Prescription Drug Trends: A Chartbook

Published: Jun 29, 2000

Prescription Drug Trends – A Chartbook, an analysis by the Kaiser Family Foundation and the Sonderegger Research Center, University of Wisconsin-Madison, provides information about trends in prescription drug coverage, spending, prices, use, and industry structure. Although overall coverage for prescription drugs has increased over the last decade, about a quarter of the nonelderly and a third of Medicare beneficiaries have no drug coverage. Spending for prescriptions is one of the fastest growing components of health care, with increases affected more by increased utilization and changes in the types of drugs used (from older drugs to newer, more expensive drugs) than by price increases for existing drugs.

Making Medicaid Managed Care Work: An Action Plan for People Living With HIV

Published: Jun 29, 2000

This is an update of an earlier report also prepared by The National Association of People with AIDS (NAPWA), with support from the Foundation. That report was the product of a 1996 meeting of people with HIV, their advocates, and researchers designed to provide information about Medicaid managed care for people with HIV. This new report updates information to reflect changes in the policy and regulatory environment since that time.

Report (.pdf)

Building Strong Medicaid Managed Care Programs: A Guide To Help Consumer Advocates Participate in Strengthening HIV/AIDS Provisions in Managed Care

Published: Jun 29, 2000

This new report, prepared by NAPWA with support of the Foundation, grew out of a key recommendation in the Making Medicaid Managed Care Work report, and is designed to provide people with HIV and their advocates with the tools for understanding Medicaid managed care contracts and for working with states to make them responsive to the needs of people with living with HIV.

Report (.pdf)

Poll Finding

Health News Index–May/June 2000

Published: Jun 1, 2000

Health News Index May/June, 2000

The May/June 2000 edition of the Kaiser Family Foundation/Harvard School of Public Health, Health News Index includes questions about major health stories covered in the news, including questions about the Congressional Democrats’ proposal to have the Medicare program cover prescription drug costs for the elderly. The survey is based on a national random sample of 580 Americans and was conducted May 26-June 4, 2000. The survey measures public knowledge of health stories covered by news media during the previous month. The Health News Index is designed to help the news media and people in the health field gain a better understanding of which health stories in the news Americans are following and what they understand about those health issues. Every two months, Kaiser/Harvard issues a new index report.

New National Survey on American Views on the AIDS Crisis in Africa

Published: Jun 1, 2000

To shed light on Americans’ views about the state of the HIV/AIDS epidemic worldwide and the role of the U.S. in addressing the global epidemic, the Kaiser Family Foundation conducted a national survey of Americans about their attitudes towards HIV/AIDS globally and in sub-Saharan Africa, in particular. This survey examines Americans’ understanding of the magnitude of the epidemic, perceptions about access to treatment and care, and support for government and private sector involvement in prevention and treatment in developing nations. It is being released in preparation for the 13th International AIDS Conference to be held in Durban, South Africa.

Table

Published: May 31, 2000

SUMMARY OF CALIFORNIA VERSUS THE U

KEY HEALTH CARE FACTS IN CALIFORNIA AND THE U.S.

California

U.S.

Percentage uninsured (non-elderly) (1998)

24.4%

18.3%

Percentage of children uninsured (1998)

20.8%

15.5%

Percentage of non-elderly enrolled in Medicaid:

1998

11.1%

8.4%

1994

14.3%

10.0%

Percentage of employers that offer health insurance (1999)

48%

61%

Percentage of workers with access to coverage for “non-traditional” partners (1999)

31%

18%

Average monthly HMO premium for family coverage (1999)

$405

$445

Percentage of premium paid by covered workers (1999):

Single coverage

11%

16%

Family coverage

24%

32%

Percentage of workers enrolled in HMOs (1999)

53%

28%

Percentage of health care dollars spent on (1993):

Hospitals

37%

41%

Nursing home care

4%

8%

Physician services

31%

24%

Physicians mean net income (1997)

$172,400

$199,600

Average spent per Medicaid beneficiary (1997)

$2,418

$3,582

Health of Californians (1998):

Overall percentage saying they re in fair to poor health

15%

13%

Percentage of Hispanics saying they re in fair to poor health

23.8%

14.8%

Percentage of the population living in poverty (1998)

15.4%

12.7%

Online Resources-Online.doc-20000613a-Online-doc

Published: May 31, 2000

Online Resources

KFF Resources

Daily Reproductive Health Reports on RU-486 and MifepristoneOffers a retrospective look at the debate, using the archives of this daily report.Abortion, Issue Update May 1999 Highlights the clinical and political issues regarding abortion.From the Patient’s Perspective: the Quality of Abortion Care May 1999 – Women’s views and perceptions of the quality of care they have received.Abortion in the U.S., Fact SheetSeptember 1998 – Offers some useful background statistics on abortion in the United States.

Will 1999 Be The Year For Mifepristone (RU-486) And, An Update on Women’s Other Options for Very Early Abortion, Q & ASeptember 16, 1998 – Examines some of the questions regarding Mifepristone.

National Survey of Women’s Health Care Providers on Medical AbortionSeptember 16, 1998 – Examined provider views of Medical abortion techniques, such as Mifepristone.Content Analysis: Sexual Health Coverage in Women’s, Men’s and Teen MagazinesApril 1997 – An assessment of magazine content, specifically looking at how these specialty magazines dealt with such subjects as abortion.

General Background American Medical Association – Publications list on Mifepristone.

FDA Approvable Letter for MifepristoneFebruary 18, 2000 – According to the FDA: “An approvable letter does not give a company permission to begin marketing the drug.” The FDA issued a prior approvable letter for mifepristone to the “Population Council in September 1996, indicating that the agency believed the drug to be safe and effective, but that unresolved issues remained, including questions about manufacturing.”

FDA Archives on Mifepristone – Offers information from FDA on-line files regarding this controversial drug.

FDA Consumer Magazine – Mifepristone – This update from May/June 2000 offers some information on the approval process.

Medline search on Mifepristone – articles from various journals .

Merck Manual Home Edition – Information Family Planning Methods, including background on medical abortion methods.

Mifepristone – Prescription Drug Reference on WebMD offers general information on the drug.

New England Journal of Medicine – Articles on Mifepristone.

The Recent Debate

Family Research Council Press Release – A pro-life perspective on FDA’s decision.

National Abortion and Reproductive Rights Action League Press Release – A pro-choice perspective.

Organizations Involved in the Debate

Alan Guttmacher Institute – reproductive health research, policy analysis and public education.

American Civil Liberties Union (ACLU) Reproductive Rights Project – Site features information on reproductive rights in Congress and other related legal issues such as privacy and equality.

American Life League – a pro-life organization.

Center for Reproductive Law and Policy (CRLP) – independent, non-profit legal organization “dedicated to promoting women’s health and rights.”

Life Issues Institute – a pro-life organization that seeks to assure “equal protection under the law for all living humans.”

National Right to Life Committee – a public policy group that is dedicated to “the protection of all human life.”

National Abortion Federation (NAF) – A professional association of abortion providers in the United States, providing information on options for pregnant women, information on abortion issues and violence at clinics, as well as fact sheets for providers.

Pacific Institute for Women’s Health – a group dedicated to improving women’s health through research, advocacy, community involvement, consultation, and training.

Planned Parenthood Federation of America – a national family planning organization that supports the use of Mifepristone.

Sexuality Information and Education Council of the U.S. – Promotes comprehensive education about sexuality, and advocates the right of individuals to “make responsible sexual choices.”

Women’s Reproductive Health Resources American College of Obstetricians & Gynecologists (ACOG) – Site provides fact sheets on all aspects of women’s reproductive health, including abortion.

Association of Reproductive Health Professionals – Organization dedicated to educating health care professionals and the public on family planning, contraception and other reproductive health issues.

FDA’s Office of Women’s Health

OBGYN.net – A site for medical professionals and women, which offers various obstetrical and gynecological information resources.

Society for Women’s Health Research – Offers a reading list on women’s health issues, including publications on abortion.

Speaker Biographies

Published: May 31, 2000

Sandra P

SPEAKER BIOGRAPHIES

SANDRA P. ARNOLD

Sandra P. Arnold is Vice President, Corporate Affairs, and Acting Secretary of the Population Council. Her responsibilities encompass information systems, finance and accounting, human resources, publications and public information, contract administration, product licensing, legal affairs, and industry relationships. As manager of the business aspects of the Council’s operations, Ms. Arnold is liaison with the U.S. Food and Drug Administration for the approval of mifepristone. The Council holds the U.S. rights to mifepristone.

The Council is an independent, nonprofit research organization dedicated to improving reproductive health throughout the world, and to achieving a sustainable balance between population and resources. To attain these goals, the Council conducts research in the social, health, and biomedical sciences.

WENDY CHAVKIN, M.D., M.P.H.

Wendy Chavkin, M.D., M.P.H. has been active on a host of reproductive health issues. Her clinical training is in Obstetrics and Gynecology. Her Master s of Public Health (MPH) is in Reproductive Epidemiology, and she is Board Certified in Public Health and Preventive Medicine. Dr. Chavkin directed the Bureau of Maternity Services and Family Planning at the New York City Department of Health from 1984 to 1988. She is Professor of Clinical Public Health and Ob/Gyn at Columbia University s Joseph L. Mailman School of Public Health and the College of Physicians and Surgeons. Dr. Chavkin assumed the position of Editor-in-Chief of the Journal of the American Medical Women’s Association in 1994. She is also a member of the Board of Directors of Physicians for Reproductive Choice and Health (PRCH) and is Associate Editor for Women’s Health Policy at the American Journal of Public Health. She has written extensively about women’s reproductive health issues, including her 1994 book Double Exposures: Women’s Health Hazards at the Job and at Home.

TINA HOFF

Tina Hoff is the Director of Public Health Information and Communication for the Media and Public Education Program at the Kaiser Family Foundation. She oversees the release of Foundation-commissioned research and several communications-related programs, including an ongoing media briefing series on reproductive health issues and the Talking with Kids campaign. She is involved with many of the Foundation’s special partnerships focusing on public education, including a briefing series for Latino journalists and a joint collaboration on women’s reproductive health with Essence, Latina, and the L.A. Times. At the Foundation, Ms. Hoff has also worked on several studies of media coverage of health and reproductive health issues, including content analyses of the sexual and reproductive health coverage in women’s, men’s, teen, and other specialty magazines, a 10-year study of news coverage of HIV/AIDS, the sexual content on television’s family hour, and the sexual content on television soap operas and talk shows. Ms. Hoff joined the Foundation in 1994 as a program officer in communications.

Previously, Ms. Hoff worked for a Washington, D.C.-based public affairs firm, The Widmeyer-Baker Group, representing primarily non-profit organizations focused on health care and women’s and children’s issues. She received a B.S. in Commerce from the University of Virginia.

CAROLE JOFFE, PH.D.

Carole Joffe is a professor of sociology at the University of California, Davis. She received her Ph.D. in sociology from the University of California, Berkeley. Her research focuses on the social dimensions of reproductive health, with a particular interest in abortion provision. She is the author of Doctors of Conscience: The Struggle to Provide Abortion Before and after Roe v. Wade (Beacon Press). Dr. Joffe has recently received grants from the Open Society Institute and the Henry J. Kaiser Family Foundation to investigate the potential impact of the coming of medical abortion to the United States. Some recent articles which have resulted from this research are “Reactions to Medical Abortion Among Surgical Abortion Providers: An Early Snapshot,” Family Planning Perspectives; “Will Medical Abortion Increase Access to Abortion Services? A Cautionary Tale,” Journal of the American Medical Women’s Association; and Medical Abortion in Social Context,” American Journal of Obstetrics and Gynecology, special supplement on medical abortion (forthcoming, August 2000).

ERIC SCHAFF, M.D.

Eric Schaff is an unusual academic pediatrician with a specialty in adolescent medicine. In 1994, he began studying medical abortion with methotrexate at the University of Rochester. In 1996, Dr. Schaff became the principal investigator of the Abortion Rights Mobilization multicenter trials with mifepristone. They have completed five trials with almost 6000 women.

In 1997, he was trained in first trimester surgical abortions at Planned Parenthood New York City s Abortion Training Program and has been providing this service since. He now directs one of eight Kenneth J. Ryan Family Planning and Abortion Fellowship programs. He is currently a full professor in the Department of Family Medicine at the University of Rochester and is a board member of the National Abortion Federation and the National Medical Committee of Planned Parenthood Federation of America.

Dr. Schaff also serves as an Attending in Pediatrics at Strong Memorial Hospital, as Courtesy Attending in Pediatrics at Highland Hospital, and is a member of the American Academy of Pediatrics Section on Adolescent Health, and the Rochester Academy of Medicine – Pediatric Society.

If The FDA Approves Mifepristone…What Happens Next? Will Doctors Provide It? Will Women Want It? And, What Effect Will it Have on Abortion Politics?

Published: May 31, 2000

For almost 20 years, women’s health advocates have been pushing for U.S. approval of mifepristone (also known as “RU-486”), a non-surgical abortion method that European women have used for a decade. Now that the Food and Drug Administration (FDA) seems poised to give the final go-ahead, the big question is: So what happens next? Will mifepristone make abortion more “private,” allowing women and doctors to avoid the threats and protests that have plagued many clinics? Will it motivate more health care providers to offer abortion services, thus making the procedure more accessible? And will women choose it when given the option?

A panel of experts, including Sandra Arnold, Vice President for Corporate Affairs at the Population Council; Eric Schaff, MD, University of Rochester School of Medicine; Carole Joffe, PhD, University of California at Davis, Department of Sociology; and Wendy Chavkin, MD, MPH, Columbia University School of Public Health, and Editor, Journal of the American Medical Women’s Association discussed at an Emerging Issues in Reproductive Health Briefing how women and health care providers will respond to mifepristone, the realities of providing medical abortions, and the likely impact that mifepristone will have on abortion practice and politics.

Recently released national survey data of ob/gyns and family practice physicians was discussed.

Briefing Resources:

New Report Looks at Health Care Trends in California Compared to Rest of Nation

Published: May 31, 2000

A new chartbook by the Kaiser Family Foundation shows that on most, though not all indicators, California’s health care system fares poorly when compared to the U.S. as a whole. The report, Health Care Trends and Indicators in California and the United States, shows that many more Californians have no health insurance than in the rest of the U.S., but when they do have insurance it tends to be more comprehensive and cost less than elsewhere.

The report, which compares key trends and indicators in California’s health care system with those in the rest of the country, is authored by researchers at the Foundation and the Center for Health and Public Policy Studies at the University of California, Berkeley.

  • News Release: California’s Health Care System Looks Significantly Different From Rest of Nation’s