About Covid-19
Low neutralization of SARS-CoV-2 Omicron BA.2.75.2, BQ.1.1, and XBB.1 by parental mRNA vaccine or a BA.5-bivalent booster “The results showed that a BA.5-bivalent-booster elicited a high neutralizing titer against BA.4/5 measured at 14- to 32-day post-boost; however, the BA.5-bivalent-booster did not produce robust neutralization against the newly emerged BA.2.75.2, BQ.1.1, or XBB.1. Previous infection significantly enhanced the magnitude and breadth of BA.5-bivalent-booster-elicited neutralization. Our data support a vaccine update strategy that future boosters should match newly emerged circulating SARS-CoV-2 variants.”
In other words, the new bivalent vaccine does not work as well on the new, emerging variants.
CDC encourages people to wear masks to help prevent spread of Covid, flu and RSV over the holidays “KEY POINTS
CDC Director Dr. Rochelle Walensky said wearing a mask is an everyday precaution that people can take to reduce their chances of catching or spreading a respiratory virus.
Flu and respiratory syncytial virus are circulating at high levels at the same time Covid is picking up, straining hospital emergency departments.”
Pfizer countersues Moderna in COVID-19 vaccine patent infringement case “Pfizer and BioNTech filed a countersuit against Moderna Dec. 5 over their rival COVID-19 vaccines made from the same mRNA technology, court documents show.
Moderna filed suit against Pfizer in late August and accused the drugmaker of infringing on patents and copying its mRNA technology ‘without ever requesting a license.’
About three months later, Pfizer submitted an 81-page document in the U.S. District Court in Massachusetts accusing the other pharmaceutical company of writing a ‘revisionist history not based on fact.’”
Paxlovid Has Been Free So Far. Next Year, Sticker Shock Awaits. “Nearly 6 million Americans have taken Paxlovid for free, courtesy of the federal government. The Pfizer pill has helped prevent many people infected with covid-19 from being hospitalized or dying, and it may even reduce the risk of developing long covid. But the government plans to stop footing the bill within months, and millions of people who are at the highest risk of severe illness and are least able to afford the drug — the uninsured and seniors — may have to pay the full price.”
About health insurance/insurers
FAQS ABOUT CONSOLIDATED APPROPRIATIONS ACT, 2021 IMPLEMENTATION - GOOD FAITH ESTIMATES (GFES) FOR UNINSURED (OR SELF-PAY) INDIVIDUALS “Q1: Will CMS enforce the requirement that GFEs for uninsured (or self-pay) individuals include cost estimates from co-providers and co-facilities beginning on January 1, 2023?
A1: No. HHS is extending enforcement discretion, pending future rulemaking, for situations where GFEs for uninsured (or self-pay) individuals do not include expected charges from co- providers or co-facilities.”
Trends In Treat-And-Release Emergency Care Visits With High-Intensity Billing In The US, 2006–19 “We performed an observational study of US treat-and-release ED visits using data from the Nationwide Emergency Department Sample. In 2006, 4.8 percent of treat-and-release ED visits exhibited high-intensity billing, and this figure rose to 19.2 percent by 2019. The proportion of visits for older patients, those with more comorbidities, and those with nonspecific but potentially serious diagnoses grew. Of the observed growth in high-intensity billing, 47 percent was expected, based on changes in administrative measures for patient case-mix and care services.”
The other conclusion is that 53% of the increase was not expected- in other words, overfilling using higher than warranted severity codes.
Trends in Episode-of-Care Spending for Cancer-Directed Surgery Among US Medicare Beneficiaries From 2011 to 2019 “This cross-sectional study revealed that 30-day episode spending for cancer-directed surgery decreased significantly among Medicare fee-for-service beneficiaries. This overall decrease was largely attributable to lower spending associated with inpatient procedures and a concomitant increase in the proportion of surgeries performed in the less-expensive outpatient setting.”
About hospitals and healthcare systems
Leapfrog Recognizes 2022 Top Hospital and Top ASC Recipients FYI
Faced with costly discharge bottlenecks, hospitals want Congress to pay for patients' extended stays “The hospital lobby is looking to secure temporary per diem Medicare payments from Congress it says are needed to offset increased costs and missed revenues caused by patients who are ready to leave the hospital but have nowhere to go.
Per a new report (PDF) from the American Hospital Association (AHA), the average hospital length-of-stay has increased by 19.2% from 2019 to 2022 as well as by nearly 24% for patients being discharged to a post-acute care provider.
That increase isn’t just due to patients getting sicker during the course of the pandemic. When adjusting by case-mix index, average length-of-stay was still up 15.4% for discharges to post-acute care providers. Adjusted average stays were even higher when discharging to a skilled nursing facility (20.2%) or a psychiatric hospital (28.9%), according to data from Strata Decision Technology cited in AHA’s report.
Rather, acute care hospitals, long-term care hospitals and rehabilitation facilities alike are facing discharge logjams due to industrywide workforce shortages.”
About pharma
Unsubstantiated price hikes drove U.S. drug spending up $805 mln in 2021-report “Price increases spread among seven of the 10 drugs in 2021 behind an $805 million increase in U.S. spending from the prior year were not supported by clinical evidence, an influential U.S. pricing research firm said on Tuesday.
The Institute for Clinical and Economic Review (ICER) said the spending increase in 2021 was still less than the $1.67 billion rise in the previous year. This is the third year the group has looked at the top 250 drugs by spending and assessed if those driving U.S. spending increases were justified.”
Drugmakers dodge US federal litigation over Zantac after judge tosses lawsuits “A judge in the US on Tuesday rejected the validity of scientific evidence used to back up claims that the withdrawn heartburn drug Zantac (ranitidine) causes a variety of cancers. The decision by US District Judge Robin Rosenberg in West Palm Beach, Florida, means companies such as GSK, Pfizer, Sanofi and Boehringer Ingelheim, which have all marketed the drug at different times, will not have to fight over 1700 lawsuits in federal court, although they still face tens of thousands of similar cases at the state level.”
About the public’s health
Effects of Diet on 10-Year Atherosclerotic Cardiovascular Disease Risk (from the DASH Trial) “Using data from the original DASH (Dietary Approaches to Stop Hypertension) trial, we determined the effects of adopting the DASH diet on 10-year ASCVD risk compared with adopting a control or a fruits and vegetables (F/V) diet… In conclusion, compared with a typical American diet, the DASH and F/V diets reduced 10-year ASCVD risk scores by about 10% over 8 weeks. These findings are informative for counseling patients on both choices of diet and expectations for 10-year ASCVD risk reduction.”
UnitedHealth report: As mental health concerns rise, more providers are available to treat these needs “The United Health Foundation, the philanthropic arm of insurance giant UnitedHealth Group, released its annual "America's Health Rankings" report and in the analysis found that between 2020 and 2021, the number of people who reported that their mental health was poor in 14 of the last 30 days increased by 11%…
However, the analysis found that the supply of mental health providers reached its highest levels since the report was first published in 2017. The number of mental health providers per 100,000 increased by 7% between 2021 and 2022 and has increased by 40% since the 2017 report.”
Comment: The entire report is worth reading for its wealth of different kinds of information.
Cardiometabolic benefits of micronutrient supplements vary “Supplementation of certain micronutrients benefited cardiometabolic health, but others did not, according to a systematic review and meta-analysis.
Specifically, supplementation with omega-3 fatty acids, folic acid and coenzyme Q10 conferred certain benefits, supplementation with vitamin C, vitamin D, vitamin E and selenium had no effect on CVD risk and supplementation with beta-carotene was harmful…”
Effect of Nudges to Clinicians, Patients, or Both to Increase Statin Prescribing “Findings In this cluster randomized clinical trial of 4131 patients from 28 primary care practices, nudges to clinicians using electronic health record active choice prompts and monthly peer comparison feedback significantly increased statin prescribing by 5.5 percentage points relative to usual care. Nudges to patients by text message before the visit did not significantly increase statin prescribing, but the combination of nudges to clinicians and patients significantly increased statin prescribing by 7.2 percentage points relative to usual care.” [Emphasis added]
Deferral of primary care signals a troubled future for Americans’ health “Primary care visits are down 10.3% on average across U.S. cities relative to pre-pandemic levels. That, combined with more people with chronic diseases like diabetes, obesity, and cancer, and accelerating health care costs as inflation soars, signal a troubled future for the health of Americans…
Commercially insured women between the ages of 20 and 49 are the ones most likely to be resuming visits with their primary care providers. However, the demand is distributed unequally across various metro areas with demand greater in areas like Dallas and Miami compared to Los Angeles, New York City, Philadelphia, Houston, Seattle, and Washington, D.C.”
About healthcare IT
FDA Clears apoQlar’s Surgical Planning Software “The FDA has granted apoQlar 510(k) marketing clearance for its VSI HoloMedicine software device which helps surgeons plan complex procedures using 3D holograms created from flat imaging sources.
The software uses Microsoft’s HoloLens 2, a mixed-reality head-mounted display inside or outside the operating room. Computed tomography scans as well as magnetic resonance imaging and positive emission tomography scans can be used to create to the interactive 3D holograms.”
About health technology
EU Tells Illumina How to Unwind Deal to Buy Cancer-Test Developer Grail “The European Union on Monday set out the details of a planned order requiring Illumina Inc. to unwind its $7.1 billion acquisition of cancer-test developer Grail Inc.
The European Commission, the bloc’s competition watchdog, said in a so-called statement of objections that it intends to require Illumina to swiftly return Grail to the same level of independence the company had before the acquisition. Grail must also be as competitive after the divestment as it was before the deal closed, the commission said.”