Twelve propositions on the state of the world This article, by Martin Wolf of the Financial Times (FT), is an excellent overview on the “state of the world.” This link is only good for the first three readers who access it. It is well worth reading if you can get access to the FT.
20 best-managed healthcare companies “One healthcare company is among the top 10 best-managed businesses in the U.S., according to the annual ranking by the Drucker Institute.” That company is J&J. See the article for 19 others in the top 150.
About Covid-19
Trends in Medical Debt During the COVID-19 Pandemic Perhaps contrary to common opinion: “We found no evidence of a net association between the COVID-19 pandemic and medical debt, overall or across areas with different incomes and pandemic severity. These results are consistent with any increase in medical debt being offset by decreases in elective medical procedures and new health care–related governmental policies.”
About health insurance
Moody's: Outlook stable for insurers even as Medicaid, ACA enrollment declines loom “Insurers can expect a stable credit outlook and low double-digit earnings growth this year after a strong first quarter, according to a forecast from Moody's Investors Service.
The analysts' report finds that the average growth in earnings before interest, taxes, depreciation and amortization (EBITDA) was 3.7% in the first quarter among seven major national payers. When excluding investment income and realized gains and losses, however, EBITDA was up 10.3% on average.
What was driving this performance? Strong enrollment growth in Medicare Advantage and Medicaid as well as improvements in the commercial book, analysts said.”
About hospitals and healthcare systems
Highmark reports operating gain of $100M, net loss of $150M “Pittsburgh-based Highmark Health posted an operating gain of $100 million for the three months ended March 31, according to its financial results released May 31.
Highmark Health — which includes the eight-hospital Allegheny Health Network — reported $6.4 billion in revenue for the first quarter of 2022, according to a May 31 news release.The organization had a net loss of $150 million, which was driven by lower equity performance, Highmark said.
Allegheny Health Network reported a $67 million loss before interest, taxes, depreciation and amortization for the first quarter, largely due to high labor and supply chain costs. It had an operating loss of $100 million.”
About pharma
U.S. Consumers Overpay for Generic Drugs “Generics account for only a slice—about 18%—of overall U.S. retail prescription drug expenditures, which reached nearly $350 billion in 2020.5,6 Nonetheless, by one estimate, U.S. use of generic and biosimilar drugs in place of branded drugs in 2020 saved $338 billion, with 10-year estimated savings from generics of nearly $2.4 trillion.”
However: “An analysis by Schaeffer Center researchers, for example, found that Medicare Part D standalone drug plans paid $2.6 billion more in 2018 for 184 common generic medications compared with prices for the same drugs available to cash-paying Costco members…
A 2018 Schaeffer Center study found that commercially insured patients’ copayments for a generic prescription exceeded the total cost of the medicine more than a quarter of the time (28%), with an average overpayment of $7.32.24 Total overpayments in the commercial claims studied amounted to $10.51 per member per year. Known as a copayment “clawback,” the practice was abetted by “gag clauses” in PBM/ insurer contracts that prevented pharmacists from telling consumers they could save money by paying the cash price; Congress outlawed such gag clauses in 2018.25 However, PBM contracts commonly require pharmacies to give the PBM their lowest price when accepting reimbursement for a prescription. As a result, pharmacies are careful to set cash prices higher than their negotiated PBM rates. Without prohibition of such anticompetitive contract clauses, pharmacies will not offer competitive cash prices for fear of triggering these best-price clauses.”
The problems with patients filling their prescriptions at “cash” pharmacies is that coordination of care may suffer (no feedback about their filling/refilling prescriptions) and the amount of spending is not counted toward their deductibles and annual out of pocket maximums.
Read the article for thoughtful solutions to these problems.
Who needs Humira? AbbVie projected to be the top pharma company by sales in 2028: analysts “Reports of the demise of AbbVie—concurrent with the loss of exclusivity for its mega-blockbuster drug Humira—have been greatly exaggerated.
At least that’s the consensus view of sell-side analysts polled by Evaluate Pharma, who predict that the Illinois-based pharma giant will generate more prescription sales than any company in the industry in 2028.
They see AbbVie's $65.7 billion in expected 2028 sales closely followed by Roche at $65 billion. Johnson & Johnson ($62.3 billion), Merck ($59.7 billion) and Pfizer ($57.1 billion) round out the top 5 in their projections.”
Pfizer to sell stake in GSK's consumer healthcare firm after spin-off “Pfizer plans to sell its stake in Haleon, the consumer healthcare company to be spun-out of GSK later this year, as it continues to increase its focus on medicines and vaccines. GSK said Wednesday that Pfizer ‘intends to exit its 32% ownership interest in Haleon in a disciplined manner, with the objective of maximising value for Pfizer shareholders.’”
World Health Organization Resolves to Improve Clinical Trials Globally “In an effort to prepare for future health emergencies, the World Health Organization (WHO) has adopted a resolution geared toward delivering higher quality data and improving the conduct and coordination of clinical trials around the world.”
Here is the full text of the resolution from the Seventy-fifth World Health Assembly last week.
About the public’s health
Biden-Harris Administration Establishes HHS Office of Environmental Justice The “U.S. Department of Health and Human Services (HHS) is establishing an Office of Environmental Justice (OEJ) to better protect the health of disadvantaged communities and vulnerable populations on the frontlines of pollution and other environmental health issues. The new office will sit within the Office of Climate Change and Health Equity at HHS…
As the HHS-wide hub for environmental justice policy, programming, and analysis, the Office of Environmental Justice is tasked with:
Leading initiatives that integrate environmental justice into the HHS mission to improve health in disadvantaged communities and vulnerable populations across the nation.
Developing and implementing an HHS-wide strategy on environmental justice and health.
Coordinating annual HHS environmental justice reports.
Providing HHS’ Office of Civil Rights with environmental justice expertise to support compliance under Title VI of the Civil Rights Act of 1964.
Promoting training opportunities to build an environmental justice workforce.”
WHO: Monkeypox won’t turn into pandemic, but many unknowns “The World Health Organization’s top monkeypox expert said she doesn’t expect the hundreds of cases reported to date to turn into another pandemic, but acknowledged there are still many unknowns about the disease, including how exactly it’s spreading and whether the suspension of mass smallpox immunization decades ago may somehow be speeding its transmission.”
Outcomes Following Taxation of Sugar-Sweetened Beverages: A Systematic Review and Meta-analysis Use of higher taxes on harmful items (like cigarettes) have consistently been the best way to reduce usage. This meta-analysis of sugar-sweetened beverages reconfirms this fact.
”In this systematic review of 86 studies and a meta-analysis of 62 studies, implemented SSB taxes were associated with higher prices of targeted beverages (tax pass-through of 82%) and 15% lower SSB sales, with a price elasticity of demand of −1.59. No negative changes in employment were identified.”
About healthcare IT
VA now required to report performance, costs of troubled EHR system to Congress This article is a update on the long saga of the VA’s (less than successful and over-budget) implementation of its IT system. “The Department of Veterans Affairs (VA) will now have to submit regular reports to Congress about the performance of its new $16 billion medical records system, including incidents that risk patient safety, under new legislation headed to President Joe Biden's desk.
The Senate approved a bill (PDF) last week that aims to increase transparency surrounding the VA's electronic health record modernization (EHRM) program, a project that has been plagued with problems as it has been rolled out to three VA locations.
This legislation already passed the House of Representatives and will now go to the president to be signed into law.”
BD to patch cybersecurity risks found in drug dispensing, lab management tech “BD said it would issue software updates for two of its products after discovering separate privacy concerns and potential hacking risks in each.
The affected technologies are BD’s Pyxis systems for medication management and dispensing and its Synapsys workflow management software for clinical diagnostic labs. BD voluntarily reported each of the cybersecurity issues to the FDA and other relevant authorities, including the Department of Homeland Security’s Cybersecurity and Infrastructure Security Agency, or CISA.”
About health technology
Racial and Ethnic Discrepancy in Pulse Oximetry and Delayed Identification of Treatment Eligibility Among Patients With COVID-19 “Are there systematic racial and ethnic biases in pulse oximetry among patients with COVID-19, and is there an association between such biases and unrecognized or delayed recognition of eligibility for oxygen threshold–specific therapy?…
The study results suggest that overestimation of arterial oxygen saturation levels by pulse oximetry occurs in patients of racial and ethnic minority groups with COVID-19 and contributes to unrecognized or delayed recognition of eligibility to receive COVID-19 therapies.”
NZ-based AI firm launches tool to assess heart risk through retinal scans in U.S. “Toku Eyes, a New Zealand-based healthcare AI company, is launching its tool that assesses heart risk through a retinal scan in the U.S.
The tool, called ORAiCLE, uses an AI platform to identify cardiovascular threats more accurately than existing risk calculators, the company claims. The platform recognizes subtle changes in aspects like blood vessels and pigmentation to identify a person’s risk of a stroke or heart attack in the next five years…
Since using a retinal camera and the AI software requires minimal training, it is more cost-effective and accessible, the company argues. The AI platform uses an image of the back of the eye to do its assessment. It then provides personalized health guidance or recommends a specialist referral. The company says the technology also works accurately with low-resolution images.
ORAiCLE is being released as a wellness device and therefore does not require FDA clearance…”