Medicare drug prices, meningitis, women’s health

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Almost exactly two years ago, the Inflation Reduction Act was signed into law, allowing Medicare to negotiate drug prices for the first time. Today the agency announced how much it has reduced costs on ten drugs in the first year of negotiations. Here, our incomparable DC team provides news and analysis and explores the implications for the presidential campaign.

Arthritis patients on Medicare are being cornered by their treatment

One rheumatologist calls it the “birthday story.” Someone with arthritis has been stable for years and uses Humira, an injection that he or she can administer at home. Then they turn 65. When people switch from private health insurance to Medicare, certain medications become unaffordable overnight because of the way the program structures the pricing of prescription drugs for home use. One patient, Linda Kaser, discovered that her pills would cost more than $4,000 a month after she turned 65. If an arthritis patient wants to avoid an increase in costs, the only solution is to switch treatment to regular visits of more than an hour to a doctor. hospital or infusion center for intravenous drug treatments.

As many as 40,000 chronically ill seniors choose to undergo these uncomfortable, time-consuming infusions because Medicare does not adequately cover much more convenient treatments. Read more about how the opaque drug pricing process leads patients to choose this lame hack.

NY tells providers to stop using ciprofloxacin for meningitis

An increase in antimicrobial resistance has prompted the New York State Department of Health to issue a decision advisory to healthcare providers to stop using the antibiotic ciprofloxacin for patients who may have been in contact with someone who has meningococcal disease (also called meningitis). Instead, healthcare providers should use the other first-line antibiotics, rifampin and ceftriaxone, as prophylactic treatment.

Meningitis is a rare but serious condition that can cause swelling of the brain or blood and joint infections. About 10-15% of cases in the US are fatal, and it is critical that people who may have been exposed to the disease initiate antibiotic treatment. Last year, four out of 20 cases of the disease in the state (but outside New York) were found to be resistant to ciprofloxacin. In the city, six of the 25 cases since last summer were resistant.

(It’s always a good idea to keep up with STAT’s coverage of antibiotics.)

The WHO declares mpox a global public health emergency

The WHO yesterday declared a public health emergency of international concern regarding the mpox outbreak in several African countries. This is the second time in two years that the agency has made such a statement in response to the transmission of this virus.

What does this mean, you might ask? A public health emergency of international concern (PHEIC) may exist when the risk of cross-border spread is considered high and international cooperation is likely to be needed to contain the threat. Cross-border transmission of MPOX has already taken place here several times. The declaration also gives the WHO director-general the authority to issue so-called temporary recommendations – guidance for countries on the steps they should take to tackle the problem. Read more from STAT’s Helen Branswell.

Is HHS climate washing? (What is climate washing?)

The Department of Health and Human Services has stated that it will do everything it can to reduce greenhouse gas emissions from the health care industry. But in a new First Opinion essay, health care consultant David Introcaso argues that the agency is really just “climate washing.”

If the term doesn’t sound familiar, climate washing is essentially when a government or company simultaneously engages in positive communications about climate performance and negative climate practices.

Introcaso provides evidence: three years ago, HHS established the Office of Climate Change and Health Equity (OCCHE). But so far, OCCHE has done nothing regulatory to reduce healthcare emissions. And since the agency’s creation, HHS Secretary Xavier Becerra has never advocated funding it in congressional budget testimony.

Read more about whether the agency is putting enough money into the fight against climate change.

How does women’s health care in the US compare to other countries?

You may not like this answer, but women in the US have worse access to health care and better outcomes than those living in 13 other high-income countries, such as Australia, Canada, Japan and South Korea, according to a new study from the Commonwealth Fund. What outcomes? Oh, you know, like life expectancy, ‘avoidable deaths’ and mental health. Here are some highlights:

• Women in the US have the lowest life expectancy and the highest number of preventable deaths. If preventive measures had been taken or proper treatment provided, 70 of the 100,000 women who die in the U.S. could live. This percentage is more than three times higher than the number of preventable deaths in South Korea.
• All thirteen other countries in the analysis provide all residents with some form of government health care coverage. None have a substantial share of people who are uninsured. In the US last year, 14% of women aged 19 to 64 said they were uninsured, including more than a quarter of Hispanic women.
• The US and Australia are the two countries where women most often report a need for mental health care. But they are also the two countries where women are most likely to skip mental health care due to costs. One in four women in each country reported skipping mental health care. (At least we’re not alone in this?)

How an ALS patient used a brain-computer interface at home for seven years

Brain-computer interfaces will not be available to the general public in the short term. For now, people with disabilities are the first to test new technology like this. It can help people who are paralyzed to communicateand could be particularly fruitful for ALS patients as their control of the eye muscles decreases, causing eye-viewing devices to lose their usefulness.

Mariska Vansteensel is a neuroscientist who has spent most of the past decade experimenting with BCI at home. Her team followed an ALS patient who used such a device for more than seven years. When the study began, no one with motor impairment had ever tried using a BCI implant at home, she told STAT’s Timmy Broderick. The team found that the person’s use of the BCI increased as time passed and paralysis increased.

Read Timmy’s interview with Vansteensel about what her team learned after observing nearly a decade of hands-on BCI use.

What we read

• The vets who prevent the next pandemic The New Yorker
• They all developed mysterious brain diseases. They fight to learn why, New York Times
• Can AI help alleviate medicine’s empathy problem? STAT
• WHO scraps weak PFAS guidelines for drinking water after alleged corruption The Guardian
• Surgeons cut a giant tumor out of my head. Is there a better way? Bloomberg