Category: Research

ICER founder Dr. Steve Pearson explains COVID-19 remdesivir pricing model

published date
November 12th, 2020 by

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Dr. Steve Pearson

Drug pricing is the hottest topic in healthcare, and ICER founder Dr. Steve Pearson is the coolest person to discuss it with.

In this episode of the HealthBiz podcast, Steve describes how the Institute for Clinical and Economic Review (ICER) compiles and analyzes clinical evidence to estimate the fair value of treatments for cancer and other serious illnesses. ICER has been especially active during the pandemic, developing a pricing model for remdesivir and other COVID-19 therapies that’s being used in the United States and by health technology assessment agencies around the world.

For fun, he has been reading Paradise Lost by John Milton.

This is the second episode I’ve recorded on COVID-19 drug pricing. Check out the first one: Remdesivir powers activate! with Dr. Surya Singh.

The HealthBiz podcast is now on SpotifyApple PodcastsGoogle Podcasts and  many more services, making it easy to subscribe.

Below is a rough (AI-generated) transcript of the episode.



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By healthcare business consultant David E. Williams, president of Health Business Group

 

Data will eat public health: Podcast with Shahir Kassam-Adams

published date
September 24th, 2020 by

The HealthBiz podcast is now on Spotify and will soon be on many more services making it easy to subscribe.

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Shahir Kassam-Adams

Shahir Kassam-Adams is one of the most knowledgeable and outspoken people in healthcare. In this episode, Shahir shares his initially unsettling but ultimately reassuring view that “data will eat public health.” He opines on interoperability and explains how his company, Datavant has promoted data sharing on COVID-19, leading to a plethora of interesting and potentially useful projects, including one that models the tradeoffs for specific American cities to reopen.

Check out the links:

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By healthcare business consultant David E. Williams, president of Health Business Group

Russia rushes its COVID-19 vaccine. Why all is not what it seems

published date
August 10th, 2020 by
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Any volunteers?

Russia –yes the Russia that exerts special influence on our president– has done a poor job of keeping the COVID-19 virus in check. But now they claim to have a safe and effective vaccine that’s ready to go.

I’m quoted in the International Business Times (Questions Surround Russia’s Ability to Deliver a Safe, Effective Coronavirus Vaccine)

Some suggest that the vaccine may not be safe – or effective.

“It’s obvious that the Russians are rushing the vaccine to market without adequate testing,” David Eugene Williams, president at Health Business Group, told International Business Times in an email. “It’s possible that the vaccine will work, but there hasn’t been enough time to verify that it’s both safe and effective. The Russians haven’t released any data that would support their claims.”

“I don’t think people will travel to Russia to receive the vaccine because, 1) they won’t trust that it will work, 2) they could get COVID-19 on their travels to Russia, and 3) the Russians may allocate it to their own citizens,” he said.

It would be great if the Russian vaccine works. But we’ll have to wait and see –which is something the developers haven’t done.


By healthcare business consultant David E. Williams, president of Health Business Group.

What do patients think of virtual care? Interview with Kyruus’s Dr. Erin Jospe

published date
July 31st, 2020 by
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Dr. Erin Jospe, Kyruus CMO

Patients have been receiving a megadose of virtual care since March. How’s it going and what will it mean long-term? Provider search and scheduling company, Kyruus asked 1000 patients for their opinions and published the findings.

How Patients Learned About Virtual Care Options
How Patients Learned About Virtual Care Options

Kyruus Chief Medical Officer, Dr. Erin Jospe and I had a chance to catch up on the report and speculate about its implications in this podcast.

Here’s what we discussed:

  • (0:15) Key findings and surprises
  • (1:54) Baby Boomers’ affinity for virtual care
  • (3:40) Paradox that Baby Boomers are big utilizers of virtual care but not so likely to switch doctors to get it
  • (6:21) Downsides and limitations of virtual care
  • (10:55) Impact of virtual care on disparities
  • (13:47) Potential to launch a virtual-first practice
  • (17:31) Why Kyruus cares about these results

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Interview conducted by healthcare business consultant David E. Williams, president of Health Business Group. Podcast production by Marina Zapesochny, social media intern.

Massachusetts school reopening plan gets an A from me

published date
June 26th, 2020 by
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See you in the fall

There’s much to like about the new Massachusetts Initial Fall School Reopening Guidance document. It is:

  • Purposeful –aiming to meet the objective of educating children in person while keeping them and staff members safe
  • Timely –coming at the end of the school year, with updates promised over the summer
  • Evidence based –relying on the latest medical and public health guidance and the experience of schools abroad
  • Appropriately detailed –with enough specifics to  guide decisions that need to be made now without being overly prescriptive
  • Circumscribed –acknowledging and accounting for issues of racism and disparities without purporting to solve every problem
  • Balanced –recognizing that we are living in the real world (such as it is!) and that COVID-19 is part of it. None of the measures (hand washing, masks, staying home when sick, social distancing) on their own will prevent the spread, but taken together they have and will

I’m not an easy grader, so my A for this assignment is real. I have publicly criticized Massachusetts’ reopening plan and its testing plan for being vague, non-evidenced based, and irrational. Privately, I’ve admonished the local school system for its defeatist attitude toward COVID-19.

Predictably, the Boston Globe (School guidelines feel unsafe to some) used today’s lead article to find fault with a wide variety of plan elements. Here are the ones I see mentioned:

  • The plan doesn’t set a cap on the number of students in classrooms
  • COVID-19 testing is not mandated
  • Daily temperature checks are not required
  • It mandates only 3 feet of social distancing even though officials have been telling us 6 feet
  • Superintendents need to develop 3 sets of plans (in person, hybrid, virtual)
  • No clear guidance on whether state should go back to in-person classes when school reopens
  • Doesn’t adequately address  challenges of urban schools that serve children from disadvantaged backgrounds and have limited space
  • Racism is not connected to students’ mental health in the plan
  • It doesn’t say how many students can ride the bus
  • People don’t like the idea of wearing masks all day

The report itself anticipates and addresses these criticisms. The Globe notes  some but not all. Here is the reasoning

  • Number of students isn’t capped because the relevant constraints are adequate space between desks and proper behavior. If a room is larger it can accommodate more students. The report encourages use of new spaces like libraries and cafeterias
  • No one in the country (or world?) is seriously suggesting testing all school age kids. It’s expensive, slow, unpleasant, impractical and unnecessary. Maybe there will be cheap, spit tests at some point. They can be used if the need is real
  • Daily temperature checks produce too many false negatives and false positives, offering a false sense of security and causing students to miss school when they don’t need to. These checks are good for other illnesses, like the flu where fever is a good indication of active infection, but it’s of limited use for COVID-19
  • There’s no magic in 6 feet. Three feet seems to work fine in other countries’ schools, especially in combination with other measures, like wearing masks. Schools with 3 feet of distance abroad have not had outbreaks. Kids aren’t going to be safer out of school
  • Superintendents need to develop plans for different scenarios. Of course they do! If they just developed one plan it would have to be for remote instruction only. Is that what we want?
  • Of course the guidelines can’t be definitive in June about whether students can go back in September. But the goal is to get as many back as possible. To make that happen requires everyone to behave well over the summer (adults, especially!)
  • Although the plan isn’t going to eliminate disparities or solve racism, there are extra funds to help all schools and especially those with extra needs. And the best way to reduce disparities is with kids in school. Disparities widen (as I’m sure they did this spring) when normal routines are thrown off. For extra space, the guidelines suggest working with local community centers, libraries, etc.
  • Kids will need to wear masks on the bus. If the bus is crowded then buses will need to be added or kids will need to get to school in other ways. They can keep windows open, too.
  • It’s true that people don’t like wearing masks all day. The guidelines call for mask breaks and make special mention of how to work with people with breathing or communication problems. If we all behave there’s a good chance we can take our masks off sooner rather than later.

Notably, these guidelines are endorsed by people who know what they’re talking about and have children’s interests at heart. The healthy approach is to work within the guidelines to plan a return to in-person classes this fall. We should continue to challenge the guidelines and expect them to be updated as we learn more and as the situation on the ground evolves.

Meanwhile, we can all contribute to a safer back-to-school scenario by continuing to follow public health guidelines that are knocking the virus down in Massachusetts. The lower the level of community spread, the safer any reopening plan will be.


By healthcare business consultant David E. Williams, president of Health Business Group.