Medicare plans to restrict access to controversial Alzheimer’s drug Aduhelm

Medicare plans to cover the controversial, pricey Alzheimer’s drug Aduhelm, but only for certain patients enrolled in clinical trials, the agency announced yesterday. Since it got the green light this summer, doctors and scientists have raised questions about whether it actually works, government watchdogs have begun investigating whether the FDA followed proper procedure to approve it, and policy experts have questioned whether it is effective enough to justify its hefty price tag. Medicare officials don’t require participation in clinical studies for beneficiaries very often. The new proposal would likely mean some patients will not be able to access the drug, but the decision could still change substantially before it's finalized later this spring. STAT’s Rachel Corhs has more.

Brain stimulation is having a moment, but hurdles remain before more patients will receive it

Kevin O’Neill of California underwent deep brain stimulation last year to treat his Parkinson's disease symptoms. (Constanza Hevia for STAT)

Brain stimulation is booming. Once rarely covered, entire conferences are now devoted to the study of what electrical currents do to the intricate networks of highways and backroads that make up the brain’s circuitry. This expanding field of research is slowly revealing truths of the brain: how it works, how it malfunctions, and how electrical impulses, precisely targeted and controlled, might be used to treat psychiatric and neurological disorders. In the last half-dozen years, researchers have launched investigations into how different kinds of brain stimulation affect addiction, depression, loss-of-control eating, tremor, chronic pain, obsessive compulsive disorder, Parkinson’s disease, epilepsy, and more. Still, even therapies that have been approved for use in patients with Parkinson’s disease or epilepsy help only a minority of patients. STAT’s Isabella Cueto has more in a special report on the scientific and other hurdles ahead.

As surges drive Covid-19 testing, companies eye an on-ramp for new markets

Throughout the pandemic, companies big and small have responded to the call for widely-available Covid-19 testing. It’s not just a public good: Supplying a flood of new diagnostics, digital backbones for data sharing, and on-site infrastructure is good business, and most companies are trying to capitalize on the demand for testing as much as possible, for as long as possible. But at the J.P. Morgan Healthcare Conference this week, some of the biggest names in Covid-19 testing described the challenge of hitting that constantly moving target. Two examples:

CVS Health saw retail revenue outperform in the fourth quarter, largely attributed to vaccinations in addition to testing, but some stores are struggling with staffing.
Abbott, maker of lab-based PCR tests, rapid molecular tests, and the BinaxNOW rapid antigen test, is seeing a surge in demand, but that may change.

STAT’s Katie Palmer has more for STAT+ subscribers.

Inside STAT: Think health care workers on the Covid frontlines are tested regularly? Think again ...

Surgical resident Orly Nadell Farber read the text while waiting in line for a Covid test — the first appointment she could snag four days after caring for a patient recovering from surgery who became Covid positive in the hospital. In those few days, she had taken care of more than 40 other patients and interacted with a dozen or so nurses, physicians, and cafeteria workers. Her friend’s text asked, “Have they stopped caring about our health?” Also a surgical resident, the friend had just learned that the CDC shortened the isolation time for Covid-positive health care workers. Testing would seem more important, if only it were more available. “I’m left guessing as to why health care workers aren’t routinely tested for Covid-19,” Farber writes in this STAT First Opinion. “But one thing is certain: Identifying Covid-infected health care workers would worsen the staffing shortages hospitals already face.”

... but health care workers do score high on the latest 'best jobs' list

The U.S. health care system is “overburdened and understaffed,” as First Opinion writer Orly Nadell Farber puts it (see above). Yet yesterday, U.S. News & World Report said health care jobs dominated the top 10 rungs on its best-jobs rankings. Information security analyst snagged the No. 1 spot, but it was followed by nurse practitioner, physician assistant, and medical and health services manager. The criteria include growth potential, work-life balance, and salary. The jury may be out on those first two attributes, but salary was confirmed by another U.S. News list, at least for M.D.s. On the $100,000-plus pay list, anesthesiologist ranked No. 1, followed by surgeon and then OB-GYN. These median M.D. salaries exceed $200,000.

Opioid deaths — and disparities — soar among older adults, too

Opioid overdose deaths have hit staggering heights in the U.S., recently surpassing 100,000 in a single year. A new study that tallied these deaths over 21 years shows people over 55 are hardly spared by an epidemic that picked up fentanyl-fueled speed in 2013. The JAMA Network Open analysis says there were 518 fatal opioid overdoses in this age group in 1999 but 10,292 in 2019. About half the deaths were among people age 55 to 64, and African American men were four times as likely as other men to die from opioids, and more likely to use illicit vs. prescription drugs. The researchers point to both racism (less access to health care and bias in pain treatment) and ageism (older patients are overlooked for opioid use disorder) to possibly explain the difference.

What to read around the web today

The world we want to live in after Covid. The New Yorker
He lost fingers in an accident. Now it’s inspiring his art. New York Times
Should teen boys get boosted? The Atlantic
Amgen, Arrakis Therapeutics partner to develop oral drugs that eliminate troublesome RNA. STAT+
A ‘skinny label’ for a generic version of a pricey cancer drug fattened consumer wallets. STAT+