Harvard Study Finds Older Insulins Are Safe as Well as Cheaper: The big story in the popular press today is a report on research looking at costs and benefits of the “newer” (analog) insulins versus older synthetic human insulins. Bottom line: except for slight increase in low blood sugar at night, the older insulins are just as good clinically as the newer ones and at 50% lower cost. With analog insulin prices increasing so rapidly (see past posts), it is important to know there are options. It will be interesting to see how pharma companies refute the study. Note: In researching this news, I came across a JAMA article from 2003 that came to the same conclusion.
Anthem moves up launch of its PBM to second quarter of 2019: Musical PBMs? Because of recent mergers and acquisitions, the PBM industry has had some major reshuffling. Cigna recently acquired Express Scripts, Anthem’s PBM. So Anthem is starting its own: IngenioRx. Watch the effect of this consolidation on free-standing PBMs like Walgreens. That company can survive on its retail business but the same may not be true for others.
About the public’s health
Quality and Experience of Outpatient Care in the United States for Adults With or Without Primary Care: The message of this research is that patients who have primary care physicians do better than those without them. I am not sure why this research was done. This finding has been in the literature for decades. In fact, a recent NY Times article touted the primary care system in Cuba. It’s time to stop doing this kind of research and put the funding into making sure people have a regular source of care.
CBO: Budget and Economic Outlook 2019-2029: The deficit outlook predicted by this study looks grim. “Over the 2020–2029 period, deficits are projected to average 4.4 percent of GDP, totaling $11.6 trillion. Such deficits would be significantly larger than the 2.9 percent of GDP that deficits averaged over the past 50 years.” A major reason for these deficits are mandatory spending through Medicare and Social Security. (Interesting to note that Medicare spending has exceeded that for Social Security since 1984.) For example, the Medicare Hospital Insurance (Part A) Trust Fund is due to be bankrupt by 2026. What is being done to correct this problem besides passing it to the next generation?