Month: June 2021

Diana Hernández: Promoting better health through better housing

first_imgHealthDiana Hernández: Promoting better health through better housing Diana Hernández is an assistant professor of sociomedical sciences at Columbia University’s Mailman School of Public Health. Molly Ferguson for STAT Karen Weintraub is an independenthealth/sciencejournalist, journalism teacher, and bookauthor. Tags Health Disparitiesinfectious diseasepovertysmoking The federal government last month proposed banning smoking in public housing units nationwide. Based on your research, what’s the best way to enforce that policy?The stress of everyday life of the poor leads them to smoke. So you have to make [the policy] resident-centered and think about why are people not compliant. They may have other health issues, so going outside is not convenient.You also study people who can’t afford to keep the lights on. What can be done about this energy insecurity?We shouldn’t live in a society where a basic need like light would be determined by someone’s socioeconomic status. We have a bunch of people who live in the dark and light candles.Have you ever faced a housing problem yourself?I don’t know that any of us has been spared. During a gut renovation I lived without gas for seven months. I couldn’t cook. There was a time when we only had cold water. [Housing problems are] more pronounced in low-income housing settings, but a lot of the issues appear across the board.You now own seven rental properties in your neighborhood. Has ownership turned out to be a good business venture?Sure has! I supplement my income as a professor. I live for free. Some of my tenants have moved on to buy their own property. I’m ready to buy another one.The tabloids aren’t going to “out” you as a slumlord, right? Not at all. To me, this is about having people live with dignity. I can’t talk about that in my work and then profit from that. I wouldn’t be able to sleep at night.How do you keep your units well maintained when other owners say they can’t afford to?I temper my greed. It’s a human thing to want more — and I do, of course. At some point, I want to be a multimillionaire because I develop properties that are worth that. But I really believe in the model of conscious capitalism. We can really do well by society, in my case by my tenants, and also live well.Do you think your modest upbringings shaped this view?Having nothing to lose really does open up so many possibilities for what you can gain.Diana Hernández is an assistant professor of sociomedical sciences at Columbia University’s Mailman School of Public Health. This interview has been edited and condensed. Why do you think it’s essential to study health in the context of the social environment?The populations I’m looking at are very low-income, in low-resourced settings. The disadvantages are already happening at the neighborhood level, in the household, and among individuals. It’s commonplace to have someone who is obese, diabetic, hypertensive, has some predisposition to cancer, demonstrating signs of psychosocial stress.This past summer, there was an outbreak of Legionnaires’ disease, a severe form of pneumonia, on a block you walk down every day. Why do you think you escaped infection when so many others fell ill or even died?The population here is already vulnerable. Their health is already compromised. I was able to breathe in the same air and not [get sick].advertisement About the Author Reprints By Karen Weintraub Dec. 5, 2015 Reprints Growing up in public housing in the South Bronx, Diana Hernández learned firsthand about the connection between poverty, living arrangements, and bad health. A sociologist at Columbia University, Hernández now studies these interrelationships in her native neighborhood where she continues to live today.STAT caught up with her about smoking bans, becoming a landlord, and how she avoided catching Legionnaires’ disease.Presumably, Columbia pays you well enough that you don’t have to live in the Bronx, the unhealthiest county in New York State. Why do you stay? I grew up in this neighborhood. In so many ways it’s shaped who I am and why I’m a professor.advertisement Karen Weintraub @kweintraub last_img read more

New York Governor Andrew Cuomo seeks to cap some drug prices

first_img In a provocative move, New York Governor Andrew Cuomo has become the latest entrant in the escalating war over rising drug prices with a budget provision that would effectively cap prices and require drug makers to provide a raft of information about their costs.The proposal marks yet another high-profile attempt to force the pharmaceutical industry to respond to the intensifying clamor over the cost of medicines. The issue has made its way into the presidential campaign and, next week, another in a series of congressional hearings on the topic is scheduled.Under the proposal, which must be approved by the state legislature, the state health department would “develop a list of critical prescription drugs for which there is a significant public interest in ensuring rational pricing.” The department would then assess the value of the drugs in order to set a “ceiling price” and could require a minimum rebate to the state Medicaid program.advertisement As part of the process, the administration wants companies to provide data about development, manufacturing, and marketing costs for drugs on this list. The proposal would also require drug makers to submit information about the prices charged other purchasers in the state and outside the United States, any rebates offered customers, and profit margins, among other things.[UPDATE: A Cuomo spokesman told us that the plan is expected to save $30 million in fiscal year 2016-17. Of that $6 million would come from price caps, but this is a “conservative estimate,” he told us, because “we’re talking about a limited number of drugs, and we cannot know for sure what blockbuster drugs will come on the market in the coming fiscal year.” The other $24 million would come from rebates that generic drug makers would be required to offer the state Medicaid program if prices of their medicines increase faster than inflation.]advertisement PharmalotNew York Governor Andrew Cuomo seeks to cap some drug prices New York Governor Andrew Cuomo has a budget proposal that would effectively cap prescription drug prices and require drug makers to provide a raft of information about their costs. Kathy Willens/AP @Pharmalot Tags Andrew Cuomodrug pricespharmaceutical industrypolicy By Ed Silverman Jan. 22, 2016 Reprints The plan won kudos from the New York Health Plan Association, which represents managed care insurers. “With pharmacy costs as one of the biggest drivers of health care costs overall, consumers need and deserve basic pricing information,” the trade group said in a statement.Not surprisingly, a spokeswoman for the Pharmaceutical Research and Manufacturers of America, the trade group for drug makers, wrote us that its members have “significant concerns” with the proposal, which was first reported by Politico.“Not only will implementing price controls have a very negative impact on innovation and send a signal that risk taking will not be rewarded, but also the so-called ‘transparency’ information called for in the proposals would be virtually impossible to achieve because it does not include the cost of failures inherent in the search for new treatments and cures.“Additionally, the proposals single out the biopharmaceutical industry, when in fact, there are a variety of stakeholders involved in determining what consumers ultimately have to pay for a medicine — insurers, pharmacy benefit managers, wholesalers and government agencies,” the spokeswoman wrote. “None of these parties are addressed in these proposals.” Ed Silverman Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. About the Author Reprints [email protected] Washington has big hopes, but little power, to negotiate drug prices Related: Nobody knows if candidates’ drug-price plans will actually work Related: The objections mirror the argument the industry trade group raised recently in California, where a bill was introduced twice over the past year to require drug makers to disclose their costs in an effort to gain more transparency into pricing decisions. Last week, though, that bill stalled again. Similar efforts in a few other states, including Oregon, North Carolina and Massachusetts, have also petered out.Other efforts are underway, however, to make it possible for state programs to obtain medicines at lower costs. In California and Ohio, consumer advocates are pushing ballot measures that would require Medicaid or prison systems, for instance, to pay no more for medicines than the US Department of Veteran Affairs. A measure will be on the California ballot, but is being challenged in Ohio.This story was updated to reflect projected savings in the next fiscal year.last_img read more

Lawmakers look to prevent drug makers from thwarting generic competition

first_img [email protected] FDA still struggling with backlog of generic drug applications PharmalotLawmakers look to prevent drug makers from thwarting generic competition Given the controversy over the cost of medicines, however, any effort to promote competition and maybe even lower prices might stand a better chance of winning support. The bill was praised in a blog post written by Geoffrey Manne, an attorney who specializes in antitrust law and economics, and heads the International Center for Law and Economics, a think tank based in Portland, Ore.The “bill is a well-thought-out and targeted fix to an imperfect regulation (concerning REMS) that seems to be facilitating anti-competitive conduct by a few bad actors,” he wrote. And he added that it does so “without imposing excessive cost or risk on the majority of brand manufacturers that behave perfectly appropriately under the law.”A spokeswoman for the Pharmaceutical Research and Manufacturers of America, the trade group for brand-name drug makers, sent us a note saying that REMS “are a critical regulatory tool for protecting patient safety. While we are currently reviewing the legislation, we would be concerned if patient safety could be jeopardized in any way.”The other senators who are sponsoring the bill, by the way, are Chuck Grassley, an Iowa Republican; Amy Klobuchar, a Minnesota Democrat; and Mike Lee, a Republican from Utah.The bill has backing from AARP; Consumers Union; Public Citizen; the American College of Physicians; the American Hospital Association; the Healthcare Supply Chain Association; the National Association of Chain Drug Stores; the Pharmaceutical Care Management Association; Express Scripts; the Blue Cross Blue Shield Association; the AFL-CIO; the American Federation of Teachers; and the UAW Retiree Medical Benefits Trust, among others. The issue of brand-name drug makers thwarting generic competition cropped up in connection with Turing Pharmaceuticals when it was run by Martin Shkreli. Seth Wenig/AP Related: More recently, the issue cropped up in connection with Turing Pharmaceuticals when it was run by Martin Shkreli. After buying a life-saving medicine last year and jacking up the price by about 5,000 percent, from $13.50 a pill to $750, Turing restricted distribution. This made it difficult to obtain samples, although the drug was not covered by a REMS plan. So unlike the previous bills, the latest legislation is targeting any company that denies samples. Tags generic drugsMartin ShkreliTuring Pharmaceuticals The legislation would allow the secretary of Health and Human Services to vet the request for samples and create a “cause of action,” presumably making it easier for a generic company to go to court in hopes of forcing a brand-name rival to make samples available. Of course, this assumes the generic company can provide sufficient evidence that samples were denied. The bill would also authorize a judge to award damages to deter brand-name companies from playing delaying games in the future.Whether the legislation will gain any traction is unclear. The two previous attempts stalled, although both focused only on drugs covered with a REMS plan. At the time, the generic industry trade group released a study showing the tactic cost the US health care system about $5.4 billion in annual drug spending that could have been saved if generic versions of 40 drugs had been allowed to reach consumers. Related:center_img Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Ed Silverman About the Author Reprints “Pharmaceutical companies should be compensated for their important work developing life-saving treatments, but predatory practices at the expense of consumers are unacceptable,” said Senator Patrick Leahy, a Vermont Democrat and one of four senators to sponsor the bill, said in a statement. And as the ranking member of the Senate Judiciary Committee, he plans to hold a hearing next Tuesday on the topic.advertisement FDA again delays rule to allow generic drug makers to change labels By Ed Silverman June 15, 2016 Reprints For the third time in less than two years, congressional lawmakers have introduced a bill designed to end a practice that generic drug makers say is used by brand-name rivals to thwart competition.Known as the Creating and Restoring Equal Access to Equivalent Samples Act, the bipartisan legislation comes amid ongoing complaints that brand-name drug makers sometimes refuse to provide samples to generic companies. They need samples to prove their copycat versions are equivalent to the brand-name drugs in order to pass regulatory muster. And the problem has worried the US Federal Trade Commission.The most common complaint involves exploiting a regulatory program called the Risk Evaluation and Mitigation Strategies, or REMS. To boost patient safety, the Food and Drug Administration can require brand-name drug makers to develop a REMS plan when a medicine is approved. This may involve disseminating physician and patient education information or monitoring distribution.advertisement @Pharmalot last_img read more

Why do Amish kids have fewer allergies? The answer may come from the farm

first_img It’s support for the so-called hygiene hypothesis: the idea that a lack of early childhood exposure to a diversity of germs can keep the immune system underdeveloped and more likely to overreact to things that are harmless — resulting in allergies and asthma.advertisement Privacy Policy Related: Related: Children with allergies, asthma may be at risk of heart problems, too In trying to explain America’s rising rates of allergies and asthma, one of the common theories is that we’re just too clean. And that theory just got a boost by scientists studying traditional farming communities.The Amish communities concentrated in America’s rust belt share many similarities with other traditionalist sects, including the Hutterites, a group of Anabaptists that live largely in Canada and in the northwestern United States. Both are Christian groups that eschew most modern technology and make much of their livelihood from farming. But they have a key difference: Amish families farm traditionally, using hand-held or livestock-powered tools, while Hutterites use modern farm implements.And that appears to make a crucial difference to their health: While less than 10 percent of Amish schoolchildren have asthma and allergies, the prevalence in Hutterite children is over 20 and 30 percent respectively.advertisement Are doctors overdiagnosing asthma? HealthWhy do Amish kids have fewer allergies? The answer may come from the farm It’s almost as if the immune system is “bored,” says Anne Sperling, an immunologist at the University of Chicago and a colleague of Ober. “Kids who live in just a bit dirtier environments are actually more protected against asthma and allergies.”The Hutterites and Amish actually have very similar ancestral backgrounds. They can trace their ancestors to Central European communities only about 15 miles apart, and they remain fairly genetically isolated from the rest of American society.This genetic similarity gave Ober and her colleagues an opportunity to focus on lifestyle differences, the major one being farming practices. Both communities rely heavily on farming, but while the Amish use pre-industrial farming practices, like horse-pulled plows and hand sowed seeds, the Hutterites use modern tractors and milking machines. Traditional farming means the Amish have much more exposure to microbes in their farms — an exposure they pass on to their children when they come home from the fields. Ober’s team found almost seven times more diversity of microbial life in dust from Amish homes than dust from Hutterite homes.The children’s blood told a story of diverging immune profiles as well. For example, Amish children had higher levels of white blood cells called neutrophils, while those cells had lower levels of three proteins known to play a role in inflammatory responses.The researchers then took those dust extracts back to the lab. For a month they exposed mice to dust from each community before inducing asthma in the mice. In mice exposed to dust from Amish households, the asthmatic response was less severe, with airways contracting half as much as control mice. The Hutterite dust almost always had the opposite effect.“This tells us something in the dust is protective,” said Sperling.And when they engineered mice lacking genes important for immune system functioning, the protective effect was lost, providing even stronger evidence that the lack of allergies and asthma in Amish children is due to something unique about their immune systems, she said.The findings are compelling, said Ober, but the scientists can’t rule out the possibility that an uncontrolled difference, like geography, could have influenced the results. (The Amish groups sampled lived in Indiana, while the Hutterites lived in South Dakota.) Ober is hoping to do a follow-up experiment in which Hutterites would expose their babies to more from their environment. Leave this field empty if you’re human: At this point the researchers are also unable to say what specific component of the dust might be protective.“We have this grandmother sort of wisdom that [says], sure you need to go and get exposed to dirt and bacteria so you can grow healthy and protected,” said Talal Chatila, a pediatric researcher specializing in immunology at Boston Children’s Hospital, who was not involved in research. “The science is now moving to actually starting to define at the molecular level what are the components or factors that enable particular exposures to be protective against allergic diseases.” By Lindzi Wessel Aug. 3, 2016 Reprints In a study published Wednesday in the New England Journal of Medicine, Carole Ober, a geneticist at the University of Chicago, and her colleagues conclude that dust from the farm fields might protect Amish children from asthma and allergies, while shelter from this exposure might leave Hutterite children vulnerable. Newsletters Sign up for Daily Recap A roundup of STAT’s top stories of the day. Tags allergiesasthmamicrobes Scott R. Galvin/AP While the idea of some sort of pill or spray that could kickstart our children’s immune systems remains in the realm of science fiction, the study reminds us that our children don’t have to live in completely sterilized environments, said Sperling.“It might be important just to let them be kids and be outside … and play in the dirt,” she said. “All that might be important stimuli to develop an immune system that’s protective against asthma.” Please enter a valid email address.last_img read more

University of Minnesota sues Gilead for infringing on hepatitis C patents

first_img Related: @Pharmalot Please enter a valid email address. There was, for instance, intense interest in recent patent litigation between Gilead and Merck. In that case, Merck sought royalties from Gilead, claiming the compounds Gilead purchased from another company closely mimicked the hepatitis C compounds Merck researched a dozen years earlier. Gilead filed a lawsuit in response, arguing the Merck patents were invalid. A jury agreed, but the verdict was overturned two months ago after a federal court judge determined a Merck attorney had lied.However, consumer groups have also pointed to Gilead patents as an example of a broken patent system. These groups lost a round last May, though, when Indian officials reversed course and granted a patent to Gilead Sciences for Sovaldi. A year earlier, the Indian Patent Office rejected the company’s patent application on the grounds that it was not a significant improvement compared with an earlier compound developed by another company. By Ed Silverman Aug. 31, 2016 Reprints Gilead gets a big win as India upholds a Sovaldi patent, after all A Gilead spokesman wrote us that the company “strongly believes that it has the sole right to commercialize (Sovaldi) in the US. We believe the University of Minnesota’s patent is invalid and is not infringed by the sale of Gilead’s medicines for chronic hepatitis C.” Eric Risberg/AP About the Author Reprints [email protected] Privacy Policy Leave this field empty if you’re human: Whether the litigation with the University of Minnesota holds the same potential for such drama is unclear. The school is claiming the patent that was infringed only refers to the technique for having the drugs absorbed in the body, not the basis compound.“I think they’re just trying to get a payoff,” said Tahir Amin, director of intellectual property at IMAK, an advocacy group that battled Gilead in India and is challenging Sovaldi patents in other countries. “I think this just goes to show what we’ve been saying all along — this kind of science is commonly used. They’re just staking a claim for their own purposes. Unfortunately, the patent system creates monopolies when, in such instances, no one should have exclusivity on old science.” Newsletters Sign up for Pharmalot Your daily update on the drug industry. Such disputes are not uncommon, but the Gilead hepatitis C drugs have generated a bonanza — more than $19 billion in sales last year, although Epclusa was not available until recently. This explains why patent challenges to its hepatitis C products are closely watched. Sales have slowed recently, but investors, in particular, still want to know if this highly lucrative revenue stream might be further diminished.advertisement Ed Silverman Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Once again, Gilead Sciences finds itself defending a challenge to a patent for its groundbreaking hepatitis C treatments. The latest test comes from the University of Minnesota, which filed a lawsuit arguing the drug maker infringed a patent pertaining to the blockbuster Sovaldi medicine, as well as two follow-up drugs, Harvoni and Epclusa.In its lawsuit, which was filed in federal court on Tuesday, the university maintained that all three drugs are covered by patent rights that were assigned to the school by Dr. Carston Wagner, a professor and an endowed chair in the department of medicinal chemistry in the university’s college of pharmacy. The school contended that he received the patent in August 2014.The patent refers to “antiviral compounds and methods for using those compounds to treat viral infections, such as that caused by hepatitis C virus,” the lawsuit states. “The importance of Dr. Wagner’s contributions … as disclosed and claimed in the patent, was widely recognized by his peers in the scientific community. Gilead’s medicines incorporate these contributions.” (Here are the exhibits).advertisement PharmalotUniversity of Minnesota sues Gilead for infringing on hepatitis C patents Tags Gilead Scienceshepatitis Cpatentslast_img read more

Startup Spotlight: A new way to rally immune cells into action against cancer

first_img STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Startup Spotlight: A new way to rally immune cells into action against cancer By Meghana Keshavan Jan. 4, 2017 Reprints Alex Hogan/STAT Immunotherapy is a delicate balance: You have to rally a patient’s immune cells into action to kill diseased cells, but keep them away from healthy tissues. Vedantra Pharmaceuticals, a startup based in Cambridge, Mass., is working on a way to refine that process.The company has developed next-gen nanoparticle vaccines — engineering vesicles that help ferry the therapy straight to the lymph nodes. That helps the body generate a stronger immune response. The work, based on research at MIT, is still preclinical, but Vedantra hopes it can be used to bolster cancer treatments. It’s focusing first on malignancies provoked by the HPV virus — such as cervical and head and neck cancer. What is it? Log In | Learn More Unlock this article — plus daily coverage and analysis of the biotech sector — by subscribing to STAT+. First 30 days free. GET STARTED About the Author Reprints [email protected] center_img Biotech Correspondent Meghana covers biotech and contributes to The Readout newsletter. GET STARTED @megkesh What’s included? Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Biotech Meghana Keshavan Tags cancerdrug developmentSTAT+last_img read more

FDA drug testing doesn’t have to sacrifice safety, or animals, for speed

first_img “Slow and burdensome” is how President Donald Trump has described the Food and Drug Administration’s drug approval process. His promise to speed it up by slashing regulations raised major safety concerns among scientists, regulators, and patient groups. But speed and safety do not have to be at odds. Modern tests that are physiologically relevant to humans because they are based on human biology — not on the biology of other animals — offer scientists more predictive information more quickly. FDA should focus on evaluating these technologies and work with industry to ensure they are implemented.Dr. Scott Gottlieb, the new FDA commissioner, addressed the false dichotomy of speed versus safety in his congressional confirmation hearing. Through advances in regulatory science, he said that “we can have our cake and eat it too.” Gottlieb also said that the FDA should consider anything that can make the drug development process more predictive, such as better tools to evaluate safety and effectiveness and to bring down cost. Politics @PCRM Elizabeth Baker Log In | Learn More China Photos/Getty Images Tags drug developmentpolicyresearch By Elizabeth Baker May 11, 2017 Reprints Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED What’s included? Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. FDA drug testing doesn’t have to sacrifice safety, or animals, for speed What is it? About the Author Reprints [email protected] STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. GET STARTEDlast_img read more

At White House opioid commission meeting, insurance industry gets a scolding

first_img Next in line as Trump’s drug czar? Names of possible contenders start to circulate Insurance groups sought to highlight their own progress against the opioid crisis, citing efforts to bring prescription practices in line with guidelines from the Centers for Disease Control and Prevention, reduce stigma surrounding substance use disorder, and grow networks for delivering medication-assisted treatment.“Cigna came out 18 months ago and was proud to make a commitment to reduce commercial opioid use by 25 percent,” said Dr. Douglas Nemecek, Cigna’s chief medical officer. “Within the first year we were successful at getting halfway there, and we’re getting close to that full 25 percent reduction already. But that’s only the first of some of our goals.”Massachusetts Gov. Charlie Baker, another member of the opioid commission, expressed frustration with comments by the insurance industry.“I didn’t hear anybody talk about recovery coaches,” Baker said. “I didn’t hear anybody talk about how long you think somebody needs to be in treatment.”Missing from the conversation, Baker said, was discussion of “how we’re keeping score and keeping track of how we’re actually doing.”At a meeting last month, the opioid commission heard from representatives of the pharmaceutical industry, who have also shared blame for their role in the opioid crisis but who largely escaped the same scolding delivered to the insurance groups.The only non-industry testimony at that hearing came from Dr. Francis Collins, the director of the National Institutes of Health, and Dr. Nora Volkow, the director of the National Institute on Drug Abuse. The NIH and NIDA have worked this year to partner with industry groups on those efforts.The meeting Friday was also attended by three cabinet secretaries: Acting Health and Human Services Secretary Eric Hargan, Veterans Affairs Secretary David Shulkin, and Labor Secretary Alex Acosta, who appeared at Christie’s request to address his department’s role in enforcing parity law for insurers. Tags addictioninsuranceopioids New Jersey Gov. Chris Christie, the Republican who chairs the panel, later confirmed what the representatives from insurers including Cigna, Aetna, Anthem, Kaiser Permanente, and Blue Cross Blue Shield had likely already learned they should expect from the commission’s final report, due Nov. 1.“It’s going to be, so you’re prepared, a real call to action for all of you,” Christie told the insurance executives. “And that’s not to say that you’re not acting now. … But when 64,000 people died last year, it’s not enough. And I heard you all say that, too. But we now have to turn those words into action.”advertisement Patrick Kennedy, a member of the president’s opioid commission, said insurers “have treated mental health and addiction as if it’s something other than the rest of medicine.” Andrew Harnik/AP Please enter a valid email address. Newsletters Sign up for Morning Rounds Your daily dose of news in health and medicine. About the Author Reprints Privacy Policy Washington Correspondent Lev Facher covers the politics of health and life sciences.center_img Leave this field empty if you’re human: Rod Rosenstein, the deputy attorney general, also attended. While he mainly addressed the Justice Department’s efforts to curb fentanyl trafficking from China, Rosenstein also carefully addressed a recent Washington Post/“60 Minutes” report that resulted in Rep. Tom Marino (R-Pa.) asking President Trump to withdraw nomination for drug czar.That report said legislation that Marino pressed on Capitol Hill weakened the Drug Enforcement Administration’s ability to crack down on suspicious shipments from drug distributors.“Just to clarify,” Rosenstein said, “that publicity last weekend concerned DEA’s administrative authority to suspend shipments of pharmaceutical drugs, so that has not impacted our ability to prosecute criminal violations, including fentanyl [trafficking].”He did not refute the report’s assertion that the legislation hampered other areas of DEA enforcement.Much of the discussion surrounding the government’s response to the epidemic in recent months has focused on the potential for an emergency declaration, which President Trump on Monday said he would deliver next week.While none of the cabinet secretaries or commission members addressed that prospect explicitly, Kennedy became animated late in the meeting when speaking of the need to deliver more overdose reversal drugs to communities and for more doctors to prescribe medication-assisted treatment like methadone and buprenorphine.“We ought to be treating this like a FEMA response and getting the necessary medication,” Kennedy said. “If this were Ebola, we would be getting it out there to every practitioner in this country. We’d waive all the rules and we’d say get it done and start saving lives.”“That’s what we’ve been saying,” Christie concurred. @levfacher Related: Lev Facher By Lev Facher Oct. 20, 2017 Reprints HealthAt White House opioid commission meeting, insurance industry gets a scolding WASHINGTON — Patrick Kennedy, it seemed, had been waiting for a public opportunity to speak directly to the nation’s health insurers.“The historic treatment of addiction and mental illness has been a separate and unequal process,” the former Rhode Island congressman and a member of the president’s opioid commission told a group of insurance executives on Friday. “All of you, as insurers and payers, have treated mental health and addiction as if it’s something other than the rest of medicine.”The in-your-face scolding, delivered during a commission meeting, centered on the disparities between insurance coverage for addiction and other medical conditions. It underlined concern among other members of the commission that the insurance industry needs to take stronger action to help address the nation’s opioid crisis.advertisement [email protected] last_img read more

Professionalism isn’t something medical students absorb. It must be taught

first_img By David Rothman Aug. 24, 2018 Reprints Newsletters Sign up for First Opinion A weekly digest of our opinion column, with insight from industry experts. Tags educationphysicians Today more than ever, we need physicians who are committed to the principles of professionalism. The principles themselves are well-established: physicians must be altruistic, always putting their patients’ interests first and above their own; they must be committed to lifelong learning; they must be responsible for the quality of care that they and their colleagues deliver; and they must advocate for the well-being not only of their own patients but also the population at large.Yet medical educators haven’t always been methodical and diligent in teaching these tenets to the next generation of doctors. It isn’t difficult. It just requires an intentional focus on helping students build an ethical foundation that will let them balance competing needs and resolve moral dilemmas while also being good, caring, tolerant, and empathetic doctors.Here are five key reasons why medical educators must do a better job of teaching medical professionalism:advertisement Related: David Rothman Patient advocacy. Patients have become far more involved in and savvy about their care. The physician monopoly of medical knowledge is broken. Patients can investigate conditions on their own by doing a simple Google search or going to the website of countless disease-focused organizations. Given this, physicians must recognize that theirs is not the only voice in the room. Professionalism makes clear that they must be more open to the perspectives that patients bring to the encounter.Although these issues are making professionalism harder to maintain, it is also spurring innovative approaches that can serve as models for educational and professional institutions. In 2010, the Josiah Macy Jr. Foundation and the Institute on Medicine as a Profession, which I direct, launched a pilot program to encourage innovative methods for teaching professionalism to the next generation of physicians and establish professionalism as a standard to be instilled and cultivated through medical education.A new report summarizes lessons learned from that effort. It offers important best practices from 19 educational institutions that have been developing new models for teaching professionalism. Here are some key takeaways to guide future work:Put small grants to work. Providing small grants to medical schools had a catalytic influence on the institution. Involving faculty, students, residents, and staff in discussions about professionalism opened opportunities to discuss other issues, such as burnout and the physician’s role as advocate, and helped break down traditional barriers between students and faculty members. As a result, all 19 programs continued after the grant period and integrated professionalism into institutional curricula or residency programming.Faculty development is essential. No professionalism program will succeed without serious attention to faculty development. Since the explicit teaching of professionalism is relatively new, most faculty members have had little experience with it as learners or teachers. Consequently, professionalism needs champions at the highest levels of the organization. This is important for both role-modeling professionalism at all levels and for the necessary commitment of time and resources. Deans and chiefs of service need to be included and visible to students and residents. [email protected] Doctor-patient disconnect. There is a growing distance between doctors and their patients; in many cases, they have become strangers at the bedside. The rise of extraordinary specialization taking the form of hospitalists for hospitalized patients and laborists for pregnant women means that in many instances doctors cannot or will not know the patient they are caring for and the patient will not always know or have a prior relationship with the doctor at his or her bedside. Under these circumstances, maintaining trust is far more difficult than it is with an established doctor-patient relationship. Professionalism will ensure that patient interest continues to dominate the clinical encounter.Governmental oversight. State and federal governments now intrude regularly on physician autonomy. Professionalism must be invoked when government bodies regulate what doctors can say or must say to patients. In 2011, for example, the Florida legislature passed a bill that limited what physicians could say to patients about firearm ownership, even though that kind of information is important to protecting adult and child health. Although the law was overturned in 2017, physicians must clarify why such intrusions are not in the best interests of patients or communities. Transparent environment. Physicians today practice under a high level of transparency. The Physician Payments Sunshine Act reveals doctors’ financial connections with pharmaceutical and device companies, while electronic health records make their clinical decisions available for the scrutiny of employers and colleagues. Professionalism will help ensure that the data will be used to improve patient outcomes.advertisement About the Author Reprintscenter_img Please enter a valid email address. Healing the ‘moral injury’ of clinicians will take a village Related: Privacy Policy Dear fellow doctors: Please play nice Leave this field empty if you’re human: For example, a project at the University of Rochester Medical Center focused on enhancing faculty members’ skills and attitudes about patient-centered communication. It established a program in which surgeons are paired to give and receive feedback on improving communication skills with patients. The ultimate aim is to create a model for peer coaching that can be adopted by other specialties and departments throughout the medical center.Aim for longitudinal integration. Professionalism needs to be integrated longitudinally and through the educational experience. The content and principles of professionalism must be continually reinforced. Advocacy and community-based programs have been effective ways to teach and model professionalism. The University of California, San Francisco-Fresno Pediatrics Residency Program is partnering with the Fresno United School District, Fresno State University, and other organizations to foster the development of lifelong advocacy skills among medical students.Pay attention to burnout. Unprofessional behavior can be a manifestation of burnout, which both faculty members and students experience. Burnout makes it difficult to put patient’s needs first. Re-instilling professionalism with its accompanying commitment to purpose can be a strong antidote to burnout. Already overburdened faculty must not see this as an additional assignment but as an opportunity to be reinvigorated. Empathy and tolerance of ambiguity in medicine are critical tenets of professionalism, yet they are not taught or tested in medical training.To combat burnout, Thomas Jefferson University joined forces with the Lantern Theater Company of Philadelphia to help physicians, residents, nurses, and medical students process the complexities of their daily experience into theatrical vignettes that will be performed. Participants are tested on empathy, tolerance for ambiguity, and burnout. Studies show that watching drama might increase empathy; this program is testing whether performing it might actually have a longer-lasting effect.Today’s health care environment places multiple stressors on doctors and other health professionals who want to put their patient’s needs first. They are confronted by increasing demands on their time, energy, and abilities. Despite these hurdles — indeed, because of these hurdles — educators in the health professions must step up and adopt a more deliberate and integrated approach to teaching professionalism.David Rothman, Ph.D., is the president of the Institute on Medicine as a Profession. Time of transformation. We are at a moment of extraordinary transformation in how medical practice is organized. Once upon a time, patients saw solo practitioners — visiting one-to-two-person offices in which the physicians were completely in charge of both the business side and the medical side of the practice. That period is over. Physicians now are usually salaried, and therefore subject to the incentives and disincentives offered by their employers. Professionalism helps ensure that patient interests, not employers’, predominate in clinical care. Adobe First OpinionProfessionalism isn’t something medical students absorb. It must be taught last_img read more

Watch: CEO Daniel O’Day says Gilead is in a ‘sweet spot.’ What’s next?

first_img Log In | Learn More Watch: CEO Daniel O’Day says Gilead is in a ‘sweet spot.’ What’s next? What’s Gilead going to buy?That’s the single, persistent question Daniel O’Day has faced in his first months on the job as CEO of Gilead Sciences.  By STAT staff Jan. 31, 2020 Reprints Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Tags biotechnologyfinanceSTAT SummitSTAT+ About the Author Reprints STAT staffcenter_img What’s included? STAT Summit What is it? Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Gilead CEO Daniel O’Day Emilie Pickering for STAT [email protected] GET STARTEDlast_img read more