DCMedical News: Tuesday, May 14, 2019
DCMedical News-DCMN
Washington, D.C.
Tuesday, May 14, 2019
DCMedical News is published every day both the House and the Senate are in session. Subscription information below.
THE BIG STORY IN HEALTH CARE
Full Court Press
The Financial Times reports (here) that “Shares in generic drugmakers including Teva, Mylan, Novartis, Sandoz, and Pfizer fell on Monday after 44 US states announced a lawsuit alleging an anti-competitive conspiracy to artificially inflate prices for more than 100 drugs, some by more than 1,000 per cent . . . The lawsuit also named 15 individual senior executives at some of the companies, including Teva, Sandoz and Mylan, accusing them of orchestrating the ‘multibillion-dollar fraud’. Teva alone is accused of raising prices on almost 112 generic drugs.” The report went on to note that “The complaint is the second to be filed in an expanding investigation, following one in 2016 that accused six generic drugmakers of illegally fixing prices. Two former executives from Heritage Pharmaceuticals have entered settlement agreements and are co-operating with the states’ attorneys-general.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
More Tinkering with Primary Care Doctor Pay
HFMA analyzes the next round (here), as follows: “On April 22, 2019, the Center for Medicare and Medicaid Innovation (CMMI) announced its Primary Care First Model (PCF). The five-year model builds on CMMI’s and providers’ experiences with the Comprehensive Primary Care Plus (CPC+). This alternative payment model seeks to prioritize the doctor-patient relationship, enhance care for patients with complex chronic needs and high need, seriously ill patients, reduce administrative burden, and focus financial rewards on improved health outcomes. The goals of the model are to reduce Medicare spending.” (Emphasis added.)
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
It’s National Hospital Week (May 12-19)
A Forbes columnist opines (here) that (see recent RAND report, here) “Employers paying double and even triple what Medicare pays for hospital care could give a boost to Medicare for All and a public option proposal.”
Making Two from One (Procedures)
Makary and Johns Hopkins colleagues report in JAMA Internal Medicine (here) that the likelihood that elective upper and lower endoscopic procedures would be performed on two separate occasions (with two separate bills) increased when those procedures were done in a physician-owned (“freestanding”) ambulatory surgery center or in a physician’s office. When “paired upper and lower endoscopic procedures [were] performed within a 90-day period among Medicare beneficiaries from January 1, 2011, to June 30, 2018, the different-day procedure rate was significantly higher in physician offices (47.7%) and freestanding ambulatory surgery centers (22.2%) compared with hospital outpatient departments (13.6%).”
Quality Improvement or Jacking Prices Up
Modern Healthcare reports (here) on the efforts of “health systems” to demonstrate value. “It’s an open question whether mergers are producing the quality and cost benefits CEOs promise, said Stephen Shortell, a health policy and management professor at the University of California at Berkeley. ‘Clinical integration is key,’ he said. ‘But making these changes isn’t easy, and that’s why it’s kind of slow.’ Others say the task grows harder as organizations get larger. That’s because clinical improvement comes from deep engagement of front-line staff at each facility, and top-down mandates from headquarters can be counterproductive.”
MEDICARE, MEDICAID, COMMERCIAL HEALTH INSURANCE
Single Payer Gets Another Hearing
The House Budget Committee will hold a hearing tomorrow (Wednesday, 10:00 a.m.) on "Key Design Components and Considerations for Establishing a Single-Payer Health Care System" with witnesses Mark Hadley, Deputy Director of the Congressional Budget Office; Jessica Banthin, Deputy Assistant Director for Health, Retirement, and Long-Term Analysis of the Congressional Budget Office; and Jeffrey Kling, Associate Director for Economic Analysis at the Congressional Budget Office.” On other hand, The Intercept reports (here) that “At a luxury resort just outside of the nation’s capital last month, around four dozen senior congressional staffers decamped for a weekend of relaxation and discussion at Salamander Resort & Spa. It was an opportunity for Democrats and Republicans to come together and listen to live music from the Trailer Grass Orchestra, sip surprisingly impressive glasses of Virginia wine — and hear from health care lobbyists focused on defeating Medicare for All.”
DRUGS AND DEVICES
Final Rule for Drug Prices in TV Advertising
Friday’s Federal Register (here) has the final rule for advertising drug prices as part of drug company television advertising. Avik Roy reports “The Trump administration announced today that it has finalized a new rule requiring all drug companies to include the list prices of their drugs in direct-to-consumer advertisements. If sunlight is the best disinfectant, the White House hopes that more visibility about drug prices will hold drugmakers more accountable, and reduce costs for patients at the pharmacy counter.” The Financial Times reports (here and here) that drug price increases are rarely “outliers,” and that significant recent increases more nearly reflect the comments of Nostrum Laboratories’ CEO (which raised the price of a prescription cold medicine by more than 300 per cent to about $170 and last year increased the price of an antibiotic to more than $2,000) who claimed a “moral requirement to sell the product at the highest price”.
Another Use for Your Smartphone
MedPage Today reports that the FDA has approved a smart-phone-enabled six-lead ECG (here).
READINGS AND REFERENCES
The National Academies focus (here) on the challenges of reproducibility in health and other research. “[A]dults who for years have been ingesting daily doses of baby aspirin, with the aim of reducing the risk of heart attack, are now being advised not to bother. The latest studies failed to confirm earlier findings that had suggested real benefits from daily aspirin.” One problem: data not “deposited” for re-examination: for NIH funded research, one review found “12 percent explicitly mention deposition of datasets in recognized repositories, leaving 88 percent (2000,000 of 235,000) [sic, 200,000, not 2000,000 of 235,000=85%] with invisible datasets.” An example: Data from 67 projects in Bayer Healthcare found “Published data in line with in-house results: ~20 to 25 percent of total projects.” Krumholz and others reported earlier this month (Annals of Internal Medicine) that “In a single survey, results of studies involving almost 90,000 people were never reported, potentially skewing the medical evidence base.”
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
May publication dates: 15, 16, 17, 20, 21, 22, 23
June publication dates: 5, 6, 7, 8, 11, 12, 13, 14, 25, 26, 27, 28
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.