Today's News and Commentary

About the public’s health

Trends in Human Papillomavirus Vaccine Types 16 and 18 in Cervical Precancers, 2008–2014: HPV vaccinations are working to reduce incidence and spread of the two most common cancer-causing strains. According to this research: “From 2008–2014, the proportion of HPV16/18-positive CIN2+ declined, with the greatest declines in vaccinated women; declines in unvaccinated women suggest herd protection.”

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Trump steps up attack on Planned Parenthood: In a rule issued Friday, the Trump administration issued new rules making clinics ineligible for Title X Family Planning funds unless they are physically and financially separate from abortion providers. This ruling hits Planned Parenthood especially hard. Undoubtedly these changes will be challenged in the courts.

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Chemicals in e-cig flavors could harm respiratory tract: Flavoring chemicals that have been regarded as safe were found to be harmful when inhaled. In recent lab experiments, “diacetyl - a chemical with a butter-like smell - and its ‘chemical cousin’ 2,3-pentanedione” were found to cause genetic damage in the cells that line the respiratory track. This study adds further evidence that e-cigarettes are not safe.

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These Are the World's Healthiest Nations:The Bloomberg Healthiest Country Index is now out. Spain took the #1 spot from Italy, which is now #2. The US is down one spot at 36- one below Costa Rica and six below Cuba. Health systems, as well as healthy practices like diet, are factors the study cites for these findings.

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Association of Physician Organization–Affiliated Political Action Committee Contributions With US House of Representatives and Senate Candidates’ Stances on Firearm Regulation: The simple (though disturbing) conclusion of this research is that for the 2016 election: “Physician organization–affiliated PACs included in this study donated more funds to more US House of Representatives and Senate candidates who oppose firearm safety policies than to candidates in support of such policies.” The reasons for PAC donations are complex and include candidate stances on insurance issues and other public health matters. Still, this issue should be high on the priority of the mix of important topics that determine support.

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About pharma

Roche nears $5-billion deal to acquire Spark Therapeutics: report: In the latest case of pharma M&A, Roche will spend a reported $4.3 billion to purchase gene therapy company Spark Therapeutics.

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GE to sell its biopharma business to Danaher for $21.4B: The above announcement was all over the news today: but in a much even bigger deal, GE is selling its biopharma business as part of a restructuring plan.

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Novartis gene therapy would be cost effective up to $900,000: U.S. group: The Institute for Clinical and Economic Review (ICER) calculated that Novartis’ gene therapy for muscular dystrophy would be cost effective not only at the target price of $900,000 but also up to $5million. These findings raise many questions about how much is available to spend on healthcare. It is unlikely countries with national budgets for healthcare (everyone but the US) would pay so much. We will need to see how this pricing plays out in the public and private sectors.

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Senators Introduce Bill to Prevent Using Native American Tribes to Shield Patents: Last year, Allergan cut a deal with the St. Regis Mohawk tribe to protect its patent on Restasis. The legal theory is that native tribes have their own sovereign immunity that gives them special status with respect to patents. Several Republican senators have introduced a bill to take such legal maneuvers off the table.

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About human resources

Changes in Burnout and Satisfaction With Work-Life Integration in Physicians and the General US Working Population Between 2011 and 2017: Physician shortages are due to both supply and demand problems. On the supply side, physicians have either been leaving practice or cutting back due to “burnout.” The good news is: “Burnout and satisfaction with work-life integration among US physicians improved between 2014 and 2017, with burnout currently near 2011 levels.” The bad new is physicians are “at increased risk for burnout (odds ratio, 1.39; 95% CI, 1.26-1.54; P<.001) and [are] less likely to be satisfied with work-life integration (odds ratio, 0.77; 95% CI, 0.70-0.85; P<.001) than other working US adults.”

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Healthcare Executives See a Mixed Outlook: Physicians are the toughest recruits for healthcare organizations but nurses, other healthcare professionals, as well as administrators are also in short supply.

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About healthcare IT

Data error exposes patient information: In the latest case of large data breaches, the University of Washington (UW Medicine) announced that a vulnerability in their system exposed Protected Health Information of about 974,000 individual patients.

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Epic Systems Remains Top Overall Software Suite in KLAS Rankings: The annual KLAS rankings are out for software systems. While Epic Systems remains best overall, each category has its own best product.

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About healthcare quality

Health plan solutions can help improve patient care, but will providers adopt them?: Physicians trust heath plans only a bit more than pharma companies (which have the lowest low scores). Yet plans need their cooperation to improve patient quality outcomes. What can be done?
A recently released Deloitte survey said that compliance and cooperation are fostered if the plans offer providers assistance, like help with care coordination and chronic care management. Also, providers would like certain benefits in return for their participation, including reduced preauthorizations and preferred status in the plan’s network.

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Factors Associated With High-Quality Guidelines for the Pharmacologic Management of Chronic Diseases in Primary Care: This article points out the need for clinical research to make sure what we do is evidence-based. The authors of this literature review found that clinical practice guidelines (CPGs) in primary care “are of widely variable quality, with less than 25% of included CPGs rated as high quality. “

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