Untangling Hospital Bills

In a guidance last year, the Trump administration asked hospitals to post prices of services online starting Jan. 1, 2019. An article published in Kaiser Health News reports that the prices posted come in a format that “may initially serve to confuse more than illuminate.” Experts point out multiple problems that would confront patients trying to make sense of the prices. First, the services are listed using terms and abbreviations that would not be familiar​ to the average person. Second, the charges are what someone uninsured might be asked to pay, not those negotiated by insurers. Finally, it’s hard to even find the lists of charges on hospital websites when they are posted.

Conditions of Enrollment

Researchers say they want more cancer patients to enroll in clinical trials, but multiple impediments keep patients from signing up. A study published Jan. 10 in JAMA Oncology looks at how health conditions existing alongside cancer, called comorbid conditions, affect enrollment. The researchers surveyed 5,499 patients with breast, lung, prostate and colorectal cancer, finding that while 11 percent of those without comorbid conditions participated in clinical trials, just 8 percent of those with comorbid conditions did. About two-thirds of patients surveyed had comorbid conditions, with hypertension being most common. Patients with comorbid conditions were also less likely to report that they discussed trial participation with their doctor or were offered participation in a trial. The researchers say that current efforts to modernize clinical trial eligibility criteria to include more patients with comorbid conditions could improve enrollment.

Cost of Marketing Medicine

A paper published in JAMA​ finds that medical marketing expenses increased from $17.7 billion to $29.9 billion in the U.S. between 1997 and 2016. Pharmaceutical marketing to medical professionals is still the highest source of medical marketing spending. But the greatest rise during this period was in direct-to-consumer advertising, which rose from 12 percent to 32 percent of spending from 1997 to 2016. Direct-to-consumer advertising expenses for cancer drugs increased from $3 million to $274 million during this period.