The Rundown | Week of 1.21.2019

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“Vaccine Hesitancy” Declared a Major Threat to Global Health

The World Health Organization (WHO) listed vaccine hesitancy — “the reluctance or refusal to vaccinate despite the availability of vaccines” — one of the top 10 threats to global health in 2019. Days after the announcement, a measles outbreak in Washington led officials to declare a public health emergency. So far there have been 22 confirmed cases of the highly contagious, inoculative virus since January 1. Nineteen of the individuals diagnosed with measles were never vaccinated while the other three’s vaccination status remains unknown. The other nine “global threats” included air pollution and climate change, noncommunicable diseases, global influenza pandemic, fragile and vulnerable settings, antimicrobial resistance, ebola, weak primary healthcare, dengue, and HIV. In response to these threats, WHO announced a goal to expand universal health coverage, protect people from health emergencies, and improve health and well-being for a total of three-billion people.
>> Read More: Ten Threats to Global Health in 2019

Report: Insulin Has Nearly Doubled in Price in Five Years

A recent report from the Health Care Cost Institute showed the average annual cost of insulin increased by 99 percent — from $2,864 to $5,705 — between 2012 and 2016. During the same period, insulin usage “rose only modestly.” Researchers noted that “the price of all types of insulin and insulin products increased, with point-of-sale prices roughly doubling.” Furthermore, “the increases in insulin spending were primarily driven by increases in insulin prices, and to a lesser extent, a shift towards [sic] use of more expensive products,” though the prices did not include drug rebates or coupons.
>> Read More: Spending on Individuals with Type 1 Diabetes and the Role of Rapidly Increasing Insulin Prices

Blood Test May Detect Alzheimer’s Disease in Early Stages

An innovative blood test may accurately predict neurodegeneration in the early stages of familial Alzheimer’s disease. The test, which measures the neurofilament light chain (NfL) in cerebrospinal fluid (CSF), may target the disease in pre-symptomatic stages — more than 16 years before the onset of dementia symptoms. Damaged or dead neurons release NfL protein into blood and CSF. Researchers examined 405 participants in the Dominantly Inherited Alzheimer’s Network (DIAN), a group of individuals who carry one of the three gene mutations linked to Alzheimer’s disease. The report in Nature Medicine relates the NfL fluid biomarker to the progression of heritable Alzheimer’s disease. However, the NfL levels could be indicative of other neurological diseases or injuries.
>>Read More: Serum Neurofilament Dynamics Predicts Neurodegeneration and Clinical Progression in Presymptomatic Alzheimer’s Disease

CMS Announces Two New Voluntary Payment Models

The Centers for Medicare and Medicaid Services (CMS) announced two Medicare Advantage (MA) voluntary “health plan innovations” that will take effect from 2020 through 2024. The first of the new models expands on the Value-Based Insurance Design (VBID) model and seeks to modernize MA delivery. The VBID model is “designed to reduce Medicare program expenditures, enhance the quality of care for Medicare beneficiaries, including dual-eligible beneficiaries, and improve the coordination and efficiency of health care service delivery.” The model builds on telehealth networks, elevates wellness and healthcare planning, offers “more meaningful rewards and incentives,” and proposes cost-sharing or supplemental benefits for low-income or chronically ill enrollees. The “Part D Payment Modernization” model “aims to reduce Medicare expenditures while preserving or enhancing quality of care for beneficiaries.” This second model is a response to President Trump’s attempts to “increase competition, improve negotiation, create incentives for lower list prices and reduce out-of-pocket costs.”
>> Read More: Value-Based Insurance Design Model (VBID) Fact Sheet CY 2020 & Part D Payment Modernization Model Fact Sheet

Opioid Marketing Costs Linked to More Prescriptions and Overdoses

A recent study established an association between marketing by the pharmaceutical industry and opioid over-prescription and opioid-related mortality. The population-based, cross-sectional study measured “mortality from prescription opioid overdoses, total cost of marketing of opioid products to physicians, number of marketing interactions, opioid prescribing rates, and sociodemographic factors.” Data from the Centers for Disease Control and Prevention showed that, over two and a half years, $39.7 million was spent on non-research-based opioid marketing (e.g. consulting fees, business lunches) to 67,507 physicians in 2,208 counties. Researchers from the NYU School of Medicine and Boston Medical Center concluded higher marketing expenditures were correlated with mortality and prescription rates, though further examination of “the influence of the pharmaceutical industry may be warranted.”
>> Read More: Association of Pharmaceutical Industry Marketing of Opioid Products With Mortality From Opioid-Related Overdoses