News & Commentary

Briefly Noted November 2018

The access to nurses that drug companies provide to doctors and patients to help them understand newer and more complex medications is coming under scrutiny, the Wall Street Journal reports. Federal prosecutors are looking into whether some companies (including Gilead Sciences, Sanofi, and Biogen) violated the law by providing the free services, which also include reimbursement assistance.

Hospitals have been slow to move to value-based care and that may be one of the reasons that operating margins have remained under stress for the second straight year, according to a report by the credit ratings company Fitch. “Median profitability levels dropped, with median operating and operating EBITDA margins of 1.9% and 8.5%, respectively, compared with 2.8% and 9.5%, respectively, the prior year,” the report states.

Many employers would rather not know if a worker has a substance abuse problem. Kaiser Health News recently reported that workplace overdose deaths have risen by 25% or more a year since 2010. At least 217 workers died from an unintentional drug or alcohol overdose while at work in 2016, up 32% from 2015. And nobody really knows how many overdoses there have been in the workplace that don’t result in death. “But despite the growing problem, many employers have turned a blind eye to addiction within their workforce, ill-equipped or unwilling to confront a complicated issue they do not know how to address, according to researchers and business executives,” KHN reports.

Yet more evidence that obesity early in life can have serious consequences later on: People age 30 and younger who are obese are at greater risk of developing 11 types of cancer later in life, according to a study in Obesity Reviews. Included in the list are colorectal, ovarian, and endometrial cancer.

The Trump administration’s effort to make short-term health insurance plans more available hit a roadblock recently in the form of a lawsuit filed by patient and provider advocacy groups that would block the move. As the Wall Street Journal reports, the lawsuit “sets the stage for a legal standoff that could affect coverage and premiums for millions of Americans in 2019.” Short-term plans don’t have to cover people with pre-existing conditions and are subject to fewer consumer protection regulations. Also, insurers can charge higher premiums based on a beneficiary’s health status. Trump administration officials say that short-term plans are more affordable and will give people who need to buy insurance in the individual market more to choose from. The suit was filed in U.S. District Court for the District of Columbia.

Sometimes hospitals promote their precision-medicine programs, highlighting people who’ve benefited and are thriving. But, as Kaiser Health News reports, precision medicine—often used for cancer patients—is still only for a minority of patients. Testing for genetic mutations has become standard for lung cancer, melanoma and a handful of other cancers. But only 9%–15% of people with advanced cancer are eligible for these approaches, according to the experts that KHN talked to. “There are very few instances in which we can look at a genomic test and pick a drug off the shelf and say, ‘That will work’. That’s our goal in the long run, but in 2018 we’re not there yet,” said Nikhil Wagle, MD, a breast cancer specialist at Dana-Farber Cancer Institute in Boston.