2017 Greetings! It’s been much longer than I anticipated to be able to get back to writing this blog, so return now to fulfill one of my New Year’s resolutions. Health justice work is more important than ever and I created this blog to share information and perspectives on topics that may not get much attention elsewhere. My goal is to post once a month at minimum, and to keep a focus on my Washington as well as local developments and the bigger picture. I will start with a story on a positive development for healthcare consumers in our state.
In the wake of the recent US measles outbreak, Public Health Seattle King County has published searchable data on student immunization levels covering all K-12 schools in the county. Data fields include vaccination completion rates at each specific school ( color-coded to show rate levels); MMR immunization among kindergarteners; and immunization coverage rates in general among kindergarten and 6th grade students. The sociodemographic correlations to vaccination rates reflect the national trends that have made headlines, are not a surprise to locals. Kudos to the PHSKC team for innovative use of technology in the public interest!
From the hyper-local to the global, news of note:
News from China gives us even more pause to reflect on the access to medicines scenario. The situation in the US where there are no good excuses for unaffordable medicines, pales in comparison to this chilling tale of a patient whose actions to secure the life-saving drug imatinib mesylate at an affordable price, has resulted in his criminal prosecution.
To prosecutors, a leukemia patient named Lu Yong is a criminal involved in credit card fraud and a counterfeit drug scam. But to 1,000 fellow leukemia patients in China, Lu is an unsung hero for helping them get access to cheap, life-saving generic medicines from India.
His crime? Selling fake drugs and breaking a law about purchase of international credit cards. What Lu did was considered criminal because any drug produced in or imported into China without the government’s approval is classified as a “fake drug,” and Lu purchased international credit cards online to facilitate the transactions. China.org.cn reported that:
The defendant, Lu Yong, was diagnosed with chronic myelocytic leukemia in 2002. He was prescribed Gleevec, a drug produced by Swiss drug-maker Novartis, which cost 23,500 yuan (US$ 3,775) per month, far too expensive for average Chinese families. Lu was even more depressed since the expenses of treating leukemia are not covered by China’s medical insurance system.
Lu later found out that India produced a generic drug which was comparable to Gleevec but which cost only 4,000 yuan, about 17 percent of the cost of Gleevec. He took the medicine himself and found it effective. Later, Lu began helping several thousand fellow patients buy the drug, since the purchasing process was difficult and some patients were not able to fill out the English purchase forms.
Meanwhile, Lu’s trial has been postponed due to his health problems, and some 300 fellow patients with CML have signed an online petition asking for his release.
Also of significance is the astronomical price of Gleevec in China, said to be the highest in the world, which led Lu to seek an alternative. As a point of comparison, Costco’s US online pharmacy is now selling a 30-day supply of the standard 400mg dose of Gleevec for $9022.05.
Posted in Access to Medicines, Advocacy, Assistance, Cancer, Economics of Health Care, Generics, Glivec, Global Health, Health Care Marketing, Health Insurance, Leukemia, Patient groups, Prescription drugs | Leave a Comment »
In recent weeks I’ve received email alerts announcing “Hospitals Making Progress on Health Care Disparities“, a new study from the American Hospital Association’s Hospitals in Pursuit of Excellence program and associated organizations. I took a look first at the infographic accompanying the notices, and then at the published study itself, the 2013 Diversity and Disparities: A Benchmark Study of U.S. Hospitals. It was no surprise to read that the demographic profile of hospital executives and boards is still so far from representative of the general population, since the last HPoE study in 2011. However, the 2013 study reports data on language services in hospitals that raised my eyebrows ( 2011 comparison data points shown in parentheses):
- 95% (90%) are collecting data on primary language of patients
- 87% (80%) are translating forms and documents for patients
- 66% (61%) collected information on patient language needs
Leaving aside the matter of ascertaining the difference between collecting “primary language of patient” and “patient language needs,” these highly encouraging results led me to seek details in the source report. Having recently done extensive research for my own presentation on the status of language services in healthcare for the 2014 WASCLA Summit, the HPoE findings seemed even more amazing. What I found in the report itself , which did conclude that more needs to be done to achieve equity of care in the broader sense, was that some basic background and research points seemed not to have been included or were too limited in scope to be meaningful. For example, the report did not include the list of hospitals which had participated in the survey, nor how the recent cohort compares to the 2011 and 2009 participant groups. There was no discussion of the statistical validity of the response rate of 1109 hospitals (~19% of all 5922 AHA member hospitals invited to participate), nor how representative the response sample is for hospitals nationwide. For example, while the study noted that all data was self-reported, there was no mention of the possibility that only hospitals which have disparities reduction initiatives chose to participate. I am pursuing the actual data used for the study, and hope to have information to share soon.
Posted in Advocacy, Discrimination, Ethics, Health Disparities, Healthcare Inequalities, Hispanic/Latino, Immigrants, Language Access, Language Services, Limited English Proficiency, Paitent safety, Patient Safety, Translation | Leave a Comment »