About the public’s health
Lifestyle changes could save $92,000 in medical costs per person: “The study examined four individual patient cases of disease reversal achieved through intensive lifestyle changes and the associated reduction in health care costs. A substantial potential cost savings for both the patients and their insurance providers was identified in each case. For an adult male who lost up to 200 pounds after committing to a lifestyle change for six months, the potential savings in avoided discrete medical costs reached $92,000.”
Cervical Cancer Screening Guideline for Individuals at Average Risk: Cervical Cancer Screening for Individuals at Average Risk: 2020 Guideline Update From the American Cancer Society:
”Major recommendations:
Begin screening at age 25 years regardless of sexual history or HPV vaccination status (strong recommendation) [Increased from age 21]
Primary HPV testing every 5 years through age 65 years (strong recommendation) [Increased testing every five years from 3 years.]
If primary HPV testing is not available use cotesting (HPV+ cytology) every 5 years or every 3 years if cytology only (strong recommendation)
Discontinue screening at age 65 years if no history of cervical intraepithelial neoplasia grade 2 or more severe diagnosis in last 25 years and adequate negative prior screening in last 10 years (qualified recommendation)”
The High Costs of Maternal Morbidity Show Why We Need Greater Investment in Maternal Health: “We identified evidence to support connections between nine maternal morbidity conditions, such as hypertensive disorders, and 24 maternal and child outcomes, such as cesarean section delivery and preterm birth. We estimated total maternal morbidity costs for all U.S. births in 2019 to be $32.3 billion from conception through the child’s fifth birthday. This amounts to $8,624 in additional costs to society for each maternal–child pair.”
About pharma
Johnson & Johnson will break itself into two companies.: “Johnson & Johnson said on Friday that it would break itself into two publicly traded companies…
The 135-year-old company, which employs more than 136,000 people, announced that it planned to spin off its consumer-products division — home to Tylenol, Band-Aid, Neutrogena beauty products and more — into a separate business.
That would leave J.&J. with its pharmaceutical and medical devices division, which includes its coronavirus vaccine manufacturing and boasts faster-growing sales and higher margins.”
Keeping the 100-year-old promise:making insulin access universal: From the WHO:
”In 1921, researchers at the University of Toronto discovered insulin, which changedthe diabetes narrative forever. In keeping with a promise that insulin ‘belongs to the world’, the patent was sold for just one Canadian dollar.” Prices had been affordable with increased production. But more recently, analogue insulins have replaced human insulin and prices have skyrocketed. The result is that about 30 million people worldwide who need insulin do not have access to it.
This monograph offers an excellent examination of what is wrong and how access can be improved.
Biden to Choose Robert Califf to Lead F.D.A., Despite Drug Industry Ties: “President Biden on Friday is expected to nominate Dr. Robert M. Califf, a former commissioner of the Food and Drug Administration, to lead the agency again, several people familiar with the planning said. The move would end nearly a year of political wrangling as the White House vetted then dropped several candidates after complaints that some were too close to the pharmaceutical industry.
In the end, White House officials might have concluded that they could not find a suitable candidate with no industry ties. Dr. Califf, 70, a respected academic and clinical trial researcher who ran the agency during the last year of the Obama administration, has long been a consultant to drug companies and ran a research center at Duke University that received some funding from the drug industry.”
Strengthening the FDA’s Enforcement of ClinicalTrials.gov Reporting Requirements: “Through an ongoing Freedom of Information Act–based investigation, all 58 Pre-Notices that the FDA issued from 2013 through April 29, 2021, were obtained. Of these, 57 described potential missing trial results information and 1 described missing registration information.”
The authors recommend several measures that the FDA can use to make sure companies comply with reporting requirements.
About Covid-19
Booster shots are most popular in poorly vaccinated states where coronavirus rages: “The rate at which fully vaccinated residents are getting the shots is highest in the states that also have high rates of new coronavirus cases, including Alaska, North Dakota and Montana, according to a review of state data by The Washington Post. In swaths of the country where health officials will not impose mask and vaccine mandates to curb the virus’s spread, or have had their powers stripped away by Republican state lawmakers or governors, boosters are one of the few shields left for those worried about contracting and spreading the virus.”
AstraZeneca to take profits from Covid vaccine sales: “AstraZeneca has signed its first for-profit deals for its Covid-19 vaccine, moving away from the completely non-profit model that it used during the pandemic. The Anglo-Swedish drugmaker is now expecting the vaccine will move to ‘modest profitability’ as new orders are received. The shot, developed with the University of Oxford, will remain non-profit for developing countries. AstraZeneca committed to selling the vaccine ‘at cost’ for the duration of the pandemic, as part of its agreement with Oxford.”
About health insurance
6 national payers ranked by Q3 profits: A good summary with links to each company for further information.
All were profitable.
New Spending from Filling the Medicaid Coverage Gap Outweighs Cuts in Disproportionate Share Payments: From the Urban Institute: “This paper provides estimates of the increase in federal subsidies under two provisions of the Build Back Better Act (BBBA) that would flow to people below the federal poverty limit in the 12 states that have not expanded Medicaid (people in the “Medicaid gap”). These subsidies are compared to the cuts in federal DSH payments also proposed in the bill. We estimate that in a year when Medicaid gap subsidies are provided, hospitals in the 12 nonexpansion states would see more than $6.8 billion in new spending for people in the Medicaid gap as a result of the coverage expansions, about 15 times larger than the expected DSH cuts of $444 million. Overall new federal health subsidies for people in the Medicaid gap going to nonexpansion states would be more than $19 billion.”
Two related papers: How would filling the Medicaid “coverage gap” affect hospital finances? from Brookings/USC Schaeffer Center which reaches similar conclusions and an opposing critiques from the AHA: Brookings paper misses the point on Medicaid DSH cuts included in BBBA
CMS nixes Medicare coverage of breakthrough medical devices: 4 things to know: “CMS said Nov. 12 it will rescind a rule introduced by former President Donald Trump's administration that allows Medicare to quickly cover medical devices deemed ‘breakthrough' technologies by the FDA…
CMS said it will rescind the rule because of concerns over Medicare patient safety.
’Although we continue to be in favor of enhancing access to new technologies, we are mindful that they may have unknown or unexpected risks and must first ensure such technologies improve health outcomes for Medicare beneficiaries,’ CMS Administrator Chiquita Brooks-LaSure said…”
About healthcare IT
FCC grants $709M to improve rural broadband access: “The Federal Communications Commission on Nov. 10 announced the fourth round of funding for its Rural Digital Opportunity Fund, awarding $709 million to support the development of high-speed broadband networks for more than 10 million Americans who live in rural areas.”
About healthcare financing
US doctors fear patients at risk as cost cuts follow private equity deals: A concerning expose from The Financial Times concerning cuts in clinical care due to private equity firms reducing expenses in their new healthcare investments.
”Private equity groups have poured money into US healthcare in recent years, as they see opportunity in an ageing society that spends more than ever on staying healthy. According to a report by Richard Scheffler at the University of California, Berkeley, and Laura Alexander at the American Antitrust Institute, annual private equity healthcare deals soared from an estimated $42bn in 2010 to $120bn in 2019, before dipping to $96bn in 2020.”