DCMedical News: Tuesday, January 29, 2019
DCMedical News-DCMN
Washington, D.C.
Tuesday, January 29, 2019
DCMedical News is published every day either the House or the Senate is in regular session.
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THE BIG STORY IN HEALTH CARE:
Older People and Their Medical Expenses Drive Debt Up: The Congressional Budget Office (CBO) delivered its ten year projection of the budget and economic outlook 2019-2029 (here) Monday. CBO Director Keith Hall noted: “Federal debt is already large, and budget deficits over the next decade and beyond are projected to keep pushing it up in relation to the size of the economy. Eventually, debt as a share of economic output would reach its highest level in our nation’s history . . . . At the end of 2018, the amount of debt held by the public was equal to 78 percent of gross domestic product (GDP). In CBO’s projections, debt equals 93 percent of GDP by 2029 and about 150 percent of GDP by 2049. Even at its highest point ever, just after World War II, debt was far less than that: 106 percent of GDP.”
Cause? “On the spending side, growth is driven by benefits for older people and by interest costs. Outlays for Social Security and Medicare increase significantly in CBO’s baseline projections. As members of the baby-boom generation age, the number of people at least 65 years old—who are the main beneficiaries of that spending—is expected to grow by about one-third, and their health care costs will continue to rise.
HOSPITALS AND OTHER HEALTH CARE FACILITIES
ED Visits Up: A group from Mount Sinai (NY) and others report in JAMA Internal Medicine (here) that “From 2006 to 2014, ED visits increased 18.4%, and ED admission rates decreased 9.8%. The increase in ED visits, outpacing population growth, underscores an unabating demand for acute, unscheduled care. Declining ED admission rates represent a significant reduction in hospital-based care that has received little attention to date.”
DRUGS AND DEVICES
Drugs and More, Four Health Hearings Today in Congress
House Ways and Means Committee: On pre-existing conditions, witness list here.
Senate Finance Committee: On drug prices, witness list here.
Senate Committee on Health, Education Labor and Pensions: On underserved communities, witness list here. And don’t forget to submit your ideas by March 1, in response to Chairman Lamar Alexander’s plea (here, Modern Healthcare coverage of the contest here) for any ideas which might help with the cost of health care.
Best Pick for Today (How Many Committee Hearings Can You Watch?): House Oversight and Reform Committee, "Examining the Actions of Drug Companies in Raising Prescription Drug Prices,” with Hopkins’ Gerard Anderson. A brief profile of the House Committee Chairs having jurisdiction in drug matters appears in Modern Healthcare, here. An essay on drug prices and the potential role they may play in the 2020 elections appears in Kaiser Health News, here.
Lipitor and Viagra Give Way to Cancer Drugs at Pfizer: A Wall Street Journal profile of the company (here) describes how Pfizer went from no cancer drugs to 17 actively marketed now. “Drug-company marketers like the category because promoting the therapies to cancer doctors and hospitals requires a smaller sales force than was needed to sell cholesterol and hypertension medicines to the much larger cadre of primary-care physicians. Cancer-drug sales are projected to reach $138 billion world-wide this year and are growing 11% a year, according to EvaluatePharma. A year’s treatment typically lists for more than $100,000.”
Outcomes Incentive Will Also Benefit Patient Finances: STAT reports (here) that AstraZeneca and UPMC Health Plan have agreed for the first time to “outcomes-based contracting — an increasingly popular tool that drug companies dangle before payers to potentially lower their costs . . . coupled with a mechanism that can make less of a dent in patient pocketbooks.”
“Netflix Model” for Pricing of Expensive Drugs: U.S. Senator Dr. William Cassidy and MSK’s Dr. Peter Bach collaborate on a subscription model for expensive drugs. Their paper (here) in JAMA says that “due in many cases to budgetary constraints of state Medicaid programs and prisons, only 15% of the estimated population of more than 3 million individuals with HCV infection in the United States have been treated.” Amortization of expense, rather than its control, is the central theme.
READINGS & REFERENCES
Worth Another Look: “Do Hospitals Still Make Sense? The Case for Decentralization of Health Care”: From NEJM Catalyst December 20, 2017, here.
Greed Is Not Good: BMJ publishes (here) honors for the “Greediest players in US healthcare.” “A drug company topped a list of the worst actors in US healthcare for the second year in a row, but other industry sectors—such as hospitals, physicians, and insurers—gained ground in the second annual Shkreli Awards.”
U.S. House of Representatives: Members at https://www.house.gov/representatives, Committees and Members at https://www.house.gov/committees
U. S. Senate: Members at https://www.senate.gov/general/contact_information/senators_cfm.cfm, Committees and Members at https://www.senate.gov/committees/membership_assignments.htm
House and Senate 2019 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
Publication dates are the regularly scheduled days the House or the Senate is in session.
Remaining January publication dates: 30, 31
February publication dates: 1, 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 25, 26, 27, 28
March publication dates: 1, 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 25, 26, 27, 28, 29
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.