Narrowing Networks, ACC’s Google Deal, Heart Effects of Vaping and More

From narrowing insurer networks to the heart effects of vaping, plenty of news items piqued the interest of Cleveland Clinic Miller Family Heart & Vascular Institute Chairman Lars Svensson, MD, PhD, over the past couple of weeks. Here’s a brief sampling, with a deliberate focus beyond the big-headline studies.

Insurer networks to narrow next year — Three-quarters of health insurance plans to be offered through Affordable Care Act exchanges in 2017 will likely be exclusive provider organizations (EPOs), which typically use narrow networks of physicians and hospitals. That’s what a McKinsey & Co. analysis of regulatory filings concludes, as reported by the Wall Street Journal.

More data doesn’t always improve HF outcomes — So concludes the lead investigator of a UK study presented at the European Society of Cardiology Congress showing that weekly remote monitoring of cardiac implantable devices did not improve mortality and hospitalization rates among a large sample of heart failure patients. “If patients are well-treated already, and have well-controlled symptoms, looking at remotely collected data weekly is no better than usual care,” the researcher noted, as reported by MedPage Today.

Is this how competitive markets are supposed to work? — Eight of the 10 drugs that had the biggest percentage price increases in 2014 were generic medications produced by multiple manufacturers, according to CMS data. So reports a Los Angeles Times feature in the wake of the EpiPen pricing scandal. “The price of an increasing number of generic drugs with multiple manufacturers is rising,” the story notes.

Study erodes idea that all ACS cases need stents — Patients with acute coronary syndromes (ACS) caused by plaque erosion who would typically be treated with stents may be able to avoid stenting and fare well simply with antithrombotic medications. That’s the upshot of the proof-of-concept study known as EROSION presented by Harvard Medical School researchers at the European Society of Cardiology Congress and published in the European Heart Journal. As the lead investigator told ACC.org: “If we can identify ACS patients with erosion without an invasive procedure [EROSION used intravascular optical coherence tomography], those patients may be triaged to a conservative therapy pathway instead of invasive catheterization and stent implantation.”

Setting the record straight at the source — A change is coming to Google searches on heart terms. When consumers look up a cardiovascular condition on the search engine, soon the search results will prominently display information based on American College of Cardiology (ACC)-developed clinical guidelines. The change stems from a new agreement struck by the ACC and Google, reports Healio. The ACC says it hopes the agreement makes it easier for the public to get accurate answers to health and medical questions.

FDA not yet among those impressed by reversal agent — “Cold comfort” is how MedPage Today describes the positive data presented on the novel NOAC reversal agent andexanet alfa at the European Society of Congress meeting just one week after the FDA demanded more evidence before it approves the drug. The recombinant modified human factor Xa decoy protein reduced anti-factor Xa activity by 89 percent in patients taking rivaroxaban and by 93 percent in those taking apixaban, two leading newer oral anticoagulants (NOACs) currently without a reversal agent for use in cases of acute major bleeding. Results were simultaneously published in the New England Journal of Medicine.

Kids aren’t the only ones with too much screen time — A perspective piece on RealClearHealth makes the case that CMS’s “meaningful use” reporting requirements vis-à-vis electronic medical records are the reason “doctors spend up to half the length of each appointment looking past their patients at their computer monitors.” Rumors that meaningful use would be scrapped as part of Medicare and CHIP Reauthorization Act (MACRA) implementation were unfounded, the story laments. Seems that the EMR reporting requirements are simply being renamed and combined with other criteria for determining reimbursement.

Where there’s vapor is there still fire? — Thirty minutes of vaping has about the same impact on aortic stiffness as five minutes of smoking a cigarette. So finds a study of 24 adults presented by University of Athens Medical School researchers at the European Society of Cardiology Congress. The Telegraph reports that the researchers say this raises serious questions about the safety of using e-cigarettes as a smoking-cessation aid and that long-term studies are warranted.