About health insurance
Patient and Payer Incentives to Use Patented Brand-Name Drugs vs Authorized Generic Drugs in Medicare Part D: “The results of this cross-sectional study suggest that authorized generic drugs for insulin and direct-acting antiviral agents may lower out-of-pocket spending for patients but are unlikely to provide savings for Part D plans or Medicare. Instead, these drugs allow manufacturers to offer products at a lower list price without materially lowering net prices or profits.”
Blue Shield of California, Google Cloud to develop real-time claims processing platform: “Together, the companies will create a real-time claims processing platform leveraging automation, artificial intelligence and machine learning technologies. The platform will be designed to streamline the back-end billing processes between Blue Shield of California and the providers it contracts with.
The solution will extract clinical data from the provider’s EMR and then codify that record into a digital claim for billing, said Lisa Davis, senior vice president and chief information officer at Blue Shield of California. The payer will adjudicate that claim and send back a claim settlement decision to the provider, which will be shared with the patient in near real time.”
Currently, the provider bills the payer based on coding criteria. This method, if proved accurate, would remove the subjectivity of billing, reduce administrative cost and decrease turnaround time for adjudication of claims.
A $1,775 Doctor’s Visit Cost About $350 in Maryland. Here’s Why.: An excellent account of the Maryland rate-control system.
About the public’s health
Cost-effectiveness Evaluation of the 2021 US Preventive Services Task Force Recommendation for Lung Cancer Screening: “This economic evaluation found that the 2021 USPSTF recommendation for lung cancer screening was cost-effective; however, alternative screening strategies that maintained a minimum cumulative smoking exposure of 20 pack-years but included individuals who quit smoking within the past 25 years may be more cost-effective and warrant further evaluation.”
CNN Investigation: Tens of millions of filthy, used medical gloves imported into the US: “A months-long CNN investigation has found that tens of millions of counterfeit and second-hand nitrile gloves have reached the United States, according to import records and distributors who bought the gloves -- and that's just the tip of the iceberg. Criminal investigations are underway by the authorities in the US and Thailand.
Experts describe an industry riddled with fraud, with one of them -- Douglas Stein -- telling CNN that nitrile gloves are the "most dangerous commodity on Earth right now."
Qiagen Gets CE Mark for Portable Tuberculosis Test Device: “The device uses blood samples to test for molecules released from T-cells that have come into contact with Mycobacterium tuberculosis, the pathogen that causes TB infections.
Qiagen says it will focus its marketing of the device on regions that face a high burden of TB and where access to laboratories and resources for testing are limited.”
About hospitals and health systems
Association Between Hospital Performance Metrics and Market Share: “The findings of this cross-sectional ecological study suggest that better hospital performance score was associated with larger market share for hip and/or knee replacement and AMI [acute myocardial infarction] procedures but not for CABG [coronary artery bypass graft] The effect size was greater for the elective procedure (hip and/or knee replacement) than for the nonelective procedure (AMI), suggesting that patients may be more able to choose their facility for elective procedures.”
About pharma
FDA withdraws more than 200 ANDAs over unsubmitted annual reports: “Almost two years after proposing to withdraw nearly 250 abbreviated new drug applications (ANDAs) after their manufacturers repeatedly failed to submit the necessary annual reports, the US Food and Drug Administration (FDA) on Thursday said it will withdraw 216 of those applications.”
FDA OKs Higher Numbers of Competitive Generic Therapies in Fiscal 2021: “CGT” is an FDA designation for drugs for which there is inadequate generic competition. Usually this means there’s not more than one approved drug for the indication.
In fiscal 2021, the FDA approved 53 ANDAs for CGT. That’s up from 35 in 2020. Applications were up significantly too. The number of CGT applications received throughout the fiscal year was 507, up from 390 in 2020.”
About Covid-19
CDC director on mask requirements: Need to continue until we can get 'cases down': “Centers for Disease Control and Prevention (CDC) Director Rochelle Walensky on Friday said that mask requirements need to be continued until we can get coronavirus “cases down.”
…Walensky said it was ‘really encouraging’ that the surge in infections from the delta variant is ‘now coming down.’ She added that the U.S. is still averaging 75,000 new infections and 1,200 deaths every day.”
Biden administration takes new steps to boost availability of rapid coronavirus tests: “The Biden administration announced additional steps on Monday to increase the availability of rapid at-home coronavirus tests and bring down their cost.
The biggest change is a $70 million investment by the National Institutes of Health — using funds from the American Rescue Plan, which was passed earlier this year — to help manufacturers navigate the Food and Drug Administration’s regulatory process. The NIH program aims to speed up the authorization process for new tests by helping manufacturers produce the data regulators need. It will also identify rapid tests that have the potential to be produced and distributed on a large scale.”
About healthcare IT
The Lancet and Financial Times Commission on governing health futures 2030: growing up in a digital world: “The Lancet and Financial Times Commission on governing health futures 2030: growing up in a digital world argues digital transformations should be considered as a key determinant of health. But the Commission also presses for a radical rethink on digital technologies, highlighting that without a precautionary, mission-oriented, and value-based approach to its governance, digital transformations will fail to bring about improvements in health for all.”
Look at the comprehensive full report .