U.S. judge strikes down Trump administration rule requiring drug prices in TV ads: This story is today’s top news. U.S. District Judge Amit Mehta in Washington ruled in favor of pharma companies Merck & Co Inc, Eli Lilly and Co and Amgen in their suit to stop the requirement for posting drug prices in ads. The judge ruled that HHS overstepped its authority in imposing this requirement and that it was up to Congress to make such a decision. Given the climate of pharma-cost bashing, Congress may pass such a measure with significant bipartisan support.
Effects of Nutritional Supplements and Dietary Interventions on Cardiovascular Outcomes: An Umbrella Review and Evidence Map: Many vitamins and dietary supplements are touted as effective preventives for cardiovascular disease. This extensive literature review, published online today, provides more insight. Other than lowering your salt intake, all other measures are, at best, unproved.
“There was moderate-certainty evidence that reduced salt intake decreased the risk for all-cause mortality in normotensive participants… and cardiovascular mortality in hypertensive participants.”
“ Low-certainty evidence showed that omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) was associated with reduced risk for myocardial infarction…and coronary heart disease…”
“Folic acid was associated with lower risk for stroke (… low certainty), whereas calcium plus vitamin D increased the risk for stroke (… moderate certainty).”
”Other nutritional supplements, such as vitamin B6, vitamin A, multivitamins, antioxidants, and iron and dietary interventions, such as reduced fat intake, had no significant effect on mortality or cardiovascular disease outcomes (very low– to moderate-certainty evidence).”
Financial Implications of 12-Month Dispensing of Oral Contraceptive Pills in the Veterans Affairs Health Care System: The arguments against dispensing a 12 month supply of oral contraceptives are financial and clinical. Less frequent renewals will require more frequent patient copays, thus reducing payer costs. Some physicians also use more frequent prescription as a way to bring patients to the office to check for side effects and deliver other preventive services. This VA study found the 12 month dispensing to be cost-effective. The one caution is that the VA population is rather stable, while the privately insured population tends to change insurance plans at a significant rate. Private insurers may be willing to pay for longer prescriptions but probably not those that exceed the contract year.
About the public’s health
Duration of Antibiotic Therapy: Shorter Is Better(Subscription required for full article): One way to reduce antibiotic resistance is to shorten the course of treatment. This article provides a review of the evidence for shorter course of therapy. For example, for community acquired pneumonia 8 randomized controlled trials “have shown that 3- to 5-day courses of antibiotic therapy are at least as effective as 7- to 14-day courses…”
2019: Vulnerabilities in Hospice Care: This site provides links to two reports by the HHS Inspector General detailing the quality of care findings for Medicare-covered hospices. In short: “the majority of U.S. hospices that participated in Medicare had one or more deficiencies in the quality of care they provided to their patients.”
About healthcare IT
Security, control of data seen as key barriers to cloud adoption by pharma: This article explains why the pharma industry does not think cloud-based data storage is safe, and therefore will not use it.
About health insurance
Trump aims to shake up kidney care market: The federal government spends more than $100 billion per year on the End Stage Renal Dialysis Program, its only disease-specific insurance. Tomorrow the Trump administration will announce plans to change payment methods to encourage more home dialysis as well as earlier detection and treatment of kidney disease.