News Briefs: Monoclonal Antibodies Yield Mixed Results Against Omicron | Dec. 22, 2021

Regeneron Pharmaceuticals’ monoclonal antibody treatment for COVID-19 has “diminished potency” when used against the omicron variant, while AstraZeneca plc’s antibody product “retained neutralizing activity” against the new variant. The antibody treatments remain the standard of care for unvaccinated COVID-19 patients with severe disease. Regeneron emphasized that its treatment is effective against the delta variant. However, omicron has become the dominant variant in recent days: the Associated Press reported 73% of new infections last week were omicron.

Innovative New Drugs, Collaborative Efforts, Digital Health Care Deals Were Among 2021 Trends

While the COVID-19 pandemic still drove a lot of the conversation around the pharmaceutical industry over the past year, much of it was focused on the development of vaccines and their rollout starting in late 2020, as well as treatments for the virus. But other innovative agents also came to market in 2021, continuing the industry’s trend of producing pioneering products. AIS Health, a division of MMIT, spoke to industry experts about the impact of COVID-19 on the industry and other 2021 pharma trends.

News Briefs: New Research Shows Rise in Telehealth Use Among Medicare Enrollees| Dec. 16, 2021

New statistics showing a rise in telehealth usage among Medicare beneficiaries during the pandemic make a strong case for permanently expanding telehealth coverage for Medicare patients. A new report from the HHS Assistant Secretary for Planning and Evaluation (ASPE) found that the number of FFS beneficiary telehealth visits rose from approximately 840,000 in 2019 to nearly 52.7 million in 2020, with the largest increase seen in behavioral health specialist visits. Black and rural beneficiaries demonstrated lower use of telehealth compared with white and urban beneficiaries, respectively. The report did not include results for Medicare Advantage members, since plans had discretion to offer telehealth prior to the pandemic, noted ASPE. Meanwhile, a new Medicare Telemedicine Data Snapshot from CMS showed that the number of Medicare beneficiaries (including MA enrollees) using telemedicine services between March 1, 2020, and Feb. 28, 2021, increased over 30 times the number of users from the prior year (March 2019 to February 2020). Dual eligibles had higher use of telehealth than those with just Medicare. “These latest numbers prove that when given the resources and opportunity to use telemedicine, many of these patients will opt to use the technology,” wrote Connected Nation, which seeks to fill broadband and digital technology gaps through partnerships across all sectors. “We would argue that among the critical needs is to expand not only access to broadband but also working to ensure it is affordable and that others understand both how to access the technology and how it can benefit them.”

Insurers Balk at Idea of Covering Unlimited At-Home COVID Tests

Recently, the Biden administration unveiled a plan to curb COVID-19 infections that promises forthcoming guidance “to clarify that individuals who purchase OTC [over the counter] COVID-19 diagnostic tests will be able to seek reimbursement from their group health plan or health insurance issuer and have insurance cover the cost during the public health emergency.”

Health insurers and health care policy researchers have a bevy of questions and concerns about this plan — and at least one public health expert has floated a different approach.


Health Insurers Embrace Vaccine Requirements for Workers

Although the Biden administration’s vaccine mandates are meeting resistance in the federal courts, many health care firms — including insurers — appear to be requiring their employees to get COVID-19 vaccinations anyway.

In a newly released survey from Willis Towers Watson, 47% of health care organizations polled said they had a vaccine requirement in place already, compared to just 18% of employers overall. On the flip side, 15% of health care companies said they were not planning to adopt a vaccine mandate, while 33% of employers overall said the same.


Biden: Health Insurers Should Pay for Home COVID Tests

In remarks to staffers at the National Institutes of Health (NIH) on the federal response to the omicron variant of COVID-19, President Joe Biden said his administration intends to make home testing more accessible — and require insurance companies to cover the cost of those tests from retailers.


Employer Plans in 2021: Premiums, Telemedicine Coverage Rise

The average annual premium for employer-sponsored health insurance increased 4% to $7,739 for single coverage and $22,221 for family coverage, respectively, this year, according to the Kaiser Family Foundation 2021 Employer Health Benefits Survey. In recent years, high-deductible plans with a savings option have been gaining popularity. About 22% of firms offered an HDHP/SO and 28% of covered workers were enrolled in such a plan in 2021, representing slight declines compared with previous years. Meanwhile, the COVID-19 pandemic has increased the use of telemedicine, as 95% of firms with 50 or more workers offered telemedicine coverage in their largest health plan, up from 85% last year. In addition, about 65% of firms with 50 or more workers made changes to enhance their telemedicine benefits after the beginning of the pandemic.

‘Long COVID’ Presents Big Challenges for Health Plans, Patients

As the country continues to grapple with the COVID-19 pandemic, the issue of “long COVID” is becoming increasingly visible — posing thorny challenges not only for the patients suffering from it but also health care providers, payers and policymakers alike.

Known clinically as post-acute sequelae of COVID-19, long COVID can be characterized by a slew of different symptoms, including neurologic, behavioral and cardiopulmonary ones. In addition to the often-debilitating symptoms associated with long COVID, patients with this condition may face the added burden of struggling to get their treatment covered.


Medication Abortion Regulations, at a Glance

Medication abortion — which involves using two drugs, mifepristone and misoprostol — accounts for 54% of all pregnancy terminations before nine weeks of gestation in the U.S., according to a recent Kaiser Family Foundation analysis. The FDA’s Center for Drug Evaluation and Research exercised “enforcement discretion” of the Risk Evaluation and Mitigation Strategy requirement that asks prescribers to dispense mifepristone to patients in-person during the pandemic. This allows providers in 32 states and the District of Columbia that do not have laws that ban medication abortion to dispense mifepristone via telehealth. Currently, 18 states and D.C. allow both advance practice clinicians and medical doctors to dispense abortion pills.

Given COVID Surge, Humana Deviates From Peers With Lower Guidance

Like the other publicly traded insurers that reported third-quarter 2021 earnings late last month, select Medicare Advantage insurers in early November demonstrated strong performances during a quarter that was tainted by a rise in COVID-related costs. Unlike its more balanced peers, however, MA-focused Humana Inc. took a decidedly conservative approach to projecting earnings for the full year given continued COVID uncertainty.