Healthcare Watch December 2022

Therapeutic Talk: PCPs Need Support to Combat Mental Illness

More than 83% of primary care physicians (PCPs) want their patients to talk about basic mental illness concerns so they can treat them themselves, but only one in four PCPs actually performed a depression screening, according to the latest GeneSight Mental Health Monitor, a nationwide survey from Myriad Genetics, Inc. The survey found that more than half of clinicians don’t think patients are aware that PCPs and nurse practitioners (NPs) are fully trained to diagnose and treat mental health conditions, while the same amount claimed that they wait to discuss specific mental health disorders such as depression and anxiety until a patient raises a concern, or when the results of a screening/evaluation indicate the need.

“When a patient comes into my practice, they may not even be aware that their symptoms could indicate depression, anxiety, or another mental health condition,” Michele Long, NP said in a statement. “It would be great if patients knew it was okay to bring up their concerns. However, it’s also my responsibility to ask the right questions—either by having my patient complete a mental health screening or just asking them myself.”

On top of this, the struggles of diagnosing and treating mental illnesses has increased for PCPs and NPs as they are increasing their referrals to mental health specialists over the past two years (63%) while availability of that healthcare has become limited. And according to the GeneSight report, only 18% of responding prescribers in primary care use an available tool like pharmacogenomic testing to help inform their mental health medication treatment plan.

“Primary care providers are now fighting two battles at once: more and more patients are experiencing mental health challenges, but there are fewer specialists available to send them to,” said Fred Fantazzia, General Manager, Mental Health, Myriad Genetics. “PCPs want to provide quality mental healthcare so their patients can have a better chance at an improved quality of life, and the GeneSight test is a tool that may help them to do that.”

Doctor Docs: Rep Access to HCPs Increases Post-Pandemic

A recent Veeva Systems report shows that rep access to HCP engagement now averages 60% across therapeutic areas and is nearing 80% in key specialties, driven by the increasing use of video meetings to complement in-person visits. After analyzing over 600 million HCP interactions, Veeva reports that more than 50% of accessible HCPs now engage with reps via video along with in-person visits. The addition of video visit options is generating three times the promotional response as well as increased in-person meeting frequency.

In addition, HCPs have become more selective with over half limiting their interactions with reps to only two or three companies. For example, 30% of psychiatrists limit access to just one company while 70% of immunologists engage with four or more companies.

“Veeva Pulse Field Trends Report gives a comprehensive view into HCP access and channel effectiveness industrywide so teams know what actions they can take to strengthen engagement and drive better outcomes,” said Dan Rizzo, Vice President of Veeva Business Consulting. Overall, those field teams with the highest impact are digitally enabled and maximize time spent with HCPs. The most successful teams hosted up to 40% more meetings, used content nearly five times as much, and drove up to 80% more new patient starts.

Med Device Department: Predicting Heart Disease with an X-ray

Researchers are developing a tool that uses artificial intelligence to produce 10-year heart disease risk scores using only a basic chest X-ray.

Doctors recommend that patients get screened for heart disease risk (which leads to heart attacks and strokes) regularly. Currently, doctors use a calculation from the American College of Cardiology that considers multiple factors for each individual patient that includes their family health history, diabetes risk, blood pressure, cholesterol levels, etc., to estimate the risk of acquiring heart disease within the next 10 years of a patient’s life.

Now, researchers at Massachusetts General Hospital are developing an AI tool that can deliver 10-year heart disease risk scores using only a basic chest X-ray. With the same purpose as the traditional method of risk assessment, this deep AI learning algorithm is designed to “identify individuals who would benefit from statin medication but are currently untreated,” states Jakob Weiss, MD, lead author of the study and radiologist at Massachusetts General Hospital.

The deep learning model was trained to analyze X-rays for any indications of an abnormal cardiovascular event occurring within a decade based on 147,000 chest X-ray images. The model was then tested by estimating the 10-year cardiovascular risk score of 11,430 Mass General patients, resulting in a significant association between the AI’s scores and the 9.6% who actually went on to experience those events within 10 years after the X-ray had been collected and similar to the risk scores given by the traditional method. This means the method can be a useful early screening tool that can supplement the traditional screenings doctors provide their patients, especially for those patients who aren’t screened as regularly as recommended.

“The beauty of this approach is you only need an X-ray, which is acquired millions of times a day across the world,” Dr. Weiss said at the Radiological Society of North America’s annual meeting in Chicago. “Based on a single existing chest X-ray image, our deep learning model predicts future major adverse cardiovascular events with similar performance and incremental value to the established clinical standard.”

FDA Update

Drug Approvals

The FDA approved Rezlidhia for the treatment of adults with mIDH1 relapsed/refractory acute myeloid leukemia. Rigel Pharmaceuticals’ oral medication taken twice a day in Phase II trials facilitated a complete remission rate of 35%.

SCYNEXIS, Inc. received FDA approval for a second indication for Brexafemme (ibrexafungerp tablets). The antifungal originally indicated for treatment of vulvovaginal candidiasis (VVC), has now received approval for use of the reduction in the incidence of recurrent vulvovaginal candidiasis (RVVC).

The FDA approved CSL Behring’s Hemgenix (etranacogene dezaparvovec), an adeno-associated virus vector-based gene therapy for the treatment of adults with Hemophilia B (congenital Factor IX deficiency) who currently use Factor IX prophylaxis therapy, or have current or historical life-threatening hemorrhage, or have repeated, serious spontaneous bleeding episodes.

Provention Bio received approval for its Tzield (teplizumab-mzwv) injection, the first drug that can delay the onset of stage 3 type 1 diabetes in adults and pediatric patients 8 years and older who currently have stage 2 type 1 diabetes.

Med Device Approvals

WISE Srl’s WISE Cortical Strip (WCS) received approval as a single use medical device intended to be used on the brain surface for Intra Operative Neurophysiological Monitoring (IONM). Unlike traditional cortical electrodes, which are made of stiff metal discs enclosed in a thick silicone foil, the WCS is made of stretchable platinum contacts embedded in a soft and thin film of silicone, which makes it highly ergonomic and conformable to the brain surface.

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