Time Sensitive!  In our September 28 issue, we promised to tell you know as soon as the Public Comment Period opened on the government’s Department of Home Security (DHS) regulation restricting immigrants with the threat of deeming them to be a “public change”on the country’s resources. This regulation is a public health issue. Fear of this designation is causing non-citizens to avoid using public health care, food and housing subsidies, etc. This is damaging their health, that of their children, and likely expanding the spread of contagious diseases.

The Public Comment period started on Oct.10, 2018 and will continue until December 9, 2018. You can review the previous article on this topic here. Then, you may want to consider submitting your public comment here. Thanks!!

Fighting US Medicine Prices with Generics

In a novel attempt to alleviate the pressure to raising pharmaceutical prices, a consortium of US hospitals, health care systems and three foundations have formed a not-for-profit generic drug company called Civica RX.  The BMJ (publisher of more than 60 medical and allied science journals) reports that they“joined forces to form a new non-profit pharmaceutical company to counter price gouging and scarcity of generic drugs by increasing their supply.” With initial funding of $100 million, the company plans to “focus on about 20 drugs primarily used in hospitals…and hopes to ship its first pills in early 2019.”

The need for such alternatives is obvious. As a New York Times op-ed pointed out recently, a “gold-standard triple therapy for HIV” was just introduced in Africa that costs $75 per year. In the U.S., an almost identical therapy costs $39,000 a year. The op-ed author adds that HIV medication is “by far the largest item in Medicaid’s drug budget, the third largest for the insurance exchanges and the fifth largest for commercial insurers” in the U.S.

In an NPR interview, one of the founders of Civica said their criteria for selecting drugs to produce focuses on those now in short supply, on the essential medications list, and those for with recent, sizable price spikes. They are also well aware of the fact that some well-established  generic companies create virtual monopolies for themselves by setting their price so low that other companies drop out, at which point they re-raise the price. Civica proposes to counter this by requiring hospitals to agree to “long-term contracts to buy the medications at fixed prices, even if another generic company drops its prices lower”. Dan Liljenquist, who first conceived of Civica, is convinces that this, “long-term stability will be more attractive than the short-term temptation of getting a deal.”

Some Health Care Providers’ Knowledge Deficits on ACA Remain

In a recent national survey, over one quarter of health care providers surveyed (including nurse-practitioners, nurses, physicians and physician assistants) did not know whether their state had expanded Medicaid or not. The study was conducted by the University of Virginia School of Medicine and engaged 253 providers across country in “an effort to better understand providers’ views on the Affordable Care Act (ACA) and its impact on their patients,” Science Direct reported.

In its own press release on the study, UV School of Medicine’s researcher Kathleen A. McManus, MD, noted that “obtaining ACA-related information from clinic case managers was associated with correct ACA knowledge, and as a clinic-based resource, these colleagues should be engaged by HIV medical providers to improve knowledge of health system shifts”.