Today's News and Commentary

About pharma

U.S. top court rejects Helsinn over anti-nausea drug patent in win for Teva:The specifics of this story are not as important as the general message. In this case, a company was selling a drug as part of a license deal but violated “a provision in U.S. patent law that forbids sales of an invention before applying for a patent…” This decision will affect many small companies who participate in such licensing deals.

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Walgreens pays $269.2 million to settle U.S. civil fraud lawsuits: Settling two separate suits, Walgreens was fined for dispensing insulin “pens” to patients who did not need them as well as over-billing Medicare and Medicaid programs.

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U.S. insulin costs per patient nearly doubled from 2012 to 2016 -study: Speaking of insulin treatment, this story documents the rapidly rising costs over the past several years. While the study stopped in 2016, the costs for insulin have continued to rise. The question is what kind of public sector controls should be placed on life-saving medications?

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About devices

High-tech hospital R&D focuses on controlling costs: This article from the Financial Times looks at a number of new tech advances that not only improve care but will lower cost. For example, ICU room and bed designs can lower rates of “ICU psychosis” and help patients recover faster. Another program seeks to enhance 3D imaging so that invasive procedures can be executed more precisely. The market costs of these programs are not specified so whether they will be cost-saving overall remains to be seen.

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Alphabet’s health division gets FDA clearance to test EKG smartwatch feature: Add this product to the Apple watch as FDA approved devices for monitoring heart rhythms. Unlike the Apple product, this one is not a consumer watch. Announcement of this product was about 2 years ago but it just received FDA approval.

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About insurance

Medicare reimbursement falls short of care delivery costs: This study, conducted by the Medical Group Management Association, found that 67% of survey responders said Medicare payments were falling behind actual costs of delivering care. Two of the major reasons were: 1) payment updates are falling below inflation rates and 2)costs of compliance with regulations (such as those dealing with quality measures) are increasing without compensating bonuses for performance. Since Medicare rates are often the starting point for private insurance fee negotiations, this concern has far-reaching implications.

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Uninsured rate at highest level since 2014: The ACA was supposed to reduce the number of uninsured. At its lowest point in 2016, the uninsured accounted for 10.9% of the population. Now that figure is 13.7%- the highest it’s been since the start of the ACA in 2014 when it was 18%. The increase from 2016 to 2018 represents 7 million people. The exact contributions of each of several causes are not clear. These reasons include: repeal of the insurance mandate; government cuts in “navigator programs” that helped people choose plans; rising premiums; removal of federal help with out of pocket expenses; and start of short term plans in some states with lower premiums but worse benefits when compared to ACA exchange coverage. Balancing those changes are increases in the number of states expanding Medicaid programs. Stay tuned for other changes that will affect these numbers.

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Rural Hospitals in Greater Jeopardy in Non-Medicaid Expansion States: Lack of Medicaid doesn’t only affect those without that coverage. This article points out that in states that did not expand such coverage, rural hospitals are closing in greater numbers. We are thus creating an access problem for all, not just Medicaid recipients.

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About the public’s health

Why Cigna is looking to subscription boxes as inspiration for addressing childhood hunger: Now some good news. To address food insecurity, Cigna is developing a program to deliver boxes to eligible children that not only contain food, but also cookbooks, cooking tools and other resources to help them learn to cook healthy meals. One presumes that the adults in the house also have the same food insecurity issues so it will be interesting to see if this targeted program succeeds. This initiative is part of Cigna’s Healthier Kids for Our Future program.

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