About Covid-19
SARS-CoV-2 and Surface (Fomite) Transmission for Indoor Community Environments: The latest on this topic from the CDC: “People can be infected with SARS-CoV-2 through contact with surfaces. However, based on available epidemiological data and studies of environmental transmission factors, surface transmission is not the main route by which SARS-CoV-2 spreads, and the risk is considered to be low. The principal mode by which people are infected with SARS-CoV-2 is through exposure to respiratory droplets carrying infectious virus. In most situations, cleaning surfaces using soap or detergent, and not disinfecting, is enough to reduce risk. Disinfection is recommended in indoor community settings where there has been a suspected or confirmed case of COVID-19 within the last 24 hours. The risk of fomite transmission can be reduced by wearing masks consistently and correctly, practicing hand hygiene, cleaning, and taking other measures to maintain healthy facilities.”
Secretary Antony J. Blinken Remarks to the Press on the COVID Response: The only new information in the announcement was the appointment of Gayle Smith to head this country’s global
Covid-19 response. She was the administrator of USAID for President Obama, and served on the National Security Council for both President Obama and President Clinton.
Researchers Are Hatching a Low-Cost Coronavirus Vaccine: A fascinating explanation of the technique for providing a low cost and highly effective Covid-19 vaccine. The article is from The NY Times, so if you cannot access it, try this site for a briefer overview.
About pharma
The top 10 pharma R&D budgets in 2020: “The roughly $70 billion total from the top 10’s budgets combined over the past five years swelled to $96 billion, with almost all seeing boosts in their research budgets (bar Novartis and Sanofi). Back in 2018, for the first time, the top 15 largest pharma companies (by sales) funneled more than $100 billion into research. Three years down the line, and our top 10 have nearly met that number on their own.”
Roche leads the pack with $13.9 billion.
Appropriate Use of Short-Course Antibiotics in Common Infections: Best Practice Advice From the American College of Physicians: Extended use of antibiotics can cause drug resistance. These gildelines for some common bacterial infections generally recommend a 5 day course of therapy with extensions if clinically warranted.
AbbVie drops Humira TV spend; Sanofi and Regeneron, Novo Nordisk step up on March pharma list: “AbbVie’s Humira dropped out of the top spot on the pharma TV ad spenders list in March for the first time in years. Sanofi and Regeneron’s Dupixent took over the No. 1 position, followed by Novo Nordisk’s Rybelsus, leaving Humira in third place, according to data from real-time TV ad tracker iSpot.tv.
Humira’s downward move has been in the works; spending has been declining over the past few months as AbbVie re-directed some of Humira’s advertising budget from the longtime blockbuster to its new generation of immunology products in rheumatoid arthritis Rinvoq and psoriasis med Skyrizi.”
FDA OKs first new ADHD drug in over a decade for children: “The Food and Drug Administration late Friday OK’d Qelbree (KELL’-bree) for treating attention deficit hyperactivity disorder in children ages 6 to 17. It comes as a capsule that’s taken daily.
Unlike nearly all other ADHD medicines, Qelbree is not a stimulant or a controlled substance, making it harder to abuse than older drugs. That’s been a problem with earlier ADHD treatments like Ritalin, nearly all of which contain the stimulants amphetamine or methylphenidate.
Qelbree, developed by Supernus Pharmaceuticals of Rockville, Maryland, carries a warning of potential for suicidal thoughts and behavior, which occurred in fewer than 1% of volunteers in studies of the drug.
Supernus wouldn’t disclose the drug’s list price, but it’s sure to be higher than the many cheap generic ADHD pills.”
This drug is one to watch. A great case for appropriate pricing. What if it were the same price as the stimulants on the market? Would it grab a huge share?
Drug prices: the lucrative world of not-so-cheap imitations: Many good examples in this article that highlights the fact that biosimilars only sell for a 10-35% discount from the branded drug, so savings are not as pronounced as with traditional chemical compounds.
Drug companies keep merging. Why that’s bad for consumers and innovation.: “In 1987, the combined market share of the eight largest drug companies stood at a relatively low 36 percent. By the conclusion of the first merger wave, it had grown to 42 percent; by 2012, in the wake of the second merger wave, the ratio had climbed to 53 percent. All told, between 1995 and 2015, the 60 leading pharmaceutical companies merged to only 10.
As a result, now only a handful of manufacturers are responsible for sourcing the vast majority of prescription drugs: Just four companies, for example, produced more than 50 percent of all generic drugs in 2017…
But the newly consolidated pharmaceutical industry actually stifled innovation. In the period following merger waves…, the industry generated fewer new molecular entities each year compared to pre-merger levels. Merged drug companies also spent proportionally less on research than their non-merged competitors.”
The Biden-Harris Administration’s Statement of Drug Policy Priorities for Year One: “The priorities are:
Expanding access to evidence-based treatment;
Advancing racial equity issues in our approach to drug policy;
Enhancing evidence-based harm reduction efforts;
Supporting evidence-based prevention efforts to reduce youth substance use;
Reducing the supply of illicit substances;
Advancing recovery-ready workplaces and expanding the addiction workforce; and
Expanding access to recovery support services.”
Cigna's $500 gift to psoriasis patients who switch to Eli Lilly's Taltz is 'rehearsal' for Humira biosimilars: analyst: “Last summer, pharmacy benefits giant Express Scripts tossed Novartis’ psoriasis drug Cosentyx out of its 2021 formulary in favor of Eli Lilly’s lower-cost Taltz. Now Cigna, which owns Express Scripts, is offering $500 to some patients who make the switch—an offer that could set a precedent as the anti-inflammatory market approaches a major biosimilar shakeup, one analyst suggested.
In a letter to doctors in March, some plans run by Cigna Pharmacy said patients could receive a $500 debit card if they switch from Cosentyx to Taltz or an older biologic before Aug. 31 and then refill the prescription before the end of this year. The letter was obtained by the American Journal of Managed Care.
The move comes as biosimilar developers prepare to launch low-cost rivals to another psoriasis remedy that happens to be the world’s best-selling drug—AbbVie’s Humira—in 2023. Bernstein analyst Ronny Gal called Express Scripts' offer to Taltz switchers a ‘general rehearsal for Humira’…”
Startup Raises Cash For Genome System: ““Startup Inscripta Inc. raised $150 million in new venture capital to roll out a genome-editing instrument that could help researchers in healthcare and other industries biologically engineer new products…
Scientists use new gene-editing techniques to make precise changes in the genetic code of organisms to study how genes function, and to genetically program cells or microbes to produce specific proteins, enzymes and other molecules…
Today, Crispr-based genome editing is a manual, labor-intensive process... It frequently requires large numbers of 96-well plates, along with gene-editing reagents, to make changes to the genetic code. Inscripta's system includes an instrument that sits on a lab bench and automates genome editing. Scientists load microbes to be edited and gene-editing reagents into the machine, and edits are made over the next two to four days…
In addition to the instrument, Inscripta's system includes reagents and software used to make the genome edits and to analyze the results.
About healthcare IT
Verizon jumps into virtual care market with BlueJeans Telehealth: “BlueJeans Telehealth, which launched Monday, was designed from the ground up for healthcare organizations to simplify the virtual experience and offer greater access to care, Verizon executives said in a press release…
The telecommunications giant says its telehealth solution address two key challenges for providers and patients: tech literacy and efficiency.
The BlueJeans platform offers one-click, download-free access to a video telehealth experience via mobile device or desktop to minimize technology complications. The platform also expedites information sharing through a customizable landing experience that includes patient onboarding and education materials, according to the company.”
Characterizing physician EHR use with vendor derived data: a feasibility study and cross-sectional analysis: “For every 8 hours of scheduled patient time, ambulatory physicians spend more than 5 hours on the EHR. Physician gender, specialty, and number of clinical hours practicing are associated with differences in EHR time.”
Is Telehealth The Next Frontier For Net Neutrality Action?: “A recent controversy over whether California's net neutrality law will block a free telehealth app for veterans is calling attention to consumer access problems that still plague the broadband industry, but advocates of the new statute say the law shouldn't pose a threat to the health care app. News reports surfaced in late March suggesting that some
U. S. Department of Veterans Affairs officials were concerned that internet service providers may stop supporting VA Video Connect, an app that provides free telehealth services to veterans and doesn't count against subscribers' mobile data caps.”
About hospitals and health systems
Analysis Suggests Government And Nonprofit Hospitals’ Charity Care Is Not Aligned With Their Favorable Tax Treatment: “Using 2018 Medicare Hospital Cost Reports, we compared charity care provision across 1,024 government, 2,709 nonprofit, and 930 for-profit hospitals. In aggregate, nonprofit hospitals spent $2.3 of every $100 in total expenses incurred on charity care, which was less than government ($4.1) or for-profit ($3.8) hospitals…Using different kinds of analyses, we also found wide variation in charity care provision within ownership types and a lack of a consistent pattern across ownership types. These results suggest that many government and nonprofit hospitals’ charity care provision was not aligned with their charity care obligations arising from their favorable tax treatment.”
Emergency Physicians Recover A Higher Share Of Charges From Out-Of-Network Care Than From In-Network Care: “Physicians collected 65 percent of the charged amount for likely surprise bills compared with 52 percent for other cases. Patients who likely received a surprise out-of-network bill for emergency care paid physicians more than ten times as much as other emergency patients paid, on average.”
The authors focus on high charges for out-of-network bills; however, that practice is only half the story of the difference. In-network contracts require providers not only to adhere to a fee schedule, but prohibit them from balance billing patients beyond agreed-upon copays and coinsurance; no such limits exit with out-of-network care.
About health insurance
Reinventing the Center for Medicare and Medicaid Innovation: An excellent review of the first 10 years of the CMMI and recommendations for its “reinvention” to make it more effective.