Good morning. We have a significant project to tell you about today, the fruit of four months of data analysis to reveal just how much CEOs are taking home in four health care sectors, and how far that diverges from median pay at their companies.

Special report: As the pandemic raged, health care CEOs’ earnings surged

Last week an astronomer said images from NASA’s James Webb Space Telescope peering deep into the universe left him “gobsmacked.” I thought of that phrase when poring over the out-of-this-world earnings of health care high-rollers. A STAT team — Bob Herman, Kate Sheridan, J. Emory Parker, Adam Feuerstein, and Mohana Ravindranath — today delivers a project revealing that health care CEOs made an average of $15.3 million last year. Salaries made up less than 6% of pay, with the actual realized gains of executives’ stock awards and options making up the lion’s share. The top earner was Regeneron Pharmaceuticals CEO Leonard Schleifer, pulling in an astounding $453 million.

For context, the collective $4.5 billion CEOs pocketed is enough money to cover the annual health insurance of roughly 580,000 individual people. Or choose your own comparator: Teslas? iPhone 13s? Tuition? Single family homes?

Here’s how four sectors shook out:

CEOs of biotech and pharma occupied three of the top 10 spots on the compensation list, but also 11 of the top 25.
Median CEO pay among 11 providers and insurance companies sat at $30 million, the highest of any sector.
The pandemic brought a windfall for private health tech startups and fueled a rush to the public markets, meaning some CEOs saw their take-home pay skyrocket.
Medical device executives generally made less in 2021 than in 2020, thanks to some pandemic-delayed surgeries, but 22 CEOs from this cohort took home at least $10 million last year.

Health care pays many — but not all — people well

(Mike Reddy for STAT)

Publicly traded companies have had to report median employee compensation in their annual proxy filings, and the differences are dizzying. The median employee at half of the 217 companies STAT studied took home at least $100,000 annually. But workers at several U.S. provider companies make wages that straddle the federal poverty line. You can check out more here.

STAT’s Bob Herman sums up the compensation picture in the sprawling health care sector this way: “It pays to be in the lab. It pays way less to be at the patient’s bedside.” Compared to other workers, people in health care generally have higher-than-average salaries. But, the STAT team's analysis shows, several health care companies pay most of their workforce low wages, and some rely on cheap foreign labor. Even with high industry salaries, health care CEOs often make 100 times what the average employee gets.

New York City pursues one-dose monkeypox vaccine strategy, defying U.S. advice

Flying in the face of CDC and FDA guidance on monkeypox vaccination, New York City — the country’s epicenter with one-third of reported cases — will deliver first doses of vaccine to people at high risk rather than holding back second doses. Second appointments would follow once the city has more supply. It’s an approach also being taken in the U.K. and Canada.

The vaccine, Jynneos, is designed to be given in two doses, 28 days apart. It’s offered to people who are known contacts of monkeypox cases and men who have sex with men who are at high risk because they have multiple sex partners or partake in anonymous sex. For that latter group, “you just need a higher level of protection than one dose will give you,” CDC Director Rochelle Walensky told STAT’s Helen Branswell. “That’s really why we’re advocating for two doses.”

Closer look: New data might have changed an FDA panel's vote on a fish-oil drug

(amarin)

If they knew then what they know now about a heart drug derived from fish oil, they might have voted differently, two members of an expert panel convened by FDA said. That’s important for Amarin’s drug, but it also has ramifications for FDA processes and other fish-oil-based heart medicines, STAT’s Matthew Herper reports. Here’s the history: At the committee’s November 2019 hearing, 16 panelists voted unanimously to recommend the agency approve Vascepa to reduce the risk of first heart attacks and other heart problems in patients with high triglycerides.

But a new analysis published in Circulation last month suggests a substantial benefit the drug showed might have been in part due to harm caused by the placebo it was compared to. Amarin stands behind its pivotal trial of Vascepa and “the FDA is aware of the publication,” an agency spokesperson said. Read more.

On the first day for 988, operators honor hard work

On the first weekend for the new 988 Suicide & Crisis Lifeline — a simpler number rolling out nationwide — STAT’s Theresa Gaffney sat in with operators in Framingham, Mass. Here’s what she saw:

Don smiled when he saw who was calling. He’s usually the overnight shift manager, so he knew she’d be surprised to hear his voice during the day. When he answered, the caller pre-empted the question Don and every Call2Talk operator must ask: No, she wasn’t feeling suicidal today. She’s been calling the crisis line regularly for years, so they have a rapport. “What, are you having a party for 988?” she joked. Not many callers mentioned the new national three-digit number, but she knew it was launch day. And she wasn’t far off about the party, either.

On Saturday, the official first day that dialing 988 anywhere connects people to a local call center like Massachusetts’ Call2Talk, volunteers and staff gathered at the office for a celebration, including a cake with “988” frosted on top.

Eileen Davis, the director of Call2Talk, said it was a “no-brainer” to commemorate the day. Her team has worked hard to take more shifts, train new call-takers, and communicate with callers to prepare for what may be a slow but steady increase in calls to the line through the easier-to-remember number.

How the pandemic affected primary care in prison

In a crisis, care is diverted to where it’s needed the most. As the pandemic burns on, health care experts are looking at what happens to primary and specialty care while bigger fires are being put out elsewhere. A new research letter in JAMA Health Forum looks in detail at people incarcerated in California, a group more likely to live with chronic disease and to have experienced more serious Covid outbreaks and deaths compared to the U.S. as a whole.

At 35 state prisons between January 2019 and July 2021, fewer people were incarcerated but they were older and sicker. During each Covid wave, both routine primary care and routine specialty care referrals dropped significantly. “Individuals who remained incarcerated experienced a higher burden of chronic disease and sustained, significant disruptions in referrals for and timely receipt of care,” the authors conclude.

If you or someone you know may be considering suicide, contact the 988 Suicide & Crisis Lifeline: call or text 988 or chat 988lifeline.org. For TTY users: Use your preferred relay service or dial 711 then 988.

What to read around the web today

Abortion laws spark profound changes in other medical care, Associated Press
UnitedHealthcare to offer $0 insulin, Epi-Pens, but only for some members, STAT
New Covid vaccines will be ready this fall. America won't, The Atlantic
UnitedHealth Group says Medicare Advantage saves money, but the data say otherwise, STAT
Largest study to date shows how Covid vaccines affect periods, New York Times