Access to expensive anti-cancer drugs

Expensive anti-cancer drugs expose controversy underlying the process for resource allocation decisions, and intermittently result in marked publicity, emotive discussions about access to novel and expensive treatments, and political involvement which may override existing processes. This column outlines the methods of determining whether or not a treatment is considered appropriate to fund, and focuses upon the evidence of patient and doctor wishes. The existing research illustrates the complexity of patient and oncologist decision-making when these drugs are to be considered. Past litigation to obtain access to expensive treatments is discussed, along with the interactions between patients, pharmaceutical companies, health services and oncologists. This evolving field is being transformed by developments in molecular biology enabling targeted drugs, and amply demonstrates the complexity of funding decisions and how expensive treatments are considered by a range of stakeholders.     

Proactive Evaluation of PRP Status at Hazardous Waste Disposal Sites

Two keys to avoiding potentially responsible party (PRP) status at future Superfund sites are to manage all waste with appropriate care and to perform appropriate inquiries into the history of new properties prior to acquisition. However, corporations can become PRPs because of their ownership and/or operation of historically contaminated property, their historical waste management practices, or their historical disposal of hazardous substances at nonowned disposal sites, such as landfills. This article describes a method by which insurance companies, waste producers, and property owners can proactively evaluate their potential liability associated with environmental response action costs at contaminated sites.     

Halfway Homeowners: Eviction and Forced Relocation in a Florida Manufactured Home Park

The last four decades of US housing policy have seen a shift from the federal allocation of affordable housing as a public good to the neoliberal model of private and for‐profit provision of affordable housing. This shift warrants a study of the link between the interests that now shape low‐income housing markets and the stability of the housing they provide. Nowhere are the effects of this shift more evident than in the homes of the 20 million Americans living in manufactured housing, which is installed largely on the private lands of for‐profit developers who can close mobile home parks and force residents to move themselves and their homes with as little as 30 days' notice. This ethnography of mass eviction in a Florida mobile home park examines state regulations intended to protect residents of closing parks and analyzes how private interests shape the implementation of these policies.