Today's News and Commentary

About information technology

In Screening for Suicide Risk, Facebook Takes On Tricky Public Health Role: This article reminded me of Dave Eggers’ book The Circle (published in 2013). It was about a tech company (like Facebook) that slowly invades everyone’s personal loves. It is a very believable dystopian vision of how our lives could come under a microscope. This NY Times piece explains how Facebook software identifies potential suicides and calls local police to intervene. It raises several questions: Is this software a medical device (which would require FDA approval)? How accurate is it? For example, how many people were incorrectly identified as suicide risks and taken for medical care unnecessarily? What is the next condition Facebook identifies that it will report to the police? One can see the potential benefit of identifying drunken selfies before the imbiber starts to drive. What about a future in which posts about binge eating lead to interventions to prevent obesity and diabetes?

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About the public’s health

NYC pharmacies can’t sell cigarettes starting Jan. 1: It has been almost five years since CVS announced it would not sell cigarettes in any of its stores. Starting yesterday, NY city pharmacies (including stores containing pharmacies- like supermarkets) cannot sell cigarettes. Store owners are worried that the reduced traffic will be very bad for business. Remember when restauranteurs gave the same argument when smoking bans went into effect for public places? Who has noticed that restaurants are less crowded? Kudos to the NYC Health Department!

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About pharma

Drugmakers Raise Prices on Hundreds of Medicine: As previously reported here, after apparent rapprochement with Congress earlier in 2018, more than” three dozen drugmakers raised the prices on hundreds of medicines in the U.S. on Tuesday… The average increase was 6.3%…” The issue of rising drug prices will be one where Democrats and Republicans can agree and may be the target for both parties for an early bipartisan win. We will need to see how strong the Pharmaceutical Research and Manufacturing Association (PhRMA) lobby is.

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In another record year for pharma TV ads, spending soars to $3.7B in 2018: In anticipation of price increases, drug companies increased their spending on TV ads. Since ethical restrictions and enhanced reporting of physician marketing expenses went into effect a few years ago, these companies have had more money to spend on Direct to Consumer ( DTC) advertising. How this spending will translate into increased sales is yet to be determined, especially in light of stricter health plan formulary controls.

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Special Report—2 years after sluggish 2016, new drug approvals hit their stride in 2018:
By the FDA’s count, it approved 59 NMEs [New Molecular Entities] in 2018, topping its previous record of 53 in 1996.” This effort appears to be due to increased efficiencies and somewhat relaxed approval standard for treatments for rare diseases. It is not known what percentage of applications are approved since the FDA does not report such statistics.

Read more details about these approvals

About insurance

ACA mandate gone, but a few states still require coverage: The individual obligation to have health insurance (mandate) has been linked to prohibiting insurance companies from discriminating based on preexisting conditions. If people can sign up whenever they want and insurance companies cannot screen applicants, those firm will go out of business. Since the federal mandate is gone as of yesterday, some states are imposing their own in order to maintain the market integrity for preexisting condition exclusions for insurance coverage.

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