PHARMACY

Analysis: Canada trumps U.S. in health outcomes, but lags behind other nations

BY Michael Johnsen

OTTAWA, Canada According to the Conference Board’s annual Health report card comparing leading developed countries, released Monday, Canada outshines the United States in health outcomes, but still trails the global leaders in the overall health of its population.

Canada ranks No. 10 among the 16 comparator countries in overall health outcomes and earns a “B” grade. The United States received a “D” grade for overall health outcomes. “Canada has been at the center of much of the debate on U.S. healthcre reform. Since Canada ranks ahead of the U.S. on all but one indicator of health status—mortality rate due to cancer—it is clear that we are getting better results,” stated Gabriela Prada, director, Health Policy, Innovation and Evaluation. “But when we look beyond the narrow Canada-U.S. comparison to the rest of the world, Canadians rank in the middle of the pack in terms of their health status.”

Canada recieved “C” grades on the mortality due to diabetes, mortality due to musculoskeletal diseases and infant mortality indicators.

“Increasing levels of mortality due to diabetes should be raising alarm bells among policy-makers and the public,” Prada said. “As the population ages, the burden from chronic diseases will only grow, unless Canadians change their attitudes and behaviors. Canada has no choice but to adopt a model of health care that focuses on sound primary care practices, particularly preventing and better manage chronic diseases.”

Canada is slightly above average — ranking No. 7 — in a new indicator that measures patient safety, mortality due to medical misadventures. About 150 Canadians die each year as a result of adverse medical events. Overall, an estimated 158,000 Canadians suffer a misadventure during surgical or other medical care, and close to 60,000 of these cases are considered preventable.

Japan is the top-ranking country in terms of health care. Switzerland, Italy and Norway also earned “A” grades. Finland moved ahead of Canada in this year’s rankings due to better results on most of the mortality rate indicators.

Most top-performing countries have achieved better health outcomes through actions on the broader determinants of health — such as environmental stewardship and health promotion programs that focus on changes in lifestyle, along with education, early childhood development and income to improve health outcomes.

How Canada Performs: A Report Card on Canada is the Conference Board’s annual benchmarking analysis, which the board has conducted since 1996. The Conference Board assesses Canada’s performance against leading countries in the domains of economy, health, society, innovation, environment, and education and skills.

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Clinical trial results conclude Novartis’ MS drug yields ‘significant’ results

BY Alaric DeArment

BASEL, Switzerland Patients taking an investigational drug for multiple sclerosis experienced “significant” reductions in relapses and disability progression, according to results of a late-stage clinical trial released Wednesday.

Novartis said initial results of a phase 3 study of the oral MS drug FTY720 (fingolimod) reduced relapse rates by 54% to 60%, compared to placebo, and reduced disability progression by 30% to 32%.

The company said the reduction in relapses was greater than in patients taking interferon beta-1a, a standard of care. A biologic, interferon beta-1a is marketed in various forms under such brand names as Biogen Idec’s Avonex, Merck KGaA’s Rebif and Bayer HealthCare’s Betaseron.

“We are proud to have reached this critical milestone in the development of FTY720, a novel oral therapy that has the potential to transform the treatment of this ultimately disabling disease,” Novartis Pharma global head of development Trevor Mundel said in a statement.

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Study finds diabetes most prevalent in southern United States

BY Allison Cerra

NEW YORK Diabetes prevalence is highest in the Southern and Appalachian states, and lowest in the Midwest and the Northeast of America, a new study found.

Researchers writing in BioMed Central’s open access journal Population Health Metrics used two public data sources to investigate the prevalence of diagnosed and undiagnosed diabetes mellitus at the state level.

Goodarz Danaei, from the Harvard School of Public Health in Boston, worked with a team of researchers to combine the data from the National Health and Nutrition Examination Survey and the Behavioral Risk Factor Surveillance System.

“Diabetes mellitus is the sixth leading cause of death in the United States, accounting for approximately 70,000 annual deaths,” Danaei said. “To our knowledge, this is the first study to estimate what the true level of diabetes disease is in every state and how the different states perform in terms of diagnosed versus undiagnosed diabetes.”

Age-standardized diabetes prevalence was highest in Mississippi, West Virginia, Louisiana, Texas, South Carolina, Alabama and Georgia, ranging from 15.8% to 16.6% for men and 12.4% to 14.8% for women. The lowest prevalences were found in Vermont, Minnesota, Montana, and Colorado, just 7% for women in the Northeast and some Western states. These results currently provide the only estimates of total diabetes and undiagnosed diabetes in U.S. states.

According to Danaei, “States like Mississippi and Alabama with the highest estimated diabetes prevalence in our analysis also have the highest levels of blood pressure and cardiovascular disease risk. This concentration of cardiovascular risks and diabetes points to the need for lifestyle and health care interventions in these states.”

The researchers hope their figures will provide motivation, guidance, and benchmarks for designing, implementing, and evaluating diabetes prevention and state level control programs at the state level.

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