This Week in Managed Care: March 5, 2021

President Biden updates production timeline for nationwide vaccine availability, Managed Care Cast discusses efforts by the National Quality Forum to measure telehealth quality and value, and FDA approves first treatment for rare genetic metabolic pediatric disorder.

Welcome to This Week in Managed Care, I’m Matthew Gavidia.

Vaccines Widely Available by May; Merck to Produce J&J Vaccine

This week, President Joe Biden announced that the United States will produce enough vaccines for every American adult by the end of May—up from his previous aim of July—and will prioritize vaccinating school staff over the next month.

The adjusted timeline comes as a new partnership between competitors Merck and Johnson & Johnson was formed in an effort to produce more doses of the company’s approved COVID-19 vaccine.

With the first 3.9 million doses of the J&J vaccine distributed to state and local governments this week, the Biden administration plans to invoke the Defense Production Act to increase supply of the vaccine and is calling on states to ensure every grade-school employee and childcare provider receives at least 1 dose of a vaccine by April.

In other COVID-19–related news, Texas became the biggest state to lift its mask mandate, despite warnings from health officials that a fourth wave may occur due to virus mutations circulating the country.

Governor Greg Abbott also lifted restrictions on the number of diners allowed to be served indoors, and he was joined by the governors of Michigan, Mississippi, and Louisiana who eased occupation limits on bars, restaurants, and other businesses.

Although cases have dropped over 70% in the past 2 months, curves of deaths and new cases have leveled off in the last several days and have even begun to rise slightly. Currently, there are 2000 deaths and 68,000 confirmed cases of COVID-19 on average each day in the United States.

For more on Biden’s vaccine announcement and Merck’s J&J production, visit AJMC.com.

How the National Quality Forum Plans to Measure Telehealth Quality, Value

As the COVID-19 pandemic has led to a nationwide boom in telehealth use, new questions are emerging regarding reimbursement, accessibility, data protection, and quality measurement.

With no current nationally endorsed telehealth quality measures, the National Quality Forum, or NQF, recently announced a committee of 25 individuals to discuss, update, and enhance the NQF’s telehealth framework that was first released in 2017.

For the past 20 years, the forum has worked to advance health care quality across the nation by endorsing measures that assess quality of care and value.

On this episode of Managed Care Cast, we speak with Sheri Winsper, RN, MSN, MHA, senior vice president for quality measurement at the NQF, to discuss how the forum plans to devise a measurement framework linking quality of care delivered by telehealth, health care system readiness, and health outcomes specifically in rural areas.

For the podcast, visit AJMC.com.

FDA Approves First Treatment for Rare Genetic Metabolic Pediatric Disorder

Last week, the FDA approved fosdenopterin, sold as Nulibry, an injection for the treatment of molybdenum cofactor deficiency, or MoCD, type A, marking the first therapy for the ultrarare genetic metabolic disorder in infants.

A progressive disease, MoCD type A affects fewer than 150 patients across the globe. Presenting 2 to 3 days after birth, often with intractable seizures, children with the condition typically do not live past the age of 4.

The approval follows efficacy established in 13 patients administered fosdenopterin, compared with 18 matched untreated patients. The therapy was linked with a survival rate of 84% at 3 years compared with 55% among those untreated.

Granted to BridgeBio Pharma and its affiliate, Origin Biosciences, the FDA reviewed the injection under its Priority Review program, with the therapy having received Orphan Drug, Breakthrough Therapy, and Rare Pediatric Disease designations.

The companies said that treatment with fosdenopterin in 3 studies was also associated with a marked reduction in urine concentrations of S-sulfocysteine, or SSC, a toxic substance that is associated with neurological damage in patients with MoCD Type A. The studies show that the reduction in SSC was sustained over 48 months with long-term use of fosdenopterin.

For more, visit AJMC.com.

Caring for the Whole Patient With Diabetes Drives ChristianaCare Pilot Success

An innovative pilot program instituted by ChristianaCare in 2019 at 4 of its primary care sites grew its population of patients with well-controlled diabetes by 16%.

Targeting patients with poorly controlled diabetes, the pilot program combined primary and supportive specialty care from an endocrinologist and behavioral health counselor, along with deploying a registry of patients with diabetes.

With the original goal set at a 10% increase in its population of patients with well-controlled diabetes, the program surpassed expectations to reach 16% while also exhibiting reductions in patients with glycated hemoglobin, or A1C, above 9% and those who were overdue for A1C testing, from 20% to 9%.

Adhering to a diabetes control roadmap that ensured patients’ physical and emotional health needs were met, the guidance consisted of 5 major steps:

• knowing who were their diabetic patients
• monitoring patients’ A1C
• titrating medications as needed
• assessing barriers to diabetes control
• addressing those barriers

Following the program’s success, ChristianaCare set a new target to have 80% of patients with well-controlled diabetes, with program leaders hoping to expand to more primary care sites, double the practices that have an endocrinology partner, and deploy wellness and chronic condition registries to all primary care practices.

“I think our journey with diabetes and optimizing diabetes care continues indefinitely,” said Marina V. Zeltser, MD, MBA, assistant chief medical information officer for population health, director of population health analytics, and a primary care physician at ChristianaCare, in an interview with The American Journal of Managed Care^®. “We’re curious and continue to look for ways to innovate. We need to innovate.”

For more, visit AJMC.com.

For all of us at AJMC^®, I’m Matthew Gavidia. Thanks for joining us!