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Morning Briefing

Summaries of health policy coverage from major news organizations

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Wednesday, Mar 15 2023

吃瓜不打烊 Original Stories 4

  • FDA Looks Into Dental Device After KHN-CBS News Investigation of Patient Harm
  • New CDC Opioid Guidelines: Too Little, Too Late for Chronic Pain Patients?
  • Two Counties Square Off With California Over Mental Health Duties
  • Listen to the Latest '吃瓜不打烊 Minute'

Pharmaceuticals 2

  • Novo Nordisk Also Cutting Price Of Insulin
  • Biden Wants To Fine Drugmakers Who Hike Prices

Environmental Health 1

  • EPA Proposes First Federal Limits On Forever Chemicals In Drinking Water

Gun Violence 1

  • Biden Signs Executive Order To Close Gun-Buying Loopholes

After Roe V. Wade 1

  • High-Stakes Hearing Today On Abortion Medication

Covid-19 1

  • FDA Authorizes Pfizer Covid Booster For Kids As Young As 6 Months

Public Health 1

  • Mortality Rate Of US Children, Teens Surged In Recent Years

Health Industry 1

  • Google Leverages AI Tech To Help With Medicaid Reenrollments

LGBTQ+ Health 1

  • Arkansas Makes It Easier To Sue Minors' Trans Care Providers

State Watch 1

  • Assisted Suicide Will Be Allowed For First Non-Resident in Vermont

Prescription Drug Watch 2

  • Meningococcal Vaccine Shows Positive Trial Results; Jynneos Proves Highly Protective Against Mpox
  • Perspectives: Are Psychedelics The Meds Of The Future?; Coming Oncology Drugs Are Quite Complex

Editorials And Opinions 1

  • Viewpoints: Why We Failed To Prevent The Covid Pandemic; How Are We Faring Three Years Into Covid?

From 吃瓜不打烊 - Latest Stories:

吃瓜不打烊 Original Stories

FDA Looks Into Dental Device After KHN-CBS News Investigation of Patient Harm

The FDA鈥檚 interest in the AGGA dental device follows a KHN-CBS News investigation, according to a former agency official. ( Brett Kelman and Anna Werner, CBS News , 3/15 )

New CDC Opioid Guidelines: Too Little, Too Late for Chronic Pain Patients?

In November, the Centers for Disease Control and Prevention released new guidelines for prescribing opioids for pain, allowing physicians more flexibility. But doctors, patients, and advocates wonder if the updated standards will be too little, too late to help chronic pain patients in a country still focused on fighting the ongoing opioid crisis. ( Sam Whitehead and Andy Miller , 3/15 )

Two Counties Square Off With California Over Mental Health Duties

The state wants to stop paying Kaiser Permanente for treating severely mentally ill Medi-Cal patients in Sacramento and Solano counties and force the counties to take on the task. The counties鈥 leaders say they can鈥檛 afford it. ( Angela Hart , 3/15 )

Listen to the Latest '吃瓜不打烊 Minute'

鈥淗ealth Minute鈥 brings original health care and health policy reporting from the 吃瓜不打烊 newsroom to the airwaves each week. ( 1/2 )

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BILLS, BILLS, BILLS

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鈥 Vijay P. Manghirmalani

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Summaries Of The News:

Pharmaceuticals

Novo Nordisk Also Cutting Price Of Insulin

The giant drugmaker is following Eli Lilly's lead by dropping the list price of several products, some as much as 75%. Sanofi, the other major insulin manufacturer, said that it is 鈥渃ontinually listening to patients, patient advocates, caregivers, and others to better understand additional actions we could take to address access or affordability challenges.鈥

Under mounting pressure, Novo Nordisk plans to cut U.S. list prices for several insulin products by up to 75%, the latest big drugmaker to take such a step in response to a years-long outcry over the cost of the diabetes treatments. (Silverman, 3/14)

The price cuts go into effect Jan. 1. A vial of NovoLog and NovoLog Mix 70/30 will drop 75% to $72.34 from $289.36. FlexPen options will fall to $139.71 from more than $500. Levemir and Novolin vials and FlexPens will drop 65% from their current list prices. (Murphy, 3/14)

President Biden said he was pleased by Novo鈥檚 price cuts and urged other insulin makers to follow suit. He also said Congress should 鈥渃ap insulin at $35 for all Americans.鈥 Lilly, Novo and Sanofi SA are the leading sellers of insulins in the U.S. and worldwide. They had substantially raised the prices for their insulin products in the U.S. during the 2010s. The companies have said they didn鈥檛 make much from the higher list prices, because they had to pay larger rebates to the companies that manage drug benefits. (Loftus, 3/14)

Novo Nordisk declined to make an executive available for an interview. Asked why it is now deciding to lower prices, the company said in a statement that the plans were made months ago, 鈥渂ut due to increased stakeholder interest, we accelerated to announce now.鈥 ... Sanofi, the other major insulin manufacturer, said in a statement Tuesday that it is 鈥渃ontinually listening to patients, patient advocates, caregivers and others to better understand additional actions we could take to address access or affordability challenges.鈥 It also provided a list of its programs to help cover costs of its insulin. (Gilbert, 3/14)

Biden Wants To Fine Drugmakers Who Hike Prices

The federal government will fine companies who increase prices faster than the rate of inflation 鈥 but only for 27 specific medications, and it won't happen until 2025.

The Biden administration will fine drugmakers who hiked prices faster than the rate of inflation on 27 medications administered in physicians鈥 offices, the agency said Wednesday. Pfizer had the most drugs on the list of any manufacturer, with five. Seagen鈥檚 bladder cancer drug Padcev, which also garnered penalties, will likely soon be in Pfizer鈥檚 portfolio, too, after the pharma giant completes its $43 billion acquisition of the Washington state company. (Cohrs, 3/15)

President Joe Biden is expected to speak at the UNLV College of Hospitality on Wednesday about his administration鈥檚 efforts to lower prescription drug costs for Americans. Biden, who landed in Las Vegas on Tuesday evening and attended a private Democratic National Committee reception and fundraiser, is scheduled to address provisions in the Inflation Reduction Act that will help lower costs for people on Medicare, and how his proposed budget will lower prescription drugs costs for all Americans. (Hill, 3/14)

President Joe Biden will highlight the stark differences in how Democrats are tackling skyrocketing drug prices compared to their Republican counterparts as he gears up for an expected reelection announcement. In a speech on Wednesday in Las Vegas that could serve as a preview of the campaign ahead, Biden planned to put the issue of lowering drug costs at the center of his policy and political agenda. (Seitz and Miller, 3/15)

Also 鈥

The head of the brand drug lobby used an in-person health insurance industry conference to blame insurers for making people pay too much for drugs. America鈥檚 Health Insurance Plans CEO Matt Eyles, interviewing PhRMA President Stephen Ubl, asked for examples of policies that would benefit both industries. Ubl responded by suggesting that insurers lower cost sharing for drugs. (Wilkerson, 3/14)

Environmental Health

EPA Proposes First Federal Limits On Forever Chemicals In Drinking Water

The Environmental Protection Agency said limits on toxic PFAS products would save thousands of lives and prevent serious illnesses, including cancer. Public water systems will be required to monitor supplies for six PFAS chemicals and alert the public if levels pass proposed standards.

The Environmental Protection Agency on Tuesday proposed the first federal limits on harmful 鈥渇orever chemicals鈥 in drinking water, a long-awaited protection the agency said will save thousands of lives and prevent serious illnesses, including cancer. The plan would limit toxic PFAS chemicals to the lowest level that tests can detect. PFAS, or per- and polyfluorinated substances, are a group of compounds that are widespread, dangerous and expensive to remove from water. They don鈥檛 degrade in the environment and are linked to a broad range of health issues, including low birthweight and kidney cancer. (Phillis and Daly, 3/14)

Under the new standard, the agency will require public water systems to monitor for six PFAS chemicals, inform the public if PFAS levels exceed proposed standards in the drinking water supply, and take action to reduce PFAS levels. Chemical companies sell PFAS for use in products ranging from paper to pans, enabling them to be stain-resistant, water-repellent and grease-proof. They are also used in industrial processes and discharged into waterways. (Volcovici, 3/14)

The proposal would require water utilities to detect and reduce PFAS contamination at 4 parts per trillion. The agency had warned in June that the compounds pose a greater danger to human health than regulators previously thought, compromising people鈥檚 immune and cardiovascular systems at a lifetime exposure of between just 0.004 to 0.02 parts per trillion, depending on the type of compound. (Puko, 3/14)

The uncertainty around how much PFAS should be allowed in drinking water due to economic and technological constraints will likely make the 60-day comment period fraught, as STAT reported late last year. 鈥淚 worry about the political and cost pressures of setting something that is actually health protective,鈥 Anna Reade, a senior scientist at the Natural Resources Defense Council, told STAT at the time. 鈥淚 do think that the MCLG should be zero and the question is what the MCLs will be set at.鈥 She hoped the MCLs would be set at 2 to 4 nanograms per liter, ranges that would be fairly protective of health but feasible for labs to measure. (Trang, 3/14)

In related news about drinking water 鈥

Last May, the National Toxicology Program (NTP), a federal research agency, was set to release its eagerly awaited report into the cognitive and neurodevelopmental impacts on humans from fluoride exposure. The report was anticipated for several reasons, including its review of studies linking fluoridated water to cognitive harm in children. Water fluoridation is the long-established public policy of adding fluoride to drinking water to fight tooth decay. The report was also set to play a key role in an ongoing lawsuit, filed by government accountability nonprofit Food & Water Watch, to get the Environmental Protection Agency to regulate water fluoridation because of fluoride鈥檚 possible neurotoxic harm. More than two years ago, the judge put the case on hold in expectation of the NTP report鈥檚 public release. (Ross, 3/14)

Gun Violence

Biden Signs Executive Order To Close Gun-Buying Loopholes

Speaking with families in Monterey Park, California, who suffered a mass shooting in January, the president revealed the order directing the Department of Justice to ensure licensed gun dealers conduct required background checks before gun purchases. News outlets note Biden's options to stop gun violence are limited.

President Biden on Tuesday signed an executive order to curb gun violence and enhance background checks on firearms buyers, spending part of the afternoon consoling a Monterey Park community devastated by a mass shooting on the eve of Lunar New Year in January. 鈥淚鈥檓 here on behalf of the American people to mourn with you, to pray with you, to let you know you are loved and not alone,鈥 Biden told about 200 people in the gymnasium of a Boys & Girls Club. 鈥淚 know what it鈥檚 like to get that call.... I know what it鈥檚 like to lose a loved one so suddenly. It鈥檚 like losing a piece of your soul.鈥 (Mehta and Subramanian, 3/14)

A solemn President Joe Biden signed an executive order to close gun registration loopholes as he delivered what amounted to a eulogy for 11 people shot to death as they celebrated the Lunar New Year in a Southern California suburb. Biden recited names of the mostly immigrant victims, recalling the love of family and community that brought them to the dance hall in January, as well as the pain that will linger with their families and made the small city another in a long line of places made infamous by violence. (Nieves and Ward, 3/14)

Mr. Biden said his executive actions are designed to move the U.S. as close to universal background checks as possible without the passage of legislation in Congress, where partisan divides have left most gun-safety legislation stalled. The president, in his Tuesday remarks, said his executive order isn鈥檛 a substitute for congressional action. 鈥淓nough,鈥 Mr. Biden said, directing his remarks to lawmakers. 鈥淒o something. Do something big.鈥 (Siddiqui and Restuccia, 3/14)

He repeated the assault weapons demand on Tuesday, noting that he had advanced the effort in the Senate in 1993 to pass a ban, which expired amid political disagreement a decade later. ... Mr. Biden鈥檚 new executive order is far more modest than that kind of lofty ambition. It directs the attorney general to make sure gun dealers are complying with existing background check laws. It seeks to improve reporting of guns and ammunition that are lost or stolen while in transit. It calls for better transparency about gun dealers who are cited for firearms violations. And it directs agencies to work with the National Integrated Ballistics Information Network to improve the quality of investigations into gun crimes. (Shear, 3/14)

In addition to the background checks, Biden鈥檚 executive order directs his Cabinet to develop a proposal on how the federal government can better assist communities after a mass killing, aiming to mobilize resources for human-caused disasters in the way that Washington already does for natural disasters. Biden is also urging the Federal Trade Commission to issue a public report that would analyze how gun manufacturers market firearms to minors. Together, the actions amount to the president鈥檚 latest attempt to use his executive authority to crack down on gun violence, efforts that necessarily are narrower in scope than measures urged by gun-control activists that would require congressional approval. (Viser, 3/14)

After Roe V. Wade

High-Stakes Hearing Today On Abortion Medication

The Texas judge's decision could have huge implications for abortion care across the country. Abortion news from Ohio and Arkansas is also reported.

A federal judge in Texas will consider at a high-stakes hearing on Wednesday whether he should block the US government鈥檚 approval of the drug used for medication abortions. The case, brought by anti-abortion doctors and medical associations, is arguably the most significant legal dispute concerning abortion since the Supreme Court ended nationwide abortion protections with its overturning of Roe v. Wade last summer. Depending on how US District Judge Matthew Kacsmaryk handles the medication abortion lawsuit, access could be cut off nationwide to the most common method of abortion in the United States. (Sneed, 3/15)

A court ruling out of Texas could have huge implications for abortion care across the country. A federal judge is currently deciding on a lawsuit from anti-abortion groups that targets FDA approval of the drug mifepristone, which is part of a two-medication combination used to end early pregnancies, often at home. (Prignano, 3/14)

U.S. District Judge Matthew Kacsmaryk is expected to question lawyers in the case that seeks to restrict access to mifepristone, the medication first approved by the Food and Drug Administration more than 20 years ago. The high-stakes hearing, for which the judge has allotted up to four hours, will be the first time the judge engages directly with lawyers for the Justice Department, representing the FDA; the company that manufactures and distributes the drug; and the antiabortion group challenging the medication. Kacsmaryk could rule at any time following the hearing, potentially disrupting access to the widely used drug, including in states where abortion is legal. (Stein, Kitchener and Marimow, 3/15)

A federal judge overseeing a high-stakes case that could threaten access to medication abortion across the nation asked lawyers for the 鈥渃ourtesy鈥 of not publicizing upcoming arguments, according to a court record released Tuesday that reveals new details of a move experts say is outside the norm for the U.S. judicial system. U.S. District Judge Matthew Kacsmaryk 鈥 who was appointed by former President Donald Trump and is known for conservative views 鈥 told attorneys during a status conference by telephone on Friday that because the case has prompted death threats and protests, 鈥渓ess advertisement of this hearing is better,鈥 according to a transcript of the meeting. (Murphy and Bleiberg, 3/14)

The federal judge overseeing a high-profile challenge to the FDA鈥檚 two-decade-old approval of certain drugs used to terminate a pregnancy is a deeply conservative jurist with a proclivity for siding with plaintiffs looking to roll back reproductive and LGBTQ rights or block key Biden administration policies. (Cole, 3/15)

Pharmacies are pressed to explain plans for abortion pills 鈥

Fourteen Democratic governors asked seven leading pharmacy retailers on Tuesday to clarify their plans for dispensing mifepristone 鈥 a pill used in medication abortions. The move comes shortly after Walgreens announced that it would not dispense mifepristone in some Republican-led states where abortion remains legal. (Saric, 3/14)

In other abortion news from Ohio and Arkansas 鈥

The Ohio Supreme Court agreed Tuesday to review a county judge鈥檚 order that is blocking enforcement of the state鈥檚 near-ban on abortions, and to consider whether the clinics challenging the law have legal standing to do so. In its split decision, the court, however, denied Republican Attorney General Dave Yost鈥檚 request to launch its own review of the right to an abortion under the Ohio Constitution, leaving those arguments to play out in lower court. This means abortions remain legal in the state for now, up to 20 weeks鈥 gestation. (Smyth, 3/14)

A monument marking the number of abortions performed in Arkansas before Roe v. Wade was struck down would be built near the state Capitol under a bill lawmakers sent to Gov. Sarah Huckabee Sanders on Tuesday. The majority-Republican House approved by a 60-19 vote a proposal allowing the creation of a 鈥渕onument to the unborn鈥 on the Capitol grounds. The bill, which the Senate approved earlier this month, requires the secretary of state to permit and arrange the placement of the monument. (DeMillo, 3/14)

Covid-19

FDA Authorizes Pfizer Covid Booster For Kids As Young As 6 Months

The shot is for children who were previously vaccinated with three doses of the original vaccine. In other covid-related news, operators of an upscale Los Angeles care facility for dementia patients were charged Tuesday with felony elder abuse.

The U.S. Food and Drug Administration on Tuesday authorized Pfizer鈥檚 omicron booster shot for kids under five years old who were previously vaccinated with three doses of the company鈥檚 original vaccine.聽聽Children six months through four years old who completed their three-dose primary series with Pfizer and BioNTech鈥檚 original monovalent shots more than two months ago are now eligible to receive a single booster dose of the updated shot. The new shot is bivalent, meaning it targets the original Covid strain as well as omicron BA.4 and BA.5.聽(Constantino, 3/14)

In other Pfizer news 鈥

The U.S. health regulator's staff reviewers said on Tuesday data from Pfizer Inc's COVID-19 drug trials support its use in adults at high risk of progressing to severe disease, bringing the pill closer to a full approval. The Food and Drug Administration made its assessment in briefing documents ahead of a meeting of the agency's external advisers on Thursday to discuss full approval to use Pfizer's oral pill for high-risk COVID-19 patients exhibiting mild to moderate symptoms. (Mandowara and Leo, 3/14)

U.S. Food and Drug Administration staff on Tuesday said Pfizer鈥檚 clinical trial results on its Covid antiviral pill Paxlovid support the drug鈥檚 use in adults at high risk of progressing to severe disease.聽The FDA staff made the conclusion in briefing documents ahead of a meeting on Thursday, when external advisors on the agency鈥檚 Antimicrobial Drugs Advisory Committee will discuss whether to recommend full approval of Paxlovid for the treatment of mild to moderate Covid in high-risk adults.聽(Constantino, 3/14)

Paxlovid isn't associated with COVID rebound, in which patients test positive or have symptoms days after a course of the drug is completed, Food and Drug Administration staff said in briefing documents released Tuesday. (Moreno, 3/14)

In other covid news 鈥

The operators of an upscale Los Angeles care facility for dementia patients were charged Tuesday with felony elder abuse and other criminal counts related to the deaths of an employee and thirteen residents during the early days of the pandemic. Silverado Beverly Place, near the Fairfax district, specializes in caring for elderly residents with Alzheimer鈥檚 and dementia, and was the site of a COVID-19 outbreak in March 2020. (Solis, 3/14)

More than 1 million Americans have died from COVID-19 since President Donald Trump declared it a national emergency three years ago. That includes 87,000 Floridians. Among the survivors, are those with long-haul COVID, or long COVID, a phenomenon still not fully understood. But what is long COVID? (Pedersen, 3/14)

One year after first testing positive for COVID-19, Mount Dora resident Tanya Balyeat still has weakened lungs and the short-term memory loss phenomenon known as brain fog. They are the lingering symptoms of long COVID, experienced by about 29% of those who test positive for COVID-19, according to the Centers for Disease Control and Prevention. (Pedersen, 3/15)

Public Health

Mortality Rate Of US Children, Teens Surged In Recent Years

The increase 鈥 nearly 11% in 2020 and more than 8% in 2021 鈥 was driven not by deaths from covid but from fatal injuries from things like firearms, drugs, and cars. Only for infants younger than 1 was no significant increase in mortality found.

The mortality rate for children and teens in the United States surged in 2020 and 2021, driven not by deaths from Covid-19 but from fatal injuries from things like firearms, drugs and cars, according to a study published Monday in JAMA. The pandemic years brought a marked shift to the trends in pediatric mortality, which had previously seen a 鈥減eriod of great progress,鈥 according to the study authors. Pediatric deaths had been ticking up, but the latest annual increases 鈥 nearly 11% in 2020 and more than 8% in 2021 鈥 were the largest in decades. (McPhillips, 3/14)

Most of the increase came from older children, ages 10 to 19, but the rate also increased among children 1 to 10. Only infants younger than 1 did not have a significant increase in mortality during this time. The researchers found that the increase was not strongly attributable to the COVID-19 pandemic but a rise in injuries, which are defined as external causes of death such as transportation, firearms and poisoning. This type of fatality was tracked separately from the noninjury causes of death, which are internal, like diseases. (Gans, 3/14)

On the anniversary of PEPFAR 鈥

A new report shows a U.S. federal program transformed the AIDS epidemic worldwide and saved an estimated 25 million lives since 2004. The U.S. President鈥檚 Emergency Plan for AIDS聽Relief, known as PEPFAR,聽increased the number of people receiving HIV antiretroviral therapy from just over 66,000 people in 2004 to more than 20 million people in 2022, according to the report published Tuesday by the Centers for Disease Control and Prevention. PEPFAR was launched by former President George W. Bush. (Rodriguez, 3/14)

In the 20 years since its inception, the President鈥檚 Emergency Plan for AIDS Relief has delivered lifesaving treatment to more than 20 million people in 54 countries, the most successful global health campaign of its kind, according to a report released on Tuesday. The $7.5 billion program, housed in the State Department, is due for reauthorization by Congress this year. In the past, it has received strong bipartisan support. (Mandavilli, 3/14)

In other health and wellness news 鈥

In the past, people needed to get a prescription in person, but a pandemic-era waiver enabled providers to prescribe the drug after online consultations. Nearly 40 percent of all prescriptions for stimulants, including Adderall, were based on telehealth visits last year, up from less than 2 percent before the pandemic, according to analytics firm Trilliant Health. The rise in Adderall prescriptions was driven by adults between 22 and 44 years old, for whom they increased 58 percent between 2018 and 2022, according to Trilliant鈥檚 analysis of insurance claims nationally. There were more adults receiving an Adderall prescription than those who had an ADHD diagnosis, the firm found. (Gilbert and Amenabar, 3/14)

KHN: New CDC Opioid Guidelines: Too Little, Too Late For Chronic Pain Patients?聽

Jessica Layman estimates she has called more than 150 doctors in the past few years in her search for someone to prescribe opioids for her chronic pain. 鈥淎 lot of them are straight-up insulting,鈥 said the 40-year-old, who lives in Dallas. 鈥淭hey say things like 鈥榃e don鈥檛 treat drug addicts.鈥欌 Layman has tried a host of non-opioid treatments to help with the intense daily pain caused by double scoliosis, a collapsed spinal disc, and facet joint arthritis. But she said nothing worked as well as methadone, an opioid she has taken since 2013. (Whitehead and Miller, 3/15)

In the summer and fall of 2021, West Nile virus spread rapidly through Arizona鈥檚 Maricopa County and other areas of the state. The outbreak, with more than 1,700 cases reported and 127 deaths was the largest in the United States since the mosquito-borne virus first emerged in this country in 1999. But with the nation facing a far larger public health crisis with the Covid-19 pandemic, it went almost unnoticed. (Van Note, 3/15)

KHN: Listen To The Latest 鈥楰HN Health Minute鈥

The KHN Health Minute this week looks at the risks of a social-media craze, the Brazilian butt lift, and what Eli Lilly鈥檚 slashing of insulin prices could mean for folks with diabetes. (3/14)

Skunks and penguins are in the headlines 鈥

Animal health officials in British Columbia, Canada, yesterday reported that an investigation into skunks found dead in residential areas of two cities at the end of February have revealed H5N1 avian influenza. (Schnirring, 3/14)

Three elderly king penguins have been fitted with custom-made eye lenses during surgery to remove cataracts in what is believed to be a world first procedure to improve their sight, according to a Singapore zoo. In a statement Tuesday, vets with the Mandai Wildlife Group said the birds were among six elderly penguins to undergo cataract surgery two months ago and have since made a full recovery. (Chen, 3/15)

Health Industry

Google Leverages AI Tech To Help With Medicaid Reenrollments

As part of Google's annual Check Up event this week, the tech giant revealed several health care initiatives, including a conversational AI tweak to its search product designed to support users who are trying to reenroll in Medicaid.

Google is helping people navigate Medicaid聽redeterminations with the latest update to its search product, the tech giant said Tuesday morning.聽Google announced several new healthcare initiatives at its annual Check Up event on Tuesday. The updates were related to聽search, artificial intelligence and interoperability.聽(Turner, 3/14)

Google showed off an array of new artificial intelligence (AI)-driven health care tools on Tuesday, from a souped-up chatbot that can shed light on your medical symptoms to enhanced search features that tell you if a doctor takes Medicaid. (Kingson, 3/15)

Alphabet Inc.鈥檚 Google unveiled plans to integrate artificial intelligence into health-related initiatives, including an update on the use of language-generating technology in medical exams and AI-assisted research, ways to help consumers find information faster via internet聽searches, and tools to help developers build health apps around the world. (Alba and Love, 3/14)

More on AI in health care 鈥

As hospitals and companies continue to leverage artificial intelligence in medicine, researchers are also grappling with how to check the AI systems to protect patient safety.聽鈥淩isk management is a tricky business,鈥 said Gyorgy Simon, scientific co-director for the University of Minnesota鈥檚 clinical AI program. 鈥淭reatment models are changing, the population is changing. So a model [from] two years ago that was working perfectly may not be working perfectly today for a particular patient.鈥 (Castillo, 3/15)

In other health care industry developments 鈥

A Catholic-run health care system has withdrawn its application to affiliate with Day Kimball Healthcare, an independent, financially struggling hospital and health care system in northeastern Connecticut. Covenant Health鈥檚 decision to terminate its agreement with Day Kimball in Putnam comes weeks before the state鈥檚 Office of Health Strategy was scheduled to hold a public hearing on the planned merger. ... The proposed merger had raised concerns among residents and Attorney General William Tong about the fate of reproductive health and other services in the mostly rural region of Connecticut that may be at odds with the Ethical and Religious Directives set by the U.S. Conference of Catholic Bishops, an issue that has come to light in other states as well. (3/15)

NYC Health + Hospitals plans to hire an outside organization to help its homeless patients find housing, a $14 million investment that officials said would improve health outcomes and slash costly emergency room visits. The municipal health system has proposed contracting with Coordinated Behavioral Care, a not-for-profit consortium of behavioral health organizations, to work with about 600 unhoused patients annually on finding a permanent home. (Kaufman, 3/14)

A Goldman Sachs fund manager knew there was going to be trouble when he read a Wall Street Journal story that accused Outcome Health of overbilling drug companies and misleading them about the effectiveness of their advertising on prescription sales. (Pletz, 3/14)

On Monday, Attorney General William Tong鈥檚 office urged the court to reject the basis of part of Hartford HealthCare鈥檚 argument to dismiss an antitrust case filed against the hospital system. The original proposed class-action lawsuit filed in February 2022 alleged the network uses its market dominance to charge higher prices to the state鈥檚 commercially insured residents. (Golvala, 3/14)

A healthcare contractor at an East Bay county hospital stole medical records and used them to impersonate the patient on social media, according to records and hospital officials. The hospital contractor working at Martinez鈥檚 Contra Costa Regional Medical Center accessed the patient鈥檚 records after she tested positive for a sexually transmitted disease, according to a claim letter an attorney representing the patient sent to the county. (Heimann Mercader, 3/14)

KHN and CBS News: FDA Looks Into Dental Device After KHN-CBS News Investigation Of Patient Harm聽

In the wake of a joint investigation by KHN and CBS News into a dental appliance that multiple lawsuits allege caused grievous harm to patients, the FDA has begun looking into the product, the Anterior Growth Guidance Appliance, or AGGA, according to a former agency official. Additionally, KHN and CBS News have learned that the Las Vegas Institute, a training company that previously taught dentists to use the AGGA, now trains dentists to use another device it has described as 鈥渁lmost exactly the same appliance.鈥 That one is called the Anterior Remodeling Appliance, or ARA. (Kelman and Werner, 3/15)

KHN: Two Counties Square Off With California Over Mental Health Duties聽

Sacramento and Solano counties are in a standoff with the state over mental health coverage for a portion of Medicaid patients in those counties 鈥 a dispute that threatens to disrupt care for nearly 50,000 low-income residents receiving treatment for severe mental illness. The Department of Health Care Services, which administers Medi-Cal, the state鈥檚 Medicaid program, says Sacramento and Solano counties must take over managing and providing specialty mental health care for thousands of Medi-Cal patients enrolled in Kaiser Permanente plans. It insists on shifting the responsibility because California鈥檚 remaining 56 counties already operate this way. State officials argue the switch would simplify the state鈥檚 disjointed mental health system and is needed to implement a larger transformation of Medi-Cal, an initiative known as CalAIM. (Hart, 3/15)

Also 鈥

Saying genetics researchers inconsistently and inappropriately use racial and ethnic labels that fail to capture the complex patterns of human genetic variation, the National Academies of Sciences, Engineering, and Medicine issued a report Tuesday calling for a transformation in how such descriptors are used. (McFarling, 3/14)

LGBTQ+ Health

Arkansas Makes It Easier To Sue Minors' Trans Care Providers

Republican Gov. Sarah Huckabee Sanders signed new legislation that will go into effect in the summer. Anti trans-care moves in Georgia are also reported.

Arkansas Gov. Sarah Huckabee Sanders has signed legislation making it easier to sue providers of gender-affirming care for children, a move that could effectively reinstate a blocked ban on such care. Sanders on Monday signed the new law, which won鈥檛 take effect until this summer. It would allow anyone who received gender-affirming care as a minor to file a malpractice lawsuit against their doctor for up to 15 years after they turn 18. Under current Arkansas law, medical malpractice claims must be filed within two years of an injury. (DeMillo, 3/14)

A Georgia House committee on Tuesday sought to make it easier to sue doctors, and possibly charge them criminally, if they violate a proposed law barring some kinds of gender-affirming care in the state for anyone younger than 18. The House Public Health Committee voted 12-10 along party lines to pass Senate Bill 140, with majority Republicans passing the measure. The bill, which advances to the full House for more debate, would ban most gender-confirming surgeries and hormone replacement therapies for people under 18. However, unlike laws adopted in some other states, it would still allow doctors to prescribe medicines to block puberty. (Amy, 3/14)

In other news about transgender health care 鈥

Republicans who control the Wisconsin Assembly voted Tuesday to continue allowing therapists and others to attempt to change a person鈥檚 sexual orientation or gender identity. The discredited practice is known as conversion therapy, and Republican lawmakers in Wisconsin have been trying to stop it from being banned. (3/14)

Judges could consider parents鈥 objections to medical treatments such as puberty blockers when modifying or deciding custody agreements for children, under a measure approved Monday by a Senate committee. The bill (SB 254) also would make it a felony for doctors or other health care professionals to order puberty blockers, hormone treatment or surgery for minors. (Kam, 3/14)

For years, Jerry Miller was a fixture at legislative hearings in Kentucky, but this time was different: the Republican ex-lawmaker opened up about how his young grandchild could be hurt by a bill to ban access to gender-affirming medical care for those under 18. 鈥淭his bill condemns vulnerable children to an even more difficult life than they鈥檝e already been born into,鈥 Miller told a Senate committee on Tuesday. 鈥淧lease don鈥檛 let a parent鈥檚 right to protect their children be collateral damage in the culture wars.鈥 Despite his emotional pleas, the transgender-related bill was approved by the GOP-led committee, sending it to the full Senate. (Schreiner, 3/14)

Both state Sen. Machaela Cavanaugh and the conservative Omaha lawmaker who introduced the trans bill, state Sen. Kathleen Kauth, said they鈥檙e seeking to protect children. Cavanaugh cited a 2021 survey by the Trevor Project, a nonprofit focused on suicide prevention efforts among LGBTQ youth, that found that 58% of transgender and nonbinary youth in Nebraska seriously considered suicide in the previous year, and more than 1 in 5 reported that they had attempted it. 鈥淭his is a bill that attacks trans children,鈥 Cavanaugh said. 鈥淚t is legislating hate. It is legislating meanness. The children of Nebraska deserve to have somebody stand up and fight for them.鈥 (Beck, 3/14)

Also 鈥

Wellesley College proudly proclaims itself as a place for 鈥渨omen who will make a difference in the world.鈥 It boasts a long line of celebrated alumnae, including Hillary Clinton, Madeleine Albright and Nora Ephron. On Tuesday, its students supported a referendum that had polarized the campus and went straight to the heart of Wellesley鈥檚 identity as a women鈥檚 college. The referendum, which was nonbinding, called for opening admission to all nonbinary and transgender applicants, including trans men. Currently, the college allows admission to anyone who lives and consistently identifies as a woman. (Patel, 3/14)

A 2013 California law barring insurers from discriminating on the basis of a patient's sex or gender identity, was associated with an increase in gender-affirming surgeries in the state, as well as an expansion of sites and providers offering the care, new research in the Journal of the American Medical Association shows. (Dreher, 3/15)

State Watch

Assisted Suicide Will Be Allowed For First Non-Resident in Vermont

In other health news from across the country: more postpartum health care coverage, and a Pennsylvania county is offering to mail up to 10 free condoms directly to residents at their request.

Lynda Bluestein has terminal cancer and knows she鈥檒l likely die soon, but until Tuesday, she didn鈥檛 know if she鈥檇 be able to choose how or when and whether her family, friends and dog would be with her when the time comes. The 75-year-old from Bridgeport, Connecticut, reached a settlement with the state of Vermont that will allow her to be the first non-resident to take advantage of its decade-old law that allows people who are terminally ill to end their own lives, provided she complies with other aspects of the law. (Rathke, 3/14)

The details of a deal reached by North Carolina legislative Republicans to expand Medicaid to hundreds of thousands of low-income adults received overwhelming initial approval from the state Senate on Tuesday. The 43-2 vote on formal legislation comes less than two weeks after House and Senate leaders unveiled an agreement that could cover 600,000 people who make too much to qualify for conventional Medicaid but not enough to obtain highly subsidized private insurance. (Robertson, 3/14)

Montana lawmakers on Tuesday took an initial vote to provide 12 months of postpartum health care coverage for people covered by Medicaid. The vote came as part of the House Appropriations committee鈥檚 opening work on the state鈥檚 $13.4 billion dollar budget, also known as House Bill 2. The committee will spend much of the week moving through state agency budgets, putting their own mark on work done previously this legislative session by budget subcommittees. (Michels, 3/14)

A new initiative announced by Mayor Michelle Wu鈥檚 office will offer free postpartum education and support to 32 women in the Boston area who have recently given birth or are expecting to give birth soon. The 10-week virtual pilot program, announced Monday, will focus on supporting mothers, particularly Black and Brown women, through the pregnancy and postpartum period. (Mohammed, 3/14)

Kentucky lawmakers have overwhelmingly passed a bill that would require health insurers to cover 鈥 biomarker tests 鈥 that can help determine the best cancer treatment plans for patients. The bipartisan measure won final passage on Monday, and was hailed as a consequential step in a state long plagued by high rates of cancers. (Schreiner, 3/14)

For years now, Democratic lawmakers have hammered a consistent point when it comes to health care prices: Coloradans are not getting their money鈥檚 worth. 鈥淲e pay too much for too little,鈥 Gov. Jared Polis said at a recent news conference. But this effort to reign in the costs of care, especially when it comes to hospitals, has this year hit a barrier. (Ingold, 3/15)

Aiming to curb the spread of diseases spread by sex, Delaware County is offering a free program that will mail up to 10 condoms directly to residents at their request. Called 鈥淒oing Delco Safely,鈥 the program allows residents to choose from options including Trojan brand condoms, non-latex and lubricated varieties and female condoms. (Whelan, 3/14)

Prescription Drug Watch

Meningococcal Vaccine Shows Positive Trial Results; Jynneos Proves Highly Protective Against Mpox

Read about the biggest pharmaceutical developments and pricing stories from the past week in KHN's Prescription Drug Watch roundup.

Nearly three years after dosing the first patient in a phase 3 trial, GSK聽has now reported positive results from the trial of its much-anticipated combination meningitis vaccine. (Becker, 3/15)

Estimated vaccine effectiveness (VE) of a single dose of the Jynneos attenuated smallpox/mpox vaccine against symptomatic mpox infection was 78% at least 14 days later, according to a study published yesterday in The Lancet Infectious Diseases. (Van Beusekom, 3/14)

Drug developer Veru Inc. on Tuesday said it plans to proceed with a late-stage trial of its COVID-19 pill, weeks after the U.S. health regulator declined to authorize the oral drug to treat high-risk patients hospitalized with COVID-19. It will, however, stop the development of the drug as a potential treatment for prostate cancer as part of its strategy to cut costs. Veru plans to continue development of the oral drug, sabizabulin, in late-stage studies with high-risk hospitalized influenza patients and COVID-19 patients. (3/14)

The European Centre for Disease Prevention and Control (ECDC) reported today that 67 cases of botulism linked to a weight loss procedure have been reported in Turkey and three other European countries. The 67 cases of the neuroparalytic illness have all been linked to intragastric injection of the botulism neurotoxin (BoNT), with 53 cases reported in Turkey, 12 in Germany, and 1 each in Austria and Switzerland. (Dall, 3/14)

A survey of healthcare facilities in the United States and seven other countries found that infection prevention and control (IPC) and antibiotic stewardship program (ASP) interventions requiring staff, time, and specialized training were implemented less frequently in 2021, researchers reported today in Infection Control and Hospital Epidemiology. (Dall, MA, 3/14)

Perspectives: Are Psychedelics The Meds Of The Future?; Coming Oncology Drugs Are Quite Complex

Read recent commentaries about drug-cost issues.

Psychedelics like psilocybin and ketamine are being touted as the next generation of treatment for depression, anxiety, and other mental health issues. There鈥檚 no question that a next generation is needed. But it鈥檚 not like flipping a switch: These therapies involve a novel administration paradigm, acceptance by regulatory bodies, and public appreciation of their unique medicinal value. (Greg Mayes, 3/13)

After much ado, Seagen Inc. is finally being acquired 鈥 by Pfizer Inc. The $43 billion proposed deal should quell investor calls for Pfizer to do something splashier with its Covid cash, and could put Pfizer into a leadership position in oncology. (Lisa Jarvis, 3/14)

Revelations that AbbVie, the manufacturer of Humira, made more than $100 billion in extra profits by abusing the patent system to delay generic competition has spurred efforts by the Biden administration and Congress to limit the length of patent monopolies over prescription drugs. (Alfred Engelberg, 3/10)

As a member of the Cabinet, the drug czar would have equal standing with the leaders of other federal departments and agencies. They would be free to call the secretary of state about the international scheduling of drugs or the attorney general about prosecuting drug cartels. (Kevin Sabet and Patrick Kennedy, 3/10)

The photograph will be forever seared into my memory: A teen girl, her T-shirt mottled with blood, lying prone on her bathroom rug. On the child鈥檚 dresser just a few feet away, a single crushed-up pill. It鈥檚 one thing to hear about a juvenile fentanyl overdose. It鈥檚 another to see the aftermath. (Leigha Simonton, 3/9)

When it comes to policy debates, any claim that you can have your cake and eat it too should be taken with an extra helping of skepticism. So it is with Rep. Zack Stephenson's and Sen. Kelly Morrison's claim that their bill to impose price controls on prescription drugs "won't reduce patient access to new or existing drugs". (Peter Nelson, 3/13)

The productivity of new-drug research and development is poor and getting worse. Many others have noticed this. It鈥檚 an important, possibly existential, issue for the biopharma industry. (Brian Finrow, Aleks Engel and Srinivas Akkaraju, 3/15)

Editorials And Opinions

Viewpoints: Why We Failed To Prevent The Covid Pandemic; How Are We Faring Three Years Into Covid?

Editorial writers examine these public health topics.

Three years after the World Health Organization declared Covid-19 to be a pandemic, we finally have reason to celebrate: Global deaths from the virus have dipped below 1,000 people per day for the first time since March 2020. But with almost 7 million dead, we must figure out a way to do better next time. And there will be a next time. (3/15)

Three years later, with uneven distribution of tests, vaccines and treatments,聽the world has recorded聽about 677 million聽cases of COVID-19 and nearly 7 million deaths, according to Johns Hopkins University. (3/15)

Recent reports that Department of Energy and FBI officials think the COVID-19 pandemic originated with a so-called lab leak appear to have provided all the "evidence" many require. As a scientist who has led or contributed to several peer-reviewed studies that tell a very different story, I've looked on with amazement at the growing divide between what the science shows and what much of the public 鈥 and a minority of the intelligence community 鈥 believe. (Michael Worobey, 3/14)

Also 鈥

President Joe Biden signed an executive order on Tuesday seeking to increase the number of background checks for gun purchasers. The measure does something else that doesn鈥檛 get nearly enough attention: It would promote the secure storage of firearms. (Jamie Gold, 3/14)

One in 3 seniors in the U.S. will develop Alzheimer鈥檚 disease or another form of dementia. This horrific disease is rapidly claiming the minds and lives of millions and requiring thousands of family members to serve as caregivers for their loved ones. The good news is that finding a cure for Alzheimer鈥檚 is achievable, and it must be a national priority. (Jerry Moran, 3/15)

Chatbots like OpenAI鈥檚 ChatGPT can hold fun conversations across many topics. But when it comes to providing people with accurate health information, they need help from humans. (Smisha Agarwal and Rose Weeks, 3/15)

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