|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
Finally, full FDA approval for a COVID vaccine
According to a recent Kaiser Family Foundation poll, 31 percent of unvaccinated Americans say that full approval of the COVID vaccines by the Food and Drug Administration (FDA) would likely convince them to get the shot. This week, at long last, the FDA called their bluff. On Monday, the agency granted full approval to Comirnaty, the vaccine developed by Pfizer and BioNTech, for people aged 16 and older. (The brand name, Comirnaty, is a portmanteau derived from the terms “COVID”, “mRNA”, and “immunity”.) Separately, Moderna applied to the FDA for full approval of its COVID vaccine on Wednesday—no word yet on expected timing of approval (or branding). Whether or not vaccine skeptics are convinced by the FDA’s action remains to be seen; what’s already clear is that many employers who were waiting for full approval to implement vaccine mandates for their employees are now moving forward with those policies. They were urged on by President Biden this week, who said, “If you’re a business leader, a nonprofit leader, a state or local leader, who has been waiting for full FDA approval to require vaccinations, I call on you now to do that—require it.” While some have followed that lead, other leaders have continued to push back against mandates, including Texas Governor Greg Abbott, who this week banned COVID vaccine mandates—regardless of whether the vaccine is fully approved—in his state, which is currently in the grips of a massive surge of COVID-related hospitalizations. The good news is that vaccination rates have been rising recently, because of concern over the Delta variant, but the increase has thus far been insufficient to fend off a wave of new cases, hospitalizations, and deaths that continues to approach last winter’s peak. The saying has taken on a numbingly grim familiarity: we may be done with the pandemic, but it’s not done with us.
Virtual mental health sees a big merger announced
Two of the best-known companies in the virtual mental health space announced plans to merge this week, creating a $3B player poised to dominate this fast-growing segment of healthcare demand. Headspace, a direct-to-consumer provider of app-based “mindfulness” meditation programs, will combine with Ginger, which sells text- and video-based coaching and therapy services to employers and insurers. Between them, the two companies claim to serve over 100M users worldwide. Headspace is best known as a consumer-focused app, while Ginger largely serves business and payer clients. The combined company, to be called Headspace Health, will surely look to consolidate offerings into a comprehensive mental health service for employees, targeting a benefits market that is rapidly becoming overwhelmed with startup providers of virtual point solutions. Behavioral health telemedicine utilization skyrocketed during last year’s COVID surge, and has been the one area of virtual care not to fall back to earth since—we’ve learned that virtual is often a superior approach for many mental health services. Two questions arose in our minds after the Headspace/Ginger merger was announced. First, does the combined company bring a broad enough value proposition to overcome employer frustration with a highly fragmented market, or will the new Headspace Health eventually need to be part of a larger insurer platform to capture the opportunity in front of it? And second, does “mindfulness” even work? The academic evidence is decidedly mixed, but the popularity of Headspace and other meditation apps, especially among Millennial consumers, might make that question moot. The mindfulness “wrapper” on more traditional mental health services may prove to be very popular with employees, and could become a must-have element of employers’ benefit packages.
Routine diabetes screening now recommended at age 35
On Tuesday the US Preventive Services Task Force (USPSTF) recommended that routine screening for type 2 diabetes should begin at age 35 for all overweight or obese adults. The new recommendation lowered the screening age by five years, drawing on research showing that the incidence of diabetes rises sharply beginning at age 35, and evidence showing that early intervention can prevent serious complications. (The previous guidance would have missed over 60 percent of potentially positive patients in the younger age group.) A 2019 study from the Blue Cross Blue Shield Association found that older Millennials (aged 34 to 36) had higher rates of chronic disease and mental health disorders, leading to a 40 percent higher risk of mortality compared to Gen X individuals at the same age. Given their poorer overall health status, it’s likely that the Millennial generation will be a target for population health and care management strategies earlier than expected—and managing these younger patients with chronic disease will create a new value proposition for direct-to-employer offerings. But to reap the benefits of earlier screening, Millennials—a third of whom do not have a primary care doctor—must first be engaged in a system of care.