Friday News Dump: Wonkbites

by Adrianna McIntyre 

NSA shenanigans got you vexed? Take a break—our roundup is surveillance-free.

  1. ACA acronyms at work: MLR. The medical-loss ratio, or MLR, requires that insurers spend 80-85% of their premium dollars on care or quality improvement; if they fall short, they must issue rebates to their customers. Those rebates are explicit savings that beneficiaries might see, but there are implicit savings, too: premiums might be lower with the MLR than they would be otherwise. Most plans sold to small and large employers were already in compliance before the requirement went into effect—but fewer than half of non-group plans were. Recent estimates out of the Kaiser Family Foundation suggest that the MLR saved beneficiaries on the individual market $3.3 billion over 2011 and 2012 when you account for both rebates and premium savings.
  2. Injunction junction, what’s your function? Last Friday, a federal judge vacated an injunction from 1979 that had prohibited the government from making Medicare information on individual doctors public. Some experts believe that this data could be used to expose waste, fraud, and abuse. Originally, the injunction was designed to protect doctors’ privacy, but the judge decided that sufficient new protections have been enacted to permit the release of this information. Don’t expect another HHS data dump anytime soon, though—the decision might be appealed, and members of the public currently need to submit a FOIA request to get their hands on it. (Also, to all of you who now have that School House Rock song stuck in your head, you’re welcome.)
  3. We need an antibiotics revolution. Pressure is coming from medical experts, government officials, and drug companies to design and approve new antibiotics to fight “superbugs”. Tens of thousands of patients die of antibiotic-resistant infections annually; often these infections are acquired in hospitals. Some stakeholders are pushing for an expedited pathway to FDA approval, with drug labeling that would restrict use to the sickest of patients. Others are skeptical that such labeling would be effective, or that speedier market approval would be safe without comprehensive testing for safety and efficacy. Another concern is that the new formulas would become too common—our current crisis of resistance is largely attributed to overuse of  antibiotics in humans and animals where the drugs are ineffective or unnecessary.
  4. Docs facing sour Apple. In response to recent FDA investigations, Apple is rejecting new medical apps that include drug dosage information not supplied by the manufacturer. What’s the problem? Apps like Epocrates are used by clinicians everywhere to look up dosing information, and would they pass muster? Mobile textbooks, too, often contain dosing information from academic studies rather than drug companies — what’ll happen to them? This seems to be a knee-jerk reaction to the FDA’s recent investigation into a urine analyzer app, and it’s possible that Apple will change its mind. But the issue is definitely one to keep an eye on.
  5. Words, words, words. I have a confession. Thanks to my graduate school colleagues, who hail from all over the nation, I’ve started committing a cardinal sin in Michigan: using the word soda. On one occasion, this resulted in a café cashier snarking, “We don’t serve soda here; we serve pop.” If you’re looking to get the lay of the land on fizzy-drink vernacular—and other food-centric dialectic quirks—check out these maps from The Atlantic. 

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Adrianna is a graduate student in public policy and public health at the University of Michigan.
Follow her on Twitter @onceuponA or subscribe to the blog.

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2 thoughts on “Friday News Dump: Wonkbites

  1. Why is the conversation about developing new antibiotics and not about reducing antibiotic use in order to slow the spread of antimicrobial resistance? There are three reasons why antibiotics might be given to livestock: 1. to make the animals grow bigger, 2. to prevent a disease outbreak, 3. to treat a sick animal. FDA was challenged to address the rampant overuse of antibiotics in livestock a year ago. Their response was the release of voluntary guidelines, including a voluntary ban on usage for growth promotion. This move was essentially pointless because 1. farmers can just as easily claim that antibiotics are given for disease prevention as for growth promotion, 2. that key word, “voluntary.” What if some of the money for drug R&D went to improving the sanitation of livestock farms, making prophylactic antibiotics unnecessary?

    Yet another situation where we look to treat the problem instead of to prevent the problem.

    Sources: http://www.theatlantic.com/health/archive/2012/04/the-fda-did-not-do-enough-to-restrict-antibiotics-use-in-animals/255878/

    http://www.fda.gov/AnimalVeterinary/GuidanceComplianceEnforcement/GuidanceforIndustry/ucm216939.htm

    • Hi Georgia, thanks for sharing your thoughts. You’re right that there’s a lot to be said about antibiotic stewardship, but it just wasn’t within the scope of the article we quoted. Also, antibiotic resistance is a natural process; it occurs in nature (bear in mind that most antibiotics are toxins that bugs in nature secrete to kill their competitors), and it can’t be prevented entirely by limiting antibiotic use. Most importantly, limiting antibiotic use won’t do anything to address the multi-drug-resistant strains already circulating and killing thousands — the only way to treat those is, unfortunately, to develop new drugs.

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