US data shows hit to diagnosis and treatment

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Concern already expressed by Australian governments and medical leaders over the decline in people visiting healthcare professionals in response to COVID-19 could come into focus further given reports out of the US.

Health minister Greg Hunt and Australian medical leaders including AMA president Dr Tony Bartone recently urged people with chronic conditions to maintain their regular health care and continue to see their general practitioner or specialist.

They issued a joint statement after reports of a significant decline in presentations to healthcare professionals, including a 40 per cent reduction in pathology testing.

Access to care is complicated by the shutdown of almost all elective surgery.

The federal government has introduced a number of changes to ameliorate the potential negative health effects of social distancing during the COVID-19 pandemic, including telehealth consultations, facilitating greater use of e-prescriptions and the postal delivery of medicines.

However, the US experience suggests they may not fully mitigate the impact of social distancing, with telehealth surging in that country. Yet it has not gone close to matching the decline in face-to-face patient visits meaning an overall decline in consults.

Market intelligence data suggests that around 50 per cent of US physicians are using telehealth for patient consults - online and telephone - but approximately 20 per cent have ceased providing routine care during the pandemic with one-quarter of those temporarily closing their practice. Consults on chronic conditions and acute symptomatic conditions are down significantly.

Importantly, the significant growth in the use of telehealth is largely limited to higher socio-economic areas - poorer areas have seen only minimal uptake of telehealth.

The overall decline in consultations is reflected in lower rates of medication prescribing and dispensing - after an early surge in response to the pandemic, weekly prescription volumes in the US are down 15-20 per cent from normal.

There has also been a sharp fall in diagnostic testing in the US with new treatment initiations down across all therapeutic areas. 

The decline in diagnostic testing in the US - which is also evident in Australia - reflects a significant fall in oncology-related patient interactions. The fear is that this will delay treatment for many patients and could ultimately lead to higher costs and mortality.