A male pharmacist is examining a drug from a pharmacy inventory.

Monthly Round-Up of What to Read on Pharma Law and Policy

By Ameet Sarpatwari, Alexander Egilman, Aviva Wang, andAaron S. Kesselheim

Each month, members of the Program On Regulation, Therapeutics, And Law (PORTAL) review the peer-reviewed medical literature to identify interesting empirical studies, policy analyses, and editorials on health law and policy issues.

Below are the citations for papers identified from the month of April. The selections feature topics ranging from a discussion of manufacturer’s restricted delivery of 340B drugs to contract pharmacies and ensuing litigation, to an analysis mapping the European patent landscape for medical uses of known products, to an evaluation of the clinical benefit of novel drugs approved in the U.S. from 2018-2019. A full posting of abstracts/summaries of these articles may be found on our website.

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Tax forms with laptop, glasses, pen, and calculator.

The Tax Code Needs to Do More for Public Health

By Bailey Kennedy

With the pain of tax day now a month behind us, it’s worth talking about something that we don’t often associate with the tax code: health. It’s not easy to imagine that the tax code could truly do much to make Americans happier and healthier — but there are ways that it could. Federal and state tax codes could both be reformed in small ways that might encourage Americans to make healthier decisions.

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Brooklyn, New York, United States - JUNE 13 2021: Protest in Brooklyn, NY for trans youth rights.

Misleading, Coercive Language in Bills Barring Trans Youth Access to Gender Affirming Care

By Arisa R. Marshall

On Friday, a federal judge temporarily enjoined part of a new Alabama law that would make it a felony for physicians to provide gender-affirming care to trans youth. The law had been in effect for less than a week.

This is only the most recent development relating to a raft of anti-trans legislation sweeping the country. More than twenty bills that would impose life-changing healthcare restrictions on transgender children have been introduced in statehouses nationwide over the past two years, threatening the wellbeing of transgender youth and communities. Most of these bills aim to entirely ban gender-affirming medical care for minors, including surgeries, prescription puberty blockers, and hormone replacement therapies.

These laws are detrimental to the mental, physical, and social health of children. They are dismissive of the experiences of transgender children and teenagers, misleading, and manipulative.

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Basketball street player making a rear slam dunk.

Another Kind of Performance-Enhancing Drug in Sports: Substances That Improve Creativity

By Jack Becker

Discussions about performance-enhancing drugs (PEDs) are normally all about physical abilities. They revolve around PEDs that can alter strength, speed, stamina, recovery, and even stability. But if every sport were just a competition of physical traits, they’d be pretty boring.

Sports combine physical competition with competition of strategy, technique, and other non-physical components (to varying degrees). While players develop some of these individually, sports also involve coaches and trainers that develop new strategies and techniques without stepping onto the field. Innovations in these non-physical components can certainly enhance a player or team’s performance. So how do they fit into the PED discussion?

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Hand holding glass ball with inverted image of surroundings reflected in ball.

Flipping the Script: Adoption and Reproductive Justice

By Kimberly McKee

Adoption is a reproductive justice issue. Pretending otherwise ignores how adoption is used as a red herring in anti-abortion arguments. A recent invocation of this faulty logic occurred in Justice Amy Coney Barrett’s questions during the November 2021 oral arguments in Dobbs v. Jackson Women’s Health Organization. Coney Barrett’s statements implied that the option to relinquish infants vis-à-vis adoption rendered abortion availability unnecessary. This line of thinking is one with which I am familiar, as both a Korean international, transracial adoptee, and a critical adoption studies scholar. 

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gavel.

Adoptee Rights and Adoption Annulment

By Gregory Luce

Annulling or legally ending an adoption is not a new concept, but it has rarely applied to the benefit of adopted people. Instead, informal practices, as well as specific legal frameworks dating back more than 100 years, have long-supported a “right of return” policy for adoptive parents who no longer feel an adoption is beneficial or even desired.

Activists within today’s adoptee rights movement, however, are working to establish a right to end a person’s own adoption by building on what has long existed in the law for adoptive parents, but refocusing it on the specific demands for autonomy of adopted people, particularly those who do not view adoption to be in their best interests.

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Austin, TX, USA - Oct. 2, 2021: Two women participants at the Women's March rally at the Capitol protest SB 8, Texas' abortion law that effectively bans abortions after six weeks of pregnancy.

Organizing and Activism of Adopted and Displaced People

By Lina Vanegas

I am a transracial and transnational displaced person. I was separated from my country, language, and culture and taken to Michigan, which has no connection to me or my ancestors. I was taken there to create a family for strangers who had the privilege and resources to buy me. I had family in Colombia and I was far from being a true orphan. I was bought in Bogota, Colombia and sold to a white couple living in the Midwest in 1976. 

I use the word “displaced” intentionally, because the word “adopted” does not define my lived experience in an accurate way. The word “adopted” is language that was created by the child welfare-industrial complex, also known as the adoption industry. I do not subscribe to any of the constraints or barriers that they attempt to put onto my life with their language choices. Using the word “displaced” defines the intentional separation from my family by the child welfare-industrial complex. 

My lived experience has informed who I am and has inspired and motivated the work that I do online and in the world. It is very rare that adopted and displaced people’s lived experiences are seen, heard, validated, centered, and believed, so my mission is to do that online, on my podcast, Rescripting The Narrative, and in the work that I do as a social worker and with the organization Adoptees for Choice.

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Empty hospital bed.

Native Reproductive Justice: Practices and Policies from Relinquishment to Family Preservation

By Lauren van Schilfgaarde

Adoption can be, and frequently is, a celebrated extension of kinship ties within Native communities. But we cannot ignore the historical context of adoption as a tool to empty tribal communities and delete tribal cultures. Nor can we ignore the historical context of the simultaneous deprivation and weaponization of reproductive health care, both of which deny Native women reproductive self-determination. 

It is these contexts in which anti-abortion proponents seek to ameliorate the further denial of health care through increased adoption. The proposal is eerily familiar. 

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Broken chain.

The Indian Child Welfare Act: Preserving Families Is in Children’s Best Interests

By Kathryn E. Fort

On February 28, 2022, the Supreme Court accepted one of the most consequential federal Indian law cases in decades, a direct constitutional challenge to the Indian Child Welfare Act (ICWA). This challenge, brought by three states and three foster families, intends to not just dismantle a gold standard law in child protection, but all of federal Indian law. The plaintiffs who brought this case are not interested in improving the child protection system, or finding ways to support promising practices, or ensuring the resiliency for Native children affected by trauma. This case is about an attempt to dismantle the current federal protections for tribal governments, tribal citizenship, and tribal sovereignty. The case does so by ignoring the best interests of Native children and the voices of a uniquely unified Indian Country

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