Thursday, February 15, 2018

Morning Rounds by Megan Thielking

Good morning, everyone. Good news: We have a STAT app, so now you can get the latest science and medicine news on your tablet or phone. Check it out here

VA secretary misused agency resources, report finds

Government oversight officials have found that VA Secretary David Shulkin’s 10-day trip to Europe last summer led to a “misuse of VA resources." Shulkin and his wife took the trip — which was supposed to be to attend a veterans’ affairs conference in London and meetings in Denmark — along with other VA execs. The VA’s inspector general found that Shulkin had tasked an aide with planning activities for him and his wife ahead of time and then spent half of the trip sightseeing.

One of those sightseeing stops? Wimbledon. The report found Shulkin improperly accepted tennis tickets, which he said were provided by a personal friend. The inspector general’s office found that they’d only met three times at official events. And the investigation found that Shulkin’s chief of staff altered an email planning the trip to get approval to use taxpayer money to pay for Shulkin’s wife’s flights, which cost more than $4,000. Shulkin told USA Today he regretted the situation and has paid the government back for his wife's airfare. 

Spending growth on prescription drugs will double this year

Prescription drug spending is going to climb quickly this year, according to new national health spending estimates from the Centers for Medicare and Medicaid Services. Here’s what the analysis found:  

  • Health spending overall is slated to jump 5.3 percent this year. That’s faster than last year, when spending grew by 4.6 percent.

  • Prescription drug spending is picking up speed. The authors of the new report say they anticipate drug spending growing by 6.6 percent this year, up from 2.9 percent last year. In actual dollars, that means spending on medicines is projected to reach $360.2 billion, up from $338.1 billion.

  • Private health insurance spending is expected to slow down. The report predicts spending on private health insurance plans will grow by 4.8 percent this year, which is actually slower than last year’s growth. That might be due, in part, to the net cost of insurance in the marketplaces falling.

Curious about CRISPR? Check this out

The first clinical trials in the U.S. of the genome-editing technology CRISPR are set to get underway this year. How will researchers measure success, and which companies are betting on the technologies to treat, cure, or prevent disease one day? STAT’s Sharon Begley and Adam Feuerstein are tackling the big questions about CRISPR in a free webinar next Thursday at 1 p.m. — sign up here.


Breaking the statin switch cycle

Did you know that at least 50 percent of people stop taking their prescribed statin within one year of starting it, despite the proven impact of statins on lowering cholesterol? With several different statins on the market and more than 100 million U.S. adults living with high cholesterol, prescribing the right statin for each patient can be challenging.

When patients complain about their statin, shouldn’t one switch be enough?

Inside STAT: Fecal transplants are becoming a mainstream treatment


A nasty bug that can cause potentially deadly infections. (CDC)

An influential medical group is recommending fecal transplants — in which donor fecal matter is transferred to a patient — for people who’ve repeatedly failed the standard treatments for severe diarrhea caused by a bacteria known as C. diff. More than half a million people get the bacterial infection in the U.S. each year, and it’s particularly dangerous for older people and those with weak immune systems. This morning, the Infectious Diseases Society of America issued new guidelines on treating C. diff infection, noting that the success rates for fecal transplants are near 90 percent. But we still lack long-term data and the FDA still considers fecal transplant an "investigational new drug." STAT's Elizabeth Cooney has the details here.

Scientists create an atlas of the brain's blood network

Scientists have created a new atlas that maps out the many blood vessels that keep the brain running, along with the blood-brain barrier that keeps dangerous pathogens out. Here’s what Michael Vanlandewijck of the Karolinska Institute told me about the work, published in Nature.

How did you create this atlas?

We broke apart the blood-brain barrier of the mouse in single cells, and from each individual cell we measured the expression level of every gene using a relatively new technology called single cell RNA sequencing. It was long thought that the blood-brain barrier was made up of specialized endothelial cells in the blood vessels. However, we found that there are probably many other types of cells involved in the maintenance of the blood-brain barrier as well.  

How could the atlas be used?

The atlas means that a number of genes with known or presumed function in different brain diseases can now be associated with specific cell types in the brain’s vasculature, shedding new light on several disease mechanisms. The database is freely available online and can be used by all researchers worldwide.

A new push to get the public thinking about science

The National Academy of Sciences is launching a cool new initiative to get the public engaged in science. The program, dubbed LabX, aims to get people interested in how science can help inform decisions they make, whether that’s in their personal life or in their communities. Geoffrey Hunt, the director of LabX, tells me he’s hopeful that the program will be able to engage people on “some of the most pressing and relevant current health issues, ranging from the opioid crisis to nutrition to mental health.” They’ll do outreach through online tools and events around D.C.

What to read around the web today

  • Afghanistan's lone psychiatric hospital reveals mental health crisis fueled by war. NPR
  • How a police chief, a governor, and a sociologist would spend $100 billion to solve the opioid crisis. New York Times
  • Inside the mystery at the Havana embassy. ProPublica

More reads from STAT

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