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Tuesday, April 24, 2018

Morning Rounds by Megan Thielking

Here's what you need to know about health and medicine this morning. 

New CDC director makes far more money than past leaders

Dr. Robert Redfield is being paid $375,000 a year as the new CDC director — nearly double the salary of his predecessor, the AP reports. Dr. Brenda Fitzgerald, who resigned from the CDC in January, was paid $197,300 a year. By comparison, FDA Commissioner Scott Gottlieb makes $155,500, while HHS Secretary Alex Azar and NIH Director Francis Collins both make $199,700. Redfield, unlike the other health agency leaders, is paid through a salary program dubbed Title 42, which is used to recruit top-tier health scientists to federal agencies. The longtime AIDS researcher took a huge pay cut to take the job. 

Trump's health insurance proposal sparks thousands of comments

More than 8,000 comments from the public have poured in on the Trump administration’s proposal to expand the time that consumers can stay on short-term insurance plans, which are often cheaper than standard insurance because they skimp on benefits.

  • The proposal: The plan would extend the maximum time people can stay on the plans from three months to one year. Public comments on the idea closed last night, and now the government will weigh those comments before potentially issuing a final rule. 
  • The details: The proposal could drive more people to sign up for short-term plans, which don't have to stick to the same requirements as other insurance plans. A new Kaiser Family Foundation analysis of 24 short-term plans finds that 43 percent don’t cover mental health care, 71 percent don’t cover outpatient prescription drugs, and none cover maternity care.
  • The opposition: Many insurers and major medical groups are against the idea, arguing it’ll drive up premiums and leave more people uninsured and underinsured. 

Lawmakers to vote on opioid, cancer registry bills

It’s a busy day for the Senate health committee, which is voting today on the Opioid Crisis Response Act, a bipartisan package of legislative proposals that would boost grant funding for states and tribes hit hardest by the epidemic. Among other proposals, the legislation also clarifies that the FDA can require drug makers to package opioids in smaller quantities, like a three-day supply. Also on the docket: a bill that would overhaul how over-the-counter drugs are regulated and a proposal that would require the CDC to set up a national cancer registry for firefighters, which researchers could use to study the risk of certain cancers among that group.

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Scientists aim to treat nerve pain with light

Nerve cells that are super-sensitive to touch are shown in green. (Dhandapani et al. / Nature Communications)

Scientists have discovered a specific set of nerve cells that play a part in neuropathic pain, which can cause severe discomfort with even a gentle touch in some patients. The researchers created a light-sensitive chemical that binds to the nerve cells. Their idea: inject the chemical and hit it with light, which causes the nerve cells to pull away from the skin’s surface and lessens pain. Mice with neuropathic pain started exhibiting normal reflexes to touch after the light therapy, but the results only lasted a few weeks until the nerve endings went back to normal. The research is still in the early stages, so much more testing is needed to figure out how it might translate to use in patients.

Inside STAT: Can weight loss drugs be used to treat addiction?

A wave of prescription weight loss drugs has hit the market in recent years — and turned out to be commercial flops. But now, scientists are looking at the drugs as potential addiction therapies. They suspect that if dependence on cocaine or cigarettes is the result of an addiction, obesity might similarly be an addiction to food. Dr. Nora Volkow, who leads the National Institute on Drug Abuse, says "there's an enormous amount of overlap" between addiction and obesity. "We’re observing that molecules that modify eating behavior also modify the motivation to take drugs," she told STAT's Meghana Keshavan. Read their conversation here

Conflicts of interest at the FDA's advisory meetings

A new paper in JAMA is raising questions about potential conflicts of interest of people who speak at the FDA's advisory committee meetings on opioids. The committee — which advises the FDA on pain drugs — allows public comments but doesn’t require speakers to disclose conflicts of interest. Researchers analyzed meeting data from 2009 to 2017 and found that nearly 20 percent had an undisclosed financial COI. Another 20 percent disclosed a COI, most often that they'd been reimbursed for their travel. Speakers with a COI were more likely to support a drug’s approval than those without one. The authors are calling on the FDA to mandate that all public speakers share their potential conflicts. 

What to read around the web today

  • A vet maimed by an IED receives a transplanted penis. New York Times
  • DEA plan to stem supply of prescription drugs draws skepticism, STAT
  • OB-GYNs urged to see new mothers sooner and more often. ProPublica / NPR
  • U.K. ministers urge Vertex to reach pricing deal on its cystic fibrosis drug. STAT Plus

Thanks for reading! More tomorrow,

Megan

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