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Orphan Diseases Or Population Health? Policy Choices Drive Venture Capital Investments
The US exhibits a remarkable pipeline of biopharmaceutical innovation, with 170 new drugs and biologics launched into the market between 2011 and 2015 and another 22 drugs approved in 2016. A striking feature of the pharmaceutical pipeline is the large percentage launched for the treatment of small “orphan” indications, defined by the Food and Drug Administration (FDA) as including fewer than, often many fewer than, 200,000 patients in the United States. Almost half (74) of the products approved by the FDA between 2011 and 2015 were for orphan indications, twice the number (36) approved during the same period by the Eu...
Source: Health Affairs Blog - July 21, 2017 Category: Health Management Authors: Dayton Misfeldt and James C. Robinson Tags: Costs and Spending Drugs and Medical Innovation Orphan Drug Act orphan drugs venture capitalism Source Type: blogs

Eliminating The Medicaid Expansion May Cause More Damage Than Congress Realizes
The American Health Care Act (AHCA) and the Senate’s ill-fated Better Care Reconciliation Act (BCRA) attempted to deliver on two promises: 1) protecting patients with preexisting conditions, and 2) eliminating the Medicaid expansion. Though repeal efforts seem to have stalled for the time being, future GOP attempts to replace the ACA will undoubtedly involve the delicate task of appeasing conservative party members while maintaining provisions of the ACA that remain immensely popular with voters. While others have already discussed the failings of the proposed legislation with respect to the Medicaid expansion and preexi...
Source: Health Affairs Blog - July 20, 2017 Category: Health Management Authors: Justin Puckett and Jalpa Doshi Tags: Featured Following the ACA Medicaid and CHIP HIV/AIDS medicaid expansion states Source Type: blogs

Healthcare ’ s Hundred Years ’ War
By JOHN IRVINE Is Trumpcare Dead? Was it ever really alive? Senators Mike Lee and Jerry Moran said yesterday that they would not vote for the Better Care Reconciliation Act, effectively killing the legislation.  As anybody who has been following this story would have predicted, President Trump reacted publicly on Twitter on Tuesday morning, vowing to let the ACA marketplace collapse and then rewrite the plan later. Senate Majority leader Mitch McConnell attempted a quick punt this morning, calling for an immediate Senate vote on the House bill, a trick card that if it worked, would give Republicans two years to work thin...
Source: The Health Care Blog - July 18, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACA Exchanges John Irvine McConnell Obamacare Trumpcare Source Type: blogs

Is Trumpcare Dead? Was It Ever Really Alive?
By JOHN IRVINE Senators Mike Lee and Jerry Moran said yesterday that they would not vote for the Better Care Reconciliation Act, effectively killing the legislation.  As anybody who has been following this story would have predicted, President Trump reacted publicly on Twitter on Tuesday morning, vowing to let the ACA marketplace collapse and then rewrite the plan later. Senate Majority leader Mitch McConnell attempted a quick punt this morning, calling for an immediate Senate vote on the House bill, a trick card that if it worked, would give Republicans two years to work things out. Unfortunately for McConnell, it probab...
Source: The Health Care Blog - July 18, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized ACA Exchanges John Irvine McConnell Obamacare Trumpcare Source Type: blogs

Unsustainable Costs of Library Resources
Sometimes I feel like medical librarians have been talking to brick walls.  Either that, or we are talking to bobble heads who don’t really listen to us but nod their heads in agreement. I get a weekly email summarizing the healthcare industry.  It is broken into local and national information and it is often an interesting quick read.  Today I read the article “US medical expenditures on the rise, except for primary and home health.” The largest expenditures were attributed to prescribed medications, specialty physicians, visits to the emergency department and inpatient hospitalizations.  While that ...
Source: The Krafty Librarian - July 18, 2017 Category: Databases & Libraries Authors: KraftyLibrarian Tags: Uncategorized Source Type: blogs

Choice: The Hidden Curriculum in Palliative Care
By Paul CarrThank you to Dr. Naheed Dosani and the excellent team at William Osler Health Centre for inspiring this post.What three words describe the essence of palliative care for you? When I asked my friends, family, and colleagues, the most common answers are: pain management, personal and spiritual support, and end of life planning. Those are all key components. But what quickly became apparent to me during my palliative care elective is that excellent palliative care providers embrace the role of enabling patients and families to make well-informed choices.I have taken a long and untraditional route to arrive in the ...
Source: Pallimed: A Hospice and Palliative Medicine Blog - July 17, 2017 Category: Palliative Care Tags: choice communication goals palliative paul carr Source Type: blogs

Another ' Oops, We Forgot To Tell You This '
Another little bitty oopsie. Many women after a mastectomy for breast cancer get implants to make them more even again. Then there are the hundreds of thousands of women who seek implants to enhance their bodies. And then comes the oopsie.There isa rare cancer which is caused by implants." The American Society of Plastic Surgeons says around 550,000 women last year received breast implants, but the FDA published a report this year linking a rare cancer to the implants.So far, there have been 359 reported cases globally,including nine deaths.The risk is low, but one in 30,000 women with implants could develop it,... "Nice! ...
Source: Caroline's Breast Cancer Blog - July 14, 2017 Category: Cancer & Oncology Tags: breast cancer treatment cancer risk side effects Source Type: blogs

Have Employer Coverage? GOP Proposals Will Affect You Too (Part 2)
As Senate Republican leaders continue to craft their bill to repeal and replace the Affordable Care Act (ACA), most attention has been focused on the number of individuals who would lose coverage if the legislation is enacted. To be sure, the ACA coverage expansions—through Medicaid and subsidized Marketplace plans—have been a lifeline for millions of people, particularly those who are low income, and have reduced the number of individuals without coverage to record lows. But the legislation that passed the House and the bill now under consideration in the Senate could also affect the more than 150 million peop...
Source: Health Affairs Blog - July 6, 2017 Category: Health Management Authors: JoAnn Volk and Sabrina Corlette Tags: Following the ACA Insurance and Coverage ACA repeal and replace employer-sponsored coverage Employer-Sponsored Insurance Essential Health Benefits Source Type: blogs

Patient Access to Medical Services Varies by Individual Physician ’ s Will to Fight Insurance Companies
American healthcare reform debates are focused on strategies to provide “access” to medical services for all. Lack of insurance (or under-insurance) seems to be the primary focus, as it is falsely assumed that coverage provides access. Unfortunately, the situation is far more complicated. Once a person has health insurance, there is no guarantee that they will receive the medical services that they need. Not because their plan is insufficiently robust, but because the roadblocks for approval of services (provided in the plans) are so onerous that those providing the service often give up before they receive i...
Source: Better Health - July 3, 2017 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Administrative Burden Coverage Is Not Care Health Insurance Roadblocks Pre-Authorization Underinsured Source Type: blogs

Amended Senate Bill Includes Waiting Period for Those Who Let Coverage Lapse
On June 26, 2017, the Republican Leadership released an amended version of the Senate Better Care Reconciliation Act.  It is very similar to the version they released on June 22, but includes two changes. First, it amends a couple of provisions of the stability and innovation funds section to allow both short and long-term funds to be used to purchase health insurance benefits.  This was apparently done to align the program more closely with the CHIP program.  The stability and innovation fund is being created through the CHIP program, reportedly so as to incorporate CHIP’s abortion funding restrictions. Second, it ma...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: Timothy Jost Tags: Featured Following the ACA Insurance and Coverage ACA repeal and replace coverage gap waiting period Source Type: blogs

Sounding The Alarms On Children ’s Health Coverage
We reported on this trend in a recent Health Affairs article, in which we found that in 2013, nearly one-third of children in low-income working families above the poverty line got their health coverage through Medicaid or CHIP, up 8 percent from just six years earlier. Today, more than 40 percent of children and adolescents in this country are now covered by Medicaid and CHIP, second only to employer-sponsored insurance. As a result, children are disproportionately vulnerable to health care reforms that cut public programs. In making any changes, caution is needed, as is an awareness of the many factors leading to familie...
Source: Health Affairs Blog - June 26, 2017 Category: Health Management Authors: David Rubin Tags: Following the ACA Medicaid and CHIP Public Health Quality ACA repeal and replace AHCA Source Type: blogs

ACA Round-Up: QHP Application Deadline Passes, House v. Price, Special Enrollment Periods
June 21, 2017, was the last day for insurers to file qualified health plan applications in the 39 states that use HealthCare.gov, including federally facilitated marketplace (FFM), plan management, and state-based marketplace-federal platform states. There were reportedly a few additional defections, including Anthem from Wisconsin and Indiana, but most insurers are back from last year, and a there are a few new entrants, notably Centene in several states. According to slides posted at the CMS REGTAP.info website, insurers may make any changes they wish to their plan filings until August 16, 2017, except for adding plans...
Source: Health Affairs Blog - June 25, 2017 Category: Health Management Authors: Timothy Jost Tags: Following the ACA Insurance and Coverage house v. price special enrollment periods Source Type: blogs

Will Senate Republicans Get 50 Votes to Repeal the ACA?
By DAVID INTROCASO THCB readers are well aware this coming week Senate Republicans plan to begin debate on passing their amended version of the House-passed American Health Care Act (AHCA), titled the Better Care Reconciliation Act.   As of today, June 23rd, immediate reactions by Republican senators to the June 22nd released discussion draft have been limited largely because members immediately left town after the draft’s release. The Congressional Budget Office’s (CBO’s) score, that will again be influential, is expected this Monday or Tuesday. Senate debate on the legislation will likely begin next W...
Source: The Health Care Blog - June 24, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized AHCA CBO David Introcaso Repeal Replace Senate Republicans Source Type: blogs

Trial by Error, Continued: Is PACE a Case of Research Misconduct?
by David Tuller, DrPH I have tip-toed around the question of research misconduct since I started my PACE investigation. In my long Virology Blog series in October 2015, I decided to document the trial’s extensive list of flaws—or as many as I could fit into 15,000 words, which wasn’t all of them—without arguing that this constituted research misconduct. My goal was simply to make the strongest possible case that this was very bad science and that the evidence did not support the claims that cognitive behavior therapy and graded exercise therapy were effective treatments for the illness. Since then, I have referred ...
Source: virology blog - June 24, 2017 Category: Virology Authors: David Tuller Tags: Commentary Source Type: blogs