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What We’re Reading: Potential Drug Supply Chain Disruption; Medically Assisted Death; Tuberculosis Cases Rise

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A wave of drug supply chain problems would occur if the FDA pulled cough and cold medications containing the active ingredient phenylephrine from shelves; lawmakers in 19 states are considering bills allowing medically assisted death; tuberculosis awareness is lagging as state and local health departments lack the resources to keep up with prevention and control efforts.

FDA Removal of Decongestants Would Disrupt Drug Supply Chain, Experts Say

A recent study published in JAMA reported that a wave of drug supply chain problems would occur if the FDA pulled cough and cold medications containing the active ingredient phenylephrine from shelves, according to CIDRAP. In September 2023, the FDA Non-Prescription Drug Advisory Committee concluded that phenylephrine is ineffective and recommended that the drug, which is used in many over-the-counter nasal decongestants, be removed from the market. Consequently, researchers analyzed pharmacy and retail-outlet purchases of phenylephrine and pseudoephedrine from 2012 to 2021 using IQIVIA’s Multinational Integrated Data Analysis quarterly sales-volume data. They found that 732 unique phenylephrine medications and 495 pseudoephedrine medications were on the market as US pharmacies bought 19.8 billion units of phenylephrine products for $3.4 billion and 13.2 billion units of pseudoephedrine preparations for $3.8 billion. Consequently, researchers said that if the FDA decided to pull phenylephrine, most multi-symptom products would be unavailable as they undergo reformulation, and few pseudoprime alternatives would be available.

More States Considering Bills Allowing Medically Assisted Death

Lawmakers in 19 states are considering bills allowing physicians to prescribe life-ending drugs to terminally ill patients, according to Axios. These bills typically allow mentally competent patients with 6 months or less to live to request prescriptions that they can take at home if and when they decide to end their lives. Despite continued skepticism, the controversial policy is gaining new momentum because of personal anecdotes from states allowing it and changing attitudes; advocates say the practice brings dignity and humanity to death. A study in the Journal of the American Geriatrics Society reported that about 5330 people in the US died with medical assistance as of 2020, and 8451 received a prescription for the drugs. Although it is not yet clear which states may legalize the practice this year, advocates are most closely watching legislation in Massachusetts, Minnesota, Maryland, New York, and Virginia, where lawmakers have previously considered the idea.

Public Health Agencies Lack the Resources to Keep Up With Rising Tuberculosis Cases

As US tuberculosis cases rise, public health experts said that awareness is lagging, and state and local health departments lack the resources to keep up with prevention and control efforts, according to Stateline. The CDC reported a 5% increase in tuberculosis cases in 2022, with some states, like South Carolina, Nevada, Alaska, and Washington, exceeding their pre-pandemic numbers. Since 1994, funding for the CDC’s Division of Tuberculosis Elimination has declined by about 60% when adjusted for inflation. Along with insufficient funding, the researchers noted that tuberculosis is difficult to treat due the vaccine not being routinely given in the US and an increasing amount of antibiotic-resistant cases; many also have latent tuberculosis, which is not contagious and does not show symptoms, but can become active and contagious if the immune system fails to contain it. As experts advocate for more resources allocated to the CDC for tuberculosis control, they noted that awareness of tuberculosis risk factors is imperative so that people can get tested and prevent the spread.

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