The New England Journal of Medicine: Search Results in Health Policy and Reform

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Adolescents’ Use of “Pod Mod” E-Cigarettes — Urgent Concerns

Adolescents’ use of electronic cigarettes initially took the public health community by surprise. In 2011, less than 2% of U.S. high school students reported having used e-cigarettes in the previous month. But by 2015, the percentage had jumped to 16%….

Heavier but Healthier — Diabetes and Smoking Cessation

Two opposing trends provide a point and counterpoint for the health of the public. The good news is that the prevalence of smoking among adults in the United States has dropped to a provisional modern low of 13.9% (although this figure means that there…

Lessons from an Angry Patient

She bore a scowl and a combative attitude from the moment I walked into the room. In response to my hopeful “How can I help you?” she unleashed a tirade that seemed to pick up where some prior conversation had left off. Though she was new to my practic…

Smoking Cessation, Weight Change, Type 2 Diabetes, and Mortality

Smoking cessation reduces the risk of major chronic diseases and extends life expectancy, but considerable weight gain may occur in quitters after cessation. Such weight gain is probably due to increased appetite and reduced energy expenditure and may …

Ibalizumab in Multidrug-Resistant HIV — Accepting Uncertainty

The Food and Drug Administration (FDA) has long recognized that physicians and patients are generally willing to accept greater risks from drugs used to treat life-threatening illnesses than they would from drugs used for less serious illnesses. The ag…

Risk Factors, Mortality, and Cardiovascular Outcomes in Patients with Type 2 Diabetes

Type 2 diabetes is a complex disease that leads to continuous medical care with comprehensive, multifactorial strategies for reducing cardiovascular risk. Patients with type 2 diabetes have risks of death and cardiovascular events that are 2 to 4 times…

The CMS Proposal to Reform Office-Visit Payments

The Medicare payment policy for evaluation and management services — the most commonly billed type of physician services in the United States — has long attracted scrutiny. Tasked with rewarding cognitive work by physicians that is commensurate with pa…

The Next Phase of Human Gene-Therapy Oversight

The National Institutes of Health (NIH) and the Food and Drug Administration (FDA) have played key roles in the emergence of safe and effective human gene therapies. Now, we are proposing new efforts to encourage further advances in this rapidly evolvi…

National Coverage Analysis of CAR-T Therapies — Policy, Evidence, and Payment

In December 2017, the Boston radio station WBUR chronicled the case of the first patient at Massachusetts General Hospital to receive axicabtagene ciloleucel (Yescarta, Gilead) outside a clinical trial. The chimeric antigen receptor T cells (CAR-Ts) we…

Will Courts Allow States to Regulate Drug Prices?

Pharmaceuticals are consuming increasingly large portions of U.S. state budgets, and high prices are preventing patients from getting, and adhering to, essential medicines. In mid-May 2018, President Donald Trump announced a heavily hyped but relativel…