Does anyone still say TGIF anymore? If not, they should, because on Friday there are Wonkbites.
- Put your drug in a box… A new paper suggests the FDA’s ominous “black box warnings” may not influence doctors as much as one might think, and that financial incentives are actually more powerful than the FDA’s edicts. When a black box warning was issued for drugs used in anemic dialysis patients, their use didn’t stop much at all. But when Medicare unwound an incentive that paid more for higher doses, their use dropped precipitously. The pen may be mightier than the sword, but once again the wallet is mightier than them all.
- Pocket protectors: If you’ve been sucked into the mess that was this week’s Obamacare-delay-gloom-and-doom story, take a deep breath and read this article clarifying what has actually changed (hint: not everything).
- Tightening the leash: A watchdog group within HHS has recommended tightening criteria for being named a Critical Access Hospital, a designation formerly reserved for isolated providers that has since ballooned to about one in four hospitals nationwide. The proposal is simple—merely that HHS ensures each hospital is actually the sole provider within a geographic area—but the politics are challenging, as the article rightly mentions. Months ago Dr. Ashish Jha proposed a similar change, but suggested it’s secondary in importance to making sure those hospitals are delivering high-quality care.
- Must be the money: It costs between $350M and $5B to develop a new drug–any new drug—and the costs have been getting worse each decade. This article explains why, and how it matters. A teaser: “There’s one factor that, as much as anything else, determines how many medicines are invented, what diseases they treat, and, to an extent, what price patients must pay for them: the cost of inventing and developing a new drug, a cost driven by the uncomfortable fact than 95% of the experimental medicines that are studied in humans fail to be both effective and safe.”
- What’s in a name? If you’ve ever wondered why generic drugs have such weird names, here’s your answer.
Karan is a student at Robert Wood Johnson Medical School and Duke graduate who previously worked in strategic research for hospital executives.