“The largest health care companies in the US are no longer just health insurers, pharmacy benefit managers (PBMs), physician practices, home health agencies, hospices, data warehouses, data analytics firms, or hospitals. They are increasingly all of the above. A small number of unavoidable health care intermediaries are incorporating these services into essential platforms that simultaneously serve as payers, providers, and everything in between. While these companies claim to rationalize health care and realize the promise of coordinated, integrated care, the reality may be quite different. The creation of “big health care” platforms risks worsening the already serious problem of monopoly … Read More
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“Two major, interconnected problems afflict organ transplantation today: the widening gap between the demand for organs and their supply and the illegal, exploitative organ trade. [..] Organ trade profits from this gap by preying upon both patients waiting for and willing to buy an organ and potential donors living in poverty and willing to sell one. In particular, the principle of financial neutrality has been questioned. This principle states that a donor or their related family should not lose, but also not gain, monetarily as a result of donation, implying that the organ does not become a commodity and money … Read More
“[Introduction] Despite spending more than any country in the world on health care, life expectancy in the US is comparably worse than that of most other high-income countries and declining both in absolute value and relative rank. However, life expectancy across US states varies just as markedly as it does across high-income countries, from 81.8 years in Hawaiʻi to 74.7 years in Mississippi in 2019—a divergence that has been increasing over time. US states vary considerably on policy decisions related to the spending, regulation, and provision of health care; reproductive health; tax policy; social welfare programs; and in relation to … Read More
“Opioid overdose continues to be the leading cause of death due to injury in the US. Recent data from the Drug Abuse Warning Network estimated 882 000 emergency department (ED) opioid-related visits in 2023, a rate of 263 per 100 000 visits, with the highest rates among Black individuals (425 per 100 000). Access to treatment with medications for opioid use disorder, specifically buprenorphine, continues to be challenging for patients in active addiction, and these disparities by race are widening. [..] In many states, rural patients with opioid use disorder have worse outcomes than urban patients. Rural hospitals are also less likely to … Read More
“The COLONPREV trial—published online in The Lancet—is, therefore, a landmark study. It is the first randomised controlled trial to compare colorectal cancer deaths in people screened with the two most commonly used methods: colonoscopy and faecal immunochemical test (FIT), an antibody-based test for haemoglobin, indicative of blood in the stool. The study finds that invitation to biennial FIT-based screening is non-inferior to invitation to one-time colonoscopy in terms of colorectal cancer mortality at 10 years. These results build on the NordICC trial, published in The New England Journal of Medicine, which showed that invitation to colonoscopy reduced colorectal cancer risk … Read More
“The tobacco and ultra-processed food industries exemplify the detrimental effects of corporate influence on public health. For decades, tobacco companies lobbied aggressively against health regulations, contributing to millions of preventable deaths worldwide. Despite still causing more than 8 million tobacco-related deaths annually, the tobacco industry now claims through its public-relations campaigns and selective science that it focuses on “harm reduction”, particularly by selling new products such as e-cigarettes. These tactics allow the industry to argue that it deserves a seat at the policy table, all while shifting to new types of addictive and harmful products, targeting youth, and continuing to oppose tobacco … Read More
“We compared public-access naloxone strategies using more than 14 000 cases of opioid poisoning in Metro Vancouver over a 6-year period. We found that the 647 take-home naloxone sites were within a 3-minute walk to more than one-third of all opioid poisonings and had high coverage efficiency (Table 2) [the top five location categories for coverage efficiency were: government office, take-home naloxone site, convenience store, retail store and pharmacy]. In addition to existing operations that distribute take-home naloxone kits, which are likely taken elsewhere, take-home naloxone site locations appear generally well-aligned with where opioid poisonings occur, so they are also … Read More
“Despite the convenience and value of telehealth, many states have rolled back COVID-19 pandemic–era flexibilities and reimposed strict licensure requirements for telemedicine. Thus, as it was prepandemic, so it is again that a physician, duly licensed in their home state, is prohibited from consulting or following up with an out-of-state patient via video or phone unless they are also licensed in the patient’s state. Penalties for doing so without that license can amount to tens of thousands of dollars in fines and potential imprisonment. Despite growing pressure to respond to patient preferences and widespread evidence of the benefits of interstate … Read More
“Why would more screening in both Black and white Americans reduce the mortality disparity between the two groups? What’s more, cancer screening actually stands out for its lack of racial disparity. The proportion of Black and white women having mammograms has been virtually identical for the past three decades (in fact, Black women currently have the test at slightly higher rates). Yet deaths from breast cancer are about one-third higher in Black women. For the past two decades, a similar pattern has been seen in colorectal cancer screening — equal rates among Black and white Americans — yet colorectal cancer … Read More
“Landeiro and colleagues computed the economic burden of four diseases (cancer, coronary heart disease [CHD], dementia, and stroke) in England using consistent methodology and a broad definition of disease burden. This analysis is an important advance that will allow policy makers, researchers, and other stakeholders to assess the absolute and relative burden of these diseases in a meaningful way. The Global Burden of Disease also uses a consistent methodology for estimating the burden of many diseases across countries. However, its methodology focuses only on mortality and morbidity, which are evaluated comprehensively, but does not account for many other costs included … Read More