A Lesson in Empathy, ​‘Misery Factories,’ Pharma’s PR Push

By Rhiannon Meyers Collette

Amid a pandemic, the pharmaceutical industry has ramped up efforts to rehabilitate its image among Americans who have long soured on high drug prices. Pharma companies are showering Congress with cash, blitzing the airwaves with advertising, and even developing their own reality television show (hosted by Lisa Ling, above).

In spite of the expensive PR campaign, the truth is, Americans want change. Polls in the past few months confirm that voters still want the government to take action to lower drug prices — and if anything, their desire for reform has gotten more aggressive.

Bottom line: Congress has been debating a number of different policy solutions aimed at lowering drug prices, but legislative momentum has slowed during the pandemic. With both a health and economic crisis underway, the need for action is urgent. “Americans were worried about their drug prices before COVID, with many people struggling to afford their cancer drugs, insulin, and other medicines needed to manage chronic disease,” says Mark Miller, AV's Executive Vice President of Health Care. “The pandemic hasn’t changed that worry — if anything, they are more concerned.”

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Related: How pharmaceutical companies use “drip” to keep their lock on patents and drive up drug prices, via this Medium post by AV grantee I-MAK.

Related: Pharma is vigorously fighting state attempts to cap insulin prices for insured and uninsured patients, reports NBC News. 

With back-to-school in full swing at college campuses across the country, it’s a good time to remember the thousands of students who have been left in debt and with a worthless degree — and little recourse — by predatory, for-profit colleges. Students like Stephanie Porreca, who learned just after graduating from the Illinois Institute of Art that the school had lost its accreditation — information it failed to share with students.
 

What’s happening: A new report from the Student Borrower Protection Center shows how a web of players and practices target and victimize students — many from low-income and historically marginalized backgrounds. Institutions are routinely dishonest with students earning degrees in fields like nursing, truck driving, or cosmetology, where wages are typically too low to repay the high “shadow” debt students accumulate. 

Bottom line: There is little federal and state oversight. The current administration has overturned or stalled on regulations meant to protect students. “We as a public are just letting it happen,” says Kelly McManus, AV’s Director of Higher Education. “We have made the active policy choice that this is okay, and to me that’s deeply wrong and offensive.”
 

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Related: For-profit colleges have already started ramping up efforts to target students looking for more skills training or a new job amid the pandemic. The Century Foundation explains how these schools are taking advantage of the COVID-19 economy. 

Communities building inclusive public spaces and shifting the role of police to better support people forced to live outside. After leaving an abusive relationship, Trina lost her home in rural Virginia, followed by her car and her job. She was living in a field when police confiscated her belongings and told her to move along or be cited for trespassing. Her search for shelter and support amid COVID-19 hit a dead end, leaving her among the many with few options but to live in a public space.

Police are often called to respond to such situations, exacerbating the homelessness-jail cycle. The Urban Institute offers three strategies communities can adopt to help people like Trina and improve everyone’s quality of life: reimagining the role of public spaces to accommodate unsheltered people, educating the public on what needs to be done, and taking police out of the equation. 

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• Michigan, which randomly selected 13 citizen commissioners to redraw congressional and state legislative district lines. This is the culmination of work by Voters Not Politicians to pass redistricting reform in 2018 and exemplifies what redistricting reform campaigns around the country are fighting for: For the first time, voters in Michigan will get to choose their politicians, not the other way around. 
   
• The Missouri judge who threw out November ballot language crafted by Republican lawmakers, saying it misled voters on the Clean Missouri effort to empower a nonpartisan state demographer to oversee redistricting. “The ballot language written by politicians for Amendment 3 was full of objective falsehoods and misleading language designed to trick voters and hide the true intention of the measure — to overturn voter-approved redistricting reforms, and install a new gerrymandering plan in the state constitution that would allow lobbyists and political operatives to draw maps designed to protect incumbents.”

By Rhiannon Meyers Collette

The multiple sclerosis drug copaxone has faced competition from a cheaper generic drug since 2015, and yet it continues to maintain its grip over the Medicare Part D market, capturing 82 percent of sales in 2018, according to a new study by researchers with 46Brooklyn. How could that be?

What’s happening: Expensive specialty brand name drugs continue to dominate Medicare Part D sales — even though cheaper drugs are available — underscoring a distortion in the market that shows why we need Medicare Part D reform.

Why it matters: For drugs like copaxone, the warped incentives of Part D mean that patients and plans may favor more expensive brands over generics because they help shift more costs onto the federal government and taxpayers. Copaxone is also a “canary in the coal mine,” 46Brooklyn argues, noting that specialty drugs like copaxone will face more generic competition in the coming years, but this competition alone won’t be enough to drive down drug prices. This report shows why national drug pricing reform is so necessary to restore balance to the market.

What’s next: Part D reform is a key component of several bipartisan legislative proposals, but with the pandemic raging, it seems likely that Congress will wait until at least next year to entertain meaningful legislation. Meanwhile the federal government this week announced an investigation into copaxone’s drugmaker, Teva, for creating an elaborate scheme to provide copay assistance while hiking the drug’s price, bilking Medicare and taxpayers.

Related: A Chicago nurse describes her struggle with the cost of copaxone after she was diagnosed with multiple sclerosis. “If my copaxone were affordable, it wouldn’t have been easy, but I would’ve been able to keep fighting to keep my life in order and protect my memory.”

I’ve just started “Outcry,” a five-part Showtime documentary that tells the story of Texas high school football star Greg Kelley, who was wrongfully convicted of child sexual assault and sentenced to 25 years in prison. (H/T to JAN's Holly Harris, who mentioned it in the podcast I wrote about in last week’s newsletter.) The crime is heart-wrenching, and even more so when you realize justice may never be served. You might recognize Patricia Cummings, Kelley’s defense attorney, who also worked to secure the exoneration of Michael Morton (this two-part Texas Monthly story is a must-read on his case) and was featured in a case on  “The Innocence Files.” Morton later criticized how both Williamson County prosecutors and Cummings were portrayed in the series (for very different reasons).


 

Also: The New York Times celebrated the centennial of the 19th amendment with “Finish the Fight,” a virtual play from Ming Peiffer that brings to life the stories of the Black, Asian, Latinx, Native American, and queer women who fought for voting rights but did not get the recognition they deserved. It’s a spare but effective retelling of some of history's lesser-known boss ladies and a powerful reminder of how far we’ve come.

By Stuart Buck, Vice President of Research

This week, NIH Director Francis Collins tweeted that an NIH-funded study found that “teens & young adults who use e-cigarettes...were 5  to 7 times more likely to be diagnosed with COVID-19 than their peers who did not vape.”
 

Quite a disparity in risk! Perhaps vaping is deadly after all. But not so fast. Let’s look at the actual article. 
 

First, an initial sign of trouble was pointed out by Nick Brown on Twitter: Some of the basic descriptive numbers just aren’t possible. For example, the respondents were asked about their mother’s level of education, and 609 said that their mother had “started college” (but not graduated). Of these 609, 48% were never-users while 52.0% had vaped. 
 

But that’s impossible: 48% of 609 is 292.32, while 52% is 316.68. People exist in integers — 1, 2, 3, etc. — and there’s no such thing as someone who has .32 or .68 of a mother. (If the researchers had rounded the numbers, that still wouldn’t explain the results here.) Similar impossible numbers can be found elsewhere. 
 

As Brown says, this is a warning sign: If researchers can’t do something as simple as calculate the percentage of people in their study who answered a certain way, what can you really trust about their numbers? 
 

Second, the reported risk here doesn’t make sense. If you look at Table 1 of the study, 17.5% of the vapers claimed to have gotten a COVID-19 test, compared to 5.7% of the non-vapers. Then, Table 1 says that 2.3% of vapers had a positive COVID-19 diagnosis, compared to .8% of the non-vapers. 
 

This actually works out to a roughly equal rate of COVID in both groups! Sure, the vapers were more likely to say they had a positive COVID-19 test, but they were also more likely to say they got tested at all. Thus, a roughly equal number of vapers and non-vapers tested positive for COVID-19 if they got tested at all.
 

Third, do we trust those numbers in the first place? The study claims that it surveyed people via a “survey Web link on gaming sites, social media, customer loyalty portals, and through website intercept recruitment.” For all we know, teens and young adults who vape might have been more likely to say that they got a COVID-19 test or that it was positive. 
 

Fourth, it isn’t believable that 17.5% of vapers had been tested for COVID-19. If 17-18% of people were getting tested, there would have been nearly 58 million tests nationwide at that time, which is about five times more than had actually occurred! This indicates a significant bias in who was responding to the survey. 
 

All told, this doesn’t seem like a reliable study. Vaping might be bad for you, but this study doesn’t show it.