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Morning Rounds Megan Thielking

Lawmakers will grill pharma execs today. Here's what to expect

The Senate Finance Committee will grill drug industry executives today about the high cost of medicines. Here’s what you need to know:  

  • The questions: STAT's Nicholas Florko caught up with lawmakers to see how they plan to press drug makers. Committee Chairman Chuck Grassley says he wants to know how drug makers set prices, a simple question that might be difficult to get answered. And both Republicans and Democrats want to know why the U.S. pays more for drugs than other countries. 
  • The witnesses: The leaders of Merck, Pfizer, AstraZeneca, Johnson & Johnson, AbbVie, Sanofi, and Bristol-Myers Squibb will testify. Read more about their preparations here
  • On a related note: Several anti-pharma groups are harnessing publicity around the hearing to promote their own messages. Among them: the patent reform coalition CAPA, which paid to wrap today’s Washington Post in a two-page ad that says “patent abuse is standard practice for Big Pharma.”  

Washington state plans to sue over Title X changes

Washington’s attorney general says the state is suing over the Trump administration’s planned changes to Title X, the federal family planning program that provides birth control, STD prevention, and cancer screenings to millions of low-income people. The planned regulation — announced as a final draft rule last week — would make any facility that provides or refers patients for abortions ineligible for Title X funding. In a press conference, Attorney General Bob Ferguson called the policy "a transparent attack on Planned Parenthood." Anti-abortion activists have praised the policy, but some clinicians and medical groups argue the changes could restrict access to critical health care services.

Is the U.K.'s health system ready for Brexit?

Experts are raising fresh concerns about the impact that Brexit — however it plays out — will impact health care in the U.K. Here’s what you need to know:

  • The background: It’s not clear yet what will happen with the U.K.’s exit from the European Union, which is expected to happen in late March. So public health and law experts looked at several possible scenarios, including a no-deal Brexit in which the U.K. leaves in late March without a formal agreement and a withdrawal agreement with a transition period through 2020.

  • The impact: There’s very little evidence the health system is prepared for any of those scenarios, the authors say. With no deal, the supply chain for drugs, vaccines, and medical devices would likely be disrupted. That plan might also limit immigration of health workers to the U.K. The withdrawal agreement could also mean an end to U.K participation in a program that allows some residents to receive medical care in other member states free or at a low cost.

  • On a related note: Last week, public health experts sent a letter to Prime Minister Theresa May warning that leaving the EU without a deal could pose serious risks to patients.

Inside STAT: After decades fighting Ebola, a beloved expert hangs up his boots

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Dr. Pierre Rollin, second from left, in Uganda during an Ebola outbreak in 2012. (CDC)

Dr. Pierre Rollin has more Ebola field experience than almost anyone on the planet — and in late January, after decades at the CDC dealing with the deadliest known viruses, he quietly retired. Rollins is renowned among the community of people who work on Ebola as someone who’s willing to do anything that needs to get done during an outbreak, from entering data to digging graves. “He’s just a giant,” Dr. Mike Ryan, a veteran of outbreak responses, tells STAT’s Helen Branswell. More here.

Can doctors count on Google to translate? 

Google Translate gets passing grades — with caveats — when it comes to translating a doctor’s written instructions in English to Spanish and Chinese, according to a new test of the tool’s skills. Researchers used Google to translate 100 sets of emergency discharge instructions. It was accurate for 92 percent of translations into Spanish and 81 percent into Chinese. But a small share of the translations — 2 percent in Spanish and 8 percent in Chinese — had the potential to harm patients. A prime example: A doctor wrote that a patient should “hold the kidney medicine,” which translated into Spanish as “keep the medication” and into Chinese as “keep taking." The researchers say doctors could use the tool in the clinic with caution. 

Lab Chat: How to build a better needle

The needle hits a sweet spot between two layers of tissue. (Randal McKenzie)

Scientists have given the needle a 21st-century upgrade to make it easier to deliver drugs to the right spot. Here’s what Jeff Karp of Brigham and Women’s Hospital told me about the proof-of-concept work, published in Nature Biomedical Engineering.  

What problem did you set out to solve?  

When you’re inserting a needle into tissue, you can’t see where that needle is going. We set out to design a system that’s as simple as what exists right now, but that could enable better tissue targeting.  

How does your new design work?

When inserting a needle, there's often a thicker tissue encountered before you get to the target. If you're trying to get a needle into a blood vessel, the blood vessel wall is dense, but where you're trying to go is fluid-filled. We designed the needle so fluid can’t come out until you’re no longer in dense tissue. We tested this in a region of the eye with two thin layers of tissue that touch, like a balloon inside of a balloon. We showed that our needle could stop in between without overshooting. 

What to read around the web today

  • Opioid crisis engulfs the blockaded Gaza strip. Associated Press
  • Fewer black donors means longer wait for a face transplant. Boston Globe
  • The jail health care crisis. The New Yorker
  • Becoming a dad after death. Undark
  • FDA takes fresh look at whether opioids are effective for chronic pain. Washington Post
  • U.K. agrees to improve clinical trial transparency, but lack of funding is ‘disappointing.' STAT Plus

Thanks for reading! More tomorrow,

Megan

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Tuesday, February 26, 2019

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