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Morning Rounds Megan Thielking

Trump will talk high health costs at SOTU

President Trump will address Congress tomorrow in his second State of the Union speech — and you can expect prescription drug costs to play a prominent role. The cost of health care — and in particular, the price of prescription drugs — were among a handful of policy items the White House highlighted when previewing the speech to reporters. Last week, health secretary Alex Azar called on Congress to eliminate rebates for medicines purchased in the Medicare program, the latest in a string of proposals that would change how the U.S. health care system pays for drugs. At least one member of Congress has invited a constituent impacted by high drug costs to Trump’s speech. Nicole Smith-Holt, whose son Alec died after struggling to pay for his insulin, is attending as a guest of Sen. Amy Klobuchar (D-Minn.).

Another topic Trump might touch on: ending the HIV epidemic in the U.S. Politico reports that Trump plans to discuss a 10-year strategy to target communities with the most HIV infections to curb new infections. 

Experts call for WHO to reconsider global warning about Ebola epidemic 

An international group of public health experts is calling on the WHO to convene its emergency committee and reconsider whether to declare the Ebola outbreak in DRC a "public health emergency of international concern," or a PHEIC. The emergency committee advised against declaring the outbreak a PHEIC in October, but the number of cases has climbed in the months since. Writing in the Lancet, the experts argue declaring a PHEIC would “galvanize high-level political, financial, and technical support.” But the experts also caution that some potential outcomes, such as trade or travel barriers in DRC, could have “devastating impacts.” They're also concerned that the declaration could create incentives for armed groups — which already pose a challenge in the response — to target Ebola workers.

Inside STAT: Not everyone is being swept up by scientific progress on cystic fibrosis


Harvard Law School student Josh Hillman uses a medical air nebulizer to breathe in antibiotic mist to treat his cystic fibrosis. (KAYANA SZYMCZAK FOR STAT)

To manage his cystic fibrosis, 23-year-old Josh Hillman inhales a mucus thinner, pops enzymes to maximize the nutrients his body absorbs, and wears a vibrating vest to help clear the mucus that gunks up his airway and lungs. When he sleeps, a nutritional shake drips directly through a tube into his stomach. It’s all part of his daily regimen — and that’s just when Hillman is healthy. But what's missing from that list is just as notable: one of the cutting-edge treatments for the progressive genetic disease. The treatments — three already available and a still-experimental treatment expected to be approved — cover the genetic mutations held by some 90 percent of CF patients. That leaves up to 10 percent of people, including Hillman, whose diseases are progressing without a powerful defense to slow them down. STAT's Andrew Joseph has the story here.

FDA warns about faulty warfarin test strips

The FDA is warning patients and doctors that test strips used to monitor levels of a common blood thinner might give inaccurate results. Roche has already recalled more than 1.1 million packages of the test strips, which are used in medical devices to measure levels of warfarin. Now, the medical product distributor Terrific Care/Medex Supply is recalling more of those test strips. The FDA says the latest recalled products weren't included in the initial warnings because they weren't authorized to be sold in the U.S. Terrific Care/Medex Supply company purchased the test strips from an unknown supplier and imported them. The FDA says the faulty test strips “can lead to errors medication dosage that could cause serious harm or death in some patients.”

University of California, Elsevier continue fight that could shape research access

The University of California and the journal publishing giant Elsevier are still in a high-stakes fight over how open-access research gets paid for. In 2018, UC paid Elsevier more than $10 million for the school's affiliates to have access to hundreds of Elsevier journals. But UC researchers also pay nearly $1 million each year in fees to make their papers freely available online. UC has been pushing to change that payment structure, rolling the subscription fee and open-access fees into a single, discounted payment. UC's contract with Elsevier expired at the end of 2018, but the groups extended the window for negotiations through January. That deadline is now up — but the two groups have “agreed to continue good-faith discussions,” Jeff MacKie-Mason, a UC Berkeley librarian who’s helping lead negotiations, tells STAT. "We are still far apart on key issues, but hopeful that we might find a way to come together," he says.

Cancers tied to obesity rise among young adults in the U.S.

New research suggests that cancers tied to obesity are on the rise among young adults in the U.S. Researchers dug into data from 25 states on cancers diagnosed between 1995 and 2014. When they looked specifically at cancers that  have been associated with obesity — including multiple myeloma, thyroid, and kidney cancers — they found that rates are rising most quickly among adults ages 25 to 49. It’s important to note that while prevalence is climbing young people, the cancers are generally much more common among older adults ages 50 to 84. The study, published in the Lancet Public Health, comes as the health community marks World Cancer Day today.

What to read around the web today

  • Shortage of anxiety drug leaves patients scrambling. New York Times
  • Transparent hospital pricing exposes wild fluctuation, even within miles. Kaiser Health News
  • From Clinton’s cabinet to Congress: Donna Shalala talks Obamacare, prescription drug ads, and importation. STAT Plus
  • Combating the opioid crisis one doctor at a time. Washington Post

Thanks for reading! More tomorrow,


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Monday, February 4, 2019


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