Today's News and Commentary

About pharma

Gottlieb Says User Fees Will Pay for Post-Market Surveillance Amid Shutdown: As previously mentioned, the budget impasse has affected FDA activities. One activity not mentioned is the so-called Phase IV studies, i.e., post-marketing surveillance for adverse drug problems. Since there is not money available for this important activity, FDA Commissioner says the user fees (normally used for drug approvals) will be diverted for this purpose.

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Rising Drug Prices Said to Strain Hospitals, Force Budget Cuts: I have commented on the issue in previous posts, but this article summarizes a recent NORC survey of 4200 hospitals. The two main problems are rising costs and shortages. The article also highlights that the increased costs are forcing some hospitals to cut back on expenses for key functions, like staffing.

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Fragile pharmaceutical supply chain increases costs, compromises care: On the same theme as the above article, this one also draws on the NORC study but focuses more on the shortages and how hospitals are “massaging” the supply chain to alleviate the problem.

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Walmart Could Leave CVS Caremark Pharmacy Networks Amid Dispute: CVS Caremark is a pharmaceutical benefit manager (PBM) that uses Walmart pharmacies as outlets. (It also uses CVS pharmacies). The two are now set to split as early as February. According to the article, the reasons are in dispute but one is that Walmart is raising its fees for filling prescriptions. The Walmart outlets are a small part of the CVS PBM but it will be interesting to see if these giant companies can come to terms.

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About information technology

Approaches and Challenges to Electronically Matching Patients’ Records across Providers: This report is from the Government Accountability Office. Everyone agrees on the benefits of being able to link patient medical records from a variety of sources and also agrees that computer system interoperability problems impede that effort. One issue being avoided is using a single patient identifier to help with this linkage. The single identifier was part of the HIPAA data standardization but was removed over privacy concerns. There is good reason for this concern given the large numbers of people involved in data breaches. Until security issues are largely resolved and the public feels comfortable, patient information will probably not flow seemlessly.

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2019 Interoperability Standards Advisory: Continuing the theme of interoperability, the Office of the National Coordinator has issued standards for nomenclature. This document is very technical but is worth a cursory look-through to get an idea of the extent of what interoperable data needs to look like. It also highlights that data sets are overseen by different organizations.

Read the report

About insurance

Optum breaks $100B in revenue for the first time, boosting UnitedHealth's growth in 2018: Somehow I think this headline should read “tail wags dog.” United Health Group started out as an insurance company- now called United Healthcare. It added another division (now called Optum) to furnish support services for health insurance companies- including banking for Health Savings Accounts, actuarial services and analytics. This year Optum broke $100B in revenue for the first time and accounted for a significant portion of its parent’s profitability.

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