Good morning ... Well here's a sentence: "An ex-stripper who became a regional sales director at Insys Therapeutics Inc gave a doctor a lap dance at a Chicago club as the drugmaker pushed the doctor to prescribe its addictive fentanyl spray, a former Insys employee testified on Tuesday." (via Reuters)
Starting this spring, 5 corporate giants — Anthem, Cigna, CVS Health, Humana and UnitedHealth Group — will control both health insurance and pharmacy benefits for more than 125 million Americans.
Why it matters: Most of this happened through rapid consolidation. Now the pressure is on these companies to prove that putting everything under the same roof will help them better control both drug and medical spending, my colleague Bob Herman writes.
Driving the news: Anthem said yesterday that its new PBM, which it has been working on for over a year, will be ready to go in March — 10 months earlier than expected.
This is the new landscape.
What's old is new again. Insurers and PBMs have lived under the same roof before, but separated years ago. Now they're coming back together.
The bottom line: These companies would not have pursued merging medical and drug plan offerings if they didn't think there was a lot of money to retain.
Hey, look! An unequivocally good thing happened in health care! The number of people who get sick while they're in the hospital is falling pretty significantly, saving lives and also billions of dollars.
By the numbers: The latest figures from HHS' Agency for Healthcare Research and Quality (AHRQ) show a big improvement from 2014 to 2017.
Hospital-acquired conditions include infections, adverse drug reactions, and similar unintended side effects. AHRQ noted a particularly strong 28% reduction in drug-related adverse events.
What's next: In 2014, AHRQ set a goal of achieving a 20% reduction in total hospital-acquired conditions by the end of this year.
A new study shows that e-cigarettes like Juul are an effective way for smokers to quit smoking — twice as effective as other nicotine products like gum and patches, The New York Times reports.
Reality check: Food and Drug Administration Commissioner Scott Gottlieb, in his crackdown on vaping products, has not challenged that contention. His complaint is entirely about Juul's appeal to non-smokers, mainly teens.
It hasn’t gotten a lot of attention — OK, almost none — but employer health plans have been covering a lot more people lately, the Kaiser Family Foundation’s Drew Altman notes in today’s column.
Why it matters: That’s a bunch of people getting health insurance through their employer. And while people do love to complain about their insurance companies, it’s not out of the question that some of those 156 million people might want to keep the coverage they have.
The bottom line: This is why Kamala Harris’ comments about doing away with private insurance as part of a Medicare for All plan drew so much attention — and why other Democratic presidential candidates will have to think through how much health care disruption voters really want.
State and local health officials are afraid that treatment programs for opioid addiction could fall short without more funding, especially in states that haven’t expanded Medicaid.
The big picture: “Unless we can find other ways to keep funding these programs, the bottom is going to fall out for some people,” Kathleen Brady, an addiction psychiatrist who heads South Carolina’s medication-assisted treatment efforts, said in an interview with Stateline.
Where it stands: Congress has authorized about $10 billion in grants to the states for addiction treatment, per Stateline. Less than $2 billion of that has been paid out so far.
What's next: Officials are hoping that lawsuits against opioid manufacturers and distributors, modeled after the tobacco litigation of the 1990s, will provide billions of dollars for treatment.
UnitedHealthcare is ending its data-sharing agreement with the nonprofit Health Care Cost Institute — and, as Bob reported yesterday, Humana likely isn't far behind.
Why it matters: HCCI isn’t dead and is still enlisting other insurers to contribute data to its warehouse. But relying on private insurers to share commercially valuable health care data was bound to have its limits.
What we're hearing: HCCI has been facing heavy criticism for a while. Many researchers have argued that some of HCCI’s research has been poorly conducted.
Losers: The public and other researchers who are trying to understand the black box of prices and spending in the commercial health insurance market.