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Behavioral Economics in Motion: UnitedHealthcare and Qualcomm

What do you get when one of the largest health insurance companies supports the development of a medical-grade activity tracker, enables data to flow through a HIPAA-compliant cloud, and nudges consumers to use the app by baking behavioral economics into the program? You get Motion from UnitedHealthcare, working with Qualcomm Life’s 2net cloud platform, a program announced today during the 2016 HIMSS conference. What’s most salient about this announcement in the context of HIMSS — a technology convention — is that these partners recognize the critical reality that for consumers and their healthcare, it’s not about the technology. It’s about

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Prescription Drug Costs Will Be In Health Benefits Bullseye in 2016

Prescription drug costs have become a front-and-center health benefits cost issue for U.S. employers in 2015, and in 2016 the challenge will be directly addressed through more aggressive utilization management (such as step therapy and prior authorization), tools to enable prescription intentions like DUR, and targeting fraud, waste and abuse. Consumers, too, will be more financially responsible for cost-sharing prescription drugs, in terms of deductibles and annual out-of-pocket limits, as described in the PBMI 2015-206 Prescription Drug Benefit Cost and Plan Design Report, sponsored by Takeda. The Pharmacy Benefit Management Institute has published this report for 15 years, which provides neutral, detailed survey

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The U.S. Will Cover the Bulk of Medicines Spending in 2020

U.S. spending on medicines will approach $590 billion in 2020, increasing 34% over 2015, IMS Institute for Healthcare Informatics projects in its forecast, Global Medicines Use in 2020. Growth in spending will be attributable to innovation (new products), price increases and some patent losses of exclusivity (e.g., branded drugs going generic). The U.S. will cover the bulk of drugs spending in 2020 at 41% of the world medicines market, shown in the first pie in the first chart. U.S. medicines spending dwarfs any other country or region in the world, including China which is expected to account for 11% of

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The Fast-Growing Consumer Digital Health Ecosystem – Health 2.0 Day 2

The fastest-growing category of products and services at Health 2.0 is consumer-facing digital health, and a panel of companies demonstrated various flavors of the New Retail Health. One of the most prominent companies featured in Health 2.0’s conferences from the inception has been MyFitnessPal (MFP), a long-time helpful tool I’ve used to manage my own health-life. Under Armour acquired MFP earlier this year, which I covered here in Health Populi. Under Armour’s original mission was to make all athletes better. With the company’s acquisition of MyFitnessPal, Under Armour continued its morphing from a textile and sports gear company to a

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Health Politics – Learning From History in Art from the Reagan/AIDS Era

By Jane Sarasohn-Kahn on 24 July 2015 in Art and health, FDA, Health costs, Health politics, HIV/AIDS

The high cost of specialty drugs, opaque information on risks of many existing prescription drugs, and lack of cures for diseases impacting millions of people are forces driving patients into activism, the likes of which we haven’t seen since the emergence of AIDS. I was reminded this yesterday, not inside the Beltway at an FDA or Congressional hearing, or in an online social network of patient activists. I was visiting the newly re-opened and re-built Whitney Museum, an architectural gem now re-energizing the Meatpacking District in Lower Manhattan. It wasn’t the building design (which is getting rave reviews from architecture

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Digital health mainstreams at CE Week 2015

Digital health is a fast-growing category of consumer electronics, and many new mobile and wearable health devices were featured at the 2015 CE Week held in New York City. The major themes of the “Fresh Gear” unveiled at the meeting included connected cars, connected home devices, 3-D printing, and a growing array of wristbands, apps, and wearable devices focused on the already-crowded health/wellness segment, and the emerging health/care area. The five I’ll focus on are good examples of digital health tech’s aimed at mainstream consumers shopping at retail at the middle of the market: an area that’s ripe to be served.

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The Internet of Healthy Me – putting digital health in context for #CES2015

Men are from Mars and Women, Venus, when it comes to managing health and using digital tools and apps, based on a poll conducted by A&D Medical, who will be one of several hundred healthcare companies exhibiting at the 2015 Consumer Electronics Show this week in Las Vegas. Digital health, connected homes and cars, and the Internet of Things (IoT) will prominently feature at the 2015 Consumer Electronics Show in Las Vegas this week. I’ll be attending this mega-conference, meeting up with digital health companies and platform providers that will enable the Internet of Healthy “Me” — consumers’ ability to self-track,

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Health IT Forecast for 2015 – Consumers Pushing for Healthcare Transformation

Doctors and hospitals live and work in a parallel universe than the consumers, patients and caregivers they serve, a prominent Chief Medical Information Officer told me last week. In one world, clinicians and health care providers continue to implement the electronic health records systems they’ve adopted over the past several years, respond to financial incentives for Meaningful Use, and re-engineering workflows to manage the business of healthcare under constrained reimbursement (read: lower payments from payors). In the other world, illustrated here by the graphic artist Sean Kane for the American Academy of Family Practice, people — patients, healthy consumers, newly insured folks,

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Live from the 11th annual Connected Health Symposium – Keeping Telehealth Real

Dr. Joseph Kvedar has led the Center for Connected Health for as long as I’ve used the word “telehealth” in my work – over 20 years. After two decades, the Center and other pioneers in connected health have evidence proving the benefits, ROI (“hard” in terms of dollars, and “soft” in terms of patient and physician satisfaction), and technology efficacy for connecting health. The 11th Annual Connected Health Symposium is taking place as I write this post at the Seaport Hotel in Boston, bringing health providers, payers, plans and researchers together to share best practices, learnings and evidence supporting the

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Specialty pharmaceuticals’ costs in the health economic bulls-eye

This past weekend, 60 Minutes’ Leslie Stahl asked John Castellani, the president of PhRMA, the pharmaceutical industry’s advocacy (lobby) organization, why the cost of Gleevec, from Novartis, dramatically increased over the 13 years it’s been in the market, while other more expensive competitors have been launched in the period. (Here is the FDA’s announcement of the Gleevec approval from 2001). Mr. Castellani said he couldn’t respond to specific drug company’s pricing strategies, but in general, these products are “worth it.” Here is the entire transcript of the 60 Minutes’ piece. Today, Health Affairs, the policy journal, is hosting a discussion

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Health on the 2014 Gartner Hype Cycle

Remote health monitoring is in the Trough of Disillusionment. Wearables are at the Peak of Inflated Expectations, with Big Data leapfrogging wearables from the 2013 forecast — both descending toward the Disillusionment Trough. Mobile (remote) health monitoring, however, has fallen into that Trough of Disillusionment as RHM has been undergoing reality checks in the health care system especially for monitoring and patient self-management of heart disease (most notably heart failure) and diabetes. Welcome to the 2014 edition of the Gartner Hype Cycle, one of my most-trusted data sources for doing health industry forecasts in my advisory work. Compared with last year’s

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Blurred lines: health, pharmacy, food and care

In the past few weeks, several events bolster the reality that health and health care are in Blurred Lines mode. Not Robin Thicke Blurred Lines, mind you, but the Venn Diagram overlapping kind. Walmart launched real primary care clinics in South Carolina and Texas. These will provide services beyond urgent care, charging $4 a visit for company employees and $40 a visit for other people The U.S. Department of Agriculture issued a report promoting “nudges” to grocery shoppers enrolled in the Supplemental Nutrition Access Program (SNAP) to buy healthy foods Apple is talking with Cleveland Clinic, Johnson Hopkins, and Mount Sinai Medical

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Over-the-counter drugs – an asset in the collaborative, DIY health economy

Nations throughout the world are challenged by the cost of health care: from Brazil to China, India to the Philippines, and especially in the U.S., people are morphing into health care consumers. Three categories of health spending in the bulls-eye of countries’ Departments of Health are prescription drugs, and the costs of care in hospitals and doctors’ offices. In the U.S., one tactic for cost containment in health is “switching” certain prescription drugs to over-the-counter products – those deemed to be efficacious and safe for patients to take without seeking treatment from a doctor. Over-the-counter drugs (OTCs) are available every

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Who’s Looking at You? consumer-generated data, Big Data, & health

Opportunities abound for sharing data “for good” – to turbocharge clinical trials, inform medical research, anticipate and better manage epidemics, and focus on individual health goals benchmarking oneself vs. peers. At the same time, third party data brokers and marketing interests with which consumers have no direct connection of knowledge are scraping together bits of personal information from internet clouds, social networks, and retail data from which profits are made. And that value does not accrue to the very individuals whose data are being sold. Here’s Looking At You: How Personal Health Information Gets Tracked And Used, published by California HealthCare

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Big Data Come to Health Care…With Big Challenges – Health Affairs July 2014

“For Big Data, Big Questions Remain,” an article by Dawn Falk in the July 2014 issue of Health Affairs, captures the theme of the entire journal this month. That’s because, for every opportunity described in each expert’s view, there are also obstacles, challenges, and wild cards that impede the universal scaling of Big Data in the current U.S. healthcare and policy landscape. What is Big Data, anyway? It’s a moving target, Falk says: computing power is getting increasingly powerful (a la Moore’s Law), simpler and cheaper. At the same time, the amount of information applicable to health and health care

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World No Tobacco Day v2014 – let’s raise (more) taxes on tobacco

Tomorrow is World No Tobacco Day. The use of tobacco is one of the most preventable public health issues on the planet. And the global tobacco epidemic contributed to 100 million deaths around the world in the 20th century. 6 million people die every year due to tobacco use — including 600,000 deaths due to exposure to secondhand smoke. About 500 million people living today will be dead from the use of tobacco products if current smoking habits continue, the World Health Organization (WHO) expects. WHO sponsors the World No Tobacco Day every year on May 31. For this year’s

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Doctors and mHealth apps: chaos, evidence, creation

Over one year ago, an eClinicalWorks survey found that 9 in 10 physicians would be interested in prescribing a mobile health app to a patient. That’s a big number. That’s “interest,” but that demand hasn’t yet been expressed in the current go-go app-happy environment.  An opinion piece in this week’s Online First edition of the Journal of the American Medical Association (JAMA) demonstrates the fork-in-the-road facing clinicians and the disruption/opportunity that is mobile health. In “In Search of a Few Good Apps,” a Boston-based trio of writers (two physicians and one PhD) talk about “the bewildering diversity of apps available

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People want to DIY with pharma

In our increasingly-DIY society, most consumers expect high levels of access and customer service from the organizations with whom we engage. With more consumers reaching into their pockets to pay for health services and products, the health industry is increasingly a retail-facing environment. So expect quality service levels from their healthcare touch points. The pharmaceutical and prescription drug touch point is not exempt from this expectation, as learned by an Accenture survey analyzed in Great Expectations: Why Pharma Companies Can’t Ignore Patient Services. As the first picture shows, 70% of patients think pharma companies are responsible for bundling information and services

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Pharma warming up to the cloud to drive efficiencies and support analytics

Over the next few years, large global pharma companies will need to wring out an additional $35 billion worth of efficiencies in order to drive profitability. While the industry has most of the patent cliff challenge behind it, companies face price constraints with respect to health reform, static national economies, and access demands. As the pharmaceutical industry enters the value-based health care era, the industry must catch up with other vertical markets in adopting information technology. In particular, pharma has been slower to migrate to the cloud than other businesses, with concerns about security and health care particular needs. Today, the

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HIMSS14 Monday Morning Quarterback – The Key Takeaways

Returning to terra firma following last week’s convening of the 2014 annual HIMSS conference…taking some time off for family, a funeral, the Oscars, and dealing with yet another snowstorm…I now take a fresh look back at #HIMSS14 at key messages. In random order, the syntheses are: Healthcare in America has entered an era of doing more, with less...and health information technology is a strategic investment for doing so. The operational beacon going forward is moving toward The Triple Aim: building population health, enhancing the patient’s experience, and lowering costs per patient. The CEO of Aetna, Mark Bertolini, spoke of the

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Patient engagement and mobile health – design and timing matter

Thinking about personal health information technology – the wearable devices, remote health monitors, digital weight scales, and Bluetooth-enabled medical equipment scaled for the home – there are two glasses. One is half-full and the other, half-empty. The half-full glass is the proliferation of consumer-facing devices like Fitbit, Jawbone and Nike, which comprise the lion’s market share in the health wearables segment; the mass adoption of mobile phones and tablets; consumers’ multi-screen media behavior (as tracked by Nielsen); and consumers’ growing share of medical spending, now about 40% of annual spending (or something north of $8,000 for a family of four

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Pharma and the health industry: when will they finally meet us Where We Live?

Millions of health citizens, consumers, patients and caregivers flock to Facebook, Twitter and Wikipedia every day the world over to seek health information, advocate for patients’ access to a cancer therapy on a health blog, engage in peer-to-peer health care in a social network, and bolster each others’ management of chronic medical conditions in a chat community. Yet the pharmaceutical and medical device industries rank well behind other industries vis-à-vis the use of social media, asserts Engaging patients through social media, with the punchline question: is healthcare ready for empowered and digitally demanding patients? from the IMS Institute for Healthcare Informatics, published on

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mHealth will join the health ecosystem – prelude to the 2014 Consumer Electronics Show

The rise of digital health at the 2014 Consumer Electronics Show signals the hockey-stick growth of consumer-facing health devices for fitness and, increasingly, more medical applications in the hands of people, patients, and caregivers. This year at #CES2014, while the 40% growth of the CES digital health footprint will get the headlines, the underlying story will go beyond wristbands and step-tracking generating data from an N of 1 to tools that generate data to bolster shared-decision making between people and the health system, and eventually support population health. For example: – Aetna is partnering with J&J to deploy their Care4Today

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23andme & Me

23andme received word from the Food & Drug Administration (FDA) on November 22, 2013, that they must cease and desist selling the company’s Saliva Collection Kit and Personal Genome Service (PGS). FDA explained in their Warning Letter, “Most of the intended uses for PGS listed on your website, a list that has grown over time, are medical device uses under section 201(h) of the FD&C Act. Most of these uses have not been classified and thus require premarket approval or de novo classification, as FDA has explained to you on numerous occasions. “Some of the uses for which PGS is intended are

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The FDA Has Spoken, and It Will Regulate “Some” mHealth Apps

The FDA has spoken: there are 2 statutory definitions for a mobile health tool as a “medical device” that the Agency says it has regulatory oversight: To be used as an accessory to a regulated medical device, or To transform a mobile platform into a regulated medical device. On page 8 of the Guidance for Industry and Food and Drug Administration Staff, you can read the FDA’s expanded definition of a mobile health app as being: “…intended for use in performing a medical device function (i.e. for diagnosis of disease or other conditions, or the cure, mitigation, treatment, or prevention

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Dietitians provide a health bridge between food and pharmacy

The registered dietitian is an in-demand labor resource for grocery stores around the U.S. Advertising Age covered the phenomenon of the growing clout of dietitians in food chains (April 14, 2013). Let’s dig further into this phenomenon through the Health Populi lens on healthcareDIY and peoples’ ability to bend their personal health care cost curves. Stores such as Giant Eagle, Hy-Vee, Safeway and Wegmans are morphing into wellness destinations, with pharmacies and natural food aisles taking up valuable square footage to meet consumers’ growing demands for healthy choices. Some stores are formalizing their approach to food = health by formulating a

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FDA goes DTP(atient)

The Food & Drug Administration (FDA) launched its new website for and about patients, the Patient Network, with the tagline, “Bringing your voice to drug and device approval and safety.” With this move, the FDA moves toward social health, someplace where at least one-third of U.S. consumers already opine, shop, share personal info, crowdsource cures, and support each other on all-matters-health-and-illness. The objective of the Patient Network is, “to help FDA help patients have a bigger voice.” Dr. Margaret Hamburg, the Commissioner of the FDA, talks about the concept here. The rationale? “When patients better understand the intricacies of how

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1 in 5 US consumers asks a doctor for a lower-cost Rx

  With U.S. health consumers spending $45 billion out-of-pocket for prescription drugs in 2011, pharmaceutical products are morphing into retail health products. As such, as they do with any other consumer good, consumers can vote with their feet by walking away from a product purchase or making the spend based on the price of the product and its attributes, along with whether there are substitutes available in the marketplace. When it comes to prescription drugs, it’s not as clear-cut, according to the Centers for Disease Control‘s analysis of data from the 2011 National Health Interview Survey titled Strategies Used by

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Living paycheck to paycheck: what it means for health

While 50% of Americans feel they have a sound financial position, the other half is living paycheck to paycheck. 8% say they can’t even pay for essentials. The second annual Allstate “Life Tracks” Poll finds American adults split between have’s and have not’s, with even the “have’s” feeling less than financially literate. There is an equal split between people who feel they’re in an “excellent” or “good” financial position compared with those who feel they’re in financially “fair” or “poor” shape. Men feel more financially secure than women; 3 in 4 single parents feel less well-off compared to the average

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Managing the abundance of mHealth apps in the urban flea market

The proliferation of mobile health (mHealth) apps appears to be an abundant cornucopia of “lite” tools that look simple to access and easy to use. But this growing menu of a la carte choices that promise to keep us healthy, track our numbers, and access useful health information can also, in the words of three Dutch health researchers, “drive us crazy.” Why mobile health app overload drives us crazy, and how to restore the sanity, by Lex van Velsen and colleagues, makes the case that the plethora of mHealth apps available in online app stores is a fragmented, disorganized marketplace

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The new bio-terrorism? Medical device hacking

A time-and-technology challenged FDA, proliferation of software-controlled medical devices in and outside of hospitals, and growth of hackers have resulted in medical technology that’s riddled with malware. Furthermore, lack of security built into the devices makes them ripe for hacking and malfeasance. Scenario: a famous figure (say, a politician with an implantable defibrillator or young rock star with an insulin pump) becomes targeted by a hacker, who industriously virtually works his way into the ICD’s software and delivers the man a shock so strong it’s akin to electrocution. Got the picture? Welcome to the dark side of health IT and

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