Tuesday, November 29, 2016

Morning Rounds by Megan Thielking

Good morning! Here's what you need to know about health and medicine today. For more STAT stories, follow us on Twitter and like us on Facebook. And congrats to all the readers who aced our 8th-grade biology test — the average score was 8.9 out of 10! 

Trump names Rep. Tom Price as HHS pick

President-elect Donald Trump has picked orthopedic surgeon and Republican Representative Tom Price of Georgia as his secretary of Health and Human Services. Price — who's been a member of the House since 2005 — penned an Obamacare replacement proposal known as the Empowering Patients First Act. (For more on his plan read this.)  In his new role, Price will oversee Obamacare and also likely play a key part in crafting its likely replacement. He'll also have control over nearly every health agency on the books — the FDA, the NIH, and the CDC, among others. The HHS Secretary is also responsible for Medicare, Medicaid, and the Children's Health Insurance Program. Price strongly opposes abortion rights and has received a 0 rating out of 100 from Planned Parenthood. 

One of Price's likely colleagues? Indiana health policy consultant Seema Verma, whom Trump has selected to run the Centers for Medicare and Medicaid Services, Reuters reports. Veerma has worked on redesigning Medicaid programs in states that've chosen to expand the program. She also spearheaded Indiana's health care reform after Obamacare passed to help health agencies prep for its implementation. 

Blood centers face significant hurdles in coming years

Experts are warning that the next few years could bring significant challenges for the US blood system, which is run by private blood centers and hospitals. A new analysis by the RAND Corporation finds that medical advances have reduced the demand for blood in the past decade, while prices have dropped due to competition between blood centers. At the same time, pathogens and a shrinking pool of donors could threaten the blood supply in some parts of the country. That’s left blood collection centers, which already make slim profit margins, struggling to adapt.

“Right now, the blood system is operating well, but there are some new and increasing threats to its sustainability over the next few years,” RAND policy researcher Andrew Mulcahy tells me. Those challenges have made it difficult for the industry to adopt new technologies and better detect blood pathogens like Zika. The RAND report lays out some suggestions for the Department of Health and Human Services. First on the agenda: “Collect more data to understand how the blood system actually works.” The authors also urge federal funding to encourage the adoption of new blood collection and testing technology.

Doctors look to shorten antibiotic courses for kids

Doctors at five children’s hospitals in the US are embarking on a study to see whether children with pneumonia can be treated with a shorter course of antibiotics. A 10-day course of amoxicillin is typically used to treat childhood cases of community-acquired pneumonia, a lung infection that often lands kids in the hospital. But doctors are worried that might contribute to the growing issue of antibiotic resistance. Now, doctors will test whether a 5-day course of antibiotics is sufficient for kids who show improvement during the first few days of treatment. Participating children will receive either one of three different oral antibiotics or a standard 10-day course of amoxicillin.

Sponsor content by Gilead

The global challenge of access to medicines

Strategies that enable swift, widespread access to medicines are just as important as the scientific innovation that leads to medical breakthroughs. There is no one-size-fits-all access solution that will apply globally. Each country has its own health-care needs and capabilities, and each country has its own social and economic profiles that influence how people access medicines. Read more about the global challenge of treatment access and how stakeholders are working to overcome it.

Inside STAT: A disinformation war on BRCA gene testing

(Molly ferguson for stat)
Myriad Genetics has long led the research pack when it comes to inherited breast and ovarian cancers. The company's DNA test to pinpoint women with a high chance of developing those cancers — launched in 1996 — led many women who learned they had a cancer-causing genetic mutation to have their breasts and ovaries removed to dodge the disease. Myriad has raked in more than $2 billion from its BRCA tests. But the tide turned in 2013, when the US Supreme Court invalidated the company’s key patents, costing Myriad its monopoly on BRCA testing. In a desperate attempt to protect its business, Myriad launched an aggressive strategy to undermine its new competitors, deploying a national sales force to stoke fears that other companies' BRCA test might miss potentially deadly mutations. STAT's Sharon Begley has the story here

Elizabeth Warren moves to block 21st Century Cures

As the 21st Century Cures Act heads to a possible vote in the House this week, one member of Congress is making her dissatisfaction clear. Massachusetts Senator Elizabeth Warren tore into the package late yesterday on the Senate floor, accusing Republican lawmakers of trying to extort Democrats into approval by rolling additional money for medical research into the bill, including millions for the White House's cancer moonshot, the BRAIN Initiative, and the Precision Medicine Initiative. “I will fight it because I know the difference between compromise and extortion," Warren said.

Warren also objected to a provision that would allow drug companies to avoid disclosing fees paid to doctors for continuing medical education, medical journals, or textbooks. Senator Charles Grassley (R-Iowa) took issue with that same provision yesterday, saying he'd consider placing a hold on the legislation unless it's taken out. 

New trial to test HIV vaccine gets underway

A new clinical trial to test an HIV vaccine gets underway this week in South Africa, where an estimated 7 million people were living with the virus in 2015. The trial will span 15 sites across the country, with researchers looking to enroll 5,400 sexually active individuals between ages 18 and 35. Each participant will receive five doses of the vaccine or a placebo, with results expected to be reported by late 2020. The upcoming trial builds on a 2009 study in Thailand of an earlier version of the vaccine, which saw modest success in preventing HIV infection for 3 1/2 years. The updated version is tailored to protect against the most common subtype of HIV in South Africa. The goal: A higher efficacy rate and prolonged protection.

Preventable health problems tied to heart failure risk

Clamping down on the development of obesity, diabetes, and blood pressure troubles during middle age can significantly cut down heart failure risk later in life, reports a study out this morning. Researchers pooled data from patients between ages 45 and 55 and found that those who didn’t suffer from high blood pressure, obesity, or diabetes during lived longer without experiencing heart failure than those who had those conditions. Notably, people without diabetes lived up to 10.6 years longer without heart failure than those with the disease. The researchers hope quantifying the role of those risk factors will put pressure on doctors and patients to prevent them. About 5.7 million people in the US have heart failure.

Big Data biomedical researchers gather to talk progress

Big Data in biomedical research is in the spotlight today as NIH-funded scientists gather for an all-hands meeting about the agency’s Big Data to Knowledge Initiative. It’s a collaborative effort between a handful of NIH offices to harness the treasure trove of patient data that could help us better understand human health. The agency started the project in 2012 to address some of the most significant roadblocks to translating that information to clinical practice. Now, researchers funded by the initiative are getting together to report on how that work is going. They’ll be meeting in Bethesda, Maryland all week — you can watch a livestream of the meeting here.

What to read around the web today

  • Deadly infections linked to heart surgery device highlight holes in FDA monitoring. Kaiser Health News 
  • For Flint residents, a fog of unanswerable questions. Undark
  • Marlboro Black lures millennials who shunned cowboy image. Wall Street Journal

More reads from STAT

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