About Covid-19
Israel finds fourth Covid jab cuts infection and serious illness: “Initial data in January from the Sheba Medical Center at Tel Hashomer suggested that the fourth dose made little difference in protecting against Omicron, and even though the jabs are now available for many population groups, diminishing numbers of Israelis are opting for the fourth jab.
However, Maccabi Health Services virus task force head Dr. Arnon Shahar said, ‘We see that when the fourth vaccine dose is freshly administered, up to six weeks, it reduces infection by 50% and the risk of serious illness is five times less.’
Israeli Ministry of Health figures show that 7% of those hospitalized in serious and critical condition with Covid had four Covid vaccinations compared with 28% who have had three jabs, with the third vaccination not administered recently, while 45% have not been vaccinated at all.”
Hospitalizations of Children and Adolescents with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, July 2021–January 2022: “Coinciding with increased circulation of the Omicron variant, COVID-19–associated hospitalization rates among children and adolescents aged 0–17 years increased rapidly in late December 2021, especially among children aged 0–4 years who are not yet eligible for vaccination. Throughout the periods of Delta and Omicron predominance, hospitalization rates remained lower among fully vaccinated adolescents aged 12–17 years than among unvaccinated adolescents.”
Excess Deaths Associated with COVID-19: Per CDC data: “Total predicted number of excess deaths since 2/1/2020 across the United States: 1,045,389”
Effectiveness of Maternal Vaccination with mRNA COVID-19 Vaccine During Pregnancy Against COVID-19–Associated Hospitalization in Infants Aged <6 Months — 17 States, July 2021–January 2022: “Effectiveness of maternal completion of a 2-dose primary mRNA COVID-19 vaccination series during pregnancy against COVID-19 hospitalization among infants aged <6 months was 61% (95% CI = 31% to 78%). Effectiveness of completion of the primary COVID-19 vaccine series early and later in pregnancy was 32% (95% CI = –43% to 68%) and 80% (95% CI = 55% to 91%), respectively.”
Covid-19 booster shot uptake is at all-time low in the US, CNN analysis finds: “As of Monday, about 64% of the US population is fully vaccinated against Covid-19 with at least their initial two-dose series, and 28% have received a booster shot. But the pace of booster doses going into arms is the lowest it has been in months -- since the US Centers for Disease Control and Prevention first recommended boosters for seniors and other at-risk adults in September, according to a CNN analysis of CDC data. The agency expanded its recommendation for booster doses in November to include all adults.”
Biden admin seeks $30 bln more from Congress to fight COVID -sources: “The $30 billion request includes $17.9 billion for vaccines and therapeutics, two sources familiar with it said.”
COVID-19 therapeutics for nonhospitalized patients: Sorting out these therapies is often confusing.
eTable 1 provides a great comparison among these treatments.
About health insurance
Fraud Section Year in Review-2021- From the Department of Justice. The healthcare report begins on page 15. In short:
”The Department announced criminal charges against 138 defendants, including 42 doctors, nurses, and other licensed medical professionals, charged between August 1 and September 17, 2021, in 31 federal districts for their alleged participation in various health care fraud and illegal opioid distribution schemes that resulted in a combined total of approximately $1.4 billion in alleged losses. The charges targeted approximately $1.1 billion in alleged fraud committed using telemedicine (the use of telecommunications technology to provide health care services remotely), $29 million in COVID-19 health care fraud, $133 million connected to substance abuse treatment facilities, or ‘sober homes,’ and $160 million connected to other health care fraud and illegal opioid distribution schemes across the country.”
About hospitals and healthcare systems
CommonSpirit Health reports $81M operating loss as COVID surges drove up supply, staffing costs: “CommonSpirit’s net patient and premium revenue for the second quarter increased 9.3% ($710 million) year over year, while same-store adjusted admissions rose 1.5% year over year, outpatient visits rose 5.1% year over year and emergency department visits jumped 16.6% year over year. Total operating revenue for the quarter was $8.88 billion.
But the health system also saw a 12.3% year-over-year increase in labor expenses per adjusted admission and an 11.6% ($152 million) rise in supply costs.”
About pharma
HOW DO COPAYMENT COUPONS AFFECT BRANDED DRUG PRICES AND QUANTITIES PURCHASED?: “Using data on net-of-rebate prices and quantities from a large Pharmacy Benefits Manager, we find that coupons increase quantity sold by 21-23% for the commercial segment relative to Medicare Advantage in the year after introduction..
For this category of drugs, we estimate that coupons raise negotiated prices by 8% and result in just under $1 billion in increased U.S. spending annually. Combined, the results suggest copayment coupons increase spending on couponed drugs without bioequivalent generics by up to 30 percent.”
Identifying Higher-Volume Antibiotic Outpatient Prescribers Using Publicly Available Medicare Part D Data — United States, 2019: “The highest 10% of antibiotic prescribers prescribed 41% of total antibiotic prescriptions for Medicare Part D beneficiaries in 2019. The antibiotic prescribing rate of these higher-volume prescribers was 60% higher than that of lower-volume prescribers.”
FDA wallops Indian drugmaker with warning letter blasting API quality, equipment cleanliness and more: “The FDA has dinged Indiana Chem-Port with a laundry list of problems related to controls, cleaning, maintenance, testing and quality assurance in its API [active pharmaceutical ingredient] production operation. The regulator handed down a five-observation warning letter earlier this month after inspecting Indiana Chem-Port’s Gujarat, India, manufacturing facility in August last year.”
The reason this action is important is that India, with China, are the top two sources for our APIs.
Merck & Co. inks drug-development deal with Curve Therapeutics: “Merck & Co. entered into an agreement with Curve Therapeutics potentially worth up to $1.7 billion to develop modulators of up to five therapeutic targets, initially for oncology and neurology indications, the latter company said Wednesday. Along with an undisclosed upfront payment and milestones, Curve is also eligible to receive sales royalties on any approved products resulting from the alliance.
Under the deal, Curve will perform high throughput mammalian cell-based functional screening, hit characterisation, data-mining and analysis, as well as optimisation using its Microcycle technology.”
About the public’s health
Validation Status of Blood Pressure Measuring Devices Sold Globally: The state of the art for blood pressure monitoring is ambulatory self-measurement, However, validation of devices has not been performed on a wide scale. Disturbingly, this global study found:
”From 2486 upper arm cuff devices, 248 (10.0%) were validated, 327 (13.2%) were equivalent, and there was no evidence of validation for 1816 (73.0%) (Table). From 925 wrist-based devices, 52 (5.6%) were validated, 51 (5.5%) were equivalent, and there was no evidence of validation for 786 (85.0%)…
Lack of validation may undermine optimal medical practice through increased potential for incorrect hypertension diagnosis and inappropriate care. Global and national policy frameworks, including regulations with enforcement, are needed, with the goal that all devices meet minimum requirements for independent validation before premarket clearance. Currently, to determine if a device is validated, consumers should check a validated device list.” See: How to check whether a blood pressure monitor has been properly validated for accuracy
About healthcare IT
athenahealth Acquired by Hellman & Friedman and Bain Capital: “athenahealth, Inc. (“athenahealth” or “the Company”), a leading provider of cloud-based enterprise software solutions for medical groups and health systems nationwide, today announced that affiliates of Bain Capital and Hellman & Friedman have completed their acquisition of athenahealth from Veritas Capitaland Evergreen Coast Capital for $17 billion.”
HHS awards community health centers $55M to expand telehealth access for underserved groups: “The Department of Health and Human Services has awarded community 29 health centers nearly $55 million to reach their underserved populations using telehealth, remote patient monitoring, health information technology platforms and other digital and virtual care tools.
The funds announced Monday will be distributed through the Health Resources and Services Administration (HRSA) and aim to ‘enable health centers to sustain an expanded level of virtual care and identify and implement new digital strategies.’”
Mobile Health App Use Among Older Adults: “Nearly three in ten adults age 50–80 (28%) said they currently use at least one mobile health app, 16% reported that they used them in the past but not currently, and 56% have never used a health app. Adults age 50–64 were more likely than those 65–80 to have ever used a health app (49% vs 38%). Overall, 34% of older adults said they use or have used apps for exercise, 22% for nutrition, 20% for weight loss, and 17% for sleep. Older adults less commonly used apps for recording blood pressure (9%), meditating (8%), and/or mental health/stress management (5%).”
About health technology
Cleveland Clinic Unveils Top 10 Medical Innovations for 2022: Each year the Cleveland Clinic publishes its “top 10 list”—always worth reading.