USC Schaeffer Center

Dr. Anne Peters, a Schaeffer Scholar and endocrinologist who practices in East LA and Beverly Hills, says there's finally a weight-loss remedy that works for all her patients: medication.

While the balance between drugs’ prices and their benefits is a fraught debate, focusing just on government ledgers can be shortsighted, Peters writes in the LA Times. Drugs like Wegovy and Zepbound can provide true benefit even if lifestyle changes are harder to implement in some communities.

"I see firsthand that medications have a big role to play in the treatment of obesity and diabetes," she writes. "Like many other drugs I have prescribed for other diseases, over time they will become more affordable while reducing the costs of treating associated illnesses."

Read here:

Opinion: I'm a doctor in East L.A. and Beverly Hills. I want to treat obesity the same way in both places In under-resourced parts of Los Angeles, people develop life-altering, preventable diabetes complications related to obesity. These patients rarely live to grow old.

Clinicians and health systems are embracing ChatGPT’s assistance with administrative tasks. However, inputting protected health information into AI chatbots may lead to patient privacy violations.

“Although the ease of pasting medical information into a chat interface is tempting, clinicians and health systems could unintentionally violate HIPAA and incur substantial fines and penalties with these GPT queries,” explains Genevieve Kanter, senior fellow at the Schaeffer Center and associate professor at the USC Sol Price School of Public Policy.

In a new article published in JAMA Network Open, Professor Kanter sheds light on both the benefits and risks of ChatGPT for medical providers. Read more:

Health Care Privacy Risks of AI Chatbots This Viewpoint notes that as clinicians incorporate new AI tools (such as chatbots) into their practice, they must also remain vigilant of the risks these tools pose to other aspects of patient care such as privacy.

Who are the people most at risk of developing any form of dementia, and how can they be identified? One solution is to add a brief cognitive assessment to primary care visits.

The payoff would be a dramatic increase in identifying people at high risk of developing dementia, notes USC Schaeffer Center expert and USC Sol Price School of Public Policy Professor Julie Zissimopoulos.

“People could get more timely treatments, begin to change diets and lifestyle habits, and take steps to plan for the future that could make a central difference in their lives,” she adds.

Opinion | Without Early Detection, Fighting Dementia Is an Uphill Battle A brief assessment in primary care can help identify patients most at risk

Biosimilar drugs offer the same therapeutic benefits at a much lower cost than biologic medications. However, limitations imposed by commercial insurers hinder their full potential.

In a study led by USC Schaeffer Center expert and USC Sol Price School of Public Policy Professor Jakub Hlávka biosimilar drugs were either excluded or faced restrictions in nearly 20% of cases analyzed.

“These restrictions hamper the potential of biosimilars to increase access to care,” says Hlávka. He adds that “such coverage variations may negatively impact patient access to effective treatments.”

Factors such as cancer treatment, the pediatric population, and coverage restrictions on reference products significantly influence decisions regarding biosimilar coverage.

Biosimilar Drugs Underutilized Due to Commercial Insurance Restrictions The first study to examine biosimilar drivers finds commercial insurers limit use in almost 20% of cases.

CMS' use of the coverage with evidence development program for new Alzheimer's drugs is restricting patients' access to treatments, writes Schaeffer Center Nonresident Senior Fellow Joe Grogan in The Wall Street Journal Opinion.

"By subjecting Alzheimer’s treatments to CED, CMS has expanded the policy beyond devices and procedures. This move calls into question the FDA’s scientific judgment and will restrict, rather than expand, patients’ access to these treatments."

Opinion | The Agency Keeping Alzheimer’s Drugs From Patients The Centers for Medicare and Medicaid Services refuses to approve breakthrough drugs.

"CMS should abandon [Coverage with Evidence Development] or, at a minimum, reform and restrict its use only for off-label applications of therapies," argues Schaeffer Center Nonresident Senior Fellow Joe Grogan in a new Health Affairs Forefront article.

Medicare’s 'Coverage With Evidence Development': A Barrier To Patient Access And Innovation | Health Affairs Forefront With the advent of a new class of Alzheimer’s treatments, CMS has now for the first time applied its Coverage with Evidence Development (CED) policy to therapies when used on-label, effectively inserting itself as a “check” on the Food and Drug Administration. CMS should abandon CED or, at min...

Although the Inflation Reduction Act of 2022 (IRA) aimed to increase patient access to prescription drugs and decrease spending, researchers warn that it may have unintended negative impacts on patients in the long run. A new Schaeffer Center white paper provides three recommendations on how best to mitigate some of the most likely negative impacts.

“The IRA lowers drug prices, but at the expense of innovation,” says Dana Goldman Goldman, who is co-director of the Schaeffer Center and dean of the USC Sol Price School of Public Policy. “The question is by how much? More transparency around value assessment will improve HHS’ price negotiation process.”

USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences

New Schaeffer White Paper Offers Solutions to Ensure Greater Patient Access to Prescription Drugs The researchers propose three strategies for mitigating negative impacts of the Inflation Reduction Act to ensure greater patient access, increased innovation and lower costs.

Transparency is "an essential first step" of any policy solution, said Schaeffer Senior Fellow Karen Van Nuys at a Senate Finance Committee hearing last month. She was part of a panel of expert witnesses called to testify on the impact of pharmacy benefit managers.

“[Transparency] gives researchers like me, and regulators like the federal government the opportunity to understand the bigger picture,” she said. “But more importantly, transparency is going to provide participants in the markets with information about the true prices that they are facing and when they have [that] information, they can make better economic decisions.”

USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences USC Sol Price School of Public Policy

Senate Finance Committee Explores Costly, Secretive Practices in the Drug Supply Chain Karen Van Nuys testified at the hearing, calling transparency “an essential first step.”

We are thrilled to announce Tom Priselac has been named vice chair of the Schaeffer Center's Advisory Board. He is the CEO and president of Cedars-Sinai and has served on the board since its inception in 2011.

“Tom has served our nation on the front lines to advance the excellence and affordability of healthcare, which is the essence of our mission,” says Schaeffer Co-Director Dana Goldman. “His counsel is invaluable.”

Prominent Health Executive Tom Priselac Named Vice Chair of Schaeffer Center Advisory Board Priselac, who is CEO and president of Cedars-Sinai, has served on the board since its inception in 2011.

It is estimated that 10%-20% of healthcare expenditures are spent on low-value care, contributing to wasteful healthcare spending. Using health technology assessment (HTA) across the spectrum of healthcare delivery—from services to biotechnologies— is an opportunity to curb use of low-value care, argues Schaeffer Fellow and USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences Assistant Professor Bill Padula in a Health Affairs Forefront article.

Addressing Value Defects From Wasteful Services Through Health Technology Assessment All parts of the health care delivery system—ranging from biotechnologies to provider-led health care services—should be held equally accountable for providing valuable services to patients.

Schaeffer expert Rosalie Liccardo Pacula talked with Smithsonian Magazine about how the rescheduling of cannabis could improve our ability to study the public health effects of products being sold.

“[Rescheduling would] enable a lot more research. It means, with federal research dollars, we [could] examine the health effects of products already being used and sold in legal markets,” explained Pacula.

University of Southern California USC Institute for Addiction Science USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences

New U.S. Law Will Boost Ma*****na Research The Medical Ma*****na and Cannabidiol Research Expansion Act will make it easier for researchers to access ma*****na and study its therapeutic uses

Can tech billionaires make prescription drugs more affordable? Schaeffer Center Senior Fellow Karen Van Nuys talked to USC Price about the Mark Cuban Cost Plus Drug Company and her work on the generic drug market.

“There is a lot of excess spending and room to cut costs because intermediaries create a lot of waste,” Van Nuys says.

USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences USC Sol Price School of Public Policy

Can tech billionaires make prescription drugs more affordable? USC experts discuss online pharmacies launched by Mark Cuban and Jeff Bezos as Americans pay high costs for prescription drugs.

Many nephrologists partially (or entirely) own dialysis facilities and refer their patients to them. Schaeffer experts Genevieve Kanter of the Perelman School of Medicine at the University of Pennsylvania and Eugene Lin of Keck School of Medicine of USC looked into this conflict of interest in a recent study published in JAMA Internal Medicine.

While they found improved patient outcomes among centers owned by kidney doctors, including increased use of home dialysis, there were significant barriers in obtaining and analyzing the data.

"CMS should make dialysis facility ownership transparency a requirement in line with other medical financial conflict of interest requirements," Lin, Kanter and their colleagues write in a follow-up blog.

https://ldi.upenn.edu/our-work/research-updates/hidden-physician-financial-conflicts-of-interest-in-dialysis/

"What's happening in this market is middlemen are making more and more money," Schaeffer Center Senior Fellow and USC Sol Price School of Public Policy Professor Neeraj Sood told The Wall Street Journal.

Schaeffer Center research shows the share of insulin dollars accruing to manufacturers decreased between 2014 and 2018, while the share going to pharmacy benefit managers and other intermediaries increased.

University of Southern California USC Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences

Elon Musk, Bernie Sanders and Others Miss the Mark Over Pricey Insulin Big Pharma has taken much of the heat for sky-high insulin prices, but scrutiny could soon shift to other companies grabbing a growing slice of spending.

AARP-Branded Medicare Drug Plan Is Too Costly for Many Retirees, Critics Say The popular plan’s price has risen sharply in recent years—prompting some experts to suggest enrollees consider switching.

More than 4 in 10 U.S. adults have obesity, a disease that damages nearly every system in the human body. In fact, according to a Schaeffer Center microsimulation model, obesity is a bigger risk to public finances than smoking. Despite this, Medicare and private insurers cover few obesity treatments. Schaeffer Center Co-Director Dana Goldman co-authored an op-ed in The Hill with Bipartisan Policy Center Chief Medical Advisor Anand Parekh to discuss what Congress can do to ensure access to treatment.

"Medicare and private insurers pay for treatments for diabetes, heart disease and high blood pressure," they write. "If saving lives is the objective, then logic, clinical evidence, and compassion dictate that they should also pay for preventing and treating obesity, starting now."

USC School of Pharmacy USC Sol Price School of Public Policy

Shame won’t solve America’s obesity crisis: How Congress can help If saving lives is the objective, then logic, clinical evidence, and compassion dictate that they should also pay for preventing and treating obesity, starting now.

Across the country, nearly 1-in-4 neighborhoods are pharmacy shortage areas, or pharmacy deserts. Schaeffer Center Senior Fellow and USC School of Pharmacy Professor Dima Qato is tackling this problem by building an interactive, nationwide mapping tool showing the location of every pharmacy in the U.S.

Map of ‘pharmacy deserts’ promotes a basic right: Access to medicine A USC-developed interactive tool shows the location of every pharmacy in the U.S.

What happens if ma*****na is no longer classified as a schedule 1 drug? USC Sol Price School of Public Policy professor and Schaeffer senior fellow Rosalie Liccardo Pacula spoke with Healthline about the reclassification Biden announced last month and what policymakers should consider to protect public health, including regulating high potency products which are growing increasingly popular.

“My concern is the federal government will just decide to deschedule cannabis entirely, including high-THC products...But there’s a middle ground that can be very rational, protect health, and be good for medical exploration and individual choice,” she said.

What Happens if Ma*****na is No Longer Classified as Schedule 1 Drug? Currently, cannabis/ma*****na is classified as a Schedule I drug, meaning it defined as having "no currently accepted medical use and a high potential for abuse." This is the same designation given to L*D, he**in and ecstasy. It’s also a designation that many ma*****na researchers disagree with.

The average out-of-pocket price for a single dose of naloxone increased by 500% between 2014 and 2018 from $35 per dose to $250 per dose. With 1 in 5 non-elderly adults with opioid use disorder uninsured, Rosalie Liccardo Pacula writes an effective strategy to reduce climbing opioid deaths would be a cap on the out-of-pocket costs for uninsured Americans.

USC Sol Price School of Public Policy; USC School of Pharmacy

During the Height of the Opioid Epidemic, the Out-of-Pocket Price of Naloxone Increased by 500% A jump in the out-of-pocket price of naloxone has likely made the lifesaving drug too expensive for most uninsured Americans.

Cash incentives and nudges did very little to persuade vaccine-hesitant Americans to get the COVID vaccine, according to new research from Mireille Jacobson and colleagues. Published in Vaccine, the findings suggest that employer requirements or government mandates may be necessary public health strategies to increase vaccination rates during future pandemics.

USC Leonard Davis School of Gerontology; USC Sol Price School of Public Policy; USC School of Pharmacy;

Traditional Vaccination Playbook Doesn’t Work with COVID New study finds financial incentives and other behavioral nudges made little difference among certain groups.

California declared a state of emergency last week as wildfires erupted across the state. Neighboring Oregon, and Washington to the north, are also contending with growing blazes. Facing the potential of another September with toxic wildfire smoke blanketing populated towns and cities, Wändi Bruine de Bruin shares five simple tips to stay protected against lifelong health challenges caused by smoke inhalation.

University of Southern California; USC Sol Price School of Public Policy; USC Dornsife College of Letters, Arts and Sciences

How to Protect Yourself Against Wildfire Smoke This Fire Season: Five Tips in Everyday Language Helpful tips on staying protected from wildfire smoke.

We’ve made significant progress in reducing deaths from certain forms of cancer. But widespread disparities still exist and there are significant barriers to accessing early detection tools. Multi-cancer blood-based tests offer promising potential in improving early detection and reducing disparities. Dana Goldman and Lincoln Nadauld argue in a commentary for Future Oncology that broader adoption of these tests should be prioritized, along with policies that will make access to screenings easier.

“If we want to bend the curve on cancer mortality and address the inequities in cancer care, we need policies that enable society to embrace innovative technological approaches that may provide more universal access to comprehensive MCED testing,” they write.

USC School of Pharmacy; USC Sol Price School of Public Policy;

Considerations in the Implementation of Multicancer Early Detection Tests An analysis of the potential benefits and challenges of multi-cancer blood-based tests.

Buprenorphine is currently the only scheduled medication approved for the treatment of opioid use disorder (OUD). Due to restrictive pharmacy regulations, nearly 80% of people with OUD still go without treatment, with racial disparities persisting. In a new JAMA Health Forum Viewpoint, Dima Qato outlines policy solutions to reduce treatment barriers at the federal and state levels.

USC School of Pharmacy; USC Sol Price School of Public Policy

Regulatory Barriers to Dispensing Buprenorphine at US Pharmacies This Viewpoint describes federal and state pharmacy regulations that may create barriers to buprenorphine access at pharmacies and suggests policy changes to address those barriers.

In 2020, some 12,290 Americans died from overdoses involving benzodiazepines and opioids, according to federal statistics. A new Schaeffer Center study from Jason Doctor and other experts finds that a courtesy letter informing physicians when a patient dies of an overdose may provide the needed “nudge” to improve prescribing practices.

In the experiment, the researchers sent out letters from a county medical examiner to prescribers whose patients had suffered a fatal overdose involving opioids. In this follow-up study, Doctor and his coauthors find that the “nudge” not only led to a reduction in opioid prescriptions, but also reduced prescriptions for the most common benzodiazepines.

USC Sol Price School of Public Policy; USC School of Pharmacy

‘Nudges’ to Reduce Opioid Overuse Also Decrease Inappropriate Benzodiazepine Prescriptions Informing physicians when a patient dies of an overdose may provide the needed “nudge” to improve prescribing practices.

New analysis in JAMA Network Open of the New York medical cannabis program finds considerable variability in patient product choice, even for patients with the same condition. Alexandra Kritikos and Rosalie Liccardo Pacula analyzed point-of-sale data from nearly 17,000 patients making more than 80,000 purchases between 2016 and 2019.

USC Sol Price School of Public Policy; USC School of Pharmacy

Patient Preference for Medical Cannabis Products in the Absence of Clinical Guidelines New analysis of New York data finds considerable variability in patient product choice, even for patients with the same condition.