Our favorite Pharma bro Martin Shkreli is running his dang company from prison.

In other news, what’s America’s least favorite company? Nope, not Comcast. The U.S. government.

5 Big Healthcare Stories

Week of March 11, 2019

1 Hospitals may be forced to post actual prices

Holy ****.

Buried deep in a 700 page report published last month (kinda sounds like the intro to an Indiana Jones film), HHS dropped a bombshell proposal that would force physicians and hospitals to disclose publicly how much they get paid by insurers. This proposal would expose the entire pricing negotiation between healthcare providers and insurers and potentially up-end the entire pricing system that the industry has grown so accustomed to. Right now, HHS is only requesting comments on said proposal, but it shows the way that the current admin is thinking about changing the healthcare industry. Also, expect major lobbying efforts.

This is BIG.

Note that this would be COMPLETELY different from the rule that went into effect at the beginning of 2019, where hospitals were required to disclose their chargemasters (which is the price they charge for procedures, not the price they’re paid from insurers). If this current proposal goes through in any form, everyone in the country would know every single healthcare provider’s negotiated rates of payment for all procedures. Providers and insurers hold rates in extreme secrecy, so this is definitely something to keep an eye on. I know it’s just a comment period on a potential proposal, but this news doesn’t seem to be getting the type of attention I’d expect for something that would probably cause a massive landslide.

Read the WSJ feature article here (paywall).

2 HIV Cured?

Virus free.

An HIV-positive British man became the second person in the world to be in complete remission from the virus after receiving bone marrow tranplants from another ‘HIV-resistant’ donor. It doesn’t necessarily mean that scientists ‘cured’ the disease, but there is no detectable amount of the virus left in his body, which is pretty cool. Before we get TOO excited, though, the treatment that led to this result doesn’t look like it’s very re-producible on a large scale. Still, baby steps….

3 Vaccines Don’t Cause Autism

Wait, What?!?!? Really!?!?!?!?!?

The Annals of Internal Medicine released a report this week supporting the fact that the measles vaccine does not increase the risk for autism, does not trigger autism in susceptible children, and is not associated with clustering of autism cases after vaccination. The organization legit made the report FREE so that everyone could see the data clearly pointing to the fact that there is no tie between vaccinations and autism.

Prove it to me.

In a nutshell, the study analyzed 657,461 children born in Denmark and compared the autism rate among vaccinated children to the autism rate among un-vaccinated children. No statistically significant difference. So basically, the measles vaccine does not increase the risk of autism in children.

Well shoot…better go vaccinate then.

The study comes at an opportune time, since multiple measles outbreaks (Seattle and New York) have been reported across the country. Someone alert the anti-vaxxers on ‘ole Facebook.

4 FDA Head is outta here

Family time.

FDA Comissioner Scott Gotlieb announced his resignation this week after tweeting a few months ago that he wasn’t “going anywhere.” He’s planning to spend some more time with his fam, considering he was commuting to Washington DC from Connecticut

So what’ll change?

Gottlieb leaves behind a legacy of combating high prescription drug costs. He actually broke the FDA’s previous record for annual generic drug approvals. The former FDA head also also took a lead role in addressing the opioid crisis and had some strong thoughts about the tobacco industry. Before his resignation, Gottlieb was working toward restricting the sale of flavored tobacco, and even called the e-cigarrette trend an “epidemic among teenagers.” (Remember when the gov raided Juul’s headquarters? Epic).

5 Insulin prices are coming down..maybe?

Fire Sale – 50% off Insulin!

Facing immense scrutiny from Congress, Eli Lilly took the first step in appeasing the wrath of Capitol Hill by creating a generic version of one of its top drugs, Humalog. You might know the drug by its more common name – insulin (the stuff that people with diabetes need to survive). The price of insulin had been conspicuously skyrocketing in recent years, which drew a lot of attention from lawmakers. Anyway, the drugmaker is naming its generic insulin drug Lispro and plans to list it at half the cost of Humalog. Good news – the lower-priced insulin has already been developed and manufactured and is ready to go.

Something to note.

Just because the list price is coming down doesn’t mean the overall cost will come down. Eli Lilly claims that after rebates and coupons, the price of the generic insulin, Lispro might end up being about the same as their brand-name version, Humalog. Still, it’s a good thing to have a larger supply of insulin, right? Higher supply, lower price – at least according to my former economics professor.

Quick Hits

Dialysis companies (DaVita, Fresenius) took a hit this week as HHS looks to revamp the kidney care industry. Specifically, HHS is pushing for a higher level of home care in the industry (instead of dialysis clinics). Health systems are playing a new, different role these days – as venture capitalists. Purdue Pharma (yes, the infamous stripper drug selling company) is considering bankruptcy after being linked to the opioid crisis during its trial.

The FDA (RIP, Scott) just approved Johnson & Johnson’s fast-acting anti-depressant nasal spray designed for those who have developed resistances to other anti-depressants. Anthem completed its annual investor day, claiming that they’re building the next-generation PBM. They also have no plans to copy UnitedHealth on physician acquisitions. Speaking of United, they’re telling us that freestanding ERs cost 22 times more than a regular doctor’s visit.

Amazon/JP Morgan/Berkshire’s (we really need an abbreviation for that) new healthcare venture FINALLY named itself (it’s Haven – saved you a click – but here’s the article anyway for you overachievers). Rural areas are hit the hardest in the no-subsidy ACA era. CMS wants to make insurance plans easier to purchase across state lines. And Centerbridge Partners’ acquisition of Civitas Solutions finally closed at $17.75/share.

Earnings Corner:

Addus Home Care’s stock took a hit after reporting a same-store revenue increase of 2.4% for the fourth quarter, below our target range of 3% to 5%. Surgery Partners didn’t fare so well, either. Neither did Acadia Healthcare, but they “didn’t rule out” getting taken private (bought out), so they’re doing fine. Also, I didn’t have time to read U.S. Physical Therapy’s report, so someone let me know how they did.

American Renal Associates took a hit when they delayed their 4th quarter earnings due to an SEC investigation over revenue recognition

Sutter Health posted a bad loss in 2018 due to poor investment results (like most of the other nonprofits this year)

Indiana University Health said earnings from operations rose 4 percent last year, but total earnings fell 70 percent due to investment losses.

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