Drug Prices Continue to Increase Costs for Consumers; Low-Value Care Study Raises AHA’s Ire

May 11, 2021 - Happy Tuesday as warm temps and dry skies seem to be in the forecast for many of us.

JAMA Study Finds 15% Increase in Out-of-Pocket Costs for Branded Drugs

A JAMA study found that for 53.7% of patients who paid drug deductibles or coinsurance between 2015 and 2017, median out-of-pocket costs increased by 15% for brand-name medications. In the study, nearly 53.7 percent of patients paid drug deductible or coinsurance. In that same group of individuals, out-of-pocket costs increased when manufacturers increased list prices.

Overall, median out-of-pocket spending increased by 15 percent for commercially insured patients. And changes were correlated with changes in list prices but not net prices, researchers explained. Among the 79 drugs studied, median list price increases were 16.7 percent. Specifically, per 30-day supply, drug prices increased from $333 in 2015 to $386 in 2017. READ MORE

Precision Medicine Corrects Immune Function in Children

A precision medicine therapy developed by researchers at UCLA and Great Ormond Street Hospital (GOSH) in London restored immune function in more than 95 percent of pediatric patients. Using the experimental approach, the team successfully treated 48 of 50 children born with a deadly and inherited disorder that keeps them from having a functioning immune system.

“All the patients are alive and well, and in more than 95 percent of them, the therapy appears to have corrected their underlying immune system problems,” said Donald Kohn, a distinguished professor of microbiology, immunology, and molecular genetics and a member of the Eli and Edythe Broad Center of Regenerative Medicine and Stem Cell Research at UCLA. READ MORE

Blue Cross North Carolina Focuses on Boosting Member Experience

When Sarah Wechsberg, manager of voice of consumer and experience strategy at Blue Cross North Carolina (Blue Cross NC), joined the team at Blue Cross NC, the problem with her company’s member experience data strategy had already grown apparent. The issue was not that the payer failed to listen to its members. In fact, Blue Cross NC listened to its consumers across multiple channels and leveraged various vendors to collect member experience data. Rather, Wechsberg and her team realized that the resultant member experience data was scattered throughout the organization.

“What we needed was a centralized place to listen to our members and a centralized place to better understand where we needed to go to drive experience metrics up to ultimately improve the experience for our members,” Wechsberg said. READ MORE

COVID-19 Mitigation Slowed by Social Determinants of Health

Patients who face social determinants of health are less likely to take part in COVID-19 mitigation strategies, heightening health disparities. That was the major takeaway from a recent study presented at the American College of Cardiology's 70th Annual Scientific Session, that examined COVID-19 preventive habits among more than 25,000 adults through the lens of sociodemographic factors. Researchers analyzed survey responses from just over 2,000 individuals who reported a history of heart disease, heart attack, or stroke.

“Unless we look at COVID-19 through the lens of social determinants of health, we may not optimize our yield from interventions, and we might not be reaching the group of individuals who need these interventions the most,” said Kobina Hagan, MD, a postdoctoral fellow at Houston Methodist Research Institute and the study's lead author. READ MORE

Study on High Rates of Low-Value Care Stirs Debate

Published by the healthcare think tank on May 4th, the study found that hospitals in the US deliver a low-value test or procedure to an older adult every 80 seconds. The tests and procedures, defined as having little to no clinical benefit, are putting hundreds of thousands of patients at risk of harm, researchers said.

And the American Hospital Association is pushing back. “[The services] represent only a portion of hospitals’ patient population and are not reflective of all the care hospitals provide,” Ashley Thompson, AHA’s vice president for public policy analysis and development, wrote in the blog post. “In addition, it is problematic to use only billing data to reach sweeping judgments about whether procedures are ‘unnecessary,’ let alone to construct a hospital ranking or rating.” READ MORE

AdventHealth Going to Disney World with Telehealth

AdventHealth has announced the expansion of a 20-year partnership with Walt Disney World to include connected health services at the Florida theme park. This will include an on-demand telehealth platform that guests, employees and others can access at any time and an mHealth app for scheduling virtual care.

“The health and well-being of our guests as they enjoy a visit to Walt Disney World is very important to us,” Walt Disney World Resort President Jeff Vahle said in a recent press release. “This enhanced relationship allows for access to AdventHealth’s services, as needed, should our guests have healthcare questions both before or during their vacation.” READ MORE