'Health Care' Archive
Drugstore operator Walgreen aims to redefine the term office visit by allowing you to visit the doctor at your office or workplace. After blanketing the nation with more than 6,900 drugstores, retail growth opportunities are slowing and the company is looking for new ways to expand. One area that Walgreen is giving plenty of attention is its Take Care Health Systems (TCHS) business, which manages more than 700 clinics inside Walgreen stores and at worksites. (Customers include QUALCOMM, Goodyear Tire & Rubber and Toyota Motor.) The company recently told Chicago’s Daily Herald that it plans to open “several thousand” work-site health clinics in the coming years to get in on the $7.3 billion market for employer-provided care.
With businesses struggling to reduce employee health care costs and the country on the verge of major health care reform, one could argue this is an idea whose time has come. The work-site clinics provide primary-care physicians (which I understand are in short supply already), nurse practitioners, nutritionists, and other health-related services. Walgreen bought TCHS in 2007 and made two follow-on acquisitions — I-trax and Whole Health Management — in 2008 in a bid to diminish its reliance on retail stores for growth and to diversify into health and wellness services. In January Walgreen launched “Complete Care and Well-Being,” a workplace program designed to cut costs for employers and improve access to health care for employees. The work-site health centers may be staffed by from one to 50 employees (depending on the size of the client) and be paired with Walgreen pharmacies and discount prescription drug plans.
This all sounds good, but I can’t help but think about the school nurse. Not to bash all school nurses, but the ones I encountered during my school days, and more recently during my children’s education, hardly inspired confidence. (My fifth grader swears her school nurse treats everything with a cough drop.) On the other hand, my employer Hoover’s already provides flu shots, blood pressure screening, and other health-related services at well-attended company-sponsored health fairs. It would be convenient to be able to get a throat culture or other simple procedure at work. But beyond routine services, there are privacy issues to consider and I’m not sure all employees would flock to a company doc.
On a related health care note: The world’s largest employer, Wal-Mart Stores, has come out in favor of requiring employers to provide health insurance to workers, much to the dismay of other retailers, large companies, and most Republicans. In a letter to President Obama dated June 30, Wal-Mart called for “shared responsibility” in the form of an “employer mandate which is fair and broad in coverage.” Wal-Mart, which for years was chastised as stingy when it came to employee benefits, has improved its benefits programs considerably. Still, the National Retail Federation, which vehemently opposes mandates for employers, said it was “flabbergasted” by Wal-Mart’s position.
Hard economic times have brought about changes in many industries, and health care is far from immune. For years nursing has been a nearly guaranteed employment choice for candidates up to the challenge. But now, shifting tides at many health care institutions have stemmed the need for trained and able workers.
One major factor is that some medical providers (such as the Boston Medical Center and the Long Island College Hospital) have had to instigate job cuts to fight against lowering profits. Many such hospitals are suffering from decreased patient volumes, Medicaid reimbursement reductions, or an increase in uninsured or underinsured customers. According to an American Hospital Association report, more than half of all US hospitals are reducing staff or otherwise cutting costs.
Another factor is that many trained and experienced former nurses are putting off retirement or going back to the health care market after other career paths (or spousal incomes) are cut off by economic troubles. Nursing graduate levels have increased in recent years as well.
The trend reversal seems to be region-specific, however. In some areas, health care firms are still expanding nurse training programs and shouting for new recruits and experienced workers alike. But in others, such as the Washington, DC and Pittsburgh metro areas, reports from the news media indicate a possible end to the nurse shortage.
While health care professionals are a necessary commodity in any economic atmosphere, the nursing profession is definitely experiencing some negative impact from the current recession. However, many reports indicate that the shortage is only under a lull, and some predict that the present decrease in demand could create an even bigger shortage in another 10 years (especially when the older nursing generation retires). Either way the future of these jobs is intimately tied to whether hospitals continue to flounder, medical bills continue to go unpaid, and ultimately whether the US health care system can be restructured for the benefit of institutions, workers, and patients alike.
That’s how many days Chrysler (now rechristened Chrysler Group) spent in Chapter 11 bankruptcy reorganization — 42 days, or six weeks. The “quick” and “efficient” reorganization promised by President Obama came to an end this week, albeit with a quick run through the Supreme Court. (I know it’s not officially summer yet, but it’s already hot and dry in Texas.)
Fiat is running the show at Chrysler now, although the Italian carmaker owns just 20% of the restructured company. The UAW’s retiree health care trust now holds 55% of Chrysler. Ciao, Cerberus Capital Management!
Sergio Marchionne, the CEO of Fiat, sent a letter to all Chrysler employees in his new role as the CEO of Chrysler. (How can one man run two car companies? Hey, Carlos Ghosn’s been running both Nissan Motor and Renault for years.)
Hundreds of Chrysler dealers closed this week, as the US Bankruptcy Court approved the company’s petition to terminate immediately its dealership agreements with about one-quarter of its retail outlets.
Meanwhile, General Motors is marking its 10th day in Chapter 11, and they’ve been busy in the Ren Center, too. The company last week struck deals to sell the HUMMER brand to an obscure Chinese manufacturer of heavy construction equipment and to divest the Saturn brand to Penske Automotive Group. A deal to unload Saab Automobile may be close at hand, although Fiat is reportedly out of the running in that auction. The GM bankruptcy is going to take more than six weeks to complete; Labor Day weekend might be a realistic and somewhat ironic deadline.
Diabetes patients forever struggling with the burden of daily injections could soon find some relief. Two new therapies under review by the FDA could change the landscape of diabetes treatment. One, MannKind’s AFRESA, delivers insulin through an inhalation device. The other is a once-a-week version of Eli Lilly’s injectable Byetta treatment.
Market optimism over the upcoming release of AFRESA is a major coup for MannKind, which experienced heavy shareholder doubt in 2008 when three other inhalable-insulin players, Pfizer, Novo Nordisk, and Eli Lilly, exited the market. MannKind’s insulin device is touted as easier to use and more effective than its rivals’ versions, as well as potentially faster-acting than some existing injectable insulin therapies.
Byetta is a non-insulin therapy — it is instead based on hormones that trigger the body’s production of insulin. While the daily form of Byetta has faced some safety concerns, Lilly and co-development partners Amylin and Alkermes anticipate that the once-weekly version will be successful. The companies have also submitted the drug for approval to be used as a monotherapy (it is currently used alongside traditional insulin or metformin treatments), and Amylin is developing it in nasal spray form.
Many of the industry’s key players, including Novo Nordisk, GlaxoSmithKline, and MannKind, are also developing hormone-based diabetic therapies. While MannKind currently has the only inhalable insulin program, several companies (including Biocon, Emisphere, Generex, and Biodel) are developing oral formulations of insulin, and additional firms (including Insulet and Medtronic) have wearable insulin pumps on the market.
Hopefully all of these measures will result in fewer diabetics having to undergo daily injections.
Two major drugmakers announced strategic deals last week that look to be directly related to the Obama administration’s health care reform policy regarding generic drugs. While rising competitive pressures in the industry have spurred diversification in recent years, the shifting landscape of America’s health care system is putting the changes into overdrive.
Top drug company Pfizer entered licensing agreements with two generic drug manufacturers based in India, giving Pfizer rights to market over 100 drugs in the US and international markets. Pfizer, which has historically focused on patent-protected drugs, formed a special unit dedicated to off-patent products just last year.
Another major player, Novartis, went the acquisition route by agreeing to pay about $1.2 billion for the specialty generics unit of Ebewe Pharma. While Novartis already has a strong generic presence through subsidiary Sandoz, the purchase will widen Novartis’ offering of generic biotech drugs (also called biogenerics, or follow-on biologics), a field that looks to be ripe for growth in the US market.
While brand-name pharmaceutical companies entering the generic market is not a new trend, President Obama’s goal of reducing health care costs by increasing access to generic products will definitely encourage new players to enter the field, while the existing generic kings bulk up to sustain their positions. If other reform measures in the works prompt similar changes, the drug industry may be a whole new ball game in future years.