Get the health information and medications you need every weekday with STAT’s free newsletter Morning Rounds. Sign up here.
good morning. Yesterday’s game wasn’t that exciting, but luckily Saturday’s third place match had all the drama I expected. Check out the news below before playing the highlights.
Good news about quitting smoking
Last week, Medicare announced proposed changes to its physician fee schedule. STAT’s Sarah Todd reports that several paragraphs embedded in the 1,592-page document suggest that doctors may soon receive financial incentives to help patients who want to quit smoking.
The proposal would increase reimbursement by 19% for physicians who counsel patients to quit smoking or other tobacco products during their visits. “We may be able to offer something to these patients,” said Ned Sharpless, former director of the National Cancer Institute, who has long advocated for this kind of change. “Nobody’s going to get rich doing this, but it’s going to be on par with any other activity going forward.” Read more from Sarah, who first reported this news.
HHS Vaccine Committee Quietly Gets New Charter
Despite the White House’s reported edict to postpone vaccine policy changes before the midterm elections, Secretary of Health Robert F. Kennedy Jr.’s team continues to overhaul the way vaccine policy is set and reviewed. One of its latest targets is the National Vaccine Advisory Committee, which advises the Department of Health and Human Services on vaccine use and safety. NVAC was previously made up primarily of scientists, doctors and public health officials who research vaccines. Its purpose was to advise on the best and safest use of vaccines to prevent infectious diseases. But the group’s new charter, dated July 7, sets out different priorities, although HHS has not made it public.
Among the changes, the committee is directed to expand its focus beyond vaccines to leverage other tools to reduce the spread of vaccine-preventable diseases among people who cannot or will not consent to vaccination. They suggest that these tools should include healthy lifestyles, nutritional supplements, and “repurposing” already approved FDA drugs. The new charter proposes limiting the number of academics whose industry-funded vaccine research can serve on the NVAC, and placing more emphasis on the public.
— Helen Branswell
Even “good” insurance can deny psychiatric care
As an emergency physician, Joy Evers knew what medical options were available to her husband if he needed emergency psychiatric treatment. She knew she had found the best facility available, but that didn’t matter. Less than a week after her husband, Randy, had been in an inpatient facility for eight weeks, his insurance company refused to cover further hospitalization and he was forced to leave the hospital. Several months later, he was found dead.
“My love for Randy and my professional experience were not enough to save him,” Evers writes in a new first opinion essay. “I’m a doctor, and when my husband passed away, it was proven that he was sick enough to receive treatment.”
Read the entire essay. This is a harrowing and heartbreaking first-hand account of how even the best-insured and medically savvy families can be seriously wronged by the system’s flaws.
Profit over patient safety?
If you go to Novo Nordisk’s website looking for weight loss drugs, you’ll see that the company promotes LifeMD as one of several telemedicine providers offering “legitimate drug sourcing and patient support.” But interviews with five former employees and two lawsuits filed by former executives highlighted serious concerns about the virtual provider. According to these accounts, in recent years LifeMD has pushed clinicians to see more patients and prescribe weight-loss drugs more quickly, with little screening or follow-up.
In an interview, CEO Justin Schreiber strongly denied that the company is putting profits over safety, saying, “Our purpose is not to run a pill mill. In fact, we are doing the opposite.” But the allegations come amid widespread concerns about lax clinical oversight among many telemedicine companies offering weight loss drugs.
Read Elaine Chen’s excellent research. Some of the allegations in a lawsuit filed by former LifeMD executive Brad Roberts, who claims he was prescribed six different GLP-1 drugs by Life MD’s chief medical officer, are particularly alarming.
England tests all newborns for SMA
England announced last week that it would expand its newborn screening program to include spinal muscular atrophy, bringing forward a planned expansion of a pilot program to extend testing to around 70% of babies. Instead, muscle-wasting diseases will be added to the panel of diseases that all newborns are tested for from later this year, with full coverage expected next year.
Doctors and advocates have long complained that the UK has been slow to bring new diseases onto the board. All 50 states, Canada, and most European countries added SMA to their testing programs ahead of the UK. Remarkably, the government has not said whether it will make broader changes to the procedure for adding diseases to the committee, which critics say is the reason the UK lags behind other countries. — andrew joseph
Access to OTC naloxone varies by country
Recent studies show that approximately 40% of opioid overdose deaths have a bystander nearby who could have administered life-saving naloxone. But even though it is approved for over-the-counter sale in 2023, it remains difficult for people to obtain the nasal spray to reverse an overdose. A new secret shopper analysis by JAMA Network Open examined the drug’s availability, location, and pricing in pharmacies.
Researchers called more than 1,100 pharmacies and found that about 61% had the drug available the same day without a prescription. Most (73%) were kept behind the counter, with an average cost of approximately $52. Predominantly white neighborhoods were more likely to offer naloxone, as were corporate chain pharmacies. Although the drug should have been made available over-the-counter, the policy’s “intended benefits were not equally realized in practice,” the study authors wrote.
There is a calculator for that, but your results may vary
When doctors need help making decisions about their patients, there are hundreds of calculators and clinical tools at their disposal. This includes simple calculations such as BMI and mean arterial pressure, as well as more complex predictive models of risk and outcome. But as STAT’s Katie Palmer reported last week, just because a tool exists doesn’t mean doctors should always trust what it says.
“In the clinical setting, we have no idea how limited the validation of many of the tools we use is,” said Shazia Siddique, MDCalc’s chief medical officer. That’s why the company is launching a quality rating system to help doctors better evaluate all the clinical tools and calculators they want to use. The company publishes scores in batches based on the tool’s clinical purpose. Last week it was a calculator that predicts cardiovascular risk. This category has seen significant changes recently. Read more from Katie about which tools have received the lowest ratings so far and how those ratings work.
what we are reading
- FDA says Taylor Farms’ Cyclospora test produced false positives for the parasite in lettuce samples, NBC News
-
Despite warnings, violence erupts repeatedly in dementia care, test finds, NPR
-
What Lionel Messi sees in the Atlantic Ocean
- Opinion: It’s time to treat the pandemic as a threat to national security, STAT
- Men sue hospital after DNA test taken 38 years ago reveals they were swapped at birth, Associated Press
- State audit of Medicaid records points to techniques used by PBMs to hide drug costs, STAT
