Importing from our neighbor to the north?
The Trump Administration has been looking for a win on healthcare. This week they got more serious about the idea of importing drugs from Canada – putting together a roadmap for progressing a policy. HHS Secretary Alex Azar told reporters that the Administration has a plan to consider proposals for demonstration projects from state governments, pharmacies and drug manufacturers for safe importation.
Importing drugs from Canada is popular with voters, with a recent poll finding 80% favor the idea. It’s also bipartisan. Sen. Bernie Sanders (D-VT) took a trip to Canada with patients to purchase insulin this week and said it would be among the first things he does if elected President. However, it’s not without its critics – pharma and Canadians – who cite concerns about safety and shortages, respectively.
The Congressional Budget Office found that importation (if viable) could save the government roughly $7 billion over 10 years. But, is the policy all it’s cracked up to be? Some say “no.” Critics argue that the President’s plans would not address many biologics and specialty drugs which are those that often account for higher-priced copays and costs. Others argue that many generic therapies are actually already cheaper in the US than they are in Canada.
So, will Canadian drugs show up in your medicine closet soon?
Probably not. It will be some time before a policy like this could be implemented. Here’s what needs to happen:
- First, the Administration needs to issue a proposed regulation, give the public at least a month or more to comment formally on it, and then finalize the regulation.
- Then, states, pharmacies and drug companies would have to develop a plan. Three states already have laws to allow importation - Colorado, Florida and Vermont. But implementation has not been easy. Vermont has been working on its plan for over a year.
- Then, the Administration will start reviewing proposals; it is unclear how long that process would take.
An algorithm to predict the risk of STDs?
By Olivia Rothseid
Turns out, people want to talk to their doctors about sex just as much as they want to discuss it with their parents. And typically, those conversations only occur around fertility, or surrounding the risk of sexually transmitted conditions. But this could change, with a new study and predictive software algorithm from Harvard and Kaiser Permanente Northern California that reviews medical data for signs of men who may be at “high risk” for contracting HIV. The public health benefit could be substantial as physicians could proactively prescribe PrEP, a preventative treatment method, to patients who do not have HIV, but who may be at risk for it.
But such technologies – and forward-looking tools that predict social determinants of health -- are not without challenges.
For example, the inherent nature of social determinant of health predictors may more heavily focus on a single race, class or community. In the case of HIV, there is high prevalence rates within ethnic minority populations, particularly among African Americans, who account for the highest proportion of HIV infections. This can make engaging in conversations about risk, predictive data, and human behavior deeply sensitive.
Worsening matters is the fact that most physicians are not trained to discuss safe sex practices, and many patients are not comfortable asking. If you ask us, this lays the foundation for some sensitive, and potentially ineffective conversations.
So how should physicians and the public health community best identify and educate patients on their risk without profiling and discriminating against certain patient groups?
Our take: Providers need to engage community members in a way that makes them feel comfortable and places them in control. Today’s technological innovation will only reach its full potential through informed consent of new tools, culturally cognizant language, strong relationships, sensitive physician counsel, and appropriate educational resources.
Who wrote this? The managing editors of TWTW are Randi Kahn, who can't believe it's already August and Dana Davis, who is attending (another) 95th birthday party this weekend. Dana hangs out at the senior center on weekends (J/K).
Syneos Health Communications' Reputation & Risk Management Practice is a team of healthcare communications consultants, policy-shapers and crisis response specialists. We provide unique solutions to the evolving communications challenges in today’s healthcare industry, using evidence-based approaches to help our clients successfully navigate the most sensitive of situations.
Got thoughts? Contact Randi
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