About the public’s health
Update on yesterday’s story about Japan’s response to disease tracking: My friend and colleague, Professor Naoki Igagami, MD in Tokyo, wrote to me that the health centers have been “ held responsible for their slow response. All wanting to have PCR must be authorized by them. Only those who had severe symptoms or who had contact were tested.” His comments highlight the importance of first hand reporting from unbiased sources.
Two articles on allocation of scarce resources:
A Proposed Lottery System to Allocate Scarce COVID-19 Medications: A proposal to deal with scarcity of medications in a crisis.
A Global Framework to Ensure Equitable and Fair Allocation of COVID-19 Products:This position paper from the WHO outlines “the major elements of WHO’s proposal for a Global Allocation Framework for COVID-19 products” and illustrates “the potential use of this framework to allocate vaccines.”
A mathematical model reveals the influence of population heterogeneity on herd immunity to SARS-CoV-2: “We show that population heterogeneity can significantly impact disease-induced immunity as the proportion infected in groups with the highest contact rates is greater than in groups with low contact rates. We estimate that if R0 = 2.5 [the number infected by each affected person] in an age-structured community with mixing rates fitted to social activity then the disease-induced herd immunity level can be around 43%, which is substantially less than the classical herd immunity level of 60% obtained through homogeneous immunization of the population.”
CDC and drugmakers boost flu vaccine doses amid fears of an unprecedented respiratory illness season: “Even though flu season doesn’t begin until the fall, major flu vaccine manufacturers say they plan to boost production by about 10 percent, to about 189 million doses, up from 170 million doses last year, to ensure enough doses exist for an anticipated surge in people seeking flu shots.”
Brazilian President Bolsonaro ordered to wear face covering or pay fine: The headline and implications for our country speak for themselves.
Morehouse School of Medicine gets $40 million grant to fight COVID-19: “The medical school will work with the HHS Office of Minority Health on a three-year project with community-based organizations across the nation to deliver education and information on resources to help fight the pandemic, such as testing and vaccinations once one is developed and federally-approved.”
About pharma
C-Path Launches CURE Drug Repurposing Collaboratory to Accelerate Identification of New Uses of Existing Drugs to Treat Infectious Diseases, Including COVID-19: “Critical Path Institute (C-Path)… announced the launch of the CURE Drug Repurposing Collaboratory (CDRC) funded by the U.S. Food and Drug Administration (FDA), in collaboration with the National Center for Advancing Translational Sciences (NCATS), part of the National Institutes of Health (NIH). A public-private partnership, CDRC will provide a forum for the exchange of clinical practice data to inform potential new uses of existing drugs for areas of high unmet medical need, advancing research in these areas. The Collaboratory will also create a network connecting major treatment centers, academic institutions and researchers, private practitioners, government facilities and health care professionals around the world.”
US sues Regeneron over alleged kickbacks for Eylea: “The US Attorney for the District of Massachusetts announced on Wednesday that the government filed a civil complaint against Regeneron Pharmaceuticals, alleging that the drugmaker paid $35 million in kickbacks for Eylea (aflibercept), using a foundation as a conduit to cover co-pays…” This strategy is common and known to be prosecutable.
U.S. group raises pricing recommendation for Gilead's remdesivir in COVID-19: “Gilead Sciences Inc’s antiviral remdesivir could be priced up to $5,080 per course based on benefits shown in COVID-19 patients, a U.S. drug pricing research group suggested on Wednesday, above its prior recommendation of around $4,500.
The Institute for Clinical and Economic Review (ICER) said its recommendation change stemmed from recent clinical data, updated cost estimates, public comments and interactions with Gilead.
However, Boston-based ICER suggested a lower price range of around $2,520 to $2,800, if steroid dexamethasone were to be cleared for use in COVID-19. The cheap and widely used steroid was found to reduce death rates in severely ill patients in a study earlier this month.”
About healthcare quality
National Quality Forum Releases Task Force Roadmap to Normalize High Quality Care for Every Person by 2030: The National Quality Forum (NQF) released “The Care We Need: Driving Better Health Outcomes for People and Communities, a National Quality Task Force report that provides a roadmap to consistent and predictable high quality care for every person by 2030. Underscored by the current COVID-19 pandemic, the report specifies opportunities to improve the health outcomes of people and communities with recommendations that focus on the importance of a seamless system of comprehensive, accessible care designed to keep people healthy and well.”
Included in these recommendations are five “Foundational opportunities to address structural change:
Implement a single-person identifier to match people to health records across all care settings
Standardize quality data to enable improvement and outcomes analysis
Adopt population health-based payment as the primary payment model
Standardize data and interventions to reduce disparities and achieve health equity
Create actionable intelligence to better educate and engage healthcare consumers”
About health insurance
Shortchanged: How the Trump Administration’s Expansion of Junk Short-Term Health Insurance Plans is Putting Americans at Risk: This report is from the House Committee on Energy and Commerce. About 3 million Americans had short-term health plans last year, an increase of 600,000 or 27 percent from 2018. “The Committee’s investigation finds that on average, less than half of the premium dollars collected from consumers are spent on medical care, unlike ACA-compliant individual market plans, which are required to spend at least 80 percent of all premium dollars on health care.” Despite the partisan title it is a really good analysis of these types of plans.