Today's News and Commentary

About health insurance

Democratic debate was a boxing match over Medicare-for-all: This review of last night’s Democratic debates (round 1 of 2) did not have any real policy surprises. The differences among candidates became more focused. This article from the Washington Post is the best summary I have read.

Fiscal Year 2020 Payment and Policy changes for Medicare Skilled Nursing Facilities: This announcement was part of a number of payment and policy changes CMS issued yesterday, This one concerns funding and revised quality measures for skilled nursing facilities. The good news is that:” CMS projects aggregate payments to SNFs will increase by $851 million, or 2.4 percent, for FY 2020 compared to FY 2019.”

Humana raises 2019 guidance as Medicare Advantage enrollment grows: This article is not so much about Humana as the prospects for continued growth for Medicare Advantage plans.

Trump Administration Drives Down Drug Costs for Seniors: The announcement is blatantly self-serving, but the message is good: “Over the past three years, average Part D basic premiums have decreased by 13.5 percent, from $34.70 in 2017 to a projected $30 in 2020, saving beneficiaries about $1.9 billion in premium costs over that time.” The announcement, however, does not include information about trends in out-of-pocket expenses.

About healthcare IT

Rite Aid launches telehealth service through in-store kiosks:”In partnership with telehealth company InTouch Health, Rite Aid will begin offering a virtual service that connects customers with clinicians via its RediClinic Express kiosks located in retail stores.” Awareness about telehealth options is a major reason for its low usage. Perhaps this opportunity will also publicize what telehealth is.

In ongoing feud with PillPack, Surescripts bars ReMy Health from using its patient data: Amazon owns PillPack and Surescripts (which manages about 80% of U.S. prescriptions) is owned by CVS Health and pharmacy benefit manager Express Scripts. By Surescripts withholding patient data from its competitor, the latter’s business model can be severely impeded. This action raises a continuing concern about antitrust activity that the FTC is currently investigating.

CMS pilot taps FHIR to give clinicians access to claims data: The more generic story in many outlets was the capability by clinicians to access claims data. This article looks into the technology a bit deeper than others do.

About pharma

Exclusive: Two powerful Canadian provinces argued against federal drug price crackdown: American pharma companies claim that controlling their prices will impede their ability to research and develop new products. At the same time, policy makers correctly claim we have the highest branded drug prices in the world and point to Canada as an example we should emulate. Well…”Ontario and Quebec, have privately expressed concerns with a federal government plan to slash the price of patented drugs, arguing that such regulatory changes could hurt investment in life sciences.”

Congress seeks briefing on potential threat to U.S. heparin supply: The specifics of the article are less important than the illustration of how fragile our pharma supply chain can be. The “blood thinner” heparin is made from ingredients originating in pig intestines. “…60 percent of the crude heparin used to make finished heparin in the United states is sourced from China,” where there is an outbreak of African swine fever.

A Massive U.S. Drug Price-Fixing Probe Has Hit Major Roadblocks (from Bloomberg, limited free access): Federal and state actions against generic manufacturers’ alleged price-fixing collusion began in September 2016 with an FBI raid on Mylan. Since then, the investigations have faced a number of roadblocks. This article is a comprehensive update on this story.

How a Big Pharma Lawsuit Could Succeed Where Big Tobacco Failed: This article provides some history behind the $246 billion settlement from Big Tobacco in the ’90s and how many states misused the payouts for purposes other than public health. The message is how settlements from the opioid lawsuits can be put to better use.

HHS Announces New Action Plan to Lay Foundation for Safe Importation of Certain Prescription Drugs: HHS announced plans for two pathways to allow states to import drugs. According to the government statement released today:
The first pathway would be through a notice of proposed rulemaking (NPRM) whereby HHS and FDA would rely on the authority under current federal law “to authorize pilot (or demonstration) projects developed by states, wholesalers or pharmacists and submitted for HHS review, outlining how they would import certain drugs from Canada that are versions of FDA-approved drugs that are manufactured consistent with the FDA approval.”

The second mechanism is through guidance, whereby the “FDA would provide recommendations to manufacturers of FDA-approved drugs who seek to import into the U.S. versions of those drugs they sell in foreign countries…. To use this pathway, the manufacturer or entity authorized by the manufacturer would establish with the FDA that the foreign version is the same as the U.S. version and appropriately label the drug for sale in the U.S.”

About the public’s health

Lyme disease: Lyme disease may be 3 times higher than previous estimates in the UK (perhaps also in the US). It is timely that the FDA has just approved four diagnostic tests with new indications for diagnosing Lyme disease.

For Mortality, Busting the Myth of 10 000 Steps per Day: You should exercise; but you may not need to do 10,000 steps a day. This research on women found that benefits start at 4400 steps, increasing with further activity and leveling off at 7500 steps.