Monday, March 19, 2018

Morning Rounds by Megan Thielking

Welcome to the work week, everyone, and welcome to Morning Rounds. 

Trump set to release new plans for tackling opioid crisis

President Trump is traveling to New Hampshire today to outline the White House's national strategy to combat the opioid epidemic, along with HHS Secretary Alex Azar and Jim Carroll, the newly appointed acting director of the Office of National Drug Control Policy. 

Beyond a controversial plan to seek the death penalty for some drug dealers, the response does include some elements that public health figures have long advocated for, like increasing access to naloxone, incentivizing use of medication-assisted treatment, and calling on Congress to lift caps on beds at addiction treatment facilities eligible for Medicaid funding. 

White House officials also touted a forthcoming public-private partnership between the NIH and drug companies to research nonaddictive painkiller alternatives, as well as new incentives for states to make their prescription drug monitoring programs compatible and form a de facto nationwide PDMP. But they didn't provide many details about a plan to reduce opioid prescriptions by one-third in the next three years.

Round two for 'right to try'

The House Rules Committee meets tonight to consider how to structure debate around the so-called "right-to-try" bill that lawmakers failed to pass last Tuesday, teeing the bill up for another vote later this week. It's pretty likely the bill — which garnered 259 votes of support last week — will pass the House when it only needs a simple majority. (Last time, Republicans tried to skip this step and bring up the bill under so-called "suspension of the rules," which requires a two-third majority.)

If it passes, lawmakers will have to iron out differences between the House bill and a similar version that passed the Senate. Supporters, including many Republicans and the libertarian think tank the Goldwater Institute, say it’ll give dying patients a new pathway to access experimental drugs. Democrats and a number of major patient groups say it'll limit the FDA's oversight of the drug approval process and that it's unnecessary, given the agency's existing expanded access program.

Teens who are homeless are at a higher risk of these health problems

An estimated 2.5 million kids in the U.S. are homeless at some point each year — and suicide is troublingly common among that group, according to a new study. Researchers looked at data from 62,000 teens in Minnesota and found that those who were homeless in the past twelve months were twice as likely to report emotional distress, self-harm, and suicidal thoughts and three times as likely to attempt suicide than their peers who aren’t homeless. The authors say there’s an urgent need for resources and policies that support stable housing for families and, in turn, hopefully reduce the prevalence of those problems. 

Inside STAT: A virtual ghost charged with fraud at Theranos


Elizabeth Holmes is the face of one of Silicon Valley’s biggest scandals — but the next act of the Theranos saga rests on a mysterious tech entrepreneur. Ramesh “Sunny” Balwani, who spent nearly seven years in the No. 2 position at the blood-testing startup, is a virtual ghost. While Holmes graced magazine covers and spoke before adoring crowds, Balwani, her former boyfriend, has almost no Internet presence. Now, he’s accused of a massive fraud. Holmes, accused of nearly identical crimes, settled with the SEC last week, as did Theranos. But Balwani didn’t — and his defense could rely on throwing Holmes under the bus, attorneys say. Read more about Balwani here.

Hear about innovative research, straight from scientists

We’re down to eight finalists in our STAT Madness bracket, and this week, we’re doing Twitter chats with the scientists behind the research. Tune in here at 4 p.m. ET today to hear from researchers at Texas A&M, who have created an animal model of preeclampsia and the team they’re up against, University of California, San Diego, scientists who are using CRISPR-Cas9 to manipulate RNA and potentially treat diseases like ALS.  

FDA brainstorms how to test drugs for rare diseases

This week, FDA staff, experts, and patients will convene to brainstorm ideas about how to test drugs for rare diseases. It can be difficult to design trials that determine if drugs actually work, particularly when so few patients have a disease. And the FDA is limited in how it can give drug companies guidance in clinical trial design that'll pass its regulatory hurdles. The agency can’t tell one company that it green-lighted another company’s clinical trial design, because the way a trial is designed is confidential, says Lisa LaVange, a biostatistician at the University of North Carolina who’s presenting at the meetings today and tomorrow.

“It’s hard to encourage innovation when you can’t give examples,” LaVange says. “People want examples.”

What to read around the web today

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