Direct-to-Consumer Drug Company Pharmacies

“In January 2024, the pharmaceutical company Eli Lilly launched LillyDirect, a service that includes a direct-to-consumer pharmacy and a referral network of in-person and telehealth clinicians. These tools are intended to add new options for patients to access the company’s drugs, including its newly approved antiobesity drug tirzepatide (Zepbound). [..] LillyDirect is similar to several pharmacies that cut out insurers and PBMs [pharmacy benefit managers] and allow patients to purchase drugs at discounted cash prices. These include pharmacies introduced by major retail companies like Walmart, Costco, and Amazon, and independent pharmacies like the one named for its billionaire cofounder Mark … Read More

Machine-learning enhancement of urine dipstick tests for chronic kidney disease detection

From the article abstract: “[Objective] [..] We developed machine-learning models to detect CKD [chronic kidney disease] without blood collection, predicting an eGFR [estimated glomerular filtration rate in ml/min/1.73 m2] less than 60 (eGFR60 model) or 45 (eGFR45 model) using a urine dipstick test. [Materials and Methods] The electronic health record data (n = 220 018) obtained from university hospitals were used for XGBoost-derived model construction. The model variables were age, sex, and 10 measurements from the urine dipstick test. The models were validated using health checkup center data (n = 74 380) and nationwide public data (KNHANES data, n = 62 945) for the general population in Korea. [Results] The … Read More

Providing Birth Control Over the Counter Should Be Just the Beginning

“At a 1992 conference on birth control, an official on the F.D.A.’s fertility and maternal health drugs advisory committee, Philip Corfman, noted that the birth control pill is safer than aspirin, which is available over the counter. The F.D.A. subsequently announced plans to convene a hearing to consider moving oral contraceptives over-the-counter. It was believed that this would greatly expand access to birth control by bypassing doctors, to whom millions of Americans then — as still now — had little access. But, as the historian Heather Munro Prescott has recounted, the hearing was canceled at least partly because of criticism from … Read More

Corporate Citizenship and Institutional Responses Post-Dobbs — Critical Lessons from Two Restrictive States

“When Roe v. Wade was decided in 1973, a group of 100 U.S. professors of obstetrics and gynecology predicted that teaching hospitals would emerge as leaders in compassionate abortion care, creating outpatient clinics to meet the demand for legalized abortion. But most hospitals did not embrace abortion provision; many of them in fact adopted policies that were more restrictive than was legally required. Freestanding clinics instead emerged as the primary provider of abortion care, and this siloing was further reinforced by stigma, threats of violence, and the exclusion of abortion coverage by major health care payers. In 2020, hospitals accounted … Read More

How Emergency Department Use in Ontario Can Help Determine the Right Dose of Telehealth

“Commensurate with the rise in telehealth has been a proliferation in publications assessing the cost, experience, efficiency, safety, and unintended consequences of telehealth. Many publications aim to answer the “Goldilocks question”: what is the right amount of telehealth that optimizes its benefits while minimizing potential problems? The right dose of telehealth needs to balance (1) concerns by payers and policy makers that it will increase cost and cause unintended consequences (eg, misdiagnosis or duplicative care) and (2) the desire of its proponents who want to allow clinicians to use it as they see fit, with few restrictions. [..] To date, … Read More

Tom Koutsoumpas: A hospice care CEO wants to ease the ordeal of dying.

Excerpt – Mr. [CEO of Capital Caring Health who is now the nation’s largest non-profit hospice and advanced illness provider Tom] Koutsoumpas is eager to correct misconceptions about hospice care. “People think it means you’re giving up and going home to die. But we find that with good symptom management and the support of family, patients often do better and live longer,” he says from Capital Caring’s offices in Falls Church, Va. President Jimmy Carter, for example, is still with his family, after announcing in February that he would forego additional medical care to spend his remaining days in hospice at … Read More

Once bullish on digital health, Orexo hits a wall on reimbursement

Excerpt – Orexo, which made almost all of its $60 million in 2022 revenues from U.S. sales of Zubsolv, a drug used to treat opioid use disorder, earned negligible income from its three software-based treatments in the first quarter of the year. On the company’s earnings call, CEO Nikolaj Sørensen attributed this to the company’s ongoing difficulty securing reimbursement for digital therapeutics. [..] Orexo’s new, careful approach is a stark contrast to the bullish tone the company took when it first dove into digital therapeutics in 2019 and 2020. At the time, Orexo was sitting on millions in Zubsolv profits … Read More

Facing headwinds, Teladoc tests its bet on whole-person care

“In recent months, executives have touted Teladoc as a source for “whole-person care” — a bid to distinguish it from smaller virtual companies addressing only one condition, or those who largely make money by facilitating prescriptions. The company offers primary care, urgent care, and virtual appointments, coaching, and disease management for chronic diseases such as diabetes and for mental health conditions. About a third of patients in Teladoc’s chronic care programs are using more than one — and that number has grown year-over-year and sequentially, executives said during a Wednesday earning call. Earlier this year, Teladoc unrolled its integrated care … Read More

Should we trust Apple with mental health data?

“the new coaching service — codenamed Quartz — sounds like an expansion of the Apple Watch play from physical health to mental health, Bloomberg reported. It is “designed to keep users motivated to exercise, improve eating habits and help them sleep better” using “AI and data from an Apple Watch to make suggestions and create coaching programs tailored to specific users.” [..] About five years ago, I wrote about the various ways that the Apple Watch failed as a behavioral intervention. There’s some behavioral science, but also — because I was using it — I discovered that the constant nudging for achievement made me miserable. … Read More

A research team airs the messy truth about AI in medicine — and gives hospitals a guide to fix it

Excerpt – The challenges uncovered by the project [reviews of AI compiled by researchers at Duke] point to a dawning realization about AI’s use in health care: building the algorithm is the easiest part of the work. The real difficulty lies in figuring out how to incorporate the technology into the daily routines of doctors and nurses, and the complicated care-delivery and technical systems that surround them. AI must be finely tuned to those environments and evaluated within them, so that its benefits and costs can be clearly understood and compared. As it stands, health systems are not set up … Read More