Today's News and Commentary

About the public’s health

Calories Purchased by Hospital Employees After Implementation of a Cafeteria Traffic Light–Labeling and Choice Architecture Program: In their main cafeteria, the Massachusetts General Hospital installed “‘traffic light’ food labels (in which green indicates healthy, yellow indicates less healthy, and red indicates least healthy) and choice architecture (product placement)…” These signals resulted in a reduction of 47 kcal per day and estimated a 2.0-kg weight loss over 3 years. This reduction was sustained and assumes no other dietary or activity changes. This program is really simple and much easier (and faster) than having people read labels.

Natural environments and craving: The mediating role of negative affect: This small, but intriguing study from the UK’s University of Plymouth shows that exposure to nature (fields, tress, etc.) reduces cravings for such items as unhealthful snacks, alcohol, or tobacco.

Association between coffee consumption and overall risk of being diagnosed with or dying from cancer among >300 000 UK Biobank participants in a large-scale Mendelian randomization study: Breath easier when you have that cup of coffee. Based on observational data as well as literature review (through a meta-analysis) the researchers found that “summary data on various cancers do not support a strong causal relationship between coffee and risk of breast, ovarian, lung or prostate cancer, upon correction for multiple testing.”

About healthcare professionals

Investing in Primary Care: A State-Level Analysis: All studies from around the world show the advantages of a primary care system; yet the US has had a very specialty-focus. This difference is highlighted by the facts that on average, “the United States spends 5%-7% on primary care as a percentage of total health care spending. By comparison, Organisation for Economic Co-operation and Development (OECD) countries average 14% spending on primary care.” This research study of primary care investment by state found an association “between increased primary care spend and fewer emergency department visits, total hospitalizations, and hospitalizations for ambulatory care-sensitive conditions.” While a causal relationship was not asserted, the results were consistent with other research studies about primary care’s benefits.

About healthcare quality and safety

Association Between State-Mandated Protocolized Sepsis Care and In-hospital Mortality Among Adults With Sepsis: Clinical protocols usually come from medical organizations or accreditation groups. In 2013 New York State mandated the use of protocols for sepsis recognition and treatment. “By the 10th quarter after implementation of the regulations, the adjusted absolute mortality was 3.2% lower than expected in New York State relative to the control states.” The authors caution about applying the program to other states.

CMS updates Medicaid and CHIP Scorecard with new data: For the second year, CMS released scorecards for Medicaid and CHIP, this time with new data. This article provides an overview of the scorecard while the CMS site provides more details. Unfortunately, like much health data, the findings are a bit old.

Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis: “Of the 7313 records identified, 70 studies involving 337 025 patients were included in the meta-analysis. The pooled prevalence for preventable patient harm was 6% (95% confidence interval 5% to 7%). A pooled proportion of 12% (9% to 15%) of preventable patient harm was severe or led to death. Incidents related to drugs (25%, 95% confidence interval 16% to 34%) and other treatments (24%, 21% to 30%) accounted for the largest proportion of preventable patient harm. Compared with general hospitals (where most evidence originated), preventable patient harm was more prevalent in advanced specialties (intensive care or surgery; regression coefficient b=0.07, 95% confidence interval 0.04 to 0.10).”

About pharma

Canada warns U.S. against drug import plans, citing shortage concerns: It might not be so easy to get medications from Canada. To save money on prescription drugs, some states (like Florida) have passed laws enabling their purchase from Canada. Canada has warned the US that if the volume is large enough to affect Canadian supplies, the exports will be cut.

Roche doomsday is here: Long-feared Herceptin, Avastin biosims bust into U.S. market: Good news for consumers, bad news for Roche. “Amgen and Allergan Thursday launched U.S. biosimilars of both HER2-positive breast cancer med Herceptin and colorectal cancer treatment Avastin, threatening a combined $5.9 billion in U.S. sales in 2018.” The prices will be 15% lower than the reference biologics, which is consistent for biosimilars.

Novartis, aiming to clean up its rep, sets aside $700M for kickback settlement: This amount should settle a decade-long federal bribery charge from a whistleblower suit. Novartis was accused of bribing physicians to prescribe their medications. “Among some of the most eyepopping claims in the suit were Novartis sales execs treating doctors to $10,000 dinners at expensive New York seafood restaurants and wild nights out at Hooters. In one instance, Novartis held one of its speaker events aboard a fishing boat, allegedly without any educational material in tow.”

About health insurance

Aetna-CVS merger to go back before judge; 5 states support approval: In a continuation of scrutiny of this merger, next Wednesday “lawyers from California, Florida, Hawaii, Mississippi, and Washington will appear before U.S. District Judge Richard J. Leon in Washington, D.C., … to defend a Justice Department-brokered settlement as an ‘effective and appropriate remedy’ for potentially anti-competitive effects stemming from the tie-up.”