Health Policy News and Views
Compiled by Benita M. Dodd
Happy New Year! Welcome to the first “Checking Up On Health” of 2014. Health care – policy and innovation – promises to be enormously interesting this year. Let’s hope it’s more of the good and less of the bad and ugly!
Where are the young ones? The White House has declared that one out of four Americans now enrolled under the federal Affordable Care Act are between ages 18 and 34. Unfortunately, this is below the White House’s target. As the Washington Post notes, “The Obama administration has previously said that if 7 million people enrolled in coverage as expected, 2.7 million of them – or about 40 percent – would have to be young adults. That’s an important target to hit because more young adults in the exchanges would mean a more healthy population, whose premiums could help subsidize the health care of older and sicker enrollees.” And it doesn’t matter whether the state or the feds run the health care exchanges where Americans find their coverage: “In state-based marketplaces, 25 percent of enrollees are between 18 and 35, compared to 23 percent in the federally-run sites.”
Solar sins: They may be past, but those long-gone days of tanning oils and playing outside without sunscreen are coming back to haunt friends, relatives and colleagues. A relative is awaiting biopsy results of a suspicious mole, a friend’s scheduled a dermatologist appointment after much nagging (Who, me, nag?!) and another is recovering from a second round of skin surgery. So it’s good news for them and 160,000 others that GlaxoSmithKline’s combination treatment for melanoma – the deadliest form of skin cancer – has won accelerated approval from the U.S. Food and Drug Administration. The green light for the combined use of Tafinlar, also known as dabrafenib, and Mekinist, or trametinib, from the FDA is the first of its kind for a form of the disease with a specific genetic profile. Both drugs are already approved for separate use but GSK believes they will have a longer-lasting effect if given together. About melanoma: Melanoma is diagnosed in nearly 160,000 people worldwide each year. It can spread quickly to internal organs and average survival is six to nine months.
Oncology overkill? Analysts are concerned that an over-concentrated R&D focus on cancer could hurt drug companies’ profits. For instance, nine drugs are being developed for one type of metastatic non-small cell lung cancer that affects only about 5 percent of non-small cell lung cancer patients. “Whilst biopharma has enjoyed significant commercial success in areas such as oncology over the past decade, pipelines are now increasingly over-concentrated against many targets diminishing future returns for the industry overall,” said Barclays analysts. Pharmaceutical R&D returns dropped from 10.5 percent in 2010 to about 4.8 percent last year, according to one study. And, as you know, diminishing profits leave less to reinvest for further R&D. Source: Reuters
Stem cell transparency: Induced pluripotent stem cells (iPSCs) are derived without destroying a human embryo, avoiding the most contentious issue besetting stem cell research. While there are ethical concerns for patients, including privacy, transparency, consent, the “immortalization” of cell lines, and the commercialization of stem cells, patients also give iPSC research “broad endorsement,” according to a team of bioethicists at Johns Hopkins University. They’re really persuaded, according to the researchers, by prior informed consent. Source: Genetic Engineering and Biotechnology News
Printed organs soon: A breakthrough in vascular 3D printing has led bio-printing firm Organovo to predict printed livers will be available within the next year. Not for transplant (yet) but for research, the company says. “We are developing a human liver tissue model for medical research and drug discovery testing.” Organovo isn’t willing to speculate on the future of 3D printed organs, the development of experimental human tissues will be a major milestone in the history of both 3D printing and biomedical science.
Predictive and preventive DNA typing: Computer giant IBM makes five predictions every year on how technology will change society within five years. This year’s “5-in-5” predicts doctors will use your DNA to keep you well. This already is happening how. But it goes beyond DNA to using the data analytic power of computers to diagnose patient ills and guide doctors in treatment. Will this gain in popularity? Today, you can have your personal genome assessed and analyzed, but few have opted to do so. How many people actually want to know whether they have a strong genetic inclination toward a disease for which there is no cure? Source: Business Finance
Está en los genes: A genetic variant may increase the risk of developing type II diabetes in Latin Americans, according to Harvard and Massachusetts Institute of Technology investigations. In a genome-wide association study, the researchers focused exclusively on Mexicans and other Latin Americans, unlike other studies that examined diverse populations. The variant uncovered exists in about 50 percent of Native Americans and 10 percent of East Asians, but is rare in Europeans and Africans. It is believed to alter lipid metabolism and may be the reason for the disparity in type II diabetes between these populations. Source: Journal Nature
Cordless, now wireless: The world’s first Internet-connected toothbrush debuted at the Consumer Electronics Show. The device from a French-based startup, Kolibree, aims “to reinvent oral care.”. The Kolibree toothbrush includes a sensor that detects how much tartar is being removed in a brushing. It also records brushing activity so users can maintain a consistent cleaning each time. The device conveys the information wirelessly to a smartphone app – a particularly useful aid for parents who want to monitor the teeth cleaning efforts of small children, according to Cessot. Can Facebook and Twitter updates be far behind? Source: IndustryWeek.com
No place for emergencies: An unencrypted, password-protected computer was stolen on November 6 last year from Phoebe Putney Memorial Hospital in Albany, Ga., compromising the information of 6,700 patients. The theft was discovered the next day. Nearly one month later, on January 3, affected patients were notified by mail and offered a year of credit monitoring. A copy of the letter is available online. The computer was found to contain the names, dates of birth, addresses, dates of service, physician’s names, diagnosis information and in some instances, Social Security numbers, of the 6,700 patients, treated between May 2010 and October 2013.
Well, well? PepsiCo’s wellness program to help its employees manage chronic illnesses saved $3.78 in health care costs for every $1 invested in the effort. But the wellness program’s lifestyle-management components that encourage healthy living did not deliver returns that were higher than the costs, according to the study, published in the journal Health Affairs. “We found that seven years of continuous participation in one or both components was associated with an average reduction of $30 in health care cost per member per month. When we looked at each component individually, we found that the disease management component was associated with lower costs and that the lifestyle management component was not. Disease management was estimated to reduce health care costs by $136 per member per month, driven by a 29 percent reduction in hospital admissions. Workplace wellness programs may reduce health risks, delay or avoid the onset of chronic diseases, and lower health care costs for employees with manifest chronic disease. But employers and policy makers should not take for granted that the lifestyle management component of such programs can reduce health care costs or even lead to net savings.”
A crowded field? Overcrowded R&D fields present a challenge for pharmaceutical companies, but both payers and patients benefit when many pharmaceutical research programs develop treatments in the same clinical area, John LaMattina, former president of Pfizer Global Research and Development, writes in Forbes. He points out that having multiple players improves the chance that more patients will have access to treatments that work for them, and competition places payers in a position to negotiate prices.
Quotes of Note:
“I think we have more machinery of government than is necessary, too many parasites living on the labor of the industrious.” – Thomas Jefferson (letter to William Ludlow, 1824)