This Week in Managed Care: October 9, 2020

President Trump is discharged from the hospital despite continued COVID-19 treatments, a poll finds Americans trust Joe Biden to lead the US health care system, and scientists who discovered the hepatitis C virus are awarded the Nobel Prize.

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

Trump Discharged From Hospital Despite Continued COVID-19 Treatments

This week, President Donald Trump was discharged from Walter Reed National Military Medical Center after a 3-day stay in which he was treated for symptoms stemming from his COVID-19 infection.

Tweeting that he was “feeling really good” and would leave Walter Reed at 6:30 pm, Monday evening, the president returned to the White House, where he continues to be treated and monitored.

Since his positive test result, the president has received multiple treatments. First, he received a single dose of Regeneron’s investigational monoclonal antibody cocktail, which was given as a “precautionary measure,” according to White House physician Sean Conley, DO, who spoke during a press briefing on Monday. In addition, the president has been treated with remdesivir and dexamethasone since entering Walter Reed.

During the briefing Conley added that it had been 72 hours since the president’s last fever and that all his oxygen levels were normal following reports over the weekend that the president’s oxygen levels had dropped twice.

“Though he may not entirely be out of the woods yet, the team and I agree that all our evaluations, and most importantly his clinical status, support the president’s safe return home, where he’ll be surrounded by world class medical care, 24/7,” Conley said.

In recent days, more than a dozen people close to the Trump administration or his reelection campaign have also tested positive for coronavirus, including First Lady Melania Trump and senior adviser Stephen Miller.

For more, visit ajmc.com.

More Americans Trust Biden to Lead US Health Care System, West Health-Gallup Poll Finds

With millions of people already turning in ballots ahead of the November 3 election, a poll from West Health-Gallup shows that a majority of Americans trust former Vice President Joe Biden to lead the US health care system over President Trump.

In the poll results, 52% of the respondents said they trusted Biden, the Democrat, more, while 39% say they trust Trump, the Republican. The gap grew further among adults aged 18 to 29 as 62% said they trust Biden on health care issues, compared with only 25% who support Trump’s leadership of the health care system. For adults aged 65 and older, Biden’s lead falls to within 2 percentage points.

Biden’s results on the health care question mirror the historically large edge he appears to enjoy in other national polls; however, that lead is not insurmountable, given the challenges of the Electoral College and the uncertainties of an election that will involve more voting by mail than ever.

“Joe Biden has a clear advantage as the candidate Americans prefer to lead healthcare and create a more racially equitable healthcare system in the United States during this global pandemic,” said Dan Witters, Gallup senior researcher. “While some groups were more split, US adults are generally aligned in Biden’s favor by wide margins. It will be interesting to see how this plays out at the ballot box in November.”

For more, visit ajmc.com.

Discovery of Hepatitis C Virus Brings Nobel Prize

This week, 2 Americans and a British scientist were awarded the 2020 Nobel Prize in Physiology or Medicine for discoveries that led to the identification of the hepatitis C virus.

Although hepatitis A and B viruses had been identified, most blood-borne hepatitis cases could not be explained prior to work by:

• Dr Harvey J. Alter, of the National Institutes of Health
• Dr Michael Houghton, a British citizen now of the University of Alberta
• Dr Charles M. Rice, now of Rockefeller University

Discovery of this new virus, “revealed the cause of the remaining cases of chronic hepatitis and made possible blood tests and new medicines that have saved millions of lives,” according to the statement from the Nobel Assembly at the Karolinska Institutet in Stockholm, Sweden.

Among other awards announced this week, 2 female scientists, Dr Jennifer A. Doudna, of the University of California, Berkeley, and Dr Emmanuelle Charpentier, of the Max Planck Institute for Infection Biology, were awarded the Nobel Prize in Chemistry for their discovery of CRISPR gene editing technology.

CRISPR involves removing problematic DNA through the use of RNA as its guide molecule and replacing it, if necessary, with healthy DNA. Diseases that hope to be cured with CRISPR genetic therapies include hemophilia, type 1 diabetes, and Rett syndrome.

A patent dispute is ongoing, however, for CRISPR, between the 2 winners and Dr Feng Zhang, of the Broad Institute, who many believe also deserves credit for his work in this space.

For more, visit ajmc.com.

Study Highlights Persistent Racial Disparities in Insulin Pump Use Among Children With T1D

According to recent study results published in the Journal of Pediatric Nursing, racial disparities in insulin pump use among children with type 1 diabetes have persisted over the past 15 years, independent of socioeconomic status, or SES.

Insulin pumps are widely used to ensure optimal glycemic control in patients with type 1 diabetes and, when used correctly, can significantly reduce the incidence of disease complications.

Previous studies have found significant disparities in the application of insulin pumps. In particular, youths who are older, are male, from racial or ethnic minorities, have lower SES, or are from single-parent households are significantly less likely to use insulin pumps.

To determine if the gap in insulin pump therapy use among Black and White youth with T1D has widened or narrowed over the past decade, researchers at Children’s Hospital of Philadelphia conducted a retrospective chart review.

In total, compared with data from 2005, insulin pump use in 2011 increased 53% among non-Hispanic White children compared with a 16% increase in non-Hispanic Black children. In the subsequent 9 years, the disparity slightly widened, as insulin pump use rates increased by around 10% in both children groups.

“Regardless of the contributing factors, increasing diversity in the health care workforce or adding community health workers to the team may play an important role in overcoming these barriers to equitable care,” concluded researchers.

For more, visit ajmc.com.

Migraine Trust International Symposium

This week, the Migraine Trust International Symposium presented its 2020 meeting in a virtual format.

AJMC.com is providing full coverage of the virtual meeting, which ran from October 3-9.

In addition to coverage of late-breaking sessions at Migraine Trust Virtual Symposium 2020, AJMC.com has several video interviews discussing new developments in migraine science, effects of the COVID-19 pandemic, and much more!

For full conference coverage, visit ajmc.com.

Paper of the Week

And, now our paper of the week, which looks back at some of the most important papers over the past 25 years of The American Journal of Managed Care^® and why they matter today.

With the discovery of the hepatitis C virus winning this year’s Nobel Prize, AJMC^® looks back at a special issue on HCV therapies that appeared in May 2016, when the debate over patient access to direct-acting antivirals was at its peak.

In his essay as guest Editor-in-Chief, Dr Jay Bhattacharya wrote about the “dismal arithmetic” of hepatitis C treatment, where he concluded that universal access to therapy was a must.

“There is no point in discovering medical cures if the majority of patients who would benefit cannot afford them,” he wrote.

For the paper, visit ajmc.com.

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