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Health Care Service Corp. will pay an undisclosed sum to buy third-party administrator Trustmark Health Benefits, the Blue Cross and Blue Shield company announced Thursday.
HCSC has been a Trustmark customer and relies on it to manage self-insured customers’ medical spending, according to a news release. Trustmark Health Benefits is a subsidiary of Trustmark Cos., an employee benefits vendor.
The acquisition will help the not-for-profit insurer customize benefits plans for self-funded employers, the company said. HCSC sells Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas and has nearly 17.5 million members. The transaction is expected to close this year, subject to regulatory approval.
HCSC and Trustmark Health Benefits didn’t immediately respond to interview requests.
Trustmark Health Benefits generated $147.2 million in revenue in 2021, down 3.7% from the year before, a drop driven by declining sales to self-insured employers during the COVID-19 pandemic, according to the company’s most recent annual report.
The company inked a deal with Teladoc Health and the Aon professional services firm to launch a virtual-first plan for employers last year. Additionally, Trustmark Health Benefits partnered with the company Included Health last year to offer navigation services for LGBTQ employees and their dependents.
HCSC’s planned acquisition of Trustmark Health Benefits continues its strategy to expand offerings for commercial customers, a critical area of the insurer’s business as its Medicare Advantage market share declines. Last year, the company invested an undisclosed sum in Collective Health, a digital health startup that provides third-party administration, patient navigation, and advocacy and analytics services to employers. As part of the deal, Collective Health created a digital platform for HCSC’s self-funded employer customers in Illinois and Texas.
About a month before giving birth, Kelly Spill said she noticed something wasn’t right. When using the bathroom, she reported “seeing blood,” and the problem persisted for months after she gave birth.
“I had a gut feeling that it was going to be cancer,” she told CBS News chief medical correspondent Dr. Jon LaPook. “I just knew.”
A colonoscopy later confirmed her suspicions, and a specialist told Spill that she had colorectal cancer, which most likely meant she would not be able to have another child due to the effects of chemotherapy, radiation and surgery.
“Pretty much it would all be fried up down here,” Spill said.
But a genetic mutation that only occurs in about 5% to 10% of people with her type of early stage cancer made her a match for an experimental trial at the Memorial Sloan Kettering Cancer Center. The immunotherapy is an antibody that allows the patient’s own immune cells to attack cancer cells.
“It sounded a lot better than chemo,” she said. “And I just thought, just, ‘What if that works?'”
Since undergoing the immunotherapy, Spill has fully recovered.She is now taking a trip around the country in an RV with her husband and son.
“I’m slowly realizing what I went through, how hard it was and now it’s like the rainbow is here,” Spill said.
And Spill isn’t alone in her recovery.
In the trial, all 18 patients had complete resolution of their early rectal cancer, were cancer-free for up to two years and did not need to have standard treatments of radiation chemotherapy or surgery.
“We truly weren’t expecting this type of response where every single patient, the tumor’s gone and how quickly they responded,” Dr. Andrea Cercek, who led the trial treatment, told LaPook.
After undergoing treatment in the groundbreaking trial, Imtiaz Hussain said he cried when the doctor called to tell him he no longer had cancer.
“It’s just relief,” Hussain said. “You’re seeing the sun after like a year — it’s that kind of feeling.”
Researchers agree the trial needs to now be replicated in a much bigger study, noting that the small trial focused only on patients with a rare genetic signature in their tumors and whose cancer had not spread beyond the colon.
Tori B. Powell
Tori B. Powell is a breaking news reporter at CBS News. Reach her at tori.powell@viacomcbs.com
The Inflation Reduction Act represents the most important effort in decades to reform how drug prices are set in the U.S., experts say.
“This is going to be game-changing,” Rena Conti, an associate professor at Boston University’s Questrom School of Business who studies drug pricing, said of the bill, which passed in the Senate on Sunday and which House lawmakers could vote on as early as Friday.
Read on to learn what the bill — which also proposes to invest $400 billion to fight climate change and raise taxes on corporations — would do to lower spiraling drug prices.
$2,000 limit on out-of-pocket costs
The biggest change for seniors on Medicare would be to limit on how much they spend out-of-pocket on medication and on vaccines. Vaccines would be free starting next year. Starting in 2025, out-of-pocket spending on drugs would be limited to $2,000 per year. In 2024, costs would be capped at Medicare’s catastrophic drug coverage limit, which this year is $7,050.
That’s good news for seniors that take expensive drugs.
“Today’s policy basically has unlimited out-of-pocket spending, and that is really bad for people who need expensive drugs,” said Stacie Dusetzina, associate professor of health policy at Vanderbilt University Medical Center. “For anyone who needs drugs to treat cancer, multiple sclerosis, rheumatoid arthritis — some of them have bills over $10,000 a year.”
In 2019, 1.5 million seniors spent more than $2,000 on prescriptions, according to the Kaiser Family Foundation. But the true number may be higher, said Dusetzina, pointing to research showing that 30% of Medicare beneficiaries who face high prices for cancer treatments don’t fill their prescriptions.
Tricia Neuman, director of the Program on Medicare Policy at the Kaiser Family Foundation, noted that half of Medicare recipients live on $30,000 a year or less.
“This is a significant savings for people on relatively modest incomes,” she said.
Subsidies for low-income seniors
The bill makes more seniors eligible for low-income subsidies intended to pay for Medicare prescription drugs.
Starting in 2024, the income limit to be eligible for Medicare’s Low Income Subsidy rises to 150% of the federal poverty level, from today’s limit of 135%. (Using today’s income levels, that means a single person could make up to $19,200 to qualify.)
As a result, about 400,000 more Medicare beneficiaries would get subsidies under the new program, according to KFF research.
How drug pricing reform in Inflation Reduction Act would work
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Insulin price cap
The Inflation Reduction Act caps how much seniors must spend on insulin to $35 a month — a boon for the more than 3 million older Americans who use insulin to control their diabetes. A provision that would have imposed that cap on all patients was stripped from the bill at the last minute, despite bipartisan support.
Since 2007, the number of Medicare beneficiaries using insulin has doubled, but the amount Medicare spends on insulin has increased twice as fast, KFF research has shown. One in four diabetes patients has skimped on insulin because of its cost.
A few high-priced drugs will be cheaper
The bill also makes several smaller changes to limit price increases of drugs overall. Most significantly, the measure directs the government to negotiate what Medicare pays for a small group of drugs starting in 2026.
In 2026, the first year that the drugs will be up for negotiation, the list will include the 10 drugs that Medicare spent the most money on the prior year. By 2029, that list would expand to 20 drugs, including medications filled at pharmacies and drugs administered by doctors, such as some chemotherapy treatments.
“The cost — and the savings to the federal government — goes up significantly as more and more drugs are added,” said Michael Levesque, lead pharmaceutical analyst at Moody’s Investors Service.
The bill limits the government’s scope to negotiate to drugs that have been on the market for at least nine or 13 years, depending on the class of medicine, and that don’t have a generic or biosimilar equivalent. The bill also directs the U.S. to focus on the medications the government spends the most money on.
“They have to be long-lived, high-spend drugs, and ones that have resisted competition,” said Boston University’s Conti.
The drugs that Medicare spent the most on in 2020 include the blood-thinner Eliquis ($9.9 billion), cancer treatment Revlimid ($5.4 billion) and the blood thinner Xarelto ($4.7 billion.)
Conti estimated that savings would amount to 40% to 70% of a given drug’s price. Over a decade, the government should save over $100 billion from negotiating drug prices, the Congressional Budget Office estimated. That’s less than 3% of the profits earned by global biopharmaceutical firms over the next decade, UBS analysts projected.
The bill should also reduce costs directly for patients who take these specific drugs. “Many people pay a coinsurance, which is based on the [medication] price. If the price is lower, and they’re paying a 33% coinsurance, they’re paying a lower price” out of pocket, said Neuman of the KFF.
Rebates for pricey drugs
The Inflation Reduction Act requires drugmakers to offer rebates to Medicare if they raise the price of medicines faster than inflation. Soaring prescription-drug prices are one reason that Medicare costs have ballooned over the past decade.
According to MedPAC, prices paid by Medicare Part D for brand-name drugs with no generic equivalent have grown by an average of 7.5% a year since 2010. Fully half of the drugs in the program increased their prices faster than inflation, KFF found. The requirement that drugmakers pay back Medicare for rising drug prices should save the government $71 billion over the next decade, CBO estimated.
“The Medicaid program has long used these drug inflation rebates, and they’ve had huge savings,” said Vanderbilt’s Dusetzina. “Having those same programs apply to the Medicare population will save a lot of money in the long run, and that saves money for all of us as taxpayers.”
Affordable Care Act subsidies in the Inflation Reduction Act would benefit millions
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Are there benefits for privately insured patients?
Aside from a provision to extend health insurance subsidies for Obamacare plans for three years, the health care aspects of the inflation bill focus narrowly on Medicare patients. Experts are divided on what effect, if any, Medicare drug reform would have on the majority of Americans who get health insurance and drug coverage through their employers.
One camp believes that drugmakers will try to make up for smaller profits in the Medicare market by overcharging the privately insured; another believes that transparency in what Medicare pays would make it easier for private plans to negotiate even better pricing. For instance, more private pharmacy benefit managers could start putting inflation protections into their agreements.
The pharmaceutical industry has said the prospect of negotiating prices on some best-selling drugs would chill innovation and reduce incentives for drugmakers to bring new medicines to market. Pharmaceutical Research and Manufacturers of America, the industry’s trade group, called it a “tragic loss for patients” and said the bill would “lead to fewer new cures and treatments for patients battling cancer, Alzheimer’s and other diseases.”
However, the CBO found that the new law would result in just 10 fewer drugs coming to market in the next decade — about 1% of the total expected to gain FDA approval.
Dusetzina called claims that negotiating drug prices would kill the market for drug development “overblown.”
“Every other country negotiates for drug prices,” she said. “We pay by far the highest prices, [yet] it’s known that these companies make profits in other countries where they’re selling these drugs.”
Could drugmakers try to game the system?
Experts noted that drugmakers could try to evade price controls on their most popular drugs, such as by introducing competing generics that don’t offer much in the way of price savings from the brand-name drug, or by hiking prices for new drugs to make up for cost reductions on older ones.
Dusetzina said the bill offers a “toe in the water” to see how the pharmaceutical industry responds to price negotiations on a very limited scale.
She added, “Medicare is something we all pay for, so we should all be concerned if we’re not getting a good deal.”
Ashton Kutcher revealed he battled a rare autoimmune disease that left him unable to walk, hear and see, saying he felt “lucky to be alive” after he recovered.
Kutcher explained that he suffered from vasculitis in the National Geographic show, “Running the Wild with Bear Grylls: The Challenge.” A preview clip of his revelation was published by Access Hollywood ahead of Monday’s episode.
Actor Ashton Kutcher reveals vasculitis condition that left him unable to walk, hear or see.
Tayfun Coskun/Anadolu Agency via Getty Images
“Like two years ago, I had this weird, super rare form of vasculitis, that like knocked out my vision, it knocked out my hearing, it knocked out like all my equilibrium,” Kutcher told Grylls.
Kutcher said it took him a year to build himself back up.
“You don’t really appreciate it, until it’s gone,” Kutcher said, “Until you go, ‘I don’t know if I’m ever going to be able to see again, I don’t know if I’m ever going to be able to hear again, I don’t know if I’m ever going to be able to walk again’.”
“Lucky to be alive,” he added.
It’s unclear exactly when the episode was filmed, but Kutcher further elaborated on Twitter that he had the “rare vasculitis episode” three years ago, resulting in impairments to his hearing, vision and balance. However, he said he was past the medical issue.
“I fully recovered. All good. Moving on. See you at the 2022 NY Marathon w/Thorn,” he wrote.
What is vasculitis?
The Mayo Clinic describes vasculitis as “inflammation of the blood cells,” which can cause walls of the cells to thicken and reduce the width of the passageway through the vessel.
“If blood flow is restricted, it can result in organ and tissue damage,” the Mayo Clinic says on its website.
Vasculitis can impact one or multiple organs – and the condition can be short or long term, according to the Mayo Clinic. Symptoms of the disease include fever, fatigue, weight loss, general pains and aches, digestive system issues, dizziness, ringing in the ears, abrupt hearing loss, temporary or permanent blindness and shortness of breath.
Christopher Brito
Christopher Brito is a social media producer and trending writer for CBS News, focusing on sports and stories that involve issues of race and culture.
Situated on 32 acres, the facility will include emergency, acute medical, and surgical care and will be built using hurricane-resistant design strategies.
Medical office buildings for specialty and primary physicians are also planned.
Climate hazards such as flooding, heat waves and drought have worsened more than half of the hundreds of known infectious diseases in people, including malaria, hantavirus, cholera and anthrax, a study says.
Researchers looked through the medical literature of established cases of illnesses and found that 218 out of the known 375 human infectious diseases, or 58%, seemed to be made worse by one of 10 types of extreme weather connected to climate change, according to a study published Monday in the journal Nature Climate Change.
Doctors, going back to Hippocrates, have long connected disease to weather, but this study shows how widespread the influence of climate is on human health.
“If climate is changing, the risk of these diseases are changing,” said study co-author Dr. Jonathan Patz, director of the Global Health Institute at the University of Wisconsin-Madison.
Doctors, such as Patz, said they need to think of the diseases as symptoms of a sick Earth.
“The findings of this study are terrifying and illustrate well the enormous consequences of climate change on human pathogens,” said Dr. Carlos del Rio, an Emory University infectious disease specialist, who was not part of the study. “Those of us in infectious diseases and microbiology need to make climate change one of our priorities, and we need to all work together to prevent what will be without doubt a catastrophe as a result of climate change.”
In addition to looking at infectious diseases, the researchers expanded their search to look at all type of human illnesses, including non-infectious sicknesses such as asthma, allergies and even animal bites to see how many maladies they could connect to climate hazards in some way, including infectious diseases. They found a total of 286 unique sicknesses and of those 223 of them seemed to be worsened by climate hazards, nine were diminished by climate hazards and 54 had cases of both aggravated and minimized, the study found.
The new study doesn’t do the calculations to attribute specific disease changes, odds or magnitude to climate change, but finds cases where extreme weather was a likely factor among many. The study did map out the 1,006 connections from climate hazard to illness.
Study lead author Camilo Mora, a climate data analyst at the University of Hawaii, said what is important to note is that the study isn’t about predicting future cases.
“There is no speculation here whatsoever,” Mora said. “These are things that have already happened.”
One example Mora knows firsthand. About five years ago, Mora’s home in rural Colombia was flooded — for the first time in his memory, water was in his living room, creating an ideal breeding ground for mosquitoes — and Mora contracted chikungunya, a nasty virus spread by mosquito bites. And even though he survived, he still feels joint pain years later.
Sometimes climate change acts in odd ways. Mora includes the 2016 case in Siberia when a decades-old reindeer carcass, dead from anthrax, was unearthed when the permafrost thawed from warming. A child touched it, got anthrax and started an outbreak.
Mora originally wanted to search medical cases to see how COVID-19 intersected with climate hazards, if at all. He found cases where extreme weather both exacerbated and diminished chances of COVID-19. In some cases, extreme heat in poor areas had people congregate together to cool off and get exposed to the disease, but in other situations, heavy downpours reduced COVID spread because people stayed home and indoors, away from others.
Longtime climate and public health expert Kristie Ebi at the University of Washington cautioned that she had concerns with how the conclusions were drawn and some of the methods in the study. It is an established fact that the burning of coal, oil and natural gas has led to more frequent and intense extreme weather, and research has shown that weather patterns are associated with many health issues, she said.
“However, correlation is not causation,” Ebi said in an email. “The authors did not discuss the extent to which the climate hazards reviewed changed over the time period of the study and the extent to which any changes have been attributed to climate change.”
But Dr. Aaron Bernstein, interim director of the Center for Climate, Health, and the Global Environment at Harvard School of Public Health, Emory’s del Rio and three other outside experts said the study is a good warning about climate and health for now and the future. Especially as global warming and habitat loss push animals and their diseases closer to humans, Bernstein said.
“This study underscores how climate change may load the dice to favor unwelcome infectious surprises,” Bernstein said in an email. “But of course it only reports on what we already know and what’s yet unknown about pathogens may be yet more compelling about how preventing further climate change may prevent future disasters like COVID-19.”
Last week, a team of international scientists said the world needs to start preparing for the possibility of a “climate endgame” as extreme weather events keep ravaging the planet.
“Right now, I think we’re being naive. We’re not looking at the worst-case scenarios at all, really,” said one of the authors of that study, Luke Kemp, of Cambridge’s Centre for the Study of Existential Risk.
The report by Kemp and his colleagues warned about the risk of a climate-driven increase in infectious diseases as well as the risks of famine, extreme weather disasters, and conflict over resources.
Almost half a million people have died in natural disasters linked to extreme weather events in the last 20 years, according to a 2021 assessment of the direct threat posed to humanity by climate change.
The only drug available to treat monkeypox is so difficult to access that just a fraction of the nearly 7,000 patients in the United States have been given it.
Health officials have designated tecovirimat, also called Tpoxx, an “investigational drug,” which they say means it cannot be released from the strategic national stockpile without a series of convoluted bureaucratic steps. But most doctors do not have the time or resources to fill out the required 27-page application or to provide the detailed patient information.
It doesn’t have to be this way, experts say: There is no law preventing federal officials from changing those rules and making the drug more widely available.
The Food and Drug Administration approved tecovirimat as a smallpox treatment in 2018, based on safety data in people and efficacy data in primates — which, for the purposes of the trial, actually were infected with monkeypox. The so-called animal rule allows the agency to approve drugs when testing them in people would be unethical.
Until the current outbreak, tecovirimat was given only rarely to monkeypox patients. As a smallpox treatment, its use against monkeypox is considered experimental. But vaccines developed for smallpox have been assumed to be effective against both diseases. Why not the treatment?
Experts say the F.D.A.’s restrictions are a policy choice that can be quickly altered.
“The bureaucracy of gaining access to Tpoxx is excessive given the crisis the U.S. is facing with monkeypox,” said Larry O. Gostin, an expert on public health law and director of the O’Neill Institute for National and Global Health Law at Georgetown University.
“The law gives the agency considerable flexibility to use scientific assessments to ensure those in need get the medication that can help them,” he added.
The Department of Health and Human Services on Thursday declared monkeypox a national health emergency. But Secretary Xavier Becerra did not take an additional step that would have allowed the F.D.A. to grant emergency use authorizations for vaccines and treatments, as the agency did during the coronavirus pandemic.
In an article published in the New England Journal of Medicine on Wednesday, federal health officials defended their decision to treat tecovirimat as an investigational drug.
While acknowledging that animal data was promising and that the drug seemed safe in healthy patients, they wrote that, without large clinical trials, “we will not know whether tecovirimat would benefit, harm or have no effect on people with monkeypox disease.”
What to Know About the Monkeypox Virus
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What is monkeypox?Monkeypox is a virus similar to smallpox, but symptoms are less severe. It was discovered in 1958, after outbreaks occurred in monkeys kept for research. The virus was primarily found in parts of Central and West Africa, but in recent weeks it has spread to dozens of countries and infected tens of thousands of people, overwhelmingly men who have sex with men. On July 23, the World Health Organization declared monkeypox a global health emergency.
How does it spread?The monkeypox virus can spread from person to person through close physical contact with infectious lesions or pustules, by touching items — like clothing or bedding — that previously touched the rash, or via the respiratory droplets produced by coughing or sneezing. Monkeypox can also be transmitted from mother to fetus via the placenta or through close contact during and after birth.
I fear I might have monkeypox. What should I do?There is no way to test for monkeypox if you have only flulike symptoms. But if you start to notice red lesions, you should contact an urgent care center or your primary care physician, who can order a monkeypox test. Isolate at home as soon as you develop symptoms, and wear high-quality masks if you must come in contact with others for medical care.
What is the treatment for monkeypox?If you get sick, the treatment for monkeypox generally involves symptom management. Tecovirimat, an antiviral drug also known as TPOXX, occasionally can be used for severe cases. The Jynneos vaccine, which protects against smallpox and monkeypox, can also help reduce symptoms, even if taken after exposure.
I live in New York. Can I get the vaccine?Adult men who have sex with men and who have had multiple sexual partners in the past 14 days are eligible for a vaccine in New York City, as well as close contacts of infected people. Eligible people who have conditions that weaken the immune system or who have a history of dermatitis or eczema are also strongly encouraged to get vaccinated. People can book an appointment through this website.
“At this time, it’s unclear if or how well this drug works for monkeypox patients,” said Kristen Nordlund, a spokeswoman for the Centers for Disease Control and Prevention.
Providing Tpoxx only as an investigational drug “ensures we have data from patients who use this drug,” she said. “This will ultimately help us understand who will benefit most, what the true benefits are and potential risks there might be.”
The restrictions on tecovirimat were even more complicated at the beginning of the outbreak, and — after much complaining from doctors — the C.D.C. loosened some of the rules. But the system remains cumbersome.
Physicians who want to prescribe the drug must first sign up to become investigators in a clinical trial, sending in résumés and informed consent forms signed by monkeypox patients — a process that is “labor intensive and virtually impossible” for most doctors, said Lynda Dee, the executive director of AIDS Action Baltimore.
“If this wasn’t such a dire emergency, it would make a very good bureaucratic joke,” Ms. Dee said. “Unfortunately, the joke is once again on the gay community.”
The rules are so complex that some patients have needed to educate their doctors on the process.
Adam Thompson, a 38-year-old cook in Atlanta, first developed a headache and body aches on July 17, and two days later had lesions on his face and rectum.
The nurse practitioner he saw had no idea how to treat him, Mr. Thompson said. Based on a friend’s experiences, he convinced her to prescribe hydrocortisone suppositories and gabapentin, a medication used to treat nerve pain.
They did not help. The nurse practitioner had heard of tecovirimat, but she told him it would take hours of paperwork to obtain.
When Mr. Thompson said he wanted her to note in his chart that she was unwilling to prescribe the drug for him, she told him the doctor would need to decide. The doctor finally called him on Sunday, July 31, nearly two weeks after he first reached out.
“She was like, ‘I’ve contacted the C.D.C., I’ve contacted the health department. I’ve contacted multiple doctors in different states, I’ve contacted multiple pharmacists in different states,’” he said.
By then, it didn’t matter. His lesions were healing, the pain had subsided and he was on the mend.
Dr. Stacy Lane, the founder and medical director of a network of seven clinics in Pennsylvania and Ohio serving the L.G.B.T.Q. population, said many of her monkeypox patients had been turned away by three or four doctors who could not deal with the tortuous federal rules regarding tecovirimat.
In early July, Dr. Lane saw a patient with eye lesions distinctive of monkeypox infection, which can lead to blindness. She tried to acquire tecovirimat, but the Pennsylvania health department insisted the patient get an eye exam first.
It was a Friday afternoon, and Dr. Lane didn’t want to have the patient wait in a crowded emergency room, so she scrambled to find an ophthalmologist instead of waiting to have the exam done “in a very controlled fashion at an outpatient office” the following Monday.
Pennsylvania has since dropped the requirement for a diagnosis, but Ohio has not.
“This doesn’t need to be held back the way it’s being held back,” Dr. Lane said of tecovirimat. “It would be ideal if we can get this Tpoxx treatment at the local pharmacies just like we can get anything else, especially as this thing continues to explode.”
Dr. Lane and others said they understood that there were still questions about the drug’s safety and effectiveness in people, but noted that it had already been shown to be safe in people and had been approved by the F.D.A.
“If a drug is already F.D.A.-approved, any physician can prescribe it as off-label because F.D.A. is not permitted to regulate the practice of medicine,” said Dr. Jay Varma, the director of the Cornell Center for Pandemic Prevention and Response.
“It is a C.D.C. policy choice to avoid releasing or recommending a drug off-label,” he added.
Many patients and doctors, including Dr. Lane, have reported that tecovirimat seems to melt away skin lesions within 24 hours. No serious adverse events have been reported.
Given the known and emerging evidence of the drug’s effectiveness in patients and the urgency of the outbreak, experts say there is little rationale for restricting access.
“I understand that there needs to be a lot more data-gathering and post-marketing surveillance and everything else,” said Dr. James Lawler, a director of the University of Nebraska’s Global Center for Health Security. “But you can do that in a way that doesn’t create barriers.”
