Midweek Update

From the Omicron and siblings front —

The Centers for Disease Control’s Advisory Committee on Immunization Practice meets Thursday to vote on recommending the Moderna Covid vaccine for younger folks aged 6 through 17. This drug would be an alternative Pfizer’s Covid vaccine for that age group. Assuming the ACIP votes in favor of the Moderna vaccine, then CDC Director must approve their recommendation for the health plan coverage with no cost-sharing mandate to kick in.

Medical Economics informs us

Electronic messages and postcards with primary care physicians’ (PCP) names got Black and Latino patients in the door for their COVID-19 vaccines.

Although the effects were “relatively modest,” if applied on a larger scale, an additional 238,000 Black and Latino older adults may have been vaccinated across the United States, according to a new study.

Kaiser Permanente Northern California’s Division of Research examined the effectiveness of standard and culturally tailored electronic messages and mailings from patients’ own PCPs encouraging COVID-19 vaccines from March 29 to May 20, 2021. The results were published in an original investigation, “Effect of Electronic and Mail Outreach from Primary Care Physicians for COVID-19 Vaccination of Black and Latino Older Adults: A Randomized Clinical Trial,” in the journal JAMA Network Open.

The study involved 8,287 patients aged 65 years and older, around the California Central Valley, Fresno, South Sacramento and San Jose, divided into three groups.

This study again illustrates the value of health plans teaming with primary care providers.

From the nicotine front, the Wall Street Journal devined from the federal government’s Spring 2022 regulatory agenda, posted Tuesday, that

The Biden administration is moving forward on a plan to mandate the elimination of nearly all nicotine in cigarettes, a policy that would upend the $95 billion U.S. cigarette industry and, health officials say, prompt millions of people to quit smoking.

The plan, unveiled Tuesday as part of the administration’s agenda of regulatory actions, likely wouldn’t take effect for several years. The Food and Drug Administration plans to publish a proposed rule in May 2023, though the agency cautioned that date could change. Then the agency would invite public comments before publishing a final rule. Tobacco companies could then sue, which could further delay the policy’s implementation.

Also the Journal reports

The Food and Drug Administration is preparing to order Juul Labs Inc. to take its e-cigarettes off the U.S. market, according to people familiar with the matter.

The FDA could announce its decision as early as this week, the people said. The marketing denial order would follow a nearly two-year review of data presented by the vaping company, which sought authorization for its tobacco- and menthol-flavored products to stay on the U.S. market.

Uncertainty has clouded Juul since it landed in the FDA’s sights four years ago, when its fruity flavors and hip marketing were blamed for fueling a surge of underage vaping. The company since then has been trying to regain the trust of regulators and the public. It limited its marketing and in 2019 stopped selling sweet and fruity flavors.

The company’s legal actions likely are in development now.

From the Rx coverage front —

Fierce Healthcare calls to our attention expert opinions rendered on better controlling prescription drug costs at an AHIP conference. The experts agreed that all of the stakeholders need to be at the negotiating table.

Scott Gottlieb, M.D., former Food and Drug Administration commissioner, on a panel at AHIP’s 2022 conference * * * said the challenge for regulators looking to address drug prices is the fact that a one-size-fits-all solution will not work in this market. He said instead that policymakers should consider pharmaceuticals in three buckets: drugs that are in an active market with significant rebate activity; drugs that currently monopolize the market but will lose that monopoly in the near future; and drugs that are likely to monopolize a market in the long term.

“I think we need to think about the market as those three segments and think about different policy solutions for each of them,” [and attention should be focused on the third category] Gottlieb said.

The FEHBlog agrees with the experts about the importance of engaging all of the stakeholders. There are no bad guys here at least in the FEHBlog’s view.

From the preventive services front, Medscape reports

There is not enough evidence to recommend for or against taking most vitamin and mineral supplements to prevent heart disease, stroke, and cancer, a new report by the United States Preventive Services Task Force (USPSTF) concludes.

However, there are two vitamins — vitamin E and beta-carotene — that the task force recommends against for the prevention of heart disease, stroke, and cancer. Evidence shows that there is no benefit to taking vitamin E and that beta-carotene can increase the risk for lung cancer in people already at risk, such as smokers and those with occupational exposure to asbestos, it notes.

These are the main findings of the USPSTF’s final recommendation statement on vitamin, mineral, and multivitamin supplementation to prevent cardiovascular disease and cancer.

The statement is published in the June 21 issue of JAMA, along with an evidence reporteditorial, and patient page.

Medscape adds that this USPSTF decision aligns with a 2014 recommendation on the same topic.

From the lab test coverage front, Fierce Healthcare reports

Optum is launching a new health plan solution that aims to reduce unnecessary testing and ensure that patients are receiving the screenings that are best for them.

The laboratory benefit management tool will assist insurers in aligning lab tests with clinical guidance and will automate large parts of lab benefit administration, Optum said in an announcement provided first to Fierce Healthcare.

The company estimates that insurers could save between $12 to $36 per member per year, or about $3 billion.

Tests that lack clinical indications can lead to unneeded sample collection form patients as well as a higher risk of false positive results, which can compound unnecessary healthcare costs. There is a dearth of industry standards and efficacy data around lab tests, making it common for results to be misinterpreted or tests to be misused.

Fierce Healthcare adds that Optum is selling this tool to all health plans.

From the U.S. healthcare front, U.S. News and World Report offers 2022 rankings on the healthiest counties in the U.S. The FEHBlog recently moved from Montgomery County Maryland to Hays County Texas. Both counties score about 55 out of 100 in the rankings.