Today's News and Commentary

About Covid-19

First Month of COVID-19 Vaccine Safety Monitoring — United States, December 14, 2020–January 13, 2021: From the CDC: “Monitoring, conducted as part of the U.S. vaccination program, indicates reassuring safety profiles for COVID-19 vaccines. Local and systemic reactions were common; rare reports of anaphylaxis were received. No unusual or unexpected reporting patterns were detected.”

Pfizer, BioNTech's COVID-19 vaccine neutralises Brazil variant in lab study: “According to laboratory study findings published Monday in the NEJM, Pfizer and BioNTech's mRNA-based COVID-19 vaccine BNT162b2 was able to neutralise the P.1 variant of SARS-CoV-2 that first surfaced in Brazil. The news follows a report late last week that suggested AstraZeneca's coronavirus vaccine AZD1222 also showed early evidence of being effective against the so-called Brazil variant.
In previous studies, Pfizer and BioNTech's vaccine neutralised a more contagious variant first identified in the UK, dubbed B.1.1.7, but appeared to elicit lower protective antibodies against B.1.351, another fast-spreading strain that initially emerged in South Africa.”

Pfizer, Moderna vaccines 10 times less effective against virus variant in small study: “The percentage of neutralizing antibodies in Moderna's vaccine that protected against the variant, called B.1.351, was 12.4 times lower compared to the original virus strain and 10.3 times lower for Pfizer's vaccine…
A mutation on the variant called E484K seemed to be a "major contributor" to the vaccines' lower efficacy, the researchers wrote in the study, which was accepted by Nature but has yet to be published.”

Vaccine responses appear weaker in elderly: “New data uploaded to medRxiv suggest that Pfizer and BioNTech's coronavirus vaccine BNT162b2 induces weaker immune responses in elderly people compared to younger and middle-aged adults... Researchers studied 91 vaccine recipients under the age of 60 and 85 recipients over age 80.
They reported that 17 days after the second of two doses, 31% of the elderly recipients did not have any antibodies capable of neutralizing the virus, whereas this was true for only 2% of the younger group. Even among those under age 60, only 16% had neutralizing antibodies after the first dose.”

About health insurance

Boosted Obamacare subsidies could soon be available at Healthcare.gov: The article discusses the proposed expansion of insurance subsidies for ACA exchanges. While premiums can be costly, subsidies to cover them are only half (or less) of the story. A major concern is the out-of-pocket expenses which make coverage, in the end, unaffordable. See, also,: COVID bill to deliver big health insurance savings for many

Cigna to expand commercial footprint 25%: 5 notes:

1. Cigna wants to reach 50 percent of Americans who are eligible for Medicare by 2025. 

2. The insurer said 150,000 of its commercial members turn 65 each year.

3. For its individual and family plans, Cigna expects to double membership to 500,000 by 2025, and double its market to 20 states in the same time frame.

4. Cigna's overall U.S. addressable market will more than double to $2.2 trillion by 2025, the insurer said.

5. Cigna also projects it will double its ACA member base and the number of states where marketplace plans are offered by 2025.

Medicare sequester stakes rise with 6% doctor pay cut in store: “Already staring down the April expiration of the moratorium on the Medicare sequester that would cut Medicare physician pay by 2%, the AMA is now raising the alarm with congressional leaders about an additional 4% cut triggered by passage of the president’s American Rescue Plan Act.”

About healthcare IT

Telehealth Claim Lines Increase 2817 Percent From December 2019 to December 2020: “Telehealth claim lines increased 2,817 percent nationally from December 2019 to December 2020, rising from 0.22 percent of medical claim lines in December 2019 to 6.51 percent in December 2020, according to new data from FAIR Health’s Monthly Telehealth Regional Tracker. From month to month, the telehealth share of medical claim lines rose 8.3 percent nationally, from 6.01 percent in November 2020 to 6.51 percent in December 2020. The data represent the privately insured population, excluding Medicare and Medicaid. With the addition of December, the Telehealth Tracker now has a complete 12 months of data for 2020 as compared to 2019.”
The Telehealth Regional Tracker is worth a look to track telehealth usage by:
Volume of claim lines;
Urban vs. rural usage;
Top five procedure codes; and
Top five diagnoses.

Health tech funding snapshot: An update on IT companies that received significant investments in the past month.

Ransomware attack exposed info of 210K MultiCare patients, providers, workers: “Information exposed by the ransomware attack includes names, addresses, Social Security numbers, medical record numbers, bank account numbers and medical record disclosure logs.”

Change Healthcare in Collaboration with AWS Announces a New Data Science as a Service (DSaaS) Offering to Drive Improved Outcomes and Healthcare Economics for Vulnerable Health Communities: “Today Change Healthcare announced a new collaboration with Amazon Web Services, Inc. (AWS) to better assess and improve the effectiveness of interventions and therapies, particularly for underserved and vulnerable populations.
The new Data Science as a Service (DSaaS) offering provides de-identified claims data, enhanced with social determinants of health, enabling security and tailored for individual customers seeking to develop and deploy compliant health analytics at scale. Historically, the process of using regulated health data with social determinants is manual, slow, and fraught with compliance challenges. Leveraging the agility, scale, and security of AWS, DSaaS will address those problems by pre-integrating data and deploying automated software that consistently monitors adherence to privacy/compliance obligations to make patient-level integration of de-identified claims, SDOH, behavioral health, and other novel data practical and timely.”

100,000 affected in Texas healthcare provider cyberattack: “Elara Caring, a home-based care provider, began notifying 100,400 patients that an unauthorized party received unauthorized access to corporate email accounts.
Upon discovery of the data breach in mid-December 2020, Elara Caring launched an investigation led by third-party security experts, notified law enforcement and reset passwords for all employees, the Addison, Texas-based organization said in a recent news release.
Elara Caring said it believes patient and employee information may have been viewed, including Social Security numbers, bank account information and driver's license numbers.”

About pharma

The top 10 drugs losing U.S. exclusivity in 2021: The saving from these drugs will be highly variable depending on the generic that replaces them. See Chapter 7 in the book for strategies that branded companies use to mitigate these losses.

AmerisourceBergen awards CEO $14.3M pay package despite $6.6B opioid settlement: REALLY?!

About hospitals and health systems

HCA shares hit 1-year high: “Shares of Nashville, Tenn.-based HCA Healthcare closed at $189.21 March 8, a new 52-week high…
March 8 marked the third consecutive day of gains for shares of HCA. Shares closed the day up 2.99 percent from $183.71 on March 5…
HCA ended the fourth quarter of last year with net income of $1.4 billion on revenue of $14.3 billion. A year earlier, the company reported net income of $1.1 billion on revenue of $13.5 billion.”

Providence's annual net income slips $619M: “Providence, a 51-hospital system based in Renton, Wash., ended last year with an operating loss and lower net income than in 2019. 
The health system reported revenue of $25.7 billion, up 3 percent from 2019, according to financial documents released March 8. Though patient volumes and patient revenue were down last year, $957 million in grants made available under the Coronavirus Aid, Relief and Economic Security Act pushed Providence's revenue higher in 2020.”

About the public’s health

Screening for Lung CancerUS Preventive Services Task Force Recommendation Statement: “USPSTF recommends annual screening for lung cancer with LDCT [low-dose computed tomography] adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years. Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery. (B recommendation) This recommendation replaces the 2013 USPSTF statement that recommended annual screening for lung cancer with LDCT in adults aged 55 to 80 years who have a 30 pack-year smoking history and currently smoke or have quit within the past 15 years.”

Changes in Diagnostic and Demographic Characteristics of Patients Seeking Mental Health Care During the Early COVID-19 Pandemic in a Large, Community-Based Health Care System: “Compared to 2019, psychiatric visits increased significantly (P < .0001) in 2020, with the majority being telephone/video-based (+264%). Psychiatric care volume increased overall (7%), with the greatest increases in addiction (+42%), behavioral health in primary care (+17%), and adult psychiatry (+5%) clinics. While patients seeking care with preexisting psychiatric diagnoses were mainly stable (−2%), new patients declined (−42%). Visits for substance use (+51%), adjustment (+15%), anxiety (+12%), bipolar (+9%), and psychotic (+6%) disorder diagnoses, and for patients aged 18–25 years (+4%) and 26–39 years (+4%), increased. Child/adolescent and older adult patient visits decreased (−22.7% and −5.5%, respectively), and fewer patients identifying as White (−3.8%) or male (−5.0) or with depression (−3%) or disorders of childhood (−2%) sought care.”

Best States Rankings: This link is to the US News 2021 ranking, best to worse, for healthcare. The top 5 overall are:

  1. Hawaii

  2. Massachusetts

  3. Connecticut

  4. New Jersey

  5. California