About health policy
KFF Health Tracking Poll – March 2022: Economic Concerns and Health Policy, The ACA, and Views of Long-term Care Facilities “As the nation’s economy and rising prices are on the forefront of the public’s mind, the latest KFF Health Tracking Poll finds the public wants lawmakers to prioritize out-of-pocket health care costs as Congress debates current health legislative priorities. A majority of the public (61%) say limiting how much drug companies can increase the price of prescription drugs each year to not surpass the rate of inflation should be a “top priority” for Congress. Slight majorities also say capping out-of-pocket costs for insulin at $35 a month (53%) and placing a limit on out-of-pocket costs for seniors (52%) are top priorities for Congress to take action on in the coming months. Majorities across partisans say many of the health care priorities asked about are important for Congress to work on in the coming months.”
Comment: No healthcare issue made the graphic reports on the country’s leading problems or major voting issues.
About Covid-19
Pfizer/BioNTech COVID vaccine slashes pediatric hospitalization risk -U.S. study “Children ages 5 to 11 who received the Pfizer /BioNTech COVID-19 vaccine were 68% less likely to be hospitalized during the Omicron wave in the United States than unvaccinated children…
Adolescents aged 12-18 who received two shots of the vaccine were around 40% less likely to be hospitalized with the Omicron variant of the virus…
The risk of more serious outcomes, including need for mechanical breathing assistance or death, was nearly 80% lower for those who received the shots in that age group.”
Number of COVID patients in US hospitals reaches record low “COVID-19 hospitalization numbers have plunged to their lowest levels since the early days of the pandemic, offering a much needed break to health care workers and patients alike following the omicron surge.
The number of patients hospitalized with the coronavirus has fallen more than 90% in more than two months, and some hospitals are going days without a single COVID-19 patient in the ICU for the first time since early 2020.”
Persistent cognitive impairment after mild COVID infection linked to CSF inflammation “People with persistent cognitive symptoms after mild COVID-19 infection had elevated cerebrospinal fluid inflammatory markers, according to a presentation at the 2022 American Academy of Neurology annual meeting…
Researchers found that those with acute-onset cognitive symptoms had higher levels of CSF immunovascular marker VEGF-C compared with those with delayed-onset cognitive symptoms, as well as cognitively asymptomatic controls.
In addition, those with acute-onset symptoms also had higher CSF levels of IP-10, IL-8, placental growth factor and intercellular adhesion molecule-1.”
Comment: The therapeutic implications of these findings are not yet clear.
About health insurance
Assessing Federal and State Network Adequacy Standards for Medicaid and the Marketplace
“Key Findings
--There is dramatic variation in standards for health insurers’ physician networks across states and among Medicaid and Marketplace plans in the same state. Individuals’ ability to access in-network providers varies widely as a result.
--Marketplace enrollees have few federal protections. Federal regulations require states to oversee insurer networks for Medicaid managed care organizations, but no such requirements exist for Marketplace qualified health plans (QHPs).
--State regulations protecting access to primary care providers and rural health clinics are limited. Federal regulations requiring health plans to contract with essential community providers, like primary care providers and rural health clinics, offer states considerable flexibility, but most states do not enforce standards stronger than baseline requirements.
--Cultural competency requirements are lacking. There are no federal requirements that individuals be able to access healthcare that meets their language or cultural needs. Although most states have cultural competency requirements for managed care organizations, far fewer have similar requirements for QHPs.”
CMS to give $110M to boost participation in Medicaid's Money Follows the Person program “The Biden administration will distribute more than $110 million to help expand home and community-based services in Medicaid via the Money Follows the Person program that aims to boost home-based care for Medicaid beneficiaries…
Money Follows the Person was approved back in 2005 and aims to reduce the use of institutional-based services and transition beneficiaries to more home and community-based services.
The additional funding aims to help states and territories get a new program off the ground, including recruiting home-care providers and experts for transition coordination and how to establish system assessments to understand how home-care services can support residents, according to a release on the funding.”
State-based ACA exchanges make backup plans in case Congress fails to act on enhanced ACA subsidies “…state-run exchanges are eyeing backup plans for outreach and marketing in case Congress doesn’t extend beyond this year a major driver for those enrollment gains: enhanced income-based subsidies. Some officials have warned that people could drop off coverage—and consumers may shift to less-generous plans—if Congress doesn't act in time.
The American Rescue Plan's (ARP's) enhanced subsidies ensured that anyone making more than 400% above the federal poverty level wouldn’t pay more than 8.5% of their income on healthcare. Previously, that was the cutoff for eligibility for income-based subsidies. The enhancements also ensured that some consumers qualified for zero premiums or $10 a month premiums.
According to a recent Assistant Secretary for Planning and Evaluation report, an estimated 3.4 million Americans currently insured in the individual market would lose coverage and become uninsured if the ARP’s premium tax credit provisions are not extended beyond 2022. Kaiser Family Foundation determined premiums would more than double for many.”
CMS: States can seek to extend postpartum Medicaid, CHIP coverage to 12 months “States are now able to extend Medicaid postpartum coverage for a year, with Louisiana being the first to take up the new expansion.
The Centers for Medicare & Medicaid Services (CMS) announced Friday that states can now seek to extend coverage approved under the American Rescue Plan passed last year. States will have the additional coverage for five years.”
About pharma
Novartis to save at least $1 billion by 2024 thanks to simplified structure “Novartis said on Monday it was integrating its pharmaceuticals and oncology units into an innovative medicines (IM) business to simplify its structure, targeting savings of at least $1 billion by 2024.
"Integrating pharmaceuticals and oncology business units into an innovative medicines (IM) business with separate U.S. and international commercial organizations will increase focus, strengthen competitiveness and drive synergies," the Swiss pharmaceutical company said in a statement.
It said it expects selling, general and administrative savings of at least $1 billion to be fully embedded by 2024 as a result of these changes.”
Comment: Companies have divided divisions by numerous segmentation categories: geography, customer type, customer size, and therapeutic product line, to name some common methods. But as far as profitability, the only “sure bet” has been achievement of economies of scale on operation functions. This action by Novartis represents a reverse trend for the industry. Let’s see if any others follow.
SGLT-2 inhibitors added to new US heart failure treatment guidelines “Updated US guidance now includes SGLT-2 inhibitors as part of recommended treatment strategies for patients with symptomatic chronic heart failure with reduced ejection fraction (HFrEF), regardless of whether they have type 2 diabetes. The new joint guidelines were issued Friday by the American College of Cardiology (ACC), the American Heart Association (AHA) and the Heart Failure Society of America.”
Medicare Part D and Beneficiaries Could Realize Significant Spending Reductions With Increased Biosimilar Use From the HHS OIG: “We estimated that with increased use of biosimilars instead of reference products, Part D and beneficiary spending could have been considerably reduced in 2019. Specifically, Part D spending on biologics with available biosimilars could have decreased by $84 million, or 18 percent, if all biosimilars had been used as frequently as the most used biosimilars. Additionally, beneficiaries' out of pocket costs for these drugs could have decreased by $1.8 million, or 12 percent. Although these amounts are modest in the context of overall Part D spending, far greater spending reductions will be possible as additional biosimilars become available.”
More Than 600 Medicines in Development for Diseases Impacting Women “To address the need for new treatments, specifically for women and for diseases that are of major concern to them, America’s biopharmaceutical research companies are developing 625 medicines targeting diseases that disproportionately or solely affect women. These medicines are either in clinical trials or under review by the U.S. Food and Drug Administration (FDA)…”
This monograph from PhRMA discusses these drugs.
Big Pharma-backed $1B AMR Action Fund picks 1st antimicrobial biotech investments “The AMR Action Fund, backed by Big Pharmas such as Pfizer, Eli Lilly, Bayer and more, has selected the first beneficiaries of its $1 billion fund to address drug-resistant bacterial infections: Adaptive Phage Therapeutics and Venatorx Pharmaceuticals.
The two small biotechs will become the first portfolio companies of the AMR Action Fund, an initiative formed in collaboration with the World Health Organization, the European Investment Bank and the Wellcome Trust. Other pharma members include GlaxoSmithKline, Johnson & Johnson, Merck & Co., Merck KGaA, Novartis, Roche, Takeda, Teva and many more.”
About the public’s health
Universal Hepatitis B Vaccination in Adults Aged 19–59 Years: Updated Recommendations of the Advisory Committee on Immunization Practices — United States, 2022 “In addition to groups for whom HepB vaccination is already recommended, the Advisory Committee on Immunization Practices recommends that all adults aged 19–59 years should receive HepB vaccines.
Universal adult HepB vaccination through age 59 years removes the need for risk factor screening and disclosure and could increase vaccination coverage and decrease hepatitis B cases.”
NoroSTAT Data From the CDC, a reminder of “other” public health issues:
“During August 1, 2021 – March 5, 2022, there were 448 norovirus outbreaks reported by NoroSTAT-participating states. During the same period last seasonal year, there were 78 norovirus outbreaks reported by these states.
The number of outbreaks reported during the 2021-22 seasonal year is below the range reported during the same period over the previous 8 years.”
Per- and Polyfluoroalkyl Substances (PFAS) in Facemasks: Potential Source of Human Exposure to PFAS with Implications for Disposal to Landfills “Inhalation was estimated to be the dominant exposure route (40%–50%), followed by incidental ingestion (15%–40%) and dermal (11%–20%). Exposure and risk estimates were higher for children than adults, and high physical activity substantially increased inhalation exposure. These preliminary findings indicate that wearing masks treated with high levels of PFAS for extended periods of time can be a notable source of exposure and have the potential to pose a health risk. Despite modeled annual disposal of ∼29–91 billion masks, and an assuming 100% leaching of individual PFAS into landfill leachate, mask disposal would contribute only an additional 6% of annual PFAS mass loads and less than 11 kg of PFAS discharged to U.S. wastewater.”
About health technology
The complete sequence of a human genome “Since its initial release in 2000, the human reference genome has covered only the euchromatic fraction of the genome, leaving important heterochromatic regions unfinished. Addressing the remaining 8% of the genome, the Telomere-to-Telomere (T2T) Consortium presents a complete 3.055 billion–base pair sequence of a human genome, T2T-CHM13, that includes gapless assemblies for all chromosomes except Y, corrects errors in the prior references, and introduces nearly 200 million base pairs of sequence containing 1956 gene predictions, 99 of which are predicted to be protein coding. The completed regions include all centromeric satellite arrays, recent segmental duplications, and the short arms of all five acrocentric chromosomes, unlocking these complex regions of the genome to variational and functional studies.”
About healthcare finance
Private equity firm Thomas H. Lee Partners snags Intelligent Medical Objects for $1.5B “Private equity firm Thomas H. Lee Partners plans to buy healthcare data enablement company Intelligent Medical Objects in a $1.5 billion deal.
The deal marks an exit for Warburg Pincus six years into its investment, valuing the Rosemont, Illinois-based company at north of $1.5 billion...
Founded almost 30 years ago, IMO manages more than 5 million clinical terms and maps to all major coding systems.”