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Health Equity & Access Weekly Roundup: August 24, 2024

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Learn more about the negotiated Medicare drug prices and what the FDA's rejection of therapeutic MDMA means for mental health care through expert reactions. Other highlights include pharmacy-based HIV care, gaps in care for gastrointestinal stromal tumors, and the obesity epidemic.

Pharmacy-Based HIV Care: New Frontiers and Patient Views

The International AIDS Society's biennial conference, held in Munich, Germany, from July 22 to 26, 2024, gathered over 11,000 participants, including activists, researchers, and health care professionals, to discuss advancements in HIV/AIDS treatment and advocacy. Jennifer Cocohoba, PharmD, MAS, AAHIVP, McKesson Professor of Pharmaceutical Technology and interim chair, Department of Clinical Pharmacy, University of California, San Francisco, School of Pharmacy, presented her research on attitudes toward pharmacy-administered long-acting injectable antiretroviral therapy (LA-ART). Cocohoba emphasized the importance of pharmacists in community health and discussed how LA-ART has transformed HIV treatment by addressing adherence challenges. However, her research revealed mixed feelings among patients about pharmacy-administered LA-ART, highlighting concerns about privacy and staff turnover, particularly among those already comfortable with clinic-administered care.

Reaction Mixed After CMS Unveils Negotiated Medicare Drug Prices

CMS recently announced reduced Medicare prices for 10 drugs selected for negotiation under the Inflation Reduction Act (IRA), eliciting mixed reactions. While some groups, like the Senate Finance Committee and the American College of Rheumatology, praised the initiative for lowering costs and improving access to medications for seniors, others, including the Biosimilars Forum and the National Pharmaceutical Council, criticized it for potentially stifling competition and innovation. Concerns were also raised about the impact on biosimilars and the broader implications for drug development and market dynamics. Despite projected savings, skepticism remains about whether patients will truly benefit from lower out-of-pocket costs and continued access to necessary treatments.

Following FDA Rejection, Experts Discuss MDMA Therapy, Improving Care for Veterans With PTSD*

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The FDA’s decision to reject midomafetamine (MDMA) capsules in combination with assisted psychotherapy (MDMA-AT) for adults with posttraumatic stress disorder (PTSD) has reignited debates around psychedelic therapy. While the therapy showed promise in phase 3 trials, the FDA deemed the data insufficient and requested another phase 3 study. This decision disappointed many in the veteran community, mental health advocates, and researchers who saw MDMA-AT as a potentially groundbreaking treatment. Critics of the FDA’s decision argue that it delays access to much-needed treatment options, particularly for veterans struggling with PTSD. Advocates emphasize the urgency of continued research and development to bridge the gaps in PTSD care while also addressing ethical concerns in the evolving field of psychedelic-assisted therapies.

Rising GIST Cases: Need for Research and Prevention

Over the past 20 years, the incidence of gastrointestinal stromal tumors (GIST) has significantly increased across most organ sites, with notable variations in survival outcomes among different racial and ethnic groups. While advances in diagnostic technology might explain some of this rise, concerns about potential overdiagnosis and the role of lifestyle factors, such as obesity, have also emerged. The study highlights significant racial disparities in overall survival, with minority groups experiencing higher mortality rates, possibly due to unequal health care access and treatment costs. The findings call for further research into environmental and lifestyle contributions to GIST and targeted prevention efforts for minority populations.

Obesity Uncovered: Dr Eden Miller on US Obesity Epidemic, Insurance Shortcomings

In this week’s episode of Managed Care Cast, Eden Miller, DO, founder of the Diabetes and Obesity Care clinic in Bend, Oregon, discusses her recently published study, titled "Inadequate Insurance Coverage for Overweight/Obesity Management." Miller explores the growing obesity epidemic in the United States and highlights the critical issue of insufficient insurance coverage for obesity management. She delves into the barriers that patients face in accessing effective treatments and offers recommendations to improve obesity management, emphasizing the need for policy changes and enhanced coverage to better support individuals struggling with obesity.

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