About the public’s health
Global reach of ageism on older persons’ health: A systematic review: “Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism).” As the global population ages, we clearly need to address this type of discrimination.
How Anti-Vaccine Activists Doomed a Bill in New Jersey: The headline is the story. It is a fascinating (and sad) tale of how lobbying killed a law that would improve the public’s health.
Sex Differences in Blood Pressure Trajectories Over the Life Course: This sex difference is new clinical information. When we construct Artificial Intelligence algorithms for treatment, it must be flexible enough to incorporate such new information.
“In contrast with the notion that important vascular disease processes in women lag behind men by 10 to 20 years, sex-specific analyses indicate that BP measures actually progress more rapidly in women than in men, beginning early in life. This early-onset sexual dimorphism may set the stage for later-life cardiovascular diseases that tend to present differently, not simply later, in women compared with men.”
About pharma
Pharmacy Owners Express Concern Over Amazon’s PillPack Prescription Transfer Requests: “Independent pharmacists are expressing concern over a growing practice involving Amazon’s Pillpack, describing what some believe is the company sending unsolicited phone calls to their patients as a way of requesting transfers of prescriptions.”
Civica Rx Partners with Thermo Fisher Scientific to Develop and Manufacture Drugs with a History of Drug Shortages: Civica announced “it has signed a long-term agreement with Thermo Fisher Scientific to develop and manufacture medications with Civica as the owner of the regulatory pathway. By working with Thermo Fisher to develop Civica-owned Abbreviated New Drug Applications (ANDAs), Civica will secure the manufacture of certain essential medications, further mitigating the risk of drug shortages in the future.”
About healthcare professionals
Half of doctors would take a pay cut for less hours, more work-life balance: “Half of physicians said they would take a salary reduction of up to $20,000 per year in exchange for working less hours and achieving a better work-life balance, according to a new survey…Millennials (52%), Generation Xers (48%) and baby boomers (49%) all said they would take a salary cut in exchange for more personal time. That was true even among millennials, who typically earn less than their more established peers. Some 53% of women said they would take a pay cut, versus 47% of men.”
How brands can inspire doctors to take more action: “Our qualitative research, validated though quantitative research, identified four major motivators for physicians, one rational and three emotional.” Key on pages five and six of the report. Think about how you would market products and services to physicians given this decision-making information.
Interesting science
Intratumoral expression of IL-7 and IL-12 using an oncolytic virus increases systemic sensitivity to immune checkpoint blockade: In mouse models, injecting a viral fragment encoded with inflammatory genes resulted in complete tumor regression, even in distant tumor deposits. “Mice achieving complete tumor regression resisted rechallenge with the same tumor cells, suggesting establishment of long-term tumor-specific immune memory. Combining this virotherapy with anti–programmed cell death-1 (PD-1) or anti–cytotoxic T lymphocyte antigen 4 (CTLA4) antibody further increased the antitumor activity as compared to virotherapy alone, in tumor models unresponsive to either of the checkpoint inhibitor monotherapies.” Benefits were seen for melanoma and, to a lesser extent, colon cancer.
About health insurance
Projected costs of single-payer healthcare financing in the United States: A systematic review of economic analyses: This study will undoubtedly be in the news in the coming days. “To achieve net savings, single-payer plans rely on simplified billing and negotiated drug price reductions, as well as global budgets to control spending growth over time.”
Not included in administrative costs for Medicare are all the fraudulent activities the program incurs because of weak oversight compared to private plans. Further, private plans offer a large variety of benefits and payment methods because the public wants such choice; that choice adds to administrative costs of plans.
One further caution, the administrative cost difference between Medicare and private plans is not as great as first appears. One reason Medicare administrative costs are “lower” is healthcare expenses are much higher than commercial populations, i.e., as the denominator increases, the percent decreases.
Repeal of Obamacare taxes stirs questions on durability of offsets: The 2019 Congressional budget resulted in repeal of three health care taxes — a 2.3 percent levy on medical devices, a fee on health insurers and a 40 percent excise tax on high-cost health plans (also known as the Cadillac tax). Despite estimates that these taxes would have produced $373 billion over a decade, the liberal Center on Budget and Policy Priorities found the health care law would still reduce the deficit by between $55 billion and $75 billion in 2025.
Avalere: CMMI will not generate as much savings for Medicare as CBO projected:
“Avalere Health estimates that CMMI’s payment demonstrations will save Medicare $18 billion from 2017 through 2026, compared to $34 billion projected by CBO back in 2016.”
How the Affordable Care Act Has Narrowed Racial and Ethnic Disparities in Access to Health Care: The headline gives the “bottom line” in the study. One example: “The gap between black and white adult uninsured rates dropped by 4.1 percentage points, while the difference between Hispanic and white uninsured rates fell 9.4 points.”
About healthcare quality
Checking in on the checklist: This monograph is a good review of the benefits of surgical checklists in the past 10 years. What is fascinating is the global view of its adoption (see pages 21 and 22). 90% of highly developed countries use checklists while only 33% of lower developed countries do so. Reasons for this huge disparity are given.