RE-DATED: DCMedical News: Friday, November 5, 2021
DCMedical News is published every day both the House and the Senate are scheduled to be in session.
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THE BIG STORY Friday, November 5, 2021
Your Money and Your Life
A study (here) in the Journal of Economic Perspectives by researchers with the Federal Reserve Bank of Boston found that there is “Rising Geographic Disparities in US Mortality.” They note, “In this paper, we find that geographic inequality in mortality for midlife Americans increased by about 70 percent between 1992 and 2016. This was not simply because states like New York or California benefited from having a high fraction of college-educated residents who enjoyed the largest health gains during the last several decades. Nor was higher dispersion in mortality caused entirely by the increasing importance of ‘deaths of despair,’ or by rising spatial income inequality during the same period. Instead, over time, state-level mortality has become increasingly correlated with state-level income; in 1992, income explained only 3 percent of mortality inequality, but by 2016, state-level income explained 58 percent. These mortality patterns are consistent with the view that high-income states in 1992 were better able to enact public health strategies and adopt behaviors that, over the next quarter-century, resulted in pronounced relative declines in mortality. The substantial longevity gains in high-income states led to greater cross-state inequality in mortality.” (Italics added.)
First Pill for COVID-19
InsideHealthPolicy (here) reports that “The United Kingdom on Thursday (Nov. 4) authorized Merck and Ridgeback Biotherapeutics’ COVID-19 drug molnupiravir, marking the first global authorization of an oral pill for COVID-19. The authorization comes weeks before FDA’s advisory committee is scheduled to discuss the drug.” IHP reports that “Merck has been producing molnupiravir at-risk and expects to produce 10 million treatment courses by the end of 2021, with at least 20 million courses to be produced in 2022. The U.S. government and Merck have entered into a procurement agreement under which the company will supply the United States with approximately 1.7 million units of molnupiravir, should the drug be authorized by FDA. The company also has entered into supply and advance purchase agreements for molnupiravir with other governments worldwide . . . Merck plans to implement a tiered pricing approach based on World Bank country income criteria to reflect countries’ relative ability to finance their pandemic responses. The company has entered into non-exclusive voluntary licensing agreements for molnupiravir with established Indian generic manufacturers to accelerate availability of the drug in more than 100 low- and middle-income countries following approvals or emergency authorization by local regulatory agencies.”
BBB Trade Offs:
Kaiser Health News reports (here) that the “Uninsured in South Would Win Big in Democrats’ Plan, but Hospitals Fear Funding Loss.”
Kaiser Hospital Workers Give November 15 Strike Notice
HealthcareDive reports (here) that “Kaiser Permanente healthcare workers in southern California sent a strike notice to executives on Thursday, notifying them of their intent to begin an open-ended strike beginning Nov. 15 over disputes for a new contract. As many as 28,400 healthcare workers, including a large contingent of nurses, could walk off the job in southern California. Another 3,400 are set to strike in Oregon. The strike notices were sent from three separate unions who are a part of a larger umbrella union that bargains as one.”
DOCTORS, NURSES AND OTHER HEALTH CARE PROFESSIONALS
Geographic Variation in the Rate of Surgical Procedures
An essay in JAMA Surgery (here) discusses geographic variation in the incidence of surgical procedure. “Where a patient resides has an important influence on the likelihood that they will have surgery for a particular condition. In the United States, variations between high-use regions and low-use regions of up to 4 times have been reported for knee and hip arthroplasty, with even larger variations for back surgery, carotid endarterectomy, and prostatectomy. Similar regional variations have been reported in Canada, the United Kingdom, Europe, and Australia. Variation is greatest for procedures that are discretionary, either because they are symptom driven or prophylactic, and that address conditions that lack highly effective nonsurgical treatments. The presence of regional variation in surgical rates raises questions about the underlying causes, including whether the variation exceeds differences that could be expected due to differences in the prevalence of the underlying disease in the population, and whether physicians or patients are the primary drivers of traits.”
HOSPITALS AND OTHER HEALTH CARE FACILITIES
COVID-19, The New HAI
Modern Healthcare reports (here) on a Kaiser Health Network survey which found that more than 10,000 patients admitted to hospitals for something else contracted COVID-19 in 2020. “They went into hospitals with heart attacks, kidney failure or in a psychiatric crisis. They left with COVID-19 — if they left at all.” They survey examined “federal and state records . . . exclusively for KHN. The number is certainly an undercount, since it includes mostly patients 65 and older, plus California and Florida patients of all ages. Yet in the scheme of things that can go wrong in a hospital, it is catastrophic: About 21% of the patients who contracted COVID in the hospital from April to September last year died, the data shows. In contrast, nearly 8% of other Medicare patients died in the hospital at the time.”
Show Me The (Accurate) Data
Sage Growth Partners has published a survey (here) showing that only 20 percent of healthcare executives trust their data. The survey of 100 executives of health systems with 250 or more beds found continuing challenges in collecting, analyzing, and using data to make timely decisions. Eighty-five percent of respondents said they view analytics as important in achieving their organization’s objectives. More than half say that their data quality leads to ineffective or slow decision making, and difficulty in identifying gaps in care in their organizations.
Going Long on Death
The Financial Times reports (here) that “Investors in Japan have been transfixed in recent weeks by a land grab for Kosaido, Tokyo’s dominant crematorium operator . . . The fight underscores the attraction of a sector that is increasingly being seen as one of North Asia’s growth opportunities: the death business. Investors have been lured to the dependable, cash-generative sector by the irreversible trend of ageing societies in Asia . . . Shanshan Wei, a portfolio manager at Tokyo-based investment fund Rheos Capital, is among those going long on Chinese death. ‘It’s a very unique investment opportunity,’ she said. ‘The potential is huge.’”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
OPPS Rule Brings Comments, Reactions
Healthcare Innovation (here) reports that “Healthcare Associations React to Elements of CMS Final Rule.” The report, with links to the statements of the various associations, said “On Tuesday and Wednesday, national professional healthcare associations responded to a variety of the elements in the final OPPS rule issued on Tuesday by CMS, praising some elements, and criticizing others.”
DRUGS & DEVICES
RAPS Reports on FDA Framework for Medical Device Software, and Software as a Medical Device, Approvals
The Regulatory Affairs Professionals Society reports (here) that “The US Food and Drug Administration (FDA) has released draft guidance for sponsors (here, Federal Register notice here) outlining its thinking about the documentation needed to support the agency’s evaluation of device software functions for premarket submissions.” When finalized, the guide will serve as an update to the May 11 Guidance . . . for Software Contained in Medical Devices (here).
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References may be found here.
2021 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
November 15, 16, 17, 18, 30
December 1, 2, 3, 6, 7, 8, 9, 10
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org