#5 • A Healthy Dose of Healthcare News • October 30, 2020

Miguel A. Padrinan — Copyright-free

Depending on your news consumption habits, this may come as a shock, but I only just downloaded an RSS reader and built my first feed. This should help me bring you more relevant content as the weeks go by.

In this edition, you will read about #5.1. an executive order on price transparency, #5.2. a big pharma acquisition, #5.3. California’s new drug manufacturing project, #5.4. Florida’s struggling drug importation plan, #5.5. 11-year-old kids consenting to vaccines, and #5.6. a holiday-appropriate podcast series.

#5.1. Biggest News: President Trump mandates that insurers give patients pricing information

FEDERAL POLICY: New Trump policy will force insurers to disclose prices up front (The Hill)

On Thursday, October 29, the President signed an executive order requiring that health insurance companies publicly disclose prices of common procedures. Beginning in 2023, insurers will have to post prices for the 500 “most shoppable services” they cover, and by 2024, the list will need to include all services. The objective is greater competition leading to lower prices. This is the latest of several steps taken by the Administration to enforce price transparency in the healthcare system. While a laudable effort, some warn that mandatory price transparency may not be the panacea so many believe it to be.

#5.2. Healthcare on Steroids: Bayer makes a $4B pharma acquisition, biggest since 2006

PHARMA: Bayer to pay up to $4 billion for Asklepios Bio (MarketWatch)

Bayer, 17th largest global pharmaceutical company by market capitalization, has suffered immensely since its acquisition of Monsanto in 2018, owing to the 42,000 lawsuits it received over herbicide Roundup. The company is now returning to pharmaceutical investments and acquiring AskBio, a Triangle Park (NC)-based biotech company working on gene therapies that can reverse diseases caused by a faulty or missing gene. Bayer agreed to pay $2 billion now and $2 billion later if the investment is successful. Needless to say, AskBio is on a hiring spree.

#5.3. What the Health: The Californian government plans to manufacture drugs

STATE POLICY: California’s Governor Signs Bill for State to Produce Its Own Biosimilars, Insulins (AJMC)

Rising prescription drug prices is one of Americans’ top concerns. High prices can signify the presence of a monopoly, so California figured out a solution: since the state has not only “market power” but also “moral power,” Governor Gavin Newsom is showing the country how it’s done and creating its own drug label, Cal Rx, saying that it will “return [pricing power] to consumers.” Its focus will be generics and biosimilars, including biosimilar insulin. Is it the role of the state to manufacture drugs? Many will respond in the negative, but not California, who’s been doing private-sector work for years in, for example, home building. You may have read in a previous AHDoHN edition that patients in L.A.’s public hospitals experience extreme delays with dramatic consequences on health. Time will tell whether California is better on drugs than on hospital care.

#5.4. Flatline: Florida wants to import drugs from Canada but can’t find a contractor

STATE POLICY: Florida Fails to Attract Bidders for Canada Drug Importation Program (Kaiser Health News)

In mid-2019, Florida Governor Ron DeSantis signed a bill allowing the importation of drugs from Canada, and the state subsequently put a $30 million contract out for bidders. The task: set up a program to import prescription drugs, Canadian drug prices being generally far lower than US ones. September 30th rolled around, and not a single private company had submitted a proposal. Hindsight is 20/20, but it seems that the Florida Agency for Health Care Administration overlooked several red flags:

  • HHS Secretary Alex Azar gave his approval to the final rules on importation on September 24, just a few days before the deadline. Private firms would think twice before bidding on a contract that might change if Florida’s rules are different from the federal rules. As a matter of fact, the final federal rules did turn out to conflict with some of Florida’s.
  • The $30 million amount might have been too low to attract the right companies.
  • Medicaid prices are confidential yet needed for the contractor to do the job right, so the contracting company couldn’t easily secure the savings the program is designed to bring about.
  • The importation of biologics (including insulin), which represents a sizable market, is illegal.
  • Canada is opposed to exporting drugs because it can worsen their own drug shortages.
  • The pharmaceutical industry is opposed to the program.

The Agency is still hopeful about finding a contractor.

#5.5. Choose Your Own Adventure: Kids may soon be able to get vaccinated against their parents’ will in D.C.

CHILDREN: Kids as young as 11 years old would be able to consent to vaccinations under a new bill proposed in Washington, DC (Business Insider)

The DC Council just voted 12–1 on a bill that would allow children as young as 11 years old to be vaccinated against their parents’ will. In times of pandemic, one would think that the objective is to ensure that children be allowed to receive an FDA-approved shot against COVID-19. Instead, the bill makes mention of a different vaccine and targets kids with a specific type of parents. If passed into law, the bill would require doctors to bill insurers directly and send the vaccination records to the kid’s school, but not to his or her parent(s),

if the parent is utilizing a religious exemption or is opting out of receiving the Human Papillomavirus vaccine. (B23–0171)

Councilmember Gray said that “one thing that we’ve learned from covid . . . is that policymakers, lawmakers, need to make science-driven decisions about public-health policy.” Childhood vaccination is essential, but most vaccines must be administered early in life. Incidentally, the original bill contained no age limit, such that a one-year-old child could have presumably consented to vaccination. Yet, it seems that science would tell us that a one-year-old cannot rationally consent to much. This “science-driven” approach to policy may not be all that scientific after all.

#5.6. Cold Sweat: Award-winning podcast Dr. Death is back for Season 2

MEDICAL MALPRACTICE: Dr. Death Season 2: Dr. Fata (podcast)

Season 1 of Dr. Death, a true-crime podcast series by Laura Beil, narrated the life and repeated acts of medical malpractice of Dr. Christopher Duntsch, a neurosurgeon who allegedly killed two patients and maimed dozens more. The series was dreadful and brilliantly produced, and I’m both terrified and excited about the new season on oncologist Dr. Farid Fata, who (spoiler alert) prescribed chemotherapy to non-cancer patients for 31 years.

Happy Halloween! Please “enjoy” a taste of my humor.

Past editions:

AHDoHN #4: sky-high excess deaths among young adults, the first FDA-approved treatment for COVID, stagnating AI deployment in Europe’s healthcare systems, reforms in the way we pay for care, and insurance premiums in 2021.

AHDoHN #3: patients returning to the doctor’s office, the political unfeasibility of Bidencare, health benefit unpredictability in 2021, a telecom company getting into home health, major financial distress for hospitals, the upcoming SCOTUS case on the ACA, and median physician assistant wages.

AHDoHN #2: $300 million ad campaign paid by taxpayers, who was uninsured last year, a Federal Supreme Court hearing on PBMs, a state Supreme Court decision that limits access to care, extreme delays at LA’s public hospitals, the Science Nobel Prize winners, and surprising differences in median ages across states.

AHDoHN #1: Biggest DOJ catch in history, the history of pre-existing condition protections, the relaxation of licensing laws, a new insurance arrangement by Walmart, non-news about drug costs, and a scary report about chronic diseases.

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