Inequality

Distributional Cost Effectiveness Analysis: A simple example

I have written previously about the need for distributional cost-effectiveness analysis (DCEA) which would increase the value of treatments who improve the health for individuals who currently have the worst expected quality-adjusted life expectancy (QALE). I’ve written about this in AJMC and Health Affairs among other places. One key question many individuals may have is …

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I thought HIV meant death but it led me to fight to save millions of lives | Vuyiseka Dubula

Twenty years ago in South Africa people were dying unable to access expensive antiretrovirals. The creation of the Global Fund was gamechanging In 2001, at the age of 22 – when I thought my life had just begun – I was diagnosed with HIV. At that time, the diagnosis felt like a death sentence. Every …

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Should hospitals pay for housing for ED frequent flyers?

That is one approach being explored in Philadelphia according to an article in Kaiser Health News. Using funding from Temple University, two Pennsylvania Medicaid health plans, and some grant funding, the Template University Health System: …launched a two-year program last year to help 25 homeless Medicaid patients who frequently use its emergency room and other …

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Fewer Pharmacies In Minority Neighborhoods

One reason for worse health outcomes for racial minorities could be reduced access to pharmacies. However, how big a problem is pharmacy access? A recent Health Affairs paper by Guadamuz et al. (2021) uses 2007-2015 data from the National Council for Prescription Drug Programs (NCPDP) to identify pharmacies, which were then geocoded and linked to …

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In the fight against Covid, have we been inoculated against compassion? | Letters

Dr Mohga Kamal-Yanni says world leaders must stop putting big pharma’s profits before people’s lives. Sue Hoar wonders why more is not being done to help Covid patients in India The shortfall in Covid vaccine doses going to the Covax vaccine-sharing scheme is deeply worrying, and highlights a massive flaw in the plans to provide …

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US adult life expectancy falling for those without a college degree

That is the finding from a study published by Anne Case and Angus Deaton this week in Proceedings from the National Academy of Sciences (PNAS). While COVID-19 has had a clear impact in the last 12 months, in fact figures from the National Center for Health Statistics (NCHS) indicate that American life expectancy peaked in …

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COVID-19 and racial disparities

On the eve of Martin Luther King Day, let us take a quick look at the impact of COVID-19 by race/ethnicity. CDC reports rates of COVID-19 cases, hospitalizations and deaths. One can see that cases are higher for most minorities (except Asians) relative to Non-Hispanic Whites, but hospitalizations and deaths are much higher for all …

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Steps Health Professionals Can Take to Reduce Inequality in Health Outcomes

That is the title of an article in AJMC co-authored with Meena Venkatachalam. An excerpt is below: While decision-makers traditionally have ignored the issue of inequality, academic researchers have already developed tools to quantify a treatment’s value from reductions in inequality. Two common methods for doing so are distributional cost effectiveness analysis (DCEA) and multiple-criteria …

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What can pharma do about social determinants of health?

The Milwaukee Bucks–my home town sports team–yesterday boycotted Game 5 of their NBA playoff series. This historical event serves to bring attention to the inequalities African-Americans and other minorities face in our society. In health care, disparities also exist. As I mentioned in my Health Affairs blog piece with Meena Venkatachalam, COVID-19 has highlighted these …

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If our patients are diverse, why are clinical trials so white?

  How many times have you been told to put on sunscreen to prevent skin cancer? About 71% of US adults use some form of sun protection when outdoors on a warm, sunny day – an increase of 3% from 2008. Now, what if I told you that despite these public health initiatives to increase …

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Disparities in COVID-19 hospitalization rates

Azar et al. (2020) use electronic health record data to examine differences in COVID-19 hospitalization rates by patient characteristics. The authors find that: …compared with non-Hispanic white patients, nonHispanic African American patients had 2.7 times the odds of hospitalization, after adjustment for age, sex, comorbidities, and income. These findings echo similar COVID-19-related conclusions across California. …

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