Drug costs for COVID-19 patients plunge at U.S. hospitals, but may rise

By Chad Terhune

(Reuters) – Medication costs for COVID-19 patients hospitalized in the United States have dropped sharply since May, reflecting advances in treatment, shorter stays and use of cheaper generic drugs.

But costs may rise again as hospitals start to pay for Gilead Sciences Inc’s remdesivir.

Research by the health data firm IllumiCare and exclusively shared with Reuters found that hospitals spent $1,090 per COVID-19 patient on medication in July. That was down from $3,011 in May among more than 50 hospitals in 10 states that were analyzed.

Several factors drove down the number. The average length of stay for COVID-19 patients declined by nearly 30%, from 9.6 days in April to 6.8 days in July, the hospital data show. And the number of medications used dropped by 22%, from nearly 20 individual drugs in April to 15.4 drugs in July.

Pharmacists say some of the decrease in medications may stem from reduced use of ventilators, which require painkillers for sedation.

“We were throwing the kitchen sink at these patients and now hospitals are getting better at treating these infections,” said G.T. LaBorde, chief executive of IllumiCare, a Birmingham, Alabama-based firm that works with hospitals and analyzes their electronic medical records.

Remdesivir, which helped speed up patients’ recovery in a U.S. trial, won emergency-use authorization in May from U.S. regulators. Gilead donated early doses but has begun charging. It has said the price for commercially insured patients is $3,120 per treatment course and $2,340 for patients on Medicare.

Michael Ganio, senior director of pharmacy practice and quality at the American Society of Health-System Pharmacists, said many of the medications being used on COVID-19 patients are not “budget busters” and drug shortages have often been a bigger problem than cost.

But Ganio said pharmacy costs could increase significantly in the months ahead because of remdesivir.

Overall, many U.S. hospitals continue to face significant financial pressure from the pandemic as new infections remain high across much of the country, including in California, Florida and Texas. And health officials have warned that the upcoming flu season could further stress the healthcare system.

“As healthcare professionals, we are holding our breath for what fall will bring with flu season and COVID,” Ganio said.

In addition to remdesivir, hospital costs also may rise because of the increased use of tocilizumab, an anti-inflammatory drug widely used to treat arthritis. Hospital use jumped 29% among COVID-19 patients during July compared with the month earlier.

Tocilizumab costs more than $2,200 per patient, and is one of a class of drugs that includes Roche’s Actemra.

The most frequently prescribed drug for COVID-19 patients was the anticoagulant enoxaparin. It was given to 50% of inpatients last month at a cost of $322 per patient, the data show.

Another treatment recently found to reduce mortality for some COVID-19 patients, the steroid dexamethasone, costs $8.78 per patient, according to IllumiCare, and it was given to 35.1% of hospitalized COVID-19 patients reviewed in July.

Overall, IllumiCare said it looked at data from March through July at health systems in 10 states, including California, Texas and Alabama. It found more than 4,000 patients who were hospitalized and under treatment primarily for a coronavirus infection, drawing on medical billing codes for respiratory infection, sepsis and related conditions.

The firm excluded some COVID-positive patients, such as pregnant women, who were hospitalized for other reasons.

(Reporting by Chad Terhune. Editing by Peter Henderson and Gerry Doyle)

Trump proposes rule on importing medicines which industry says won’t cut costs

By Michael Erman and Carl O’Donnell

NEW YORK (Reuters) – The Trump administration on Wednesday said it is proposing a rule to allow states to import prescription drugs from Canada, moving forward a plan announced this summer that the president has said will bring cheaper prescription drugs to Americans.

Importation of drugs from Canada as a way to lower costs for U.S. consumers has been considered for years. Alex Azar, secretary of the Department of Health and Human Services (HHS), called the move “a historic step forward in efforts to bring down drug prices and out-of-pocket costs.”

He said HHS would also offer guidance to drugmakers that wish to voluntarily bring drugs that they sell more cheaply in foreign countries into the United States for sale here.

Both pathways for importation were announced in July when Azar unveiled a “Safe Import Action Plan.”

Azar could not provide an estimate as to how soon Americans could start receiving drugs from Canada. He said the proposed rule would need to pass through a 75-day comment period before being finalized.

“We’re moving as quickly as we possibly can,” he said.

Governors of states including Florida, Maine, Colorado, Vermont and New Hampshire have already expressed an interest in importing drugs from Canada once the pathway to do so is fully in place, he said. States would be required to explain how any proposed drug imports would reduce drug prices for consumers.

The proposal faces opposition from large U.S. pharmaceutical and biotech companies.

Jim Greenwood, current head of biotech industry group BIO and a former Republican congressman, said that importation would not result in lower prices for consumers, citing nonpartisan budget experts and past FDA commissioners.

“Today’s announcement is the latest empty gesture from our elected lawmakers who want us to believe they’re serious about lowering patients’ prescription drug costs,” Greenwood said.

The Canadian government has also criticized the plan. The country’s ambassador said last month that importing medicines from Canada would not significantly lower U.S. prices. Reuters previously reported that Canada had warned U.S. officials it would oppose any import plan that might threaten the Canadian drug supply or raise costs for Canadians.

Drugs approved to be imported from Canada would exclude many prescribed drugs, such as biologic drugs, including insulin, controlled substances and intravenous drugs.

Trump, a Republican, has struggled to deliver on a pledge to lower drug prices before the November 2020 election. Healthcare costs are expected to be a major focus of the campaign by Trump and Democratic rivals vying to run against him.

The Trump administration in July scrapped an ambitious policy that would have required health insurers to pass billions of dollars in rebates they receive from drugmakers to Medicare patients.

Also in July, a federal judge struck down a Trump administration rule that would have forced pharmaceutical companies to include the wholesale prices of their drugs in television advertising.

Both the House of Representatives and the Senate are putting forth drug pricing bills that contain some of the proposals Trump has advocated, such as indexing public drug reimbursements to foreign drug costs.

But Trump has said he will veto the Democrat-led House bill if it comes to his desk on the grounds that it would slow down innovation.

(Reporting by Michael Erman and Carl O’Donnell; Editing by Leslie Adler and Nick Macfie)

Cyber-attack on Singapore health database steals details of 1.5 million, including PM

Singapore Prime Minister Lee Hsien Loong in Manila, Philippines November 14, 2017. REUTERS/Aaron Favila/Pool

By Jack Kim

SINGAPORE (Reuters) – A major cyber attack on Singapore’s government health database stole the personal information of about 1.5 million people, including Prime Minister Lee Hsien Loong, the government said on Friday.

The attack, which the government called “the most serious breach of personal data” that the country has experienced, comes as the highly wired and digitalized state has made cybersecurity a top priority for the ASEAN bloc and for itself.

Singapore is this year’s chair of the 10-member Association of Southeast Asian Nations (ASEAN) group.

“Investigations by the Cyber Security Agency of Singapore (CSA) and the Integrated Health Information System (IHiS)confirmed that this was a deliberate, targeted and well-planned cyberattack,” a government statement said.

“It was not the work of casual hackers or criminal gangs,” the joint statement by the Health Ministry and the Ministry of Communications and Information said.

About 1.5 million patients who visited clinics between May 2015 and July 4 this year have had their non-medical personal particulars illegally accessed and copied, the statement said.

“The attackers specifically and repeatedly targeted Prime Minister Lee Hsien Loong’s personal particulars and information on his outpatient dispensed medicines,” it said.

A Committee of Inquiry will be established and immediate action will be taken to strengthen government systems against cyber attacks, the Ministry of Communications said in a separate statement.

It did not provide details about what entity or individuals may have been behind the attack.

Lee, in a Facebook post following the announcement, said the breach of his personal medical data was not incidental and he did not know what information the attackers were hoping to find.

“My medication data is not something I would ordinarily tell people about, but there is nothing alarming in it,” he said.

(Reporting by Jack Kim; Editing by Clarence Fernandez and Michael Perry)