About health insurance
Medicare Advantage enrollment swells: “Roughly 24.4 million seniors and people with disabilities were enrolled in a Medicare Advantage plan as of this month, a 9.4% jump from the same time in 2019, according to the latest federal data analyzed by Axios.”
About the public’s health
Hospice writes prescription for social interaction: Doctors, nurses and social workers at the Hospice of Windsor & Essex County (Ontario) can write a referral allowing patients and caregivers to attend programs at the YMCA, the Art Gallery of Windsor, or the Windsor Symphony Orchestra at no cost.
Behavioral Heuristics in Coronary-Artery Bypass Graft Surgery: This letter in the New England Journal of Medicine made its way into the popular press and deals with number bias. “Patients with acute myocardial infarction [heart attack] who were admitted in the 2 weeks after their 80th birthday were similar to those admitted before their 80th birthday with regard to various baseline characteristics... However, those admitted after their 80th birthday were significantly less likely to undergo CABG than those admitted before their 80th birthday…, with no corresponding difference among patients who were admitted in the 2 weeks after as compared with 2 weeks before their 77th through 79th or 81st through 83rd birthdays.”
Twice as High Diet-Induced Thermogenesis After Breakfast vs Dinner On High-Calorie as Well as Low-Calorie Meals: “Our data show that the time of day of food intake makes a difference in humans’ energy expenditure and metabolic responses to meals. These in-laboratory standardized experiments, which eliminated the possible influence of sleep disturbances and carbohydrate preloads, support the thesis that… breakfast has a more efficient energetic value for our body than dinner.”
About healthcare IT
Diabetes patients who use online tools manage disease better:”Kaiser Permanente scientists report that diabetes patients who used the Kaiser Permanente patient portal and mobile phone app improved their diabetes management outcomes.” Here is the original research.
About pharma
PBM industry report claims greater use of tools can generate $1T in savings over next decade: “The tools the study examined include rebates and discounts PBMs negotiate from drugstores and manufacturers, mail-service and specialty pharmacies, drug utilization programs, adherence programs to improve care management and formulary management tools such as step therapy and prior authorization.
Visante estimated that if plan sponsors use the full range of PBM tools, they could save more than 30% on drug benefit costs compared to sponsors that ‘opt out or are required to limit their use of PBM tools,’ the study said.
While a majority of commercial plans use prior authorization or step therapy, PBM-funded research found that 38% of plans don't use mandatory generic drug programs and 47% don't use a preferred pharmacy.”
About healthcare IT
Number of patient records breached nearly triples in 2019: “Over 41 million patient records were breached in 2019, with a single hacking incident affecting close to 21 million records…Staff members inside healthcare organizations were responsible for breaching 3.8 million patient records in 2019, up from 2.8 million records in 2018.”
About pharma
Prescription Price Transparency and the Patient Experience: Fascinating results indicate that not only do people not fill prescriptions that they perceive are too expensive, but also are not filled promptly. The decisions on cost and speed vary greatly by generation. Millennials are very impatient.
Oscar Health caps price of 100 drugs at $3 per month: In a related article, “Oscar said it made the decision to cap the out-of-pocket cost of 100 of the most common drugs to boost medication adherence, which typically results in fewer physician and emergency room visits.”
Court Rules that a Drug’s API Doesn't Impact ‘U.S. Made’ Designation: “The decision by the Federal Circuit Court of Appeals stemmed from a two-year dispute between Acetris and the Department of Veteran’s Affairs over the department’s decision to not purchase ten of its drugs, including the generic Hepatitis B drug entecavir, because the APIs were sourced from India.
The VA argued that buying ‘products of India’ would violate the federal law dictating that the department can only purchase U.S.-made end products.’”
Be careful with biosimilars marketing, FDA and FTC say. We're watching: “The two agencies released a joint statement detailing their promise to police promotional messaging as well as review patent agreements to prevent antitrust collations, share best practices and collaborate on public outreach…Another key to ensuring that public information surrounding biosimilars and their reference products is communicated in a truthful and non-misleading manner is the FDA’s regulation of industry’s promotional materials for all prescription drugs, including biosimilar and reference products.”