeons making small incisions in the abdomen and inserting tools with their own hands to slice out the organ.

Few procedures have skyrocketed in popularity as much recently, with robot-assisted prostate operations surging from an 5,000 a mere eight years to 85,000 last year. And it’s questionable whether the additional millions in spending helped patients at all:

Medical researchers say the robot situation is emblematic of a more general issue. New technology has sometimes led to big advances, which can justify extra costs. But often, technology spreads long before investigators know whether it is worthwhile.

Recession brings good times for insurers: The Great Recession has injured tens of millions of Americans financially and will continue to plague millions more. The nation’s five-largest health insurers … not so much. Last year, those five companies racked up combined profits of $12.2 billion–up 56 percent over 2008, according to a new report by a liberal health care group. It seems 2009 was a year of “addition by subtraction” for insurers WellPoint Inc., UnitedHealth Group, Cigna Corp., Aetna Inc. and Humana Inc., since they covered 2.7 million fewer people than they did the year before.

“It is disingenuous to look at the profits at one company today compared to where it was in the depth of a recession,” said Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, the industry’s Washington-based lobbying arm. One could argue that it was disingenuous for Mr. Zirkelback to try to dismiss and minimize the report by portraying it as having focused on one company when in reality it was five companies, but that’s another story. It’s these types of numbers that President Obama could publicly emphasize to more strongly make his case for health overhaul, yet the president has too-rarely chosen to be confrontational with this fairly publicly unpopular segment of American industry.

What’s next for PhRMA? After the resignation of PhRMA leader Billy Tauzin, speculation abounds on what’ll come next for the trade group that represents America’s largest pharmaceutical companies. Will PhRMA be more or less supportive of federal health overhaul efforts, or does it even matter? It’s hard to say whether Tauzin’s perceived cozy relationship with the White House helped grease his exit. NPR reports that Tauzin lost support from some Pharma companies after his notorious $80 billion deal to cut drug costs went up in smoke after Scott Brown’s election in Massachusetts.

However, Politico reports that recently Tauzin had fallen out of favor so much that CEOs from the companies his organization represents jumped over his head to negotiate with Congress. In any case, the abrupt nature of Tauzin’s resignation and his lack of clear subsequent plans suggest he was pushed out. What that means for the tenuous health overhaul process is an issue to follow.

Texas nurse update: A Texas nurse whose whistleblower case attracted national attention has been acquitted. In this case, the American system of justice worked. As was widely reported, the nurse was simply fulfilling professional obligations by reporting to authorities a doctor whose care routinely fell below adequate standards. And for doing the right thing, she was charged with a felony. Thankfully, it took a jury less than an hour to acquit her.

“If anything was to be gained from the absurdity of this criminal trial, it is the reaffirmation that a nurse’s duty to advocate for the health and safety of patients supersedes all else,”  said the Texas Nurses Association’s president.

Photo courtesy of the U.S. Army.