Health Affairs

Patients' access to medical marijuana has dramatically increased despite the lack of Food and Drug Administration approval. Joseph W. Thompson of Arkansas Center for Health Improvement and UAMS - University of Arkansas for Medical Sciences and coauthors assessed the conditions under which individuals were certified for medical marijuana and examined the evidence of physician collaboration in traditional care. Read the full article here: https://lnkd.in/eQ4cNmjq

We're excited to note that a recent Forefront article on children's health and affordable housing was authored by Michael Luke, MD, a Fellow in the Health Equity Fellowship for Trainees (HEFT). Congratulations, Michael, on this publication! https://lnkd.in/eHx6sZqe HEFT provides multi-layered mentorship to early career health equity researchers. As part of the program, HEFT fellows receive mentorship from experienced Health Affairs authors and editorial staff for 18 months. https://lnkd.in/eCvy-HA9

The inflationary rebate provisions of the Inflation Reduction Act of 2022 require pharmaceutical manufacturers to pay money back to Medicare if they raise prices faster than inflation. Marissa B. Reitsma of Stanford University and coauthors describe the potential impact of extending inflationary rebates to commercial plans. Read the full article here: https://lnkd.in/gSV8WkB7

In their new Forefront article, Gigi Hirsch, Sharon Phares, and Peter Neumann from Tufts Medical Center discuss how incorporating systems thinking into drug value assessment promises more realistic evaluations of the impact of new therapies, but it requires buy-in from policy makers, biopharmaceutical firms, clinical leaders, patients, payers, and investors. "Value assessments can influence coverage policies for medications. However, the gap between projected and realized value can be profound. Cost-effectiveness analyses and budget-impact assessments that ignore real-world access barriers can themselves exacerbate barriers to access because they can distort coverage and pricing policies and diminish public trust. For example, the introduction of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) was projected to have a major impact on payer budgets (as much as $108 billion over five years) under the assumption of uptake by approximately 2.6 million of the roughly 18.0 million Americans, with heterozygous familial hypercholesterolemia (FH) or with prior heart attack or stroke, who are unable to lower their LDL cholesterol with statins and diet. At least in part reflecting these concerns, payers implemented strict prior authorization criteria. In reality, use was much lower than anticipated, with less than 1 percent of patients with heart disease initiating PCSK9i therapy in the four years following their market entry." Read the full article here: https://bit.ly/43yegaw

In her new #Crossroads article, Katie Keith of the O'Neill Institute for National and Global Health Law summarizes several recent actions by President Trump and his administration in the last 50 days, including a dizzying array of health policy and related actions—from new executive orders to federal funding freezes to aggressive moves to reshape the federal government. "One issue to watch is how much the Trump administration’s health policy agenda will be affected by the chaos and turmoil at federal agencies as a result of layoffs and other actions by the Department of Government Efficiency and other directives from President Trump and the Office of Management and Budget on staffing reductions, agency reorganizations, and the use of federal funds. These layoffs are expected to have short- and long-term consequences for the public’s health and the health programs that millions of Americans rely on, including Trump administration health policy priorities." Read the full article here: https://bit.ly/4kG5IEE

This Women's History Month, we're elevating women who work to advance health equity and policy, such as Jacqueline Fiore. In a June 2024 article, Fiore and colleagues at the Centers for Medicare and Medicaid Services document national health expenditure data for 2023-2032. Among other findings, the report projects that health spending growth is expected to outpace gross domestic product (GDP) growth, resulting in a health share of GDP that reaches 19.7%. Read the full article: https://lnkd.in/etV_r9e3

In their new Forefront article, Hope Glassberg, Henry Chung, Jordanna Davis, Adam J. Falcone, and Anthony Shih of Decipher Health Strategies, the Albert Einstein College of Medicine, the Rockingstone Group, Feldesman Leifer LLP, and The Commonwealth Fund discuss how, without targeted investments, community health centers (CHCs) may struggle to fully engage in value-based payment (VBP), limiting their ability to drive cost savings and improve outcomes. "To support CHCs under VBP models, policymakers should prioritize enhancing visibility into VBP participation and performance. Dedicated funding is also essential, including temporary infrastructure payments or grants to help CHCs build capacity and take on additional financial risk. Standardizing VBP contracting terms can further reduce administrative burdens and streamline payer-provider collaboration." Read the full article here: https://bit.ly/4iuhssd

In their new Forefront article, Spreeha Choudhury and Richard Hughes IV from Epstein Becker & Green, P.C. argue that, when the the Advisory Committee on Immunization Practices (ACIP) reevaluates its recommendations, it should give greater weight to feasibility and implementation considerations including provider choice, rather than subordinating these to minuscule cost-effectiveness differentials. "While aiming to streamline the meningococcal vaccination schedule, the committee has instead added complexity. As a result, providers are effectively asked to stock three separate vaccine products rather than two. The committee is expected to reevaluate the meningococcal vaccination schedule in 2025, and we believe that it must more fully account for implementation considerations, including provider choice." Read the full article here: https://bit.ly/3QMSDf7

In her new #Crossroads piece, Katie Keith of the O'Neill Institute for National and Global Health Law argues that regulatory and reimbursement pathways should consider indirect benefits in addition to direct health benefits when evaluating novel vaccines, therapeutics, and diagnostics. "Direct benefits can be categorized as health outcomes for the individuals receiving the products and are relatively straightforward to measure and incorporate in policy decisions. However, growing public health and technology assessment literature is addressing both the direct and indirect benefits (and risks) of vaccines and other biomedical products intended to prevent or reduce the severity of respiratory viral infections and other communicable diseases. These assessments can enable more confident conclusions about indirect benefits, including better insights into the impact of product use on the risk of transmission to others, as well as the impact of positive diagnostic tests on those who modify behavior to avoid exposing others." Read the full article here: https://lnkd.in/eQaYEi7h

In their new Forefront article, Ronald O. Valdiserri, David R. Holtgrave, and Julie Scofield of Rollins School of Public Health at Emory University, New York State Department of Health, and Defend Public Health discuss how recent policy directives from the White House seek to compel actions that are contrary to widely accepted standards of ethical public health practice. "Looking through the lens of public health ethics, the January 20th executive order (EO) that characterizes diversity, equity, and inclusion (DEI) programs as “radical” and “wasteful,” calling for their termination, is wrong-headed. A recent twenty-two year systematic review of DEI efforts recommended that outcomes should be standardized to better assess the long term consequences of DEI trainings. The authors of this systematic review emphasized the need for improvements in DEI efforts; they did not call for their eradication. If we fail to train practitioners and policy makers about the role that DEI plays in effective public health actions, we run the risk of miscommunication, misunderstood priorities, misplaced programs, wasted resources, and adverse public health outcomes." Read the full article here: https://bit.ly/3QNejb7