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Osaka University researchers improve solar panels' efficiency
 Figure 1. Fabrication of ultralow reflectance polycrystalline silicon wafers by use of the developed technology. Credit: Osaka University

Power generation cost using solar panels depends on getting as much electricity out of the panels as possible while keeping the manufacturing costs low. Anyone who has considered installing solar panels might be aware of the trade-off between efficiency and the initial cost of the panels. Engineers and researchers are finding new ways to obtain power out of solar modules, but doing so without adding to their costs is becoming more and more difficult.

Now a team of scientists at Osaka University has taken a step closer to making inexpensive solar cells that can deliver the same high efficiency as more complex and expensive cells.

"Unmodified silicon solar cells throw away light energy in the form of reflection, so most solar cells have some kind of antireflective coating," explains first author Daichi Irishika. "To avoid using these extra coatings we fabricated a submicron structure using a simple wet treatment directly into the silicon surfaces to give the cell its own antireflective coating."

Antireflective coatings, similar to those used on reading glasses, can help to get more light into solar cells and boost their electricity output. However, these coatings are expensive to produce, especially for covering large areas.

The Osaka team has previously made low reflection silicon cells using a much cheaper process based on the surface structure chemical transfer (SSCT) method to fabricate so-called black silicon. Chemically treating the front side of silicon cells produces tiny submicron silicon structures, which prevent light reflection and give a black appearance. The team has also developed a method to passivate the submicron silicon structures with huge surface area to prevent the recombination loss by deposition of phosphosilicate glass followed by heat treatment. This method can simultaneously form pn-junction to separate photo-generated electrons and holes, and therefore, it isn't an additional process.

Figure 2. Comparison of low reflectance mechanisms for previous technology and developed technology. Credit: Osaka University

Building on their previous success, the Osaka team turned their attention to the back side of the silicon cells and created rougher light-trapping microstructures to capture even more infrared light.

Group leader Hikaru Kobayashi says, "Making very high efficiency solar cells is important but we should also consider the economics and practicality of any processes used to increase efficiency. The wet processes we have developed are simple yet effective, and our work with black silicon has real-world applications in making cost-effective silicon solar panels."

More information: Daichi Irishika et al. Improvement of Conversion Efficiency of Silicon Solar Cells by Submicron-Textured Rear Reflector Obtained by Metal-Assisted Chemical Etching, Solar RRL (2017). DOI: 10.1002/solr.201700061

Output: Researchers from Osaka University have made progress in developing a low-cost solar cell that is as efficient as more complex, costly cells. Unmodified silicon solar cells throw back light energy, making anti-reflective coatings a necessity. However, the researchers have developed a submicron structure applied through a wet treatment that can integrate this coating within the cell itself. The method can be incorporated during the regular manufacturing of solar cells for use in solar panels.


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TalkTalk Most British workers don't want to be microchipped
 US software company Three Square Market (32M) recently announced that they were trading in work passes for RFID microchips on a trial basis. On our side of the pond, a new survey reveals that employees are highly unlikely to stick around if this were the case.

The research was commissioned by TalkTalk Business’ Workforces 2025 initiative, which examines the trends set to transform the future of employment and the workplace. Over 2,000 working adults over the age of 18 in the UK in June 2017 were asked to consider how they would react if their employer asked them to have a microchip implanted into their body to help increase their efficiency at work.

The smaller the business, the less likely employers are to consider implanting employees with electronic chips as a priority. Less than one in ten employers do, however, consider it a business priority over the next 10 years. Why? According to over a third of the employers surveyed, it was for streamlining employees’ access to work devices, but for one in five employers, it’s more for tracking employees’ movements.

Other findings from the research found that generationally speaking, over a third of Generation Z and younger millennials vehemently oppose wearing an RFID implant, citing they would quit their job. Older millennials (between 25 and 34) are more open to trialling the technology, however. Across the board, five per cent of British workers would consider wearing a microchip if they were paid extra.

“My immediate thought is, why would it need to be implanted?,” asks Stephen Robinson, employment partner at law firm Ward Hadaway. “The microchip is much like the fobs that hang around our necks or in our handbags. Even having access via phone would be more convenient than an implant.”

Convenience and common sense aside, is microchipping your staff legal? Robinson says it depends on employers asking individuals for consent, and more importantly, make sure that volunteering to be microchipped is an informed decision made by employees. Employers who are bought in will understandably explain the benefits of these implants, but Robinson stresses that they ought to also say explain the negatives.

“There are some technological advantages to the chip, but what happens if the individual is on probation and has to leave? How easy is it to be removed? What happens if it reacts badly to the individual’s skin or body? What happens if that individual decides not to have it anymore? How easy is it to remove it? There are practical issues like that,” he says.

Another element to this argument is the question of employee privacy. Employers need to stress that the chips won’t be used as monitoring devices. “This is where it’s a little bit like the Twilight Zone, where concerns that Big Brother is watching you begins. This is also where the law becomes quite protective over the individual’s privacy.”

The fact that the impetus stems from a business need raises a lot more questions.

“Because this comes from a business need, it’s really interesting, and we see negatives in it. In the next few years, big manufacturers like Apple or Samsung may introduce something similar, but because the technology will be led by safe leaders in the industry, it will be marketed much better and become part of the norm. Then it’ll be easier for people (and businesses) to embrace the technology,” Robinson explains.

Samsung is currently marketing a phone that uses iris recognition, while the iPhone has been using fingerprint ID for years now. But for Robinson, biometric authentication is one thing, and RFID microchipping is another. “The difference is technology like this is intrusive in the body. That’s quite a leap from having a Fitbit that you can take off. It’s that permanency of having something on you that could go wrong.”

From a regulatory perspective, the right to privacy has to be paramount, he adds. “Presumably, the chips are gathering data, but where will this data be stored or used. In the UK, there is specific legislation around who owns data. There’s also the potential of having data breaches.” Robinson says that it’ll be a long time before the right regulations come into place. It’s always been the case that the law is playing catch-up to technology, he adds. “Unfortunately, the law reacts to changes in technology, often led by something going wrong. It usually depends on the government identifying an issue to be resolved, such as privacy laws, anti cyber-bullying, and so on. This is untested technology in an untested legal regime. For me, I’m not sure the benefits of having it outweigh the negatives.”

Output: A report produced by TalkTalk has found more than two-thirds of the British working population would refuse to be microchipped to improve efficiency if asked to by their employer. After interviewing more than 2,000 working adults, the TalkTalk Business’s Workforces 2025 initiative found that the smaller the business, the less likely it was that employers considered chipping their workers. Older millennials (between 25 and 34) were found to be more open to the technology being tested on them. About 5% of workers would consider being chipped if they were paid more.


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Regus Regus opens workspace in Zaragoza
 Recursos Humanos RRHH Press. Regus, proveedor mundial de espacios de trabajo, ha abierto su primer centro de negocios en Zaragoza.

La compañía ha escogido la tercera planta de Torre Aragonia, ubicada junto a oficinas de la administración local, la Universidad de Zaragoza y un gran número de empresas de servicios.

En esta torre, Regus ocupa un espacio de más de 900 metros cuadrados para oficinas y cuenta con una terraza anexa de 155 metros cuadrados. El nuevo espacio de trabajo incluye 48 despachos de oficinas, 2 salas de reuniones, office y una zona de coworking, además de recepción, baños y un gran parking con acceso directo a los edificios.

La Torre Aragonia se encuentra integrada en el complejo Aragonia, que comprende un edificio destinado a oficinas, un centro comercial, una cadena de gimnasios, viviendas, salas de cine y un hotel 5*, el Reina Petronila.

La llegada de nuevas empresas como Regus al edificio, es una de las mayores operaciones del mercado de oficinas en Zaragoza.

RRHHpress.com

Output: Workspace provider Regus has opened its first business centre in Zaragoza, Spain. The 900 sq metre-plus facility includes 48 offices, two meeting rooms, and a co-working area. The workspaces provider is located on the third floor of the Torre Aragonia complex, near the University of Zaragoza.


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IBM launches automotive and IoT security testing service
 IBM on Monday is launching new security services testing for Internet of Things (IoT) developers, as well as the automotive industry. The new services should help test the security of connected devices throughout development and deployment.

First, IBM is announcing that Watson IoT Platform is offering its customers services from IBM X-Force Red, its year-old security testing group. Some analysts have wondered whether Watson will pay off for IBM before other tech companies catch up in terms of their cognitive offerings. With this new service, IBM is trying to prove it's the best partner for enterprises that want to develop smart connected devices.

"It's not just about the technology, it is also about the global reach, investment, and collaborative approach which make IBM a trusted IoT partner for enterprise IoT solutions," James Murphy, offering manager for IBM Watson IoT Platform, said in a statement. "With IoT technologies permeating the farthest corners of industry, IBM is bringing our Watson IoT Platform and X-Force Red security talent together to address present and future concerns."

In a study IBM commissioned this year in conjunction with Arxan Technologies, the Ponemon Institute found that 58 percent of organizations only test their IoT applications during the production phase, leaving room for vulnerabilities to be introduced into existing systems. The new X-Force Red services IBM is offering bring an added layer of security and penetration testing to address that, with researchers testing backend processes, apps and physical hardware.

Meanwhile, the X-Force Red Group has also been building up a dedicated automotive practice, in order to help clients secure hardware, networks, applications and human interactions.

Given the huge number of interconnected components and systems in a modern car, connected vehicles can be seriously vulnerable. The X-Force Red group is aiming to influence best practices and standardize security protocols within the automotive industry. The group has worked with more than a dozen automotive manufacturers and third-party suppliers to build expertise and programmatic penetration testing and consulting services.

Output: IBM has launched a security services testing platform for Internet of Things (IoT) developers to help protect connected devices throughout their manufacture and use. IBM’s Watson IoT Platform will extend its security testing service group, IBM X-Force Red, to customers in a bid to build the company’s reputation as an enterprise IoT partner. The X-Force Red Group has also run an automotive service to secure applications, networks, hardware and human interactions against interference.


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RealtyShares buys Acquire Real Estate platform
 SAN FRANCISCO--(BUSINESS WIRE)--RealtyShares, a leading online marketplace for real estate investing, today announced the acquisition of technology-first, marketplace platform Acquire Real Estate, an innovative rival that has set a bar for product development within the industry.

Both companies took different paths toward building successful online real estate investing platforms. RealtyShares has excelled at scaling operations and offering diverse investment opportunities. The company boasts more than 120,000 registered investors and has surpassed $500 million deployed for real estate projects across nearly 1,000 deals in 39 states. It has quickly gained traction by making investing and financing across the capital stack easier than ever, fueling a record second quarter where they tripled business over the prior year by originating almost $140 million in real estate projects.

Led by CEO Josh Klimkiewicz and CTO Gerry Polucci, Acquire focused on developing industry-first products to serve its commercial sponsors and investors, keeping the platform at the forefront of innovation despite better-funded rivals. It was the first real estate marketplace to introduce a real estate exchange, investor profiles, a dynamic investment calculator and self-directed IRA investing. Both Klimkiewicz and Polucci will join RealtyShares as part of the acquisition, spearheading integration from the company’s East Coast office.

“RealtyShares and Acquire share a vision that technology will make real estate investing easier and more accessible, uniting bold thinkers to set an innovative tone for the industry,” said RealtyShares founder and CEO Nav Athwal. “Josh and Gerry are a perfect culture fit for our company. They bring the intuition, tenacity and experience we need to remove friction from the real estate investing process and help RealtyShares redefine this industry.”

Klimkiewicz is a Harvard graduate with an extensive commercial background including the acquisition, disposition and structured finance of over $6 billion in real estate transactions as vice president of capital markets at CBRE. He began Acquire in 2014 after 8 years with the commercial real estate behemoth.

“Like RealtyShares, we saw a real opportunity to use technology to close the gap and create a better process for raising capital,” said Klimkiewicz. “We targeted commercial equity day one, specifically middle market projects with equity checks between $5 million and $10 million, recognizing that there was just no efficient way for institutions or investors to participate in those types of deals without innovative solutions. By taking the time to understand our community, we were better able to address needs and build products that truly solved problems.”

Klimkiewicz will serve as the director of commercial business development while colleague Polucci will join as a director of engineering. Polucci’s background is atypical within real estate. He is an entrepreneur, product leader and software architect with more than 30 years of software engineering experience across a number of industries, including healthcare, storage management and technology.

“I saw a lack of audacity,” said Polucci. “Technology can transform our industry, but people with real estate backgrounds saw complex problems in their industry as intractable. Our team possessed a unique perspective, which allowed us to identify and tackle those challenges directly.”

Klimkiewicz and Polucci join a company leading the charge to bring innovation to one of the largest asset classes in the world, driven by other key additions over the last few months. In May, RealtyShares named Former Cushman & Wakefield CEO Edward Forst to the board of directors and Senior Vice President of Marketing Kristina Wallender joined in June after working with market innovators Amazon and Ticketfly.

About RealtyShares

RealtyShares is transforming the real estate investment landscape by connecting borrowers and sponsors to debt and equity capital from accredited and institutional investors, across an array of financing products. Private investments are highly illiquid and risky and are not suitable for all investors. Through the RealtyShares website, these investors can browse investment opportunities, perform due diligence, invest online and gain 24/7 access to an investor dashboard to watch how their investments are performing. RealtyShares offers securities through North Capital Private Securities Corporation, member FINRA/SIPC. For more information on how to become a real estate investor or to seek capital through the RealtyShares marketplace, please visit www.realtyshares.com.

Output: San Francisco-based online real estate investment marketplace RealtyShares has acquired rival Acquire Real Estate for an undisclosed amount. Acquire's former CEO, Josh Klimkiewicz, will become director of commercial business development, while CTO Gerry Polucci has been appointed as director of engineering. RealtyShares tripled business during Q2 2017, compared with the same period the previous year, originating almost $140m in real estate projects. RealtyShares has 120,000 registered investors and to date has deployed more than $500m in various real estate deals.


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Royal Mail buys 100 electric vans from Peugeot
 Royal Mail has signed an agreement with PEUGEOT today (July 27) to purchase 100 zero-emission Partner L2 Electric vans, to be used by postmen and women on their delivery rounds. The vans will go into service from December 2017 at delivery offices around the UK, supported by a comprehensive rollout of charging infrastructure. “With electric … Continued

Royal Mail has signed an agreement with PEUGEOT today (July 27) to purchase 100 zero-emission Partner L2 Electric vans, to be used by postmen and women on their delivery rounds. The vans will go into service from December 2017 at delivery offices around the UK, supported by a comprehensive rollout of charging infrastructure.

“With electric vehicles firmly on the agenda this week, there couldn’t be a better time to announce this landmark deal with the Royal Mail”, says PSA Group Fleet Director Martin Gurney, “The order was won after Royal Mail carried out extensive trials with the Partner Electric. It’s a tribute to their performance in the trials that PEUGEOT Electric vans will soon be helping Royal Mail to significantly reduce the environmental impact of its delivery fleet.”

Paul Gatti, Royal Mail Fleet Director, said: “Our research has shown that electric vans are an excellent operational fit with our business and we are delighted to be ordering such a large volume to use in our daily operations. This is good news for our customers and the towns and cities which we serve. It also means we are on the front foot for future changes in emissions legislation.

“Emissions are an important issue for us at Royal Mail and we are continuously looking at new and innovative ways to reduce our carbon footprint and our impact on air quality. Improving the efficiency of our fleet by introducing electric vans is just one example of this.”

The Partner L2 Electric was launched in February and this is the first major fleet order for the van.

Its Lithium-ion battery pack is fitted under the load floor, ensuring there is no loss of load space compared with petrol and diesel-powered Partner L2 models. The Partner L2 Electric will carry a gross payload of 552kg.

Power comes from a compact and highly efficient permanent magnet synchronous motor producing 49kW (67hp) at 4,000rpm and maximum torque of 200Nm. The front wheels are driven through a speed reducer and single ratio gearbox.

The Partner Electric’s 22.5kWh high-capacity lithium-ion batteries offer a range of up to 106 miles, measured on the NEDC cycle. The batteries can be re-charged to 80 per cent capacity in 30 minutes from a dedicated rapid charge point. The drive motor also provides regenerative braking when slowing down, helping to re-charge the batteries and reduce brake wear.

Partner Electric customers are eligible for the Plug in Van Grant (PiVG) from the Office for Low Emission Vehicles (OLEV) towards the cost of buying the vehicle. The PiVG covers 20 per cent of the cost of the vehicle including VAT but excluding on-the-road costs.

Partner Electric drivers in London would be eligible for the Ultra Low Emission Discount (ULED), which provides a 100 per cent discount from the London Congestion Charge, an exemption worth up to £2,989 per year. London boroughs such as Hackney also offer a 100 per cent discount on parking permits for electric vehicles, resulting in substantial savings each year. In running electric vehicles, all drivers benefit from reduced running costs vs a conventional petrol or diesel car. Lower running costs and lower service maintenance and repair costs add to the financial incentives available, which means that electric motoring can bring about significant savings when considering the total cost of ownership, rather the upfront purchase cost only.

Output: The Royal Mail is to buy 100 electric Partner L2 vans from car maker Peugeot for use in deliveries from December this year, with the Royal Mail also installing the required infrastructure. The Peugeot Partner Electric’s 22.5kWh lithium-ion batteries have a range of up to 106 miles and is one of several vehicles to be tested by the UK postal service.


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Facebook pledges funds to prevent election cyber attacks
 Mandatory Credit: Photo by Mike Nelson/Epa/REX/Shutterstock (8457750ao) Republican Presidential Candidate Rand Paul is Seen on a Messenger Screen in the Facebook Election Booth in the Spin Room As the Us Democratic Presidential Candidates Debate Nears at Wynn Las Vegas in Las Vegas Nevada Usa 13 October 2015 United States Las Vegas Usa Elections Democratic Debate - Oct 2015

Mandatory Credit: Photo by Mike Nelson/Epa/REX/Shutterstock (8457750ao) Republican Presidential Candidate Rand Paul is Seen on a Messenger Screen in the Facebook Election Booth in the Spin Room As the Us Democratic Presidential Candidates Debate Nears at Wynn Las Vegas in Las Vegas Nevada Usa 13 October 2015 United States Las Vegas Usa Elections Democratic Debate - Oct 2015 Credit: Mike Nelson/Epa/REX/Shutterstock

Less than a year after Mark Zuckerberg derided the idea that his social network might have any serious impact on the U.S. election, Facebook announced that it will donate money to cybersecurity education efforts as well as a new project to ensure election security.

Facebook's chief security officer, Alex Stamos, announced the new funding on Wednesday at Black Hat USA, the largest conference dedicated to cybersecurity.

Facebook will put $1 million toward funding "to encourage original defensive research," Stamos said in a blog post (opens in a new tab)accompanying his talk. The company will make additional donations for "scholarships and programs that help expand the diversity of the security workforce."

Facebook is also now the "founding sponsor" of the Defending Digital Democracy Project, which will operate at Harvard University to "better secure elections and other democratic processes through collaboration and information sharing."

Wednesday's announcement is only the most recent in a series of moves from Facebook that address a variety of the critiques hurled at the social network following the 2016 U.S. election. It's a stark reversal from when Zuckerberg called the notion that Facebook could influence the election a "crazy idea."(opens in a new tab) Since then, Facebook has taken a variety of steps to address misinformation on its platform.

Stamos pointed to two problems that he sees in the world of cybersecurity: A lack of focus on defense, and a lack of diversity.

"The security community needs more diverse people, backgrounds, and thought to live up to our potential," Stamos said in the blog post.

Output: Facebook has pledged to donate $1m to cybersecurity educational initiatives, as well as election security drives. The money will be used for “defensive” research, said Facebook's chief security officer Alex Stamos, as well as scholarships and programmes designed to extend the security workforce. Facebook has taken a position as the founding sponsor of the Defending Digital Democracy Project, run through Harvard University, in a bid to better protect democratic processes such as elections.


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Signal Vine raises $2m for its university messaging platform
 ANOTHER CHATTY BOT: Signal Vine, a text messaging platform for colleges, has raised $2 million in a Series A round led by New Markets Venture Partners. Signal Vine provides a platform for campus staff to remind students about upcoming financial aid deadlines, campus events or scheduling advising appointments. Based in Alexandria, Va., the company claims 200 higher-ed institutions and college success organizations currently use the platform.

“Communication is changing quickly, and we want to help institutions keep up with these changes and reach students where they are—on their phones, texting,” Signal Vine CEO Brian Kathman said in a prepared statement. “Texting is a very personal form of communication, so it needs to be done right to be effective at the scale that universities need.”

Output: Virginia-based edtech company Signal Vine has raised $2m in a Series A funding round. The round was led by New Markets Venture Partners. Signal Vine has developed a text-messaging platform which enables campus staff to contact students directly, regarding topics like deadlines, appointments and social events. The firm claims 200 higher-education institutions and colleges are using its platform at this time.


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‘Hygiene poverty’ on rise in UK
 Growing numbers of people are facing hygiene poverty, where they are unable to afford essential products such as shampoo and deodorant, and are having to choose between eating and keeping clean, a charity has found.

A report from In Kind Direct says thousands of people are seeking help and describes the issue as a “hidden crisis”. Last year the charity distributed a record £20.2m of hygiene products, a rise of 67% on £12.1m the year before.

Robin Boles, chief executive of In Kind Direct, said: “This is hitting families hard. The fact that last year was our busiest year ever, distributing products to charities and the people they help, highlights the stark choices people are facing.”

The study has prompted campaigners to call for the government to do more to alleviate poverty. They say cuts to working benefits coupled with rising inflation have left families struggling.Samantha Stapley, operations manager for England at the Trussell Trust food bank network, described the report as “very concerning”. She added: “When people are referred to food banks with no money for food, they’re often struggling to afford other basic essentials too.”

The report shows 82% of 948 charities have seen an increase in demand over the past year from people who cannot afford essential items.

A further poll of 1,000 people, conducted by In Kind Direct, found that 37% of those surveyed, and 56% of 18- to 24-year-olds, have had to go without hygiene or grooming products, or cut down on them, owing to low finances.

Stapley said Trussell Trust research with the University of Oxford had found that more than half of the households visiting the network’s food banks were struggling to afford toiletries.

She added that voluntary organisations alone could not resolve the problem and the underlying causes of poverty needed to be addressed. “Making work more secure, tackling the high cost of living and working to reduce the issues people experience with benefit payments would all make a difference,” she said.

Her words were echoed by Alison Garnham, chief executive of the Child Poverty Action Group, who said: “To tackle it we first need to ensure that benefits once again reflect families’ needs and so rise with inflation. No one should have to suffer the indignity of living without basic sanitary products.”

Andrew Barr, manager of the Trussell Trust food bank in Oldham, said: “People are not able to afford the things that they need, not want, and that is a worry.”

Barr noted a rise in people coming to the service. “There is certainly an increase in demand for them [hygiene products] and it’s something we try and get people to donate to us,” he said.

The In Kind Direct report cites the case of Rucksana Begum, 32, who gets products from her local charity in Tyneside, Crest UK. She said: “I’m a new mum, not working, so I struggle to pay household bills. Not having to worry about buying sanitary towels, shaving gel and products, which I wouldn’t be able to afford, is a big help. I feel better about myself and it helps my mental wellbeing.”

The report comes amid campaigns for free sanitary products. Amika George, 17, from London, is petitioning for these items to be provided to all girls on free school meals.

She said: “I read about the issue of period poverty in March and was bewildered that … [the charity] Freedom4Girls had to redirect sanitary products from Kenya to Leeds. I did some research and no one could believe it was happening in the UK.

“The work charities are doing is really great, but the government should implement something long-term to change people’s lives for the better.”

George commented on the growing gap between rich and poor, saying: “It’s really tragic that there are children who struggle with the effects of poverty at such a young age … Something like not being able to afford sanitary products has a long-lasting impact on health and also dignity.”

Output: Hygiene poverty, the inability to afford basic cleanliness products, is affecting increasing numbers of people in the UK, according to a report from charity In Kind Direct. The charity distributed a record £20.2m ($26.5m) worth of hygiene products in 2016, an increase of 67% from the previous year. The report indicates that of 948 charities, 82% have seen an increase in demand for essential items over the past year. Campaigners have blamed cuts to working benefits combined with rising inflation for the increasing problem.


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Growth in energy storage will spur demand for metals: World Bank
 The global trend towards using clean energy systems such as battery storage technology will see “heightened demand” for minerals and metals including lead and lithium, according to a new World Bank report.

A shift to a low-carbon future “could result in opportunities for mineral-rich countries”, the report said. But it warned these nations must have “long-term strategies in place that enable them to make smart investment decisions”.

The report – ‘The Growing Role of Minerals and Metals for a Low-Carbon Future’ – highlights energy storage among “key examples of low-carbon or ‘green’ energy technologies” and examines the types of minerals and metals “that will likely increase in demand as the world works towards commitments to keep the global average temperature rise at or below 2°C”.

“The most significant example is electric storage batteries, where the rise in relevant metals – aluminium, cobalt, iron, lead, lithium, manganese and nickel – grow in demand from a relatively modest level under 4°C to more than 1,000% under 2°C,” the report said.

World Bank senior director and head of the organisation’s energy and extractive industries global practice, Riccardo Puliti, said: “With better planning, resource-rich countries can take advantage of the increased demand to foster growth and development. Countries with capacity and infrastructure to supply the minerals and metals required for cleaner technologies have a unique opportunity to grow their economies if they develop their mining sectors in a sustainable way.”

The report said: “The low-carbon technologies that emerge as most applicable and beneficial, will play an important role in defining the commodity marketplace of the next 50 years. For example, the three leading forms of alternative vehicles — electric, hybrid, and hydrogen — each have different implications for metal demand. Electric vehicles require lithium; hybrid vehicles use lead; and hydrogen-powered vehicles use platinum.”

Based on current trends, the bank’s report said “it is expected that Chile, Peru, and (potentially) Bolivia, will play a key role in supplying copper and lithium”.

“Brazil is a key bauxite and iron ore supplier, while southern Africa and Guinea will be vital in the effort to meet growing demand for platinum, manganese, bauxite, and chromium,” the report said. “China will continue to play a leading role in production and reserve levels in practically every key metal required under low-carbon scenarios. India is dominant in iron, steel, and titanium, while Indonesia, Malaysia, and Philippines have opportunities with bauxite and nickel.”

Output: The global trend towards renewable energy and energy storage technology will create a "heightened demand" for metals such as lead and lithium that are used in batteries, according to a World Bank report. The shift towards clean energy "could result in opportunities for mineral-rich countries" but the bank warned these states must prepare "long-term strategies that enable them to make smart investment decisions".


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China develops nanobots capable of intravenous drug delivery
 Michael Phelps: Faster than a nano-swimmer but won’t fit in your veins Francois Xavier Marit/AFP/Getty Images

It’s no Michael Phelps, but this tiny magnetic robot swims the front crawl at 10 micrometres per second. It would take about two months for the bot to swim the length of an Olympic swimming pool – in that time, Phelps could swim over 200,000 lengths. But the nano-swimmer is fast for its size, and it’s strong enough to pass through more viscous liquids, like blood, to deliver medicine from inside your veins.

The front crawl is the fastest way for humans to swim. So Tianlong Li at the Harbin Institute of Technology in China and his colleagues built their swimming robot to mimic that motion.

Each nano-swimmer is 5 micrometres long and has three main parts, connected together like sausage links by two silver hinges. Its gold body is flanked by two magnetic arms made of nickel, and applying a magnetic field to the tiny robot makes the arms move.

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As the researchers switch the magnetic field’s direction back and forth, it causes the arms of the nano-swimmer to rotate and propel it forward, just like the arms of a human swimmer doing the front crawl.

“It’s exciting due to its speed and its really small size, just about the same size as a blood vessel,” says Eric Diller at the University of Toronto in Canada who researches micro-robots. “It’s small enough basically to go anywhere within the body.”

Because bodily fluids are more viscous and difficult to swim through than water, the researchers also tested their nano-swimmers in serum. The bots were only able to swim 5.5 micrometres per second, but that’s still faster than many other similar mini-machines.

For targeted medicine delivery without invasive procedures, these nano-swimmers could be coated with medicine and injected into the bloodstream, where their trajectories could be roughly steered by external magnetic fields.

Since they are so small, just one nano-swimmer wouldn’t be able to carry enough medicine to actually help. “Maybe a thousand of them would be necessary,” says Diller. “There’s no way to keep track of all of them, so there are a lot of questions about safety and toxicity.”

The next generation of these tiny machines will have to be made from biodegradable materials before they can be used in the bloodstream. But, Diller says that for less complicated areas in the human body like the urinary tract or the eyeballs, clinical trials could begin within the next five to 10 years. Injecting a single swimmer into an eyeball, where it could deliver medication directly to the retina and then be removed, would be much less complicated than letting a swarm of them swim throughout the entire circulatory system.

We don’t know how fast Michael Phelps could swim through blood – thankfully, his recent race against a great white shark didn’t provide a testing ground. But since you can’t inject him into your bloodstream, these nano-swimmers will have to do.

Read more: DNA origami nanorobot takes drug direct to cancer cell

Output: Scientists at the Harbin Institute of Technology in China have developed nanobots which use magnetic fields for propulsion, and could be used to deliver medicine to the human body via the bloodstream. Each gold nanobot is five micrometres long, and has arms which, when the team manipulate the magnetic field, respond in a way similar to the front crawl. Scientists say thousands of these machines would need to be used to deliver enough medicine, with clinical trials at least a decade away.


Instruction: create a high quality summary of the given input

Input:
These 10 drugs each rang up more than $4 billion in U.S. sales last year
 These 10 drugs each rang up more than $4 billion in U.S. sales last year

A whopping $450 billion was spent in the United States on prescription drugs last year.

Topping the list, perhaps unsurprisingly, are medications whose patents were still in force or had recently expired. When a patent expires, generic versions — or biosimilar versions of biologic drugs — can become available, driving down costs that in turn make them accessible to more patients.

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That’s one reason why none of the drugs that brought in the most money in sales also showed up on our list of most-prescribed drugs.

Output: A whopping $450 billion was spent in the United States on prescription drugs last year. Topping the list, perhaps unsurprisingly, are medications whose patents were still in force or had recently expired. When a patent expires, generic versions — or biosimilar versions of biologic drugs — can become available, driving down costs that in turn make them accessible to more patients.


Instruction: create a high quality summary of the given input

Input:
Availability and Variation of Publicly Reported Prescription Drug Prices
 ABSTRACT

Objectives: To examine how often retail prices for prescription drugs are available on state public reporting websites, the variability of these reported prices, and zip code characteristics associated with greater price variation.

Study Design: Searches of state government-operated websites in Michigan, Missouri, New York, and Pennsylvania for retail prices for Advair Diskus (250/50 fluticasone propionate/salmeterol), Lyrica (pregabalin 50 mg), Nasonex (mometasone 50 mcg nasal spray), Spiriva (tiotropium 18 mcg cp-handihaler), Zetia (ezetimibe 10 mg), atorvastatin 20 mg, and metoprolol 50 mg.

Methods: Data were collected for a 25% random sample of 1330 zip codes. For zip codes with at least 1 pharmacy, we used χ2 tests to compare how often prices were reported. For zip codes with at least 2 reported prices, we used Kruskal-Wallis tests to compare the median difference between the highest and lowest prices and a generalized linear model to identify zip code characteristics associated with greater price variation.

Results: Price availability varied significantly (P <.001) across states and drugs, ranging from 52% for metoprolol in Michigan to 1% for atorvastatin in Michigan. Price variation also varied significantly (P <.001) across states and drugs, ranging from a median of $159 for atorvastatin in Pennsylvania to a median of $24 for Nasonex in Missouri. The mean price variation was $52 greater (P <.001) for densely populated zip codes and $60 greater (P <.001) for zip codes with mostly nonwhite residents.

Conclusions: Publicly reported information on state prescription drug price websites is often deficient. When prices are reported, there can be significant variation in the prices of prescriptions, which could translate into substantial savings for consumers who pay out-of-pocket for prescription drugs.

Takeaway Points

Across state government websites reporting retail prices for medications commonly prescribed for chronic conditions, price information is often deficient. However, when retail prices for prescription medications are publicly reported, these prices vary significantly.

This is the first study to document variation in publicly reported retail prices for prescription medications across different classes and different states.

More consistent reporting of such prices could potentially yield substantial savings for consumers who face high out-of-pocket expenditures.

Policy makers should work to ensure retail prices for prescription drugs are reported consistently and strive to develop new strategies to facilitate consumers’ use of this information.

As Americans are asked to pay a larger portion of their healthcare costs,1 there are mounting calls to make healthcare prices more transparent to consumers.2 In response, many state governments now publicly report prices for healthcare services, such as prescription drugs, to consumers.3-5 Prescription drugs are a particularly good candidate for such consumer reporting because they can be expensive, represent recurring out-of-pocket (OOP) costs,6 and are equivalent across pharmacies, unlike other medical services in which prices could vary based on quality. Consumers who are enrolled in high-deductible health plans (HDHPs) or who are uninsured often pay retail prices for prescription drugs.6 Therefore, providing price information could help them reduce their OOP expenditures7,8 and enhance their access and adherence to needed medications.9-11

Although at least 9 states now publicly report prescription drug prices,3 little is known about the information that is being reported on these states' websites. The objectives of this study were to: 1) determine how often prices for commonly prescribed medications are available on state public reporting websites, 2) quantify the variability of retail prices for selected medications on these websites, and 3) identify zip code-level factors associated with greater price variability.

METHODS

Data Collection

We conducted a systematic search of state government prescription drug price websites in Michigan, Missouri, New York, and Pennsylvania (available in the eAppendix [eAppendices available at ajmc.com]). Each of these state reporting websites obtained retail prices12 for commonly prescribed drugs from Medicaid claims and permitted searches for retail prices for a 30-day supply of these drugs within a 5-mile radius of the centroid of each zip code in that state.

The criteria we used to identify medications for which we searched retail prices on these 4 state websites included: 1) the medications had to be listed on the drugs.com list of the 100 most commonly prescribed medications in the United States,13 2) retail prices for a 30-day supply of a typical dose of the most common form of the medications had to be listed on all 4 websites, and 3) the medications had to be recognized as generally used for chronic, rather than acute, conditions. Seven prescription medications met these criteria at the time of our study: 5 as brand name only—Advair, Lyrica, Nasonex, Spiriva, and Zetia—and 2 generics, atorvastatin and metoprolol (see "Study Design" section for dosage and delivery).

We used both brand and generic names to search for retail prices for a 30-day supply of each medication at pharmacies within 5 miles of the centroids of a random sample of 25% of the zip codes in each state. For each medication search conducted within a specific zip code, we recorded: 1) the number of pharmacies listed, 2) whether retail prices for the medication were reported, and 3) the highest and lowest prices quoted when prices were reported for a specific medication. All data were collected between July 2014 and March 2015.

Data Analysis

For searches in which at least 1 pharmacy was listed, we used χ2 tests to compare how often the listed pharmacies reported prices, both across medications within each state and across the states included in the study, for each medication. For this analysis, we examined data from only Michigan and Missouri, which reported the number of pharmacies within 5 miles of each zip code centroid, regardless of whether any prices for a medication were reported. We excluded data from New York and Pennsylvania, which reported the number of pharmacies within 5 miles of each zip code centroid only when prices for a medication were reported.

To evaluate price variation among searches in which at least 2 prices for each drug were reported, we used Kruskal-Wallis tests to compare the median difference in US dollars between the highest and lowest reported prices, and the median percent variation in price, which we defined as ([highest price — lowest price]/[lowest price]) × 100. To determine which zip code–level factors were associated with greater variation in reported prices, we merged 2010 US Census zip code tabulation–area data on population density, median household income, median age, and the proportion of residents identified as minorities.14 For zip codes in which at least 2 prices for a drug were reported, we estimated a generalized linear model with a log link in which the dependent variable was the difference between the highest and lowest reported prices. The key independent variables were zip code population density, percentage of nonwhite residents, median age, and median household income. We also controlled for medication type, state, and number of reporting pharmacies.

RESULTS

Availability of Prices

We found substantial variation in the availability of retail prices for zip codes with at least 1 pharmacy (P <.001) across medications within each state and across states for each medication), ranging from 52% of zip codes reporting at least 1 retail price for metoprolol in Michigan to 1% for atorvastatin in Michigan (data not shown).

Variation in Prices

For zip codes in which at least 2 pharmacies reported retail prices for a drug, there was significant variation in the median difference between the highest and lowest reported retail prices, as well as the median percent variation in price (P <.001 both across medications within each state and across states for each medication). The median price variation ranged from $159 (interquartile range [IQR] = $113-$186) for atorvastatin in Pennsylvania to $24 (IQR = $15-$54) for Nasonex in Missouri. The median percent variation ranged from 974% (IQR = 355%-1419%) for metoprolol in New York to 11% (IQR = 6%-36%) for Advair in Missouri (Table 1).

Factors Associated with Greater Price Variation

When at least 2 prices were reported for a drug in a zip code, the mean differences between the highest and lowest reported retail prices were $52 greater (95% CI, $39-$66; P <.001) for more densely populated zip codes, $60 greater (95% CI, $37-$83; (P <.001) for zip codes with mostly nonwhite residents, and $1 less for each 1-year increase in zip code median age (95% CI, —$1.70 to –$0.08; P = .03) (Table 2). The full model coefficients are shown in the eAppendix Table.

DISCUSSION

Across 4 state government websites reporting retail prices for 7 medications commonly prescribed for chronic conditions, price information is often lacking. However, when retail prices for prescription medications were publicly reported, these prices varied significantly. Although other studies have examined variation in prices of a certain class of medications15-17 or in a particular geographic area,18-20 ours is the first study to document variation in publicly reported retail prices for prescription medications across different classes and different states.

From our searches in Michigan and Missouri, we found prices for medications were not reported for many zip codes in which there were pharmacies. Other research has illuminated the lack of availability of medications at pharmacies in a certain geographic area,18,21 but we searched for prices of some of the most commonly prescribed medications in the United States and it is unlikely that these medications were truly unavailable at pharmacies. It is unclear why prices were not reported in these cases, but other studies have shown inconsistent availability of price information for other health services.22-24 The causes of such deficiencies should be examined and remedied to make price information consistently available to consumers—a prerequisite for increasing the use of price information.25,26

When retail prices for prescription drugs were reported, we found substantial variation across all states and drugs we studied. These price variations comported with the findings of studies that reported high variability in prices both for medications representing a certain class15-17 or a specific geographic area18-20 and in prices for other health services, such as imaging27 and laboratory studies.28 Variations in prices for prescription medications may be attributed to an array of factors, including differences in pharmacies’ payer mix and reimbursement levels, product costs, and discretion over pricing decisions.29

Regardless of their origins, large variations in retail prices for medications could potentially translate into large OOP savings for consumers who use this information to find a more affordable pharmacy. For example, the median price variation for a monthly supply of Lyrica was $74 inNew York (Table 1), meaning consumers who switch from paying for this medication OOP at the highest-cost pharmacy in their zip code to the lowest-cost pharmacy could potentially save up to $888 annually.

The extent to which this publicly reported price information could translate into OOP savings for consumers is unknown and requires further study. Yet, other initiatives to make healthcare prices more transparent and increase consumer use of price information have shown such efforts can indeed yield meaningful savings for consumers.7,8

In regression analyses, we found these price variations were greater in zip codes that represented more densely populated areas or had mostly nonwhite residents. This information could be used by policy makers to target outreach to communities where consumers could anticipate greater savings from using publicly reported retail prices.

Finally, any effort to help consumers take advantage of these price variations must concede that despite growth in price transparency initiatives,3,30 consumer use of price information remains low. An April 2015 Kaiser Health tracking poll found that fewer than 1 in 10 Americans reported seeing price comparison information for hospitals or doctors in the last year and that fewer than half of these individuals used this information when making healthcare decisions.25 An earlier survey found that 6% of Americans tried to determine the price they or their insurer would incur for a medical service, but less than half of these consumers compared prices from multiple providers.31 Most recently, the results of another survey showed Americans in HDHPs were no more likely than individuals in traditional plans to compare prices when seeking care.32 These data suggest that simply improving the comprehensiveness and consistency of publicly reporting prices does not translate to lower consumer OOP expenditures without pairing these enhancements with efforts to help consumers use such information when making healthcare decisions.

Limitations

To ensure comparability across medications and states, we limited our data collection to 7 medications for which prices were publicly reported in 4 states; however, these findings may not apply to all states or medications. Our estimate of price variation for each zip code was an upper bound, which would only translate into large OOP savings for consumers who switched from a higher cost pharmacy to a lower cost pharmacy. Our examination of zip code-level factors associated with greater price variability was limited to the factors that were in the zip code tabulation—area data we derived from the 2010 US Census. The price data we collected does not account for discounts that may apply at the point of sale and could impact the overall variability in prices. Such discounts were integrated into medication prices reported by GoodRx, a national website and smartphone app that allows consumers to view medication prices, coupons, discounts, and savings tips at nearby pharmacies. Because we did not collect data on the types of pharmacies reporting prices, we are unable to identify the characteristics of pharmacies associated with lower prices. Future research should examine how prices for prescription medications vary by type of pharmacy (eg, independent, chain, and discount).

CONCLUSIONS

Our study demonstrated that public reporting of retail prices for commonly prescribed prescription drugs was often incomplete. More consistent reporting of such prices could yield substantial savings for consumers who face high OOP expenditures. Policy makers should work to ensure retail prices for prescription drugs are reported comprehensively and consistently in order to develop new strategies to facilitate consumers’ use of this information.Author Affiliations: VA Center for Clinical Management Research, VA Ann Arbor Healthcare System (JTK), Ann Arbor, MI; Department of Internal Medicine (JTK, AMF) and Department of Emergency Medicine (TAP), University of Michigan Medical School, Ann Arbor, MI; Department of Health Management and Policy, School of Public Health (AMF, SS), University of Michigan, Ann Arbor, MI; Institute for Healthcare Policy and Innovation, University of Michigan (JTK, TAP, AMF, SS), Ann Arbor, MI; Department of Health Policy and Administration, Pennsylvania State University (JES), State College, PA.

Source of Funding: This research was supported by a grant from MCubed at the University of Michigan. Support was also provided by the Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service. Dr Kullgren is a VA HSR&D Career Development awardee at the Ann Arbor VA.

Author Disclosures: The authors report no relationship or financial interest with any entity that would pose a conflict of interest with the subject matter of this article.

Authorship Information: Concept and design (JK, JES, TAP, AMF, SS); acquisition of data (JK, JES, SS); analysis and interpretation of data (JK, JES, TAP, AMF, SS); drafting of the manuscript (JK, JES, TAP, AMF, SS); critical revision of the manuscript for important intellectual content (JK, JES, TAP); statistical analysis (JK, JES); provision of patients or study materials (JK); obtaining funding (JK, TAP, SS); administrative, technical, or logistic support (JK); and supervision (JK).

Address Correspondence to: Jeffrey T. Kullgren, MD, MS, MPH, VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, PO Box 130170, Ann Arbor, MI 48113-0170. E-mail: jkullgre@med.umich.edu. REFERENCES

1. Clarke TC, Ward BW, Freeman G, Schiller JS. Early Release of Selected Estimates Based on Data From the January—September 2015 National Health Interview Survey. National Center for Health Statistics website. https://www.cdc.gov/nchs/nhis/releases/released201602.htm. Published February 23, 2016. Accessed September 9, 2016.

2. Kocher RP, Emanuel EJ. The transparency imperative. Ann Intern Med. 2013;159(4):296-297. doi: 10.7326/0003-4819-159-4-201308200-00666.

3. Kullgren JT, Duey KA, Werner RM. A census of state health care price transparency websites. JAMA. 2013;309(23):2437-2438. doi: 10.1001/jama.2013.6557.

4. Tu HT, Corey CG. State prescription drug price Web sites: how useful to consumers? Res Brief. 2008;(1):1-16.

5. Sinaiko AD, Chien AT, Rosenthal MB. The role of states in improving price transparency in health care. JAMA Intern Med. 2015;175(6):886-887. doi: 10.1001/jamainternmed.2015.0628.

6. Cox C, Kamal R, Jankiewicz A, Rousseau D. Recent trends in prescription drug costs. JAMA. 2016;315(13):1326-1326. doi: 10.1001/jama.2016.2646.

7. Whaley C, Schneider Chafen J, Pinkard S, et al. Association between availability of health service prices and payments for these services. JAMA. 2014;312(16):1670-1676. doi: 10.1001/jama.2014.13373.

8. Wu S, Sylwestrzak G, Shah C, DeVries A. Price transparency for MRIs increased use of less costly providers and triggered provider competition. Health Aff (Millwood). 2014;33(8):1391-1398. doi: 10.1377/hlthaff.2014.0168.

9. Goldman DP, Joyce GF, Escarce JJ, et al. Pharmacy benefits and the use of drugs by the chronically ill. JAMA. 2004;291(19):2344-2350.

10. Goldman DP, Joyce GF, Zheng Y. Prescription drug cost sharing: associations with medication and medical utilization and spending and health. JAMA. 2007;298(1):61-69.

11. Greene J, Hibbard J, Murray JF, Teutsch SM, Berger ML. The impact of consumer-directed health plans on prescription drug use. Health Aff (Millwood). 2008;27(4):1111-1119. doi: 10.1377/hlthaff.27.4.1111.

12. Prescription drugs: trends in usual and customary prices for commonly used drugs. Government Accountability Office website. http://www.gao.gov/products/GAO-11-306R. Published February 10, 2011. Accessed September 9, 2016.

13. US pharmaceutical sales—2013: top 100 drugs for 2013 by units sold. Drugs.com website. https://www.drugs.com/stats/top100/2013/units. Published February 2014. Accessed September 9, 2016.

14. Zipcode demographics. Easy DBS website. http://www.easydbs.com/zipcode-demographics-database. Accessed February 17, 2014.

15. Alghanem N, Abokwidir M, Fleischer AB Jr, Feldman SR, Alghanem W. Variation in cash price of the generic medications most prescribed by dermatologists in pharmacies across the United States. J Dermatol Treat. 2017;28(2):119-128. doi: 10.1080/09546634.2016.1182614.

16. Reif MC, Carter VL. The retail cost of antihypertensive therapy: physician and patient as educated consumers. Am J Hypertens. 1994;7(7 Pt 1):571-575.

17. Zite NB, Barry AD, Wallace LS. Variation in prescription contraceptive pricing across Florida ZIP code income groups. Contraception. 2014;89(1):54-56. doi: 10.1016/j.contraception.2013.10.006.

18. Amstislavski P, Matthews A, Sheffield S, Maroko AR, Weedon J. Medication deserts: survey of neighborhood disparities in availability of prescription medications. Int J Health Geogr. 2012;11:48. doi: 10.1186/1476-072X-11-48.

19. Aronson Y, Addo-Atuah J. Accessibility to essential medicines in New York City by zip code income levels and boroughs. Innov Pharm. 2013;4(3):1-12.

20. Gellad WF, Choudhry NK, Friedberg MW, Brookhart MA, Haas JS, Shrank WH. Variation in drug prices at pharmacies: are prices higher in poorer areas? Health Serv Res. 2009;44(2 Pt 1):606-617. doi: 10.1111/j.1475-6773.2008.00917.x.

21. Green CR, Ndao-Brumblay SK, West B, Washington T. Differences in prescription opioid analgesic availability: comparing minority and white pharmacies across Michigan. J Pain. 2005;6(10):689-699.

22. Willey JC, Reuter LS, Belatti DA, Phisitkul P, Amendola N. Availability of consumer prices for bunion surgery. Foot Ankle Int. 2014;35(12):1309-1315. doi: 10.1177/1071100714549045.

23. Bernstein JR, Bernstein J. Availability of consumer prices from Philadelphia area hospitals for common services: electrocardiograms vs parking. JAMA Intern Med. 2014;174(2):292-293. doi: 10.1001/jamainternmed.2013.12538.

24. Rosenthal JA, Lu X, Cram P. Availability of consumer prices from US hospitals for a common surgical procedure. JAMA Intern Med. 2013;173(6):427-432. doi: 10.1001/jamainternmed.2013.460.

25. DiJulio B, Firth J, Brodie M. Kaiser Health Tracking Poll: April 2015. Kaiser Family Foundation website. http://kff.org/health-costs/poll-finding/kaiser-health-tracking-poll-april-2015/. Published April 21, 2015. Accessed September 9, 2016.

26. Kullgren J. How to teach people about health care pricing. Harvard Business Review website. https://hbr.org/2015/09/how-to-teach-people-about-health-care-pricing. Published September 29, 2015. Accessed September 9, 2016.

27. Paul AB, Oklu R, Saini S, Prabhakar AM. How much is that head CT? price transparency and variability in radiology. J Am Coll Radiol. 2015;12(5):453-457. doi: 10.1016/j.jacr.2014.12.016.

28. Hsia RY, Akosa Antwi Y, Nath JB. Variation in charges for 10 common blood tests in California hospitals: a cross-sectional analysis. BMJ Open. 2014;4(8):e005482. doi: 10.1136/bmjopen-2014-005482.

29. Brooks JM, Doucette WR, Wan S, Klepser DG. Retail pharmacy market structure and performance. Inquiry. 2008;45(1):75-88.

30. Phillips KA, Labno A. Private companies providing health care price data: who are they and what information do they provide? J Manag Care Med. 2014;17(4):75-80.

31. How much will it cost? how Americans use prices in health care. Public Agenda website. http://www.publicagenda.org/media/how-much-will-it-cost. Published March 11, 2015. Accessed September 9, 2016.

32. Sinaiko AD, Mehrotra A, Sood N. Cost-sharing obligations, high-deductible health plan growth, and shopping for health care: enrollees with skin in the game. JAMA Intern Med. 2016;176(3):395-397. doi: 10.1001/jamainternmed.2015.7554.

Output: Retail prices for commonly prescribed drugs are often absent from state prescription drug price websites, but when reported, can vary substantially.


Instruction: create a high quality summary of the given input

Input:
Coalition Of San Diego Healthcare Groups Protest Efforts To Replace Obamacare
 Listen Coalition Of San Diego Health Care Groups Protests Efforts To Replace Obamacare A coalition of major players in the San Diego healthcare market are protesting efforts to replace Obamacare.

A coalition of health organizations in San Diego held a rally Wednesday to protest the U.S. Senate’s attempt to repeal and replace Obamacare.

Local healthcare advocates say Obamacare has extended coverage to millions of Californians who did not have insurance.

Advocates contend Republican lawmakers should try to improve the current system, not throw it out.

Jan Spencley, executive director of the coalition San Diegans for Healthcare Coverage, said she was an administrator at UC San Diego Health before the implementation of Obamacare.

RELATED: GOP Senators Blink On A Big Chance To Repeal ‘Obamacare’

“I saw people that didn’t get adequate care," she said. "I saw people that didn’t get their mammograms, who didn’t get their breast cancer diagnosed early and who were in stage 4, when they could have been in stage 2, or 1, and we could have cured them.”

Henry Tuttle, president of Health Center Partners of Southern California, a network of 17 community healthcare organizations, said efforts to slash Medicaid just do not make sense.

“We care for 800,000 patients, 2.5 million visits a year supported by Medicaid," Tuttle said. "If we take Medicaid away, where do they go? Who’s going to care for them? Who has the capacity to care for 800,000 patients?”

Senate Republicans are said to be considering a so-called "skinny repeal" of Obamacare, that would eliminate the mandate that people have health insurance, but would leave most other elements of Obamacare intact.

Output: A coalition of health organizations in San Diego held a rally Wednesday to protest the U.S. Senate’s attempt to repeal and replace Obamacare. Local healthcare advocates say Obamacare has extended coverage to millions of Californians who did not have insurance.


Instruction: create a high quality summary of the given input

Input:
Yelp Offers Clinical Data And Consumer Ratings On California Hospitals
 Listen Yelp Offers Clinical Data And Consumer Ratings On California Hospitals Clinical data on hospitals can be hard to find. Now, Yelp provides that info along with consumer ratings of nearly 250 hospitals.

Clinical data on maternity care at California hospitals is available on the web. But consumers might not know how to find it.

That is the idea behind a new project funded by the California Health Care Foundation.

Starting Wednesday, people can check Yelp to get clinical information and consumer ratings on all California hospitals that deliver babies.

The clinical measures include the rates of C-sections, breastfeeding and episiotomies. That data sits side by side with consumer feedback and comments.

Stephanie Teleki, the foundation’s director of evaluation, said where a woman delivers her baby can make a big difference. For example, the C-section rate in California hospitals ranges from 15 to 64 percent.

“You could use this information to inform the conversations that you’re having with your doctor, even if you don’t intend or can’t switch a doctor or a hospital," Teleki explained. "Knowing this information may lead to a lot of other useful conversations about what kind of birth you actually want.”

More than 500,000 babies, or one in eight babies born in the U.S., are born each year in California hospitals.

Output: Clinical data on maternity care at California hospitals is available on the web. But consumers might not know how to find it. That is the idea behind a new project funded by the California Health Care Foundation.


Instruction: create a high quality summary of the given input

Input:
AMIA throws its support behind proposed interoperability framework
 The American Medical Informatics Association has told the Office of the National Coordinator for Health IT that it supports the agency’s draft framework for measuring the use of interoperability standards in health IT.

The organization also urged ONC to take a measurement approach that focuses on the clinician and patient experience.

In its comments, AMIA emphasized the need to have the benefits of measurement outweigh the costs, and it urged ONC to provide sufficient support to develop and implement automated measurement.

“Interoperability is hard in the concrete and impossible in the abstract,” AMIA President and CEO Douglas H. Fridsma, MD, wrote in his comments to ONC. “We will make the best progress toward measuring interoperability when we can clearly define what we want to do with the information that is exchanged.”

[Also: ONC leaders see Silicon Valley-like future for EHR interoperability]

“Focusing on specific ways in which we can support clinicians and improve the health and healthcare of patients is the best hope we have to make substantive and measurable progress towards widespread interoperability,” Fridsma added.

“We need federal officials to think differently about how to measure interoperability,” Thomas H. Payne, MD, said in a statement. “The issue of ‘do we have interoperability?’ is a complex and dynamic question, but a vitally important one.”

Payne, chair of the AMIA Board and medical director of IT Services at the University of Washington’s UW Medicine, advocated for digging into the details to answer that question from both a clinician’s and a patient’s perspective.

ONC issued its “Proposed Interoperability Standards Measurement Framework” last April, asking for feedback regarding an industry-wide measurement framework for interoperability standards.

Today, capabilities to measure and report on the use of standards vary significantly across healthcare IT, ONC noted, and the agency is striving for uniform measures.

ONC is accepting public comment on the proposed Interoperability Standards Measurement Framework until July 31.

Twitter: @Bernie_HITN

Email the writer: bernie.monegain@himssmedia.com

Like Healthcare IT News on Facebook and LinkedIn

Output: The American Medical Informatics Association has told the Office of the National Coordinator for Health IT that it supports the agency’s draft framework for measuring the use of interoperability standards in health IT.


Instruction: create a high quality summary of the given input

Input:
How Many People Across America Are at Risk of Losing Their Health Insurance?
 Between 2010 and 2015, more than 19 million people in the United States gained health insurance, mostly through key provisions under the Affordable Care Act, according to an analysis by the Urban Institute.

Number of people younger than 65 who became insured in each state, from 2010 to 2015 WASH. ME. 531,000 22,000 MONT. N.D. VT. 54,000 18,000 21,000 ORE. MINN. 54,000 387,000 N.H. 241,000 N.Y. IDAHO WIS. S.D. 106,000 MASS. 968,000 MICH. 104,000 212,000 7,000 75,000 WYO. R.I. 603,000 23,000 116,000 PA. CONN. IOWA NEV. OHIO 481,000 409,000 NEB. N.J. ILL. 138,000 285,000 630,000 38,000 72,000 874,000 DEL. MD. UTAH IND. 24,000 W.VA. CALIF. 277,000 D.C. COLO. 140,000 316,000 155,000 3,849,000 407,000 VA. MO. KAN. KY. 263,000 202,000 132,000 382,000 N.C. TENN. 509,000 ARIZ. OKLA. 251,000 N.M. ARK. S.C. 391,000 181,000 ALA. 182,000 232,000 293,000 188,000 GA. MISS. 554,000 TEX. 147,000 1,749,000 LA. ALASKA 243,000 FLA. 28,000 1,539,000 HAWAII 48,000 Number of people younger than 65 who became insured in each state, from 2010 to 2015 WASH. ME. 531,000 22,000 MONT. N.D. VT. 54,000 18,000 21,000 ORE. MINN. 54,000 387,000 N.H. 241,000 N.Y. IDAHO WIS. S.D. 106,000 MASS. 968,000 104,000 MICH. 212,000 7,000 WYO. 75,000 R.I. 603,000 23,000 PA. 116,000 CONN. IOWA NEV. 481,000 OHIO NEB. 409,000 ILL. N.J. 138,000 285,000 630,000 72,000 874,000 38,000 MD. DEL. UTAH IND. 277,000 W.VA. CALIF. 24,000 140,000 COLO. D.C. 316,000 155,000 3,849,000 407,000 VA. MO. KAN. KY. 263,000 202,000 132,000 382,000 N.C. TENN. 509,000 ARIZ. OKLA. 251,000 N.M. 391,000 ARK. 181,000 S.C. ALA. 182,000 232,000 293,000 188,000 GA. MISS. 554,000 TEX. 147,000 1,749,000 LA. ALASKA 243,000 FLA. 28,000 1,539,000 HAWAII 48,000 Maps show the number of people younger than 65 who became insured, from 2010 to 2015 ME. Northeast 22,000 VT. 21,000 N.H. 54,000 N.Y. MASS. 968,000 106,000 CONN. R.I. 116,000 75,000 PA. N.J. 481,000 409,000 DEL. MD. 38,000 277,000 W.VA. D.C. 155,000 24,000 South VA. KY. 263,000 382,000 N.C. OKLA. TENN. 509,000 181,000 251,000 ARK. 232,000 ALA. S.C. 188,000 293,000 GA. MISS. TEX. 554,000 147,000 1,749,000 LA. FLA. 243,000 1,539,000 Midwest N.D. 18,000 MINN. 241,000 WIS. S.D. MICH. 212,000 7,000 603,000 IOWA OHIO NEB. ILL. 138,000 630,000 72,000 874,000 IND. 316,000 MO. KAN. 202,000 132,000 West WASH. 531,000 MONT. 54,000 ORE. 387,000 IDAHO 104,000 WYO. 23,000 NEV. 285,000 UTAH CALIF. 140,000 COLO. 3,849,000 407,000 ARIZ. N.M. 391,000 182,000 ALASKA 28,000 HAWAII 48,000 Maps show the number of people younger than 65 who became insured, from 2010 to 2015 ME. Northeast 22,000 VT. 21,000 N.H. 54,000 N.Y. MASS. 968,000 106,000 R.I. CONN. 116,000 75,000 PA. N.J. 481,000 409,000 DEL. MD. 38,000 277,000 W.VA. D.C. 155,000 24,000 South VA. KY. 263,000 382,000 N.C. OKLA. TENN. 509,000 181,000 251,000 ARK. 232,000 ALA. S.C. 188,000 293,000 GA. MISS. TEX. 554,000 147,000 1,749,000 LA. FLA. 243,000 1,539,000 Midwest N.D. 18,000 MINN. 241,000 WIS. S.D. MICH. 212,000 7,000 603,000 IOWA OHIO NEB. ILL. 138,000 630,000 72,000 874,000 IND. 316,000 MO. KAN. 202,000 132,000 West WASH. 531,000 MONT. 54,000 ORE. 387,000 IDAHO 104,000 WYO. 23,000 NEV. 285,000 UTAH CALIF. 140,000 COLO. 3,849,000 407,000 ARIZ. N.M. 391,000 182,000 ALASKA 28,000 HAWAII 48,000

Many of the newly insured were not poor enough to qualify for Medicaid but too poor to buy their own coverage. Others were shut out because of pre-existing conditions.

These groups and others make up the millions that the Congressional Budget Office says could lose their coverage under the Republican plans to repeal and possibly replace the Affordable Care Act.

“All of the elements that enabled more people to get insurance under Obamacare — protections for pre-existing conditions, the expansion of Medicaid and subsidies to make insurance more affordable — are potentially at risk under the various options the Senate is debating,” said Larry Levitt, a policy expert at the Kaiser Family Foundation.

Under six Republican proposals that the Congressional Budget Office had analyzed, the number of uninsured in America would increase by 22 million to 32 million people in 10 years — essentially erasing much of the gains made under the Affordable Care Act. A C.B.O. analysis released Wednesday night showed that a “skinny” repeal measure being floated by lawmakers would increase the number by 16 million in 10 years.

Output: Between 2010 and 2015, more than 19 million people in the United States gained health insurance, mostly through key provisions under the Affordable Care Act, according to an analysis by the Urban Institute.


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No Insurance, but for 3 Days, Health Care Is Within Reach
 WISE, Va. — For a man who needed 18 teeth pulled, Daniel Smith was looking chipper.

Anxious, too, for he was facing a pair of forceps. But Smith, 30, a contractor with no health or dental insurance, who hadn’t seen a dentist in more than 20 years, was looking forward to an imminent end to the pain and rot in his mouth.

“I’ve always worked, since I was 14, but I’ve never had dental insurance,” Smith told me. After his teeth are out, he has a lead on low-cost dentures.

“I’d like to have a straight smile,” he said. “I’ve never had one in my life.”

All around Smith were uninsured patients receiving free dental or medical care, including dozens of men and women in side-by-side dental chairs in the open air. Organizers mercifully arranged the long line of people waiting to have teeth pulled so that they were facing away from those currently enduring extractions.

The patients swamped the county fairground here for a three-day health extravaganza of free care organized by Remote Area Medical, an aid group that holds these events across the country. This one involved about 1,400 volunteers serving 2,300 men and women who needed care of every kind.

Output: For a man who needed 18 teeth pulled, Daniel Smith was looking chipper. Anxious, too, for he was facing a pair of forceps. But Smith, 30, a contractor with no health or dental insurance, who hadn’t seen a dentist in more than 20 years, was looking forward to an imminent end to the pain and rot in his mouth.


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Senate Votes Down Broad Obamacare Repeal
 WASHINGTON — The Senate voted narrowly on Tuesday to begin debate on a bill to repeal major provisions of the Affordable Care Act, but hours later, Republican leaders suffered a setback when their most comprehensive plan to replace President Barack Obama’s health law fell far short of the votes it needed.

The Tuesday night tally needed to reach 60 votes to overcome a parliamentary objection. Instead, it fell 43-57. The fact that the comprehensive replacement plan came up well short of even 50 votes was an ominous sign for Republican leaders still seeking a formula to pass final health care legislation this week.

For Republicans, the failure ended the day on a sour note, hours after a more triumphant scene on the Senate floor. Lawmakers from both parties had risen to their feet in the afternoon and applauded when Senator John McCain, Republican of Arizona, showed up in the chamber despite his diagnosis of brain cancer. He cast a crucial vote in favor of opening what promises to be a freewheeling, hard-fought debate over the future of the Affordable Care Act.

Output: The Senate voted narrowly on Tuesday to begin debate on a bill to repeal major provisions of the Affordable Care Act, but hours later, Republican leaders suffered a setback when their most comprehensive plan to replace President Barack Obama’s health law fell far short of the votes it needed.


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The Senate Health-Care Vote Is a Travesty
 On Tuesday, after this piece was published, Senate Republicans voted to move ahead and debate a repeal of Obamacare.

When future historians look back on American governance during the early decades of the twenty-first century, they will have many tragic and troublesome episodes to dwell on: the hanging chads of Palm Beach County, the invasion of Iraq, the passage of the Patriot Act, the Citizens United ruling, the Republican-controlled Senate’s refusal to grant Supreme Court nominee Merrick Garland a hearing, and the election of Donald Trump and his subsequent dumbing down and demeaning of the Presidency.

In this chronology, Tuesday’s health-care vote may also figure prominently: it could well be remembered as a historic abuse of the legislative process that the Founders spent so much time and energy constructing. Mitch McConnell, the Senate Majority Leader, is asking his colleagues to vote blindly and authorize consideration of a health-care-reform measure that could dramatically affect the welfare of tens of millions of Americans and shake up roughly a sixth of the U.S. economy.

Officially, McConnell is presenting a “motion to consider” the American Health Care Act of 2017, the bill that House Republicans passed in May. But the motion is really just a way to start debate on a Senate version of the reform measure—a version no one knows anything about. McConnell is refusing to say what the bill under consideration will look like. It could be the revised version of the Senate G.O.P.’s bill to repeal and replace Obamacare, which was widely thought to have perished early last week. Or it could be the repeal-only bill that was widely thought to have died late last week. Or it could be some other proposal, or many others, depending on how many senators are allowed to offer amendments and put forward their own pet plans.

McConnell is refusing to clarify what he intends to do because he and his colleagues in the Republican leadership believe that keeping things uncertain gives them the best chance of bringing on board some of the moderates and conservatives who scuttled their previous efforts. “We have no earthly idea what we will be voting on tomorrow other than that it’ll be moving to the House bill,” Senator Rand Paul, of Kentucky, who was one of those conservative dissidents, told Fox News on Monday. “But everybody knows it’s not really going to be the House bill.”

It is a ludicrous situation, and one that makes a mockery of the idea of the Senate as a highfalutin deliberative body. No major bill in recent history has been railroaded through the upper chamber in such a manner—conceived of and written in secret, and subject to no markups or committee hearings. If McConnell were to succeed in getting some sort of bill passed, it would be a travesty.

About the only thing that can be said for the lawmakers who brought things to this juncture is that they have been pretty open about their intentions. Indeed, they appear to wear their cynicism with pride. “We’re trying to maximize the number of votes,” Senator John Cornyn, the Majority Whip, told reporters on Monday. “What we’re trying to do is convince everybody that if they’d like to get a vote on their amendment, then they need to vote to proceed to the House bill.”

Senate Republicans, one would hope, haven’t descended so far that they would fall for this ruse, and Paul, for one, said that he wouldn’t. “I don’t think we should move to the bill with so many unknowns unless we’re going to be told what exactly we’re going to move to,” he said. Maine’s Susan Collins, one of the moderate Republican dissidents, also indicated that she was likely to vote against the motion. There were reports that Lisa Murkowski, of Alaska, was also going to vote no, but it later emerged that she was still undecided. If three Republican senators oppose the motion to proceed, it will fail. (The Republicans have a majority of just two.)

It was clear by early Tuesday that the G.O.P. leadership and the White House were making an effort to rally party loyalists and cajole the holdouts. McConnell was said to be willing to sweeten the pot for Republicans concerned about slashing Medicaid by adding back some two hundred billion dollars of spending for the federal program. Trump, meanwhile, spent some of Monday afternoon in West Virginia with the state’s junior senator, Shelley Moore Capito, whose vote will be crucial. And on Monday night, John McCain, stricken with brain cancer, gave the party leadership a boost by announcing that he would return to Washington for the health-care vote, in which he will almost certainly join the yeas.

Thankfully, the opponents of the Republican designs—which, let us not forget, could lead to at least twenty million Americans losing their health-insurance coverage, and countless others ending up with skimpier plans and astronomical deductibles—are also rallying. Democratic politicians and activists are fired up and engaged, as are organizations representing the people and interest groups that the reform would affect. On Monday night, A.A.R.P., which has about thirty-eight million members, called on all senators to vote against the motion to proceed.

But this looks like a close one—perilously close given that opinion polls show that a large majority of Americans prefer keeping Obamacare to adopting any of the Republicans plans. If the vote were to go McConnell’s way, it would be another sign that American democracy is failing.

Output: When future historians look back on American governance during the early decades of the twenty-first century, they will have many tragic and troublesome episodes to dwell on: the hanging chads of Palm Beach County, the invasion of Iraq, the passage of the Patriot Act, the Citizens United ruling, the Republican-controlled Senate’s refusal to grant Supreme Court nominee Merrick Garland a hearing, and the election of Donald Trump and his subsequent dumbing down and demeaning of the Presidency.


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Older Patients Often Don’t Ask Pharmacists for Lower-Cost Drug Options
 More than a quarter of Americans aged 50 years and older say their drug costs cause financial strain, but many of them don’t ask their pharmacist or other healthcare professionals to help them find lower-cost options.That’s according to the University of Michigan National Poll on Healthy Aging , a new initiative based at the university’s Institute for Healthcare Policy and Innovation and sponsored by AARP and Michigan Medicine.The survey notes that most people aged 50 years and older in the United States take two or more prescription medications for prevention or treatment of health issues.“We already know that cost can keep patients from taking the drugs they need to maintain health or prevent complications, but these new data suggest that many older adults aren’t talking to their doctors or pharmacists about cost and less-expensive alternatives as often as they could,” explained Preeti Malani, MD, director of the poll and a professor of internal medicine at the University of Michigan Medical School. “This represents an opportunity for patients, clinicians—as well as health systems, insurers and policymakers.”The poll involved a nationally representative sample including 2,131 participants, about half of them aged 50 to 64 years, and the other half aged 65 to 90 years, who are eligible for Medicare. The questions were available online, and laptops and Internet access were provided to respondents who did not have those tools.Overall, 27% responded that prescription drug costs posed a financial burden. Yet 49% of those hadn’t discussed the problem with their physician. Of respondents who did raise the questions with a healthcare professional, 67% of those who talked to their doctor and 37% of those who talked to their pharmacist were able to get a recommendation for a less-expensive medication, according to poll results.High cost was especially an issue for the one in six respondents reporting a “high complexity” of prescription management, defined as taking six or more prescriptions drugs and seeing more than one doctor.“Based on these findings, and other evidence, we encourage patients to speak up during their clinic visits, and when they’re at the pharmacy, and ask about ways to reduce the cost of their prescriptions,” Malani emphasized. “But equally, we see a need for health professionals to find ways to more routinely engage with patients about cost— especially through formal medication reviews such as the one that Medicare will cover.”

Output: More than a quarter of Americans aged 50 years and older say their drug costs cause financial strain, but many of them don’t ask their pharmacist or other healthcare professionals to help them find lower-cost options.


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State Street's gender diversity campaign scuppers 400 votes
 State Street Global Advisors, a huge asset manager, called for the companies it invests in to improve their gender diversity – or else face a vote against them.

The call came as part of State Street's installment of "Fearless Girl," a statue of a defiant girl in front of downtown Manhattan's Wall Street bull.

State Street has since followed through on its promise, voting against 400 companies that failed to act.

The $2.6 trillion asset manager behind the"Fearless Girl" statue is putting its money where its mouth is.

State Street Global Advisors, one of the world's largest money managers, installed in March a statue of a defiant girl in front of the Wall Street bull in downtown Manhattan. As part of that rollout, State Street vowed to take action against companies that it holds which don't take action to increase their boards' gender diversity.

State Street has since voted against 400 of those companies.

"Basically, we hold these companies forever," said Lynn Blake, the CIO of Global Equity Beta Solutions. State Street is a major player in passive investing, which means that they hold stocks of companies in major market indexes.

"We’re the epitome of a long term investor and the only way we can influence companies is by active engagement and ultimately our vote," Blake added.

State Street declined to identify the companies it voted against, but said that the vast majority of the companies – 394 of the 400 – are based in the US.

Over the past few months, during proxy voting season mostly in the US, State Street identified 476 companies that didn't have any women on their boards. Four hundred of them didn't take any action to increase their diversity.

In turn, State Street voted against the reelection of the chair or the most senior member of the nominating and governance committee – those that identify future directors – at those companies.

It is becoming increasingly common for investors to call for change at the companies they hold, though State Street may have taken one of the most vocal steps yet.

Its competitor, BlackRock, the world's largest asset manager, "voted against board members at five companies who sat on nominating committees but failed to respond to investors' concerns about diversity," per Reuters.

To be sure, State Street also has its own gender problem, with women making up only one in five employees at the firm's investment unit, and only three women on the company's 11-person board. The company has said it is working on improving that ratio.

State Street Global Advisors managed $2.6 trillion as of June 30, a representative said.

Output: State Street Global Advisors, the company behind the 'Fearless Girl' statue in the Wall Street district, has identified 476 companies it holds that have no women on their boards. It voted against the reelection of chairs at 400 of the companies that took no action to correct this. "We’re the epitome of a long-term investor and the only way we can influence companies is by active engagement and ultimately our vote", said Lynn Blake, CIO of Global Equity Beta Solutions. State Street is also working to change its own imbalance, with women making up just one in five employees at its investment unit.


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Facebook and football clubs question the value of live streams
 The world’s biggest football clubs are looking outside Facebook to host their live streams after the social network stopped paying them to produce live videos earlier this year.

Many teams previously on Facebook’s books, such as Real Madrid, FC Barcelona and Manchester United, are pondering greater investments on YouTube, Instagram and even in-house channels. Teams’ contracts with Facebook varied in length from between a month to a year, but none were renewed by the social network, according to multiple sources.

Low engagement with the live videos led Facebook to scrap the cash incentives, which allowed FC Barcelona to pocket an eye-bulging $1 million for 10 months. Facebook wanted to be the go-to place for those streams, but it quickly became apparent that those types of videos rarely prove popular. A live streamed press conference for FC Barcelona last season racked up more than 500,000 views, a tiny proportion of the 100 million or so Facebook fans of the club.

Now, Facebook would rather buy longer-form premium content from clubs, such as documentaries about fan culture, a move that aligns with the social network’s wider plans to root its video offering in original content it owns. Going down this path for Facebook Live paves the way for its mid-roll videos. Facebook has experimented with mid-roll ads within live content for some sports publishers in the U.K., sequencing five or six to mimic a traditional TV ad buy. Facebook handles the ad sales and gives the content creator most (55 percent) of the revenue.

However, there’s a sense of frustration among many of the clubs Digiday spoke to about Facebook’s latest move as they try to monetize content produced off the field. Many teams in the Premier League seem unsure of Facebook Live’s role in their plans, as evidenced by the dearth of posts last season. Of the English clubs that produced the top 20 most popular Facebook Live feeds over the past year, 12 posted less than 50 times in that time period, according to Socialbakers.

Some clubs are starting to question whether Facebook Live’s long-term ROI justifies the extra investment. To date, Facebook has failed to show football marketers how to monetize the engagement they’re bringing to the platform beyond reach, which clubs can then use to woo sponsors. It’s left one senior marketer at a Premier League club reluctant to stray too far away from the world’s biggest social network as it searches for a new place for its live videos.

“We’ll still be producing live games; now, it’s about finding a home for them,” he said. “Last season, it was always going on Facebook [Live] because of the money they were paying. This season, we’ll test across more platforms. The likelihood is it will end up on Facebook as they offer the biggest numbers, and as a result, are most attractive to partners.”

There lies the rub: Making money from their own content on Facebook may be tricky, but as clubs attempt to commercialize their own brands, Facebook’s reach is hard to ignore, as publishers can attest. Unlike publishers, however, other options exist for football marketers, namely YouTube. YouTube views on football-related content grew 36 percent year over year between the beginning of January 2016 and the end of May 2017, whereas Facebook views grew 19 percent in the same period, according to Tubular Insights.

Instagrammers also love football, according to the Facebook-owned social network. One in five (21 percent) of the world’s 700 million-plus Instagram users is what is loosely described as a “fan” — someone who follows an account from a team, player or news outlet that Instagram deems football-specific. This popularity was demonstrated earlier this month when Manchester United player Paul Pogba congratulated friend Romelu Lukaku ahead of Lukaku’s move to the club with an Instagram video of the pair that more than 3 million people watched within hours of being posted.

Football clubs have other good options to distribute live content — “in particular, their own OTT platforms,” said Phil Stephan, the director for global consulting at sports marketing agency Two Circles, which works with several top-tier European football teams on parts of their commercial strategy.

“Football clubs are yet to be convinced of the monetization potential for what they put on Facebook,” Stephan said. “Our view, and what we say to our rights-holder partners, is that they need to continue experimenting with Facebook — and other social media and digital platforms that are now competing for quality sports content — in addition to bundling content into broadcast and sponsorship deals or going direct to fan via OTT.”

Output: Football clubs, including Real Madrid, FC Barcelona and Manchester United, are unsure of the appeal of live streaming matches, after poor audience figures last season led to Facebook not renewing any of their contracts. Clubs are considering investing more in YouTube, Instagram or in-house channels, however, some believe the huge audiences offered by the social media giant should not be ignored. Phil Stephan, the director for global consulting at sport marketing agency Two Circles, suggested clubs need to "continue experimenting with Facebook", however, some Premier League clubs are unsure about how to monetise the social media network.