Today's News and Commentary

About health insurance/insurers

HIV prevention pills should be free, but insurers are still charging “Nearly a third of a national sample of 325 health coverage plans on government insurance marketplaces did not include PrEP on their lists of covered preventive services, according to the AIDS Institute, a New York-based nonprofit.|
Between 20 and 30 percent of PrEP users with commercial insurance still had to pay for it despite the coverage mandate, with an average cost of $227 for 2022, according to the Centers for Disease Control and Prevention.”

About hospitals and healthcare systems

25 largest health systems by hospital beds FYI

Update from StatNews:

Ascension: The Catholic system, still reeling from a massive cyberattack earlier this year, has been busy offloading hospitals in Alabama and Michigan. Its operating margin stood at -3% in the most recent quarter.

Bon Secours Mercy Health: BSMH narrowed its operating losses in the latest quarter as demand for care grows. Bon Secours Mercy also received $331 million in July from its investment in the revenue cycle company Ensemble Health Partners.

Cleveland Clinic: The 21-hospital academic health system posted a 1.1% operating margin in the quarter on almost $4 billion of revenue, and big investment gains pushed Cleveland Clinic’s total margin above 9%. Higher drug costs continued to gnaw at its expenses.

Northwell Health: Northwell, which operates 21 hospitals throughout New York, remained in the black with a 1.7% operating margin in the quarter. The system noted higher demand for medical care and pharmacy services.

Providence: The 51-hospital system that’s mostly in the Pacific Northwest has been losing money from patient operations for years, the latest quarter being no exception. But Providence narrowed its operating losses in the most recent quarter thanks to seeing more patients, negotiating higher prices from commercial insurers, and reducing contract labor costs by 39%. Providence registered a 1.3% net margin in the first nine months of this year after factoring in investment profits.

UPMC: UPMC registered a -0.7% operating loss in the last three months, but not because of its hospital and physician businesses, which were booming. It was due to higher costs in its insurance business. Pennsylvania is one of 13 states where Medicaid programs and their insurers cover the pricey GLP-1 drugs for obesity.”

8 health systems ditching their health plans FYI

Novartis pays PTC $1B upfront for midphase Huntington's program, reestablishing itself in R&D race “Novartis is paying $1 billion upfront for global rights to PTC Therapeutics’ midphase Huntington's disease program, helping the biotech bounce quickly back from disappointing data on another program.
PTC went into the Thanksgiving break reeling from the failure of an amyotrophic lateral sclerosis trial and its subsequent decision to stop further development of the candidate. Monday, PTC revealed a deal with Novartis for its Huntington's drug candidate PTC518, sending its share price up 17% to above $51 in premarket trading.”

About pharma

Trump taps Florida sheriff as DEA administrator “President-elect Donald Trump on Saturday tapped Hillsborough County Sheriff Chad Chronister to lead the Drug Enforcement Administration, replacing Anne Milgram.
In picking the Florida sheriff to lead the DEA, Trump has selected a law enforcement professional with three decades of experience working for the Hillsborough County Sheriff’s Office but seemingly little time in the national spotlight.”

A twice-yearly shot could help end AIDS. But will it get to everyone who needs it? “The twice-yearly shot was 100% effective in preventing HIV infections in a study of women, and results published Wednesday show it worked nearly as well in men.
Drugmaker Gilead said it will allow cheap, generic versions to be sold in 120 poor countries with high HIV rates — mostly in Africa, Southeast Asia and the Caribbean. But it has excluded nearly all of Latin America, where rates are far lower but increasing, sparking concern the world is missing a critical opportunity to stop the disease.”

Drug Prices Negotiated by Medicare vs US Net Prices and Prices in Other Countries “Apart from insulin, which had a voluntary price reduction in 2024, all products remained more expensive in the US than in other countries (Table). For example, the price negotiated by Medicare for ustekinumab ($4695.00 per 30-day supply) was higher than prices in other countries, which ranged from $1219.92 in France to $2503.99 in Germany. However, the gap between US and non-US prices narrowed for all drugs.”

About the public’s health

Reusing plastic water bottles, to-go containers? Scientists say that’s a bad idea. “That means a single-use plastic water bottle sheds micro- and nanoplastics into your water when you refill it, and a takeout container or frozen meal tray sheds these particles into your food.”

Characteristics of Older Adults Who Met Federal Physical Activity Guidelines for Americans: United States, 2022 From the CDC: “Overall, 13.9% (age adjusted) of adults age 65 and older met federal physical activity guidelines for both aerobic and muscle-strengthening activities in 2022. Differences were seen by several sociodemographic characteristics. Men (16.9%), White non-Hispanic adults (15.2%), and those living in metropolitan areas (14.7%) were more likely to meet the guidelines. The percentage meeting the federal physical activity guidelines increased with increasing education level and family income and decreased with number of chronic conditions.”

How Much Water Should We Drink in a Day? The “8 glasses a day” you may be used to hearing does not tell the whole story. This article provides a really good, evidenced-based reply to the title’s question.

About healthcare technology

Baxter moves closer to 100% allocation levels for IV products “Baxter… outlined plans to gradually increase allocations over the next several weeks, with the goal of reaching 100% allocation for several IV product codes by the end of 2024. The company has also said it will provide updates on its allocation plans in mid-December and again at year's end.” 

About healthcare personnel

The Past, Present, and Future of Restrictive Covenants in Medicine in the United States: A Narrative Review An excellent review of the topic from The Annals of Internal Medicine. If you are interested in this topic, it is well-worth seeking out this article, which is from a subscriber-only publication.