Get your daily dose of health and medicine every weekday with STAT’s free newsletter Morning Rounds. Sign up here.
Good morning. Yesterday’s game wasn’t the most exciting, but luckily the third place game on Saturday had all the drama I’d hoped for. Before replaying the highlights, catch up on a bunch of news below.
Some good news re: smoking cessation
Last week, Medicare released proposed changes to the physician fee schedules. A few paragraphs buried in the 1,592-page document indicate that doctors may soon get some financial encouragement to help patients who want to quit smoking, STAT’s Sarah Todd reports.
The proposal says that doctors who offer counseling on quitting cigarettes or other tobacco products during patient visits would get a 19% increase in reimbursement. “We have something to offer these patients,” said Ned Sharpless, a former director of the National Cancer Institute who has long advocated for this sort of change. “Nobody’s getting rich off this, but now it’ll be more on par with other activities.” Read more from Sarah, who was the first to report the news.
HHS vaccine committee quietly gets new charter
Despite the reported White House edict to sideline vaccine policy changes in advance of the midterm elections, health secretary Robert F. Kennedy Jr.’s team continues its efforts to overhaul how vaccination policy is set and reviewed. One of its latest targets: the National Vaccine Advisory Committee, which advises the Department of Health and Human Services on vaccine use and safety. NVAC was previously made up primarily of scientists who studied vaccines, physicians, and public health officials; its goal was to advise on the best and safest uses of vaccines to prevent infectious diseases. But a new charter for the group, dated July 7 but not publicized by HHS, sets out different priorities.
Among the changes: The committee is being instructed to broaden its focus beyond vaccines to embrace other tools to curb spread of vaccine-preventable diseases for people who cannot or won’t agree to be immunized. It suggests those tools should include healthy lifestyles, dietary supplements, and “repurposed use” of already approved FDA drugs. The new charter suggests limiting the number of academics who do industry-funded vaccine research who can serve on NVAC, with a larger focus on members of the public.
— Helen Branswell
Even ‘good’ insurance might deny psychiatric care
As an emergency physician, Joy Evers knew what health care options were available at the moment her husband needed immediate psychiatric treatment. She knew she found the best facility available — but it didn’t matter. Less than a week into her husband Randy’s eight-week stay at an inpatient facility, their insurance company denied further coverage of the stay and he was forcibly discharged. Months later, he was found dead.
“My love for Randy and my professional experience were not enough to save him,” Evers writes in a new First Opinion essay. “I am a physician, and yet my husband died, proving he was sick enough to deserve care.”
Read the whole essay. It’s a harrowing, heartbreaking firsthand account of how even a family with the best insurance and fluency with health care can be deeply wronged by the flaws in the system.
Profits over patient safety?
If you go to the Novo Nordisk website in search of a weight loss drug, you’ll see the company promote LifeMD as one of a number of telehealth providers offering “legitimate medicine sourcing and patient support.” But interviews with five former employees and two lawsuits filed by former company leaders underline deeper concerns about the virtual provider. Over the last few years, LifeMD has been urging clinicians to see more patients and prescribe weight loss drugs faster with little screening and follow-up, according to these accounts.
In an interview, CEO Justin Schreiber strenuously denied that the company prioritizes profit over safety: “Our objective has not been to run a pill mill. We’ve actually taken the opposite position.” But the allegations come amid broadly growing concerns about lax clinical oversight among the many telehealth companies offering weight loss medications.
Read Elaine Chen’s great investigation. Some of the allegations made in a lawsuit filed by former executive Brad Roberts, who claims to have been prescribed six GLP-1 drugs by LifeMD’s chief medical officer, are particularly alarming.
England will test all newborns for SMA
England said last week that it would expand its newborn screening program to include spinal muscular atrophy, moving up and broadening what was meant to be a pilot program that would extend testing to about 70% of infants. Instead, starting later this year, the muscle-wasting disease will be added to the panel of diseases that all newborns are tested for, with complete coverage expected next year.
Doctors and advocates have long complained about how slow England is to adopt additional diseases for its panel. All 50 states, Canada, and most European countries were ahead of England in adding SMA to their testing programs. Notably, the government did not say if it would change its procedure more broadly for adding diseases to its panel, a process that critics point to as the reason England is behind other countries. — Andrew Joseph
OTC naloxone access varies across the country
In nearly 40% of opioid overdose deaths, there’s a bystander nearby who could have intervened with lifesaving naloxone, according to recent research. But it’s still not always easy for people to get the nasal spray that can reverse overdoses, even though it was approved to be sold over the counter in 2023. A new secret shopper analysis from JAMA Network Open analyzed the availability of the drug in pharmacies, as well as where it’s placed and how it’s priced.
The researchers called more than 1,100 pharmacies and found that about 61% had same-day availability for the drug without a prescription. In most cases (73%) it was kept behind the counter, and the average cost was about $52. Areas with more white people were more likely to offer naloxone, as were corporate chain pharmacies. While it was necessary to make the drug available over the counter, the policy’s “intended benefits were not realized equally in practice,” the study authors wrote.
There’s a calculator for that — but results may vary
When doctors need help making a decision about a patient, there are hundreds of calculators and clinical tools at their disposal. That includes simple calculations like body mass index and mean arterial pressure, but also more complex prediction models for risks and outcomes. But as STAT’s Katie Palmer reported last week, just because a tool exists doesn’t mean doctors should always trust what it says.
“In clinical practice, a lot of the tools that we use, we genuinely have no idea how limited it is in its validation,” said Shazia Siddique, the chief medical officer of MDCalc. That’s why the company is launching a quality-rating system to help doctors better assess all the clinical tools and calculators they may want to use. It’s releasing scores in batches based on a tool’s clinical purpose — last week, it was calculators predicting cardiovascular risk, a category that has seen a lot of change recently. Read more from Katie on which tool got the lowest rating so far, and how the assessment works.
What we’re reading
- FDA says Taylor Farms lettuce sample tested for cyclospora produced false positive for the parasite, NBC News
-
Violence repeatedly erupts in dementia care despite warnings, inspections show, NPR
-
What Lionel Messi sees, Atlantic
- Opinion: It’s time to treat pandemics as threats to national security, STAT
- Men sue hospital after DNA tests showed they were switched at birth 38 years ago, AP
- State audit of Medicaid records points to methods used by PBMs to obscure drug costs, STAT