Morning Rounds Shraddha Chakradhar

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Washington to become first state to offer public health insurance option

Washington Gov. Jay Inslee is expected to sign legislation today to make Washington the first U.S. state to offer a public option for health insurance regardless of income level. The plan, which is set to go into effect in 2021 and is dubbed Cascade Care, will be available to state residents in addition to private plans. The government plans to hire private insurers to administer the new public plans, and will set a cap — 160% of federal Medicare rates — on payments made to providers. 

But there are still a lot of unknowns with the new plan: A reporter friend of mine in Washington tells me that it’s unclear how many private insurers will opt in to accept the new public plans. It’s also not clear how much Cascade Care will cost taxpayers, even though some estimates say that the new plans will be about 10% cheaper than comparable private plans. 

Federal lawsuit alleges generic drug makers engaged in price-fixing

The attorneys general of 43 states and Puerto Rico filed a lawsuit late last week alleging that many of the largest generic drug makers conspired to keep the cost of drugs high. The drugs involved in the lawsuit account for billions of dollars, according to investigators, who also allege that generic companies agreed not to compete with each other and to settle instead for a share of the market that would prevent pushing prices down through competition. Generic drug company Teva, which is accused of raising prices of more than 110 drugs, issued a statement denying any wrongdoing and said the company is dedicated to complying with laws and regulations in its quest to deliver medicines to patients.

FDA finalizes rules on when biosimilars can be interchangeable with biologics

The FDA has released its final word on the kinds of studies that biosimilar makers will have to conduct in order to be considered interchangeable with biologic drugs, which are made from living organisms and often come with a high price tag. Just as generics are a cheaper alternative to brand-name drugs, biosimilars are an alternative to biologics, but without the “interchangeable” designation, pharmacists can’t automatically swap out biologics for biosimilars. Among the new rules, biosimilar makers will have to do so-called switching studies, in which patients in trials switch back and forth between the biologic and the biosimilar to show no adverse effects on the patients. Some major biosimilars group have welcomed the move, while others have lamented that the new FDA rules may mean more of a burden for biosimilar makers to get their product to market.

Inside STAT: Hospitals look to computers to predict patient emergencies before they happen


Hospital command centers have proliferated in recent years, and have allowed hospitals to better track warning signs. Take the example of John S., a patient at the Cleveland Clinic in Ohio. As his heartbeat quickened and signs pointed to cardiac arrest, it was not his nursing team at the hospital that caught the impending crisis to get him the help he needed. Instead, a technician at the hospital’s Central Monitoring Unit several miles away was tracking his vital signs and was able to trigger an emergency response in time to help the patient. But with recent advances in artificial intelligence, hospitals are looking to get even better at predicting when crises can be caught in advance and avoided. STAT’s Casey Ross has more here.

Philip Morris suspends social media campaign of its ‘heated tobacco’ device

Tobacco giant Philip Morris is suspending a global social media campaign to market its “heated tobacco” product known as IQOS following an investigation by Reuters. Philip Morris’ internal marketing standards prevent the company from using social media influencers below the age of 25, according to Reuters, but the investigation found that the IQOS device — which is touted as having 95% fewer toxic chemicals than cigarettes — was being marketed on Instagram by women as young as 21. The FDA last month began allowing the company to sell the IQOS device in the U.S. after Philip Morris “repeatedly assured the regulator that it would warn young people away from the product,” according to Reuters. The company also told Reuters that it had launched an internal investigation into the social media campaign.

How opioids may end up in the hands of those not prescribed them

Some 1.2 million opioid prescriptions filled in 2016 were to people who had family members who had engaged in “doctor or pharmacy shopping,” a new study of insurance data finds. The “shopping” occurs when one seeks opioids from multiple prescribers and pharmacists in order to avoid detection, and the findings underscore the dangers of overprescribing opioids. Researchers looked at insurance data from more than 550,000 patients, and roughly 1% of the opioid prescriptions were for a person who had a family member who had been to at least four prescribers and pharmacists. This was a conservative estimate, the authors say, indicating that the actual numbers — and therefore the actual risk — of opioids ending up in the hands of those who weren’t necessarily prescribed the medication may be higher.

What to read around the web today

  • This doctor posted online in favor of immunization. Then vaccine opponents targeted her. The Boston Globe
  • “Am I a bad person?” Why one mom didn’t take her kid to the ER — even after poison control said to. Vox
  • As emergencies rise across rural America, a hospital fights for its life. The Washington Post
  • Transplants a cheaper, better option for undocumented immigrants with kidney failure. NPR
  • Can we live longer but stay younger? The New Yorker

Thanks for reading! More tomorrow,


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Monday, May 13, 2019


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