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Not even the healthcare industry is recession-proof
By Staff Reporters
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According to Kristine White of Healthcare Brew, New York City-based Memorial Sloan Kettering Cancer Center (MSK), one of the country’s top cancer treatment facilities, laid off 337 employees on Jan. 17 in response to ongoing financial challenges, according to a New York State Department of Labor filing.
The 337 employees, who worked across 14 sites and in multiple departments, represent about 1.5% of MSK’s 22,500 employees. This is a slight decrease from the expected 3% of layoffs announced in November 2022.
“This reduction was necessary to ensure that MSK can continue to invest in the future of cancer care, research, and education for the benefit of generations to come, and every effort has been made to ensure that patient care is not impacted,” spokesperson John Connolly said in a statement shared with Healthcare Brew.
The institution’s operating losses totaled $116.1 million for Q3 of 2022, compared to a loss of $8.7 million during the same period in 2021, according to a quarterly financial report released in November last year.
Factors such as increased patient activity, wages, and supply costs from inflation pushed the system’s operating expenses up by 7.5% from Q3 of 2021 to Q3 of 2022. The cancer center hired more staff in 2022 with the expectation that patient volume would increase, according to the financial report.
Health systems like MSK often reevaluate their biggest expense (workers) when business is down, Lori Kalic, a healthcare senior analyst at consulting firm RSM, told Healthcare Brew.
Just this year, multiple hospitals and health systems have also announced layoffs, including Tufts Medicine in Boston and Integris Health in Oklahoma, according to White.
The Food and Drug Administration said it can’t vouch for the safety of cannabidiol (CBD)—a nonpsychoactive compound found in marijuana and hemp plants—and because of that, it can’t regulate it. Instead, it’s calling on lawmakers to help supervise $12 CBD lavender sodas.The FDA said that CBD doesn’t fit the mold of the dietary supplements and food additives it typically monitors, such as ginseng and caffeine.
The agency claims the science is lacking on the safety of long-term CBD use, let alone on any potential perks—like preventing diabetes or aiding sleep.
Congress legalized hemp four years ago, and most CBD is derived from hemp, not marijuana. As a result, CBD got kicked off the controlled substances list and got lobbed from the Drug Enforcement Administration’s desk to the FDA’s.
Since then, the FDA’s been less active in regulating CBD than a teen in a ’90s anti-marijuana ad. That’s resulted in a chaotic and confusing marketplace, and CBD industry players were hoping the FDA would soon start reining it in.
President Biden plans to end both the public health and national emergencies originally declared to address the Covid pandemic in 2020 (and extended several times since) on May 11th 2023.
The White House just disclosed the plan while opposing efforts by Republican lawmakers to end the emergency declarations immediately with a bill called the Pandemic Is Over Act. The end of the emergencies will mean that many Americans will have to start paying for COVID tests, treatments, and vaccines.
It also signals a shift in how serious the government considers the pandemic to be. But, is this wise?
Yesterday, Amazon announced the launch of RxPass: an add-on to Prime memberships that provides subscribers with access to 50 generic prescription drugs for a $5 monthly fee.
RxPass will launch immediately in most states (though not California and Texas, the most populous ones) and include generic drugs that treat common conditions like high blood pressure, anxiety, acid reflux, and hair loss. About 150 million US residents have a prescription for one of the drugs included in RxPass, according to Amazon.
But the service is not available to people on Medicare or Medicaid, and it doesn’t offer insulin.
RxPass is Amazon’s answer to the Mark Cuban Cost Plus Drug Company (which offers significantly more medications—1,100 of them) and is likely part of an effort to attract more users to Amazon Pharmacy. Amazon Pharmacy could use the boost—it launched in 2020 but ranked at the bottom of a list of which Prime perks drew members to the service, a Morgan Stanley survey found last summer.
U.S. equities came well off their lows of the day to finish nearly where they began, as the Street sifted through a slew of mixed results with Q4 earnings season kicking into gear.
IOW: A seismic morass.
Dow member Microsoft topped profit projections, but its revenues and guidance disappointed, and Dow Component Boeing Company posted an unexpected loss, and its revenues came in short of forecasts. Elsewhere, AT&T exceeded earnings estimates and topped subscriber expectations, which are overshadowing its lackluster guidance, and Texas Instruments is lower on its outlook. The economic calendar was relatively light today, with the lone report being a third-straight weekly gain for mortgage applications.
Treasury yields were lower, and the U.S. dollar lost ground, while crude oil prices were nearly unchanged, and gold prices were higher.
And, Asia finished mixed, with mainland China and Hong Kong remaining closed for the Lunar New Year holiday, and Europe was mostly lower as investors continued to digest yesterday’s flood of manufacturing and services data.
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Finally, Walgreens Boots Alliance Inc. is weighing a sale of its pharmacy automation business, which could fetch up to $2 billion, according to people familiar with the matter.
The United States Congress designated January as Cervical Health Awareness Month. More than 14,000 women in the United States are diagnosed with invasive cervical cancer each year, but the disease is preventable with vaccination and appropriate screening.
During January, NCCC and its many local chapters across the country highlight issues related to cervical cancer, HPV disease and the importance of early detection. While NCCC chapters host events throughout the year, January is a month with a special focus as chapters celebrate Cervical Health Awareness Month and work to spread the word in their communities.
NCCC and the American Sexual Health Association (ASHA) also offer a range of resources (listed below) to educate the public and healthcare providers about cervical health, from fact sheets to episodes of ASHA’s Sex+Health podcast.
As you likely know, the US spends muchon healthcare ($4.3 trillion in 2021, to be exact). But did you also know that healthcare fraud makes up a not-so-small piece of that pie?
The National Health Care Anti-Fraud Association (NHCAA), a national organization that works to prevent health insurance fraud, conservatively estimates that 3% of the US’s total annual healthcare spend—a hearty $129 billion—is lost to healthcare fraud. Some government agencies estimate that percentage to be as high as 10% (that’s $430 billion), according to the NHCAA.
Overall, Medicare fraud costs the US about $60 billion each year, Nicole Liebau, national resource center director for Senior Medicare Patrol, a government-funded organization designed to help prevent Medicare fraud, told Healthcare Brew, though she added that “the exact figure is impossible to measure.”
While Medicare fraud isn’t new, the US saw a rise in one particular tactic during the pandemic: a durable medical equipment (DME) scheme.
How the schemes work.
In a DME scheme, scammers target Medicare patients—often after a procedure or an injury—and cold-call them to offer free equipment, said Jennifer Stewart, senior associate general counsel and senior director of fraud prevention and investigation at Blue Cross Blue Shield of Massachusetts. The scammers offer consumers items like lidocaine, wheelchairs, walkers, or braces.
The scammers have roped in doctors—who are often unaware they’re working with scammers instead of legitimate medical companies—to sign off on prescriptions that are then used to bill Medicare for the equipment, Stewart said. Sometimes patients actually receive the products, and sometimes they don’t.
“It’s really dangerous because [a prescription like lidocaine] could have reactions with other medications. The durable medical equipment isn’t sized for them, and certainly the doctor who treated their injury didn’t prescribe it […] There is a lot of patient harm involved,” Stewart said. Keep reading here.
Dry January is a campaign delivered by Alcohol Change UK where people sign up to abstain from alcohol for the month of January. The term “Dry January” is a registered trademark with Alcohol Change UK and was first registered in 2014.
The campaign was first delivered in 2013 by Alcohol Concern (now called Alcohol Change UK) and 2023 marks the 10th anniversary of the campaign. Emily Robinson, founded the campaign after taking a month off alcohol in January 2011 to prepare for a half marathon. After noticing the benefits and people’s interest in her month off alcohol she decided to start the campaign when she joined Alcohol Concern in 2012. Around the same time Nicole Brodeur of The Seattle Times wrote a column on her first Dry January motivated by a friend who had done the same for several years before.
In its first year, 4,000 people signed up for Dry January and it has grown in popularity ever since with over 130,000 people signing up to take part in 2022. Dry January was endorsed by Public Health England in 2015 leading to a large uptake in numbers and steady increase in participants year on year. Research by the University of Sussex published in 2020 found that those signing up to take part in Dry January using Alcohol Change UK’s free Try Dry app and/or coaching emails were twice as likely to have a completely alcohol-free month, compared to those who try to avoid alcohol on their own in January, and have significantly improved well-being and healthier drinking six months later.
New medicines launched by US drug makers reached a median price of $222,003 last year, according to Reuters. These astronomical prices were fueled by three very-expensive gene therapies approved by the FDA. In fact, one of them, from Hemgenix, costs $3.5 million, making it the most expensive drug ever.
Congress did cap annual drug price increases via the Inflation Reduction Act, but that doesn’t cover the cost of new medications. Drug-makers, meanwhile, say the cost of their drugs doesn’t reflect what patients pay out-of-pocket for them.
he emerging Omicron subvariant XBB contributes to an increasingly high number of COVID-19 cases in the U.S., rivaling the sister strains BQ.1.1 and BQ.1, according to the latest estimates from the Centers for Disease Control and Prevention (CDC).
Recent studies have indicated that the updated bivalent COVID-19 booster performed poorly against BQ.1.1, with even a weaker antibody response against XBB.
In late November, citing its poor neutralization effect on BQ.1 and BQ.1.1., the FDA pulled the emergency use authorization granted for bebtelovimab, a COVID-19 antibody therapy developed by Eli Lilly (LLY) and AbCellera Biologics (ABCL).
The CDC estimates for the week ending Dec. 24 show that XBB has made up ~18% of COVID cases in the U.S. compared to ~11% a week ago. Meanwhile, BQ.1.1 has led to ~36% of cases unchanged from a week ago, and BQ.1 caused ~27% of cases, a decline from ~29% last week.
You don’t have to sign all the forms to be treated
Part of being a patient is signing stacks of forms, most of which you barely read much less understood. This is a mistake, Charlotte O’Leary says. Look for any “blank check” clauses on intake forms—it’s the part that reads, “I will be responsible for all costs not covered by insurance.”
Instead, Charlotte Hilton Andersen, MS recommends crossing it out and writing, “I will be responsible for all costs that are medically necessary, that are not the responsibility of my insurer, are competitively priced, and that I am made aware of prior to treatment if they are not part of standard operating procedures.”
DEFINITION: Retail pharmacist work in a retail setting rather than in a hospital. They are responsible for dispensing and controlling both prescription and non-prescription medicine, advising customers on general healthcare and must work to high legal and ethical guidelines.
Today, retail pharmacies across the board are struggling to hire and retain enough pharmacists and pharmacy technicians to keep up with the increased pandemic-related demand for vaccinations and prescriptions. On top of that, pharmacist burnout has prompted companies like Walgreens to reduce the workloads of their employees.
The stakes are high. A decline in pharmacy school enrollees and a seemingly tight job market for those graduates makes it hard to replace departing staff.
“One of the challenges in healthcare in general is that it has been a difficult couple of years for those working in this industry. And pharmacy isn’t immune to that,” said Nate Shenck, a managing director and senior partner at Boston Consulting Group.
To tackle the worker shortage, Walgreens announced it would invest $265 million in its pharmacy staff in FY 2023. Those funds are earmarked for raises, additional training and career development opportunities, and larger scholarships for pharmacy students, Erin Loverher, a spokesperson at Walgreens, said via email.
PS:Some retailers, such as CVS and Kroger, are limiting the sale of children’s pain relievers. Demand for pediatric pain meds has spiked due to the “tripledemic” of respiratory illnesses spreading right now.
Here’s what Covid vaccines have to do with auto insurance
A new study of 11 million adults in Canada revealed that people who weren’t vaccinated against Covid were 72% more likely to get into car accidents where at least one person had to go to the hospital.
Now, that doesn’t mean your jab protects against car accidents, of course, but it does suggest that folks who reject public health recommendations might also reject road rules. The difference was striking enough that the researchers said doctors should discuss road safety with unvaccinated patients, and that car insurance companies might want to factor it into their rates.
When Rite Aid dropped roughly $2 billion in 2015 to buy its pharmacy benefit management (PBM) subsidiary now known as Elixir, the company had framed the investment as a strategic move to compete in the healthcare marketplace among rivals like CVS and Walgreens.
The deal quickly helped make Rite Aid $4.1 billion in its newly formed pharmacy services segment—including Elixir and other pharmacy services, according to the company—bolstering its financial standing the next fiscal year. Maybe it would no longer be the ugly duckling next to the cooler, sleeker swans.
It seemed to be working—for a while at least. But by 2018, analysts were recommending Rite Aid sell off Elixir to reduce the parent company’s debt. Still, Rite Aid stuck with Elixir in hopes of boosting its competitiveness in the retail pharmacy scene.
This year, Rite Aid President and CEO Heyward Donigan was still painting a rosy picture of Elixir, saying in earnings calls that the PBM was gaining more members and Elixir’s operating margins were improving.
But a month after its latest earnings call in September, Rite Aid was hit with a class-action lawsuit accusing the company of making “false and/or misleading statements” to investors about Elixir’s status between April and September of this year.
(Bloomberg) — Amgen Inc. has agreed to buy Horizon Therapeutics Plc at a valuation of about $26 billion in what would be its biggest-ever acquisition, according to a person familiar with the matter. The US biotechnology giant offered around $116.5 for each Horizon share, said the person, who asked not to be identified as the information is private. The offer price is at a around 20% premium to Horizon’s closing price of $97.29 on Friday.
Horizon rose as much as 15% to $111.70 in pre-market trading today while Amgen slipped 0.5%. But, the deal or announcement could be delayed and talks could still fall apart.
As of Friday’s close, Horizon shares had surged 24% since the company revealed on Nov. 29th that Amgen, Sanofi SA and a Johnson & Johnson unit were in preliminary talks about a possible acquisition. That pushed its market value to $22 billion, prompting Sanofi to back out Sunday, as J&J did earlier this month. Amgen has a market value of about $149 billion after rising by 24% this year.
The FDA has approved a new gene therapy to treat hemophilia B, a genetic bleeding disorder. The drug maker CSL Behring set a $3.5 million price for the one-time treatment.
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The recent stock choppiness has come amid uncertainty regarding the ultimate economic impact of aggressive rate hikes, of which inflation has been a primary driver of the tightening. More key inflation data is on tap next week, courtesy of the Consumer Price Index (CPI) and the Import Price Index. These reports will lead up to the Federal Open Market Committee’s (FOMC) long-awaited monetary policy decision that will be released on Wednesday.
In other economic news, a preliminary look at consumer sentiment surprised to the upside. On the equity front, Lululemon Athletica beat top and bottom line estimates but lowered its guidance, RH also bested forecasts though warned of worsening demand moving forward, Broadcom posted upbeat results and increased its dividend, and Microsoft is now facing a U.S. government antitrust lawsuit in its attempt to acquire Activision Blizzard.
Treasury yields rose following the wholesale price data, and the U.S. dollar gained modest ground, while crude oil prices dipped, and gold increased.
Asian stocks finished higher with Hong Kong markets leading the way, and European stocks gained ground as the global markets absorbed inflation data out of the U.S. and China.
A new examination by Senate Democrats of how the federal government bungled its early response to the coronavirus pandemic faults President Donald J. Trump and his administration for numerous missteps while also laying blame on “multiple systemic problems” that long predated his time in office.
*Stock data as of market close, cryptocurrency data as of 3:00am ET.
U.S. equities reversed course and finished with solid gains in the wake of remarks from Fed Chairman Jerome Powell at a gathering at the Brookings Institution in Washington. The Chairman reiterated the Fed’s plan to “stay the course” with its rate-hike campaign, but noted that smaller increases were likely ahead, as soon as next month’s meeting. Powell’s comments came just before the Fed’s release of its Beige Book report on business activity across the nation that showed a slight moderation. Preceding Friday’s key nonfarm payroll report, ADP’s private sector payroll data came in below estimates, and job openings remained robust.
In other economic news, mortgage applications snapped a two-week winning streak, Q3 GDP growth was revised higher, Chicago manufacturing unexpectedly fell further into contraction territory, and pending home sales continued to fall but at a slower pace. Moreover, the advance goods trade deficit widened surprisingly, and wholesale inventories rose more than projected. Treasury yields turned lower following Powell’s comments, and the U.S. dollar tumbled, while crude oil prices rose and gold was solidly higher. Earnings season has headed toward the finish line, with CrowdStrike Holdings topping profit and revenue estimates but missing its annual recurring revenue growth forecast, though Workday topped earnings expectations, raised its guidance, and announced a $500 million share buyback plan.
Asia finished mostly higher and stocks in Europe gained ground, with the markets digesting mixed economic data, while optimism remains that China may be set to ease some COVID-related restrictions.
This quarter’s pharmaceutical earnings were overall better than expected. Especially Merck, thanks to its Keytruda sales. The cancer drug brought in $5.4 billion last quarter, accounting for a whopping 36% of the company’s revenue for that period. But, Keytruda’s patent is expiring in 2028, and everyone is waiting to see what Merck pulls out of its hat to replace it.
Apartment rents across the US dropped in November by the most in at least five years, a sign that a key cost tracked by the Federal Reserve could be easing up. A national index of rents fell by 1%, the third straight month-over-month decline and the steepest drop in data going back to 2017, Apartment List said in a blog post recently.
As of the week ending Nov. 19th, Americans aged 65 and older make up 92% of all deaths from the virus, according to data from the Centers for Disease Control and Prevention.MORE: Latest COVID vaccine will help people ‘move on’ from the pandemic, White House’s Jha says It’s the first time senior citizens have made up more than nine out of 10 deaths since the pandemic began and a drastic increase from the roughly 58% of deaths they made up in summer 2021, an ABC News analysis showed.
It’s looking more than likely that we’ll see a recession in the next year, and Americans are preparing themselves by taking steps like delaying major purchases, allocating more of their income to savings, and staying in jobs they don’t love. Another thing they’re not doing? Getting Botox. And that’s bad news for AbbVie; according to Neal Freyman of Morning Brew.
AbbVie, one of the biggest drug manufacturers in the US, brought Botox into its medical aesthetics portfolio—which also includes the popular dermal filler Juvederm—in 2020, when it bought rival drugmaker Allergan for $63 billion. AbbVie CEO Richard Gonzalez said during the company’s Oct. 28 earnings call that the company expects the aesthetics business to take a hard hit in 2023 as recession fears cause consumers to be more cautious with their spending.
“Based on all the data we’ve been observing, especially in the US, with both the consumer-confidence index and real personal consumption expenditures trending down and continued high inflation, these factors are putting pressure on consumer’s discretionary spending,” Gonzalez said.
AbbVie lowered its 2022 full-year forecast for its aesthetics business by $600 million, down to $5.3 billion. After the earnings call, AbbVie’s stock fell 4.3%. Through the third quarter of 2022, Botox has brought in $1.97 billion for the aesthetics business. The third quarter saw $637 million in cosmetic Botox sales, down from an expected $640 million. Gonzalez said he doesn’t think the hit on sales will last long, though.
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“As consumer confidence improves, we would once again expect the market growth to accelerate. Our aesthetics portfolio experienced a rapid and sustained recovery following the 2008, 2009 recession,” Gonzalez said.
But Botox also faces a new competitor, called Daxxify, which just got FDA approval in September. Made by Revance Therapeutics, the drug may last longer: In clinical trials, Daxxify injections lasted six to nine months, while Botox injections typically last three months.
Rina Shah has been working at Walgreens her entire career—close to 25 years—but this year she got a shiny new title: vice president of pharmacy of the future. The role was created as part of what CEO Rosalind Brewer said in Walgreens’ latest earnings call is the company’s top priority: creating a consumer-centric healthcare company. The retail pharmacy giant essentially wants to free up its pharmacists’ time so they can go from filling prescriptions all day to engaging more directly with patients.
Shah is heading up these efforts, and she sat down with Neal Feyman to talk about what Walgreens sees when it pictures the pharmacy of the future.
What does “the pharmacy of the future” mean? When we talk about the future of pharmacy, it’s to leverage our pharmacists in a much more data-driven, effective way to lower costs in the system.
For example, in certain states where there’s higher pollen counts and pollution, we’re seeing higher emergency room visits because of asthma. We can educate people on the difference between a rescue inhaler and a maintenance inhaler—and how they can understand triggers—and ultimately impact lower emergency room visits because of that.
What problems are you trying to solve in this role? Prior to the pandemic hitting, we had been asked by providers and payers and other organizations for our pharmacists to do more. We were being asked to provide testing services and in-depth consultations with patients.
However, our operating model didn’t really account for that. Our pharmacists were busy doing many more administrative tasks. We made the decision that we needed to transform the model, which meant really freeing up the capacity of our pharmacists so they could spend time with patients delivering care, as it’s always intended to be. Keep reading here.—NF
On World Pancreatic Cancer Day, loved ones, communities and organizations around the world unite to shine a light on pancreatic cancer and share our universal message that it’s about time we all know the symptoms!
Raise awareness on this special day as we share the facts about this disease, survivor stories and what you can do to make an impact.
GoodRx Holdings, Inc. is an American healthcare company that operates a telemedicine platform and a free-to-use website and mobile app that track prescription drug prices in the United States and provide free drug coupons for discounts on medications. GoodRx checks more than 75,000 pharmacies in the United States
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Good Rx makes money by perpetuating the, artificially set, high sticker prices of medications and receiving a portion of Pharmacy Benefits Manager [PBM] fees.
How it Works
GoodRx taps into PBM network for their “discounts” off of sticker price (e.g. Express Scripts, Optum Rx, Navitus … etc)
Consumer pays the newly “discounted” drug price.
Pharmacy pays PBM fee.
PBM pays GoodRx portion of the fee.
Good Rx adjusted EBITDA in 2019: $160 Million
Good Rx 2020 revenue is up 48% first half of 2020 – $257M
Elizabeth Holmes will find out how much time she’s spending in prison. The Theranos founder will be sentenced on Friday after being found guilty of fraud for lying to investors about her blood-testing startup. Prosecutors want 15 years.
Meanwhile, beaten-down tech stocks were the stars of last week’s rally, staging their biggest two-day pop since the financial crisis after inflation numbers came in cooler than expected. Investors still caution that this might be a classic case of a “bear market rally,” or a brief glimpse of the sun before the storm clouds return. Corporations haven’t exactly been lighting it up with profits right now.
The US will extend its Covid public health emergency through the spring of 2023 in anticipation of another winter surge.
The emergency, first issued in January 2020, broadens eligibility for both Medicaid and the Children’s Health Insurance Program, and the government estimates that ~15 million people will lose their benefits from those programs once it ends.
According to the White House, “Americans pay two to three times as much as people in other countries for prescription drugs, and one in four Americans who take prescription drugs struggle to afford their medications. Nearly 3 in 10 American adults who take prescription drugs say that they have skipped doses, cut pills in half, or not filled prescriptions due to cost.” In an effort to combat this growing crisis, both the federal government and private companies have taken a number of steps over the past year aiming to lower drug prices. This Health Capital Topics article will review those actions and the potential unintended consequences of these actions.
CVS, Walgreens, and Walmart agree to pay $13 billion over opioids
The pharmacy chains have reached a tentative deal to settle thousands of lawsuits brought by state and local governments that accuse them of contributing to the opioid epidemic.
If the deal goes through, CVS and Walgreens will each cough up around $5 billion, and Walmart will reportedly be on the hook for $3 billion.
CMS Cracks Down on Medicare Advantage TV Marketing
Dr. David Edward Marcinko MBA
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CMS is cracking down on deceptive marketing practices and will no longer allow Medicare Advantage or Part D prescription drug plans to advertise on television without agency approval first. The new policy is effective Jan. 1st and was discussed in an Oct. 19th memo from CMS to MA and Part D providers. The agency said it issued the new policy after reviewing thousands of beneficiary complaints regarding confusing, misleading or inaccurate information from plans — plan sponsors are also responsible for all marketing activities from brokers and third-party agencies.
“CMS has conducted so-called ‘secret shopping’ by calling numbers associated with television advertisements, mailings, newspaper advertisements and internet searches to monitor the experience beneficiaries have engaging these entities,” the agency wrote.
“Our secret shopping activities have discovered that some agents were not complying with current regulation and unduly pressuring beneficiaries, as well as failing to provide accurate or enough information to assist a beneficiary in making an informed enrollment decision.”
Source: Jakob Emerson, Becker’s Payer Issues [10/27/22]
DEFINITION: A Colonoscopy and/or sigmoidoscopy are procedures that let your doctor look inside your large intestine. They use instruments called scopes. Scopes have a tiny camera attached to a long, thin tube. The procedures let your doctor see things such as inflamed tissue, abnormal growths, and ulcers.
EDITOR’S NOTE: The ME-P does not normally discuss medical or clinical matters. But, this report is noteworthy to all.
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About 15 million colonoscopies are performed in the US yearly as part of standard preventive care for adults over 45, but a new study has called into question whether all the footage from those tiny cameras is really necessary.
Over a 10-year period, people who had the screenings were 18% less likely to develop colon cancer than people who didn’t, according to the study in the New England Journal of Medicine. However, the risk of death from the cancer for both the screened and un-screened was about the same, hovering around 0.3%.
WASHINGTON (Reuters) – The United States on Thursday extended the COVID-19 pandemic’s status as a public health emergency for another 90 days, thereby preserving measures like high payments to hospitals and expanded Medicaid.
The extension was announced by U.S. Health Secretary Xavier Becerra on Thursday. Last month, President Joe Biden said in an interview that “the pandemic is over,” which prompted criticism from health experts.
Two issues related to medication have an impact on county mental health programs. The first is the new emphasis on drug therapy and the second is targeted marketing by pharmaceutical companies of newer, more costly drugs.
First
In the past, psychiatrists focused on identifying the “cause of the problem” and developing associated treatment plans to treat the cause. With the increasing number of mental health patients, especially those with chronic mental illness conditions, psychiatrists do not have the time to focus solely on the treatment plan and the underlying cause of the mental illness. Instead, their focus has had to become intake evaluations, case coordination, and medication checks. Use of medication has replaced the treatment plan, and continues to play a much larger and more primary role in the treatment of most, if not all, patients.
Second
The second major issue is advertising. The Food and Drug Administration (FDA) lifted restrictions against direct pharmaceutical advertising several years ago, enabling the representatives of these firms to market and advertise their drugs. Advertisers target both medical and mental-related problems, including everything from depression, anxiety, attention deficit disorder, acid reflux disease, high cholesterol, erectile dysfunction, arthritis, allergies, over-active bladder, to asthma. With the advent of marketing, many drugs are now being over-prescribed and are becoming a component of spiraling healthcare costs.
Assessment
In summary, both of these pharmaceutical issues are having an impact on county mental health centers — first, as a cost issue, second because of the change-in-direction treatment modality, and third from the perspective of potential ethical issues involved in provider/pharmaceutical company ties and relationships.
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
I’m a doctor. My father is a doctor. My colleagues are doctors, the people I train are doctors, lots and lots of my friends are doctors.
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But, that doesn’t meant that doctors sometimes aren’t blind to certain issues like their own financial conflicts of interest. Sometimes we have to poke doctors with a stick. That’s how we show our love.
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Conflicts of interest are the topic of this Healthcare Triage video.
Dr. Carroll has published some of the seminal work on various types of health care reform, and continues to be a sought after speaker on cost, quality and access-and the Affordable Care Act and its implications for our future. Considered one of the leading pediatric informaticists in the U.S. he has received millions of dollars in grants to explore the use of information technology in health care. Dr. Carroll was the Primary Investigator on a grant from the Agency for Healthcare Research and Quality to study the true impact of malpractice claims on the practice of medicine.
Conclusion
Your thoughts and comments on this ME-P are appreciated. Feel free to review our top-left column, and top-right sidebar materials, links, URLs and related websites, too. Then, subscribe to the ME-P. It is fast, free and secure.
Speaker: If you need a moderator or speaker for an upcoming event, Dr. David E. Marcinko; MBA – Publisher-in-Chief of the Medical Executive-Post – is available for seminar or speaking engagements. Contact: MarcinkoAdvisors@msn.com
OUR OTHER PRINT BOOKS AND RELATED INFORMATION SOURCES:
988, a New National Suicide Hotline, Launched on July 16th, 2022
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A new national suicide hotline, 988, becomes operational nationwide on July 16th. People experiencing a mental health emergency, such as suicidal thoughts, a substance-use crisis, or any other emotionally distressing event, will be able to call during times of crisis, but operators will also be available via text and online chat (at https://suicidepreventionlifeline.org/chat), according to the Substance Abuse and Mental Health Services Administration (SAMHSA).
The 988 hotline will essentially replace the National Suicide Prevention Lifeline (1-800-273-TALK); however, the previous hotline will not be discontinued when 988 is rolled out, and callers will be directed to the same services offered via 988. Mental health experts say the new hotline will provide necessary updates to the services currently provided by the 1-800 number, chief among them a focus on sending trained experts to respond to mental health emergencies rather than law enforcement who are unfamiliar with protocols when approaching suicidal individuals.
On August 30, 2022, the Centers for Medicare & Medicaid Services (CMS) released the financial and quality performance results for the Medicare Shared Savings Program (MSSP) Performance Year (PY) 2021.
The results revealed net savings of $1.66 billion for Medicare, marking the fifth consecutive year of savings. In total, 58% of MSSP accountable care organizations (ACOs) achieved savings as a result of their performance. This Health Capital Topics article will discuss the 2021 performance results, which are being released on the eve of seismic changes to the MSSP. (Read more…)
Most likely to have an identity crisis: The Inflation Reduction Act
After a seemingly endless will-they-or-won’t-they make a deal dance, Democrats passed their signature piece of legislation, the Inflation Reduction Act, without Republican support.
The 755-page climate, tax, and healthcare package does a lot of things: It establishes a 15% minimum tax on megacorporations, boosts funding for the IRS, allows Medicare to negotiate prescription drug prices, offers $260 billion in tax credits for renewable energy projects, and more. One thing it likely won’t do: reduce inflation. Despite the name, the law’s impact on rising prices through 2023 is expected to be “negligible.”
Lecanemab, an Alzheimer’s drug from Eisai and Biogen, slowed cognitive decline in patients with early Alzheimer’s by 27% over 18 months in a final-phase trial, the companies said recently.
That rate of decline met the study’s targets and offers hope to the 6 million people in the US with Alzheimer’s that their dementia can be slowed down or delayed. The companies hope lecanemab will fare better commercially than their previous Alzheimer’s drug Aduhelm—which was a flop.
AHIP: Botox Marked Up 78% in Hospitals Over Pharmacies
• Botox markups: 78% in hospitals, 17% in physician offices • Herceptin markups: 131% in hospitals, 40% in physician offices • Keytruda markups: 104% in hospitals, 21% in physician offices • Ocrevus markups: 59% in hospitals, 13% in physician offices • Opdivo markups: 112% in hospitals, 18% in physician offices • Prolia markups: 215% in hospitals, 49% in physician offices • Remicade markups: 124% in hospitals, 15% in physician offices • Rituxan markups: 85% in hospitals, 7% in physician offices • Tecentriq markups: 95% in hospitals, 25% in physician offices • Xolair markups: 76% in hospitals, 16% in physician offices
Notes: Drugs with the highest total spend in 2019, which are also commonly delivered through specialty pharmacies. The drug cost estimate in physician offices and hospitals does not include the cost of administering the drugs. Source: AHIP, “Hospital Price Hikes: Markups for Drugs Cost Patients Thousands of Dollars,” February 2022
Dr. Sachin MD MBA Jain wrote an outstanding article on Value Based Care in the April 12, 2022 issue of Forbes stating that the Patient Must Come First in Value Based Care.
The Supreme Court of the United States (SCOTUS) has ruled that doctors must show intent to mis-prescribe opioids in order to face criminal charges.
Despite the drop in opioid prescriptions in recent years, opioid overdoses and deaths are on the rise, largely because of street drugs.
The CDC’s position is that physicians can better serve patients by focusing on when to initiate and continue opioid treatment, what type and dosage of opioid to use, and how to address risk of drug abuse when prescribing opioids.
The attached photo and video was passed on to us from an anonymous rogue DEA agent. Although in Russian, one can see a visual depiction of Krokodil’s effects.
Apparently the life expectancy of users of the drug is 2-3 years. We would not be surprised to see it show up in the USA very soon
Conclusion
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In probability theory and statistics, Bayes’ theorem (alternatively Thomas Bayes’ law or Bayes’ rule, also written as Bayes’s theorem) describes the probability of an event, based on prior knowledge of conditions that might be related to the event.
Examples:
For example, if cancer is related to age, then, using Bayes’ theorem, a person’s age can be used to more accurately assess the probability that they have cancer, compared to the assessment of the probability of cancer made without knowledge of the person’s age.
As another example, imagine there is a drug test that is 98% accurate, meaning 98% of the time it shows a true positive result for someone using the drug and 98% of the time it shows a true negative result for nonusers of the drug. Next, assume 0.5% of people use the drug. If a person selected at random tests positive for the drug, the following calculation can be made to see whether the probability the person is actually a user of the drug.
(0.98 x 0.005) / [(0.98 x 0.005) + ((1 – 0.98) x (1 – 0.005))] = 0.0049 / (0.0049 + 0.0199) = 19.76%
Bayes’ theorem shows that even if a person tested positive in this scenario, it is actually much more likely the person is not a user of the drug.
Assessment
In finance, Bayes’ theorem can be used to rate the risk of lending money to potential borrowers.
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