Today's News and Commentary

About pharma

FDA OKs Descovy, Second Drug for HIV PrEP: Another drug in this class has been approved. “The US Food and Drug Administration (FDA) has approved a second drug for HIV-1 preexposure prophylaxis (PrEP) as part of ongoing efforts to end the HIV epidemic.
Descovy (Gilead Sciences) is a fixed-dose combination of emtricitabine (200 mg) and tenofovir alafenamide (25 mg). It is indicated to reduce the risk for HIV-1 infection from sex (excluding those who have receptive vaginal sex) in at-risk adults and adolescents weighing at least 35 kg (77 lb).
Descovy is not indicated in individuals at risk for HIV-1 infection from receptive vaginal sex because the effectiveness in this population has not been evaluated, the FDA said.”

After much fanfare, Civica Rx delivers its 1st drugs: As previously reported, a consortium of providers formed a pharma company (Civica Rx) to lower costs and increase access to drugs that experience shortages. “Riverton Hospital, an Intermountain Healthcare facility in Utah, received the first batch of vancomycin hydrochloride, an injectable antibiotic that is commonly in short supply for hospitals across the country, Civica Rx said Wednesday. The antibiotic will be available to all health systems by the end of the month. Shortly after that, another essential antibiotic, daptomycin, will be made available, according to the company.”

More do-it-yourself docs are finding pharma answers on their own as sales rep contact declines: This marketing channel has changed quickly. “In the 2019 survey, only 54% of physicians say they see pharma reps in person, down from 67% in 2018. That’s the lowest contact rate the ePharma survey has recorded since it started asking similar questions in 2014… Meanwhile, the percentage of doctors who had no interactions with pharma reps at all jumped from 24% last year to 39% this year.”

Big Pharma CEOs' Chinese names: Here's how they look and what they mean: A “fun” article.

HHS Appeals Court Decision on Proposed TV Ad Rule: “HHS has formally appealed a July ruling by a federal court in Washington, D.C., which blocked the department from requiring drug companies to disclose the prices of drug prices in their direct-to-consumer TV ads.”

About the public’s health

Breast cancer statistics, 2019: Some good news: despite an increase in incidence, breast cancer mortality has decreased. The bad news is that there is still great racial disparity in the mortality figures, with black women lagging far behind.

Association of Optimism With Cardiovascular Events and All-Cause Mortality: Always look at the bright side of life. “The findings suggest that optimism is associated with a lower risk of cardiovascular events and all-cause mortality.”

About healthcare professionals

Drop in primary-care docs hasn't hurt patient access yet, MedPAC says: The Medicare Payment Advisory Commission (MedPAC) was classifying hospitalists as primary care physicians because both groups used the same billing codes for hospital-based services. MedPAC found that “that the number of primary-care physicians was closer to 140,000 in 2017 than the 186,000 it initially reported, a decrease of about 46,000.” Given the declining rate of increase in primary care physicians, MedPAC is concerned that their future supply may create problems in quality care in the near future.

Risk Factors Associated With Food Insecurity in the Medicare Population: “Nearly 1 in 10 Medicare enrollees 65 years and older and 4 in 10 enrollees younger than 65 years experience food insecurity, suggesting both poor eating patterns that threaten health and inadequate access to other basic needs… We found disabled status, lower incomes, Medicaid dual enrollment, chronic condition burden, depression, and anxiety to be distinct factors. However, our cross-sectional analyses cannot establish causality.” Clearly a pervasive problem that needs to be addressed to improve health.

About hospitals and health systems

High Medical Bills Set Up Major Legal Showdown in California: Research consistently shows that hospital consolidation causes price increases. “In a less than a week, Sutter Health, a sprawling system of 24 hospitals and 5,500 doctors, will face a court trial over accusations that it used its dominance in Northern California to stifle competition and force patients to pay higher medical bills.”

About health insurance

Humana's chief strategy officer: Insurance giant is shifting to be a healthcare company: “Insurance giant Humana operates a mail-order pharmacy, has more than 230 owned or alliance primary care clinics and a large home health care provider, Kindred at Home. And the payer continues to build out capabilities to address members' social determinants of health.

These healthcare services are part of Humana's shift from ‘an insurance company with elements of healthcare to a healthcare company with elements of insurance,’ Vishal Agrawal, chief strategy and corporate development officer at Humana, said during CB Insights' Future of Health event in Manhattan Wednesday.”
Recall Humana started as a nursing home chain, then became a hospital company, added an insurance function and dropped the hospitals. Now it is adding the above-mentioned services. Where will the cycle go next?

Walmart unveils major employee health benefit changes aimed at cost cutting: On the heels of Sam’s club announcement (previously reported) that it is extending its employee benefits, Walmart unveiled five initiatives: a list of “featured” providers; expanded telehealth; a personal healthcare assistant; a national quality provider resource; and nationwide access to fitness clubs.

BCBSA: ACA premiums in 23 states expected to rise an average 2.3% in 2020: While average premiums are expected to rise 2.3%, as in the past, there are wide variations. According to preliminary filings, rates will “range from an 18% decrease in Colorado to a 13% increase in New Mexico.”