About pharma
Nobel Prize in chemistry awarded to duo who made a tool to build molecules in an environmentally friendly way: “The Nobel Prize in chemistry was awarded Wednesday to two scientists who built a tool for constructing molecules in a cheap, environmentally friendly way, allowing researchers to more easily make products including pharmaceuticals.
David W.C. MacMillan of Princeton University and Benjamin List of the Max Planck Institute in Germany were awarded the Nobel for their development of a precise new tool for molecular construction known as organocatalysis…
The tool can be used to construct new drugs and chemicals, as well as molecules that can capture light in solar cells. The breadth of commercial and everyday products it can help create is enormous, ranging from clean energy to cosmetics.”
About health insurance
Maine launching state-run health insurance marketplace for 2022 enrollment: “Starting Nov. 1, people signing up for ACA insurance in Maine will go through the coverme.gov website rather than the federal government’s healthcare.gov website, where Maine people have bought Obamacare insurance since 2014. A total of 15 states, including all of New England except New Hampshire, have been using state-based marketplaces rather than the federal version.
The federal government also approved new state marketplaces for Kentucky and New Mexico on Monday. The open enrollment period goes from Nov.1 to Jan. 15, 2022, but consumers need to enroll by Dec. 15 to have coverage begin on Jan. 1. Enrollees who want to keep their current plans will be automatically re-enrolled.”
Willis Towers Watson: Employers expect health costs to rise by 5% in 2022: “Employers expect their health costs to rise by more than 5% in 2022 as concerns about the COVID-19 pandemic linger, according to a new survey from Willis Towers Watson.
Medical and pharmacy benefit costs are expected to increase by 5.2% next year, the report found, a slight decline from the 5.5% increase projected in 2021 but significantly higher than the 2.1% increase felt in 2020 as many people deferred healthcare services during the pandemic.
Including premiums, total costs per employee are expected to increase from $12,501 in 2020 to $13,360. Employer premium contributions are also set to go up, rising from $3,269 to $3,331.”
CMMI director hints at shift away from payment models for every episode of care, specialties: “The Biden administration wants to move away from creating value-based care payment models for every type of disease, episode of care or specialty groups to streamline its projects, a top official said.
Center for Medicare and Medicaid Innovation (CMMI) Director Liz Fowler said during a briefing Tuesday hosted by the Alliance for Health Policy that more mandatory models are needed, including those that focus on the total cost of care.”
New York suspends prior authorizations, eases reporting requirements: “Tucked in an executive order to address staffing challenges in the state, New York Gov. Kathy Hochul has suspended prior authorization requirements for 30 days.
The order, signed Sept. 27, suspends requirements for prior authorization review for scheduled surgeries in hospital facilities, hospital admissions, hospital outpatient services, home healthcare services following a hospital admission and inpatient rehabilitation services following a hospitalization.
Additionally, concurrent and retrospective review of claims are suspended for the duration of the order.”
CMS overpaid providers $636M for neurostimulator surgeries: OIG: “CMS should recoup $636 million in overpayments to hospitals and other providers from the improper billing of neurostimulator implantation surgeries, according to HHS' Office of the Inspector General.
An audit from the OIG found that more than 40 percent of healthcare providers didn't comply with Medicare requirements when billing for neurostimulator implantation surgeries.
The OIG audit covered $1.4 billion in Medicare payments to providers for 58,213 beneficiaries who had a neurostimulator implant surgery from 2016-17. The OIG randomly selected a sample of claims from 106 beneficiaries submitted by 102 providers. “
Medical Service Use and Charges for Cancer Care in 2018 for Privately Insured Patients Younger Than 65 Years in the US: “This cohort study found that the total estimated cost of cancer care for privately insured adults in the US was $156.2 billion. Patients with breast, colorectal, and prostate cancers had the greatest number of services performed, particularly for pathology and laboratory tests, and patients with breast, lung, and colorectal cancer incurred the highest costs, particularly for medical supplies and nonphysician services.”
About Covid-19
White House to announce $1 billion purchase of rapid, at-home coronavirus tests: “The administration said the plan to buy $1 billion worth of rapid, at-home coronavirus tests and other actions should address ongoing shortages and quadruple the number of tests available to Americans by December, according to a White House official and senior administration official with knowledge of the pending announcement.”
Vaccination-related employee departures at 24 hospitals, health systems: “Amid health system and state COVID-19 vaccination requirements, workers have been fired for noncompliance, and some have resigned or quit.
Here are stats from 24 organizations, announced since June.”
In a related article: Demand for labor drives costs up, straining hospital profitability, report finds: “The surge of COVID-19 cases driven by the delta variant is creating a shortage of healthcare workers, leading to hospitals increasing wages and suspending elective surgeries. In turn, hospital profits are taking a hit, an Oct. 5 Moody's Investors Service report found.
The report also said it expects margins to decline because of wage inflation, expensive nursing agencies, increased attempts at recruitment and retention, and expanded benefit packages.
According to Moody’s not-for-profit medians for 2020, growth in salaries has surpassed hospitals' expense growth, a trend expected to continue for the rest of 2021 and into 2022.”
It's time to upgrade from cloth masks, experts say: “Misinformation surrounding masking has turned the topic into a binary for Americans: either you're masked or not — but experts say the public needs to start paying attention to the quality of their masks.
In an Oct. 4 piece for The Atlantic, science editor Yasmin Tayag cited a study from Bangladesh linking surgical masks to an 11.2 percent decrease in COVID-19 symptoms and antibodies compared to a 5 percent decrease with cloth masks…
Linsey Marr, an environmental engineer and aerosol science expert, told Scientific American in a Sept. 30 piece that disposable masks may actually be worn until they become ‘visibly damaged or soiled.’
The Scientific American piece went on to say, contrary to the start of the pandemic, there is now a ‘cornucopia’ of high-filtration respirator-style masks. The most important considerations for mask effectiveness are filtration, fit and comfort.”
About the public’s health
WHO endorses use of first-ever malaria vaccine: “The World Health Organization on Wednesday endorsed the world’s first malaria vaccine for use in children. It said the vaccine could help save tens of thousands of lives each year.
The life-threatening parasitic disease kills more than 400,000 people a year, and the WHO says more than 260,000 of them are African children under age 5. Most cases and deaths caused by the disease, which is transmitted through bites of infected mosquitoes, occur in sub-Saharan Africa…
The vaccine, manufactured by the British-based pharmaceutical company GlaxoSmithKline, is only moderately effective. Findings from the pilot program showed the immunization reduced cases of severe malaria by about 30 percent, said Ashley Birkett, the head of malaria vaccine development at PATH, an international global health organization that helped fund the immunization.”
J&J’s RSV Shot Cut Disease Risk by 80 Percent in Older People: “Johnson and Johnson’s investigational vaccine against respiratory syncytial virus (RSV) reduced the risk of RSV-associated lower respiratory tract disease by 80 percent in older adults in a phase 2b trial.
J&J subsidiary Janssen released data showing that the CYPRESS study met both its primary vaccine efficacy endpoint and a secondary goal, reducing by 70 percent the risk of any symptomatic RSV-associated acute respiratory infection in adults aged 62 and older.”
Health of Women and Children Report 2021: From the UnitedHealth Foundation. Lots of good information about these two groups. One major area for improvement is the 16% increase in maternal mortality rate.