It’s the Same, Only It’s Not: Perceptions of the Prescription Drug Market in Comparison With Other Illicit Drug Markets

2018 ◽  
Vol 48 (3) ◽  
pp. 393-408
Author(s):  
Jennifer Gatewood Owens ◽  
Michelle Smirnova
Keyword(s):  
Illicit Drug ◽  
Drug Market ◽  
The United States ◽  
Drug Markets ◽  
Rapid Rise ◽  
Public Health Response ◽  
Illicit Markets ◽  
Health Response ◽  
Effective Public Health ◽  
Prescription Drug Market

Given the rapid rise of prescription (Rx) opioid overdoses in the United States, it is crucial to understand how people acquire Rx drugs. Prior research suggests individuals obtain Rx drugs through both legal and illegal channels, but there has been limited qualitative research focused upon the intersections between Rx drug markets and other drug markets. To understand the similarities and differences, we interviewed 40 incarcerated women about their experiences with both markets. Based upon these conversations, we find that few women received pills exclusively through doctors and 90% of them had used illicit markets or informal social networks to acquire Rx drugs. Although there is extensive overlap between the users, dealers, and operations between Rx and illicit drug markets, these women draw attention to how certain agents, processes, and social reactions differ in meaningful ways that are crucial to an effective public health response.

scholarly journals United States response to the COVID-19 pandemic, January–November 2020

2021 ◽  
pp. 1-14
Author(s):  
Mathew Alexander ◽  
Lynn Unruh ◽  
Andriy Koval ◽  
William Belanger
Keyword(s):  
United States ◽  
The United States ◽  
Contact Tracing ◽  
Public Health Response ◽  
The Public ◽  
The Past ◽  
Health Response ◽  
Physical Infrastructure ◽  
Key Policy ◽  
United States Healthcare

Abstract As of November 2020, the United States leads the world in confirmed coronavirus disease 2019 (COVID-19) cases and deaths. Over the past 10 months, the United States has experienced three peaks in new cases, with the most recent spike in November setting new records. Inaction and the lack of a scientifically informed, unified response have contributed to the sustained spread of COVID-19 in the United States. This paper describes major events and findings from the domestic response to COVID-19 from January to November 2020, including on preventing transmission, COVID-19 testing and contact tracing, ensuring sufficient physical infrastructure and healthcare workforce, paying for services, and governance. We further reflect on the public health response to-date and analyse the link between key policy decisions (e.g. closing, reopening) and COVID-19 cases in three states that are representative of the broader regions that have experienced spikes in cases. Finally, as we approach the winter months and undergo a change in national leadership, we highlight some considerations for the ongoing COVID-19 response and the broader United States healthcare system. These findings describe why the United States has failed to contain COVID-19 effectively to-date and can serve as a reference in the continued response to COVID-19 and future pandemics.

scholarly journals A Geography of Risk: Structural Racism and COVID-19 Mortality in the United States

2021 ◽  
Author(s):  
Lauren C Zalla ◽  
Chantel L Martin ◽  
Jessie K Edwards ◽  
Danielle R Gartner ◽  
Grace A Noppert
Keyword(s):  
Minority Groups ◽  
Ethnic Disparities ◽  
The United States ◽  
Structural Racism ◽  
Public Health Response ◽  
Health Response ◽  
The Us ◽  
Racialized Minority ◽  
Racial And Ethnic Minority ◽  
Disproportionate Burden

Abstract Coronavirus disease 2019 (COVID-19) is disproportionately burdening racial and ethnic minority groups in the US. Higher risks of infection and mortality among racialized minorities are a consequence of structural racism, reflected in specific policies that date back centuries and persist today. Yet, our surveillance activities do not reflect what we know about how racism structures risk. When measuring racial and ethnic disparities in deaths due to COVID-19, the CDC statistically accounts for the geographic distribution of deaths throughout the US to reflect the fact that deaths are concentrated in areas with different racial and ethnic distributions than that of the larger US. In this commentary, we argue that such an approach misses an important driver of disparities in COVID-19 mortality, namely the historical forces that determine where individuals live, work, and play, and consequently determine their risk of dying from COVID-19. We explain why controlling for geography downplays the disproportionate burden of COVID-19 on racialized minority groups in the US. Finally, we offer recommendations for the analysis of surveillance data to estimate racial disparities, including shifting from distribution-based to risk-based measures, to help inform a more effective and equitable public health response to the pandemic.

The Prescription Drug Market

2021 ◽  
pp. 14-37
Author(s):  
Neumann Peter J. ◽  
Cohen Joshua T. ◽  
Ollendorf Daniel A
Keyword(s):  
Health Insurance ◽  
Prescription Drug ◽  
Drug Market ◽  
Supply Side ◽  
Drug Markets ◽  
Demand Side ◽  
Considerable Uncertainty ◽  
Pricing Power ◽  
Prescription Drug Market ◽  
System Feature

This chapter describes how prescription drug markets deviate from “normal” competitive markets. On the demand side, there is considerable uncertainty in disease prognosis and treatment effects; buyers have much less information than sellers; consumers usually do not pay directly for their prescriptions but rather have health insurance, which protects them from a drug’s full price; and physicians and insurers play a major role in consumer choices. On the supply side, firms are heavily regulated, subject to laws requiring that drugs undergo extensive testing before entering the marketplace. Monopolies are a system feature, designed to incentivize companies to invest in expensive and risky drug discovery by providing the prospect of a big payoff if the investment succeeds. Patents and market exclusivity restrict competition and provide drug developers considerable pricing power. The challenge for policymakers is how to achieve reasonable or fair drug prices in light of these market distortions.

scholarly journals A collaborative multiyear, multimodel assessment of seasonal influenza forecasting in the United States

2019 ◽  
Vol 116 (8) ◽  
pp. 3146-3154 ◽  
Author(s):  
Nicholas G. Reich ◽  
Logan C. Brooks ◽  
Spencer J. Fox ◽  
Sasikiran Kandula ◽  
Craig J. McGowan ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Real Time ◽  
Forecast Accuracy ◽  
The United States ◽  
Public Health Response ◽  
Public Health Decision ◽  
Health Decision Making ◽  
Health Response ◽  
Health Decision

Influenza infects an estimated 9–35 million individuals each year in the United States and is a contributing cause for between 12,000 and 56,000 deaths annually. Seasonal outbreaks of influenza are common in temperate regions of the world, with highest incidence typically occurring in colder and drier months of the year. Real-time forecasts of influenza transmission can inform public health response to outbreaks. We present the results of a multiinstitution collaborative effort to standardize the collection and evaluation of forecasting models for influenza in the United States for the 2010/2011 through 2016/2017 influenza seasons. For these seven seasons, we assembled weekly real-time forecasts of seven targets of public health interest from 22 different models. We compared forecast accuracy of each model relative to a historical baseline seasonal average. Across all regions of the United States, over half of the models showed consistently better performance than the historical baseline when forecasting incidence of influenza-like illness 1 wk, 2 wk, and 3 wk ahead of available data and when forecasting the timing and magnitude of the seasonal peak. In some regions, delays in data reporting were strongly and negatively associated with forecast accuracy. More timely reporting and an improved overall accessibility to novel and traditional data sources are needed to improve forecasting accuracy and its integration with real-time public health decision making.

scholarly journals Human Immunodeficiency Virus in the State of Texas of the United States: Past Reflections, Present Shortcomings, and Future Needs of the Public Health Response

2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Ume L Abbas ◽  
Camden J Hallmark ◽  
Marlene McNeese ◽  
Vagish Hemmige ◽  
Joseph Gathe ◽  
...  
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
The United States ◽  
Lessons Learned ◽  
Accelerated Expansion ◽  
Public Health Response ◽  
Treatment And Prevention ◽  
Health Response ◽  
Immunodeficiency Virus ◽  
Exposure Prophylaxis

Abstract A strategy titled “Ending the HIV Epidemic: A Plan for America” aims to reduce human immunodeficiency virus (HIV) incidence in the United States by at least 90% by 2030, using diagnosis, treatment, and prevention strategies. Texas is a Southern state that has one of the highest numbers of new HIV diagnoses and people with HIV in the country, and where HIV disproportionately impacts minorities. We retrace the historical epidemic in its largest city, Houston, to illustrate the lessons learned and milestones accomplished, which could serve as guideposts for the future. We examine the current epidemic in Texas, including the achieved levels of HIV testing, treatment continua, and pre-exposure prophylaxis prescription, and compare and contrast these with the national estimates and Plan targets. Our findings call for urgent and accelerated expansion of efforts to end HIV in Texas.

Drug Market Criminology

2017 ◽  
Vol 28 (3) ◽  
pp. 191-205 ◽  
Author(s):  
Kim Moeller
Keyword(s):  
Illicit Drug ◽  
Competitive Equilibrium ◽  
Interpersonal Relations ◽  
Transaction Cost Economics ◽  
Drug Market ◽  
Social Embeddedness ◽  
Drug Markets ◽  
Criminological Research ◽  
Middle Range ◽  
Abstract Level

There is a divide between economic and criminological research on illicit drug markets. Economists have focused on modeling markets at an abstract level, while criminologists have focused on offending in individual street-level marketplaces. This article combines the economic and criminological research on illicit drug markets through the lens of social embeddedness theory. The analysis concerns how participants reduce the uncertainties that follow from the illegality of the product, the lack of reliable information on product quality, and the trustworthiness of the trading partner. Social embeddedness theory is reconcilable with transaction cost economics but puts more emphasis on the importance of longer term interpersonal relations and trust. Using this framework provides a middle-range interpretation for the economic irregularities observed in drug markets: how prices deviate from the competitive equilibrium and how distributors develop and maintain interpersonal trust and balance competitiveness with security concerns.

scholarly journals Clinical Response, Outbreak Investigation, and Epidemiology of the Fungal Meningitis Epidemic in the United States: Systematic Review

2015 ◽  
Vol 10 (1) ◽  
pp. 145-151 ◽  
Author(s):  
Kaja M. Abbas ◽  
Nargesalsadat Dorratoltaj ◽  
Margaret L. O’Dell ◽  
Paige Bordwine ◽  
Thomas M. Kerkering ◽  
...  
Keyword(s):  
Public Health ◽  
United States ◽  
Systematic Review ◽  
Clinical Response ◽  
Policy Development ◽  
The United States ◽  
Outbreak Investigation ◽  
Public Health Response ◽  
Fungal Meningitis ◽  
Health Response

AbstractWe conducted a systematic review of the 2012–2013 multistate fungal meningitis epidemic in the United States from the perspectives of clinical response, outbreak investigation, and epidemiology. Articles focused on clinical response, outbreak investigation, and epidemiology were included, whereas articles focused on compounding pharmacies, legislation and litigation, diagnostics, microbiology, and pathogenesis were excluded. We reviewed 19 articles by use of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The source of the fungal meningitis outbreak was traced to the New England Compounding Center in Massachusetts, where injectable methylprednisolone acetate products were contaminated with the predominant pathogen, Exserohilum rostratum. As of October 23, 2013, the final case count stood at 751 patients and 64 deaths, and no additional cases are anticipated. The multisectoral public health response to the fungal meningitis epidemic from the hospitals, clinics, pharmacies, and the public health system at the local, state, and federal levels led to an efficient epidemiological investigation to trace the outbreak source and rapid implementation of multiple response plans. This systematic review reaffirms the effective execution of a multisectoral public health response and efficient delivery of the core functions of public health assessment, policy development, and service assurances to improve population health.(Disaster Med Public Health Preparedness. 2016;10:145–151)

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