Today's News and Commentary

About health insurance

Federal judge upholds Trump's expansion of non-ObamaCare plans: Washington U.S. District Judge Richard Leon ruled that expansion health plans (that is, non-ACA compliant health insurance) can be offered. They do not have to meet the coverage requirements of ACA plans so they can be sold at a cheaper price. To what extent these offerings will further fragment the healthcare insurance market remains to be seen. If experience is any guide, healthier people will flock to them, making the exchange offerings more expensive. The federal government will end up picking up the tab for the higher costs through premium subsidies.

Colorado’s reinsurance bill drops marketplace health insurance: The Colorado legislature passed a law last session that set up a reinsurance scheme for ACA health plans operating in the state. The money comes from the federal government that would go to financial assistance. Since insurance companies have limits on their liability, the premiums have decreased. Other states have also looked at this program, which requires HHS approval. Depending on the individual states, this financial arrangement could be cheaper for the federal government and individuals than straight premium subsidies.

With lessons from hospitality and tech, Forward expands primary care footprint on East Coast: This article looks at the “latest” in concierge medicine, a high tech approach to primary care. While physician and lab fees are part of the monthly charge, patients will need traditional insurance if they really get sick.

About pharma

Incenting Competition to Reduce Drug Spending:The Biosimilar Opportunity : This in-depth report looks at potential cost-savings from current and expanded use of biosimilars: “… the current biosimilar market share is annually creating $253.8 million in savings… Greater savings are possible if the share of biosimilars were higher. Should biosimilars grow to 25 percent, 50 percent, or 75 percent of the market, annual total health care spending would be $2.5 billion, $4.8 billion, and $7.2 billion lower respectively than the baseline scenario. Over 10 years, these savings would become $24.7 billion, $48.0 billion, and $71.7 billion respectively. It should be noted that these savings only count the nine biologic drug classes where approved biosimilars already exist. Even greater savings will be realized if biosimilars were approved for more drug classes.”

Biosimilars were supposed to save us. Can they even save themselves?: On the same theme as the above study, this article keys on patent protections preventing biosimilars from getting to market. Also, discounts in this country start at about 15% below reference drugs- a figure the latter can easily match. In Europe, biologics have shorter patents and can be discounted as much as 80%. The savings outside the U.S. are therefore more substantial. Time to reexamine the regulations for this market?

Lyrica generics roll: Pfizer blockbuster finally hits patent cliff: On Friday, the FDA approved 10 generics for Pfizer’s blockbuster drug Lyrica. With that many competitors, prices are expected to drop by about 75%.

Mounting battle between Amazon's PillPack and Surescripts over access to patient data: Amazon’s PillPack has been cut off from patient medication histories by Surescripts, which is owned by competitors CVS Health and pharmacy benefit manager (PBM) Express Scripts. This action comes, as previously reported, during an FTC investigation of Surescripts for alleged antitrust. PillPack is suing so the fight is not yet over.

About healthcare IT

Anti-extremism software to be used to tackle vaccine disinformation: “Technology used to counter violent messages online from Islamic State and the far right is being adapted to counter the spread of ‘anti-vax’ conspiracy theories.”

Philips Future Health Index 2019 finds US among leaders in EMR use and AI spend, but overall digital health technology adoption mixed: The title is a bit misleading. Much of this wide-ranging report covers American healthcare IT issues such as interoperability, desire for privacy and telemedicine. One part of the report compares the U.S. with other countries. In comparing the percentage of U.S. healthcare professionals who currently use digital health technology or mobile health apps (76%) against many other countries, we do not do so well; for example, Russia is at 81%, Saudi Arabia is at 85% and China tops out at 94%. Clearly we have a long way to go.

Do protections for people with disabilities apply online? Domino’s asks high court: This article is not, strictly speaking about healthcare but the implications for the field are obvious. Domino’s Pizza is being sued by a blind customer because the website does not offer ordering options for his disability. The overall question being raised is in the article’s title.

About the public’s health

Oral health: This link is for a special issue of The Lancet on important trends in oral health- a topic that is often ignored in public health.

Trump administration pauses new rule limiting abortion referrals: The rule prohibiting abortion referrals for all organizations receiving Title X funds has been paused. Affected groups now have up to 2 months to comply.

About healthcare quality and safety: The American College of Surgeons, along with 50 stakeholder organizations (the ACS Coalition for Quality in Geriatric Surgery Project) launched The American College of Surgeons (ACS) Geriatric Surgery Verification (GSV) Program. The GSV consists of “30 new surgical standards designed to systematically improve surgical care and outcomes for the aging adult population.” Included are assessments of social issues, such as a patient’s caregiver situation.