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Morning Rounds

The Senate passed opioids legislation. What comes next?

The Senate has passed wide-ranging legislation aimed at addressing the opioid crisis. Now, lawmakers have to get to work hammering out the differences between the Senate bill and a version that the House passed earlier this summer. One provision to keep an eye on during those conversations: a provision to let the government waive a rule that prohibits Medicaid from paying addiction treatment facilities with more than 16 beds. The House version had a limited version of the provision — which could expand treatment access but cost Medicaid billions — while the Senate bill didn't include it.

Senate lawmakers also overwhelmingly passed a bill that would let pharmacists inform consumers when it’s cheaper to buy a drug without insurance. So-called gag clauses don't allow pharmacists to tell people when that's the case. 

Foster children are often prescribed psychiatric drugs, but without a treatment plan

Kids in foster care are often prescribed psychiatric drugs — but there isn’t always a plan in place for their treatment or follow-up care, according to a new report released by the inspector general’s office at HHS. Here’s what you need to know:

  • The findings: About 1 in 3 kids in foster care who were prescribed psychiatric drugs didn't receive a treatment plan or medication monitoring. The study looked at five states where kids in foster care were most often prescribed psychiatric drugs: Iowa, Maine, New Hampshire, North Dakota, and Virginia.

  • The recommendations: “Improved compliance and strengthened state requirements are imperative to provide protections for children who are at risk for inappropriate treatment and inappropriate prescribing practices,” the report concludes.

  • On a related note: In a new report, the EPA’s watchdog office found that the agency isn't doing a good enough job keeping tabs on asbestos levels in schools. 

Hospitals and drug manufacturing plants open after Hurricane Florence

Some hospitals in areas hit by Hurricane Florence have started reopening their doors as the region continues to grapple with rain and flooding. Most drug manufacturing plants in the region are also up and running again. While some stayed open, companies including GlaxoSmithKline, Novartis, and Pfizer shut down or scaled back operations at plants in the storm’s path. It was a difficult decision to navigate: The safety of thousands employed at the facilities was at stake, as was the loss of drugs already in production. STAT contributor Max Blau has more on how drug companies handled the storm here.

Lab Chat: Teaching machines to peek inside cells


The method captures nuclear envelopes in purple, mitochondria in green, and cell membranes in pink. (allen institute)

Scientists have trained computers to peer into living cells and detail their structures, which could reveal new clues about the state of healthy and diseased cells. Here’s what Molly Maleckar of the Allen Institute told me about the work, published in Nature Methods.

What problem did you set out to tackle?

One of the grand challenges in modern biology is to understand how the components inside of a cell work together. We have these bright-field microscopes like those you had in high school that produce black and white images relatively cheaply. There’s a lot of information in those images, but it looks jumbled and is hard for the human eye to see. And we have a way to image cells by adding fluorescent tags that let us see more, but cells can be damaged by that.

How did you try to solve that?

We have these pairs of images, one grayscale, one glow-in-the-dark. We trained a computer model to learn the relationship between the two. The idea is that you can take a grayscale image, feed it to the model, and the model will predict the fluorescent structure. You can do that for the mitochondria, the cell membrane, the nucleus, until you get an integrated look at a cell.

Inside STAT: Will insurers have to cover a pregnancy prevention app? 

Now that the FDA has cleared the controversial Natural Cycles app as a pregnancy prevention tool, questions have cropped up about whether insurers will have to cover the app under Obamacare's contraception mandate. Experts say that means the $9.99-a-month app, which uses basal temperature to predict ovulation, should be covered. But it's anyone's guess how that will actually work. “What’s the official trigger that tells insurance companies they have to cover it now?" said the Guttmacher Institute's Adam Sonfield. The answer to that still isn't clear. STAT's Kate Sheridan has the story here

One in 11 adolescents in U.S. have vaped marijuana

More than 2.1 million young people in the U.S. have vaped marijuana, according to a new survey of students across the country. The study found that more than 12 percent of high schoolers and nearly 5 percent of middle schoolers had used marijuana in an e-cigarette, echoing results from previous studies. The findings fuel growing concern about the popularity of e-cigs among teens. Last week, the FDA issued warnings and fines to 1,300 retailers for illegally selling vapes to kids and told five e-cig makers that they had two months to come up with a plan to prevent minors from using their products.

What to read around the web today

  • Justice Dept. approves merger of Cigna and Express Scripts. New York Times
  • The health dangers don’t stop with a hurricane’s churning. They can get worse. Washington Post
  • You need a new kidney to stay alive. Would you reject one from someone who died of a drug overdose? STAT
  • Day-tripping to the dispensary: Seniors in pain hop aboard the canna-bus. Kaiser Health News
  • In response to critic, NIH alcoholism institute changes online explanation of cancer risk from drinking. STAT

Thanks for reading! More tomorrow,


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Tuesday, September 18, 2018


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