Inflation-Adjusted Health Care Spending is Falling for the First Time in Half a Century “…for the first time in 2021, real health care spending growth was flat, and in the first quarter of 2022, real health care spending actually declined by 1.7% year over year (Figure 1). This is seven full percentage points lower than the long-term average (+5.3%). As a result, we have also seen health spending decline as a percentage of US GDP (falling from a peak of over 20% in mid-2020 to 18.0% in May 2022) as overall US economic growth has rebounded much faster than health spending in the post-2020 period…
This decline in real health care spending is driven largely by a decline in health care price growth relative to economywide inflation (though slower utilization growth has also had an impact)….
However, despite indications of a slowing health care cost trend over the past 18 months, many of these impacts are expected to be short-lived.”
Schumer, Manchin announce deal on reconciliation bill with tax, climate, energy provisions The healthcare highlights include savings of “$288 billion through prescription drug pricing reforms, including measures to allow Medicare to negotiate drug prices and cap out-of-pocket costs to $2,000” and spending of “$64 billion from extending an expanded Affordable Care Act program for three years, through 2025.
The full Senate will consider the bill next week, Schumer and Manchin said. They hope that the legislation will meet the Senate Parliamentarian’s budget reconciliation rules, allowing Democrats to pass it without needing GOP votes.”
About Covid-19
Fall COVID-19 booster drive could save up to 160,000 U.S. lives: report The headline is the story.
Promising developments in pursuit to design pan-coronavirus vaccine “Researchers at the Francis Crick Institute have shown that a specific area of the SARS-CoV-2 spike protein is a promising target for a pan-coronavirus vaccine that could offer some protection against new virus variants, common colds, and help prepare for future pandemics.”
Texas Panel Upholds School District's Vax Mandate “Texas Gov. Greg Abbott cannot prevent the San Antonio Independent School District from requiring its employees to be vaccinated against COVID-19, a state appellate court panel ruled on Wednesday, finding the governor doesn't have authority over policies implemented by school districts. A three-judge panel of the Fourth Court of Appeals in San Antonio affirmed a Bexar County District Court judge's order denying Texas' bid to prevent school district officials from implementing a vaccine mandate that requires its staff to get inoculated or face termination. “
About health insurance
Attorney General James Sues CVS for Harming New York Safety Net Hospitals and Clinics by Diverting Millions from Underserved Communities “New York Attorney General Letitia James today sued CVS Health Corporation (CVS) for violating antitrust laws and hurting New York safety net hospitals and clinics that provide care for underserved communities across the state. CVS required New York safety net hospitals and clinics to exclusively use a CVS-owned company, Wellpartner, to process and obtain federal subsidies on prescriptions filled at CVS pharmacies. CVS’s scheme forced safety net health care providers to incur millions in additional costs, while CVS continued to benefit through its subsidiary. The lawsuit alleges that CVS’s unfair business practice deprived safety net hospitals and clinics of critical federal funding that could have been used to improve and expand patient care. Through her lawsuit, Attorney General James is seeking to end CVS’s unfair and illegal practices and to recoup lost revenue for impacted safety net hospitals and clinics that would improve health care services.”
CMS drops 3 final payment rules: 8 things to know “CMS has released its annual payment updates for hospices, inpatient psychiatric facilities and inpatient rehabilitation facilities for fiscal year 2023.”
The article is a nice, short summary of these rules.
About hospitals and healthcare systems
Preventing Patient Harm and Death from Diagnostic Errors: New Leapfrog Report Identifies 29 Recommended Practices that Hospitals Should Implement Now “The Leapfrog Group… today released the report Recognizing Excellence in Diagnosis: Recommended Practices for Hospitals. This landmark report is the result of an intensive year-long effort bringing together the nation’s leading experts on diagnostic excellence, including physicians, nurses, patients, health plans, and employers. Together, the multi-stakeholder group reviewed the evidence and identified 29 evidence-based actions hospitals can implement now to protect patients from harm or death due to diagnostic errors…
Leapfrog will use practices from the report issued today and survey hospitals on their current implementation status via a national pilot in fall 2022. The feedback collected from hospitals during the pilot will be used to develop a new section on the Leapfrog Hospital Survey slated for launch in 2024. The Society to Improve Diagnosis in Medicine (SIDM), a key partner in this initiative, was a leading stakeholder in identifying the practice recommendations and will develop tools and training materials to support hospitals in implementing the practices outlined in the report.”
[Disclosure: I am on SIDM’s finance committee.]
CHS posts $326M loss in Q2 “Franklin, Tenn.-based Community Health Systems, which operates 83 hospitals, saw revenues decrease in the second quarter of this year and ended the period with a net loss.
In financial documents released July 27, CHS said revenues and admissions were down in the three months ended June 30. Admissions declined 3.4 percent year over year and revenues were down 2.4 percent compared to the second quarter of 2021.
About pharma
Top 15 specialty pharmacies by revenue The top 4 are:
CVS Specialty — $52.9 billion
2. Accredo / Freedom Fertility — $43.5 billion
3. Optum Specialty Pharmacy — $25.8 billion
4. AllianceRx / Walgreens stores — $19.2 billion
TO highlight the market dominance of these firms, each of the other 11 have revenues <$5 billion.
AbbVie's Allergan reaches $2 bln opioid lawsuit settlement “AbbVie Inc's unit Allergan has reached an agreement to pay over $2 billion to resolve thousands of lawsuits related to the marketing of its opioid painkiller…
The deal would settle more than 3,000 lawsuits filed by state and local governments, but complete terms of the settlement are still being chalked out, according to the report. Thousands of lawsuits have been filed against drugmakers, distributors and pharmacies over the U.S. opioid crisis.”
GSK, still early in US launch, licenses long-acting HIV PrEP drug Apretude to patent pool for poorer nations “GSK has signed a licensing deal with the United Nations-backed Medicines Patent Pool (MPP) for its long-acting HIV PrEP drug Apretude, or cabotegravir, the two parties unveiled during the 24th International AIDS Conference. The arrangement gives selected generics manufacturers rights to make and supply copycats of Apretude for 90 poorer countries.”
About the public’s health
Modification of the Association Between Frequent Aspirin Use and Ovarian Cancer Risk: A Meta-Analysis Using Individual-Level Data From Two Ovarian Cancer Consortia “This study, the largest to-date on aspirin use and ovarian cancer, provides evidence that frequent aspirin use is associated with lower ovarian cancer risk regardless of the presence of most other ovarian cancer risk factors. Risk reductions were also observed among women with multiple risk factors, providing proof of principle that chemoprevention programs with frequent aspirin use could target higher-risk subgroups.”
An additional 786,000 monkeypox vaccine doses will soon be available in the United States “The US Food and Drug Administration said Jynneos monkeypox vaccine doses filled and finished at a Denmark manufacturing facility meet the agency’s quality standards and it has approved a supplement to the vaccine’s biologics license. Doses that were previously manufactured at the facility had already been shipped to the United States, so the FDA action clears the way for doses to be distributed and administered.”
Physical and Mental Activity, Disease Susceptibility, and Risk of Dementia “In a prospective cohort study based on UK Biobank, 501,376 dementia-free participants were recruited in 2006-2010 and followed from one year after the recruitment date until the end of 2019 for ascertainment of dementia…
Activity patterns more adherent to frequent vigorous and other exercises, housework-related activity, and friend/family visit were associated with a reduced risk of multiple types of dementia. Such associations are independent of disease susceptibility, highlighting the potential of these physical and mental activity patterns, as effective interventions, in the primary prevention of dementia.”
The Best & Worst States for Health Care The best is Hawaii; the worst (by far) is West Virginia.
About healthcare IT
Major privacy issues in IQVIA’s data sharing deal with Experian An investigative story from STAT (subscription required):
“Health analytics company IQVIA has carefully crafted a reputation for its deep commitment to data privacy. But internal documents paint a different picture — including what experts say are major privacy lapses in a marketing data partnership with credit reporting company Experian…
IQVIA purchased detailed consumer data from Experian and links it to Americans’ health records to deliver marketing insights to its customers, drug companies and device makers. While IQVIA compiled anonymized personal and financial information from the credit reporting company on 120 million people, its employees worried that the data, including information about income, jobs, and ethnicity, could put consumer privacy at risk.
’There are a number of changes and indications in emails that have us concerned about the exposure of these data,’ said one email from an IQVIA employee in 2016. The company also went several years without commissioning an expert privacy review of its use of Experian’s data, internal company emails show.”
Medicare Telehealth Services Extension Approved by House
Bill would extend Medicare telehealth waivers through Dec. 31, 2024
Over 28 million beneficiaries used telehealth services in 2020
Teladoc takes hefty impairment charge in Q2 with losses mounting to nearly $10B “The company took a $3 billion hit from an impairment charge that pushed the company to a loss of $19.22 per share in the second quarter compared to a loss of $133.8 million, or a loss of 86 cents per share, for the same period a year ago…
Companies opt for impairment when the value of assets or goodwill on their books is no longer fully recoverable.”
About healthcare personnel
Medical Education Goes Woke:Future doctors will be obliged to learn how health relates to ‘systems of oppression.’ “The Association of American Medical Colleges (AAMC)… recently released a report describing the new “diversity, equity and inclusion competencies” that medical students and residents will be expected to master.” That sentence is the premise of this Wall Street Journal editorial. It is well-worth trying to get a copying think about all the issues it raises.
The Rise and Potential of Physician Unions FYI
About health technology
Oldest patient yet cured of HIV after stem cell transplant – researchers “The oldest patient yet has been cured of HIV after receiving a stem cell transplant for leukaemia, researchers reported on Wednesday.
While the transplant was planned to treat the now-66-year-old's leukaemia, the doctors also sought a donor who was naturally resistant to the virus that causes AIDS…”
Labcorp is spinning out its clinical development unit in major shakeup “Labcorp announced this morning that it is spinning out most of its CRO business, eight years after its $6 billion Covance acquisition.
Labcorp will keep its core business directed at diagnostic testing, the company said Thursday morning after the Wall Street Journal reported the split earlier in the morning, citing sources familiar with the matter. A tax-free spinout is expected in the second half of next year, the company said.
The new spinout accounted for roughly 20% of Labcorp’s $13.5 billion 2021 revenue, WSJ reported, excluding Covid-19 testing.”