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.
The number of new drug shortages in the U.S. increased by 27 percent in 2018, after three consecutive years in which the dearth of needed medicines remained troubling, if relatively stable, according to a new analysis. Specifically, there were 186 new shortages noted last year, up from 146 in 2017, and this was also the highest amount since 2012, when 204 new drug shortages were seen. Injectable medicines used in hospitals accounted for more than half—or 55 percent—of the newest shortages, a decline from 64 percent in 2016. The number of ongoing shortages, meanwhile, remained at similar levels from 2016 to 2018. Via STAT.
University of Minnesota Health and Fairview Health are the first in the world to treat cancer patients with "digital medicine," which combines an oral chemotherapy pill with a sensor that allows patients and their doctors to track dosage. The two health partners have been using digital medicine to treat a small group of colorectal cancer patients since September, using a sensor developed by the company Proteus Digital Health. The sensor sends signals to a patch worn by the patient, which then transmits data to a smartphone or device such as an iPad. Via KARE.
Physician burnout has reached alarming levels and now amounts to a public health crisis that threatens to undermine the doctor-patient relationship and the delivery of health care nationwide, according to a report from Massachusetts doctors to be released. The report—from the Massachusetts Medical Society, the Massachusetts Health & Hospital Association, and the Harvard T.H. Chan School of Public Health—portrays a profession struggling with the unyielding demands of electronic health record systems and ever-growing regulatory burdens. It urges hospitals and medical practices to take immediate action by putting senior executives in charge of physician well-being and by giving doctors better access to mental health services. The report also calls for significant changes to make health record systems more user-friendly. Via Boston Globe.
For the first time on record, Americans are more likely to die of an accidental opioid overdose than in a motor vehicle crash, according to a new report from the National Safety Council. The group calculates that the chance of dying from an opioid overdose has increased to 1 in 96, surpassing the odds of dying in a car accident, at 1 in 103. It's also greater than the odds of dying from a fall, a gun assault, pedestrian accident, or drowning. "The opioid crisis remains an abstract issue for many people; they still believe it will not happen to them, or it isn't a risk facing them or their family," Maureen Vogel, spokeswoman for the National Safety Council, told CBS News. "These numbers show the gravity of the problem our country is facing. We need to reprioritize and regroup, because all these deaths are preventable." Via CBS Health.
A new study has identified biological markers that may distinguish between low-risk and intermediate- and high-risk prostate cancer, ultimately helping to guide treatment decisions, according to the Mayo Clinic. The study, published in Mayo Clinic Proceedings, determined that genetic alterations associated with intermediate- and high-risk prostate cancer may also be present in some cases of low-risk prostate cancers. “We have discovered new molecular markers that can help guide men in their decisions about the course of their prostate cancer care,” lead study author George Vasmatzis, Ph.D., co-director of the Center for Individualized Medicine Biomarker Discovery Program, said in a press release. “Overtreatment has been an issue for the group of men that our study targets. We found that the presence of genetic alterations in low-risk cancer can help men decide whether treatment or active surveillance is right for them.” Via Specialty Pharmacy Times.
Marie Kondo was likely just out of diapers and making a mess when Regina Leeds got into this work. Organizing was Leeds' "side hustle" starting in January 1988, what she did to get by while hoping to become a full-time actress. People at Los Angeles parties raised their eyebrows or looked confused when Leeds told them what she was doing. But that newfangled business idea became a successful career. Ten books later, including her 2008 New York Times bestseller, One Year to an Organized Life, Leeds knows as well as anyone the power of decluttering. The tolerance for clutter varies from person to person, said Tompkins. A pile that makes one person's skin crawl can be completely overlooked by another. There's also a continuum when it comes to our propensity for acquiring and holding onto stuff, said Craig Sawchuk, a Mayo Clinic psychologist and co-chair of the Division of Integrated Behavioral Health. Via CNN.
For many of us, coffee is an indispensable part of our daily routine, available to give us that much-needed boost of energy we need in the morning or during a mid-afternoon slump. However, while it may seem as if the effects of your 1 p.m. latte have worn off by 4 p.m., leaving you wanting another cup, the reality is it is better to steer clear—as science suggests a specific window you should leave caffeine-free. According to research, you should avoid consuming caffeine from around 2 p.m., or at least seven hours before bed, as it can otherwise negatively affect your sleep. Via The Independent.
With trust in governments taking a hit since the global financial crisis, people around the world view their employer as the most trusted institution in their lives, according to a survey published. In a survey of trust in institutions that public relations firm Edelman releases each year on the eve of the World Economic Forum in the Swiss ski resort of Davos, the firm found that 75 percent of respondents trusted their employer. That's a hefty 19 percentage points more than the equivalent trust in business as a whole and 27 points more than governments. "The past two decades have seen a progressive destruction of trust in societal institutions, a consequence of the Great Recession, fears about immigration and economic dislocation caused by globalization and automation," said Richard Edelman, the firm's president and CEO. Via Star Tribune. (Link expired.)
Race and ethnicity affect how patients respond to drugs, but participants in clinical trials are disproportionately white. This diversity gap weakens efficacy and could be undermining outcomes for minorities suffering from diseases including HIV, hypertension, and cancer. People of African descent respond less well to certain hypertension drugs, and have been found to metabolise an anti-HIV drug less efficiently. White and black patients metabolise some antidepressants and antipsychotics less well than Asians, and blacks and Hispanics respond worse to a hepatitis C antiviral treatment. Asians have genetic variants that impair the production of enzymes which activate an antiplatelet drug. African-American, Hispanic, and Native American ancestry all confer poorer survival following treatment for acute lymphoblastic leukaemia compared with European Americans or Asians, and may need to be recommended additional chemotherapy. One-fifth of new drugs approved between 2008 and 2013 showed racial differences in drug response that were, in some cases, significant enough to impact prescribing decisions. Via Financial Times.
Four titans who defined a new era in business during the past decade recently concluded their terms: PepsiCo’s Indra Nooyi, Unilever’s Paul Polman, Mayo Clinic’s John Noseworthy, and US Bancorp’s Richard Davis. When they became CEOs, the Great Recession of 2008 was consuming the world’s attention. Many speculated about the possibility of a new depression, a collapsing stock market, and extreme unemployment. Some observers even began to question the foundations of capitalism, arguing it needed to change in order to endure. When John Noseworthy became CEO of Mayo Clinic in 2009, the world-famous medical center was struggling financially. Congress would soon be negotiating the terms of the Affordable Care Act (ACA), the Obama Administration’s signature health care legislation. From the outset, Noseworthy built on the values of the Mayo brothers and Mayo Clinic’s historic mission of putting patients first. He prioritized Mayo’s focus on the most complex diseases patients faced, using its research to develop new treatments for many diseases. Via Harvard Business Week.