About Covid-19
Cue the lawsuits: Biden's vaccine mandates are here: The official recommendations are now out. The article provides a good summary of what will be officially published in The Federal Register tomorrow.
Among the highlights:
”The Biden administration is implementing a true vaccine mandate for 17 million health-care workers. The emergency regulation requires vaccines for staff of the roughly 76,000 health facilities participating in Medicare and Medicaid, such as nursing homes, hospitals and home health agencies. Unlike other mandates, staff won’t be allowed to test regularly in lieu of getting the shot, though it does include religious and medical exemptions…”
CMS is making the immunization a Condition of Participation for Medicare, meaning that non-compliant hospitals can lose their Medicare provider status.
”Companies with 100 or more employees must now mandate coronavirus vaccine shots or weekly testing.
The Occupational Safety and Health Administration is relying on little-used emergency powers to issue the new rules expected to cover 84 million workers.
Under the regulations:
The unvaccinated will be required to wear masks.
Employers must provide paid time off for their staff to get a shot.
Companies can make their employees foot the bill for their own tests.”
EMA Scraps Review of Eli Lilly’s COVID-19 Antibody Therapy: “The European Medicines Agency (EMA) has stopped its rolling review of Eli Lilly’s COVID-19 antibody cocktail after the drugmaker withdrew its request because of the lack of demand among EU member states.”
Contrast that action with the US where the federal government announced it will purchase “a further 614,000 doses of Eli Lilly’s COVID-19 therapy, bamlanivimab and etesevimab, for $1.29 billion.”
Britain authorizes Merck’s molnupiravir, the world’s first approval of oral covid-19 treatment pill: “Regulators in Britain granted approval to the experimental drug molnupiravir from U.S. pharmaceutical giant Merck on Thursday, marking the first authorization from a public health body for an oral antiviral treatment for covid-19 in adults.”
Visualizing in deceased COVID-19 patients how SARS-CoV-2 attacks the respiratory and olfactory mucosae but spares the olfactory bulb: Covid-19 appears to inflict the peripheral mucosa causing derangements in smell. “Thus, SARS-CoV-2 does not appear to be a neurotropic virus.” What the finding means is that, since permanent central nerve damage is not occurring, prospects for recovery of function are good.
About the public’s health
Life expectancy fell sharply in the U.S. last year among high-income countries: “The United States had the second-steepest decline in life expectancy among high-income countries last year during the pandemic, according to a study of death data spanning several continents.
The only country studied that saw a starker overall trend was Russia.
U.S. men saw life expectancy fall by nearly 2.3 years, from about 76.7 to 74.4. Women lost more than 1.6 years of life expectancy, from about 81.8 to 80.2…
One surprise: The drop in life expectancy in the U.S. was driven by the deaths of young people…”
Panel: All US adults under 60 should get hepatitis B shots: “The Advisory Committee on Immunization Practices voted unanimously to approve the recommendation Wednesday. The CDC’s director, Dr. Rochelle Walensky, must sign off on it before it becomes public policy, but it’s not clear when she will decide.”
The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study: “We observed a substantial reduction in cervical cancer and incidence of CIN3 in young women after the introduction of the HPV immunisation programme in England, especially in individuals who were offered the vaccine at age 12–13 years. The HPV immunisation programme has successfully almost eliminated cervical cancer in women born since Sept 1, 1995.”
For those vaccinated at age 12-13 the risk reduction was 97%.
About pharma
Novartis to sell Roche stake for $20.7 billion: “Novartis said Thursday that it agreed to sell its stake in Roche for $20.7 billion, with the proceeds to be used ‘in line with capital allocation priorities to enhance strong returns to shareholders.’ Novartis built up the stake between 2001 and 2003, and currently holds 53.3 million bearer shares of Roche's stock, representing approximately 33% of aggregate outstanding bearer shares.
’After more than 20 years as a shareholder of Roche, we concluded that now is the right time to monetise our investment,’ remarked Novartis CEO Vas Narasimhan.”
About health insurance
45% of Insured Americans Considering Health Insurance Changes During Open Enrollment: “Most commonly, those looking to change their health insurance are doing so in response to the COVID-19 pandemic (35%) or their transforming health needs (33%).
Additionally, 27% of consumers are considering changing their health insurance coverage for cost-related reasons. For 18% of this group, the driving force is that out-of-pocket costs were too high last year. Another 9% of people feel they pay for more insurance than what they use, so they're seeking to cut back on expenses.”
Next is seeing how many actually switched, as contemplation of changing insurance is not highly correlated with actual changing.
Centene selling off majority stake in U.S. Medical Management: “Centene will sell off its majority stake in home health company U.S. Medical Management, the insurer announced Wednesday.
Centene will maintain a minority stake in USMM, according to the announcement, and will sell the rest of its stake to Rubicon Partners; Valtruis, a WCAS company; Oak HC/FT; and HLM Venture Partners.
USMM operates a family of companies that provide home health services, and in 2015 launched an accountable care organization. It owns assets that assist with home-based primary care and house call programs, according to the announcement.”
A noteworthy development as other insurers are increasingly vertically integrating. As an example:
CVS Looks to Add Doctors to Its Payroll: “On Wednesday, CVS Chief Executive Karen Lynch said the company is working with “speed and urgency” to create physician-staffed primary-care practices, which she said will be a priority for CVS as it considers potential acquisitions in the coming year.
’Primary care isn’t a big medical cost but it wields a lot of influence,’ Ms. Lynch said in an interview, referring to the role physicians can play in lowering insurers’ costs.”
Cigna beats the Street with $1.6B in Q3 profit: “Cigna wrapped up third-quarter earnings for major national payers Thursday morning, where it reported $1.6 billion in profit for the quarter.
The results surpassed Wall Street expectations, according to Zacks Investment Research. Cigna also brought in $44.3 billion in revenue in the third quarter, according to the earnings report, which also beat analysts' projections.”
Humana cuts 2021 outlook after higher COVID-19 expenses but still plans robust Medicare Advantage growth for 2022: “Humana expects its individual Medicare Advantage membership to grow by 8% in 2022 as part of a more conservative financial outlook.
The insurer gave hints to its outlook for next year as part of its earnings report released Wednesday that saw Humana post a $1.5 billion profit in the third quarter but cut its financial outlook for 2021 due in part to higher-than-expected COVID-19 costs.
The insurer’s third-quarter earnings report, though, released Wednesday, pointed to strong growth in its Medicare Advantage offerings and lower-than-expected healthcare use among MA beneficiaries.”
CY 2022 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Final Rule (CMS-1753FC): The announcement has specifics about price transparency requirements (previously reported), OPPS and ASC payment rates, changes to the inpatient-only list, and much more.
Calendar Year (CY) 2022 Medicare Physician Fee Schedule Final Rule: Many more details about changes, including telehealth payment and the previously reported new conversion factor:
”With the budget neutrality adjustment to account for changes in RVUs (required by law), and expiration of the 3.75 percent temporary CY 2021 payment increase provided by the Consolidated Appropriations Act, 2021 (CAA), the CY 2022 PFS conversion factor is $33.59, a decrease of $1.30 from the CY 2021 PFS conversion factor of $34.89. The PFS conversion factor reflects the statutory update of zero percent and the adjustment necessary to account for changes in relative value units and expenditures that would result from our finalized policies.”