In a recent JAAD study, researchers evaluated acquisitions and organic growth made by dermatology management groups (DMGs) with private equity (PE) investment from July 2018 through July 2019. During this period, clinic locations increased 10%, from 765 to 842. Of new clinics, 68% were associated with newly acquired practices while 32% were either part of non-publicly disclosed acquisitions or organic growth, including organic expansion of previously acquired practices.
Despite closure or consolidation of many clinic locations, DMGs expanded from July 2018–July 2019, although the study authors note that “DMG expansion may be more dynamic than linear.” As fewer practices become available for purchase by DMGs, trends in organic growth will be important to monitor, the study researchers conclude.
Physician practices are not the only health care entities private equity has a stake in. GoodRx took on a substantial private-equity partner in 2018 and expanded into telemedicine along with prescription discounting. Demonstrating the ephemeral nature of PE-backing, the company is now filing an IPO.
DermWorld examined what the rise of private in dermatology means for dermatology in a January 2018 feature. The Academy’s Practice Management Center includes resources to help you assess the pros and cons of various practice options. Check them out.
DermWorld Insights and Inquiries: New data to recall when considering radiation recall dermatitis
I have always been mystified by the diagnosis of radiation recall dermatitis (RRD). RRD was first described in 1959 by D’Angio et al who stated: “Actinomycin D therapy alone can reactivate ‘latent’ radiation effects in normal tissues. For example, in skin previously irradiated but normal in appearance, an erythema may develop during actinomycin D therapy, identical in type to that produced by roentgen irradiation. This response is sharply restricted to the areas previously treated by X-rays. The severity of the reaction varies from a mild reddening to pronounced desquamation. It is most accentuated when only a brief interval separates the courses of radiotherapy and chemotherapy.” Keep reading!
Young Physician Focus: Prepping for round two
As I prepare my children for the start of another school year, this year’s supply list looks a little different: Masks and hand sanitizer will accompany their pencils and paper. Parents, educators, and students across the country will collectively embark on a journey into a new frontier of hybrid schedules and remote learning, all in an effort to slow the spread of COVID-19. These are fascinating times.
Hopefully we have learned some lessons from the sudden shutdown in the spring and will more quickly adapt to whatever surprises this fall may bring. Like many parents, I have constructed elaborate plans and backup plans in the (highly likely) event that my kids’ school converts to fully remote learning at some point during the school year. My plans for another shutdown affecting my practice, however, are less clear. I did not find telemedicine particularly effective, although we are utilizing it whenever possible for follow-up patients. My group has worked diligently this summer to reduce patient density in our building and optimize cleaning and distancing measures. With any luck, the expected surge in COVID cases this fall will be mitigated by these actions, and we will avoid a full shutdown. Somehow though, knowing that we are prepared does not quell my anxiety as we bid farewell to a “normal-ish” summer and enter an unknown fall. Read more from DermWorld Young Physician Advisor Jenna O’Neill, MD.
Practicing cosmetic dermatology during COVID-19
In this preview of an upcoming Answers in Practice column, DermWorld talks with Sean Wu, MD, Monica Boen, MD, Douglas C. Wu, MD, PhD, and Mitchel P. Goldman, MD, from Cosmetic Laser Dermatology in San Diego, about best practices for offering cosmetic dermatology during COVID-19. Read more about their experience re-opening the practice.
FDA, UMD seek feedback on compounded drug use
In collaboration with the FDA, the University of Maryland Center of Excellence in Regulatory Science and Innovation (M-CERSI) is conducting an anonymous survey to better understand how compounded drugs containing bulk drug substances are used in clinical practice. Protecting dermatologists’ access to compounded drugs is a top advocacy priority for the AADA and quality data will help the Academy effectively advocate for the specialty and its patients.
The goal of this survey is to understand how medical practitioners prescribe and administer compounded drugs. The survey feedback will help the FDA develop a list of drugs that can be used in bulk compounding by 503B outsourcing facilities. The anonymous responses will be shared with the FDA as part their project, “Clinical Use of Drugs Including Bulk Drug Substances Nominated for Use in Compounding by Outsourcing Facilities.”
Several substances are being surveyed as it relates to the specialty, including lidocaine, epinephrine, salicylic acid, lactic acid, thymol iodide, and others. Take the survey.
FDA rule allows drug importation from Canada to lower drug prices
On Sept. 24, the U.S. Food and Drug Administration (FDA) took action to lower the cost of prescription drug prices as outlined in the Safe Importation Action Plan, a part of the July Executive Order. The final rule allows FDA-authorized programs to import certain prescription drugs from Canada under specific conditions that ensure no risk is posed to the public’s health and safety while achieving significant cost reduction for American consumers.
The final rule allows states, tribes, pharmacists, and wholesalers to submit plans to the FDA to import medications provided they can demonstrate the moves would save patients money. Import plan sponsors must also show the medications being brought in pose no threats to patient safety.
In a separate guidance, the FDA detailed requirements to import biological products. The products must be approved by the FDA and be manufactured and approved for sale in other countries.
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