Morning Briefing
Summaries of health policy coverage from major news organizations
Eli Lilly To Hospitals: Give Us Claims Data Or Lose 340B Price Breaks
Stat: Eli Lilly Tells Hospitals To Submit Claims Data In Days Or Lose 340B Drug Discounts
Eli Lilly has told about 50 hospitals participating in a federal drug discount program to submit comprehensive claims data over the next five days or they will no longer receive the mandated price breaks. The move comes after the company announced a policy in January demanding such data in a bid to reduce what it calls duplicate discounts paid to participating hospitals. The issue has riled the pharmaceutical industry and contributed to a long-standing clash with hospitals over the 340B drug discount program. (Silverman, 6/1)
Modern Healthcare: Hospitals Invest In Specialty Pharmacy Programs To Boost Revenue
For Chattanooga, Tennessee-based Erlanger, investing in a specialty pharmacy program filled a noticeable care gap across its seven-hospital footprint. The safety-net health system has many patients with chronic and complex conditions, and it lacked the expertise to give them timely access to specialty medications, President and CEO Jim Coleman Jr. said. After partnering with specialty pharmacy company Shields Health Solutions in 2024, Erlanger built a program that has grown to include treatments in 10 specialties. (Hudson, 6/1)
Stat: Servier To Buy Edgewise Therapeutics' Muscular Dystrophy Drug
The French pharma company Servier said Monday that it would buy Colorado-based Edgewise Therapeutics’ muscular dystrophy business in a deal worth up to $2.65 billion. The centerpiece of the deal is Edgewise’s sevasemten, which is being studied in a pivotal trial in Becker muscular dystrophy and in a Phase 2 trial in Duchenne muscular dystrophy. The oral drug is designed to protect muscles from the damage that accrues in both rare conditions. (Joseph, 6/1)
Bloomberg: Ulcerative Colitis Drug From Abivax Achieves 40% Remission Rate In Trial
Abivax SA shares plunged after cancer cases in a crucial clinical trial for an experimental bowel disease drug threw the French biotech’s future into question. The medicine, obefazimod, was more effective than expected in the study, helping patients reach clinical remission rates of about 40% with two different doses when adjusting for placebo. But Abivax also reported cancer cases in several patients, including one treated with a placebo. (Kresge and Pham, 6/1)
Fierce Healthcare: Noom Offers At-Home Biomarker Test Kit For 17 Health Indicators
Weight loss company Noom is offering an at-home biomarker testing kit for its U.S. members, expanding its platform into diagnostics and metabolic health monitoring. It marks an expansion of the company's proactive health program, which rolled out in December, offering microdose GLP-1 medications combined with at-home biomarker testing and insights. (Landi, 6/1)
In other healthcare industry developments —
Fierce Healthcare: UnitedHealth To Nix Nearly Two Thirds Of Pediatric Prior Auths
UnitedHealthcare is set to eliminate close to two-thirds of pediatric prior authorization requirements by the end of the year. The insurance giant announced Friday morning that it will nix prior auth on an array of diagnostic tests, routine surgeries and specialty services, including cardiology, neurology, pulmonology and orthopedics. (Minemyer, 5/29)
Modern Healthcare: CHS Sells 4 Arkansas Hospitals To Freeman Health System
A Community Health Systems subsidiary sold four Arkansas hospitals to Freeman Health System for $110 million. The sale includes 128-bed Northwest Medical Center-Bentonville, 222-bed Northwest Medical Center-Springdale, 64-bed Northwest Medical Center–Willow Creek Women’s Hospital and 73-bed Siloam Springs Regional Hospital, in addition to related outpatient centers and practices, CHS said in a Monday news release announcing the deal’s completion. The health systems entered into a definitive agreement March 5 for an initial sale price of $112 million. (DeSilva, 6/1)
Stat: Legal Fights Brewing Over The Basic Business Model Of Telehealth
In less than a decade, telehealth has expanded from a sideshow of health care to an industry worth tens of billions of dollars. Companies like Hims & Hers and Teladoc have become household names, their ads interrupting streaming TV and flooding social media feeds with the promise of quick, convenient care. Despite their popularity, few patients understand who’s actually taking care of them when they click through a telehealth site. (Palmer, 6/2)
Fierce Healthcare: Patients With Treatment-Resistant Depression Costing Medicare
A patient with treatment-resistant depression (TRD) costs Medicare 21%, or $8,000, more annually than a patient with depression that is controlled. So finds a new report from Health Management Associates (HMA), a health policy consulting firm. The report aimed to quantify the direct economic impact of the condition, looking at Medicare claims data from 2022 and 2023 for its analysis. (Gliadkovskaya, 6/1)
MedPage Today: Patients With Tardive Dyskinesia Symptoms May Go Undiagnosed
Tardive dyskinesia (TD), a movement disorder that causes involuntary movements often triggered by antipsychotic exposure, has appeared in the DSM for decades. Despite advancements in diagnostic tools and treatments, TD still goes unrecognized in many cases. (Monaco, 6/1)
The Wall Street Journal: The Autism-Therapy Business Is Booming—And So Is The Billing Abuse
Carolina Lopez searched for therapy services for her autistic son, Ezekiel, who was then 3 years old. But every provider she called had a wait list. “There seemed to not be much I could do,” said Lopez, 33, a bank employee in Roselle Park, N.J. A provider called the Perfect Child promised immediate treatment—and no out-of-pocket costs. (Weaver and Wilde Mathews, 6/1)
