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Morning Rounds Shraddha Chakradhar

Drug importation proposals threaten one drug maker more than others

The Trump administration yesterday fleshed out proposed rules to begin to allow states to import certain medicines from Canada in an attempt to help reduce drug costs. Some states, including Florida and Colorado, have already released plans to begin drug importation. But not all drug makers are poised to be affected in the same way if and when the rules eventually go into effect. For example, makers of insulin, which states won't be able to import, won’t be threatened. Other companies, especially those that make high-priced HIV and hepatitis C drugs, are likely to be hardest hit. In fact, of the 16 drugs that Florida has said it wants to import, more than half are HIV and hep C drugs. And Gilead, which has staked a lot of its business on both these drugs, is likely to be especially hurt by the new rules. Read more here

Nearly half the U.S. population will be obese by 2030

New data that estimate rates of obesity at the state level in the U.S. find that by 2030, nearly half of all Americans will be obese. Here’s more: 

  • Overall prevalence: The prevalence of obesity will be higher than 50% in 29 states in the next 10 years, and no state will have an obesity rate of less than 35%. 

  • Demographic trends: Severe obesity (BMI of 35 or higher) is likely to be the most common form of obesity among women, black people, and those with household incomes of less than $50,000.  

  • State trends: Oklahoma, Alabama, and Arkansas are projected to have an obesity rate of nearly 60%. Hawaii, New York, and Massachusetts — with obesity rates of around 40% — are projected to have the lowest rates.  

Lab Chat: A pre-pregnancy vaccine for Zika 

In a new study, researchers describe how a Zika vaccine — one developed by NIH scientists — given to rhesus macaques who were then impregnated seems to prevent transmission of the virus to the fetus and protects against brain damage. I spoke with Dr. Koen Van Rompay, an infectious disease specialist at the University of California, Davis, to learn more. 

What’s the biggest takeaway? 
As far as we know, this is the first study that shows that this vaccine protects monkeys that go on to become pregnant. Many vaccine studies are done where you expect peak immune response. But we first immunized and then got them pregnant — and they got pregnant anywhere from three days after we tried to a year, [which shows this could be a long-term strategy for protection]. 

Is there any pharma interest? And if not, what’s to say this will help humans? 
I’m hoping with our data and data generated by the NIH’s trials of this vaccine, that we can increase interest. If pharma completely pulls out, we’ll never get anywhere. It's dangerous [because] we’re just sitting on a ticking time bomb for the next outbreak somewhere out there. 

Inside STAT: Waning treatment is a warning for all ‘one-and-done’ therapies


(MOLLY FERGUSON FOR STAT)

Severe combined immunodeficiency — or SCID — is a genetic disorder that hampers the growth of essential immune cells, leaving people vulnerable to any infection. For decades, bone marrow transplants have allowed many affected babies to survive past infancy and lead relatively normal lives. But it's become increasingly clear that these patients' immunity sometimes starts to fade decades after a transplant. Now, patient advocates are trying to change the way we talk about treatments — and not just for SCID. They see this experience as a cautionary tale for anyone receiving treatments that are touted as potentially curative. STAT’s Eric Boodman has more.

White House holding mental health summit

The White House is holding a meeting this afternoon on the Trump administration’s strategies for enhancing mental health treatment, and how that can ease homelessness, violence, and substance use disorder. The summit will feature experts in these subject areas, as well as leaders from law enforcement and local, state, and Cabinet government levels, according to a senior administration official. At least one person who is scheduled to speak at the invite-only meeting is DJ Jaffe, the executive director of the advocacy group Mental Illness Policy Organization. He has shared that he plans to speak on a range of issues, including increasing the use of assisted outpatient treatment — where the court orders mental health treatment for those too ill to recognize their need for care — as well as reducing incarceration of the seriously mentally ill.

In a first, tobacco use among males is on the decline

A new WHO report on global tobacco trends finds that, for the first time, the number of males smoking tobacco is on the decline. Here’s what else is in the report: 

  • Long-term trends: The decline in tobacco smoking was most pronounced among women, and overall, 60 million fewer people smoked in 2018 than in 2000. 

  • Declines: The WHO projects 10 million fewer tobacco users by next year. The agency also projects that more than 1 million fewer men will be using the substance by then — and 5 million fewer men will be tobacco users come 2025. 

  • Geographic trends: Countries in Southeast Asia had the highest proportion of tobacco users, while countries in the Americas were most on track to meet the WHO’s goal of reducing tobacco use by 30% in the next decade.

What to read around the web today

  • Top Republican blasts McConnell for derailing bipartisan drug pricing bill. STAT
  • Moffitt Cancer Center shakeup: CEO and others resign over China ties. Tampa Bay Times
  • My mother’s dementia made me a better person. My dog agreed. The New York Times
  • From clinic to courtroom, fighting for immigrant health care. Kaiser Health News
  • Appeals court rules ACA’s individual mandate unconstitutional; lower court to decide whether rest of law can stand without it. The Washington Post

Thanks for reading! More tomorrow,

Shraddha

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Thursday, December 19, 2019

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