Wednesday, June 7, 2017

Morning Rounds by Megan Thielking

Happy Wednesday, everyone, and welcome. A special bulletin for Boston readers: STAT is hosting an event with the Atlantic next Tuesday, June 13, on the state of health care and the future of medicine. Among the speakers are CRISPR pioneer Feng Zhang, Joyce Tung of 23andMe, and Dr. Anthony Fauci, who heads up the National Institute of Allergy and Infectious Diseases. Register here

20 Ohio counties won't have any ACA insurers next year

Health insurance officials are anxiously eyeing health insurance giant Anthem, which announced it's withdrawing from the Obamacare exchange in Ohio next year. That could leave 20 counties in the state without any plans in the ACA marketplace. Anthem currently offers plans in 13 other states, and says it's still weighing whether to stay in the Missouri market. The company said instability in the individual market and doubt about whether Congress and the Trump administration would keep reimbursing insurers for ACA subsidies drove its decision, among other factors.  

Last month, Blue Cross and Blue Shield of Kansas City said it would pull out of exchanges in part of western Missouri, putting those areas also at risk of being without any marketplace insurers. It's the first time Anthem has withdrawn from an ACA exchange, but it's the latest in a string of such withdrawals. Humana and Aetna have announced they'll pull out of the exchanges next year.

Salmonella outbreak tied to baby chicks spreads

A salmonella outbreak partly blamed on baby chicks and ducklings is continuing to spread across the U.S. The CDC says there have been 372 cases of salmonella in 47 states this year, and Montana has been particularly hard hit with 14 new cases of the bacterial illness announced this week. Many of the infected individuals have reported coming into contact with live poultry shortly before their illness set in. Health officials say outbreaks linked to live poultry have risen in recent years, as keeping flocks of barn animals in the backyard becomes more common. There were a record number of illnesses in 2016 linked to backyard poultry.

Senator spearheading EpiPen inquiry meets with Mylan

The staff of Sen. Chuck Grassley — who has been spearheading an investigation of pharma company Mylan — will be meeting today with execs from the company. The EpiPen manufacturer has been in hot water for months over accusations that it potentially misclassified EpiPens as a generic product, rather than a brand-name item. Doing so enabled Mylan to charge Medicaid a higher price for the injectors. That allegation came to light last year, and in October, Mylan agreed to a $465 million settlement. But a letter from HHS last week disclosed that Medicaid was allegedly overcharged by a much steeper $1.27 billion. Grassley has threatened to subpoena Mylan, which he’s said hasn’t cooperated with his investigation, for information about why EpiPens were misclassified.

Sponsor content by EMD Serono

Insights into managed care trends

Ensuring clinically appropriate use and managing oncology drugs were identified as the top challenges in a survey of health plans for the 13th edition of the EMD Serono Specialty Digest. The Digest is an industry resource that provides market data on health plans’ management of specialty pharmaceuticals and identifies common trends across plans in an effort to spur conversations around ways to ensure continued patient access to optimal care.  Review the Digest here.

Inside STAT: Is this FDA warning system working?

(mike reddy for stat)

In 2007, Congress ordered the FDA to set up an early warning system to detect harmful drugs after a number of dangerous medicines were pulled from the market. The FDA created a system known as the Sentinel Initiative, which was touted as a revolutionary way to glean valuable information from insurance data and medical records. But a STAT examination, including interviews with drug safety experts, finds that the system has had very little measurable impact ten years in and with a price tag of $207 million. Critics question whether Sentinel lives up to its hype of being able to adequately flag potential risks — notably, it has only been used to revise the warning labels of two drugs to date. STAT’s Sheila Kaplan has the story here.

Cutting cardiovascular deaths with food policies

New research details how food policies —from sugary drink taxes to fresh produce subsidies — could cut down on cardiovascular disease deaths in the U.S. The study by nutrition policy researchers, published in PLOS Medicine, found:

  • A 10 percent tax on sugary drinks could prevent up to 31,000 cardiovascular deaths. Just yesterday, Seattle approved a tax on soda and other sugary drinks, becoming the eighth city in the U.S. to impose such a tax.

  • A 10 percent subsidy across the board for fresh produce could result in 150,500 fewer cardiovascular disease deaths by 2030. The researchers estimate that’s the most beneficial of the interventions they studied.

  • A 30 percent fruit and vegetable subsidy just for people on food stamps would prevent 35,100 deaths in the same time frame. This type of targeted intervention would do the most to reduce health disparities by socioeconomic status, the researchers say.

The FDA is stumped by faulty blood lead tests

The FDA is struggling to nail down the problem that’s causing commonly used blood lead tests to produce inaccurate results, and now, two more of those tests are being recalled. Last month, federal health officials warned that Magellan blood lead tests might understate results. The agency said that kids age six and under and pregnant and nursing women might need to be retested. Now, Magellan is recalling two more of its testing systems as the FDA scrambles to pinpoint what’s skewing the results. They’re still conducting tests with the CDC to better understand the scope of the problem.

The tie between weight gain and pregnancy outcomes

There’s a recommended range of weight gain during pregnancy, and a new study examines how often pregnant women fall into that range. Health experts advise underweight women gain 28-40 pounds, average-weight women 15-24 pounds, and overweight women 11-20 pounds. In a review of 23 studies on gestational weight gain — which included a cumulative 1.3 million pregnancies — researchers found that 47 percent of pregnant women gained more weight than recommended, and 23 percent gained less. Extra weight gain was associated with a higher risk of C-section and of a baby being born with an excessive birth weight. Not gaining enough weight was associated with an increased risk of preterm birth. 

What to read around the web today

  • Selling doctors on cutting drug costs. New York Times
  • How Donald Trump shifted money for a kids' cancer charity to his business. Forbes
  • When your therapist is a chatbot. The Ringer

More reads from STAT

The latest from STAT Plus

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