Viewpoints: Effectiveness Should Guide Doctors’ Prescribing; Climate Change And Medicine

Stat: Drug Effectiveness Should Influence What Doctors Prescribe
Physicians and payers have called for more outcomes-based drug pricing arrangements. These tie reimbursements to innovation and the value the drug provides, such as how well a drug reduces hemoglobin A1c (a measure of blood sugar) among people with diabetes, or alleviates skin plaques among people with psoriasis, or reduces fracture rates among those with osteoporosis, to name a few examples. Yet the execution of such programs is limited to a handful of agreements between payers and drug makers, each one unique to the parties involved. (Larry Blandford, 4/27)

The Des Moines Register: Saving Medicines, Saving Money, Saving Lives
After the rough, recently-concluded legislative session, you might need a reason to feel good about our state's priorities. Fortunately, if you were tuned in to NPR’s Morning Edition on Thursday, you would have gotten a strong dose of Iowa pride. Iowa, it turns out, is the envy of the nation for a unique lifesaving, cost-saving and environmentally friendly approach to providing no-cost medicines to people in need. It's based on reclaiming and redistributing unused prescription drugs through a drug donor repository. (Rekha Basu, 4/27)

The New England Journal Of Medicine: Preventive Medicine For The Planet And Its Peoples
For many Americans, the effects of climate change seem distant: island nations will sink beneath rising seas, areas of the Middle East will become uninhabitable because of extreme heat. But though the worst effects will be felt by poorer people in poorer countries that are less resilient to droughts, floods, and heat, climate change already affects the health of vulnerable U.S. populations, and U.S. health professionals see these effects. (David J. Hunter, Howard Frumkin and Ashish Jha, 4/27)

Cincinnati Enquirer: How The Trump Administration Is Fighting The Opioid Epidemic
One of the most exciting lines of work we get to support at the U.S. Department of Health and Human Services is the development of new drugs to combat deadly diseases. America’s scientists are constantly pushing the boundaries of what is possible, solving or ameliorating conditions we once thought incurable. So it is both heartening and heartbreaking that one of our top priorities in that work is now fighting a disease that is largely of our own making: opioid addiction. (Secretary of Health and Human Services Tom Price, 4/27)

The Washington Post: If Abortions Become Illegal, Here’s How The Government Will Prosecute Women Who Have Them
You’ve heard the stories of the coat hanger and the back alley, those bloody days before Roe v. Wade. Sen. Patrick Leahy told one recently at the Supreme Court confirmation hearings for Judge Neil Gorsuch. As a state prosecutor in 1968, three years before the court struck down state abortion bans, cops woke him up in the middle of the night, because “a young co-ed nearly died from bleeding from a botched abortion.” The senator from Vermont’s drift was clear: If confirmed, Gorsuch could cast a vote, or several, to bring back those horrors (if not the archaic phrase “co-ed”). (Irin Carmon, 4/28)

The New England Journal Of Medicine: Bridging The Data-Sharing Divide — Seeing The Devil In The Details, Not The Other Camp
The movement toward sharing data from clinical trials has divided the scientific community, and the battle lines were evident at a recent summit sponsored by the Journal. On one side stand many clinical trialists, whose lifeblood — randomized, controlled trials (RCTs) — may be threatened by data sharing. On the other side stand data scientists — many of them hailing from the genetics community, whose sharing of data markedly accelerated progress in that field. (Lisa Rosenbaum, 4/26)

The New England Journal Of Medicine: Learning What We Didn’t Know — The SPRINT Data Analysis Challenge
On January 28, 2016, the International Committee of Medical Journal Editors (ICMJE) posted for public comment a proposed plan on sharing clinical trial data. The response was starkly divided: data analysts called for immediate and open access to all clinical trial data; clinical trialists were convinced that investigators should hold data closely. Trialists argued that they would have no incentive to conduct trials if they weren’t given the opportunity to publish all their findings, while data analysts countered that data obtained under federally funded programs belonged to the public and should be available for examination. Ideally, at the center of the debate are patients who participate in clinical trials, often at great risk to themselves, who expect researchers and analysts to use the data in a responsible way to advance medicine. Although much subjective input was obtained, few respondents offered concrete examples on which to base directive action. (Nancy S. Burns and Pamela W. Miller, 4/26)

The New England Journal Of Medicine: Whose Data Are They Anyway? Can A Patient Perspective Advance The Data-Sharing Debate?
Most patients haven’t thought much about data sharing, according to Sara Riggare, but those who have “find the current system unreasonable. Patients expect that health care professionals and researchers use patient data in the best possible way. That there is a fight over what the best way is is perplexing and disappointing.” (Charlotte J. Haug, 4/26)

Tampa Bay Times: Adverse Childhood Experiences Can Have Long-Term Health Consequences 
Lungs expand, and every muscle sits on the verge of action. This describes the stress response, a normal reaction to a normal emotion. But when a child experiences strong, frequent or prolonged adversity, without adequate adult support, it's referred to as toxic stress, and there can be long-term health consequences. (Zach Spoehr-Labutta, 4/27)