Jeffrey Benedix

The Pfizer-BioNTech COVID-19 vaccine (BNT162b2) prevented about 110,000 deaths and 700,000 hospitalizations in the U.S. and saved more than $70 billion in health care costs and lost productivity in 2021, a new study finds.

The vaccine, which first became available in December 2020, was the only one with FDA approval in 2021. The Centers for Disease Control and Prevention estimates that 57% of fully vaccinated individuals in 2021 received the Pfizer vaccine, the highest proportion of the vaccinated population.

The study’s authors all received funding from Pfizer, either as employees, consultants or employed of companies paid by Pfizer. To carry out the study, the authors first developed a combined Markov and decision tree model. Then they entered both real-world and trial data into the model to estimate the one-year public health impact of the Pfizer-BioNTech vaccine compared with no vaccine.

The data they used included the number of vaccines administered, and the vaccine’s efficacy in different age groups, as well as the probability of catching COVID-19, developing symptoms and being hospitalized. They also accounted for the effects of long COVID and the number of working days likely to have been lost due to short-term illness and the economic cost of premature deaths.

They found that compared to no vaccination, the two-dose series of the Pfizer-BioNTech vaccine prevented almost 8.7 million symptomatic cases of the disease, averted approximately 690,000 hospitalizations, and saved over 110,000 lives.

In addition, the reductions in COVID-19 symptomatic cases were associated with $43.7 billion in productivity gains. Around 36% of the gain came from preventing productivity loss due to early death, with the remainder due to avoiding workdays lost to illness.

The authors note their findings didn’t include the vaccine’s potential to reduce transmission of COVID-19 or its severity, and thus may underestimate the full impact of the vaccine.

“The analyses show that the Pfizer-BioNTech COVID-19 vaccine contributed substantial public health impact in the U.S. in 2021, and had a deep effect on the trajectory of the pandemic,” Manuela Di Fusco, senior director, health economics and outcomes research at Pfizer and one of the study’s authors, said in an accompanying press release. She added that the results “highlight the opportunity to continue widespread vaccination uptake to prevent COVID-19 related disease and generate societal benefits.”

Di Fusco M, Marczell K, Deger KA, et al. Public health impact of the Pfizer-BioNTech COVID-19 vaccine (BNT162b2) in the first year of rollout in the United States. 

. 2022;25(1):605-617. doi: 10.1080/13696998.2022.2071427.

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The vaccine also prevented nearly 9 million symptomatic cases.

More Than 100,000 US Deaths Prevented by Pfizer-BioNTech Vaccine in 2021

As the nation’s death toll from COVID-19 inches towards one million, the Biden administration is intensifying efforts to inform clinicians and ordinary Americans about treatments for the disease, and to make testing and treatment more widely available.

 released Tuesday, the administration outlined the latest steps the government is taking to distribute medications for treating COVID and inform people about their availability. These include:

Making it easier for pharmacies to obtain oral antiviral treatments.

 It will do this by allowing pharmacies that are partners in the federal antiviral pharmacy program to order free oral antiviral treatments directly from the federal government. Doing so will increase from the number of locations where antivirals are available from 20,000 to 30,000, according to the statement.

Working with states and other jurisdictions to increase the number of Test

These will provide COVID-19 testing, assessment by medical professionals and distribution of oral antiviral treatments in the same location. The sites will be established in partnership with state, Tribal and territorial governments with support and coordination from the U.S. Department of Health and Human Services and the Federal Emergency Management Agency.

Increasing public awareness of, and education about COVID-19 treatments. 

The White House fact sheet says administration efforts will focus on making sure people know that COVID-19 oral antiviral treatments must be taken within the first five days of symptom onset and help them understand what they can do to reduce the risk of severe disease and death from COVID-19. These efforts build on other steps the administration has taken recently, such as launching the COVID.gov website, promoting test-and-treat messages on social media, and establishing a call center to provide help in English, Spanish and more than 150 other languages.

Giving medical providers more guidance and tools for understanding and prescribing treatments

. According to the fact sheet, earlier this week the CDC issued a Health Alert Network health advisory

 to public health officials with additional information about the efficacy and availability of oral antiviral treatments. In addition, the administration is asking electronic health records companies to incorporate information about oral antivirals directly into health records interfaces. Doing so would make it easier to integrate the prescribing of oral antivirals into doctors’ everyday practice.

Responding to the White House fact sheet, a spokesperson for the Electronic Health Record Assocation (EHRA) said in a statement, “Just as we have for clinical alerts in general, EHRA members have worked closely with their clients, the CDC, and other agencies throughout the pandemic to ensure that, as new COVID-19 vaccines and treatments become available, clinicians are provided with the most appropriate alerts and reminders in the right context within the EHR. The EHRA continues to work with key stakeholders to increase awareness and best practices as we work toward reducing the impact of the pandemic.”

This article originally appeared on Medical Economics.

Fact sheet: Biden Administration increases access to COVID-19 treatments and boosts patient and provider awareness. The White House. Published April 26, 2022. Accessed April 27, 2022. 

https://www.whitehouse.gov/briefing-room/statements-releases/2022/04/26/fact-sheet-biden-administration-increases-access-to-covid-19-treatments-and-boosts-patient-and-provider-awareness/

Updated information on availability and use of treatments for outpatients with mild to moderate COVID-19 who are at increased risk for severe outcomes of COVID-19. CDC Health Advisory. Published April 25, 2022. Accessed April 27, 2022. 

https://emergency.cdc.gov/han/2022/pdf/CDC_HAN_463.pdf

The country's COVID-19 death toll is nearing 1 million. 

Biden Administration to Intensify Test to Treat Efforts

Health care provideres and others wanting to comment on the proposed updates to the federal opioid prescribing guidelines have only 5 more days to do so.

The CDC National Center for Injury Prevention and Control, which has been developing the update, has an April 11 deadline for public input. Comments can be submitted at to the 

“This comment period provides another critical opportunity for diverse audiences to offer their perspective on the draft clinical practice guideline,” Christopher M. Jones, PharmD, acting director of the injury prevention and control center said in a statement on the CDC’s website. “The ultimate goal of this clinical practice guideline is to help people set and achieve their personal goals to reduce their pain and improve their function and quality of life. Getting feedback from the public is essential to achieving this goal.”

The CDC issued its “Guideline for Prescribing Opioids for Chronic Pain”

 in 2016, following a 16-year period that saw more than 165,000 Americans die from opioid-related overdoses. These guidelines covered topics from determining when to initiate or continue opioid therapy, selection, dosage, duration, and discontinuation of opioids, and assessing risks and harms of opioid use. 

In the following years, opioid prescribing declined substantially, but doctors increasingly took the guideline to mean they shouldn’t prescribe opioids at all, leading some people with severe chronic pain to begin using heroin and synthetic drugs such as fentanyl.

In soliciting comments for the updated guideline, the CDC calls the guideline recommendations voluntary and “are not intended to be applied as inflexible standards of care or replace clinical judgment or individualized, patient-centered care.”

Proposed 2022 CDC clinical practice guidelines for prescribing opioids. 

Published February 7, 2022. Accessed April 7, 2022. 

https://www.federalregister.gov/documents/2022/02/10/2022-02802/proposed-2022-cdc-clinical-practice-guideline-for-prescribing-opioids 

CDC guideline for prescribing opioids for chronic pain—United States, 2016

. 2016;65(1):1-49. doi:10.15585/mmwr.rr6501e1

The deadline to submit comments is April 11. 

Deadline for Public Feedback on Updated Opioid Prescribing Guidelines Approaching

Drug overdoses have killed more than a million Americans since 1999, more than the number killed in battle during all wars the U.S. has fought in its history, according to a bipartisan Congressional report issued Tuesday.

The report, a product of the Commission on Combating Synthetic Opioid Trafficking, calls deaths from drug overdoses a “national emergency.” It notes that the situation has grown more dire recently, with about 100,000 Americans dying from overdose deaths during the 12 months ending in April 2021, the majority involving fentanyl and other synthetic opioids. That is twice the number who died from traffic fatalities or gun-related violence during the same period.

Along with their social and psychological costs, overdose deaths represent an enormous financial cost. The report cites a 2018 White House Council of Economic Advisors report putting the cost of overdose fatalities at $696 billion. Since the number of deaths then was about two-thirds the current total, the report estimates that drug overdoses now cost the United States about $1 trillion annually.

The report traces the roots of the crisis to the FDA’s 1995 decision to approve OxyContin, a prescription opioid painkiller. It and similar drugs were marketed as non-addictive cures for pain without considering a patient’s other conditions that might drive misuse of the drugs. The result was a dramatic increase in prescription opioid dependence and addiction.

After prescription opioids became less easily available, people with substance abuse disorders frequently began using heroin and, sometimes unknowingly, powerful synthetic opioids. “In less than a decade, illegal U.S. drug markets that once were dominated by diverted prescription opioids and heroin became saturated with illegally manufactured synthetic opioids,” some of which are easier and cheaper to produce than heroin, according to the report.

When fentanyl and other synthetic opioids first appeared in the U.S. in 2014, they were largely made in and shipped from China. But in recent years Mexico has become the country of origin. Fentanyl’s potency, combined with a lack of quality control and imprecise dosing increase the risk of fatal overdose.

“The bottom line is that fentanyl is undeniably extremely dangerous to people who acquire drugs from illegal markets that operate with little transparency or care for consumer safety,” the report reads.

Reducing the number of overdose deaths will require addressing both demand for and supply of illegal drugs. To do that, the report lays out a multi-pronged strategy built around five “pillars” that include:

developing a unified, central body to coordinated planning, implementation and evaluation of all U.S. drug policies,

using targeted oversight and enforcement to disrupt drug supply,

making public health demand-reduction approaches central to the fight against opioid trafficking so as to reduce the number of potential buyers,

collaborating with other countries involved in producing and distributing synthetic opioids and the materials used to make them; and

improving surveillance and data analysis to allow for more timely and effective interventions

“Given the gravity of this crisis, new approaches, additional resources, and a reconsideration of ongoing interventions are essential,” the report concludes. Absent such steps, “the economic costs will continue to rise, and hundreds of thousands more Americans will perish from preventable drug overdoses.”

Drug overdoses now cost the United States about $1 trillion annually.

Drug Overdose Deaths Top 1 Million, Per Bipartisan Congressional Report

 use, including video visits, spiked at the start of the 

 pandemic, as both doctors and patients sought to minimize in-person contact. But a new survey finds that Americans are of two minds about video visits for non-emergency health care after the pandemic ends: they don’t mind using them, but given the choice, most would still prefer in-person visits, even if they have to pay more out-of-pocket than for a video visit.

Researchers asked 2,080 people to rate their willingness to use 

 in the future on a scale of one (unwilling) to five (very willing) if out-of-pocket costs were not a factor. More than 61% rated their willingness as a four or five, while 16% responded with a one or two.

But asked their preference for the amount of video visits they wanted after the pandemic, 63.6% said they wanted “none” or “a little,” with the rest saying they wanted “some” or “as much as possible.”

When told they’d have to pay $30 out-of-pocket for an in-person visit versus $10 for a video visit, half of those who initially preferred an in-person visit maintained their preference, and 23.5% switch to a video visit. The remainder had no preference.

In contrast, when those who initially preferred a video visit were told it would cost more than an in-person visit, only 19% still wanted a video visit, while 61.7% switched their preference to in-person. The authors say the difference in perceived value suggest that while patients may like telehealth in some circumstances, such as care for minor acute conditions, they might not perceive it as having the same value as in-person care.

The authors note that the results have troubling implications for the hope that video visits can result in more care for 

, such as racial and ethnic minorities or people living in rural areas: 49.3% of Black/African American respondents, and 58.6% of Hispanic/Latinos said they prefer in-person visits, while 16.5% and 23%, respectively, expressed a preference for video visits.

Similarly, 56% of respondents living in rural areas or cities with fewer than 50,000 residents preferred in-person visits, while 17.6% wanted video visits. “Findings of this survey suggest that these [underserved] populations may be the least likely to demand it [video visits] and that ongoing efforts to promote equity of access to telehealth need to consider these preferences,” they write.

The study, “Assessment of Patient Preferences for Telehealth in Post-COVID-19 Pandemic Health Care,” was published December 1, 2021 on JAMA Network Open.

This article was originally published on 

Americans want the technology available, but most prefer in-person visits.

Patients Still Prefer In-Person Visits Over Telehealth, Study Shows

Health care providers, like nearly everyone else, have experienced strains on their 

 during the COVID-19 pandemic. But the effects have been particularly acute among health care providers without prior histories of mental health or substance use problems, a new study finds.

 compares the rate of outpatient visits for mental health and 

 for the 12 months following and preceding the start of the pandemic among 34,000 providers in Ontario, Canada.

It found that the proportion of respondents making first-time mental health/substance abuse visits during the pandemic grew by 40.6%, compared with a 19.3% increase among those who had made such visits before the start of the pandemic. Overall, the annual number of visits was up by 27%, from 816.8 to 1,037.6 per thousand physicians.

The findings suggest, according to the researchers, that the increases in visits result from both an increase in the number of health care providers accessing mental health services and in the number of those with multiple mental health visits.

“Together, these findings suggest that generally, [providers] have displayed resiliency during the pandemic, but a small group may have developed very high new mental health care needs…which are possibly related to pandemic-specific stressors.”

Among practicing specialists, surgeons and anesthesiologists were the least likely to seek mental health/substance abuse help, with 460.6 and 740.3 visits per thousand physicians, respectively. On the other hand, visits among anesthesiologists grew by 74% after the start of the pandemic, the largest among any of the specialties in the study. Specialties with the greatest number of visits were psychiatrists (4,252 per thousand) and family physicians (890.3 per thousand.)

The authors noted that while earlier studies have shown prolonged contact with COVID-19-infected patients to be a risk factor for negative psychological outcomes, their results found little difference between respondents who did or did not provide acute care for these patients. They speculate this may be because health care providers providing acute care for COVID-19 patients had lower rates of mental health/substance abuse visits before the pandemic.

This result may, in turn, suggest that this group of providers has greater resilience to mental health conditions, be more reluctant to 

, or a combination of the two that continued during the pandemic. Another possibility is that their increased workloads during the pandemic may not have allowed them time to seek mental health care.

The authors say that their findings of increases in mental health/substance abuse visits, when combined with surveys of providers showing high levels of self-reported anxiety, depression and stress, may indicate worsening mental health among providers generally.

Myran DT, Cantor N, Rhodes E, et al. Physician health care visits for mental health and substance use during the COVID-19 pandemic in Ontario, Canada. 

2022;5(1):e2143160. doi:10.1001/jamanetworkopen.2021.43160

First time outpatient visits for mental health services were sharply increased compared with the period before the pandemic. 