Health Costs And Financing: Challenges And Strategies For A New Administration.

It is likely that 2021 will be a dynamic year for US health care policy. There is pressing need and opportunity for health reform that helps achieve better access, affordability, and equity. In this commentary, which is part of the National Academy of Medicine's Vital Directions for Health and Health Care: Priorities for 2021 initiative, we draw on our collective backgrounds in health financing, delivery, and innovation to offer consensus-based policy recommendations focused on health costs and financing. We organize our recommendations around five policy priorities: expanding insurance coverage, accelerating the transition to value-based care, advancing home-based care, improving the affordability of drugs and other therapeutics, and developing a high-value workforce. Within each priority we provide recommendations for key elected officials and political appointees that could be used as starting points for evidence-based policy making that supports a more effective, efficient, and equitable health system in the US.

Building the Critical Path for COVID-19 Therapeutics

From the Executive Summary: Hundreds of therapeutics are in preclinical or clinical development for treating COVID-19 [coronavirus disease 2019] patients. But as of May 2020, so far none have demonstrated effectiveness sufficient to warrant approval for general use, although one antiviral drug (remdesivir) has shown sufficient impact in ongoing clinical trials to support an authorization for emergency use. This is a reflection of the complexity, time, costs, and uncertainties associated with developing therapeutics - a process that not only encompasses preclinical evaluation and clinical trials to demonstrate safety and effectiveness, but also manufacturing at pandemic scale, and sufficient payment to enable appropriate and effective access. [...] Policy attention has understandably focused on the development of vaccines as the path to recovery. But even with these unprecedented actions, the widespread availability of effective vaccines remains many months away, if not longer. To reduce the impact of the pandemic in the meantime, intensive effort is also needed to accelerate therapeutics development to help prevent infections, reduce their severity, and mitigate or prevent further outbreak waves.COVID-19 (Disease);Therapeutics;Public health

Coronavirus Testing, Tracing, and Targeted Containment: Steps to Reopen the Country

From the Document: Everyone wants to know when we'll be safe from COVID-19 [coronavirus disease 2019]. The answer is we're probably in for a long fight. [...] A critical element going forward is the ability to bring accessible, dependable and affordable testing to people who have symptoms or are at risk of contracting the disease. That doesn't mean we need to screen everyone all the time. But for those who are symptomatic or were exposed to the illness--or for those people who work in professions or live in communities where there's a higher chance for spread--we need to make sure that testing is available. We've largely relied on a technology called polymerase chain reaction (PCR), where swabs are used to collect samples, which are then scoured for the virus's genetic material. This RNA [Ribonucleic acid] is then amplified and analyzed to reveal the presence of active virus. But the whole process takes time, and results may not be available for at least a day. [...] New technologies are becoming available that will expand testing so that it will be accessible whether you're a large employer, a patient in a community setting or a college student returning to campus.COVID-19 (Disease);Health--Testing;Epidemics