Can voice-based AI help patients with diabetes move more quickly towards optimal insulin dosing? According to a Nayak et al. (2023) study out today in JAMA Network Open, the answer is yes. Question  Can a voice-based conversational artificial intelligence (AI) application help patients with type 2 diabetes titrate basal insulin at home to achieve rapid glycemic control? Findings  In this randomized clinical trial that included 32 adults with type 2 diabetes requiring initiation or adjustment of basal insulin, participants who used a voice-based conversational AI application had a si ..read more

How CADTH thinks about equity. FDA-approved pharmaceuticals for dogs. State Freedom Index.  Ho-hum: another $10 billion deal in pharma. Sociopath or saint ..read more

Just this year a majority of Medicare beneficiaries enrolled in a Medicare Advantage plan. While these plans are popular with patients, I recently wrote that some rural providers are refusing to accept Medicare Advantage due to low reimbursement. A recent article from Kaiser Health News finds that provider frustration with Medicare Advantage is spreading to urban areas as well, such as San Diego and Louisville. …more than 30,000 San Diego-area residents are looking for new doctors after two large medical groups affiliated with Scripps Health said they would no longer contract with Medica ..read more

Many health policy experts–including myself–have noted that treatments that help reduce health disparities may be especially valuable whereas those that exacerbate inequalities may be somewhat less valuable than predicted by standard cost-effectiveness analysis. A key question is, health disparities over what dimension(s)? Is it race? Income? Education? O’Nell et al. (2013) developed the PROGRESS framework. More recently, the PROGRESS-Plus proposes an even more extended list of dimensions: Place of residence Race/ethnicity/culture/language Occupation Gender/sex Religion Education Socioeconomi ..read more

According to the OECD, In 2021 the U.S. spent $1,432/capita on pharmaceuticals compared to only $517/per capita in the UK. The UK’s figure was slightly higher that Poland and Norway, but less than Latvia, the Slovak Republic, Portugal and Romania. How does the UK spend so little on drugs? Many people focus on the efforts of National Institute for Health and Care Excellence (NICE) and their focus on linking drug prices paid to health value delivered. Typically, however, the value of health in the UK is priced relatively low (only £20,000-£30,000/QALY compared to $100,000 – $150,000 in the US ..read more

We ought not be ashamed of appreciating the truth and of acquiring it wherever it comes from, even if it comes from races distant and nations different from us. For the seeker of truth, nothing takes precedence over the truth, and there is no disparagement of the truth, nor belittling either of him who speaks it or of him who conveys it. Al-Kindi as quoted in Centers of Progress: 40 Cities that changed the World ..read more

Be prepared to say “Go”. Dana Farber to build stand-alone cancer center in Boston. Robots will pick fruit in the future. Proximity to fast food and weight gain. Pharma CEOs summoned to the Hill. mRNA patents being disputed. Mental health and being grateful ..read more

That is the finding from a CDC report released this month. Mortality rates fell by 24% between 2001 and 2021. Specifically, the cancer death rate for youth ages 0–19 years was 2.75 per 100,000 in 2001, but decrease to 2.10 per 100,000 in 2021. The analysis uses data including (i) cause of death data from National Center for Health Statistics 1999–2020, and (ii) population information from the US Census, , Some key figures and a more detailed summary are below. https://www.cdc.gov/nchs/data/databriefs/db484.pdfhttps://www.cdc.gov/nchs/data/databriefs/db484.pdfhttps://www.cdc.gov/nchs/data/datab ..read more

As individuals live longer, governments and employers are considering increasing the age at which individuals become eligible for either public or private pensions (e.g., Social Security). Why this fiscal impacts of changing the retirement age has been well-studied, the labor market and health outcomes are less well-known. A paper by Serrano-Alarcón et al. (2023) examines the impact of pension reform in Italy. Italy has a public pension system that is financed using a (PAYGO) mechanism. Income replacement rates historically have been 77%. A 2012 pension reform increased the retirement age, suc ..read more

Patients assigned to different primary care providers in the US have different levels of spending. This is not surprising, but to what degree is this result driven by variation in health care utilization compared to prices? A paper by Mehrotra et al. (2023) aims to answer this question using 2018 claims data from a large commercial insurer. They find that: Per-patient spending in the highest quartile of spending medical groups was $1813 higher than per-patient spending in the lowest spending quartile of medical groups (50% higher relative spending). This overall difference was primarily drive ..read more