Illumina Inc. (ILMN) on Wednesday reported fourth-quarter earnings that topped Wall Street projections.
The San Diego-based genetics-technology company posted quarterly net
income of $239 million, or $1.61 a share. On an adjusted basis, profit
rose to $1.70 a share from $1.31 a share a year earlier.
Revenue rose to $953 million from $867 million a year earlier.
Analysts surveyed by FactSet expected $1.46 a share, or $1.58 a share as adjusted, on $942.4 million in revenue.
This year, Illumina expects to make $6.45 to $6.65 a share, or $6.80
to $7 a share as adjusted, with revenue increasing 9% to 11%. The
guidance, the company said, doesn’t factor in any impact from the
termination of the merger agreement with Pacific Biosciences of
California Inc. Illumina was to pay Pacific Biosciences $98 million as a
termination fee.
Analysts expect $6.73 a share, or $7.02 a share as adjusted, with revenue increasing about 11%.
The outbreak of a new virus that originated in the central-Chinese
city of Wuhan is likely to slow China’s economic growth at least in the
near term and could hurt its trading partners around the world.
The potential effects of the spread of the coronavirus, which has
sickened more than 6,000, mostly in China, and killed 133 since its
detection early last month, took center stage in U.S. Federal Reserve
Chair Jerome Powell’s news conference on Wednesday following the central
bank’s widely expected decision to keep interest rates unchanged.
The Fed is “very carefully monitoring the situation,” Powell told reporters.
While Powell noted that it is “too early to say” what the extent of
the impact on the United States will be, he said it is “a significant
thing which will have some effects on the Chinese economy, at least in
the short term.”
A Chinese government economist earlier on Wednesday projected the
outbreak would cut China’s first-quarter growth by one percentage point
to 5% or lower.
Powell also acknowledged the risks, including to the U.S. economy, from any slowdown in the world’s second-biggest economy.
“China’s economy is very important in the global economy now, and
when China’s economy slows down we do feel that – not as much though as
countries that are near China, or that trade more actively with China,
like some of the Western European countries,” Powell said.
China has imposed travel restrictions and shut businesses and schools
in an attempt to contain the outbreak, but it has not quelled rising
concern among companies and governments across the world, some of whom
are taking swift action.
Airlines including British Airways, United Airlines and Lufthansa
are cutting or suspending flights, tourists are canceling trips, and
businesses including Apple and Starbucks are warning of the potential
impact on their supply chains and sales. Starbucks
has closed more than half its cafes in China and Walt Disney shut its
resorts and theme parks in Shanghai and Hong Kong during what is usually
its busiest time of year. Alphabet Inc Google has said it is temporarily shutting down its offices in China, Hong Kong and Taiwan.
“The coronavirus will likely have the largest negative impact on
goods and services sectors within and outside of China that rely on
Chinese consumers and intermediary products,” Moody’s analysts said in a
report on Wednesday.
The assessments suggest the impact could be larger than that of the
2002-2003 Severe Acute Respiratory Syndrome (SARS) epidemic, the last
novel virus to cause global alarm.
That outbreak resulted in about 800 deaths and slowed Asia’s economic
growth. But the overall effect on the U.S. economy was ultimately
limited and short-lived.
But as the Moody’s analysts and others point out, China accounts for a
bigger share of global economic growth now than it did then, and the
world is more closely connected.
Over the past week, amid news of coronavirus cases in the United
States and more than a dozen other countries, trading in U.S. Treasuries
reflected rising concern about a spillover effect.
Futures tied to the Fed’s target policy rate also moved in the past
week, and are now pricing in bets the Fed will cut interest rates again
in July. CAREFUL COMMENTS
In his news conference on Wednesday, Powell gave no hint the central
bank plans to lower borrowing costs anytime soon. Indeed, he suggested
the global risks from uncertain trade policy and slowing global growth,
which prompted the Fed’s three rate cuts in 2019, looked to be receding,
prompting “cautious optimism” on the U.S. economic outlook this year.
Still, his careful comments about the impact of the coronavirus
outbreak likely reflects behind-the-scenes work by Fed staffers, who
brief policymakers at each meeting on risks to the economic outlook.
The Fed’s May 2003 policy meeting, which occurred as the extent of
the SARS epidemic was becoming apparent, began with a briefing on
uncertainties, including the effect of the outbreak on various Asian
economies and the potential knock-on impact for the U.S. economy, a
transcript of the meeting shows.
Staff at the time modeled a worst-case “SARS demand shock” showing a
0.3 percentage point hit to U.S. GDP growth in the second half of 2003,
with the impact lasting to the first half of 2004.
The outbreak of a novel coronavirus in China and its spread to more than a dozen countries has presented health experts with a rapidly evolving and complex challenge.
That means there are a lot of unknowns.
Here are some of the outstanding questions that doctors, scientists,
and health agencies are rushing to answer. (And a reminder that,
already, they’ve learned quite a lot.)
When are people contagious?
One of the luckiest breaks the world got with the SARS outbreak of
2002-2003 was that people weren’t contagious until they developed
symptoms. The same is true of MERS. As a result, it became easier for
health officials to try to limit spread once they identified a new case.
Public health experts watching this outbreak unfold have been hoping
2019-nCoV, which is a member of the same virus family, would follow that
pattern. Now they’re not so sure.
Chinese health authorities said over the weekend they’ve recorded
cases where transmission occurred before the transmitting person showed
symptoms. And German authorities reported a case Tuesday in which a man
was infected by a colleague visiting from China. The colleague only
began to feel sick on her flight back home.
If that’s a common feature of this infection, it’s going to cause serious problems.
With some viral illnesses — like influenza for example — people can
actually start infecting the people around them a day or two before they
start to feel sick. That’s insidious, because it means infected people
can go to work, take the subway, go to church or to the movies — unaware
that they are emitting viruses that can infect others. How long is the period between when a person gets infected and when they develop symptoms?
In the past few days several papers from China describing the illness
have been published or posted on preprint websites (sites that share
papers before they have been peer-reviewed or published in journals). In
a paper
posted to bioRxiv, scientists from Guangdong province estimated the
incubation period — the time from infection to symptoms — to average
between four and five days, which was also the case with SARS. There is
clearly a range, though; on Monday, the WHO said the information to date
suggests two to 10 days.
Another paper, published
last Friday in The Lancet, estimated the incubation period in a cluster
of six family members to be three to six days. These estimates are
compatible and suggest it takes a few days for people to start feeling
ill — which explains how a number of travelers who have brought the
virus to other countries only realized they were sick a day or two after
getting home. Are there mild cases that aren’t being detected? How big a proportion of the overall cases are they?
Most diseases have a spectrum of illness, ranging sometimes from
asymptomatic infection — symptom free — to very severe disease and
death. But some diseases tend to tilt toward one end of the spectrum.
With SARS, most of the cases were seriously ill. While that was bad
for anyone infected, it made detecting where the virus was spreading
easier. In this outbreak, it’s starting to look like there are mild and even asymptomatic cases.
How often they occur still isn’t clear. Nor is it known yet if they
are able to transmit the virus, or how often they do. With some
illnesses, mild and asymptomatic cases don’t contribute much to spread. How dangerous is this infection?
The reports emerging suggest a pretty significant portion of cases are seriously ill. For instance, in a report
China’s national health authorities posted Monday, about 17% of total
cases were severely ill. And about 3% of confirmed cases had died.
Those are frightening numbers. But if the confirmed cases represent
only a fraction of the total cases — and they likely do — that could
really change the math. Until we have a better handle on the total
number of cases it’s premature to draw conclusions. How far has the virus spread already?
It’s hard to get a clear picture.
On Monday, infectious diseases experts from Hong Kong University said
they believe the virus is now transmitting person-to-person, in a
sustained way, in all major cities in mainland China.
Epidemiologists who use mathematical modeling to calculate disease
spread have been looking at how many cases have been found in other
countries. There are formulas that give you an idea of how many
infections probably occurred in China before a case was exported.
As of Sunday, when the number of exported cases was approaching 60,
Neil Ferguson of Imperial College London estimated there were likely already 100,000 cases in China. But that was two days ago.
Ferguson told STAT it’s getting hard to run that calculation, “given
the exit screening and then quarantine of Wuhan,” the central Chinese
city where the outbreak is believed to have started.
To date, about 14 countries and territories outside of mainland China
have detected cases, but none has yet reported seeing sustained
human-to-human transmission of the virus. China is taking unprecedented and draconian measures to stop
the virus from spreading, cutting off transit to cities with millions of
people. Can these measures work?
Nothing like this has ever been tried before.
During the 2003 SARS outbreak, the World Health Organization issued
what were called “travel advisories” — telling people around the world
not to go to affected cities. The travel advisories, which the WHO has
never used since, were loathed by the locations battling SARS, which saw
tourism dry up and hotel vacancies soar. Though they certainly had the
desired effect of driving away tourists, the travel advisories were
advice only.
In China, this isn’t advice. The country is cutting off travel
between cities. Is it possible to enforce? Can the Chinese economy
sustain this? Big, big unknowns right now.
And will these measures stop the spread of the disease? When
draconian restrictions are imposed, desperate people tend to use
underground efforts to get around them. Still, spread of the virus may
happen at a lower or slower rate than if the measures weren’t put into
place.
In the end, it may turn out these measures were imposed too late.
Analysis of the genetic sequences of viruses from more than two dozen
cases suggest the virus had been transmitting person-to-person for a
couple of months now — maybe starting in November or early December. Was there initial transmission outside of the seafood market that authorities tied many of the first cases to?
Now that the virus appears to be spreading effectively among people,
tracking down the initial source has become secondary to trying to
contain the outbreak. But both as a scientific curiosity and for
possible insights about how to prevent the next outbreak, it’s useful to
know when and how the virus started infecting people.
Early in the outbreak, local authorities in Wuhan said that most of
the early cases were linked in some way to a large seafood market that
also had live animals for meat. This seemed like a logical source for
the outbreak; coronaviruses can jump from animals to infect people.
These viruses are thought to originate in bats, but can use a middleman
as they hopscotch to humans. The 2002-2003 SARS outbreak, for example,
was traced to palm civets, while MERS infections come from camels.
But then last week, in some of the first analyses of the initial cases, a team of researchers reported
that the first patient in Wuhan hospitalized with pneumonia caused by
the virus had no tie to the market. The patient’s symptoms also started a
week earlier than later cases who were tied to the market.
That raises several possibilities: Perhaps the virus was spreading
among people earlier than first noticed or reported by Wuhan health
officials, and that one of these patients brought the virus to the
market. Or, perhaps there was a group of infected animals that could
have seeded the outbreak at different locations.
Presidential candidates can’t stop talking about insulin.
At a campaign stop here on Sunday, Sen. Amy Klobuchar retold the now-familiar story of Alec Smith, whose highly publicized death from insulin rationing
in 2017 sparked nationwide outrage. Sen. Elizabeth Warren, who has
vowed to lower the drug’s price on her first day in office, lambasted
Eli Lilly, one of just three U.S. insulin manufacturers, at an Iowa
rally the day before. And since July, when Sen. Bernie Sanders joined a
highly publicized “insulin caravan”
seeking cheaper prices in Canada, he has flooded this state with
television ads that picture him brandishing an insulin vial in outrage.
Even in a primary dominated by broader health care issues, insulin
has emerged as particularly alluring campaign fodder for Democrats.
Unlike more perplexing topics like health insurance reform or the cost
of drug research, candidates have a plain and simple rallying cry for
insulin: That it’s corporate profiteering.
“Everything is coming together,” said Lija Greenseid, a
Minnesota-based advocate working to push insulin into the political
mainstream. “We’ve finally caught the attention of people in power.”
While insulin has existed for a century, American voters have taken
notice of backbreaking price hikes that drug companies have imposed in
recent decades as some insulin products have grown more technologically
advanced and more effective. One recent poll showed that allowing the
U.S. government to manufacture insulin is the single most popular element
of progressive candidates’ entire 2020 agenda. And it has made for a
ready opportunity for Democrats to attack President Trump: His health
secretary, Alex Azar, spent five years as a top executive at Eli Lilly
prior to joining the administration.
The focus on insulin is a rare point of consensus among candidates
who have otherwise bickered over health care matters. It is a testament,
too, to how the issue is clearly stirring voters. Even the Trump
administration is beginning to signal an interest in addressing insulin specifically, after years of a broader effort to lower drug prices that has had mixed success.
“Access to affordable insulin is a life-and-death matter,” said Maura
Calsyn, the managing director of health policy at the Center for
American Progress. “Insulin is one of the clearest examples of drug
manufacturer price-gouging, and grassroots groups have done a really
phenomenal job explaining the issue and outlining why insulin is a real
problem.”
But in the early primary states of Iowa and New Hampshire, and at
campaign events across the country, a growing advocacy network is
pushing candidates to be bolder, and to use insulin as a catch-all
example of America’s health care ills. As the 2020 campaign shifts into
high gear, virtually every Democratic candidate has listened. Sen. Amy Klobuchar (D-Minn.) speaks during a campaign stop in Waterloo, Iowa. Rebecca F. Miller for STATJanelle
Lutgen drove 92 miles on Sunday to present Klobuchar with a tiny gift:
an empty insulin vial, spray-painted gold, barely an inch tall.
Following a Waterloo town hall appearance in front of 250 prospective
caucus-goers, Klobuchar accepted her present somberly. But it was the
accompanying story that got the senator’s attention: Lutgen had also
lost a child to insulin rationing.
Ever since her son, Jesse, died nearly two years ago after struggling
to afford treatment for his type 1 diabetes, Lutgen has used his story
to launch an advocacy campaign that has pushed elected officials who run
the gamut from Democratic presidential candidates to Republican state
lawmakers to spotlight insulin. For months, Lutgen and her 32-year-old
daughter, Theresa, have spent weekends waking up at the crack of dawn
with the singular mission of hand-delivering insulin vials to
presidential candidates.
The mother-daughter pair has orchestrated handoffs to almost every
major contender. Lutgen has exacted a sympathetic hug from Joe Biden, a
photograph from Elizabeth Warren, an impassioned speech on the need for
lower drug prices from tech entrepreneur Andrew Yang, and a brief
interaction with Pete Buttigieg, the former mayor of South Bend, Ind.
With each handoff, Lutgen tells a horror story that mirrors a tale
being told by advocates across the country. Jesse was first diagnosed at
12, she tells candidates, after suffering from flu-like symptoms for
days. His symptoms escalated, and Jesse was eventually airlifted to a
hospital in Iowa City. His family learned to manage his care, buying
insulin and needles and blood-glucose monitors again and again. Janelle
had health insurance through the federal government then, thanks to her
job at the United Postal Service. Her copays for Jesse’s treatment were
low, sometimes zero.
Jesse Lutgen, pictured at age 26. He died at age 32 after attempting to ration his insulin. Courtesy Janelle Lutgen
As a young adult, however, Jesse had trouble paying for his health
care. He couldn’t afford insurance, Lutgen said — the cheapest
Affordable Care Act plan available cost $300 per month and carried a
deductible of several thousand dollars. Insulin, which Americans with
type 1 diabetes rely on daily, can cost well over $1,000 per vial before
discounts, though most patients with insurance pay far less.
Like most Americans, Jesse didn’t have the flexibility to pay $10,000
a year for prescription drugs — a distinct possibility in light of the
insulin price hikes that occurred during his lifetime. A patient paying
roughly $175 for a vial of insulin 15 years ago might pay nearly $1,500
for the same dose today, according to an Elsevier database. Costs for
Americans with diabetes often reach into the thousands, or tens of
thousands, annually.
He would occasionally ask his mother to borrow money. Once, she
recalled, she brought him two vials of Lantus, the Sanofi insulin
product, back from a trip to Washington state — leftovers from a friend
of a friend who’d recently died.
It wasn’t the formulation that Jesse used, she reasoned, but they
might prove useful anyway. Days after Jesse died, Lutgen said, she found
the two Lantus vials in his apartment, empty. He hadn’t asked to borrow
money.
“That kind of hit me, too,” Lutgen said. “Why didn’t he ask me for
help? And then when I found out how much insulin cost, I thought: How do
you ask your mom for $1,300 a month, every month, for you don’t know
how long?” Advocacy
campaigns like Lutgen’s have helped to elevate insulin from a health
care obscurity to a central element in each Democratic candidate’s
health policy agenda.
Sanders has spent $5.5 million on television ads in Iowa alone,
according to FiveThirtyEight — many of which spotlight his “caravan” to
Canada or images of a patient drawing a syringe from an insulin vial.
Warren, whose proposal to let the federal government manufacture
insulin and other generic drugs is a signature campaign plank, also
orchestrated an investigation in which Senate aides called nearly 400 pharmacies
around the country to ask whether they stocked a cheaper generic
product from Eli Lilly, introduced in the wake of price criticisms.
(Only 17% of pharmacies said they carry the product.)
Former Vice President Joe Biden, in interviews, has cited insulin as a key example
of how Americans are getting “ripped off” on drug prices. Tom Steyer,
the billionaire hedge fund manager and environmentalist, complains that
drug companies “charge Americans 10 times what they charge Canadians”
for insulin. And Klobuchar, in 2019, invited Nicole Smith-Holt, the
mother of Alec Smith, as her guest for Trump’s State of the Union
address. When she declared her candidacy a week later, she retold Alec’s
story. Her message quickly caught fire, even spurring an impassioned
tweet from the pop icon Cher.
On Monday, Michael Bloomberg, the former New York City mayor, became
the latest candidate to excoriate the Trump administration and Azar for
their lack of success lowering drug prices and for the perceived
conflict of hiring a former pharmaceutical executive to lead that
effort.
“The Trump administration is full of pharmaceutical executives,” Tim
O’Brien, a Bloomberg adviser, said on a call with reporters. Azar, he
added, “in his work for Eli Lilly, prior to joining the administration,
doubled the price of its top-selling insulin product over a five-year
period.”
Caitlin Oakley, a spokeswoman for Azar, said the criticism was “old
news,” and that Azar has prioritized lowering drug costs more
aggressively than any prior health secretary.
“In fact,” she said in a statement, “it is his deep knowledge about
the opaque drug pricing system that has driven this administration
priority forward.”
Even in the campaign’s early stages, long-shot candidates spotlighted
their own insulin bona fides. Eric Swalwell, the California
congressman, whipped an insulin vial out of his pocket
during a CNN town hall, telling a national audience that he had carried
the medication on his person for three months after a constituent
gifted it to him.
“When you run for president, you can’t go a couple of days without
talking to somebody who’s describing someone they love who’s dependent
on insulin or some medication,” Buttigieg told a STAT reporter at a
recent meeting with the Boston Globe’s editorial board.
One particular example, Buttigieg said, remained top of mind.
“A lady gave me an insulin vial the other day that she had
spray-painted gold,” he said. “The tag on it said: This is worth its
weight in gold, and it shouldn’t cost that. You see what people are up
against, and it requires action.”
Lutgen (left) and her daughter Theresa (right) give a gold insulin vial to Klobuchar (center) at a campaign stop in Waterloo. Rebecca F. Miller for STAT
The gold-painted vials that Lutgen and other advocates have distributed to elected officials across the country. Rebecca F. Miller for STAT
Lutgen’s
advocacy represents just a tiny slice of the fast-growing nationwide
effort to draw attention to insulin prices. Her efforts fall under the
umbrella of the Gold Vial Project: a loosely organized group co-founded by Greenseid and another Minnesota-based advocate, Meghan Mateuszczyk.
One affiliated advocacy network, the insulin-focused nonprofit T1 International, has grown to encompass chapters in 34 states.
The growing “Insulin for All” campaign and other diabetes advocacy
organizations have orchestrated regular insulin “caravans” to Canada, a
protest at Eli Lilly’s U.S. headquarters, and a “die-in” at the
Cambridge, Mass., offices of another insulin manufacturer, Sanofi. (In a
statement, an Eli Lilly spokesman said that 95% of patients using
Humalog pay under $100 monthly and touted the company’s half-priced
generic, Lispro. The spokesman faulted health insurers and pharmacies
for failing to cover or stock the cheaper medication.)
Lutgen’s enthusiasm, and her proximity to the Iowa caucuses, has
earned her star status within the Gold Vial Project, which aims to reach
elected officials at all levels and gift them both a vial and the
message that Buttigieg referenced: To people with diabetes, insulin is
worth its weight in gold — but that’s not what it should cost.
So far, Gold Vial advocates have delivered vials to six presidential
candidates — in addition to Janelle’s handoffs, there has been a
California delivery to Bloomberg and a New Hampshire presentation for
Yang — as well as 11 more to members of Congress and 18 to state
lawmakers and local government officials.
Soon, the Insulin for All movement could even have a lawmaker born of
its own ranks: Quinn Nystrom, a longtime insulin advocate and Democrat
running to represent Minnesota’s 8th Congressional District on a largely
health care-centric platform.
The informal grassroots groups have also enjoyed increasing backup
from national organizations more closely tied to the political
mainstream. Health Care Voter, the left-leaning group founded in 2017 to
oppose repeal of the Affordable Care Act, recently announced a new
spinoff organization: Affordable Insulin Now.
“We had so many conversations with advocates and patients across the
country who knew there was a void that needed to be filled,” said
Rosemary Enobakhare, the group’s director. “We decided to take this on
not just at the local level but at the federal level, to make sure they
know that people are literally pleading with them.” Lutgen speaks during a meeting of Iowa’s chapter of T1 International, a national Type 1 diabetes advocacy group. Rebecca F. Miller for STATAt a
meeting of the Iowa T1 chapter in a library basement just outside Iowa
City, Janelle and Theresa Lutgen were celebrating a more local victory.
The previous week, state lawmakers had introduced legislation capping
copays for insulin at $100 per month, an effort to prevent Jesse’s story
from playing out even for Iowans with health insurance.
Despite the chance for a major victory in the state legislature,
however, it was Lutgen’s success contacting the national political
figures campaigning for the Democratic nomination that fueled the
discussion.
John Tagliareni, the Iowa chapter leader, summed up her success in
simple terms: “How do you not listen to a mom who lost her child to
corporate greed?”
Lutgen, however, won’t let herself be swayed by any of the
sympathetic overtures the Democratic candidates make when they hear her
story. As the chair of the Jackson County Republican Party, she plans to
vote for Trump come Election Day.
But she has relished the opportunity to ensure that even a Democratic
president would address the issue dearest to her heart. Access to
insulin, she says, shouldn’t be partisan.
“If I had to choose,” she said, “I liked what Andrew Yang had to say on drug prices.”
And while she is a committed Republican, even Lutgen admitted she had
reservations about Trump’s efforts on drug pricing. He should be
pushing Congress harder to pass a drug pricing bill, she said, citing
the Senate package authored by Sen. Chuck Grassley, the Iowa Republican.
The more time passes without real reform, the more Lutgen has begun
to doubt whether Azar, the former Eli Lilly executive, is likely to fix
the problems that contributed to her son’s death.
“I’m starting to have my doubts,” she said. “Maybe it would be better
to have a doctor — somebody who has the patients in mind first, and not
pharmaceutical companies.”
Federal officials on Tuesday called for a team of Americans to be
allowed to enter China and assist with the local response to the novel coronavirus outbreak
there, an offer that U.S. officials say the Chinese government has not
yet authorized since it was first extended three weeks ago.
A group of U.S. public health workers and scientific researchers is
standing by to travel to China, according to health secretary Alex Azar,
who said he and other officials have reiterated the offer twice to the
Chinese government: once to the country’s health minister and again at a
World Health Organization meeting in Beijing.
“We’re urging China: More cooperation and transparency are the most
important steps you can take for a more effective response,” Azar said
at a press conference.
Earlier on Tuesday, however, Chinese President Xi Jinping did agree
to allow a team of WHO experts to enter the country “to work with
Chinese counterparts on increasing understanding of the outbreak to
guide global response efforts.”
Azar said he was “delighted” by the news, though it was not
immediately clear whether personnel from the U.S. Centers for Disease
Control and Prevention would be included within the WHO group. The U.S.
already has personnel embedded within China’s disease control office,
Azar said, but he urged that more American personnel be allowed to take a
more active role in addressing the outbreak.
At the briefing, Azar and other health officials stressed that the
coronavirus outbreak did not present an imminent threat to Americans.
Azar, smiling, dismissed the recent rash of Americans attempting to
purchase face masks at pharmacies and convenience stores as
“unnecessary.”
The disease outbreak, which is most severe in the Chinese city of
Wuhan, has resulted in over 4,500 reported cases and at least 100 deaths
in China. At least 14 territories and countries outside the Chinese
mainland have reported cases as well, including five in the U.S.
CDC Director Robert Redfield was also careful to emphasize that the
disease is not spreading within the U.S. And its transmission rate as
measured in early research, he said, is substantially lower than for
other infectious diseases, including measles.
American authorities announced Monday they would expand coronavirus
screenings of passengers arriving from China at 20 airports, up from a
list of five airports to which authorities had directed flights from
Wuhan specifically.
“Americans should know that this is a potentially very serious public
health threat,” Azar said. “But at this point, Americans should not
worry for their own safety.”
Nonetheless, Azar said, the U.S. government stood ready to deploy all
available tools for dealing with the outbreak, citing efforts to
determine whether the disease could be transmitted even by individuals
who have not displayed symptoms and tracking down contacts of
individuals who have fallen ill.
“All options for dealing with infectious disease spread have to be on
the table, including travel restrictions,” Azar said. “But diseases are
not terribly good at respecting borders, so we would have to assess
carefully whether the evidence recommends any steps beyond the
thoroughly tested methods I just described.”
Coalition of State Rheumatology Organizations
(CSRO) physicians are voicing concern for patients who will fall victim
of a dangerous new prescription policy. New requirements from BlueCross
BlueShield (BCBS) of Tennessee, which
may be a bellwether for other insurers, are reversing the trend
providers have achieved in keeping prices down for physician
administered medications.
Normally provider administered drugs are obtained via a “buy and
bill” system where a provider purchases medication and bills the
insurance company under a patient’s medical benefit. The new BCBS policy
moves the acquisition of these administered medication away from the
physician to the patient’s pharmacy benefit, handled by pharmacy benefit
managers (PBMs.)
The Centers for Medicare and Medicaid Services (CMS) dashboard
purports that prices of Part D medications, those managed by a PBM, rise
at much faster rates than physician “buy and bill” Part B medications.
“Now PBMs and insurers are integrated, they finally have the chance
to move payments away from the medical side and put it on the pharmacy
side, where more money is made with rebates and hidden fees,” said Dr. Madelaine Feldman, president of the CSRO.
“This policy is about one thing, profits,” Dr. Feldman, continued.
“PBMs construct formularies encouraging pharmaceutical manufacturers to
raise prices of drugs. The higher the price, the more money PBMs make,
resulting in PBMs choosing higher priced drugs for the preferred tier.”
Another consequence of this new policy will be that physicians will no longer be able to infuse patients in their office. Dr. Robert Levin of the Alliance for Transparent and Affordable Prescriptions
(ATAP) added, “We make decisions based on the needs of our patients,
including how and where care is given. Needlessly driving up prices and
making treatments more complicated to obtain is moving health care in
the wrong direction. Patients deserve better.”
“Patients will be increasingly forced into expensive sites for care
such as hospitals or where there is no direct supervision by physicians,
nurse practitioners, or physician assistants,” said Dr. Aaron Broadwell, rheumatologist from Shreveport, Louisiana. The CSRO is comprised of 43 state and regional professional
rheumatology societies formed to advocate for excellence in
rheumatologic disease care and ensure access to the highest quality care
for the management of rheumatologic and musculoskeletal diseases. https://www.biospace.com/article/releases/drug-prices-to-skyrocket-with-new-health-insurance-company-policy-according-to-coalition-of-state-rheumatology-organizations/
