Archive for the ‘Healthcare’ Category

Service of Protecting Your Personal Data

Thursday, February 6th, 2020

Fitness trackers Photo: sundried.com

I’m suspicious of any and all data sharing about my health, my DNA–you name it. Today’s protections can be gone in a flick of a pen with a law change or the information exposed to all as a result of a data breach. Lemmings happily line up to learn about their ancestry and I’m dead-set against that, as I’ve written in this blog, as I’m sure that information won’t be used solely to determine that great grandma came from Minsk.

Thorin Klosowski’s New York Times article, “What to Consider Before Trading Your Health Data for Cash–Don’t trade away your health data without considering the potential issues first” cemented my feelings on the subject.

Photo: healthdata.gov

Some are tempted by discounts, gift cards or financial rewards by an employer, HMO, health care plan or insurance company–or they are pressured by an employer or their team–to enroll in a wellness program involving a phone or fitness tracker. The idea: a healthy lifestyle will lessen the cost of health care.

The tracking device must be covered by the Health Insurance Portability and Accountability Act [HIPAA] or you are unprotected.

Klosowski wrote: “If a program or wearable tracking device is covered by HIPAA, your employer will never have access to the data collected, but if HIPAA doesn’t apply, you’re trusting those entities to not share the data with your employer, third-party ad agencies, or anyone else. Without HIPAA, a wellness program (or, more accurately, the operator or administrator behind it) may sell the health information it collects, which could put you at risk of having your data used against you or unlawfully in some way.”

You are not protected if the device is only HIPPA compliant.

compliancy-group.com

In addition “The U.S. Department of Health and Human Services also adds this distinction,” Klosowski wrote: “If a wellness program is offered as part of a group health plan, your information is protected by HIPAA rules; if the wellness program is offered directly by an employer, the information is not protected.”

In addition, warned Klosowski, you may be asked to answer survey questions you don’t want to, such as whether you plan on becoming pregnant in the next few years. You might now want your employer to know this. Also avoid programs that ask for genetic test results, he suggested.

You may be fine today and diagnosed with something dicey tomorrow that you’d prefer be kept under wraps. When Nora Ephron died her closest friends were shocked, some angry that she hadn’t shared that she had acute myeloid leukemia. She knew if the news was well known she wouldn’t be insured to work on big film productions. She was right.

With an administration that flirts with removing insurance protection for preexisting conditions or a promotion at work in the balance, it would seem that people should take extra care before enrolling in anything they might later regret. Would you be tempted to take money to wear a tracking device?

Photo: npr.org

 

Service of 5 Plus 2 Equals 10: A Hard Pill to Swallow

Thursday, March 7th, 2019

Photo: mathspig.wordpress.com

Of course the math in the headline is wrong. I’m writing about drug prices in this country and nothing about what they cost and why computes either.

Did you see the alarming New York Times editorial, “Getting Answers on Drug Prices,” published the day before last week’s hearing at which seven heads of pharmaceutical companies were to meet the Senate Finance Committee? They represented Pfizer, Sanofi, Janssen, Bristol-Myers Squibb, AstraZeneca, Merck and AbbVie.

Photo: Microsoft.com

Between DJT’s trip to Vietnam and the Michael Cohen hearing, the results of the big pharma exec hearings were largely buried, at least on the news shows I hear/see. What I found didn’t really answer one eye-opening fact—why drugs cost so much more here than elsewhere. According to the editorial, a month’s worth of Actimmune to treat malignant osteoporosis costs under $350 in Britain versus $26,000 here. The editorial contends that drug prices have skyrocketed to the point that many who take them for such ailments as high blood pressure, cancers, allergies and more ration them “at great peril.”

NBC News politial reporter Leigh Ann Caldwell reported that the top exexs “could not commit to lower the price of commonly used prescription drugs even as they admitted that they control those prices. And one executive acknowledged that the high cost of medicines hits poorest patients the hardest.” That executive was Kenneth Frazier, Merck Chairman and CEO. Note: According to Caldwell the pharma industry spent a record $28 million on lobbying last year.

Photo cnn.com

The execs blame Medicare regulations. “‘The system itself is complex and it is interdependent, and no one company could unilaterally lower list prices without running into financial and operating disadvantages,’ Frazier said.” He suggested that by sitting all parties around a table “‘I think we can come up with a system that works for all Americans.’

“They pointed to a statistic that consumers on Medicare pay 13 percent out-of-pocket for prescription medication, compared to just 3 percent for a hospital stay. Some senators connected the large salaries of executives or the profitability of the company to drug costs.” In 2016, Medicare Rx drug spending, according to the Kaiser Family Foundation, accounted for 30 percent of all.

In a Wall Street Journal analysis of the hearings, Peter Loftus summarized questions directed at AbbVie CEO Richard Gonzalez, responsible for “about the biggest-selling medicine in the world, Humira, a treatment for rheumatoid arthritis and gut disorders. Humira generated $19.9 billion in global sales for AbbVie in 2018, up 8% from the year before.” In 10 years list price for a box of two pre-filled syringes went from $1,524 to $5,174 today. The company has maintained exclusivity on the drug by taking patents out on the nine or 10 diseases the drug addresses.

People—and companies that pay for their health care—are desperate to find reasonable alternatives not always with acceptable success. Sheila Kaplan wrote about the F.D.A. accusation against Canadian drug distributor CanaRx. According to her New York Times article the F.D.A. claimed that the company was selling “unapproved and mislabeled medicines to unsuspecting Americans looking to save money on prescriptions, and warned it to stop.”

Photo: fda.gov

F.D.A. commissioner Dr. Scott Gottlieb “was especially concerned about CanaRx’s sale of drugs with special safety requirements because they were high-risk and needed to be carefully managed to protect vulnerable patients.” Tracleer, for pulmonary arterial hypertension and CellCept, for transplant patients, were two on the agency’s warning list.

Through its attorney Joseph Morris, CanaRx denies the charge. He told Kaplan “Every prescription that is dispensed through a CanaRx program is dispensed directly to the patient from a licensed, regulated, brick-and-mortar pharmacy in Canada, Britain or Australia, and the patient can be sure that medicine she receives is the medicine that her doctor ordered.” Morris explained that CanaRx “serves as a broker between the companies’ employees and pharmacies and physicians in Canada, Australia or Britain.” The employees are encouraged to buy their meds to save their employer money by sending their Rx to CanaRx “which finds a foreign doctor to reissue it, and have it filed locally.”

The Times editorial began by comparing the promise of these hearings with one in 1994 in which the heads of seven of the country’s biggest tobacco companies admitted the truth about cigarettes. “The hearing ushered in a public health victory for the ages.” I fear nothing like this will result from last week’s hearings with big pharma.

I’d accept a difference of a few hundred dollars between medicine sold in the UK and here to make up for our complex Medicare and Medicaid pricing regulations and rules, but isn’t a difference of $25,650, in the instance of Actimmune, a bit of a stretch? With technology on the side of efficiency and cost-savings, why does a vial of insulin cost $1,500 today vs. $200 a decade ago? Could the paucity of TV news coverage about these hearings be related to the enormity of pharma ads on these shows? Will anything rattle the industry sufficiently so it becomes more responsible and less greedy?

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