Good News: Opioid Prescribing Fell. The Bad? Pain Patients Suffer, Doctors Say: The pendulum seems to be swinging back. First we did not treat pain adequately. Then came the call to treat pain control as a “vital sign,” which led to over treatment and the opioid epidemic. Now that we are beginning to control opioid overuse, physicians are saying our zeal is causing under-treatment.
Read the article (NY Times but appears to be open-access)
J&J prices ketamine-like depression treatment at $590-$885 for two doses: To amend a previous story, J&J has announced the price for its new anti-depression drug Spravato.
Office of Generic Drugs- 2018 Annual Report: While this report was issued about a week ago, it is noteworthy to recall the accomplishments on the heels of Commissioner Gottlieb’s resignation. Among the milestones are approval or tentative approval of 1,021 Abbreviated New Drug Applications (ANDAs) and publication of more than 250 new or revised guidances, product- specific guidances (PSGs), and manuals of policies and procedures (MAPPs) for stakeholders.
Louisiana's 'Netflix' deal for hepatitis C drugs wins bids from AbbVie, Gilead and Merck: As previously reported, Louisiana was considering a “subscription price” for pharmaceuticals as a way to control costs- like Netflix. Now the state has moved forward and is accepting bids for drugs that treat hepatitis C.
About healthcare IT
6 top challenges to successful data integration: This short explanation is a good summary of barriers to data integration. For example: “Each organization has a unique set of APIs, and 47 percent of survey respondents pointed to integrating all these sources as their most challenging task.”
Lawmakers voice concerns about VA’s plans for Cerner EHR: The integration of VA and DoD information systems as well as upgrading for both will take another 10 years and $16.1 billion. Congress is now concerned about that timeline and cost. Further, with new VA initiatives to expand care options in the private sector, it appears the new system may not be interoperable with non-governmental provider sites.
2019 CIO Survey Report: This survey was conducted by Grant Thornton and the results were sorted by industry sector. One key finding for the healthcare/life science sector was that the top problem for Chief Information Officers is conflicting priorities among stakeholders. This finding is no surprise, particularly in hospitals systems where different departments not only have different information needs but their financial metrics are different and can come into conflict.
About the public’s health
Federal judge in Boston sets timeline for FDA to produce graphic cigarette warnings:”A federal judge in Boston has ordered the US Food and Drug Administration to create mandated colorful graphic health warnings on cigarette packs and advertising products by mid-March of next year.” If you ever find yourself in a Canadian airport and go to a duty-free shop that sells cigarettes you will see what these packages might look like.
Even with measles outbreaks across the US, at least 20 states have proposed anti-vaccination bills: Given population mobility, we need a national immunization policy that will protect the whole country. Think about federal regulation of interstate commerce as an example.
Industry Voices—Six keys to focusing on social determinants with the biggest economic impact: This article provides a short, useful list of best cost-effective strategies for implementation of programs to address the social determinants of health.
WHO unveils sweeping reforms in drive towards “triple billion” targets: In order to accomplish its five year strategic “triple billion plan,” the WHO announced a major reorganization. The strategy calls for: “one billion more people benefitting from universal health coverage (UHC); one billion more people better protected from health emergencies; and one billion more people enjoying better health and well-being.” The four pillar structure will deal with Programmes, Emergencies, External Relations and Governance, and Business Operations. All will be supported by the Division of the Chief Scientist at WHO Headquarters in Geneva “to strengthen WHO’s core scientific work and ensure the quality and consistency of WHO’s norms and standards.”
The Atul Gawande health care company finally has a name: Haven: The health care company formed in January, 2018 by Amazon, Berkshire Hathaway, and JPMorgan Chase & Co. finally has a name and website. It is called Haven and it will focus on “improving access to primary care, lowering prescription drug costs, and making insurance benefits easier to understand.” While initially focusing on the 1.2 million employees of its founders, the venture is expected to expand its practices more widely once it gets going (and is successful).
Why judge’s ruling against UnitedHealth could be turning point for mental health parity: U.S. Chief Magistrate Joseph C. Spero of the U.S. District Court in Northern California ruled that United Behavioral Health (UnitedHealth’s behavioral health subsidiary) unlawfully used internal policies to discriminate against patients with these needs order to cut costs. Federal law mandates that behavioral health benefits are on parity with other benefits. The decision in this class action suit is expected to be appealed.
Trump Administration Looks to Jump Start Interstate Health-Insurance Sales: The Trump administration has discussed this initiative before. Somehow it has the idea that if cross-state products were offered it would lower insurance costs. I think the policy makers forgot that healthcare is delivered locally and costs reflect that fact. A policy sold in Oregon (where costs are relatively cheap) will not cost less if the customer lives and receives health services in the expensive Miami area.
Read the article (Wall St Journal but appears to be open access)