Today's News and Commentary

About the public’s health

Liver transplant rules spark open conflict among transplant centers: As previously reported, federally sponsored allocation methods for organ transplants have been changing. Undersupplied, populated areas complained that they don’t have enough organs. Relatively underpopulated areas (which are better-supplied) say they will be discriminated against if their available organs go elsewhere. Atlanta federal court judge Amy Totenberg said she will allow a lawsuit to go forward by those claiming to be adversely affected by the new rules.

Read the story (Washington Post but appears to be open access)

Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake: This research explains the science of why junk food is bad for you. Subjects were presented with identical diets were with respect to calories, sugar, fat, fiber, and macronutrients. One diet was “ultra processed” and the other was a healthier offering. In addition to the presented diets, subjects were free to eat other foods without caloric restriction. Results showed the ultra processed diet (junk food) led to about 500 calories more per day than the healthier diet, with a significant increase in weight gain. The healthier diet also led to weight loss.
Reasons for these findings? The glucose tolerance between groups was not changed but “the appetite-suppressing hormone PYY increased during the unprocessed diet as compared with both the ultra-processed diet and baseline. Also, the hunger hormone ghrelin was decreased during the unprocessed diet compared to baseline.” Other researchers have been investigating obesity treatments using PYY and ghrelin. This study may lend some scientific credence to those investigations.

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Fostering Productive Health Care Cost Conversations: Sharing Lessons Learned and Best Practices: This themed issue of the Annals of Internal Medicine has articles about how physicians can conduct cost of care conversations with patients.

Link to the articles (Open access)

About pharma

Trump administration backs off Medicare drug pricing rule: “Under current law, private Medicare health plans are required to cover all or ‘substantially all’ drugs in six ‘protected”’classes, such as HIV treatments, antidepressants, drugs to treat epileptic seizures, and cancer drugs, regardless of cost.
Last fall, the administration proposed allowing health plans to exclude protected drugs with price increases that are greater than inflation, as well as certain new drug formulations that were not a ‘significant innovation’ over the original product.” Yesterday, CMS Administrator Seema Verma said that, based on feedback, the agency is withdrawing the proposal.

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White House, Congress considering killing Part D rebate rule, creating spending cap: In a related story about Medicare drug costs, the White House and Congress are considering abandoning a policy of rebates going to patients in favor of a spending cap.

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Modernizing Part D and Medicare Advantage to Lower Drug Prices and Reduce Out-of-Pocket Expenses: CMS issued final rules to address lowering drug costs. Among the rules are: the requirement to include “negotiated drug pricing information and lower cost alternatives in the Part D Explanation of Benefits beginning on 01/01/2021”; the requirement that Part D plans provide access to a Real Time Benefit Tool to be integrated into clinicians’ electronic prescribing or electronic health records systems no later than 01/01/21; and “certain new requirements for when MA [Medicare Advantage] plans may apply step therapy as a utilization management tool for Part B drugs.”

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Are pharmaceutical companies making progress when it comes to global health?: The Access to Medicine Foundation issued this report looking at how pharma companies are responding to the healthcare needs of developing countries. Among the findings: “…several pharmaceutical companies are now doing business in new, inclusive ways that aim to reach people on very low incomes. Seven companies are running a total of ten inclusive business models, eight of which are being expanded. Plus, 17 companies now set measurable targets related to access to medicine, up from eight in 2010. Yet, only some companies (9) are tackling the risks of unethical sales behaviour by changing sales bonuses. Fewer companies (4) have consistently supported international trade agreements designed to ensure the poorest people can benefit from medical innovation.” 

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AAM Rejects FDA’s Updated Biosimilar Naming Policy: As recently reported, manufacturers of branded biological drugs want the FDA to come up with a suffix for the product’s name that will identify it as the “original.” Predictably, “the Association for Accessible Medicines (AAM) and its Biosimilars Council is urging the FDA to scrap its proposed suffix-based naming policy for biological products because it would act as ‘a barrier to biosimilars access.’”

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Gilead schemed with J&J, Bristol-Myers to keep their HIV combo monopoly, lawsuit claims: It seems there is an epidemic of anticompetitive behaviors among pharma companies. On the heels of the recently reported Teva case, Gilead and others have been charged with monopolistic practices regarding a key component in an HIV treatment combination.

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Dems push bill on health care, drug prices through House: Along with five Republican votes, House Democrats passed a bill to address high drug prices. However, the bill also has provisions to rescind Executive Orders intended to dismantle the ACA, like allowing short-term plans to compete with those on the exchanges. Because of that addition, senate Republicans say it is DOA.

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