Today's News and Commentary

About pharma

Would Trump's new drug-imports plan do much to prices—or to pharma?: Yesterday, CMS announced two pathways that would allow drug importation with the aim of lowering costs. On further reflection, it may not have such a large impact. First, “…many of pharma's most costly products—biologics such as AbbVie's Humira; IV drugs, a category that would include many pricey cancer treatments; and inhaled products, such as respiratory therapies from GlaxoSmithKline and AstraZeneca, are all excluded. So are meds that require Risk Evaluation and Mitigation Strategies at the FDA—a group that comprises many expensive and newer drugs, such as multiple sclerosis treatments.” Next, the second pathway that allows drug manufacturers to import medications does not compel them to do so- particularly if it is not in their best interest. Finally, we need to realize that not all drugs are cheaper abroad. Certainly, generics are much cheaper in the US than in the countries from which we would import drugs. We will need to see how much these pathways are used and whether it is worth the effort for interested stakeholders.

About healthcare IT

Unbounded—Parent-Physician Communication in the Era of Portal Messaging: While patient portals can increase accessibility of care, for physicians it can represent another “time sink” for uncompensated care. In addition to phone calls, this pediatric study states that “the average pediatrician currently answers approximately 10 patient portal messages a day, and this number is expected to grow.” The authors opine that one reason the number of messages will grow is that the bar is much lower for messaging than phone calls. This article is a balanced presentation of this issue.

About healthcare insurance

Health Plans Are Riding The Medicare Wave:This survey of insurance executives shows how bullish they are about growing their Medicare Advantage businesses. 92% say they plan to grow that product faster that their traditional Medicare offerings. The survey cites the growth of the Medicare-eligible population and value-based results as reasons for this growth.

HHS approves Colorado's waiver to set up ACA reinsurance program: Colorado became the eighth state to get a waiver that “enables the federal government to use ‘pass-through’ money that it would have spent on ACA tax credits to help fund the reinsurance program.” By offering health plans reinsurance for claims above $30,000 (with a cap of $400,000), premiums can be lowered. According to CMS, “the waiver is expected to lower premiums in the state by 16% in 2020, and enrollment could increase by nearly 3% because of the lower premiums…”

Democrat’s Proposals: Here are a couple good articles summarizing last night’s “round 2” of Democratic debates: The messy health care discussion at the second Democratic debate, explained and Biden and Harris put health care plans to test on Democratic debate stage. Bottom line is that the debate focuses mainly on two candidates. Harris has her version of “Medicare for All” and Biden wants to make the ACA better.

About the public’s health

Poorer U.S. patients less likely to get blood pressure controlled: A reminder that economic disparities are an independent factor in receipt of appropriate care. The headline speaks for itself.

Trump administration tightens opioid prescriptions for feds: The Federal Employee Health Benefits Program will change its coverage of opioids in view of widespread abuses. “Under the new policy, the initial prescription will be for a 7-day supply, instead of up to 30 days.”

Nutrient deficiencies in rice grown under higher carbon dioxide could elevate health risks for tens of millions: This article raises a “new” concern about global warming due to rising CO2 levels. “In the past decade both laboratory and free-air studies have shown that crops of many dietary staples, including wheat, barley, rice, potatoes, and soybeans, develop lower concentrations of iron, zinc, protein, and other nutrients crucial to human health when they are grown under elevated levels of carbon dioxide… Now a recent study in the AGU journal GeoHealth finds declines in B-vitamin concentrations in rice grown under elevated CO2 concentrations may increase the future health risks of large numbers of people around the globe.”