Category: Uncategorized

PHARMA: Health Business Blog interviews Genentech about Avastin

Nov 2, 2007• 5

This is a pretty good example of a smart consultant using his blog to explain something complex. David Williams at the Health Business Blog got an on the record interview from Genentech about Avastin and Lucentis. If you know the background story skip this and go to the Interview with Genentech about Avastin distribution changes.

If you haven’t been following at home here’s a quick synopsis (and I’m in a rush and doing this from memory so I hope I get it right—please comment if you know more!).

POLICY: And a little more from Health Affairs

Nov 2, 2007

My favorite parts of the magazine are the book reviews and the letters. One book, the reviewer loves; another (with a different reviewer) not so much. Cue letters, is my guess. (Inside joke. I’m sorry)

Meanwhile, it’s about time Health Affairs made its charts a) more easily understandable, and b) ready for online publication. (This editions are not even readable in some cases). We’ve learned something about communication of complex data in the last 25 years and it’s about time the magazine that is the bible of health policy caught up.

THCB Classifieds

Nov 2, 2007

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POLICY: State-sponsored terrorism, courtesy of the DEA

Nov 1, 2007• 1

This from a May 2001 discussion article in The Guardian about the new definition the Bush Administration introduced

Using the definition preferred by the state department, terrorism is: "Premeditated, politically motivated violence perpetrated against noncombatant* targets by subnational groups or clandestine agents, usually intended to influence an audience."

<SNIP>

The key point about terrorism, on which almost everyone agrees, is that it’s politically motivated.

Despite Californians voting for Prop 215 in 1996 and in every survey since clearly being in favor of medical marijuana, this is how the DEA treats those running dispensaries. It violently raids their homes with massive firepower, takes their money, assets and possessions, and destroys their families by taking away their children. And of course this is designed—for purely political purposes—to send a message to anyone wishing to protest the Federal government’s insane policies, or trying to help patients. Both of which are legal under state law.

If that’s not terrorism under the Administration’s definition, then I don’t know what is. When we get a change of Administration the DEA needs to be abolished. And we need, at the least, a Truth and Reconciliation Commission where those involved in its policies and actions can confess their sins. I have no idea how these people sleep at night.

BLOGS: HWR-The Anti-Halloween Edition

Nov 1, 2007• 1

Joe Paduda calls this the best HWR ever. He might well be right—Hank Stern has done an incredible job doing an anti-Halloween edition of “it happened this day” and somehow making every entry relevant and funny.

Rush over to InsureBlog: HWR: The Anti-Halloween Edition.

Meanwhile, if you’re a subscriber, Health Affairs 25th Anniversary edition is a treat.

POLICY: Vic Fuchs speak–You listen

Oct 31, 2007• 1

Just one article in a wonderful 25th Anniversary perspective for Health Affairs.

From the greatest health economist of them all, What Are The Prospects For Enduring Comprehensive Health Care Reform?.

POLICY: David Gratzer, source of Rudy misinformation

Oct 31, 2007• 10

My, my. We can’t exactly be surprised that Rudy Giuliani is on the one hand telling yet more porky pies and on the other hand not contributing to the debate in health care—other than shouting “socialized medicine” as loudly as he can.

It’s interesting to note that Giuliani who’s playing a moderate has surrounded himself with some of the most extreme wingnuts in health care, including Sally Pipes and David Gratzer. (Full disclosure, I think David is a very nice guy, but I think he massively misrepresents the facts in his book—as we discussed when I interviewed him. Also Rudy does have Mark McClellan on the list, who’s not an extremist.)

But I can’t understand how Giuliani can possibly believe that surrounding himself with people who think that Medicare is evil socialized medicine (after all it’s single payer for seniors) is going to help him. After all Rudy will need all the moderate votes he can get if he’s around come November 2008.

But according to the Giuliani campaign Gratzer is “an expert at a highly respected think tank”. And Gratzer has the chutzpah to say that Commonwealth is biased! As if Manhattan has no views, and no opinions.

And of course the tosh about cancer survival rates has long been revealed to be crap by John Cohn & Ezra Klein based on Gerald Anderson’s work—differences in survival rats are all based on early screening and doesn’t show up in overall death rates. In other words there’s have a different denominator.

It is amusing that the Brits are now saying that their prostate survival rate is 74% not what Commonwealth reported a while back. But as I’ve explained at nauseum it’s all about picking your disease. If you want to pick a bunch of others, we do much much worse. And of course we’re paying way, way more.

But the real point is not that Giuliani is misrepresenting the cancer rates.

BLOGS: Grand Rounds is up at Running A Hospital

Oct 30, 2007

Everyone’s favorite blogging hospital CEO Paul Levy hosts Grand Rounds at Running a hospital

HEALTH PLANS: Trading health plan stock rumors for fun & profit

Oct 30, 2007• 3

Just when you thought stock action in health plans was all dull, along comes a little fun. Wellcare’s chart of course looks about as good as the average stock chart when the Feds raid. Whatever the company says, Wall Street believes it’s bad news. $120 to $25 in 5 days is Enron-type numbers, and one rumor is that some directors were selling not a couple of months back, but a couple of weeks.

Wellcare

But the fun continues. Humana is the “big” health plan that’s made the greatest push into Medicare Private FFS where most of the abuses have occurred and it’s also huge in Florida. (I don’t have to explain that statement I hope). That was enough for one analyst to say on Friday that they heard the sound of FBI sirens too, and the stock fell about 5% in a few minutes, before recovering when it was confirmed that the sirens were in his head. (OK, maybe the FBI doesn’t use sirens!)

Humana

But then Humana released some great financial results on Monday and the stock rallied on the opening up 5% from where it had been, but then ended up falling more than 10% on the day. Why? Well perhaps its because when some smart types look at the numbers they notice that the MLR fell from 84% to 81% in a year. So first, what happened that there was such a big fall? And second, if most of this increased profit comes from the Medicare business, why would the end-payer (you and me represented by Pete Stark et al) put up with it?

This of course makes Humana a fun stock for the swing traders on the message boards. But I’m not so sure it makes for great public policy.

Patients: Coordinated Physician Care Pilots – Paul Grundy MD, IBM

Oct 30, 2007• 5

Dr. Paul Grundy helped organize
the Patient-Centered Primary Care
Collaborative at IBM and serves at its Chair. IBM spends about $1.7 billion a year on
healthcare for its employees and families, providing coverage for half a million people. The company is working to improve their
healthcare quality, while lowering costs through wellness programs, but believes that more could be accomplished if a critical mass of key
healthcare participants work together to drive even more significant change. Executives believe the Patient-Centered Primary Care Collaborative is a major step towards that goal.