Public health
New study highlights potential benefits of taxing sugary drinks
In the five major cities where taxes on sugar-sweetened beverages have been implemented, purchases of those drinks declined an average of 33% in the two years after the tax went into effect. This matches an average price increase of 33% that largely fell on consumers, according to a new cross-sectional study from JAMA Health Forum.
The study estimated and analyzed price and purchase changes in five cities with the tax — Boulder, Philadelphia, Oakland, San Francisco, and Seattle — along with neighboring areas and unaffected controls from other cities between 2012-2020. The decline in purchases was immediate, and endured for months after the tax implementation, without any increase in people traveling to untaxed areas to make purchases. The study authors believe this suggests that these taxes could have population-level effects on consumption and health. The World Health Organization has long recommended that countries tax sugary drinks. And experts have argued that taxes on sugary drinks, tobacco, and alcohol could also benefit strained government budgets.
public health
Legal challenges to PrEP coverage could have serious consequences, per study
Despite the effectiveness of the oral HIV preventative medication PrEP ("pre-exposure prophylaxis" for long), the majority of adults in the U.S. who might benefit from it are not taking it. While public and private insurance covers PrEP, out-of-pocket costs vary and are often cited as a barrier to accessing the medication. And it could get worse: last year, a federal district court judge struck down a mandate for no patient cost-sharing on preventive services like PrEP with high ratings from the U.S. Preventative Task Force. The federal government appealed the decision and a stay was issued, but experts remain concerned about access.
Because of this concern, researchers calculated the potential percentages of patients who would stop taking PrEP if their out-of-pocket charges increased, using a national database of prescriptions from 2015-2019. They estimated that with no out-of-pocket costs, about 5.5% of people wouldn't pick up a new prescription. That rate doubled when the monthly cost rose to $10, and with costs of more than $500, they estimated that almost half of people would not take the prescription, according to the study results published today in Health Affairs.
But despite the potential damages of the legal battle ahead, "there is an opportunity to ensure payer coverage of PrEP is maintained and even improved," wrote lawyer Richard Hughes IV in a First Opinion last summer. Read more on his proposal, and listen to his conversation with editor Torie Bosch.
insurance
Why doesn't Medicare cover Wegovy?
It seems like no drugs have ever captured the national attention like the new weight loss medications Wegovy and Ozempic have. (If you need the proof — have you seen our outstanding Obesity Revolution series?) Yet despite the buzz and promising clinical trial data, Medicare does not cover any weight loss prescription.
In a new First Opinion, Harvard Medical School student Daniel Weiner writes about the origins of the federal restrictions on anti-obesity medication. It has nothing to do with cost, as one might expect, he says. Rather, it's "a legislative legacy reflecting a different cultural and clinical understanding of obesity." Weiner explains that advances in scientific knowledge, along with shifting attitudes about weight, mean that restrictions on coverage may need to be updated for the current day. "Obesity is no longer discussed alongside 'cosmetic' conditions as it was in 1990 — it's a disease we treat," he writes. Read more.
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