Study Finds that Being Uninsured Does Affect Health Outcomes for Children in Hospitals

Posted on: October 31, 2009  |   Author: Asha
Filed Under: Access to Care, HMOs & Health Plans, Healthcare Reform, Insurers/Payors, Other   |   Leave a Comment

The Children’s Center at Johns Hopkins conducted a study including 23 million children from 37 different states between 1988 and 2005. The study showed that uninsured children hospitalizations compared with children having either private or government insurance had a 60 percent higher chance of dying. The study also indicated that at least 1,000 hospitalized children died annually due to a lack of insurance. This means that uninsured children deaths comprise nearly half of all children deaths nationally.

Though the study was not directed at cause, the study also showed that uninsured children are more likely to end up in emergency rooms, where the condition may have worsened by the time care is administered. The time spent in a hospital between insured and uninsured children varied. On average, uninsured children were in the hospital for less than a day when they died. Overall hospitals charges for uninsured children was significantly less than for insured children (less than half).

The author of the study, Dr. Abdullah, did not believe in a causal connection between the amount of care providers gave and insurance status. He noted that children often arrived at the hospital too late for any revival to occur.  These discrepancies are unique because children do not die often. However, nearly seven million children remain uninsured in the United States.  This study helps to show the vast disparate health outcomes that not having insurance can create. According to the Congressional Budget Office, 14 million children will be covered by CHIP by 2013.

Commentary: As the article mentions, such studies help shine light on a moral obligation we face in granting children insurance. Their insurance status is not a choice but a predetermined situation. Uninsured children are more likely to have unmet medical needs, which leads to poorer quality of life. Having such a high number of uninsured children also contributes to overall costs to the health care system, as these children are more likely to end up in emergency rooms where services are expensive and may not be of the highest quality. Thus, it is to the benefit of society overall to keep the number of uninsured children as low as possible

The New York Times, October 30, 2009.

Biologics: Extended Exclusivity?

Posted on: July 23, 2009  |   Author: Asha
Filed Under: Access to Care, Bioethics, Drug & Device, Life Sciences, Other, Technology   |   Leave a Comment

A pressing issue is how long pharmaceutical makers of biologics (drugs comprised of complex proteins that are extracted from living cells) can keep their drug recipes from generic drug companies. Biologics are costly drugs that are used to combat fatal diseases such as multiple sclerosis, cancer, and other rare diseases. Biologics makers argue that their innovation and financial incentives will be displaced if their exclusivity period is not extended. However, in addition to the already granted patent protection, the House and Senate have provided these types of companies with twelve years of exclusivity, free of generic drug market competition.

Biologics makers’ wishes cannot capriciously be granted because consumers and the health care industry in general could save billions of dollars over a period of years if no exclusivity extension were given. Another interesting aspect of biologics is that they are hard to copy. This is meaningful because even when the generic market opens for biologics, many generic companies may not bother investing due to this impenetrability.

An example of lengthy patent protection includes some of the most useful drugs, like Herceptin that is used to treat breast cancer, and is under patent protection until 2019. Though savings from the rejection of exclusivity extension for biologics makers would only be about $10 billion, with such a costly health reform in place, that could be a significant amount put towards a more meaningful channel rather than mere competition protection. The positive effects of not granting an exclusivity extension may be latent until years down the road.

Additionally, biologics copycats would be required to undergo brief drug trials because an identical copy of the original biologics is nearly impossible. An effect like the generic biologics in Germany had is possible here as well. There, “biosimilars” or biologic generics occupied thirty-percent of the market and forced brand-name manufacturers to lower their steep prices. Biologics do not require any more time or money to bring onto pharmacy shelves than do regular small-molecule drugs. Therefore, it is likely that biologic makers do not require any longer than the general five-year exclusivity protection that small-molecule pharmaceutical companies enjoy.

Commentary: Pharmaceuticals are extremely profitable companies. Extending the competitive market protection is unnecessary. If their incentives for innovation and drug research are exclusively founded in profit, perhaps it is time that a sector in charge of curing diseases rethinks its principles. Patents already grant considerable competition deterrence to pharmaceuticals. Additionally, through extensive lobbying, the House and Senate have offered even more protection to the already monopolizing pharmaceutical companies. Therefore, in the words of the executive director of the Coalition for a Competitive Pharmaceutical Market, “If your parents are strong, let them stand for themselves. That’s what every other industry has to do.”

The New York Times, July 22, 2009