Health

BY JAY JOSHI We’re seeing a trend of late, where matters in healthcare once deemed to be civil in nature are turning criminal. We see it for nearly every polarizing health issue, from abortion to opioids. And it’s affecting vulnerable patients the most. We have two separate systems in place, civil and criminal, because we have different standards of behavior. Civil laws determine whether undue harm was caused by one party to another. Criminal laws determine whether someone committed a crime. The threshold is distinctly different. If someone is caught driving ten miles over the designated speed limit, that person committed a civil infraction of traffic laws. But if someone is caught speeding well in excess, say thirty or forty miles over the speed limit, while driving reckless...

Multiple digital health companies are reporting first quarter earnings this week. Here are few notable companies. Related: Digital health could get a reset following Silicon Valley Bank failure  Amwell Amwell, a Boston-based telehealth company, suffered a goodwill impairment charge worth more than $330 million in the first quarter of 2023.  The impairment charge came from sustained decrease in the company’s publicly quoted share price and market capitalization throughout the year, according to a filing to the Securities and Exchange Commission. The impairment charge helped cause Amwell to post a net loss of $398.5 million, or $1.42 per share in the quarter, compared a net loss of $61.6 million, or 26 cents per share, in 2022. Amwell’s Converge telehealth platform connects all of its pr...

WASHINGTON — Days out from a surgery and with a young son undergoing chemotherapy, Kyle McHenry was scrambling to figure out if his Florida family will still be covered by Medicaid come Monday. One form on the state's website said coverage for their sick 5-year-old son, Ryder, had been denied. But another said the family would remain on Medicaid through next year. Still, a letter from the state said McHenry now makes too much money for him, his wife and their older son to qualify after the end of the month. Related: A state-by-state look at the impact of Medicaid determinations Three phone calls and a total of six frustrating hours on hold with Florida's Department of Children and Families later, the McHenrys finally got the answer they were dreading on Thursday: Most of the family is ...

THCB Gang By KIM BELLARD I first became aware of Casey Quinlan in 2017, when she published an article in Tincture, which I was helping to edit.  In it, she discussed how she’d had her medical history and advance directive tattooed on her chest, out of frustration with the lack of health information exchange in healthcare.  As she said, “ALL. THOSE. FUCKING. FORMS. ON. CLIPBOARDS.” Well, I thought: she sounds like an interesting person.  I started following her on Twitter, enjoying her outspokenness and agreeing with many of her points of view.  Then early in the pandemic Matthew Holt started THCB Gang podcast, and I got to participate in many of them with her as a co-panelist. It was sometimes hard to get a word in edgewise, but when she was on we always knew it was go...

The health insurance industry trade association AHIP launched a national advertising campaign Monday that reignites its public spat with pharmaceutical companies over the cost of prescription drugs. "Health insurance companies are your bargaining power" begins the 30-second spot that AHIP is spending "seven figures" to air on television and social media through the end of the year, according to a news release and an association spokesperson. In the ad, AHIP urges viewers to "Reject Big Pharma's Rx Distractions." The industry group said it also has placed ads with Capitol Hill publications in Washington, D.C. Drugmakers, represented by the Pharmaceutical Research and Manufacturers of America, likewise point fingers at health insurance companies and pharmacy benefit managers for driving ...

LCMC Health filed suit against federal antitrust regulators Wednesday after they sought to temporarily halt the health system's plan to buy three HCA Healthcare hospitals in Louisiana. In its lawsuit against the Federal Trade Commission and others, New Orleans-based LCMC said it is seeking a declaratory judgment determining the $150 million deal is not subject to federal regulatory review. The transaction, part of a partnership with Tulane University, was approved a few months ago with a Certificate of Public Advantage, making it immune from antitrust-related prosecution.  "The Certificate of Public Advantage process was rigorous and transparent, with active supervision to ensure consumer protection," LCMC said in a statement. "We are on solid ground, and Louisiana knows what is best f...

BY HANS DUVEFELT A month ago an oncologist called and asked me to see one of my heart failure patients whose chronically swollen legs seemed unusually blue but not cold. Before I could get him in to see me, he ended up seeing a colleague, who called me up and said the man’s legs were cool and there was no Doppler in that office to check for pedal pulses. The man was sent for an urgent CT angiogram with runoff. The test was perfectly normal. He had clean arteries. When I saw him, the legs were less blue than they must have been and they felt OK but he had what looked like a shingles rash around his right elbow. There was some surrounding swelling and redness, so I prescribed an antiviral, an antibiotic and prednisone and arranged to see him back. My diagnosis was eryt...

That is the questions Peter Neumann and David Kim (2023) answer in their JAMA research letter published today. They use 1990-2021 data from the Tufts Medical Center CEA Registry. The results are summarized in the graphs below. First, we see the use of a explicit cost effectiveness threshold increasing over time, from only 45% of published studies to 91% of all studies. Second, the cost-effectiveness thresholds have increased over time. Whereas 43.6% of studies reporting a CEA threshold used a $50,000/QALY threshold in the 1990s, now only 13.8% of studies use that threshold; whereas 0% of studies used $150,000/QALY threshold in the 1990s, now 25.9% of studies do so. The authors also note that: Cancer-related CEAs referenced higher thr...

The Environmental Protection Agency’s proposed new rule meant to limit exposure of ethylene oxide to workers in sterilization plants has medical device manufacturers worried about potential delays and shortages. The EPA proposed stricter controls on facilities to protect workers from exposure to the cancer-causing chemical. Ethylene oxide is used to clean spices, produce antifreeze, in textile manufacturing and as a pesticide. The carcinogen also sterilizes 20 billion medical devices annually, including syringes, catheters, infusion pumps, surgical kits and pacemakers. The Food and Drug Administration has been piloting alternatives for ethylene oxide to sterilize medical devices but none have the scale to replace the carcinogen without disrupting the supply chain. The rule would requir...