About health insurance/insurers
Trump Association Health Plan Rule Axed by Labor Department “The US Department of Labor has rescinded a Trump-era rule that made it easier for small businesses and self-employed people to use cheaper association health plans that don’t comply with all the requirements of the Affordable Care Act.
The final Biden rule (RIN:1210-AC16) on association health plans was issued by the DOL’s Employee Benefits Security Administration Monday after clearing White House review, and will take effect 60 days after its April 30 publication in the Federal Register.”
Court says state health-care plans can’t exclude gender-affirming surgery “A federal appellate court in Richmond became the first in the country to rule that state health-care plans must pay for gender-affirming surgeries, a major win for transgender rights amid a nationwide wave of anti-trans activism and legislation.”
About hospitals and healthcare systems
Walmart shuttering all 51 health centers, citing lack of profitability “Walmart is shuttering all 51 of its healthcare clinics along with its virtual care services, the retail giant announced Tuesday morning.
‘Through our experience managing Walmart Health centers and Walmart Health Virtual Care, we determined there is not a sustainable business model for us to continue,’ company executives announced in a press release.”
Comment: Shades of Walgreens and VillageMD?
About pharma
Judge rejects J&J, Bristol Myers Squibb challenges to Medicare drug-price negotiations “A federal judge in New Jersey rejected Johnson & Johnson’s and Bristol Myers Squibb’s legal challenges to the Biden administration’s Medicare drug-price negotiations, ruling that the program is constitutional.”
Estimated Medicare Part D Savings From Generic Drugs With a Skinny Label “Actual Medicare spending on these 15 drugs and their skinny-label generics was estimated to be $16.8 billion, and projected spending without generic competition was $31.5 billion. Thus, skinny-label generic competition saved Medicare approximately $14.6 billion. Estimated savings were the greatest for rosuvastatin (Crestor, AstraZeneca; $6.5 billion), pregabalin (Lyrica, Pfizer; $4.2 billion), and imatinib (Gleevec, Novartis; $3.1 billion)…”
Background: “To prevent these from indefinitely delaying generic competition, federal law allows the FDA to approve generic drugs that carve out brand-name drug indications protected by patents or exclusivities. For example, when generic versions of the β-blocker carvedilol (Coreg, GlaxoSmithKline) launched in 2007, their labels listed indications for hypertension and myocardial infarction but not for heart failure, because this indication remained patent protected.
These ‘skinny-label’ generic drugs are frequently the first to enter the U.S. market, can dramatically lower costs for patients and the health care system, and can be used off label for the carved-out indications.”
Enormous Demand for Weight-Loss Drugs Drives Up Total U.S. Prescription Spending “Blockbuster growth in weight-loss drugs was the main driver of a 13.5% increase in spending on prescription medications in the U.S. in 2023, according to ASHP's (American Society of Health-System Pharmacists) report, National Trends in Prescription Drug Expenditures and Projections for 2024. By contrast, hospital drug spending dipped slightly as the pandemic ended and remdesivir injections were replaced by less-costly oral COVID treatments.”
About the public’s health
Screening for Breast Cancer:US Preventive Services Task Force Recommendation Statement “The USPSTF recommends biennial screening mammography for women aged 40 to 74 years. (B recommendation) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women 75 years or older. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of supplemental screening for breast cancer using breast ultrasonography or MRI in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement)”
DEA plans to reclassify marijuana as a lower-risk drug, officials say “The measure, if enacted, would not instantly legalize marijuana at the federal level but could broaden access to the drug for medicinal use and boost cannabis industries in states where it is legal.”
Biomarkers of metal exposure in adolescent e-cigarette users: correlations with vaping frequency and flavouring “Vaping in early life could increase the risk of exposure to metals [lead and uranium], potentially harming brain and organ development. Regulations on vaping should safeguard the youth population against addiction and exposure to metals.”
About healthcare personnel
No One Can See You Now: Five Reasons Why Access to Primary Care Is Getting Worse (and What Needs to Change) An excellent analysis of this problem.
“This assessment identifies five reasons why primary care in the United States is inaccessible for so many Americans…
Reason 1: The primary care workforce is not growing fast enough to meet population needs.
•The number of primary care physicians (PCPs) per capita has declined over time from a high of 68.4 PCPs per 100,000 people in 2012 to 67.2 PCPs per 100,000 people in 2021.
•While the rate of total clinicians in primary care, inclusive of nurse practitioners (NPs) and physician assistants (PAs), has grown over the past several years, it is still insufficient to meet the demands of overall population growth…
Reason 2: The number of trainees who enter and stay on the professional pathway to primary care practice is too low, and too few primary care residents have community-based training.
Reason 3: The US continues to underinvest in primary care.
Reason 4: Technology has become a burden to primary care.
Reason 5: Primary care research to identify, implement, and track novel care delivery and payment solutions is lacking.”
In a related article: Med school association projects physician shortfall of 86,000 by 2036 “Based on 2036 projections:
There will be a shortage of 20,200 to 40,400 primary care doctors.
Surgical specialties will have a shortage of 10,100 to 19,900 physicians.
Medical specialties could have a shortage of 5,500 to a surplus of 3,700 doctors, if surpluses arise in specialties such as critical care/pulmonology and endocrinology.
Other specialties could face a shortage of 19,500 to a surplus of 4,300 physicians, if surpluses in emergency medicine and physical medicine and rehabilitation materialize.”