Health Policy News and Views
Compiled by Benita M. Dodd
I’m back after a month’s hiatus! If you missed the Georgia Legislative Policy Forum on September 19, you missed a great discussion on health care and alternatives to Medicaid expansion for Georgia’s uninsured. The video will be online soon, and I’ll share it here.
Global community spreads disease: The enemy is Ebola, not people, Dr. Thomas Frieden, the head of the Atlanta-based Centers for Disease Control and Prevention, reminded Americans several times in his update broadcast Tuesday afternoon about the deadly virus that has killed and sickened thousands in Africa. Now it’s made its appearance in both Europe and the United States.
Unfortunately, the enemy resides in the people – more specifically, in people who have been in West Africa or in contact with ailing people in West African countries. While health officials talk about “breaking the chain of transmission” through better burial processes and isolation procedures, the bottom line is that the United States needs to remember that this disease is entering the country inside people and to stop the disease, you must stop the people.
This should not be treated as a science experiment. Infected individuals with this deadly virus require incredibly expensive treatment. Ebola is transmitted by contact with bodily fluids and profiling should be a part of “breaking the chain of transmission.” If testing is too expensive for asymptomatic people, then another approach is necessary. Until this epidemic is stopped, it needs to be contained. Quarantine is an advisable and cost-effective response; allowing only essential travel into the United States must be seriously considered.
“We know how to stop Ebola, but it is going to be a long, hard fight,” Frieden said today.
President Obama is sending 4,000 troops to “fight” Ebola, where, according to reports, some will come into contact with the virus. The troops alone will cost $750 million – at least. It’s not a “war,” and the enemy is not the West Africans or people who have been there. But this requires a clinical response, including allowing only essential travel, along with the testing. Georgia is a gateway to this disease: The state is home to the world’s busiest passenger airport, Hartsfield-Jackson International Airport. It makes sense to seize enemy ground; don’t allow the enemy to get a foothold on home ground.
This is also a harsh reminder of this nation’s global vulnerability, whether by current accidental infection or contamination one day by deliberate, successful bioterrorism. We should take this lesson to heart. At the very least, this should get CDC back on task and away from mission creep.
By the way, I’m from Africa. No matter what they tell you, such a response is realism, not racism. It’s practical, not paranoia.
Priorities, priorities: The Food and Drug Administration (FDA) acts faster on essential drugs when it is aware that the public is watching, writes Dr. Henry I. Miller, the founding director of the FDA Office of Biotechnology. Expanded access for an Ebola drug was granted by the FDA because the Ebola outbreak in Africa is front-page news, while U.S. approval of drugs for diabetes, multiple sclerosis and Duchenne muscular dystrophy have been plagued by delays, Miller writes in The New York Post. “To put it less charitably, FDA routinely drags its feet on the approval of products critical for the prevention or treatment of fatal diseases that are far more common in this country than Ebola.”
Close to home: The Columbus Ledger-Inquirer reports that some of the support team headed to West Africa to combat Ebola are soldiers from Georgia’s Fort Benning.
Health care facts vs. myths: Do you believe physicians are all-knowing? “Despite all claims to the contrary, we are no smarter than teachers or engineers, no braver than soldiers or firefighters, and no more infallible or crucial to human health than nurses or sanitation workers, writes Dr. Louis Collar in KevinMD. “If you want to find brilliance, look to the individual, not the career. No profession has a monopoly on intellect.” Nor is it true that they’re underpaid or that they’re altruistic. And big pharma isn’t evil. And technology won’t save health care, he points out: “Good technology can certainly help, but only good people, good judgment, and good intentions can truly improve our health care system.” Read it here.
Stem cell hope for MS patients: Multiple sclerosis is a chronic, life-altering, incurable autoimmune disease that afflicts 2.3 million people. Researchers from Mount Sinai say they have designed an unprecedented treatment that could open doors for a successful treatment using cells from human placenta tissues. In a six-month treatment period, damaged nerve cells in 16 MS patients were repaired with cultured placenta cells that resemble the connective tissue found in bone marrow. The next step is expanded testing. Source: MedicalDaily.com
The high cost blame game: After Sunday’s CBS News “60 Minutes” report that attacked the high costs of cancer drugs, the Biotechnology Industry Organization (BIO) is pushing back and pointing fingers at the insurance industry for out-of-pocket costs. “It is unfortunate that CBS has chosen to attack the price of specialty cancer medications while ignoring the value created by these drugs for patients and the health care system. Cancer patients today are able to live longer and enjoy a higher quality of life than ever before thanks to medicines made by biopharmaceutical research companies,” BIO said. The cost-sharing model “in which patients must pay a relatively high percentage of their drug costs, rather than a flat co-payment … can cost patients thousands of dollars out of pocket, and in effect limits their access to medicines and injects a third party between doctor and patient when determining the best course of treatment.”
Let the games begin: About 245 companies around the world are chasing an emerging market for cheaper copies of costly biotech drugs, with more than 700 so-called biosimilars now in development or already approved, Reuters reports. Biotech medicines – made from proteins and other large molecules – account for six of the 10 biggest-selling drugs in the world today, led by AbbVie’s $12 billion-a-year rheumatoid arthritis injection Humira. The total market for such biological medicines could exceed $250 billion by 2020 but many of today’s bestsellers are losing patent protection or will do so in the next few years. That has opened up an opportunity for companies with the technical ability to copy the drugs. And that, as Reuters points out, is something that is easier said than done: Such drugs are produced in living cells and imitations can only ever be similar, not identical.
Transparency in the eye of the beholder: Over the course of just five months in 2013, U.S. doctors received more than $3.5 billion in consulting fees, travel reimbursements and gifts from pharmaceutical and medical-device companies, according to Open Payments, a database launched on last month under the Affordable Care Act. How much of that is buying influence? How much to reimburse for lectures? How much is endorsement? How much is conflict of interest? How much of it is data error? How complete is the information? The problem is that disclosing industry payments to doctors can have unintended effects on the relationships between doctors, patients and drugmakers, according to some transparency advocates. “Publishing inaccurate data leads to misinterpretations, harms reputations and undermines the trust that patients have in their physicians,” the American Medical Association said. Data on industry gifts received by doctors and prescriptions written over time are limited and hard to analyze, according to Carnegie Mellon University economist George Loewenstein. Source: Nature.com
Quote of note
“I always end our discussion with these words: “In six months’ time, when you are fully recovered from whatever treatment you choose, I would rather you come to my door and tell me that I scared you with my frankness, and that none of what I said ‘could happen,’ did happen, than you come to my door and ask me why I didn’t tell you about something, because if I had, your decision would have been different.” – Anne Katz
“We are at a crossroads: International travel and lower vaccination rates are coming together to make those diseases we wiped out come back. Please, let’s find a way to have some productive, thoughtful conversations, conversations in which both sides are heard, before more people get sick. Remember, it’s the young, the old and those that are already sick that are most likely to get into trouble from vaccine-preventable diseases. They need us to take care of them.” – Claire McCarthy