While a law to thwart counterfeit medicines gradually takes effect, fake pills still circulate

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When we pick up our prescription medicines, we might fumble with the child-proof cap on the bottle or fiddle with the foil seal, but we’d be confident that pills inside are what the doctor ordered. That’s not necessarily true, STAT’s Ed Silverman and Jonathan Wosen report as they trace how a collection of little-known distributors — sometimes working with pharmacies — disseminated resealed bottles containing either fake or incorrect pills, according to lawsuits filed by Gilead Sciences and Johnson & Johnson, which manufacture and sell HIV medicines. There is a federal law to curb these sorts of occurrences, but it won’t go into full force until November 2023. “This is not to say that counterfeiting can be stamped out altogether,” Ed and Jonathan write. “Think of it this way: When you build a better mousetrap, you get a smarter mouse.”

Health officials peg monkeypox risk at ‘moderate’

The WHO said on Sunday that the ongoing monkeypox outbreak currently poses a moderate risk to global public health, but its statement didn't rule out the virus becoming entrenched as a pathogen that spreads from person to person. Pressed yesterday, a WHO official said she didn’t think the outbreak outside Africa would lead to a pandemic, Reuters reported. "We don't know but we don't think so," Rosamund Lewis said. "At the moment, we are not concerned of a global pandemic." The WHO said that 23 countries have reported 257 confirmed cases and roughly 120 suspected cases — a rapid accumulation in an unprecedented outbreak first detected earlier this month. Monkeypox is considered endemic in roughly 12 countries in West and Central Africa. Nigeria, which has experienced an outbreak since 2017, reported the first death this year from monkeypox yesterday, the Associated Press says, while Congo has confirmed nine deaths in 2022.

In the U.S., the CDC is considering expanding testing networks, STAT’s Andrew Joseph reports, even as it emphasizes the current two-step process is not delaying treatment or containment of the outbreak. As it now stands, swabs from a patient are sent to both a local or state lab for initial testing to see if it’s an orthopox, and then to CDC for to confirm that it’s monkeypox.

The AMA is fighting a bill to require training for doctors on opioid use disorder

This is a puzzler, or maybe not: The AMA is on record recommending more training for doctors on treating people with opioid use disorder, but the group is opposing an otherwise popular bipartisan bill that would mandate doctors be trained on treating people with opioid use disorder, according to a letter from the organization obtained by STAT’s Nicholas Florko. “A one-time training mandate for substance use disorders, no matter how well-intentioned, will not have a meaningful impact on reducing drug-related overdose,” the AMA wrote on May 6. “The AMA is unable to support this legislation.” When asked for comment, the AMA referred STAT to its letter, which says much of the group’s resistance stems from its long-standing opposition to lawmakers imposing federal mandates on the practice of medicine. Read more.

Closer look: To move the needle on health disparities, a call to include patient voices

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Sylvie Leotin, founder and CEO of Equify Health, is a Stanford-trained scientist who has worked in high tech for decades. She is also a Black woman whose nightmare experience with cancer — being butchered during a biopsy and receiving her breast-cancer diagnosis by email — jolted her to pivot toward improving cancer care for underserved patients. Currently the principal investigator of a health equity innovation grant from Genentech, in collaboration with Emory School of Medicine, she hears again and again how patients are not being heard. “To see health disparities evaporate in this generation, they must no longer be treated as a data problem,” she writes in a STAT First Opinion. “Only the marriage of data and human insight will unlock human progress. For this, we must factor in the lived experiences of those excluded and poorly served by the health care system.”

More RN staffing tied to fewer sepsis deaths

Sepsis is an overwhelming response to infection that can lead to organ failure and death if it’s not recognized and managed properly. It’s a challenging problem that Medicare tracks in acute-care hospitals. A new study in JAMA Health Forum analyzed 2018 data from nearly 2,000 hospitals caring for over 702,000 patients and drew a connection between hours of care by registered nurses and the likelihood a Medicare patient would die of sepsis within two months of hospital admission. The researchers found that an increase in RN hours per patient day was associated with a 3% decrease in mortality, suggesting that hospitals that provide more RN hours of care could likely decrease sepsis deaths. “Nurse workload is an overlooked and underused aspect of the treatment bundle for patients with a diagnosis of sepsis,” the authors say.

Rise in new daily vapers was highest in teenagers

In 2017, there was a 40% jump in U.S. e-cigarette sales, two years after Juul introduced a high-nicotine, flavored product advertised on social media. Based on two surveys of 14- to 34-year-olds starting in 2014, a new study in Pediatrics says new daily tobacco use jumped in only one age group over that time frame: 14- to 17-year-olds. Three-quarters of those new users vaped daily and had dependence scores like daily cigarette smokers and older vapers. Those numbers translate into 600,000 teenagers, a rate 2.5 times daily vapers over 25. After data collection ended in 2019, Juul ended sales of flavors except menthol and tobacco, and the FDA limited access to flavored e-cigarettes. Still, the authors say, “The large increase in daily use among U.S. adolescents could presage future health consequences and needs urgent additional action from the regulatory body.”

In the new episode of "Color Code," STAT science reporter and podcast host Nicholas St. Fleur takes a deep dive with STAT’s national health tech correspondent Casey Ross and UC Berkeley's Ziad Obermeyer into how racial bias creeps into health care AI — and what can be done to prevent it. Listen here.

What to read around the web today

We got Covid shots in one year. Why did a malaria vaccine take 35? The Atlantic
Biden administration won’t lower seniors’ Medicare premiums this year, despite changes to coverage of new Alzheimer’s drug. STAT
Key Senate committee proposes a council to ensure FDA better coordinates on accelerated approvals. STAT+
How a Boston doctor diagnosed the first U.S. case of monkeypox. Boston Globe
ViiV will make it easier for generic companies to copy its HIV prevention shot, but it’s not clear when. STAT+