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Drug companies are people, gun control, and immigration and health

September 17, 2015

In order to bring you more of the news you want to read, RightCare Weekly summarizes and interprets three important articles and provides headlines linking to the many other articles and editorials you’ll find interesting. As always, RightCare Weekly presents articles related to moving our healthcare system toward the right care for all patients.

Join the conversation: Post your comments in our section at the bottom of this page.

 

Features:

 

Current policy dictates that drug companies may not advertise drugs for unapproved uses. However, two companies are suing the FDA for not allowing them to promote their drugs for a range of off-label uses, claiming this infringes their First Amendment rights. The ruling could have far-reaching implications for patients and doctors, The Boston Globe reports. Drug companies have already won several small victories in this arena, and health experts express concern that the industry is headed toward less oversight – and patients may be headed for more harm. Shannon Brownlee, MSc,  Senior Vice President of the Lown Institute, wrote in a blog post last week, “[The FDA] is an agency under siege, whose power to protect the public from bad science and dangerous or ineffective drugs is being steadily eroded by Congress and the courts.” And Jerry Avorn, MD, professor of medicine at Harvard Medical School, laments, “It’s a very worrisome situation.” Independent watchdogs are not equipped to replace the FDA as industry watchdog. The Boston nonprofit Institute for Clinical and Economic Review has recently begun a series of cost-effectiveness reviews for certain prescription drugs, but with only 22 employees, its reach is limited. ICER is hosting a hearing in Boston next month on its approach.

 

Not even the devastation at Sandy Hook Elementary School in 2012 has put a stop to meaningless mass shootings, which are defined as four or more individuals being hit. Since then, there have been 887 mass shootings in the United States. For long, we’ve called gun deaths a public safety concern, but they’re very much a public health concern, often involving the mentally ill; today more people die by guns than by cars in the U.S. But the largest threat from guns isn’t from people killing others, it’s from suicide. Of the 40,000 suicides that occurred in 2013, half were committed with guns. A recent study by Johns Hopkins, examined suicide-by-gun data from Missouri, which repealed its permit to purchase guns, and Connecticut, which has a permit to purchase policy. The authors concluded that permits can potentially reduce suicides, making it more difficult for at-risk parties to purchase guns. Laws are one means for restrictions, but sensible measures like securing guns under lock, as advocated by the The New York Times, is a step in the right direction. Suicidal thoughts are believed to be transient, and not having a firearm at hand might give a distraught person the pause needed to change his or her mind. Above all, better mental healthcare access in the country is imperative, now more than ever.

 

In Texas last week, the Houston Post reports, a woman arrived at a gynecological office for an appointment, and was led to an exam room under the pretense that she was going to receive her annual exam. When she filled out the intake paperwork, staff suspected that her ID was fake, and they called the county sheriff. Instead of seeing her doctor, the woman was met by police and arrested for being an undocumented immigrant. Many have expressed concerns over the backlash this might have for other undocumented immigrants seeking care, and whether such an action by the medical office staff violates HIPAA. These concerns are particularly salient now, as 400,000 immigrants had their insurance canceled due to immigration and citizenship issues, according to Modern Healthcare.  While government leader incumbents and hopefuls debate immigration policy, there are small steps that states have taken to improve access to care. For example, California lawmakers recently passed a bill mandating that pharmacists provide prescription drug labels in five languages, in addition to English.

 

Announcements:

 

  • The BMJ is holding a one-day conference on medical investigative journalism to share tips and  techniques that have led to the journal’s major investigations over the years. The event, by invitation only, will be held on Tuesday, November 10 at Soros HQ, New York, NY. Contact Emma Hayes, ehayes@bmj.com for details and an invitation.

 

  • For RightCare Action Week, how about going on a few “rounds” with your hospital chaplains? Leave your white coat and stethoscope in your office, and go pay a few visits to patients as a chaplain’s apprentice. You’ll be amazed at what you will learn. This idea was submitted to the RightCare Action Forum and found here. What do you think? Join the conversation.

 

Headlines:

 

Overtreatment/overdiagnosis

 

More on the FDA

 

End-of-life care

 

Practice

 

Social determinants

 

Hospitals

 

Med ed

 

Patient safety

 

Cost of care

 

Prevention

 

Doctor-patient communication

 

Evidence-based medicine

 

Design

 

RightCare Weekly is made possible through the generous support of the Robert Wood Johnson Foundation.

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