Shorts: Virtual MH, GLP effectiveness, bird flu, and excess pediatric deaths
July 25, 2024
Those with pre-deductible coverage for tele-mental health have more visits.
Many employers eliminated out-of-pocket costs for telemedicine mental health services during the pandemic, but some have reinstituted these costs. A study of over 15,000 members who received virtual mental health care showed that the group that had cost-sharing reinstituted on average had 1.5 fewer visits compared to those who continued to have out-of-pocket costs waived. The cost sharing on average was about $30 per visit.
Employers should consider this when they are determining whether to continue to offer pre-deductible coverage for virtual mental health services.
Tirzepatide weight loss higher than semaglutide weight loss in those with diabetes
Likelihood of achieving 5%, 10% and 15% weight loss
Source: Rodriguez, PJ JAMA Int Med July 8, 2024 LINK
A study of over 41,000 people with diabetes treated with either tirzepatide (Mounjaro and Zepbound) or semaglutide (Ozempic or Wegovy) showed that weight loss was significantly higher with tirzepatide. This is consistent with other published information on the two medications. Weight loss with semaglutide was medically significant, too, and many with obesity do not need the enhanced weight loss from tirzepatide. Right now, semaglutide is more expensive; I hope that this will help push the manufacturer to lower the price so that this class of drugs can be available to more of those who could benefit. Both drugs have been in short supply in recent months.
Bird flu cases continue to increase
Bird flu has now been identified in wild birds in all 50 states, poultry farms in 48 states, and cattle herds in 13 states. There are 9 reported cases in the US in humans, none of which has been fatal. This is a global problem, and in Finland cattle workers are now being vaccinated. The Centers for Disease Control and Prevention (CDC) has stockpiled about 5 million doses of vaccination for the influenza A virus that causes bird flu.
It’s a good time to re-read Patricia Toro, MD MPH’s note from May on what employers should know about bird flu.
Excess mortality among US children
JAMA Pediatrics reports that a substantial portion of the reason why life expectancy in the US lags behind other developed countries is that the US has excess mortality in children. This includes higher rates of infant mortality, as well as higher rates of death in older children.
Age specific mortality per 100,000
Source: LINK Comparison countries include Australia, Austria, Canada, Denmark, Finland, France, Germany, Italy, Japan, the Netherlands, Norway, Portugal, Spain, Sweden, Switzerland, and the United Kingdom.
The excess death rates among teenagers, pictured above, is due to deaths from suicide, guns (a third of suicides involve guns, too), and drug overdoses. The impact of deaths of teens on the workforce is devastating. Employers can be sure their employees and families have access to naloxone (Narcan) in case of a witnessed overdose. This link provides more information about implications of gun violence for employer-sponsored health plans.