Checking Up On Health: September 3, 2013

Health Policy News and Views
Compiled by Benita M. Dodd


Benita Dodd Vice President, Georgia Public Policy Foundation
Benita Dodd
Vice President, Georgia Public Policy Foundation

Healing broken hearts: Reprogrammed cells could be used to grow new muscles that help repair scar tissue after a heart attack, according to a preclinical study in the journal Stem Cell Reports. Scientists say they’ve transformed one kind of human heart cell into another in laboratory experiments. “Soon we will be able to repair damaged hearts with these kinds of cells as patches. We may not generate enough to generate a whole heart. But we will be able to generate cells from the same patient to treat heart disease and heart attacks,” said researcher Robert Schwartz, who has analyzed a similar approach. There are about 5 million heart attack survivors in the United States. Source: Health Day

Help for clean freaks? The Food and Drug Administration (FDA) has cleared BioMérieux to market a mass spectrometry device that can detect 193 disease-causing germs and can simultaneously run as many as 192 tests. The Vitek MS system, said to be the first such device to be approved for clinical applications in the United States, can generate results in just about a minute. In clinical testing, the new device correctly identified a germ’s scientific group or family more than 93 percent of the time, the agency said. (Still waiting for the machine that dispenses elbow grease.) Source: Health Day

Evolution of EHRs: More than one in six providers currently using an electronic health record (EHR) system has plans to change vendors within the next year, according to Becker’s Hospital Review. Many of these providers are physician practices upgrading to meet federal “meaningful use” requirements or replacing a poorly functioning system, but hospitals have increasingly been switching to new vendors as well. It’s hard work and big money to switch, the article points out, meaning the hospitals contemplating a switch have very good reason to do so. For example, Medinotes, the initial EHR system at UHS Delaware, didn’t meet “meaningful use” criteria. “Like every other hospital, we have those incentives on our minds,” a spokeswoman said, as well as the looming threat of noncompliance penalties. But acquisitions are another factor. One company, Medinotes, was acquired by Eclipsys then by Allscripts. Allscripts decided to sunset the system, which means the EHR would no longer be supported.

Incentives: Through July 2013, according to recently released data from the Centers for Medicare and Medicaid Services, 4,051 hospitals have received electronic health record incentive payments since 2011. 272,550 In 2013, 545 hospitals received payments, along with 3,206 hospitals in 2012 and 2,316 in 2011. To date, total payout is $15,884,674,56. The incentive programs offers eligible physicians maximum payments of $44,000 and $63,750, for Medicare and Medicaid programs, respectively.

The bigger you are: A state’s health care spending, specifically Medicaid, represents a significant portion of its budget – on average, 15 percent of total state expenditure. The cost of care for Medicaid agencies and commercial payers varies considerably by provider. Often, large practices receive higher reimbursements than small practices by using their greater bargaining power in negotiations. And that, according to Becker’s Hospital Review, is one reason so many small practices are consolidating. Another reason is the high cost of getting their EHR systems compliant; incentive amounts often do not completely cover a practice’s additional cost.

Top drugmakers: Pfizer, which generated revenue of $58.986 million last year, topped IndustryWeek’s 2013 ranking of the world’s largest public manufacturers of pharmaceuticals based on revenue. Following closely was Novartis with revenue of $58.748 million. Not counting its consumer goods revenue, Johnson & Johnson would rank third. Other top companies were Roche Holding, Sanofi and Merck & Co.

Pay up or shut up: According to a study done by Tufts University, roughly 40 years ago (1975) it only cost $100 million in 2005 dollars to develop one drug from the lab to FDA approval. By 1987, that figure had tripled and by 2000 the cost was up to $800 million. In 2005, the per-drug cost of a successful approved drug had reached a whopping $1.3 billion. There are several reasons that drugs cost so much, and you can find some of the explanation here. “I see nothing wrong with pharmaceutical companies earning a good return given the large amounts of capital and high risks that go with drug development,” Stephen D. Simpson writes in Investopedia. More important, he notes: “Perhaps just as much to the point, if the public continues to demand new drugs that allow them to live longer and/or better and that are proven to be relatively safe, they need to realize that they’re going to have to pay for them to keep the companies motivated to take on the development risks.”

FDA concerns about biosimilars: The Food and Drug Administration is concerned about bills in several state legislatures that seek to restrict pharmacists’ ability to dispense biosimilars, according to published reports. California pharmacists would be allowed to dispense substitute medications that are biologically similar to brand-name treatments under a bill that cleared the state Assembly last week. Pharmacists would have to notify physicians and patients if they swap out a branded biotech drug for a biosimilar. Biological medicines, which are created from living cells rather than by mixing chemicals, have been used to treat cancer and immune-system disorders. Those treatments are becoming a fast-growing segment of the pharmaceutical market, with manufacturers also creating medications that are similar to some biological medicines. These biosimilars resemble but are not identical to the biological medication they are replicating. quoted an FDA spokeswoman as saying “efforts to undermine trust in these products” were cause for worry and did not serve the interests of patients. Source: News reports, Biosmart Briefs

Bill goes after bilharzia: Bill & Melinda Gates Foundation has granted $1.15m funding to a global public-private partnership (PPP), to develop a new pediatric formulation to fight schistosomiasis, commonly known as bilharzia, in preschool children. Formed in July 2013 and coordinated by TI Pharma, the PPP consortium members include Merck KGaA, Astellas Pharma and the Swiss Tropical and Public Health Institute (Swiss TPH). The available standard recommended praziquantel treatment is in oral tablets for adults and children from age 6 and is tough for younger children to swallow. Caused by parasitic worms, schistosomiasis is a severe chronic inflammatory disease, endemic in 78 developing nations and infecting 243 million people every year.

Quotes of note:

“My health is good; it’s my age that’s bad.” – Roy Acuff

“Those who do not find time for exercise will have to find time for illness.” – Earl of Derby

“We forget ourselves and our destinies in health; and the chief use of temporary sickness is to remind us of these concerns.” – Ralph Waldo Emerson



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