Generic drugs, cancer risks, decreasing overdose deaths, and pediatric obesity
September 20, 2024
I’ve been vacationing at Yellowstone and Grand Teton this past week - so the next full note will be on Friday.
In the meantime, there’s been a lot of health policy news relevant to employers.
Here are some of the articles (and a podcast) that I couldn’t resist even on vacation; more on some of these will follow in future notes.
Tradeoffs, the podcast, ran the first two of its three-part series “Race to the Bottom” on generic drugs
The US government, through the Hatch-Waxman Act (1984), essentially created the generic drug market. Previously, most generic firms were smalll family businesses that wouldn’t go head-to-head with the brand name manufacturers. We have saved hundreds of billions due to generic drugs. However, sometimes the market has pushed prices so low that generic manufacturers stop manufacturing a drug, causing shortages or steep price increases. The FDA also can’t inspect every factory often enough to prevent some generic manufacturers from cutting corners.
Here’s a link to a post on low generic prices in the US, and another on who gets paid what for generic drugs (TLDR - the manufacturers don’t get very much.)
The American Association for Cancer Research published its summary of risk factors for premature cancer. Here’s a link to this report, which I plan to review further. Alcohol use is high on the list. The New York Times did a summary of this report, and had an accompanying article on foods that decrease inflammation. Beans and kale are looking quite good.
The Centers for Disease Control and Prevention reported that overdose death rates appear to be declining in 2024. Here’s a link to the National Public Radio report on this, and a link to the CDC’s data visualization. Experts suggest that increasing access to naloxone (Narcan) and more interdictions of fentanyl at the border both help. Here’s a link to a post by Jeremy Faust pointing out that death rates from drug overdoses increased based on geographic penetration of fentanyl, rather than decriminalization. Here’s a link to the JAMA Network Open article that he reviews. Here is a link to a post on what employers can do in the workplace to combat opioid overdoses.
StatNews reported that American Academy of Pediatrics (AAP) guidelines recommending aggressive screening and treatment for pediatric obesity are based on “shaky evidence.” Aggressive screening and treatment of obesity can increase incidence of eating disorders. Use of Body Mass Index, which correlates only modestly with clinically meaningful obesity, makes aggressive identification of obesity in adults problematic; generally weight percentiles are used in younger children, but these, often don’t correlate well with medical risk. The AAP gets substantial revenue from pharmaceutical sponsorships, which is not a good look. Here are my recent posts on BMI and a potential replacement, Body Roundness Index.
While I’ve been doing less thinking about health policy, I’ve been enjoying Yellowstone and Grand Teton. This bison walked along our car; I was pretty happy not to be on a bicycle.
Have a great weekend.
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Jeff