Late last year, the Centers for Disease Control and Prevention (CDC) announced that more than 70,000 people died from drug overdoses in 2017, a 9.6% increase from 2016. Deaths continue to soar, even as states and health systems implement policies to curb the overprescribing of opioids that led to the epidemic in the first place. It’s hard not to be discouraged by these numbers and our failure to reduce overdose deaths. To fully appreciate the shifting dynamics of the opioid crisis, we need to understand both the nature of the policies we are implementing as well as their likely short- and long-term effects.
There have been concerns about the long-term health of retired National Football League (NFL) players. But evaluating these long-run consequences is challenging, because professional football players tend to be at the extremes of physical fitness. Finding an appropriate comparison group to such a highly select population is hard. So we reached back into NFL history and found the “replacement players” - generally men with some prior football experience (college, semi-pro, sometimes other pro leagues) who played during the three weeks of the NFL player strike in 1987 to use as a comparison group. Here's what we found.
Two Senior Fellow articles make Health Affairs' Top 10 most shared list in 2017. Articles on the effects of the ACA on payday borrowing and the prevalence of completed advance directives captured the public's attention.
In response to Pennsylvania declaring a state of emergency for the heroin and opioid epidemic, we asked our Senior Fellows, physicians on the front lines of the epidemic, to share their thoughts on what the declaration means for their current approaches to identifying and treating substance use disorder patients.
In a New England Journal of Medicine Perspective on the proposed Right to Try Act, LDI Senior Fellows Steven Joffe and Holly Fernandez Lynch argue that the benefits of the proposal are more symbolic than real, while the potential long-term harms to the FDA’s public health mission are great.
In a recently published Health Working Paper for the Organisation for Economic Co-operation and Development (OECD), Claudia Maier and LDI Senior Fellow Linda Aiken analyze the changing role of nurses in response to health care workforce demands in 37 OECD and European Union countries.
Community Health Workers (CHWs) work with people to detect and address the root causes of chronic illness, and to improve aspects of their lives that are contributing to poor health. This isn’t a new idea, but it seems like one whose time has come. Does the evidence support the use of CHWs as an effective and sustainable solution to addressing the evolving face of disease in America? The short answer is, it depends.
Similar to 23 other states, Pennsylvania requires nurse practitioners to maintain a collaborative practice agreement (CPA) with a physician as a condition of state occupational licensure. In a recent LDI seminar, Dan Gilman, Attorney Advisor of the Federal Trade Commission’s Office of Policy Planning, provided a relevant framework to consider how mandatory CPAs may undermine the delivery of health services to consumers.
Despite professional consensus, guidelines, and national campaigns, physicians continue to provide many low-value services. An emerging policy solution is to financially penalize the physicians who deliver low-value care, but physician support for these policies is largely unknown.
Using a legislatively-mandated, integrated dataset, the Massachusetts Department of Public Health has published its first comprehensive look at the state’s opioid-related overdoses between 2011 and 2015. The dataset links information on an individual level across diverse state databases, including mental health data, jail and prison data, vital records, substance abuse treatment data, and many others. The findings highlight the need to improve treatment access for people who experience a non-fatal overdose, and to tailor treatment to the needs of vulnerable populations.
Prescription drugs are often held as the leading case for a strong patent system: billions of dollars in R&D investment can only be incentivized via ironclad intellectual property protections. With Americans spending over $300 billion annually on prescription drugs, the stakes for incentivizing the right kinds of innovation and paying for value are high. This ongoing work suggests that drugs that rack up patent citations may not be the most innovative, and the most valuable drugs may not be generating the most revenue.