Axios Vitals: Hospitals sue surgical robot maker

Plus: Pay disparities in academia | Tuesday, July 13, 2021

Open in app View in browser   Presented By PhRMA   Axios Vitals By Tina Reed ·Jul 13, 2021 Good morning, Vitals readers. Today's newsletter is 871 words, or a 3-minute read. Situational awareness: The Food and Drug Administration on Monday added a warning to the Johnson & Johnson coronavirus vaccine.  The shot can lead to an increased risk of a rare neurological condition, it said.     1 big thing: Hospitals sue surgical robot maker Illustration: Aïda Amer/Axios   Hospitals have mounted a legal battle against the company that makes the da Vinci surgical robot, alleging the company forces them to buy its maintenance services and replacement parts at inflated prices even though cheaper options exist, Axios' Bob Herman writes. Driving the news: In one allegation, a hospital says Intuitive Surgical remotely shut down a hospital's surgical robot "in the middle of a procedure" which forced the surgeon "to convert the procedure to open surgery with the patient on the operating table," after the hospital said it was considering a service contract with a third party. The big picture: Intuitive Surgical makes the da Vinci surgical robot, and sells them to hospitals for anywhere from $500,000 to $2.5 million each. But a majority of Intuitive Surgical's $4 billion of annual revenue comes from instruments, accessories, and service contracts that are needed to keep the robots operating. Where things stand: Franciscan Health, headquartered in Indiana; Valley Medical Center in Washington; and Kaleida Health in New York filed class-action lawsuits. They claim Intuitive Surgical has a monopoly on minimally invasive surgical robots, which gives the company a "near-stranglehold" on the market for all the parts and services the robots need after hospitals buy them. One lawsuit alleges hospitals cannot have their da Vinci robots serviced by third parties because Intuitive Surgical forces hospitals to sign "multi-year, exclusive servicing agreements" at rates that are much higher than other vendors'. Hospitals also allege that engineers at Intuitive Surgical have threatened to turn the machines into "paperweights" if hospitals look to outside vendors for repairs or new parts. Intuitive Surgical has faced antitrust lawsuits from third-party repair and service companies since 2019, but these hospital class-action lawsuits are new. A spokesperson said Intuitive Surgical would not comment on the lawsuits. Go deeper.     2. Timeline for boosters under discussion Illustration: Sarah Grillo/Axios   Conflicting statements from Pfizer and the Biden administration were just the beginning of what will likely be a contentious debate over booster shots, Axios' Caitlin Owens writes. Why it matters: Making decisions based on emerging science is difficult on a good day. But until global supply outpaces global demand for the vaccine, how to allocate doses will remain a life-or-death decision. Driving the news: Biden administration officials met with Pfizer yesterday evening to discuss whether new data suggests that some Americans may soon need a third shot. Sources told Caitlin that officials agreed they need to continue looking at the data. "For those who are at risk, there may be a need for boosts ... the real risk is, right now there are people who are not vaccinated," a person familiar with the discussion in that meeting said. "No one walked out of there and said boosters are needed imminently." Between the lines: Not only is the science unclear, but there would also likely be a global uproar if Americans began receiving a third shot before most of the rest of the world received their first. On the other hand, some Americans — especially older ones or those with health conditions — could become increasingly nervous about the status of their protection, especially after reading warnings like Pfizer's.     3. Next steps on Aduhelm Medicare has started the process of determining whether it will deny, limit or allow full coverage of Alzheimer's drug Aduhelm, Bob writes. What we're watching: The federal government will make a final coverage decision by no later than next April, and the public can submit comments now and after a proposed decision in January.     A message from PhRMA Out-of-pocket costs don't have to be out-of-this-world confusing     The way insurance covers your medicine is too complicated. Getting to what you pay for medicines shouldn't be a maze. What you pay out of pocket for medicines should be more transparent, more predictable and more affordable. If we fix insurance, we can fix out-of-pocket medicine costs. See how.     4. Gender pay gaps in medical education Illustration: Aïda Amer/Axios   Women who teach internal medicine specialties get paid less and have less representation in leadership than men, Axios' Marisa Fernandez writes from a new study published in JAMA Internal Medicine. The big picture: In an analysis across 154 medical schools in the U.S. between 2018 and 2019, researchers found women were paid at least 90% of men's median annual salary in 10 of 13 internal medicine specialties. Women's median salaries did not reach 90% of men's salaries in cardiology, gastroenterology, and critical/intensive care. While representation was nearly equal at the instructor and assistant ranks, it dropped to 24% at higher ranks, such as professor and "chief" ranks. Read more.     5. Honeywell, Premier ink domestic glove deal Illustration: Sarah Grillo/Axios   Global tech company Honeywell has inked a deal with Premier — a company that represents hospitals — to expand domestic production to upwards of 1.5 billion exam gloves annually in the U.S., the companies plan to announce this morning. Why it matters: After COVID-19 exposed vulnerabilities of the U.S. medical supply chain, particularly when it came to PPE, hospitals are seeking to protect themselves against future shortages. The companies declined to disclose the financial terms, but said 80 of Premier's member hospitals have committed to collectively purchase at least 750 million gloves annually from Honeywell. Honeywell needed a minimum commitment to build out the infrastructure for domestic nitrile glove production. Meanwhile, "health care system executives are very keen to ensure that we're making the right levels of investments to make a resilient supply chain," said Michael Alkire, CEO of Premier. The backstory: The announcement comes several months after Premier announced a joint venture between 34 of its member health system members and DeRoyal to produce isolation gowns. Premier and 15 member health systems also acquired a minority stake in Prestige Ameritech last year to support the production of masks and other PPE.     A message from PhRMA Out-of-pocket costs don't have to be out-of-this-world confusing     The way insurance covers your medicine is too complicated. Getting to what you pay for medicines shouldn't be a maze. What you pay out of pocket for medicines should be more transparent, more predictable and more affordable. If we fix insurance, we can fix out-of-pocket medicine costs. See how.   Like this email style and format? Learn more about Axios HQ. It'll help you deliver employee communications more effectively.   Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here. 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