The Truven Health Blog

The latest healthcare topics from a trusted, proven, and unbiased source.

Testosterone Therapy Tied to Heart Attack (A Hint: It’s Not Rhinoceros Horn)

By William Marder/Thursday, February 13, 2014
Bill Marder imageOver the years, men have tried a lot of things to cope with diminished sex drive — rhinoceros horn included. While that strategy created a lot of risk for the rhinoceros, a recent study published in PLOS ONE found that our modern pharmaceutical solutions are posing significant risks to the men.

The study, by William Finkle and colleagues, examined the frequency of adverse side effects stemming from testosterone therapy. It found an increased risk of heart attack in men younger than 65 with a history of heart disease and in older men even without a history of heart disease. The study results have garnered a lot of interest and even prompted the Food and Drug Administration (FDA) to review the safety of the therapy. The results and their ripple effects are getting a lot of attention in the press and for a number of good reasons.

First, testosterone therapy has been a rapidly growing phenomenon. Some of the growth is related to our aging population, but their manufacturers have also promoted these hormone supplements as a cure for low testosterone or
“low T” (code for diminished sex drive) — and that has been controversial. Sexual references tend to generate a fair amount of press, all other things equal.

Second, any drug marketed with direct-to-consumer advertising can expect more press because it is familiar to the public and the advertising itself generates controversy. Patients are more likely to request an advertised drug from their physician and that can influence prescribing decisions.

Finally, and perhaps most importantly, this study is getting a lot of attention because it is well done. This is an observational study that examined a large population — 55,593 men. All of these men had been prescribed testosterone treatments and 48,539 of them were younger than 65 years old.

The study was executed with great care and its results reflect the power of observational studies to advance our understanding of complex events, especially those that are rare. The authors analyzed medical and drug claims from our Truven Health MarketScan® Research databases, meaning they had access to the most robust Big Data healthcare claims source in the industry. It has been referenced in hundreds of peer-reviewed studies and this one is an interesting new addition to the literature.

Superior data is a necessary condition for a quality study. It may not be as sexy as a cure for “low-T,” but it is rewarding to know that we provide a quality foundation for research that is headline-worthy.

Bill Marder
Senior Vice President, Custom Services

Slowdown in Health Spending Could be at Risk

By William Marder/Thursday, July 18, 2013
 Bill Marder imageThe Wall Street Journal article, "Slowdown in Health Spending Could be at Risk," hints at a flattening of the U.S. healthcare spending curve. Economists have long made the distinction between a one-time change in price and inflation which is an ongoing process. The classic example involves monopoly power. Breaking up a monopoly pricing scheme lowers prices to the consumer, and it happens quickly. This happened with the introduction of a generic substitute for Prozac.

As soon as generic fluoxetine was available, the price fell dramatically. While that, by itself, slowed the growth of healthcare spending, it did nothing to change the underlying trends. The situation is a lot like the hypothetical graph below. The blue line represents an interrupted but not changed underlying trend.

Slowdown in Health Spending graph image 

A number of careful analysts have highlighted one-time events that have slowed healthcare spending in the most recent periods. The underlying trends are driven by the aging population, with slowly growing incomes – that is ongoing growth in demand – coupled with limited supply of health professionals. Those underlying factors are only exacerbated by the Affordable Care Act (ACA). The ACA includes a number of potential onetime events to mitigate the underlying trends but it was designed to improve health insurance coverage and not, fundamentally, to lower healthcare costs.

William (Bill) Marder, PhD
SVP Custom Service

Supporting Reporters with Trusted Data

By William Marder/Wednesday, July 10, 2013
Bill Marder imageWorking with journalists can be fun. We recently supported Elisabeth Rosenthal, a reporter for The New York Times, on a story about the cost of childbirth (American Way of Birth, Costliest in the World, June 30, 2013).

It was fun because we had a carefully developed, detailed study for a starting point. When Elisabeth asked for more information, we did do something simple and quick that could fit into the story. Both elements, the careful study and the quick descriptive filler made a good story and a satisfying encounter.


SVP Custom Services