Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
Arthritis Drug Price Spiked 50-Fold
The cost of a 30-count box of indomethacin (Indocin), an anti-inflammatory rectal suppository for arthritis, surged from $198 in 2008 to more than $10,000 by October 1 of this year, according to Axios. That’s an increase of more than 50-fold.
“Indocin is another example of how nothing prevents some drug companies from hiking prices at will and selling them within a broken supply chain,” Axios stated.
Indocin has changed ownership several times over the years, most recently being acquired by Assertio in May 2020. Assertio raised the price twice, first to about $6,000 at the start of 2021, then to $10,350 earlier this month.
Last week, MedPage Today reported on a recent documentary about Martin Shkreli, which notes that the price of toxoplasmosis drug pyrimethamine (Daraprim) remains at $750 per pill, after Shkreli’s company infamously hiked its price from $13.50. The film ends with a reminder that there “remains no national pharmaceutical price gouging or drug price transparency law in the United States.”
Who Is Monica Gandhi, Really?
The San Francisco Chronicle profiled infectious disease specialist Monica Gandhi, MD, whose pandemic-era tweets and other public statements in favor of harm reduction have sometimes gone against the conventional public health grain.
Early in the pandemic, Gandhi countered an edict from San Francisco officials that ordered her staff to shut down their HIV-AIDS clinic. Instead, she emailed staff telling them that they would still provide in-person care when necessary. (Her edict was rebuked by the city.)
Since then, she has encouraged students to return to classrooms early this year, and public officials to craft metrics on when and how to soften safety measures — including masking.
In June 2020, she reopened the clinic, asserting the lack of outpatient care was more destructive than the risk of the novel coronavirus as long as proper measures were in place.
She has received “fierce” backlash on social media, particularly Twitter. She has been wrong at times, including when she asserted that the worst of the pandemic was over early this summer — before the Delta variant hit.
Gandhi is puzzled about the backlash, especially in her home town. “I’m a woman, I’m short, I’m of color, maybe that doesn’t have the authority — maybe it doesn’t give people as much confidence in our unconscious-bias society,” she said. “It weighs on me a lot — I’ve been feeling really uncomfortable in my own skin, in this city, for the last year and a half.”
Public Health in Crisis
American public health agencies are “in crisis” and ill-prepared to face another pandemic, according to a national analysis by the New York Times.
Dozens of public heath workers have left their positions, and local and state health departments lack the funds they need to handle even their core functions, let alone another catastrophe.
Over the past 19 months, more than 500 top health officials have left their jobs; more than 100 new laws have been enacted limiting health department powers; and numerous new government leaders have been voted into positions after promising to “rein in” public health departments.
More than 200 departments had to temporarily — or even permanently — ignore other functions to deal with the pandemic, leading to surges in drug overdoses and unreported child abuse.
The departments need “a higher baseline” of qualified, permanent employees to carry out their roles and handle another pandemic. Instead, they have been asked to buy equipment or hire temporary staff to handle the pandemic.
“It’s a depressing moment. What makes a society if you can’t even get together around keeping your people healthy?” David Rosner, PhD, MPH, a public health historian at Columbia University, told the Times.
Then there are the restrictive new state laws. Montana, for example, is preventing hospitals from requiring staff to get the flu shot, per usual. Lawmakers there did not include Health Department officials in crafting new public health laws.
The Times examined hundreds of health departments in all 50 states. The newspaper interviewed more than 140 local health officials, public health experts, and lawmakers; analyzed public documents; and surveyed county health departments.
“Basic” Security Flaws Expose Patient Health Data
“Basic” security flaws in third-party apps are jeopardizing millions of patient records, according to a STAT News report citing a review by a hacker-cybersecurity analyst.
It is “remarkably easy” to steal patient health data through these apps and data aggregators, which are plugged into electronic health record (EHR) systems. One such aggregator was collecting data from more than 20,000 providers, for example.
“Why go after the individual healthcare providers when I can just hack the aggregator and steal the data from them?” the analyst said.
The vulnerable health records included demographics, lab results, medications, procedures, and allergies.
The review did not find any vulnerabilities in the Fast Healthcare Interoperability Resources (FHIR) API’s made by providers or EHR companies.
But the growing popularity of the FHIR standard for healthcare data, and expanding remote patient care and data sharing “has accelerated the number of apps and APIs facing sensitive healthcare data,” according to STAT.
Last Updated October 20, 2021