MSSNY eNews: January 22, 2021 – NYS BUDGET The Good, The Bad and The UGLY


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Colleagues:

With a $14.9 billion 2-year deficit and a $39 billion 4-year deficit looming, it is no surprise that Budget cuts and new sources of potential revenue are proposed. However, the share of cuts proposed on the backs of New York State’s physician heroes and proposals that will jeopardize the health and well-being of physicians and New Yorkers in the middle of a pandemic is baffling.

The Good

While the good is overshadowed by the bad and the ugly, there are some welcome aspects in the proposed budget.  State oversight of Pharmacy Benefit Managers (PBMs) is again included and is sorely needed.  An expansion of the manufacturing of personal protective equipment (PPE) could shore up supply and help fend off future shortages like we saw this spring.  Additional funding to increase reimbursements to providers in the state’s Essential Plan program, and to cover premiums for those in need will help enhance access to care for New York’s most vulnerable populations.

The Bad

 A requirement that the 16,000 or so physicians insured through the Excess Medical Malpractice Insurance program bear 50% of the cost of a policy was dusted off from last year.  This is both ill timed and shortsighted. Physician practices in the pandemic have been struggling to keep the doors open.  If imposed, this will be the final straw for many practices and additional patients will lose access to care at a time when they and their communities need their physicians most. The excess program exists in the first place due to New York’s dysfunctional medical malpractice adjudication system (the worst in the country) and is akin to treating cancer with pain medications only. It is time to use tried and true remedies like caps on pain and suffering, expert witness reform and certificate of merit reform.  These have worked in other states that are similar in size such as California and Texas and if enacted in our state, New York can put the entire amount of the excess fund toward other uses. You can send a letter of opposition and tweet at your elected officials here: Don’t Balance the Budget on the Backs of Physicians (p2a.co)

Cutting the appropriation of MSSNY’s Committee for Physicians Health by 20% is another perplexing proposal contained in the budget.  This program provides essential counseling services for physicians confronting alcoholism, substance abuse, or mental illness. We have had at least two physician suicides in NYS in the past year, we have physicians suffering from COVID-related PTSD and nearly all physicians are under significantly increased stress related to the pandemic. It is hard to conceive of a worse time to impose cuts on a program that is a lifeline for physician wellbeing. This proposed cut endangers physician health and well-being as well as public safety.

Other problematic proposals include a continuation of the authority for an additional 6 years for certain nurse practitioners to practice without a written collaborative agreement of a physician provided there is proof of “collaborative arrangements” with physicians in that specialty of practice and proposals that would greatly enhance the ability of pharmacists to provide patients with lab tests and provide other healthcare services to patients (including the right to prescribe!) without any physician oversight. Additional tethers to physician led team care and safeguards for our patients must be inserted into these proposals, or they must be rejected altogether. Patient safety is paramount.

The Ugly

Another proposal recycled from last year is comprehensive “Office of Professional Medical Conduct modernization”. While we are committed to working to identify gaps in the NYS disciplinary, this Budget proposal would give the Commissioner of Health the authority in their sole discretion to disclose to the public that a complaint has been filed against a particular physician, despite the fact that very few complaints ever actually result in a finding of professional misconduct. This information can remain on the Internet forever, potentially ruining a physician’s professional reputation. The law already permits the Commissioner to disclose information to the public when there is a public health threat. This provision would eliminate important due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct.

You can send a letter in opposition and tweet at your elected officials here.

It is time to take action:  Here is your checklist:

  • Go to the above links to send letters and tweet at your state legislators to urge that they reject these problematic proposals.
  • Text 52886 to sign up for Text Grass action updates.
  • Are you friends with or a relative of an elected official?  Sign up here to become a part of the MSSNY PAL (Physician Advocacy Liaison) Network  
  • Sign up here for MSSNY Virtual Advocacy Day March 2, 2021. The location will be virtual, but our presence must be very real!

Click here to donate to MSSNY PAC or text MSSNY PAC to 52886

With a $14.9 billion 2-year deficit and a $39 billion 4-year deficit looming, it is no surprise that Budget cuts and new sources of potential revenue are proposed. However, the share of cuts proposed on the backs of New York State’s physician heroes and proposals that will jeopardize the health and well being of physicians and New Yorkers in the middle of a pandemic is baffling.

Bonnie Litvack, MD
MSSNY President


 


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MSSNY Weekly Podcast


Statement of MSSNY President Dr. Bonnie Litvack, MD, on the Litany of Concerning Proposals in the Executive Budget
“Over the last year, tens of thousands of physicians across the State of New York put their health and the health of their families at risk to ensure patients receive the care they needed. Many of them became sick themselves and, sadly, some even passed away from COVID-19.

Yet these physicians continue their work on the front lines every day to be there for their patients.

That is why we are stunned by the litany of proposals in the Executive Budget that will make it even harder for physicians to continue to provide the care our patients need. We note that there are some positive aspects in this State Budget proposal, including to provide needed regulation over PBM practices and expanding the state’s capacity to manufacture personal protective equipment (PPE) that physicians often lacked and have been the subject of enormous cost increases. However, we are extremely concerned with several other Budget proposals.

One State Budget proposal would foist tens of thousands of dollars of new costs on physicians (totaling over $50 million) for keeping liability insurance protections that are absolutely necessary due to New York’s excessive medical liability premium costs. These liability costs far exceed any other state in the country. The substantial new costs will be near-impossible for many physicians to absorb given the enormous drop in patient visits and revenue experienced by physicians across the State over the last year. As an example, it would impose an approximate $20,000 new cost for an OB-GYN practicing on Long Island. If the Excess Insurance program is eliminated or reduced, then we need comprehensive medical liability reform instead.

We are also perplexed by proposals to eliminate important due process protections for physicians against whom a complaint has been filed with the Office of Professional Medical Conduct. As we have previously stated, while we are anxious to work to identify gaps in our disciplinary system to protect the public, this Budget proposal would give the Commissioner of Health the authority in their sole discretion to disclose to the public that a complaint has been filed against a particular physician, despite the fact that very few complaints ever actually result in a finding of professional misconduct. This information can remain on the internet forever, potentially ruining a physician’s professional reputation. The law already permits the Commissioner to disclose information to the public when there is a public health threat.

Another Budget proposal would impose huge cuts to the Committee for Physicians Health (CPH), a successful long-standing organization that provides essential counseling services for physicians confronting alcoholism, substance abuse, or mental illness. Many of these conditions have been exacerbated by the pandemic, making CPH more essential than ever. CPH provides important confidential peer to peer services to physicians in need of support for their health and well-being. Studies that review the long-term model effect of physician health programs show that physician recovery rates are markedly higher than the general population—even when extended into five years or more. If these cuts were to go through, it would substantially limit the work CPH can provide for physicians – and indirectly the public at large – at a time when the program is needed more than ever.

These are just a few of the very concerning proposals in the state Budget. While we understand that the State is responding to the huge drop in revenue arising from the pandemic, these proposals will be the “last straw” for many physicians who already are finding it difficult to remain in practice to deliver patient care due to New York’s already notoriously hostile practice environment.

We urge the Legislature to reject these unfair proposals in the State Budget.” (AUSTER)


Governor Cuomo Releases State Budget Proposal – Contains a Number of Problematic Proposals to Impose New Costs on Doctors, Expand Pharmacy Scope, and Reduce Due Process
Governor Cuomo released his proposed 2021-22 State Budget to address a 2-year $14.9 billion deficit and a 4-year $39 billion deficit.  The presentation identified that the Budget submission was based upon the likely receipt of additional $6 billion from the federal government but noted that $15 billion was needed to avoid the combination of Budget cuts and revenue increases in the Budget he proposed.  As has been previously discussed, new revenue sources included $500 million through mobile sports betting and $350 million through the sale of adult use cannabis (when fully implemented), as well as higher taxes for those making more than $5 million per year.  The Governor further noted that while he was hopeful to receive additional funding from the federal government, they would examine the possibility of litigation to ensure New York receives it fair share.

Among the positive items in the proposed Budget include:

  • A call once again to require state oversight over Pharmacy Benefit Managers (PBMs),
  • To significantly expand the manufacturing of personal protective equipment (PPE) and
  • Additional funding to increase reimbursements to providers in the state’s Essential Plan program, and to cover premiums to ensure those enrolled stay enrolled if they are eligible.

However, the Executive Budget contains a number of significantly problematic initiatives, including several rejected by the State Legislature in previous Budget cycles. These include:

  • Requiring the 16,000 or so physicians insured through the Excess Medical Malpractice Insurance program to bear 50% of the cost of a policy. This proposal was a recommendation from the Medicaid Redesign Team last spring, and was advanced during State Budget negotiations last March, but rejected by the State Legislature.  Given the huge financial losses faced by many physicians practice across the State arising from the pandemic, this “Budget savings measure” could not come at a worse time!  You can send a letter/tweet in opposition here: Don’t Balance the Budget on the Backs of Physicians (p2a.co)
  • A comprehensive “OPMC modernization” proposal which would take away important due process for physicians for whom a complaint is filed with the OPMC, despite the fact that most complaints do not result in any findings of misconduct. Specifically, it would permit the Commissioner the discretion to public identify a physician against whom a complaint has been filed prior to the conclusion of an investigation and hearing, and greatly increase the authority to impose a “summary suspension” prior to the conclusion of an investigation and hearing.  This was also proposed in last year’s Executive Budget and rejected by the State Legislature.  You can send a letter/tweet in opposition here: Reject Governor’s Physician Disciplinary Proposal (p2a.co)
  • Cutting the appropriation to MSSNY’s successful Committee for Physicians Health (CPH) – a decades’ old program that has assisted countless physicians in overcoming addiction and return safely to medical practice – by hundreds of thousands of dollars.  As a result of all the stressors caused by the pandemic, this program is needed more than ever.
  • Permitting pharmacists to act as a “referring healthcare provider” for providing to patients asthma and diabetes self-management, and permitting them to order various lab tests – without any requirement to engage in meaningful coordination with the patient’s physician.
  • Greatly expanding the existing physician-pharmacist collaborative drug therapy program to permit pharmacists to “prescribe” and inclusion of nurse practitioners. This was also proposed in last year’s State Budget and rejected by the State Legislature.
  • Continuation of the authority for an additional 6 years for certain nurse practitioners to practice without a written collaborative agreement of a physician provided there is proof of “collaborative arrangements” with physicians in that specialty of practice.
  • Giving health insurance companies the power to bring in out of state health care professionals to deliver telehealth services to their enrollees, potentially preventing community physicians from being able to provide telehealth services to their patients. While MSSNY greatly supports efforts to maintain the telehealth flexibilities for patients adopted during the pandemic, we are concerned that this proposal could actually prevent some physicians from continuing to provide telehealth services to their patients and/or to be reimbursed fairly for these services.

It is important than ever as well that physicians plan to participate in MSSNY’s virtual Physician Advocacy Day on March 2.  You can register here.
(DIVISION OF GOVERNMENTAL AFFAIRS)


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Join Us for MSSNY’s Virtual Lobby Day on March 2
Please plan to put aside Tuesday, March 2 for MSSNY’s Annual Physician Advocacy Day – this time Virtual!  To register, click here.

The format will follow previous years formats, where assembled physicians and allies will hear from legislative leaders in the morning (this year via Zoom), and then have virtual visits with their respective legislators in the afternoon.

With the Governor and the State Legislature needing to create tens of billions of savings to the State Budget, any number of healthcare programs of interest to physicians could be on the table, not to mention concerns with the numerous proposals to inappropriately expand the scope of practice for various non-physicians as well as numerous proposals to mandate how physicians provide care to their patients.

Please plan to join hundreds of colleagues from around the State on March 2!
(DIVISION OF GOVERNMENTAL AFFAIRS)


Registration Now Open: Veterans Matters: PTSD in Returning Veterans Webinar
Tuesday, January 26th @ 7:30 am
The Medical Society of the State of New York is hosting a Continuing Medical Education (CME) program entitled Veterans Matters: PTSD in Returning Veterans live webinar on Tuesday, January 26, 2020 at 7:30 am.

Click HERE to register for the program! View the program flyer HERE

When:                 January 26, 2020 at 7:30 am
Faculty:               Frank Dowling, MD

Educational Objectives:

Identify diagnostic criteria for PTSD
Discuss medical and psychiatric comorbidities of military-related PSTD
Discuss evidence-based treatment modalities for PTSD including medications and psychotherapy
Discuss strategies to help veterans overcome stigma to seek and accept treatment for military-related trauma

For more information, contact Jangmu Sherpa at jsherpa@mssny.org or call (518) 465-8085.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates this live activity for a maximum of 1.0 AMA PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


 

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Registration Now Open – Physician Wellness/Medical Matters COVID-19 & Mental Health of Physicians and Other Healthcare Providers

Friday February 5, 2021 @ 7:30am

Click here to register 

The COVID-19 pandemic has had a significant impact on the Mental health of physicians and other healthcare providers.  Learn more on February 5th at 7:30am.  Dr. Craig Katz will serve as faculty.

Educational Objectives are:

  • Examine the mental health risks posed by COVID-19 for physicians
  • Review the possible range of psychological and psychiatric responses to the pandemic
  • Discuss principles and interventions for helping ourselves, our families, and our colleagues

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates each live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Hoffman)


Registration Now Open – Medical Matters: COVID Vaccine Update

Wednesday February 17, 2021 @ 7:30am

Click here to register

Registration is now open for the next Medical Matters webinar: COVID Vaccine Update.  Learn more about the COVID-19 vaccine on February 17th @ 7:30am.  The discussion will include the types of vaccine in development, distribution priorities and barriers surrounding vaccine administration.  Dr. William Valenti will serve as faculty.

Educational Objectives:

  • Recognize the types of COVID-19 vaccine in development
  • Discuss priorities for vaccine distribution
  • Identify barriers to COVID-19 immunization

Additional information or assistance with registration may be obtained by contacting Melissa Hoffman at mhoffman@mssny.org.

The Medical Society of the State of New York is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

The Medical Society of the State of New York designates each live activity for a maximum of 1.0 AMA/PRA Category 1 credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity. (Hoffman)

 


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eNews

NYS Vaccine Information
New York Gov. Andrew Cuomo said the state is administering about 65,000 doses a day — a rate that will deplete its current supply in two or three days. “What’s clear now is that we will be going from week to week and you will see a constant pattern of basically running out, waiting for the next week’s allocation and then starting up again,” Cuomo said.

The state will receive 250,400 doses next week, but Cuomo urged President Biden to increase the supply to states immediately…”At this current rate of supply, it takes seven and a half months to get enough vaccine for the currently eligible population,” Cuomo said.


Please Take Statewide UHC/OPTUM Survey Now
MSSNY is addressing an issue brought to our attention by a large group of medical practices.  The issue involves claims filed on behalf of United Healthcare (UHC) patients. 

We have been advised that often, once the claims are filed, the medical practice receives a request for additional medical information, either from UHC or its utilization review entity, Optum.
Subsequently, the practice calls to request the status of the claim based on the additional information submitted.  Regrettably, the practice is often advised that the records were not received.  Based on further discussion during the call, the practice is told the records were sent to an incorrect address.

MSSNY has been interacting with UHC on behalf of our members in reference to this problem since June 2019.

Due to the length of this ongoing burden, MSSNY is now seeking assistance from the NYS Department of Financial Services (DFS).  Therefore, we are asking you for further information to address this matter.  DFS is regulatory authority over NYS regulated health plans/insurers. https://www.surveymonkey.com/results/SM-B9CWXYX57/


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Office of Pharmacy Benefits Investigates Drug Price Spikes During Pandemic
The new Office of Pharmacy Benefits announced it has initiated investigations into significant price spikes for six drugs that were connected to the COVID-19 pandemic. The Office will send a demand, related to New York Insurance Law Section 111, requiring a statement from the manufacturer explaining the causes of the spikes.

“Throughout the COVID-19 pandemic, we’ve seen too many instances of pharmaceutical companies taking advantage of those in need and significantly raising the prices on life-saving prescription drugs,” Governor Cuomo said. “This shameful behavior cannot stand and needs to be rooted out at all costs. Companies should be on notice – if you attempt to capitalize on the health needs of New Yorkers, we will investigate you and hold you fully accountable.” Since these drugs are sometimes the difference between life and death, an extreme price spike can be a barrier to lifesaving treatment, particularly during a global health emergency.

The Department of Financial Services’ (DFS) Office of Pharmacy Benefits (OPB) has examined changes in drug prices during the state of emergency to identify spikes in price worthy of further investigation.  On Thursday, the OPB commenced investigations into price spikes for six drugs, including:

  • Ascor (ascorbic acid) 25,000 mg/50 mL bulk vial – Ascor is a formulation of Vitamin C for IV injection manufactured by McGuff Pharmaceuticals. McGuff raised the price of this drug by 110% about a week after clinical trials were announced for use of the drug to treat COVID-19 patients suffering acute symptoms.
  • Budesonide 0.5 mg/2 mL inhalation (60 mL) – One of two corticosteroids to be investigated, a generic formulation produced by Cipla USA Inc. increased in price by over 1350% in the midst of the first wave of COVID-19 cases in the U.S. and on the heels of an announcement of international clinical trials for its use to treat COVID-19 patients.
  • Dexonto (dexamethasone) 5 mL vial of a 0.4% solution – Dexonto is the other corticosteroid under investigation and is a branded generic drug manufactured by Nubratori, Inc.  This manufacturer announced a price increase of over 65% at the beginning of the pandemic, just 11 days before clinical trials for treating COVID-19 patients with the drug were announced in China.
  • Mytesi (crofelemer) 125 mg delayed release tablet, 60s – Manufactured by Jaguar Health, Mytesi is a drug used to treat gastrointestinal side effects of antiretroviral therapies used by HIV patients.  Jaguar increased the price of the drug by 230% just days after it applied for an emergency use authorization for use to treat COVID-19 patients.
  • Duramorph (morphine sulfate) 1 mg/1 ml (10 mL 10s) – While most morphine formulations experienced modest increases in price during the early months of the pandemic, this branded product manufactured by Hikma Pharmaceuticals experienced an anomalous increase of nearly 60%.
  • Chloroquine phosphate 250 mg tablets – The chloroquine family of drugs has made many headlines during the pandemic, but Rising Pharmaceuticals appears to have attempted to capitalize on unsubstantiated reports of its effectiveness in treating COVID-19 patients early in the pandemic when it raised its price by 97.8%.

Each of these manufacturers will now be required to provide a justification for each spike the OPB identified.  Pursuant to the demands, the manufacturers will provide DFS with written responses to questions such as the dates pricing decisions were made, the officers or employees involved in the decisions, any analyses conducted prior to the price spike, and the reasons for the price spike given internally.  The OPB is authorized to collect additional information, including by examining witnesses or issuing subpoenas.

The beginning of an investigation does not mean that a price spike was unlawful or even unjustified. It means that DFS has determined the circumstances need a closer look.  If the investigation finds that illegal conduct occurred or that a price spike was not justified, it will be memorialized in a report of the Drug Accountability Board. If it is determined that a valid reason for the spike exists, DFS will announce that development and close the investigation.

For more information or to report a drug price spike, visit the DFS Website.


Altfest Interactive Webinar: New COVID Stimulus Package: Opps for Physicians
We have been monitoring the Coronavirus stimulus bill and its contents very closely in recent weeks. This bill, as you may know, attempts to alleviate some of the financial burdens that individuals and businesses may be facing.

Join Altfest Personal Wealth Management on Tuesday, January 26 for The New COVID Stimulus Package: Opportunities for Physicians an interactive webinar highlighting specific opportunities available for physicians and their businesses.Topics to be discussed: 

·        The second round of PPP Loans
·        Employee Retention Credit
·        Opportunities for Physicians
·        What will the future bring?

Date: Tuesday, January 26, 2021 @12:00pm ET

Speakers:

Ekta Patel, CFP®
Director and Advisor, Altfest Personal Wealth Management
Ryan Graham, CFA, CFP®
Senior Financial Advisor, Altfest Personal Wealth Management

CLICK HERE TO REGISTER

There is no fee to attend this webinar. Enrollment is limited.


Inspector General Urges CMS to Take Action Against 100 “Error-Prone” Providers
CMS should take action against 100 healthcare providers who had high rates of improper Medicare payments, the HHS Office of Inspector General said in a report released Jan. 19.

Using comprehensive error rate testing program data, the inspector general identified 100 “error-prone” providers from 2014 through 2017. Of $5.8 million reviewed, $3.5 million was incorrect, an improper payment rate of 60.7 percent. From 2014 through 2017, Medicare made $19.1 billion in payments to the 100 “error-prone” providers, according to the OIG.

Based on its findings, the inspector general recommended that CMS review the list of 100 providers and “take specific action” such as prior authorization, prepayment, and post payment reviews. The report also recommended that CMS use annual comprehensive error rate testing data to identify providers that have an increased risk of receiving improper payments and apply more program integrity tools to them.

In written comments on the draft report, CMS did not agree with the inspector general’s recommendations. CMS also disagreed with the inspector general’s methodology for identifying error-prone providers. CMS said it has tried to use comprehensive error rate testing data to identify error-prone providers but found that the data was ineffective for this purpose.

After reviewing CMS’ comments, the inspector general maintained its findings and recommendations. (Becker’s Hospital Review, Jan.21)


AMA Program: Release the Pressure! Blood Pressure Control in Blacks; 7 pm
Jan. 27
The American Medical Association is a member of the Release the Pressure (RTP) coalition which is focused on blood pressure control in Blacks. They are launching the 2021 campaign with an RTP Wellness Wednesday event, which airs January 27th at 8:00 p.m EST via ReleaseThePressure.org. During this special episode, Tom Joyner will host an all-Black male panel discussion on racism in health care. It’s a conversation you don’t want to miss! Join radio icon @TomJoynerMorningShow as he leads an all-Black male panel on racism in health care ReleaseThePressure.org


Optum Expects to Add 10,000 Physicians This Year
OptumCare, the part of UnitedHealth Group that provides direct patient care, plans on adding thousands of physicians in the next year, UnitedHealth’s CEO said during a Jan. 20 earnings call.

Currently, OptumCare employs or is affiliated with 50,000 physicians and 1,400 clinics. OptumCare expects that its employed and affiliated physicians will grow by at least 10,000 during 2021, according to UnitedHealth CEO David Wichmann.

“This work of building local, physician-led systems of care continues to be central to our mission and is accelerating with notable progress in the Northeast, Pacific Northwest and Southern California in 2020,” Mr. Wichmann said.

The statement comes as UnitedHealth posted a profit of $2.2 billion in the fourth quarter of 2020, down about 38 percent from $3.5 billion in the same period of 2019. In its Jan. 20 financial release, UnitedHealth said the declines were expected as care patterns normalized and costs related to COVID-19 care grew. (Becker’s Hospital Review, Jan 21)


J&J COVID-19 Single-dose Vaccine Candidate Shows Promise
A single-dose coronavirus disease 2019 (COVID-19) vaccine candidate in development by Johnson & Johnson’s Janssen Pharmaceutical Companies appears to provide a sustained response against the virus based on phase 1/2a trial data, according to a company press release.

Those interim results, published ahead of phase 3 findings anticipated later this month, demonstrated that the J&J vaccine (JNJ-78436735) provided an immune response that lasted for at least 71 days, the duration of time measured in this study in participants aged 18 to 55 years.

The interim analysis appeared this week online in the New England Journal of Medicine.

Data demonstrated that, after a single vaccination, neutralizing antibodies against COVID-19 were detected in more than 90% of study participants at day 29 and in 100% of participants aged 18 to 55 years at day 57. These neutralizing antibodies remained stable through day 71, the latest timepoint available in the ongoing study.

Data on durability of immune responses in trial participants aged >65 years will be available in late January and longer-term follow-up to one year is planned. Top line data from the company’s phase 3 ENSEMBLE trial of a single dose is due later this month, although this timing may change due to disease events. The ENSMBLE trial will evaluate the vaccine’s safety and efficacy vs placebo in up to 60 000 adults aged 18 years and older and will include a significant proportion of adults aged >60 years.

The most frequent solicited adverse events (mild-to-moderate side effects typically associated with vaccinations) in the vaccine study arms were fatigue, headache, myalgia, and injection site pain. Reactogenicity was lower in the older age group. The study also evaluated a two-dose regimen, in which reactogenicity was observed to be lower after the second vaccine dose. (Patientcare Online, Jan.15)


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Unique Rheumatology Practice Opportunity – Great Neck, NY
Partnership opportunity available at an established rheumatology practice in Great Neck, NY. Looking for a dedicated physician to join our practice or merge practices. Contact 516-972-2986 / susanrita1@msn.com for more info.

 

 

 

 

 

 

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