This Week in Managed Care: February 5, 2021

This week, the top managed care news included nationwide pharmacies to receive vaccine doses; experts issue recommendations for improving health care in 2021; HIV may increase risk of severe COVID-19 infection.

Nationwide pharmacies to receive vaccine doses, experts issue recommendations for improving health care and costs in 2021, and HIV may increase risk of severe COVID-19 infection.

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

Nationwide Pharmacies to Receive Vaccine Doses

This week, the Biden administration announced that it will expand access to COVID-19 vaccines, providing more doses for states and initiating distribution to retail pharmacies.

With distribution set to begin next week, nationwide pharmacies, including CVS, Walgreens, Walmart, Costco, and several supermarket chains, could receive 1 million doses of available COVID-19 vaccines. Weekly allocation of vaccines to states will additionally be increased by 500,000 in the coming weeks, according to The Associated Press.

However, eligibility will be determined by state and local guidelines, with one of the top priorities being minority communities, who have been disproportionately affected by the pandemic.

In other vaccine related news, GlaxoSmithKline, or GSK, has announced that German biotech firm CureVac will help to both produce 100 million additional doses of its current COVID-19 vaccine and jointly produce a new vaccine to target variants of the virus.

As the latest of several partnerships meant to accelerate delivery of vaccines to fight the pandemic, the new GSK/CureVac vaccine has a target delivery date of 2022. Sanofi and Novartis also both announced last week that they are partnering with BioNTech/Pfizer, and CureVac, which is still trialing its mRNA vaccine, has enlisted Bayer’s help.

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Experts Issue Recommendations for Improving Health Care, Costs in 2021

In a recent commentary published in Health Affairs, health care industry experts, including William Shrank, MD, chief medical and corporate affairs officer at Humana, and Nancy-Ann DeParle, JD, a managing partner and cofounder of Consonance Capital Partners, outlined health reforms that can lead to improved health care access, affordability, and equity in the United States.

As part of the National Academy of Medicine’s Vital Directions for Health and Health Care: Priorities for 2021 initiative, the authors focused on 5 policy priorities:

  • expanding insurance coverage
  • accelerating the transition to value-based care
  • advancing home-based care
  • improving the affordability of drugs and other therapeutics
  • and developing a high-value workforce.

“After reaching a nadir of 28.7 million in 2016, the number of uninsured people is expected to rise to 37.2 million by 2028. This comes at a time when a growing body of research links insurance coverage to improvements in financial security, health, and longevity,” the authors wrote.

As political resistance to expanding insurance access under certain Affordable Care Act provisions persists, the authors call for bipartisan approaches and public-private partnerships. In particular, experts propose reallocating the considerable resources spent on care that does not improve health to sustainably finance coverage expansion.

Despite time, funding, and resource constraints due to the COVID-19 pandemic, the authors push for disciplined prioritization and a willingness to accept incremental progress and small wins in an effort to implement these proposals.

“Achieving meaningful change in this environment will require significant resolve from policy makers and public support for difficult decisions…We hope that the policy priorities and recommendations articulated in this commentary provide a focused starting point for evidence-based policy making that supports a more effective, efficient, and equitable health system in the United States.”

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HIV May Increase Risk of Severe COVID-19 Infection

With New York being at the crossroads of the HIV epidemic and the COVID-19 pandemic, researchers of a study published this week in JAMA Network Open wanted to know what, if any, correlation there was between the 2 disease states.

“Persons living with diagnosed HIV infection with a low CD4 cell count or not receiving HIV treatment are currently listed by the [CDC] as possibly at risk for severe illness from COVID-19,” the study authors noted, but just how much that risk is elevated and the actual rates of serious COVID-19–related outcomes remain unknown.

Conducting a retrospective cohort analysis, researchers assessed for a potential association between prior diagnosis of HIV infection and COVID-19 diagnosis, hospitalization, and in-hospital death among residents of New York state.

Among all persons living with HIV who were hospitalized through June 15 because of severe cases of COVID-19, an overall 6.9% in-hospital mortality rate was found, representing elevated rates per population and among diagnosed individuals.

Despite overall similar COVID-19 diagnosis rates vs persons not living with HIV, the investigators also saw higher levels of hospitalizations and elevated COVID-19 diagnoses in those with HIV, with risk of hospitalization greater among persons with higher-stage HIV.

“Because HIV infection is a marker for, and may play a direct role in, more severe COVID-19 outcomes, persons living with diagnosed HIV may warrant recategorization from ‘might be at increased risk’ to ‘increased risk’ in the [CDC]’s underlying medical conditions list,” the authors conclude. “Our findings present an opportunity to address health equity with regard to HIV and COVID-19 through a combination of prevention and treatment approaches.”

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Dr Harvey Kaufman on Racial Disparities Brought to Light by COVID-19

In this week’s Managed Care Cast, we speak with Harvey Kaufman, MD, senior medical director at Quest Diagnostics, on the organization’s latest Health Trends study that underscores racial disparities in US health care brought to light by the COVID-19 pandemic.

The online survey, made in collaboration with The Harris Poll and conducted from November 10-12, 2020, found that among over 2000 adult participants, Black and Hispanic/Latinx Americans are nearly 2 times as likely as White Americans to say their access to COVID-19 vaccines, treatments, and health care, once available, is worse than other racial/ethnic groups.

Kaufman discusses results of the Health Trends Study, as well as his organization’s recent launch of the Quest for Health Equity Initiative in August 2020 to mitigate these health disparities.

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