What’s New in Health Care Reform: Aug. 22

What's New in Health Care Reform provides an overview of the past week’s news, updates, and commentary in health care reform and utilization management.

NYU School of Medicine Will Provide Free Tuition to Students

NYU School of Medicine announced it will provide all current and future students full-tuition scholarships to attend medical school. The institution, which broke the news to incoming students and their families during the White Coat Ceremony, is the first major medical school in the U.S. to provide free education to all students regardless of financial merit. NYU leaders called the decision a "moral imperative" considering the impact medical school debt has on physician stress levels, diversity in the profession and the provider shortage. Via Modern Healthcare.

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EpiPen Shortage Raises Alarm for Parents as Kids Head Back to School

A widespread shortage of EpiPens across the country could send children with serious allergies to school without the medication that prevents them from going into anaphylactic shock if they are exposed. The scarce availability, caused by manufacturing issues and local supply disruptions, has been an issue for months. Sales of the pens typically spike during the back-to-school season, as parents buy two-packs to leave at school and refill expiring prescriptions to keep in children’s backpacks or at home. Now many parents are heading to pharmacies for fresh medications to find that they are in short supply. Via Washington Post.

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The U.S. Opioid Crisis Has "Peaked," Says One of the Nation's Leading Health Care Authorities

The opioid epidemic in the United States has "peaked," says Dr. Toby Cosgrove, one of the nation's leading voices on health care reform. "We're starting to see the understanding of the problem," Cosgrove said Monday on CNBC's "Squawk Box." "[We] are getting to the point where people are certainty prescribing fewer drugs and people are recognizing how serious this is." But Cosgrove, former CEO of the renowned Cleveland Clinic, also said opioids remain a major health risk for Americans, especially from drugs laced with synthetic opioids such as the pain killer fentanyl or ones with similar effects like carfentanil. "Carfentanil is 10,000 times as potent as morphine. These drugs are getting laced," said Cosgrove, who is also a cardiac surgeon. "We just had an outbreak of deaths in Ohio from drugs being laced with very potent carfentanil and fentanyl." Via CNBC.

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FDA Approves First Generic Version of EpiPen

The Food and Drug Administration approved the first generic version of EpiPen, a move that will bring new competition for the lifesaving allergy injection that helped spark public furor over high drug prices. The new drug, from Teva Pharmaceuticals USA, is the first to be deemed a therapeutic equivalent of the EpiPen, which means that it can be automatically substituted at the pharmacy counter for prescriptions for EpiPen or EpiPen Jr. The approval comes right before the back-to-school season, when sales of EpiPen typically spike as parents stock up on injectors for school or replace expired ones, and people have reported difficulty filling EpiPen prescriptions. There has been “limited availability of EpiPen in certain areas in the U.S., including both pharmacy-level supply disruptions and a manufacturer issue,” according to FDA spokeswoman Theresa Eisenman. Via Washington Post.

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States Rush to Rein in Prescription Costs, and Drug Companies Fight Back

States around the country are clamping down on pharmaceutical companies, forcing them to disclose and justify price increases, but the drug manufacturers are fighting back, challenging the state laws as a violation of their constitutional rights. Even more states are, for the first time, trying to regulate middlemen who play a crucial role by managing drug benefits for employers and insurers, while taking payments from drug companies in return for giving preferential treatment to their drugs. Via NY Times.

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Why Hospitals Are Getting into the Real Estate Business

The hospital's initiative was called Healthy Neighborhoods Healthy Families (HNHF). In partnership with the city and community groups like the United Way and a local Methodist congregation, HNHF renovated vacant homes for resale, built new affordable housing, and wrote checks to homeowners to fund renovations on their homes. But why is a hospital getting into the housing business? A body of evidence points to a link between living in areas of concentrated poverty and health. It's something doctors at Nationwide Children's were seeing first-hand. Via NPR.

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Medical Students Are Skipping Class in Droves—and Making Lectures Increasingly Obsolete

The future doctors of America cut class. Not to gossip in the bathroom or flirt behind the bleachers. They skip to learn—at twice the speed. Some medical students follow along with class remotely, watching sped-up recordings of their professors at home, in their pajamas. Others rarely tune in. At one school, attendance is so bad that a Nobel laureate recently lectured to mostly empty seats. Via STAT.

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Moderate "Bad Cholesterol" Levels Tied to Early Death for Healthy People

Healthy adults who don’t keep their LDL-C, or “bad cholesterol,” in check are more likely to die prematurely from cardiovascular disease than peers with lower cholesterol levels, a U.S. study suggests. Researchers examined data on 36,375 adults with no history of heart disease or diabetes and a low 10-year risk for events like heart attacks or strokes. Most had levels of the type of cholesterol that builds up in blood vessels and can lead to blood clots and heart attacks, known as low-density lipoprotein cholesterol (LDL-C), below the threshold that usually leads doctors to prescribe cholesterol-lowering drugs. During the study follow-up period of about 27 years, 1,086 people died of cardiovascular disease and 598 died from coronary heart disease. Via Reuters.

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Vaping Can Damage DNA, but Will It Cause Cancer

E-cigarettes produce chemicals that can damage a person's DNA, the first step on a path that might lead to cancer, a new study reports. The saliva of a small group of e-cigarette users contained increased levels of three DNA-damaging compounds, the researchers said. These chemicals are formaldehyde, acrolein and methylglyoxal. Further, four of the five e-cigarette users showed increased DNA damage in their mouths related to acrolein exposure, when compared against people who don't vape. "This is a device that is considered to be safer with compared to regular cigarettes and I agree with that, because we don't have the same levels of carcinogens that are present in tobacco," said senior investigator Silvia Balbo, an assistant professor with the University of Minnesota Masonic Cancer Center. Via HealthDay.

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Mayo Clinic, NDSC Launch EHR-Integrated Blood Management Tool

Mayo Clinic has partnered with National Decision Support Company (NDSC) to launch an EHR-integrated blood management solution that pairs Mayo Clinic’s clinical expertise with NDSC’s EHR-enabled clinical decision support product offerings. The patient blood management tool—called CareSelect Blood—will help providers more effectively utilize blood products to improve patient care delivery and reduce health care costs. “With blood being a finite and expensive resource, we need to practice proper stewardship to prevent overuse,” said anesthesiologist and Mayo Clinic Patient Blood Management Medical Director Daryl Kor, M.D. “Current studies indicate that 40 to 60 percent of transfusions are deemed unnecessary or avoidable.” Via EHR Intelligence.

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Andy Tofilon

Andy Tofilon is a Marketing Segment Manager at Mayo Medical Laboratories. He leads strategies for corporate communications, public relations, and new media innovations. Andy has worked at Mayo Clinic since 2003. Outside of work, Andy can be found running, hiking, snapping photos, and most importantly, spending time with his family.