Today's News and Commentary

About health insurance/insurers

 NeueHealth reports a nearly quarter-billion net loss during Q4 earnings “NeueHealth posted a $242 million net loss during its fourth-quarter earnings March 6, as the insurtech attempts to turn a corner after a tumultuous 2023.
The company recorded a net loss of $1.2 billion last year, but it achieved $292 million in revenue last quarter, up 29% year-over-year, and $1.2 billion in full-year consolidated revenue, a 55% increase year-over-year. Earnings per share came in at a loss of $30.47, though that jumps to $19.54 in the black once it excluded discontinued operations.
NeueHealth rebranded from Bright Health in January, attempting to put its past troubles in the rearview mirror.”

About hospitals and healthcare systems

UPMC reports almost $200M operating loss as expenses rise “Pittsburgh-based UPMC, a 40-hospital system, has reported a 2023 operating loss of $198.3 million (-0.7% operating margin) on revenue of $27.7 billion. 
Those figures compare with a $162.1 million operating gain on revenue of $25.5 billion in 2022. Expenses in 2023, totaling $27.9 billion, were approximately 10% up on 2022. That included a 13.6% jump in insurance claims expenses. 
The healthcare system's measure of inpatient activity grew 3% over the previous year while average outpatient revenue per workday rose 10% and average physician revenue per weekday grew by 9%.”

Mayo Clinic closed out 2023 with $18B in revenue, 6% operating margin “Rochester, Minnesota-based Mayo Clinic reported revenue of $17.9 billion in 2023, outpacing expenses by over $1 billion and resulting in what the health system called a “mission-sustaining” 6% operating margin.
The revenue figure, which compared with $16.3 billion in 2022, included investments totaling $536 million which were used to support current operating activities, the health system recently reported in financial disclosures.
The organization saw its net medical service revenue grow 8.8% year over year to $15.1 billion.
Though revenue outpaced expenses, the health system's expenses were up 7.4% compared to 2022, totaling $16.9 billion for the year. Mayo Clinic said it welcomed 14,000 new staffing roles into the system in 2023, up almost 5% from 2022.”

Trauma Center Hospitals Charged Higher Prices For Some Nontrauma Care Than Non–Trauma Center Hospitals, 2012–18 “Hospitals serving as trauma centers are often endowed by regulators with monopoly power over trauma services in their geographic areas, and this monopoly power may spill over to nontrauma services. This study focused on the growing number of designated trauma centers and how trauma center status affects hospital prices for other, nontrauma services. We found that hospitals designated as trauma centers charged higher prices for nontrauma inpatient admissions and nontrauma emergency department visits when compared with hospitals that were not designated as trauma centers, even after controlling for potential confounders.” 

About pharma

 Drugmakers take Biden health-care win to court today “A federal judge in New Jersey accepted Bristol Myers Squibb, Novo Nordisk, Novartis and Johnson & Johnson’s request to present oral arguments jointly, citing the “overlapping nature” of their claims. Notably, each defendant manufactures one of the 10 drugs selected for Medicare’s inaugural round of price negotiations.”

Another day, another win for Novo in obesity, as early oral med appears to beat Wegovy “Novo Nordisk appears to have blown its own drug Wegovy out of the water. The Danish pharma reported early results for a next-gen oral weight loss drug called amycretin, showing 13.1% weight loss after 12 weeks.
Reporting the early phase 1 results during a capital markets day Thursday, Novo was sparse on details but still generated significant excitement.
Amycretin is a GLP-1 and amylin receptor agonist that Novo is hoping will show additive benefits with a differentiated mode of action from its comparable GLP-1 drug semaglutide, marketed as Wegovy for weight loss and Ozempic for diabetes. The therapy is dosed once daily—which could prove to be a huge improvement over the weekly injections of Wegovy and competitor Zepbound, which is marketed by Eli Lilly.”

Medicare Part D Plans Greatly Increased Utilization Restrictions On Prescription Drugs, 2011–20 “We examined trends in the prevalence of utilization restrictions on non-protected-class compounds in Medicare Part D plans during the period 2011–20, including prior authorization and step therapy requirements as well as formulary exclusions. Part D plans became significantly more restrictive over time, rising from an average of 31.9 percent of compounds restricted in 2011 to 44.4 percent restricted in 2020. The prevalence of formulary exclusions grew particularly fast: By 2020, plan formularies excluded an average of 44.7 percent of brand-name-only compounds. Formulary restrictions were more common among brand-name-only compared with generic-available compounds, among more expensive compounds, and in stand-alone compared with Medicare Advantage prescription drug plans.”

Boehringer Ingelheim to cap asthma inhaler out-of-pocket costs at $35 “Facing criticism over its pricing, Boehringer Ingelheim plans to cap out-of-pocket costs at $35 a month for its entire line of inhalers that are used to combat asthma and chronic obstructive pulmonary disease.
The program, which begins on June 1, is directed at Americans with commercial health insurance, but also at those who lack insurance and, therefore, must pay cash for their inhalers. In taking this step, the company cast its efforts as a bid to assist ‘vulnerable’ patients at a time when an increasing number of people are complaining about the cost of prescription drugs.”

About the public’s health

Do the associations of daily steps with mortality and incident cardiovascular disease differ by sedentary time levels? A device-based cohort study “Any amount of daily steps above the referent 2200 steps/day was associated with lower mortality and incident CVD risk, for low and high sedentary time. Accruing 9000–10 500 steps/day was associated with the lowest mortality risk independent of sedentary time. For a roughly equivalent number of steps/day, the risk of incident CVD was lower for low sedentary time compared with high sedentary time.” 

Cancer-causing chemical found in Clinique, Clearasil acne treatments, US lab reports “High levels of cancer-causing chemical benzene were detected in some acne treatments from brands including Estee Lauder's Clinique, Target's Up & Up and Reckitt Benckiser-owned Clearasil, said independent U.S. laboratory Valisure.
Valisure has also filed a petition with the U.S. Food and Drug Administration, calling on the regulator to recall the products, conduct an investigation and revise industry guidance, the New Haven, Connecticut-based lab said on Wednesday.”

Plastics, Fossil Carbon, and the Heart “In this issue of the [New England Journal of Medicine], the results of the prospective study by Marfella et al. on the asso- ciation of microplastics and nanoplastics with cardiovascular outcomes further expand our understanding of the health hazards posed by plastics. This study, which included 312 patients who underwent carotid endarterectomy, showed that microplastics and nanoplastics were detect- able in the excised plaque of 58% of the patients. The presence of microplastics or nanoplastics in carotid artery plaque was associated with a sub- sequent risk of nonfatal myocardial infarction, nonfatal stroke, or death from any cause that was 2.1 times that in patients whose plaques did not contain microplastics or nanoplastics. Patients with microplastics or nanoplastics in their plaque tissue also had elevated expression of circulating inflammatory markers…
Previous investigations have detected micro- plastics and nanoplastics in multiple tissues, including colon, placenta, liver, spleen, and lymph node tissues. Animal studies indicate that micro- plastics and nanoplastics can cause toxic effects at multiple sites, potentially by inducing oxidative stress…
What can physicians and other health professionals do? The first step is to recognize that the low cost and convenience of plastics are deceptive and that, in fact, they mask great harms, such as the potential contribution by plastics to outcomes associated with atherosclerotic plaque. We need to encourage our patients to reduce their use of plastics, especially unnecessary single-use items. We need to inventory our own and our institutions’ use of plastics and identify areas for reduction. We need to express our strong support for the United Nations Global Plastics Treaty. We need to argue for inclusion in the treaty of a mandatory global cap on plastic production, with targets and timetables, restrictions on single-use plastics, and comprehensive regulation of plastic chemicals.”