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These Illegal Drugs Are Important Medicines | The War on Drugs
Posted on March 31, 2023 by Pharmaciststeve
this is the result of our FDA lacking the cojones and chutzpah to make these dangerous procedure ILLEGAL
Posted on March 30, 2023 by Pharmaciststeve
I have read where 5% of pts that get ESI ( Epidural Spinal Injections) will end up with arachnoiditis https://en.wikipedia.org/wiki/Arachnoiditis.. it is very painful – irreversible disease – These type of ESI are ILLEGAL in just a few countries, but our FDA and Pfizer that makes the most used med in these injections – DO NOT RECOMMEND this med to be used in ESI – apparently our FDA has neither the chutzpah nor cojones to ban these dangerous procedures
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If you can no longer get the ADD/ADHD meds you were prescribed before the pandemic
Posted on March 30, 2023 by Pharmaciststeve
After the DEA loosen what could be done via tele-video office visits….below are hyperlinks of two of the major players – there were also many more – in tele-video office for diagnosing and prescribing controlled substances – especially ADD/ADHD meds without the pt being seeing for an in person exam – as required by the Controlled Substance Act.
https://www.medpagetoday.com/psychiatry/adhd-add/103798
Prescriptions for Stimulants Jumped During the Pandemic
Data might signal improved adult ADHD awareness, but questions remain about pandemic prescribing
Prescriptions for stimulants have risen in recent years, with the sharpest increases seen during the pandemic, according to the CDC.
In an analysis of claims from employer-sponsored insurance, the percentage of enrollees with one or more prescription stimulant fills rose from 3.6% in 2016 to 4.1% in 2021, Melissa Danielson, MSPH, of the CDC, and colleagues reported in Morbidity & Mortality Weekly Reportopens in a new tab or window (MMWR).
The largest single-year increases were seen during 2020-2021, with the annual percentage change exceeding 10% in many groups, Danielson and colleagues reported.
“Although improved access to ADHD care through telehealth during the pandemic might have benefitted some persons with ADHD symptoms, it might have also introduced the potential for inadequate ADHD evaluations and inappropriate stimulant prescribing,” the researchers wrote.
Using employee-sponsored insurance claims from the MarketScan database, Danielson and colleagues found that across all years, prescription stimulant fill rates remained stable or decreased among females ages 24 and under and rose modestly among those ages 25-64. However, during 2020-2021, prescription stimulant fills rose substantially among women in most age groups, with the largest annual percentage changes seen among those ages 15-44 and 50-54, ranging from 14.3% to 19.2%.
For males, the pattern was similar, decreasing slightly among those age 24 and under and remaining stable or increasing modestly among those ages 25 and up. But during 2020-2021, prescription stimulant fills rose substantially among those ages 25-44 and 50-54, with annual percentage changes ranging from 11.1% to 14.7%, the researchers reported.
Danielson and colleagues wrote that there are a host of factors at play regarding the uptick in prescription stimulants in 2020-2021. The pandemic had negative effects on mental health, which might have exacerbated ADHD symptoms. Changes in healthcare policy and reimbursement, including expansion of telehealth and easing requirements around in-person visits prior to prescribing stimulants and other schedule II substances might have also played a role, they said.
ADHD among adults has also been increasingly recognized over the years, Danielson and colleagues wrote. Most people in the study with one or more prescriptions for stimulants met the case definition for the receipt of ADHD care in the preceding or current calendar year, suggesting most were receiving ongoing care for ADHD, they noted.
Thus, the study calls attention to the need for clinical practice guidelines for ADHD in adults, they said. While guidance exists for treating children and adolescents, adult ADHD is a public health concern because of “challenges associated with the differential diagnosis of ADHD and general inadequate access to mental health providers trained to diagnose and manage” the condition in adults.
In an editorialopens in a new tab or window published in the Journal of Attention Disorders in conjunction with the MMWR report, Margaret Sibley, PhD, of the University of Washington in Seattle, and colleagues called attention to a lack of knowledge and support for research on adult ADHD.
The NIH RePORTER funding databaseopens in a new tab or window lists just under $5.5 million in active funding for adult ADHD research, whereas it lists over $42 million in pediatric ADHD research and at least 10-fold greater support for depression research compared with ADHD research overall, “despite only slightly higher population prevalence of depression,” they wrote.
“ADHD needs to now take its rightful and more central place in adult mental healthcare,” Sibley and colleagues wrote.
At the same time, they acknowledged that, during the pandemic, digital startups “recognized a mounting demand for adult ADHD treatment” and companies capitalized on relaxed regulations.
“Did these companies drive 2021’s spike in stimulant fills and subsequent 2022 stimulant shortage?” they wrote. “Start-ups may have shouldered an urgent need for adult ADHD care during the pandemic. However, their purported methods (widespread online advertising, quick assessments, and one-size-fits-all prescription of stimulants) may have oversupplied stimulants to U.S. adults.”
When the U.S. Public Health Emergency endsopens in a new tab or window, patients will once again be required to have in-person visits with clinicians before stimulants can be prescribed, the authors noted.
The study included several important limitations, including the fact that it might not be generalizable outside of people with employer-sponsored insurance; it did not include extensive demographic information; it didn’t capture stimulants procured through other means; and it couldn’t discern whether stimulants were prescribed for conditions other than ADHD.
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Some Mexican pharmacies sell pills laced with deadly fentanyl to U.S. travelers
Posted on March 26, 2023 by Pharmaciststeve
Some Mexican pharmacies sell pills laced with deadly fentanyl to U.S. travelers
https://www.npr.org/2023/03/14/1163146258/fentanyl-mexico-pharmacy-american-medical-tourism-overdose
Some Mexican pharmacies that cater to U.S. tourists are selling medications that appear safe but are laced with deadly fentanyl and methamphetamine.
That’s the conclusion of new research that examined medications purchased legally in four cities in northern Mexico where travelers from the U.S. often seek low-cost health care and pharmaceuticals.
“For pills sold as oxycodone, we tested 27 and found 10 or 11 of them contained either fentanyl or heroin,” said Chelsea Shover, a researcher at the UCLA School of Medicine.
She said the behavior by retail pharmacies in Mexico puts unsuspecting people at high risk of overdose and death.
“When I see there are fentanyl pills somewhere that look like [prescription drugs], I know there have to have been people who’ve died from that,” Shover said.
Her team also found medications sold at Mexican pharmacies laced with methamphetamines.
While these drug stores sell medications to Mexican consumers, Shover says their main customers appear to be Americans.
“Similar products are available at a much lower price in Mexico, so Americans do travel to save money.”
Two Democratic lawmakers sent a letter to the U.S. State Department calling for a travel advisory to warn Americans of the danger of purchasing medications in Mexico.
“We should be absolutely very concerned,” said Rep. David Trone (D-Md.), one of the authors of the letter. “We have almost 12 million Americans visiting Mexico every year.”
According to Trone, pharmacies boosting profits with the high-risk practice are located in communities where Americans travel seeking relief from high-cost prescription medications sold in the U.S.
“There’s literally a pharmacy on every corner, they’re everywhere down there, because the price of drugs is cheaper.”
On Saturday, the Los Angeles Times reported State Department officials apparently knew about the danger posed by Mexican pharmacies as long ago as 2019 but failed to issue a high-profile alert to travelers.
According to the newspaper’s investigation, at least one U.S. traveler is known to have overdosed and died after taking medications purchased at a drug store in Cabo San Lucas, Mexico, in 2019.
Rep. Trone said if U.S. officials knew about unsafe medications being sold at legal outlets in Mexico, they should have warned travelers sooner.
“We’ve heard nothing back [from the State Department] and it’s very frustrating,” he added.
The State Department sent a statement to NPR saying it wouldn’t comment on the letter from lawmakers.
On background, an official pointed to an advisory included in the State Department’s standard on-line information about Mexico that urges travelers to “exercise caution when purchasing medications overseas.”
“Counterfeit medication is common and may prove to be ineffective, the wrong strength, or contain dangerous ingredients,” the advisory reads.
There’s no reference, however, to the specific risks of dangerous drugs laced with fentanyl sold at legal pharmacies.
During a press briefing Monday, spokesman Ned Price said American officials constantly update safety advisories issued for Mexico.
“We are always looking at information to determine whether it is necessary to move our travel warnings in one direction or another,” he said.
Earlier this month, four Americans were kidnapped by gunmen while traveling to Mexico to seek low-cost medical care. Two of them were killed.
That case had already raised concerns about the safety of medical tourism in the country.
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FDA: Watch for Joint Replacement Device Failure After Exactech Recall
Posted on March 24, 2023 by Pharmaciststeve
FDA: Watch for Joint Replacement Device Failure After Exactech Recall
Revision surgery only recommended for patients with pain
https://www.medpagetoday.com/orthopedics/orthopedics/103686
The FDA reminded healthcare providers and patientsopens in a new tab or window on Thursday that several Exactech joint replacement devices packaged in defective bags should be closely monitored for device wear or failure.
Many of the devices for knees, ankles, and hips — which were manufactured by Exactech from 2004 to August 2021, and recalled in 2021 and 2022 — were packaged in bags that were missing one of the oxygen barrier layers that protect devices from oxidation, which can degrade the plastic component before it’s transplanted into the patient.
Proper packaging features multiple oxygen barrier layers to protect the device from air, the agency noted in their safety communication.
Oxidation of this polyethylene component may cause a slew of issues for patients, such as pain, bone loss, component fracture, device failure, premature device wear, or swelling of the area, all of which may result in the need for revisional surgery.
Exactech first recalled only certain hip replacement devices due to premature wear without a known cause. This was labeled as a Class II recall — the second most serious grade indicates that the “product may cause temporary or medically reversible adverse health consequences, or the probability of serious adverse health consequences is remote.”
By February 2022, the manufacturer expanded a voluntary recall for certain knee replacements and total ankle replacements packaged in the defective bags, regardless of the device’s label or shelf life. An estimated 80% of knee and ankle replacement devices manufactured since 2004 were packaged in defective bags.
Later that year, the company expanded its hip replacement device recall to include all hip devices with polyethylene components packaged in defective bags.
“The FDA is working with Exactech to assess whether any of its other joint implants that contain polyethylene components packaged in defective bags may result in increased oxidation and similar risks,” the agency said.
The FDA recommended that no future implant surgeries be performed with any of the recalled knee, ankle, and hip devices. The agency also advised that healthcare providers monitor patients who have any of these implanted devices for possible wear, failure, and resulting bone loss. If there is a device failure suspected, providers should consider performing x-rays.
For patients who are experiencing pain, revisional surgery should be discussed on a case-by-case basis. That being said, it’s currently not recommended that joint replacement devices be removed from patients who aren’t having any new or worsening pain.
Patients are recommended to contact their healthcare providers about any pain, swelling, weakness, grinding, noise, or inability to bear weight on the device.
Exactech has set up an online databaseopens in a new tab or window for recalled knee and ankle devices that are searchable by device serial number.
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Ascend Laboratories LLC. Issues Voluntary Nationwide Recall of Dabigatran Etexilate Capsules, USP 75 mg and 150 mg, Due to the Detection of N-Nitrosodimethylamine (NDMA) Impurity
Posted on March 24, 2023 by Pharmaciststeve
Ascend Laboratories LLC. Issues Voluntary Nationwide Recall of Dabigatran Etexilate Capsules, USP 75 mg and 150 mg, Due to the Detection of N-Nitrosodimethylamine (NDMA) Impurity
Summary
- Company Announcement Date:
- FDA Publish Date:
- Product Type:
- Drugs
- Reason for Announcement:
-
Detection of N-Nitrosodimethylamine (NDMA) Impurity
- Company Name:
- Ascend Laboratories LLC.
- Brand Name:
-
Ascend Laboratories
- Product Description:
-
Dabigatran Etexilate Capsules, USP
Company Announcement
FOR IMMEDIATE RELEASE- Parsippany. New Jersey. Ascend Laboratories LLC. is voluntarily recalling Dabigatran Etcxilate Capsules. USP 75 mg and 150 mg to the consumer/user level due to the presence of a nitrosamine. N-nitroso-dabigatran, above the established Acceptable Daily Intake (ADI) level. To date, Ascend Laboratories LLC., has not received any reports of adverse events related to this recall.
Nitrosamines are common in water and foods, including cured and grilled meats, dairy products and vegetables. Everyone is exposed to some level of nitrosamines. These impurities may increase the risk of cancer if people are exposed to them above acceptable levels over long periods of time.
The product is used as an oral anticoagulant to lower the risk of stroke and blood clots.
The NDC. Lot Number. Expiration Date. and Packaging Configuration details for Dabigatran Etexilate Capsules that are subjected to this recall are indicated in the table belov,:. The product lots were distributed nationwide to wholesalers, Distributors and Retailers (dispensers) in the United States from June 2022 to October 2022.
| Product | NDC | Lot Number |
Expiration Date |
Presentation | Configuration /Count |
|---|---|---|---|---|---|
| Dabigatran Etexilate Mesylate Caps 150 Mg |
67877-475-60 | 22142448 | MAY.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 150 Mg |
67877-475-60 | 22142449 | MAY.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 150 Mg |
67877-475-60 | 22142450 | MAY.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 75 Mg |
67877-474-60 | 22142462 | MAY.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 75 Mg |
67877-474-60 | 22142463 | MAY.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 75 Mg |
67877-474-60 | 22142464 | MAY.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 75 Mg |
67877-474-60 | 22143000 | JUN.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 75 Mg |
67877-474-60 | 22143001 | JUN.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 75 Mg |
67877-474-60 | 22143002 | JUN.2024 | HDPE Bottles |
60 capsules/bottle |
| Dabigatran Etexilate Mesylate Caps 150 Mg |
67877-475-60 | 22143845 | JUL.2024 | HDPE Bottles |
60 capsules/bottle |
Wholesalers/distributors and pharmacies with an existing inventory of the lots listed in the table above, should stop use and distribution and quarantine the product immediately.
Wholesalers and Distributors are advised to recall the distributed product. Please notify any accounts or additional locations that may have received the recalled product from you. Please conduct a sub-recall to those accounts and communicate this recall information immediately. Ascend requests that they immediately cease distribution of the affected product.
Patients who have received impacted lots of Dabigatran Etexilate Capsules, USP 75 mg and 150 mg are advised to continue taking their medication and contact their physician for advice regarding an alternative treatment.
Consumers with questions regarding this recall can contact Ascend Laboratories LLC. using the below information.
| Contact Center | Contact Information | Area of Support |
|---|---|---|
| Ascend Laboratories, LLC | 877-272-7901, 24 hrs., 7 days a week | To report adverse events and product complaints |
Consumers should contact their physician or healthcare provider if they have experienced any problems that may be related to taking or using this drug product.
Customers with medical-related questions, who wish to report an adverse event, or quality issues about the products being recalled should contact Ascend Laboratories LLC., by phone at: 877- 272-7901, 24 hrs., 7 days a week.
Adverse reactions or quality problems experienced with the use of this product may be reported to the FDA’s MedWatch Adverse Event Reporting program either online, by regular mail or by fax.
- Complete and submit the report Online: www.fda.gov/medwatch/report.htm
- Regular Mail or Fax: Download form www.fda.gov/MedWatch/getforms.htm or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
This recall is being conducted with the knowledge of the U.S. Food and Drug Administration.
Company Contact Information
- Consumers:
- Ascend Laboratories LLC.
- 877- 272-7901
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David Fincher: The Bleeding Edge (The Definitive Documentary) – The Directors Series
Posted on March 24, 2023 by Pharmaciststeve
BCBS takes steps to respond to opioid abuse
Posted on March 23, 2023 by Pharmaciststeve
This article is from Aug 2017, and according to this .. their timetable for and contributing factors to opiate epidemic. Once again Congress gets a pass on their passing of the Decade of Pain Law that became law in 1999-2000. That was a significant cause of the creation of “the fifth vital sign” and the joint commission adopted that as a major standard that hospital had to address pt’s pain and most had discharge surveys that included a question if their pain was well treated. When the law expired the political party in control of Congress had flipped and it was not renewed. The “fifth vital sign” DISAPPEARED and no longer any concern of the Joint Commission. Opiate Rxs peaked in 2011-2012 and have dropped every year since and now about 60% down from their peak, but the number opioid poisoning – most all from illegal “street fentanyl” has increased SEVEN TIMES in the last 10 yrs. It seems, that most all bureaucrats still believes that the “jury is still out on the matter of prescribing opiates to treat pain doesn’t cause addicts ” Since “we” don’t track suicides from untreated pain and/or premature deaths from under/untreated pain very well… “we” really don’t seem to care how many people are dying while bureaucrats are trying to satisfy their opiophobia.
BCBS takes steps to respond to opioid abuse
https://mibiz.com/sections/health-care/bcbs-takes-steps-to-respond-to-opioid-abuse
Jody Gembarski, pharmacy manager at Blue Cross Blue Shield of Michigan
Nearly one in five Blue Cross Blue Shield of Michigan members had a prescription for an opioid filled in 2015. The dispensing rate nationally was higher, at 21.4 percent. Between 2010 and 2016, the 36 Blue Cross Blue Shield plans across the U.S. recorded a 493-percent spike in enrollees diagnosed with a disorder associated with opioid use. Those statistics from the Chicago-based Blue Cross Blue Shield Association reflect the opioid epidemic in America that in 2016 resulted in more than 33,000 overdose deaths. MiBiz spoke with Jody Gembarski, a pharmacy manager at Blue Cross Blue Shield of Michigan who oversees its controlled substance work group, to discuss the association’s analysis and the role the state’s largest health insurer has in responding to the epidemic.
What do you make of the Blue Cross Blue Shield Association data on opioid use?
There clearly is a problem with opioids for our members and across the nation. Michigan definitely has a problem. You can see the statistics. We have a high dispensing rate of opioids and high opioid use disorder. It’s definitely a problem and we are very invested in attacking that and seeing what we can do to improve the situation for everyone involved.
What can Blue Cross Blue Shield of Michigan do?
We try to look at it on multiple different avenues. There’s no one solution that fixes this. We look at it from the providers, our physicians and health care providers that are involved with this. We have educational webinars (and) an opioid toolkit for them to use. We encourage them to check the Michigan Automated Prescribing System that will let them see if the member and their patient has gone to a physician a week before or a month before (for an opioid prescription).
What about from the member perspective?
We have a new pilot program that focuses on overdoses and trying to get those members connected to treatment or help. My controlled substance work group, what we do is we monitor claims and if somebody has a concerning behavior, we try to connect them with appropriate resources, whether behavioral health, case management, a pain management referral, or even treatment of a substance abuse disorder that they have.Do you have a way of identifying doctors who perhaps are outside of the norm and have a higher prescribing rate for opioids?
We have a corporate and financial investigations unit. They do look at prescribers who are outliers and compare them to their peers and they investigate those prescribers. There is a whole process to evaluate physicians prescribing opioids, and we have a process to remove them from our network. A lot of times we are ahead of the state and federal government because we have our own data. We actually receive reports from the Centers for Medicare and Medicaid Services — it’s a prescriber outlier report — and we take action on that as well.
Is Blue Cross getting more aggressive in identifying outliers prescribing opioids?
We’ve definitely increased our focus there as we’re seeing how much the opioid epidemic is impacting everything. We are looking much more closely at those that are outliers and identifying what’s going on (and) why. It’s definitely a high priority for us.
Why should this be an issue for employers?
The impact of the opioid epidemic is significant. It’s raising health care costs overall with the prescribing of opioids, and then once somebody is addicted, it is very costly for the health care system. The cost for the health care system is definitely going to impact employers and everyone else involved.
What should an employer do?
Ask what type of programs are in place from the health care provider that they have. We have a list of initiatives and programs and things that we do to help identify fraud, waste and abuse. We have initiatives in providing treatment of our members. As an employer, it is worth investigating and asking the question of what’s being done from the health provider perspective? What are you doing to help improve the situation or decrease prescribing?
Is there any consensus out there on what led to the epidemic?
There are a number of factors and we all ask, ‘What’s the root cause?’ Some of the national meetings that I sit on, there is discussions about how in the ’90s there was this push about the ‘fifth vital sign’ and pain management. That was kind of the focus and people shouldn’t be in pain if they’re having pain. Maybe that fueled a little. Everyone you talk to might have a different idea about that, but that is something that is on the table. There was this focus on pain management. It wasn’t being assessed appropriately and it wasn’t given enough attention. That could be the reason that partly led to this, but that’s not the reason. I don’t think there’s one reason. There are multiple things that led to this and it’s kind of hard to point to something.
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Sen. Tammy Baldwin (D-Wisc.): we don’t only try to prevent people from taking up a drug
Posted on March 23, 2023 by Pharmaciststeve
Is Sen. Tammy Baldwin (D-Wisc.) suggesting that opiates should not be prescribed to treat pain and/or all opiate prescribing creates addicts ?
Senators Press HHS Chief on Alzheimer’s Drugs, Opioids at Budget Hearing
https://www.medpagetoday.com/publichealthpolicy/healthpolicy/103674
WASHINGTON — Alzheimer’s disease treatments, the opioid epidemic, and funding for rural healthcare were all in the spotlight during a Senate hearingopens in a new tab or window on the Biden administration’s proposed budget for the Department of Health and Human Services (HHS) in fiscal year 2024.
“It is with great disappointment that [I understand] CMS [the Centers for Medicare & Medicaid Services] is blocking and acting as a roadblock for patient access to drugs that could be very helpful to these patients,” Sen. Susan Collins (R-Maine) told HHS Secretary Xavier Becerra, the lone witness at Wednesday’s hearing held by the Senate Appropriations Subcommittee on Labor, HHS, Education, and Related Agencies. “I just do not understand CMS’s misguided and outright unprecedented decision to not cover a whole class of Alzheimer’s drugs. It is not CMS’s job to second-guess the drug approvals of the FDA. That’s not what CMS is supposed to do.”
Collins was referring to the agency’s decision in Januaryopens in a new tab or window not to cover the Alzheimer’s disease treatment lecanemab (Leqembi) for Medicare beneficiaries unless the beneficiary is enrolled in a clinical trial of the drug. The FDA approved lecanemabopens in a new tab or window under an accelerated approval pathway, as it had done with aducanumab (Aduhelm) in 2021opens in a new tab or window. Medicare also has the same coverage requirement for aducanumabopens in a new tab or window.
“It’s not enough to say you can get it if you’re in a clinical trial,” Collins continued. “That’s so little help to states like ours where there may not be a clinical trial going on, or it may be far away from most people in the state. I’m just asking you to tell CMS to let this drug be used, and let people get access to it when the patient and the clinician agree it’s the appropriate treatment.”
But Becerra pushed back. “There’s no doubt we want to get to the type of lifesaving treatment Americans can benefit from,” he said. “The difficulty here is that we have to remember that the process that the FDA uses is different from the process that legally CMS must use to make their determinations. And while it may not make a lot of sense to folks, there is a legal distinction. And CMS has to remain consistent in the way it treats any drugs.”
Subcommittee chair Sen. Tammy Baldwin (D-Wisc.) asked Becerra to discuss the administration’s plans for tackling the mental health and substance use disorder crises, which have worsened during the pandemic. “In my state of Wisconsin, there were over 1,427 opioid-related deaths in 2021, a 16% increase over 2020 and a 70% increase over the number of deaths in 2018,” she said. “I know my colleagues are seeing similar grim statistics in their states. Of particular interest, I will want to know what the administration is doing to curb the tragic increase in overdoses and poisonings due to fentanyl. This drug is wreaking havoc across the country, and we must partner to take an ‘all of government’ approach to prevent it from coming into our communities.”
“This budget invests some $11 billion, including some $10 billion in discretionary funding for programs that try to target opioids and overdose-related activities,” Becerra said. “It is a significant increase over previous years, and it complements the work that we’ve done to establish a new strategy when it comes to drug overdose and treatment, where we don’t only try to prevent people from taking up a drug, but also … we worry about harm reduction, to make sure that we’re preventing people from harming themselves before they finally can get the treatment they need.” HHS also is investing in post-treatment services so people become productive members of society after they finish treatment, he added.
Sen. Cindy Hyde-Smith (R-Miss.) asked what HHS was doing to help keep smaller, rural hospitals open. Although hospitals are paid a set amount for each patient’s illness using the diagnosis-related group (DRG) system, “patients are staying longer and they’re exceeding those DRG payments, and hospitals are losing money hand over fist,” she said. “They’re held longer in their smaller hospitals while waiting for bed placements in a larger hospital … But how do we overcome a financial challenge that was made worse by COVID and inflation? Have you or the agency considered establishing a temporary per diem payment to the hospitals to help address this?”
Becerra agreed this was a problem. “Everyone is trying to figure out: How do we get resources and commitments into these communities?” he said. “One of the things we’re trying is [with] graduate medical education slots … Maybe we could try to get some of these into communities that haven’t always had these teaching slots available, because the evidence shows that if you locate a student in the residency program, by the time they finish that residency program in that community, they often stay there and develop their practice there.”
Hyde-Smith seemed dissatisfied with that answer. “So are you saying that a temporary per diem is not being considered?”
“I have to get back to you — I’m not sure if that is one of the considerations,” said Becerra. “I would suspect that one of the issues with a temporary per diem would be the cost. Where would the money come from to do that?”
Sen. Jeanne Shaheen (D-N.H.) wanted to know how well the $35-per-month cap on insulin copayments for Medicare beneficiaries — passed as part of the Inflation Reduction Act — was working. “Do we have any data that shows what the impact of that has been?”
“We’re beginning to collect the data,” Becerra said. “And the anecdotal stories I’m hearing from actual insulin users is perhaps the best evidence.” He cited a North Carolina woman he had spoken to who was shocked when she was only charged $35 for her monthly supply of insulin after previously paying $117. “She went back to the insurer and said, ‘I think I owe some money.’ She had to be told, ‘No, that’s the cost now.'”
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A conversation with Kristen Ogden, patient advocate for Dr. David Bockoff
Posted on March 21, 2023 by Pharmaciststeve
A conversation with Kristen Ogden, patient advocate for Dr. David Bockoff
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