Tags concussionsDNAPresidential campaign Before we dive headlong into 2016, I’d like to reflect, briefly, on the two months since we launched — two months in which STAT has produced nearly 600 stories, told in words, video, photographs, and data visualizations by dozens of journalists from our headquarters in Boston and our offices in Washington, New York, and San Francisco.Our best-read piece, which has even been translated into Chinese, was Sharon Begley’s penetrating profile of Feng Zhang, widely considered the most transformative biologist of his generation. Don’t miss the accompanying video from Dom Smith and Matthew Orr, who found the whimsy in a daunting subject like gene editing with CRISPR-Cas9.We see our role as that of a journalistic watchdog, and I’m proud of our first two investigations. Charles Piller found that many of the most prestigious universities and hospitals in the United States routinely break a law that requires them to publicly report results of human studies of new treatments. His story, with a striking data visualization by Talia Bronshtein, was hailed as a crucial call to action by top officials at the WHO and NIH. In another special report, Sheila Kaplan found that a device widely promoted for use in heart surgery was never, in fact, approved for that purpose — and carried hidden dangers for patients.We also want to tell deeply personal stories, like Bob Tedeschi’s unforgettable look at the emotional toll of targeted therapies that pull cancer patients back from the brink of death — but only temporarily. Or a piece by Rebecca Robbins on two paralyzed patients who found hope in a startup’s experimental device, chronicled their ups and downs on social media — and took the company’s stock on a roller coaster ride.We always aim to be authoritative, but we love to find the fun in the life sciences, too. I’m a big fan of our Science Happens! series; check out Carl mimicking a dolphin as he plays a video game being tested as a treatment for people recovering from stroke. And I still get a kick out of this video explaining how Donald Trump once lent his brand to a dubious vitamin business. Also be sure to read Leah Samuel’s great list of seven creepy crawlies that could be the future of medicine.I’ve called out mostly feature stories, but STAT’s mission also includes staying on top of, and ahead of, the news. We aim to keep you informed of the latest lab discoveries, pharma and biotech developments, and political news that could affect public policy on health care and medical research. When Jimmy Carter announced his brain cancer was gone, we weighed in immediately with a piece on how his advanced age may actually have helped him beat the odds. On New Year’s Eve, Helen Branswell brought us word of an important development in the fight against polio, and Melissa Bailey explained a breakthrough finding involving potential gene therapy for a fatal disease.As STAT grows and evolves, I’d encourage you to share your comments, critiques, and story ideas. You can reach reporters and editors directly through our staff page. We’ve also set up a page to collect more general feedback.Thank you for reading STAT. [email protected] Don’t MissA letter from the executive editor of STAT @rickberke Co-founder & Executive Editor About the Author Reprints Rick Berke We’ll be offering several new newsletter options this year, starting with the best of Pharmalot, Ed Silverman’s must-read column about the drug industry. (Don’t worry, we’ll continue to hit your inbox at 6 a.m. with Megan Thielking’s Morning Rounds, a runaway hit.) We’re also expanding our expert commentary section, First Opinion, which editor Patrick Skerrett has turned into a lively forum on everything from the ethics of genome editing to the merits of regulating dietary supplements. And we’ll be a go-to source for health and science issues that intersect with the presidential campaign, including our monthly national polls with the Harvard T.H. Chan School of Public Health.Our authoritative and engaging Signal podcast, with veteran biotech journalists Luke Timmerman and Meg Tirrell, has already drawn a loyal following. The next installment: a preview of next week’s J.P. Morgan biotech investment conference in San Francisco, the industry’s event of the year.advertisement STAT Happy New Year!Thank you for your interest in STAT. We’re grateful that since our November launch, we have built an engaged and thoughtful readership in the United States and around the world.I wanted to start the new year by sharing some of our ambitious plans for 2016. We’ll have a story in coming days by David Armstrong with fresh revelations about concussions in college football; it’s part of our continuing series on concussions. Look for national correspondent Carl Zimmer’s deep dive into his own DNA in another compelling series. And watch for us to deliver important stories from overseas (starting today, in fact, with a fascinating profile from Cambridge, England, of Fiona Godlee, a muckraking journal editor).advertisement By Rick Berke Jan. 4, 2016 Reprints
Related: By Ed Silverman March 4, 2016 Reprints PharmalotLawmaker seeks to end tax breaks for consumer drug ads About the Author Reprints Overall, the pharmaceutical industry spent about $3.6 billion on direct-to-consumer advertising during the first half of last year, up from $3.2 billion, or 12.5 percent, during the comparable period in 2014, according to Kantar Media, a market research firm. These were the most recent figures available.The move is not surprising. For years, consumer groups and physicians have argued that ever since the Food and Drug Administration revised guidelines in 1997 to permit drug makers to use broadcast advertising, some ads too often encourage patients to seek medicines unnecessarily.advertisement Why doctors’ call to ban drug advertising is a dead end Lawmaker seeks moratorium on consumer drug ads Senator Al Franken has introduced a bill to eliminate tax breaks given to drug makers for advertising medicines to consumers. Jim Mone/AP Another trade group, meanwhile, suggested the legislation may run into difficulty if it is perceived as trying to throttle industry free-speech rights.“We have seen versions of this legislation before and it’s not surprising that it rears its ugly head again in this campaign season,” said John Kamp of the Coalition for Healthcare Communication, which represents ad agencies and medical publishers. “But the premise and the public policy are just plain wrong … Laws that ban truthful messages are a violation of the First Amendment.”Indeed, one industry watcher believes the bill is unlikely to gain traction.“This is not a new idea,” said Ira Loss of Washington Analysis, who tracks the intersection between drug makers and policy makers. “Liberals feel the drug industry spends too much money on promoting drugs, particularly the high-priced ones, and by eliminating the tax deductibility, the advertising would be greatly reduced or stop. I doubt there are the votes to pass this.” Related: Tags Al Frankendrug adsdrug marketingpolicy Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Ed Silverman [email protected] A congressional lawmaker introduced legislation that would end the tax break that drug makers can take for advertising medicines to consumers. Called the Protecting Americans from Drug Marketing Act, the bill is designed to encourage companies to focus on developing new medicines, instead of “marketing schemes,” according to US Senator Al Franken (D-Minn.) who introduced the legislation on Thursday.The legislation, which would amend the Internal Revenue Code, is part of a growing trend to minimize the prevalence of direct-to-consumer drug advertising. Two weeks ago, Representative Rosa DeLauro (D-Conn.) introduced a bill calling for a three-year moratorium on advertising newly approved prescription drugs to consumers. In November, the American Medical Association called for an outright ban on this form of promotion. Like the AMA, Franken argued that increased spending on advertising contributes to higher drug costs, since many ads feature newer and pricier medicines. Drug makers, he said in his statement, are “trying to encourage Americans to buy the most expensive drugs, even when cheaper, equally effective drugs are on the market … This is just a common sense measure to help cut down health care costs.”advertisement @Pharmalot And as we have noted previously, the cost of pharmaceuticals is a hot-button issue that has jolted the American public and, consequently, figured prominently into the presidential race. Over the past several months, various congressional lawmakers have held hearings on the topic.A spokeswoman for the Pharmaceutical Research and Manufacturers of America wrote us that “proposals to eliminate the tax deductibility of DTC advertising ignore the value of informing patients about their health care and treatment options … An unintended consequence of eliminating” the tax deduction “may be fewer patients seeking medical care for chronic conditions that could be managed earlier and more cost effectively.”In response to criticism of consumer ads, the trade group has previously cited a 2012 survey of patients by Prevention magazine that found 71 percent of people agreed that DTC ads “allow people to be more involved with their health care” and 75 percent believed DTC ads are useful because they “tell people about new treatments.”The trade group has also pointed us to a statement made in 2004 by the FDA, after the agency conducted several surveys. “By and large, DTC advertising seems to increase awareness of conditions and treatments, motivate questions for the healthcare provider, and help patients ask better questions,” the agency concluded.
Micah Johnson For a family of three earning $30,000, the Harvard plan requires an employee to contribute a premium of $233 a month, while the health exchange has plans that require no premium at all. Harvard Medical School faculty and the World Health Organization have defined any health spending over 10 percent of annual income as a catastrophic expenditure. The Harvard plan comes perilously close to this with premiums alone. The cherry on top? Harvard’s plan also has higher co-pays than the exchange plans.advertisement Harvard Medical School students decry lack of diversity Related: Sanjay Kishore It is shocking that these low-income workers would be better off financially if they were not offered employer-sponsored insurance.This may seem confusing. After all, exchange plans have been lambasted for their soaring costs. But the sobering truth is that the situation is worse among employer-provided plans. A recent Urban Institute study showed that total premiums were lower in exchange plans than in employer-provided plans in more than 80 percent of major US markets. In Boston, the premiums for exchange plans were 35 percent less expensive than employer plans. The gap would likely be even larger for lower-income employees, who would be eligible for more robust subsidies in the exchange plans.Why are employer plans so expensive? Frankly, health care is expensive. The rising prices of prescription drugs coupled with the consolidation of hospital systems have made the deep-seated cost issues driving the Harvard dining workers’ fight that much more difficult to address. There are no silver bullet solutions. And while promising policy options are in the works, overall progress is likely to be gradual.In the meantime, we must confront a key question: Who should bear the brunt of high health care costs?The answer can be a matter of life or death. Landmark studies like the RAND Health Insurance Experiment have shown that increased out-of-pocket costs can jeopardize health outcomes, not to mention financial stability. For some people, higher out-of-pocket costs decrease utilization of health care in ways that don’t affect health outcomes. For the poorest and the sickest, however, extra expenses cause some people to forego essential medical services, leading to worse control of chronic health problems and increased risk of death.Harvard’s proposal for its dining workers threatens to widen health disparities along lines of race and class. Many of the dining workers are immigrants, over half identify as people of color, and nearly half earn less than $35,000, a salary deemed insufficient to support more than one person in Boston according to the MIT Living Wage Calculator. Some workers, like Anabela Pappas, a 33-year veteran of Harvard, already struggle to manage chronic conditions like type 1 diabetes on a limited income. Increased health care costs for at-risk families like hers only worsens existing inequities in our system. Innovation in health care is more likely to happen when big employers, rather than low-income workers, feel the burden of health care costs. Institutions like Harvard hold tremendous untapped power to implement novel programs and pressure health systems to make badly needed reforms. Now is the time for our university to take the insights generated by its economists and health policy researchers, like value-based insurance design, and implement them for members of its community.Not every creative intervention will work. But only by moving beyond the status quo will we learn which new ideas have real benefits. Simply making poor families pay more for essential services like insulin prescriptions and hospital admissions is an unacceptable cop-out.As physicians in training, we cannot stand by as the world’s richest university forces its most vulnerable employees to choose between dinner and a doctor’s visit. Harvard can do better, and this “better” can have a ripple effect on other unions, other universities, and other workplaces across the nation. Employers like Harvard must pursue real innovation, not simply balance their budgets on the backs of those least able to afford it — and least likely to survive it.Micah Johnson and Sanjay Kishore are second-year students at Harvard Medical School. By Micah Johnson and Sanjay Kishore Sept. 30, 2016 Reprints The affordability of health insurance plans comes down to two factors: premiums and out-of-pocket costs. How affordable are employer plans? A team of Harvard medical students compared the plan Harvard proposed for the dining workers to what would be available on the Massachusetts health exchange. (State exchanges were set up under the Affordable Care Act, often called Obamacare, to facilitate the purchase of health insurance by individuals and families.) About the Authors Reprints [email protected] First OpinionHarvard’s low-income workers deserve affordable health insurance Related: There’s an outbreak of a hidden epidemic — unaffordable employer-based health insurance, especially for low-income workers — at Harvard, a place where it should never occur.As medical students at Harvard, we were deeply troubled to learn that our university was proposing changes to dining workers’ health plans that would make essential health care unaffordable. After months of negotiation, the dining workers’ union voted to authorize a strike, which will launch on Wednesday if a deal is not reached. The campus has rallied around the workers, circulating a petition of support signed by 2,500 students, including us, in advance of federal mediation held earlier this week.In the dining workers’ fight with Harvard, we see a microcosm of current challenges for health insurance across America.advertisement Jeff Pachoud/AFP/Getty Images Are insurance policies saving patients money, or keeping them from the treatment they need? [email protected] Tags Harvardhealth insuranceunions