Thursday, November 10, 2016

Morning Rounds by Megan Thielking

Good morning, everyone, and welcome to the Morning Rounds. 

Grappling with the future of Obamacare and Medicaid

Come January, Donald Trump will have the support of a Republican-led Congress in rolling back large parts of the Affordable Care Act. It’s still unclear what that will look like, but what is known is that it will also have ripple effects on Medicaid. Millions of Americans are at risk of losing the Medicaid coverage they gained under the ACA, and states stand to gain more authority over how they operate the program. Trump has previously said he’d move Medicaid to a block grant formula that would award states a certain amount of money — determined by poverty levels — to let them manage Medicaid on their own with some federal oversight.

Meanwhile, many non-Medicaid people insured under the ACA will also likely lose coverage. There’s no way of knowing exact numbers because there’s no precedent for this kind of action, and much depends on what Republican leaders choose to replace Obamacare with. That uncertainty comes as open enrollment for 2017 plans carries on. 

IBM and the Broad Institute team up to tackle cancer

IBM Watson Health and the Broad Institute of MIT and Harvard are announcing a major research effort this morning aimed at discovering what drives cancer drug resistance. The project includes a $50 million investment to generate drug-resistant cancer genome data from 10,000 patient samples as well as laboratory studies. The Broad Institute will make that anonymized data available to the global scientific community to galvanize research. Most cancers eventually recur, in part because they acquire mutations that make them drug-resistant. The goal of this five-year collaboration: Find patterns in the genomic data that predict which tumors will develop drug resistance — a major cause of nearly 600,000 annual cancer deaths in the US alone. In September, President Obama’s Cancer Moonshot Blue Ribbon Panel identified the issue of drug resistance as a major research focus in accelerating the fight against cancer.

Public librarians can serve public health

Public health researchers are turning to a surprising ally to help research underserved populations: local librarians. A new collaboration between the University of Pennsylvania and the Free Library of Philadelphia has developed a pilot program to make library employees into community health workers. A bit of backstory: The Free Library had 5.8 million in-person visits in 2015. Of those, 500,000 were for programs that addressed health determinants including job skills and literacy. Public health experts saw that as a unique opportunity — library employees could be better trained to help connect patrons with housing, food, work, and health care.

The program offered evidence-based public health information to library staff and trained them on how to work with children and families experiencing everything from immigration difficulties to homelessness. "Librarians are closely attuned to community needs," University of Pennsylvania's Carolyn Cannuscio tells me. "Being on the 'front lines,' librarians are in many ways like health care providers or social workers." Read more about the program in the new Health Affairs.

Sponsor content by convergehealth by deloitte

Shifting power to the patients: Patient Connect from Deloitte

Previously life science organizations developed and marketed therapies without patient contact, but the changes in technology and the health care ecosystem are increasing the patient’s role in decision making and reshaping their health expectations. Now, there is an opportunity to help patients navigate the complexities involved in receiving the original diagnosis, deciding on treatment, securing financial assistance, connecting with other patients and community experts, and supplementing clinical education. Patient Connect™ by ConvergeHEALTH can help.

Inside STAT: Trump a likely roadblock to key health bill

The Senate has spent months working on a package of bills to speed up the process of getting new drugs and medical devices to market — a companion to the House’s 21st Century Cures Act, which passed last year. Democrats and Republicans have been going back and forth to reach an agreement that could be approved in a lame-duck session of Congress. Republicans negotiated to simplify the regulatory process, and Democrats countered to secure additional funding for the NIH and the FDA. That funding included NIH dollars that could be used for the cancer moonshot and the Precision Medicine Initiative. But the election of Donald Trump — who has railed broadly against government regulation — has made the fate of that legislation all the more uncertain. More from STAT's Sheila Kaplan here

Scientists comb through drugs to battle superbugs

a cluster of sphere-shaped drug-resistant Streptococcus pneumoniae bacteria. (James archer / cdc)

Researchers at the NIH’s centers for translational science and infectious diseases have a new way to pinpoint drugs effective against antibiotic-resistant infections. The test can quickly rifle through thousands of existing drugs and drug combinations to see if they could turn up some new superbug-battling candidates in the large trove of known drugs. Scientists screened about 4,000 known drugs and other compounds, 25 of which seemed to clamp down on the growth of antibiotic-resistant Klebsiella pneumoniae. Three drug combinations also showed promise in combating 10 other commonly seen strains of drug-resistant bacteria. Read more about the approach in Emerging Microbes & Infections

Mylan reports revenue after EpiPen controversy

EpiPen manufacturer Mylan reported a loss of $119.8 million in the third quarter of this year. The company said in an earnings call that its recent settlement with the Department of Justice — to the tune of $465 million — was largely to blame for the loss. That settlement came out of an investigation into whether Mylan overcharged Medicaid for EpiPens. Despite the controversy of the product's price hikes, EpiPen prescriptions were up during the third quarter. Mylan did sell less volume of EpiPens than in previous quarters, likely because wholesale buyers are anticipating a lower-cost, generic version of the product, which the company announced in response to the recent outrage over pricing. Earlier this week, a group of senators called for Mylan to repay $50 million to the Pentagon for EpiPen purchases. 

Veterans feel healthier than the general population

Men and women who’ve served in the military are about 10 percent more likely to report being in excellent health than their peers who haven’t — but those groups also face distinct health disparities. A new report out from UnitedHealth Group examines data culled from more than 400,000 phone interviews to better understand health outcomes among veterans. While those who served reported better overall health, they also reported higher rates of cancer, heart attack, and coronary heart disease. About 6 percent of veterans have suffered heart attacks, compared to just 3.6 percent of the general population. The good news for veterans: Those who have served are more likely to be physically active than their peers.

What to read around the web today

  • How dams risk poisoning indigenous diets. The Atlantic
  • Breathe. Exhale. Repeat. The benefits of controlled breathing. New York Times
  • Monkeys regain control of paralyzed legs with help of an implant. NPR

More reads from STAT

As always, thank you for reading. Back tomorrow to round out the week, 


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