Ozempic and related semaglutide drugs represent a popular new strategy to address obesity in the United States, yet uptake of these medications has sparked opposition highlighting concerns about off-label drug use policies, drug safety, supply shortages and cost. Public attitudes towards off-label prescribing by physicians broadly, and towards Ozempic in particular, in light of this opposition are unclear. To better understand public sentiment on this topic, we analysed data from a representative survey of 3,420 US adults conducted from 13 to 22 June 2023. Public attitudes towards off-label prescribing were split, with 46.3 percent supporting physician discretion to prescribe off-label. Importantly though, 58 percent of respondents were at least somewhat concerned about Ozempic supply shortages caused by off-label use and 63 percent were concerned about Ozempic safety in the context of off-label use. Further analysis from an embedded survey experiment shows that rhetoric highlighting safety (but not supply) concerns surrounding off-label Ozempic prescribing is associated with a significant drop in support for off-label use. These results suggest that the introduction of obesity drugs like Ozempic present a pharmaceutical industry-led path for combatting obesity, but rhetoric opposing these drugs could blunt public support and uptake.

Legal status is an important social determinant of health. Immigration enforcement policies may be an important contributor to health disparities in the form of interior border checkpoints (IBCs). These checkpoints may prevent immigrants and their families from seeking needed medical care. Currently, we do not know how these barriers are perceived by the public. We administered a survey of 6,178 respondents from 13 November to 19 November of 2023 that contained a survey experiment to assess public attitudes on the issue. Respondents were generally not supportive of detaining individuals at IBCs or medical facilities for emergencies regardless of characteristics of the care-seeking individual. A majority was supportive of detention when medical treatment was complete. Respondents were generally more sympathetic towards children and pregnant women. Partisanship and sympathy expressed towards immigrants influenced attitudes towards detention. Findings based on race and ethnicity showed inconsistencies. A majority of Americans did not believe that IBCs should impede undocumented immigrants from accessing medical care, especially in emergency situations and for children and pregnant women. Our findings indicate that there is broad public support for expanding existing policies to allow for undocumented individuals to pass through IBCs to access medical care.

Conducting scientific medical research with human subjects presents risks that raise both ethical and human rights concerns. We argue in this article that applying a human rights framework to the problems that arise in the context of scientific medical research can contribute to a better understanding of the impact on individuals, the related obligations of the State, and the avenues to make the State accountable when things go wrong. We start our analysis with a case brought to the European Court of Human Rights, which we use as an illustration throughout the article. We then discuss the relevance of human rights to the field of scientific medical research with a focus on the right to life and the right to health. The article draws on international human rights jurisprudence that deals with concrete disputes arising from the clinical reality. We use case law to highlight the role of human rights law in tackling the real-life problems that may occur during scientific medical research. Our analysis contends that human rights law can provide valuable guidance for healthcare professionals and equip them to handle concrete situations in the clinical reality when the safety of research subjects is at stake.

During the 1970s and 1980s, over 30,000 people in the UK were infected with HIV and/or hepatitis C because of treatment with blood and blood products for conditions such as haemophilia or through blood transfusion. We used the social harms perspective to understand the experiences of those affected. We conducted in-depth interviews with 41 infected people and 11 family members and analysed the data according to five dimensions of social harm: physical harms, psychological harms, cultural harms, economic harms, and harms of misrecognition. We found that people were harmed by the medical system, the social context that perpetuated stigma and shame against them, and successive governments being largely unwilling to address the many health, social, and economic impacts of infection on families. What stood out were the many reports of harms of misrecognition, which were often experienced as more irreconcilable than the circumstances of infection itself. They were also harms that have been largely ignored.

While patient safety encompasses a broad field of work, much of the research focuses on physical harm and medical error. The social harms lens can provide important insights into patient safety incidents as it can help explain the complexity of the different dimensions of harm that individuals and their families experience.

This study estimates productivity losses resulting from intellectual decrement due to paediatric lead exposure in low- and middle-income countries (LMICs). The published literature on blood lead levels in LMICs was reviewed and summarised. Intelligence Quotient decrement and consequent productivity losses were calculated for a one-year cohort of 5-year-old children in each country. We calculated the present value of lifetime earnings as the discounted average earning potential for workers in a specific economy. Blood lead level (BLL) data for children were available for 39 countries and could be interpolated for additional 82 countries, resulting in 121 countries in the final analysis. Total lead-attributable productivity losses in LMICs ranged from USD 305 billion in our high discount scenario to USD 499 billion in our low discount scenario for each one-year cohort of 5-year-old children (2019 USD). As a share of GDP, these costs ranged from 0.7 to 4.2% by region, depending on discount scenario used. Total economic impacts were generally consistent with previous estimates and further validate those efforts with a substantially expanded dataset. Differences in the findings resulted primarily from the use of a more conservative dose–response model in the present study. Improved reporting of BLLs is essential and could be facilitated through a centralised registry of study results.

The impact of health technologies may extend beyond the patient and affect the health of people in their network, like their informal carers. The National Institute for Health and Care Excellence (NICE) methods guide explicitly allows the inclusion of health-related quality of life (HRQoL) effects on carers in economic evaluations when these effects are substantial, but the proportion of NICE appraisals that includes carer HRQoL remains small. This paper discusses when inclusion of carer HRQoL is justified, how inclusion can be substantiated, and how carer HRQoL can be measured and included in health economic models. Inclusion of HRQoL in economic evaluations can best be substantiated by data collected in (carers for) patients eligible for receiving the intervention. To facilitate combining patient and carer utilities on the benefit side of economic evaluations, using EQ-5D to measure impacts on carers seems the most successful strategy in the UK context. Alternatives to primary data collection of EQ-5D include vignette studies, using existing values, and mapping algorithms. Carer HRQoL was most often incorporated in economic models in NICE appraisals by employing (dis)utilities as a function of the patient's health state or disease severity. For consistency and comparability, economic evaluations including carer HRQoL should present analyses with and without carer HRQoL.