Today's News and Commentary

Welcome back after the long July 4 “weekend”

In the new format below, the article link will be in the story’s title

About pharma

Fast-Track Drug Approval, Designed for Emergencies, Is Now Routine: This article was in the print edition of the Wall Street Journal this weekend. It is a great piece about the balance between quick drug approval to help people who need treatment and the possibilities of harm from unanticipated side effects.

Only 2% of genomic material available for research comes from Africa; 54gene wants to change that: The headline is self-explanatory. The article highlights the opportunities for drug discoveries by conducting more research on highly diverse African genomes.

Exclusive: Five couples lined up for CRISPR babies to avoid deafness: Five Russian couples with hereditary deafness have applied to the country’s authorities to have children who will be genetically modified to correct the defect.

About the public’s health

Fight over vaccine exemptions hits state legislatures: This article is a nice summary of the issues around state requirements for vaccination versus personal liberties. The one key factor is that the individual risk of vaccination is negligible while the public risk of non-vaccination is considerable.

Smoke-free and tobacco-free colleges and universities in the United States: Restaurants and public places have adopted tobacco-free environments. According to this research: “In 2017, just 16.7% of accredited, degree-granting institutions in the USA had 100% smoke-free or 100% tobacco-free protections. Despite progress, more efforts can ensure that students and staff benefit from comprehensive 100% smoke-free and 100% tobacco-free protections at US colleges and universities.”

Natural history of prediabetes in older adults from a population‐based longitudinal study: One of the screens done in older adults is for pre-diabetes, i.e., an abnormal blood sugar level that doesn’t quite meet criteria for the disease. This 12 year-long Swedish research study looked at 918 individuals who had prediabetes. During that time, 22% reverted to normal, 13% developed diabetes and 23% died. The exact causes of death are not specified. The takeaway here is that prediabetes does not always progress to the disease and normal sugars can be achieved. The modifiable factors to achieve this goal are lowering systolic blood pressure and promoting weight loss. Providing this data to patients with prediabetes may give them hope so that can engage in healthy lifestyles and comply with treatment recommendations.

National and State Estimates of Lost Earnings From Cancer Deaths in the United States: “A total of 8 739 939 person-years of life were lost to cancer death in persons aged 16 to 84 years in the United States in 2015, translating to lost earnings of $94.4 billion (95% CI, $91.7 billion-$97.3 billion). For individual cancer sites, lost earnings were highest for lung cancer ($21.3 billion), followed by colorectal ($9.4 billion), female breast ($6.2 billion), and pancreatic ($6.1 billion) cancer.” Large state-by-state differences also occur.

2019 Review of Physician and Advanced Practitioner Recruiting Incentives: This recent report by physician search firm Merritt Hawkins has a number of important public health findings. Among them:

—”For the 13th consecutive year, family physicians topped the list of Merritt Hawkins’ 20 most requested recruiting assignments, underscoring the continued robust demand for primary care physicians.”

—”The use of quality/value-based physician compensation is rising. 56% of physician production bonus formulas tracked in the 2019 Review feature quality-based metrics, up from 42% the previous year.” Such figures often fail to note how much of the compensation is value-based.

—”Employment rather than independent practice remains the dominant physician recruiting model. Over 90% of Merritt Hawkins’ search assignments feature employed practice settings, while less than 10% feature independent practice.” This finding may be based on the fact that hospitals and other large employers can afford expensive search companies.

The survey also lists salary trends by specialty. Guess where the primary care physicians fall?

About healthcare IT

6 ways smaller health systems are falling behind in cybersecurity: CHIME-KLAS survey: “While large healthcare organizations are successfully adopting best practices for cybersecurity, smaller health systems and hospitals are falling behind as budget constraints and a lack of qualified talent hinder progress…” As large systems try to implement interoperability solutions, linkages with smaller organizations which are not as “cybersecure” may pose a threat. There needs to be a systemic solution to the security issue, not just an institution-by-institution implementation.

Global EHR market hits $31B but faces usability, interoperability challenges: This article summarizes a proprietary research study. “The market for EHRs, which includes revenues for EHR systems, computerized provider order entry systems, and directly related services, such as installation, training, servicing, and consulting, grew 6% from $29.7 billion the previous year…” Read the article for more details.

About health insurance

ObamaCare repeal lawsuit faces major court test: Tomorrow the 5th Circuit Court of Appeals in New Orleans “will hear arguments in a lawsuit backed by the Trump administration seeking to overturn the entire 2010 Affordable Care Act (ACA).” The article is a nice summary of the events leading up to this hearing.

Congress has ambitious agenda tackling health care costs: Now that the 4th of July holiday is over, Congress will begin to address a variety of health issues ranging from surprise medical bills to lowering out-of-pocket drug costs. This article is a nice summary of these initiatives.

Study finds 33% of ACOs took on major risk in 2018 as new program starts: This article summarizes recent research in Health Affairs (subscription only access). The survey found that “only 33% of accountable care organizations have at least one contract that takes on greater risk,” up from 28% in 2012. It will be interesting to see how many ACOs stay in the program. Starting July 1, they are allowed up to 3 years in a no-downside risk program. Previously, they could remain in that status for 6 years.