PHARMACY

CMS reports slowed health spending growth

BY David Salazar

The Centers for Medicare and Medicaid Services have released new data from 2016 showing that upward trajectory of U.S. healthcare spending has slowed. The agency, in a report published in the January 2018 issue of Health Affairs that 2016 saw spending increase to 17.9% of U.S. gross domestic product. But that it only grew at a rate of 4.3% — down from the 5.1% and 5.8% spending growth rates seen in 2014 and 2015, respectively.

The rate of spending growth for 2016 is more in-line with the average of 4.2% growth seen between 2008 and 2015. CMS attributes the slowdown to a wider slowdown in spending growth for retail prescription drugs, hospital care and physician and clinical services. It also noted that private insurers, Medicare and Medicaid all saw spending slowed due to lower growth rates per enrollee. On a per-capita basis, spending grew at 3.5%, reaching $10,348 last year.

Private insurer spend increased 5.1% to $1.1 trillion in 2016 (roughly 33% of all health expenditures), which is a slowdown from the 6.9% growth seen in 2015. CMS said that a downturn in enrollment growth, as well as lower retail prescription drug spending. Medicare spending grew 3.6% to $671.2 billion in 2016, compared with 4.8% in 2015, while reporting stable enrollment growth. Per-enrollee spending also increased at a slower rate than 2015 — 0.8% compared with 2.1%. Medicaid spending hit $565.5 billion last year, making up 17% of all national health expenditures. Medicaid spend grew 3.9%, compared with 9.5% in 2015 and 11.5% in 2014. CMS attributed the spikes in past years to the initial impact of the Affordable Care Act’s expanded Medicaid eligibility and an increase in enrollment.

Retail prescription spending increased 1.3% in 2016, growing to $328.6 billion — roughly 10% of overall health spending. The growth is markedly lower than the 12.4% seen in 2014 and 8.9% in 2015, which CMS said was due to an influx of hepatitis C treatments on the market. The share of spending made up of retail prescription drug is similar to what it was in 2009, CMS said.

Among goods and services, retail prescription drugs saw the lowest growth rate, with physician and clinical services, which make up 20% of overall health spend, up 5.4% and hospital spending up 4.7%, making it 32% of all healthcare spending.

“Over the last decade, the US has experienced unique events that have affected the health care sector, including the most severe economic recession since the Great Depression, major changes to the health care system because of the ACA, and historic lows in medical price inflation,” said Micah Hartman, a statistician in the Office of the Actuary at CMS and lead author of the Health Affairs article. “In 2016, the slowdown in health care spending followed significant insurance coverage expansions under the ACA and very strong growth in retail prescription drug spending in 2014 and 2015.”

To read the full report, click here.

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Flu illness tracking season officially kicks off with Walgreens’ latest Flu Index

BY Michael Johnsen

Walgreens on Wednesday launched its first Flu Index for the 2017-18 season. The Flu Index is a weekly report that ranks the top markets and states for flu activity in the U.S., including Puerto Rico.

Brownsville and Beaumont, Texas are among the top markets for flu this week, and Texas and Arkansas top the list of U.S. states with the most flu activity.

“Each flu season is unique and unpredictable, which is why we developed the Flu Index four years ago to help our customers, health officials and local news media stay up-to-date on flu activity in their community,” stated Dorothy Chrzaszcz, director of immunizations at Walgreens. “The Flu Index leverages data from nearly 8,000 locations across the U.S. each week, and can serve as a trusted resource and indicator of activity, reminding people of the importance of flu prevention.”

The flu season last week crossed the seasonal threshold established by the Centers for Disease Control and Prevention as 2.3% of patient visits reported through the U.S. Outpatient Influenza-like Illness Surveillance Network were due to influenza-like illness. This percentage is above the national baseline of 2.2%.

Now in its fourth year, the Walgreens Flu Index is compiled using the drug store chain’s weekly retail prescription data for antiviral medications used to treat influenza across Walgreens and Duane Reade locations nationwide, and Walgreens locations in Puerto Rico. In addition to the top markets and states for activity, the Flu Index also ranks the markets and states experiencing the greatest gains in activity on a week-over-week basis. As flu cases continue to increase across the U.S. just as the holiday travel season approaches, the Flu Index underscores the importance of taking preventive measures, such as receiving a flu shot, to help stay healthy throughout the season.

As of Dec. 2, the top 10 designated marketing areas with flu activity were:

  1. Harlingen-Weslaco-Brownsville-McAllen, Texas;
  2. Beaumont-Port Arthur, Texas;
  3. Tyler-Longview (Lufkin & Nacogdoches), Texas;
  4. Corpus Christi, Texas;
  5. Houston;
  6. Little Rock-Pine Bluff, Ark.;
  7. Waco-Temple-Bryan, Texas;
  8. Dallas-Ft. Worth, Texas;
  9. San Antonio; and
  10. Ft. Smith-Fayetteville-Springdale-Rogers, Ark.

The Index is not intended to illustrate levels or severity of flu activity, but rather, based on this methodology, to show which populations are experiencing the highest incidences of influenza within the U.S. and Puerto Rico each week.

Data for the Walgreens Flu Index is analyzed at state and geographic market levels to measure absolute impact and incremental change of antiviral medications on a per store average basis, and does not include markets in which Walgreens has fewer than 10 retail locations.
 

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GSK’s Shingrix proven effective in immune-compromised patient populations

BY Michael Johnsen

GlaxoSmithKline on Wednesday announced that new data from a Phase III clinical study supports the safety and efficacy of Shingrix ((Zoster Vaccine Recombinant, Adjuvanted) in preventing shingles (herpes zoster) when given to adults 18 years and above shortly after undergoing autologous haematopoietic stem cell transplant (auHSCT).

“The immune systems of these stem cell transplant recipients is substantially weakened compared to the general older adult populations studied in other Shingrix efficacy trials,” Emmanuel Hanon, senior vice president and head of vaccines R&D for GSK said. “This puts them at much higher risk for viral diseases like shingles and, at the same time, makes developing an effective vaccine to help protect them more challenging. Today’s results, demonstrating the vaccine’s ability to help prevent shingles and its complications with just two doses, may provide a much-needed benefit to these patients considering the high incidence and burden of disease they face.”

GSK is evaluating these results together with those of other Phase III studies in immune-compromised patient populations. All these data will be shared and discussed with regulatory as well as public health agencies with the objective of best informing health care providers on the use of Shingrix in those patients with greatest medical need.

Shingrix is a non-live, recombinant adjuvanted subunit vaccine given intramuscularly in two doses and is the first shingles vaccine to combine a non-live antigen, to trigger a targeted immune response, with a specifically designed adjuvant to generate a strong and sustained immune response.

Shingrix is now approved in Canada and U.S. for the prevention of herpes zoster in adults aged 50 years and above. Regulatory reviews are currently underway in the European Union, Australia and Japan.

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