High costs and opioid overuse aren’t the only prescription drug challenges in the U.S. The wrong dose, skipped doses or inappropriate medication use can cause adverse health events and even death--and medical results related to that cost an estimated $528 billion in 2016, according to a new study. Non-optimized medication therapy accounts for about 16 percent of the nation’s annual drug spend. The study, published in the
Annals of Pharmacotherapy
, recommends expansion of comprehensive medication management to mitigate avoidable costs and improve patient health. (
Science Daily
;
Annals of Pharmacotherapy
)
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Insiders say Walmart Inc. is seriously considering a purchase of the Humana health plan, which is valued at $37 billion and owns its own pharmacy benefits management business. If it comes to pass, the deal would be the latest and largest in a string of health care mergers and acquisitions, within six months of CVS Health’s announcement that it intends to buy Aetna and Cigna Corp.’s agreement to buy Express Scripts Holding. And it would be the only real competitor to Amazon’s recent collaboration with JP Morgan and Berkshire Hathaway to disrupt health care cost and delivery. (
The Wall Street Journal
[subscription required];
CNN Money
)
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Innovation & Transformation
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The recent budget bill eased reporting requirements for doctors participating in the merit-based incentive payment system (MIPS), and health policy analysts think MIPS should be discarded. Earlier this year, MedPAC recommended that Congress scrap MIPS altogether and push doctors into advanced alternative payment models instead. But fewer than one in five eligible physicians will qualify as an APM participant next year, largely because there aren’t a lot of APM options yet available. The voluntary payment committee tasked to review and recommend APM options has pushed more than a dozen models forward, but the Department of Health and Human Services has yet to adopt a single recommended model. (
Health Affairs
)
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Do Medicare Shared Savings ACOs save money? By and large, they don’t, according to analysis by Avalere, which found net savings fall short of CMS’ 2010 projections by more than $2 billion. The reason: Most ACOs in the program have chosen the model that pays a bonus only, rather than puts an ACO’s performance at risk. The ACOs in the at-risk track reduced federal spending by $60 million over five years; what’s more, CMS notes, ACOs are improving the quality of care delivered. While the net dollar rewards aren't there yet, Avalere notes that ACO cost savings increase with time and organizational experience.
(
analysis
;
Inside Health Policy
[registration required])
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The CEO's Guide to Restoring the American Dream offers a behind-the-scenes look at how public and private employers and unions across the U.S. are reducing their spending by 20 percent or more while improving care quality and access. The book uses real-life examples to outline how top-performing benefits purchasers take control of the purchasing process, align economic incentives and apply simple, practical and proven approaches.The new edition also unpacks how employers have been the key (unwitting) enabler of the opioid crisis and how smart employers are going upstream to solve the opioid problem before it happens. Now available to H2RMinutes subscribers as a free download
here.
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Apple’s latest operating system update allows users to access its new Health Records feature. More than 100 health care providers are participating in the new app, which allows consumers to retrieve their medical records, view lab results and receive notifications directly on Apple devices. Some 39 health systems across the country are working with Apple to integrate their medical records. Apple’s move may herald truly disruptive change, liberating data for new uses and empowering patients. (
Consumer Affairs
;
Commonwealth Fund
)
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Surescripts, the electronic prescribing vendor, announced a new service to monitor accuracy of prescriptions generated from EHRs. The idea is to reduce systemic points of failure in the electronic prescribing process. Surescripts is also collaborating with six EHR vendors, CVS Health and Express Scripts to deliver data about prescription benefits and pricing to health care providers at the point of care. The effort is envisioned to make the data available to more than half of U.S. physicians as they work with patients to discuss the cost and effectiveness of drugs during an office visit. (
HealthDataManagement
;
Healthcare IT News
)
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HHS chooses Best:
Health and Human Services Secretary Alex Azar announced selection of Daniel Best, vice president of trade relations for CVS Health, to lead the agency’s drug price reduction initiative. Azar also tapped Brett Giroir as senior advisor for mental health and opioid policy. Giroir is already an HHS assistant secretary; he has a long track record in the U.S. Public Health Service as a physician and four-star admiral.
(
The Hill
)
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Board puts kibosh on Allergan’s patent switch scheme:
Last September, Allergan, manufacturer of dry eye medicine Restasis, transferred its patents to the Saint Regis Mohawk Tribe in a move to avoid review by the Patent Trial and Appeal Board. Allergan argued the company’s tribe status made it a sovereign entity, above the Patent Board’s jurisdiction. But the U.S. Patent Office dismissed the maneuver and the company will have to face a challenge to the validity of its Restasis patent by Mylan NV, a generic drug company. (
Reuters
)
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Colorado pharmacists to be paid as providers:
Legislation awaiting the governor’s signature in Colorado will require health plans to pay for pharmacist-provided services if they are offered within a shortage area and if the plan covers the same services provided by a licensed physician or advanced practice nurse. In essence, pharmacists in underserved regions will be able to provide contraception and smoking cessation services or administer vaccines and receive health plan payment for services. (
National Alliance of State Pharmacy Associations
)
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FDA recalls kratom bars:
Triangle Pharmanaturals
, based in Las Vegas, was ordered to pull its food bars containing kratom off the shelves this week after it ignored the FDA's warnings about their safety. It's the first time the FDA has invoked its mandatory recall powers; Triangle is on the hook to notify everyone involved in manufacturing, distributing or handling the product within 24 hours, plus a number of ongoing tasks. Salmonella infections were connected to the bars, affecting 87 people in 35 states. Kratom is an herbal product with opioid-like psychoactive properties, often used in teas and nutrition bars.
(
MedPageToday
)
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Research on applying artificial intelligence to radiology imaging is coming along nicely, but AI can only automate a small portion of a radiologist’s work, says Google Cloud’s lead on research and development. AI can certainly help doctors quickly and efficiently identify x-ray abnormalities and highlight those areas and could help experts spend less time on repetitive tasks. (
MIT Technology Review
)
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MarketVoices...quotes worth reading
“Non-optimized medication therapy is a massive avoidable cost. If medications were prescribed, monitored and taken properly, we wouldn't face this cost, and patients would be healthier.”
Jonathan Watanabe, PharmD, PhD, associate professor of clinical pharmacy in the Skaggs School of Pharmacy, University of California, San Diego, as quoted by
Science Daily
.
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Editor
Sandy Mau
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