This Week in Managed Care: December 6, 2019

HHS launches a plan to reduce HIV infections, high rates of teens and young adults have prediabetes, and a tech outage hits a popular CGM system.

Welcome to This Week in Managed Care, I’m Laura Joszt.

HHS Launches Initiative to Increase PrEP Access

HHS Secretary Alex Azar this week announced the launch of a plan to bring free doses of pre-exposure prophylaxis, or PrEP, to large numbers of at-risk groups, with the goal of sharply reducing the number of new HIV infections.

Called Ready, Set, PrEP, the program is part of the Trump administration’s initiative, Ending the HIV Epidemic: A Plan for America, which was announced in the 2019 State of the Union Address.

Said Azar, “Ready, Set, PrEP is a historic expansion of access to HIV prevention medication and a major step forward in President Trump’s plan to end the HIV epidemic in America. Thanks to Ready, Set, PrEP, thousands of Americans who are at risk for HIV will now be able to protect themselves and their communities.”

The plan seeks to reduce new HIV infections by 90% through 2030 through collaboration across multiple federal agencies, including CDC, the Health Resources and Services Administration, Indian Health Service, and National Institutes of Health. The program will start in known hotspots before expanding nationwide.

Read more.

Prediabetes Seen in 20% of Adolescents, 25% of Young Adults

A quarter of young adults under age 35 and 20% of adolescents have developed prediabetes, according to a new study that warns rising numbers of young Americans are at risk of type 2 diabetes and cardiovascular disease.

The study in the journal JAMA Pediatrics reports on a decades’ worth of data from the National Health and Nutrition Examination Survey, which showed that the prevalence of prediabetes was higher in males and those with obesity.

Researchers from the CDC found the following:

• Prevalence of prediabetes among those aged 12 to 18 was 18%
• Prevalence of prediabetes among those aged 19 to 34 was 24%

The authors wrote: “The finding that a large proportion of adolescents and young adults with obesity already present glucose metabolism abnormalities is of great public health concern given the sharp increase in type 2 diabetes in adolescence.”

The authors write that adults have been able to delay type 2 diabetes with lifestyle interventions such as the National Diabetes Prevention Program but that these strategies have not been widely studied in adolescents.

Read more.

Dexcom Outage Makes Blood Glucose Data Unavailable

A server outage over Thanksgiving weekend shut down a key feature of the Dexcom continuous glucose monitoring system, which allows parents and caregivers to receive alerts of dangerous shifts in blood sugar levels.

The Dexcom Follow service went dark for most users sometime Friday evening and was not fully restored until Monday. Parents on social media expressed outrage at the lack of notification on the initial disruption, saying their children could have been at risk. Some were unaware of a problem until they checked the app on Saturday morning.

Dexcom has attributed the issue to overloaded servers and said because it had not released any updates, it made finding the cause difficult.

The company issued a statement that said: “This is an unfortunate but isolated event for Dexcom. It has revealed some areas for improvement, both with our system and in how we communicate with our users. Once we have fully solved the issue and understand the root cause, we will follow our standard assessment procedure to learn from what happened and help prevent issues like this from happening again.”

Read more here.

Michigan Governor Seeks to Delay Medicaid Work Requirements

Michigan’s governor has called for a pause in the state’s impending Medicaid work requirements, which are set to take effect January 1st.

Governor Gretchen Whitmer asked Republican legislators in her state for the delay while a lawsuit challenging the work rules makes it way through the courts. She said GOP-led states such as Indiana and Arizona have halted similar rules while they await court decisions.

Said Whitmer: “To expend all this money to take healthcare away from people and then find out that you were not doing it lawfully is incredibly wasteful and that’s why I’ve asked the legislature to put a pause on the work requirement implementation.”

Republican legislative leaders in Michigan said they have no plans to enact a delay, however.

Read more.

American Society of Hematology Meeting Coverage

Finally, this weekend brings the 61st American Society of Hematology Annual Meeting and Exposition, which takes place in Orlando, Florida.

AJMC^® will bring you full coverage of the meeting, including:

• The latest news on CAR T-cell treatments
• Phase 2 results from the CAPTIVATE study, evaluating ibrutinib with venetoclax in chronic lymphocytic leukemia
• Full results from the CANDOR phase 3 study comparing daratumumab in combination with carfilzomib and dexamethasone, compared with carfilzomib and dexamethasone alone.

Read full coverage from ASH here.

For all of us from AJMC^®, I’m Laura Joszt. Thanks for joining us.