Stuart O. Schweitzer

Smoking and alcohol abuse: a comparison of their economic consequences.

This paper examines the health and economic costs of smoking and alcohol abuse to society. Total economic costs of diseases related to smoking are multiplied by the corresponding estimated smoking factor (Table 2). The results adjusted to 1976 prices includes cost of property fires estimated to have been caused by smoking. The total direct health-care costs related to both behaviors is calculated at

Patient-Related Predictors of Rehabilitation Use for Community-Dwelling Older Americans

20.2 billion in 1976 or almost 20% of the total estimated cost of direct medical care in the U.S. Total economic costs (medical care and lost earnings) of illnesses related to smoking and alcohol abuse is

Benzodiazepine Use in Older, Community-Dwelling Southern Californians: Prevalence and Clinical Correlates

59.9 billion or 25% of the total economic cost of illness to the nation. While it is well known that alcohol abuse results in decreased human productivity and lost earnings due to alcoholism is widely reported lost earnings due to cigarette smoking (95% which are almost as high as alcohol abuse) are not well known. This is because lost production due to smoking is variously associated with death or disability related to different categories of illness (e.g. heart disease stroke or cancer).

The persistence of the discouraged worker effect

To determine patient factors that predict use of physical or occupational therapy (PT/OT) services by elderly people.

Issues in Drug Pricing, Reimbursement, and Access in China with References to Other Asia-Pacific Region

OBJECTIVE: To determine the use of benzodiazepines (BZDs) in an older, community-dwelling sample and to examine the sociodemographic and clinical correlates of BZD use. DESIGN: A cross-sectional study of 1752 elderly people (aged ≥65 y) who completed a mailed medication survey and a telephone health status survey. PARTICIPANTS: Participants were invited to participate in a large Medicare demonstration project on prevention by their private physicians, who were also enrolled in the larger study. Participants had to be English-speaking, could not have dementia or a terminal illness, and had to give informed consent to participate in the study. MAIN OUTCOME MEASURES: Sociodemographic and health status variables that predicted BZD use were examined. Sociodemographic variables included age, gender, ethnicity, education, and income. Health status variables included functional status, with measures of mental, social, and physical health. Influenza immunization status was used as an indicator for preventive health services use and self-reported chronic illness was used as a measure of comorbidity. RESULTS: Twenty percent of the participants used BZDs at least twice in the past year. We found that those who used BZDs were more than twice as likely to take ten or more drugs, two-and-a-half times more likely to have difficulty falling asleep, and over twice as likely to be depressed. BZD users were also more likely to be white, to have a college education, and to have received a recent influenza shot, but were not more likely to be women when controlled for health status. CONCLUSIONS: Further clinical research should explore the relationship between BZD use among older patients and the BZD-associated adverse clinical factors we observed, as well as the association between multiple drug use and potential adverse outcomes in older BZD users.

The social drug lag: An examination of pharmaceutical approval delays in medicaid formularies

Determination of the relationship between labor force and worker participation rates in the United States in the 1970s. Hypothesis as to why unemployment affects youth; Significance of work orientation for work relationships; Description of the labor participation model. (Abstract copyright EBSCO.)

Industrial Policy in America

OBJECTIVES Pharmaceutical policies have become paramount in China and other countries of the Asia-Pacific region because of rapidly rising expenditures on drugs. The problems are especially acute in China because expenditures on drugs are typically so large. This article intends to review effects of the policy of drug expenditure containment with primary reference to China, and it proposes some measures to deal with rising pharmaceutical expenditures. METHODS This article overviews the issues of pharmaceutical pricing, reimbursement, and access in China, and there are a number of policies or measures to control pharmaceutical expenditures. Nevertheless, the effect of those policies of containing drug expenditure is ambiguous so far, and some policies have negative impacts to the manufacturers, providers, and patients. Some underlying reasons are identified. First, the policys focus on health-care costs is, to some extent, neglected. Second, the governance of the health sector, including pharmaceutical sector, needs to be improved by both the government and the market. RESULTS This article proposes some suggestions to change policies in drug pricing, reimbursement, and access, and make policies more responsive to the main problem of rising health-care expenditures rather than that of pharmaceutical expenditures alone. CONCLUSIONS The policy suggestions include those of setting the reasonable price for pharmaceuticals, instituting reasonable incentives for all health decision-makers to encourage efficient use of pharmaceuticals and other health resources, and making pharmaceutical markets more efficient, either in the demand or the supply side.

Trying Times at the FDA — The Challenge of Ensuring the Safety of Imported Pharmaceuticals

Several states have enacted restrictive drug formularies in order to control the costs of their Medicaid pharmaceutical programs. This study investigates the restrictiveness of these formularies by analyzing the delay in approving new drug products for Medicaid reimbursement. A restrictiveness index is developed which relates the drug product months which are denied to Medicaid patients to the potential product months of availability if all products which were newly approved for general use were simultaneously made available to the Medicaid population. The study then relates the restrictiveness of state formularies to Medicaid drug program costs and to total Medicaid program costs. We find that restrictiveness of formularies is not associated with lower drug costs, but that total Medicaid costs are lower in states with more restrictive formularies. We suggest that restrictive formularies may occur in states with other Medicaid cost-containment measures, so that total Medicaid expenditures are contained in those states, even though there is no reduction in drug expenditures.

The Effect of Medicaid Formularies on the Availability of New Drugs

In contrast to what observers have frequently argued, this timely and thought provoking book suggests that the concept of industrial policy is not alien to the American past and present. The debate on this topic in the US has always been full of contradictory rhetoric and policy practices, and the expert authors therefore acknowledge a need to rethink the traditional antagonist positions. They illustrate that contemporary markets continue to demand to be fixed by government policies, and governments continue to show how fixing-the-market policies might fail. The conclusion is that the future of industrial policy is about how to make both markets and governments better in their functioning, but that the real goal for industrial policy is to make better-market and better-government policies consistent with the goal of building a better society.

Cost-effectiveness analysis of prenatal diagnosis intervention for Down's syndrome in China

In recent years, the FDA has faced serious challenges to its ability to ensure the safety of the countrys medical devices and drugs. What can be done? Stuart Schweitzer writes that one approach is to attempt to boost the FDAs efficiency. Stuart Schweitzer discusses challenges and recent crises at the FDA and the scope of the agencys responsibilities. Dr. Schweitzer is a professor of health services at the UCLA School of Public Health, Los Angeles.