January 3, 2020
Trump administration issues partial e-cigarette ban but concerns remain
After a long-awaited decision, the Trump administration issued a limited ban on e-cigarettes on Thursday. The ban will remove certain flavors of vaping products from the market; however, menthol and tobacco flavored products are exempt from the ban, and it only applies to flavors in pod-based products. Pods are pre-filled with a set amount of vaping liquid, while open tank vaping products are refillable. Although pods are more popular, all flavors will still be available in open tank vaping systems, meaning flavors will still be widely available and accessible.
The ban is intended to stem the youth vaping epidemic, but it is a large step back from the President’s original announcement from last year that covered all flavored e-cigarette products. Companies will have 30 days to cease the production and distribution of the covered products before the Food and Drug Administration (FDA) begins enforcement.
When asked about the announced ban, Health and Human Services (HHS) Secretary Alex Azar said, “By prioritizing enforcement against the products that are most widely used by children, our action today seeks to strike the right public health balance by maintaining e-cigarettes as a potential off-ramp for adults using combustible tobacco while ensuring these products don’t provide an on-ramp to nicotine addiction for our youth.”
The Prevent Cancer Foundation® supports efforts to curb the use of e-cigarettes among teens and young adults; however, this ban does not go far enough to protect youth and end the ongoing epidemic. All flavored products are still available through the open tank systems. While identifying cessation products for adults is important, there is currently no credible evidence to support that e-cigarettes are a safe and effective method, nor are they FDA approved for cessation. Therefore, they should not be used as a justification to maintain the availability of flavors which can still be accessed by youth.
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Alex Azar announces new proposed rule on drug importation
On Wednesday, Health and Human Services Secretary Alex Azar spoke to the press about the administration’s intent to begin the process of allowing states to import drugs from Canada to help reduce drug prices. Under the plan, states would be able to work with wholesalers or pharmacies to develop a process for how the drugs would be imported. There are certain restrictions on the types of eligible drugs, specifically any products that are considered controlled substances and those that are not subject to the FDA safety systems. Insulins and other biologic drugs (drugs made from living cells) are not eligible either.
Azar also announced the FDA will be releasing a draft guidance to drug manufacturers on how the process would work and get their feedback.
Although implementation of the policy will likely take months or possibly years, four states have already submitted plans or declared intent to engage in the process—Colorado, Florida, New Hampshire and Vermont. Florida’s proposal includes a list of 19 drugs it will seek to import.
In his comments to the press, Azar sought to engage other states saying, “We want to see proposals from states, potentially in conjunction with wholesalers and pharmacies, that can help accomplish our shared goal of access to safe and effective prescription drugs at lower prices.”
This is a developing story. We will provide updates as they occur.
CMS seeks to support states with work requirements
Center for Medicare and Medicaid Services (CMS) Administrator Seema Verma has rolled out new tools to help support states seeking to submit 1115 waivers, which allow states to make changes to their Medicaid programs, such as adding work requirements. These tools will help states with implementation plans and data collection to demonstrate the effectiveness of their proposals.
“The Medicaid program was designed to serve our most vulnerable populations like children and people with disabilities, so it’s logical that the nature of demonstration projects would change given the unprecedented expansion of Medical eligibility to childless, working-age adults that occurred under Obamacare,” wrote the CMS Administrator Verma in a blog post Thursday.
Since their introduction, seven states have received approval for work requirements through CMS. However, results have been mixed, and many have criticized CMS for its implementation of the requirements. For example, Arkansas has dropped 18,000 beneficiaries from its program, but CMS does not have records documenting why. The Los Angeles Times also reported that none of the states that have received approval have plans in place to track whether the work requirements have improved health outcomes or led to increased employment.
Work requirements disproportionately impact cancer patients who may be undergoing treatment and cannot actively work or may not be able to work full-time. The Prevent Cancer Foundation supports patients and caregivers that may desperately need health care. We urge CMS to work with these individuals to help access crucial services, including screenings and diagnostic tests in order to help reduce their risk of progression into a later stage.
