Global population hits 8 billion as growth poses more challenges for the planet
About Covid-19
Cost of COVID-19 hospital admissions among people with private health coverage “We find that, in 2020, COVID-19 hospitalizations cost an average of $41,611, including an average out-of-pocket payment of $1,280 for people with large employer coverage. In 2020, many private insurers and employers temporarily waived out-of-pocket costs for COVID-19 treatment (this is generally no longer the case). For COVID-19 hospitalizations with some cost-sharing expense, an average of $1,880 was spent out-of-pocket by individuals with large employer coverage.”
Biden requests $9.25 bln for COVID, $37.7 bln for Ukraine from Congress -officials “The Biden administration is asking Congress for $9.25 billion to fight COVID-19…
The administration is also requesting $750 million to fight other infectious diseases and will be seeking additional money for natural disaster relief, the officials said.”
NICE recommends 3 treatments for COVID-19 in draft guidance “Three treatments for COVID have been recommended in draft NICE guidance released today for public consultation.
The recommended treatments are:
Nirmatrelvir plus ritonavir (also called Paxlovid and made by Pfizer).
Tocilizumab (also called RoActemra and made by Roche).
Baricitinib (also called Olumiant and made by Eli Lilly and company, subject to it receiving a marketing authorisation in Great Britain for treating COVID-19).”
Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patient “Findings This cross-sectional study found that the proportion of patients with at least 1 post–COVID-19 symptom 2 years after acute infection was 59.7% for hospitalized patients and 67.5% for those not requiring hospitalization. No significant differences in post–COVID-19 symptoms were seen between hospitalized and nonhospitalized patients.
Meaning Similar rates of post–COVID-19 symptoms between hospitalized and nonhospitalized patients suggest that, among all patients who contract COVID-19, these sequelae deserve attention.”
About health insurance/insurers
Working full time doesn’t always make it easier to get health insurance at the job “Though the number of full-time, year-round workers ages 19 to 64 jumped by 10.4 million last year, the uninsured rate of this group also rose – by 0.6 percentage points to 9.1%, according to Census Bureau data.
That’s partly because the occupations that had the largest increases in the share of full-time, year-round workers last year were service and construction, which are less likely to provide job-based health benefits. Only about 62% of service workers and 56% of construction workers have employer-sponsored insurance.
At the same time, the share of employees in professional and management occupations – which have the highest rates of workplace coverage at 89% and 85%, respectively – declined somewhat last year. This also contributed to the drop in coverage among all full-time, year-round workers.”
About hospitals and healthcare systems
Midwest nonprofits Sanford Health, Fairview Health Services target a 58-hospital merger for 2023 “The nonprofits have signed a nonbinding letter of intent as they proceed with due diligence and regulatory antitrust reviews, they said in a press release. Each would maintain their own regional presence, leadership and regional boards but operate as a single integrated system under Sanford Health’s banner.
The organizations said they anticipate closing their deal sometime next year.”
CommonSpirit Health kicks off its fiscal 2023 with a $397M net loss, 0.3% operating margin “The system’s $23 million operating income (0.3% margin) for the three months ended Sept. 30 represents a slight decline from the $34 million (0.4%) recorded during the same time last year.
Operating revenue for the quarter rose to about $9.01 billion from the previous year’s $8.55 billion (5.4% year-over-over increase).”
Leapfrog Group Releases New Hospital Safety Grades, Marking 10th Anniversary “Highlights from the fall 2022 Leapfrog Hospital Safety Grade include:
Thirty percent of hospitals received an "A," 28% received a "B," 36% received a "C," 6% received a "D," and 1% received an "F.”
The top ten states with the highest percentages of "A" hospitals are New Hampshire, Virginia, Utah, Colorado, Idaho, New Jersey, North Carolia, Maine, Pennsylvania, and Florida.
There were no “A” hospitals in the District of Columbia, North Dakota, or Vermont.”
About pharma
Optum to add biosimilars to formulary to tackle the massive cost of Humira “Optum Rx, the pharmacy benefit management subsidiary of UnitedHealth Group, manages more than 66 million members and is one of the three largest PBMs that dominate the market, alongside CVS Health's Caremark and Cigna's Express Scripts.
The company said it will place those biosimilars on its formulary at parity with Humira, meaning they'll be on the same tier. The first biosimilar to compete with Humira will arrive next year and will be the first added to the formulary.
The goal, CEO Heather Cianfrocco said at a HLTH session Tuesday, is to make a dent in rising specialty drug costs, which represent just 2% of prescriptions but 50% of costs. Optum Rx said Humira alone accounts for $20 billion in sales each year.”
AbbVie Reaches $54.4 Million Settlement Over Its Alzheimer’s Drug “AbbVie has agreed to a $54.4 million settlement for alleged anticompetitive abuse of the generic pharmaceutical approval process involving Namenda (memantine hydrochloride), an FDA-approved drug to treat Alzheimer’s.”
Deductibles and Coinsurance Drive High Out-Of-Pocket Costs For Commercially Insured Patients Taking Brand Medicines “As new data shows, this discriminatory practice can lead to higher costs for patients at the pharmacy. For commercially insured patients taking one or more brand medicines in 2021, the sponsored health care data analytics firm IQVIA found that:
Patients with deductibles or coinsurance spent six times ($261) more out of pocket, on average, for their brand and generic medicines than patients with only copays.
Insurers and PBMs subjected two-thirds of patients to the medicine’s full list price through the use of deductibles or coinsurance.
Deductibles and coinsurance accounted for 60% of patients’ out-of-pocket spending on brand medicines.
Patients filling a brand prescription in the deductible paid eight times more for their medicine than patients filling a brand prescription with copays.
Patients were nearly four times more likely to abandon newly prescribed brand medicines filled in the deductible compared to those filled with copays.
Patients using cost-sharing assistance to access their brand medicines reduced their annual out-of-pocket costs by nearly 60%, leading to average savings of nearly $500.”
About the public’s health
Screening for Obstructive Sleep Apnea in Adults “The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in the general adult population. (I statement)”
FDA moves to boost access to overdose reversal med with preliminary over-the-counter endorsement “In a Federal Register notice issued Tuesday, the U.S. drug regulator released its preliminary assessment that certain naloxone products “may be approvable”—i.e., safe and effective—for over-the-counter use. The decision—while not a formal OTC approval determination—is many years in the making and could ease development and approval of nonprescription naloxone, the agency said in a release. This could include transforming the approvals for existing prescription naloxone products into OTC nods.”
Notable Survey: 61% of Patients Skip Medical Appointments Due to Scheduling Hassles The headline is the story.
Judge overturns Georgia’s six-week abortion ban “A Fulton County judge has overturned Georgia’s six-week abortion ban, ruling that two key parts of the law “were plainly unconstitutional when drafted, voted upon, and enacted” and writing that the law cannot be enforced.
The 15-page ruling by Fulton County Superior Court Judge Robert McBurney stemmed from a lawsuit that argued the state’s “heartbeat bill” violated pregnant people’s liberty and privacy rights under Georgia’s constitution. The plaintiffs also argued that the law violatedthe U.S. Constitution at the time it was enacted — in 2019, when Roe v. Wade was still the law of the land.”
About healthcare IT
Best Buy expands push into home healthcare with investment in remote patient monitoring firm “Best Buy has made an initial investment in remote patient monitoring company Coeus h3c as the tech retailer looks to expand in the home healthcare market.
Coeus h3c offers a cloud-based platform that automates technology and logistics processes for remote patient monitoring vendors.”
Mayo Clinic launches digital referee for spotting potential bias in healthcare AI programs “Dubbed Platform_Validate, the program is designed to put an algorithm’s credibility to the test, and act as a third party to confirm the AI’s efficacy in meeting its intended clinical purpose.
By generating standard reports on specificity and sensitivity, the Mayo Clinic said it aims to address some of the skepticism of implementing AI programs in healthcare and diagnostics—especially where programs may inadvertently reinforce inequities in the current system, by underlining disparities present in potentially poor-quality data used to construct and train the algorithm in the first place.”
Teladoc Health Reaches 50 Million Visit Milestone The headline is the story.
About healthcare finance
DispatchHealth raises $330M led by Optum Ventures “Home healthcare company DispatchHealth has raised $330 million in a funding round led by Optum Ventures, Home Health Care News reported Nov. 15.
DispatchHealth offers on-demand in-home acute care delivered by emergency and internal medicine teams. Blue Shield of California was among the other investors.”