In the news:

A new study in the New England Journal of Medicine shows that the prescription drug benefit passed in 2003 (Medicare Part D) resulted in higher overall health care costs for most enrollees. However, it did lower costs for those who previously had limited coverage.

The study compared those who previously had no prescription drug coverage and those that had $150 and $350 quarterly caps on their private plans to those who had no cap on coverage, both before and after passage of the new benefit. From the study:

After 2 years of Part D, enrollees in the no-coverage group had increased their monthly drug spending by $41, as compared with that in the no-cap group, but that was roughly offset by a decrease of $33 in their monthly medical spending, perhaps because increased use of medication led to improved control of chronic illnesses. Similarly, the group with a previous $150 quarterly cap on drug spending increased their drug spending by $27, which was offset by a decrease of $46 in their medical spending. The group with a previous $350 quarterly cap spent $13 more on drugs and $30 more on other medical services.

President Obama's willingness to entertain an individual mandate and tax health benefits represents a shift from stances taken during the campaign, a Wall Street Journal story points out . . . . Pfizer's anti-smoking drug Chantix will get a black box warning after the Food and Drug Administration warned smokers of mental illness and suicidality side effects. GlaxoSmithKline's Zyban, which is also sold as Wellbutrin for depression, will get a similar warning, the New York Times reports . . . . Roche announces it will sell its anti-flu drug Tamiflu at about a one-third discount in the developing world. About 70 countries are eligible, excluding India which makes a generic version of the drug. . . . 

New York Times op-ed writer Rosanne Leipzig of the Mt. Sinai School of Medicine in New York offers a heartfelt plea for better geriatric medicine . . . . 

Do Third World countries have something to teach us about health care? This story in the Wall Street Journal looks at how an AIDS clinic in Alabama adopted lessons learned at one in Zambia to improve patient outcomes. It also features a low-cost technology for giving blood tests that is slightly less accurate than the standard test used in the U.S., which raises the important question of cost-effectiveness. Would the U.S. ever accept technologies that help more people at lower cost if the side effect is some people getting less than optimal care? "In the developing world, people are willing to make the tradeoff in accuracy for simplicity and low cost," the technology's developer tells the paper. "In the U.S., that kind of trade-off is a hard sell."

An Associated Press story in the Washington Post's online edition reports on a new study from the Trust for America's Health that shows obesity rates rose in 23 states last year and fell in none. . . .