This Week in Managed Care: December 13, 2019

This week, the top managed care stories included the White House seeking a truce between CMS Administrator Seema Verma and HHS Secretary Alex Azar; Sanofi will shift its focus from diabetes to cancer drugs; results highlight real-world evidence of chimeric antigen receptor T-cell therapies.

The White House seeks a truce between the nation’s top healthcare leaders, Sanofi shifts its focus from diabetes to cancer drugs, and a sleep disturbances are blamed for burnout in police work.

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

CMS, HHS Heads at Odds

The acrimony between CMS Administrator Seema Verma and HHS Secretary Alex Azar took a turn this week as they were scheduled to meet with White House acting chief of staff Mick Mulvaney to settle their differences, which have spilled into the media.

Congressman Joseph Kennedy of Massachusetts called on Verma to resign after reports that she wanted taxpayers to reimburse her for $47,000 in stolen clothing and jewelry lost last year when was making a speech in California. She was only reimbursed about $2800. Verma also made news for spending thousands on consultants to boost her profile.

HHS released the following statement: “It’s perfectly appropriate that the administrator filed a personal property loss claim for goods stolen while on work travel, and this is not an unusual practice for federal employees.”

Azar and Verma have feuded over who will take the lead on key administrative priorities. Azar, the former head of Eli Lilly, has been on the outs after President Trump rejected his plan to eliminate drug rebates.

Sanofi to End R&D on Diabetes, Cardiovascular Drugs

The pharmaceutical leader Sanofi, one of the world’s three largest insulin manufacturers, announced it is shifting away from diabetes and cardiovascular research to focus on cancer drugs.

CEO Paul Hudson made the announcement Monday in a media call. He said, “We as a company have probably done more than almost any other companies combined, to innovate and to transform lives in diabetes and cardiovascular. Now we need to be efficient and move our resources to areas of opportunity, unmet needs and to grow our pipeline.”

The move comes as Sanofi’s longtime mainstay insulin, Lantus, is under increased pressure from follow-on competition, as Boehringer-Ingelheim’s Basaglar gains market share. Sanofi, however, will still pursue its own biosimilar fast-acting insulin.

Bipartisan attention from Congress to high insulin prices has also forced all new discounting measures directed at patients.

For more, visit our sister site, The Center for Biosimilars^®.

Police Shift Work Associatde With Public Health Concerns

Irregular schedules, night shifts, and lost sleep were all linked to high burnout rates among police officers, according to a new study. Sixty-three percent of officers who completed Maslach Burnout Inventory met the criteria for at least one indicator of burnout, which include emotional exhaustion, depersonalization, and low personal accomplishment.

The study found that emotional exhaustion was tied to greater frequency of working long shifts as well as mandatory overtime. Shift work has been tied to higher rates of diabetes and obesity, and a recent increase in police officer suicides has raised additional public health concerns.

Writing in BMJ Open, the authors concluded: “Although shift work is unavoidable for industries such as law enforcement, optimizing work hours in relation to control over overtime, consistency of schedules and reducing duration and frequency of night and long shifts should be explored as a way to lower the high level of burnout among police, leading to improved health for personnel and enhanced performance for their department and communities whom they serve.”

Real-World CAR T-Cell Results

Results presented at the American Society of Hematology last weekend show that once patients get through the expense and side effects of chimeric antigen receptor (CAR) T-cell therapy, their other healthcare costs can drop.

A study from Avalere Health is the first review of real-world evidence based on Medicare Part A and B claims from the first year that the revolutionary gene therapy was approved.

Said author Karl Kilgore, PhD, “Our findings offer evidence that older patients with multiple comorbidities can be treated successfully with CAR T. While we don’t know the long-term outcomes yet, nearly three-quarters of the patients were still alive 6 months posttreatment.”

Kilgore, however, was clear that this was not a cost-effectiveness study about CAR T-cell treatments, which cost at least $373,000 before administrative costs.