About health insurance
More Medicare Advantage Plans Will Offer Non-Medical Benefits in 2022: “…in 2022, the most commonly offered benefit of the 4 that Avalere analyzed is meals (68%), followed by transportation (39%), nutrition (30%), and in-home support services (11%). The percentage of plans offering these types of benefits will increase from 2021 to 2022, with the largest increases for nutrition and in-home support. Smaller increases will occur in the percentage of plans offering meals and transportation.”
Commercial Health Insurance Markups over Medicare Prices for Physician Services Vary Widely by Specialty: “In this study, we assess the variation across physician specialties in commercial markups over Medicare prices for professional services…
Our sample includes 17 physician specialties and approximately 20 services per specialty that represent about 40 percent of total professional spending. We find that family medicine, obstetrics and gynecology, dermatology, ophthalmology, and psychiatry had the lowest commercial markups relative to Medicare prices, averaging about 110 percent of Medicare rates or less. Nine specialties received commercial payments between 120 and 150 percent of Medicare rates, on average. These included gastroenterology, cardiology, general surgery, and orthopedics. Radiology and neurosurgery received commercial payment rates of 180 and 220 percent of Medicare rates, whereas emergency department and critical care specialties received commercial payment rates of 250 percent of Medicare rates. Anesthesia received the highest markup at 330 percent of Medicare rates. Our findings have important implications for debates over physician payment reforms, public option and single-payer policies, and Medicare payment reforms.”
About hospitals and health systems
Tenet's operating income hits $1B in Q3: “Dallas-based Tenet Healthcare saw many of its key financial metrics improve in the third quarter of 2021, according to its financial report released Oct. 20.
In the third quarter ending Sept. 30, the for-profit hospital system saw its net operating revenue hit $4.9 billion, up 7.4 percent from the $4.6 billion recorded in the same period last year.
Tenet saw revenue growth in its hospital and ambulatory divisions.”
About healthcare IT
Oak Street Health buys virtual care provider for $130M: “Oak Street Health, a Chicago-based network of primary care centers for Medicare patients, acquired virtual consult platform RubiconMD for $130 million, the company said Oct. 21…
Under the deal, Oak Street Health will integrate RubiconMD's virtual specialty care services into its existing care model.”
About pharma
Pfizer says its vaccine booster restores full protection against COVID-19: “Pfizer and BioNTech said Thursday that a late-stage trial of the drugmakers' COVID-19 vaccine booster showed it restored full protection against the disease. In a test involving 10,000 participants, the additional shot was 95.6% effective against the disease, according to the companies.”
Aduhelm is bombing: “Biogen sold $300,000 worth of Aduhelm in the third quarter, well below Wall Street's expectations, which prompted analysts at Raymond James to call the Alzheimer's drug ‘potentially the worst drug launch of all time’ amid Biogen's ‘persistent hyperbole about the drug's purported benefits.’..
Aduhelm's controversial approval and high price tag have shaped the market reaction. Health insurers are hesitant to cover Aduhelm until Medicare makes a decision next year, and doctors aren't embracingthe drug either.”
New initiative launches to attack problem of substandard generic drug distribution: “ARTiFACTS, creator of the world's first blockchain-based platform for scientific and academic research, today announced a partnership with the Distributed Pharmaceutical Analysis Lab (DPAL) at the University of Notre Dame to develop a prototype solution for tracking pharmaceutical chain-of-custody information in real-time using distributed ledger technology. Working with ARTiFACTS, DPAL will record all physical handling and research metadata starting from the point-of-purchase of prescription drugs and sustained throughout the testing, analysis and reporting requirements.”
About Covid-19
‘They rushed the process’: Vaccine maker’s woes hamper global inoculation campaign: Wonder what happened to Novavax?
”The U.S. government invested $1.6 billion in Novavax in 2020 — the most it devoted to any vaccine maker at the time — in hopes that it would offer the world another option for a safe and effective vaccine to help protect against Covid-19. But the company has consistently run into production problems. The methods it used to test the purity of the vaccine have fallen short of regulators’ standards and the company has not been able to prove that it can produce a shot that is consistently up to snuff, according to multiple people familiar with Novavax’s difficulties.”
COVID vaccine makers brace for a variant worse than Delta: “Over the past few months, all three companies have been running dress rehearsals by practising on known SARS-CoV-2 variants. This involves updating their vaccines to match variants such as Beta and Delta, testing them in clinical studies, tuning their internal workflows and coordinating with regulators. Their goal is to learn from these warm-up trials and smooth out kinks in their processes, so that they can move fast if, or when, a true escape variant emerges.”
In secret vaccine contracts with governments, Pfizer took hard line in push for profit, report says: “A report released Tuesday by Public Citizen, a consumer rights advocacy group that gained access to a number of leaked, unredacted Pfizer contracts, sheds light on how the company uses that power to ‘shift risk and maximize profits,’ the organization argues…
Public Citizen found common themes across contracts, including not only secrecy but also language to block donations of Pfizer doses. Disputes are settled in secret arbitration courts, with Pfizer able to change the terms of key decisions, including delivery dates, and demand public assets as collateral.”
Gates Foundation to spend $120 mln to speed access to generics of Merck COVID-19 pill: “The Bill & Melinda Gates Foundation said on Wednesday it would spend up to $120 million to kick-start development of generic versions of Merck & Co's oral COVID-19 treatment to help ensure lower-income countries have equal access to the drug.”
About health technology
In a First, Surgeons Attached a Pig Kidney to a Human, and It Worked: “Surgeons in New York have successfully attached a kidney grown in a genetically altered pig to a human patient and found that the organ worked normally, a scientific breakthrough that one day may yield a vast new supply of organs for severely ill patients…
[S]urgeons at N.Y.U. Langone Health took an astonishing step: With the family’s consent, they attached the pig’s kidney to a brain-dead patient who was kept alive on a ventilator, and then followed the body’s response while taking measures of the kidney’s function. It is the first operation of its kind.”
Largest ever global study of tuberculosis identifies genetic causes of drug resistance: “Using cutting-edge genomic sequencing techniques, researchers at the University of Oxford have identified almost all the genomic variation that gives people resistance to 13 of the most common tuberculosis (TB) drug treatments…
Using two key advances: a new quantitative test for drug resistance and a new approach which identifies all the genetic changes in a sample of drug-resistant TB bacteria the researchers have generated a unique dataset which the team has used to quantify how changes in the genetic code of M. tuberculosis reduce how well different drugs kill these bacteria that cause TB. These innovations, combined with ongoing work in the field, promise to profoundly improve how patients with TB are treated in the future.”
About the public’s health
The 2021 report of the Lancet Countdown on health and climate change: code red for a healthy future: The report is a comprehensive analysis of the health impact of global warming. In addition to such obvious harm as deaths due to excessive heat, other consequences include: “The number of months with environmentally suitable conditions for the transmission of malaria (Plasmodium falciparum) rose by 39% from 1950–59 to 2010–19 in densely populated highland areas in the low HDI group, threatening highly disadvantaged populations who were comparatively safer from this disease than those in the lowland areas…”