Good morning. Today we lead off with a STAT investigation into allegations about an abusive workplace led by a scientific luminary, which reminded one source of Eric Lander’s resignation as White House science adviser and the pushback against “big ego” science.

A STAT investigation: Gene therapy pioneer Jim Wilson presided over a toxic workplace, staffers say

(MIKE REDDY FOR STAT)

Scientist Jim Wilson’s name is synonymous with gene therapy. But his success has obscured a darker side to his leadership of the Gene Therapy Program, the acclaimed University of Pennsylvania research center — a style that for years permitted toxicity and mismanagement to roil the workflow of lab experiments and research. In interviews with STAT, current and former employees of the program said Wilson and other senior managers fostered and condoned an abusive workplace culture where bullying and harassment were commonplace.

Deep, internal strife has marred research programs, and in at least one case, derailed key growth plans. A university investigation confirmed some of the allegations of an abusive workplace culture. In a statement to STAT, Wilson said he did not initially “appreciate the challenges of managing the tremendous growth in our organization.” Read more from STAT’s Allison DeAngelis, Adam Feuerstein, and Jason Mast.

Senate advances historic drug pricing reform

STAT’s Rachel Cohrs brings us this report from Washington: After more than two decades of effort, Democrats are finally on the verge of breaking down the firewall between the pharmaceutical industry and the federal government. Senate Democrats yesterday advanced a substantive drug pricing reform package that would allow Medicare to negotiate some drug prices, would cap Medicare beneficiaries’ costs at $2,000 per year, and impose penalties on drugmakers that hike prices faster than inflation. However, the legislation was narrowed in the process, as two provisions that would have helped patients who get insurance through their jobs violated Senate rules.

Democrats and advocates for reform are rejoicing, but the pharmaceutical industry is warning that the legislation will change incentives for research investments and doesn’t address other players in the supply chain that contribute to high drug costs. The next stop is the House of Representatives, which is expected to pass the bill after it comes into session on Friday.

Getting the messaging right on monkeypox

As the monkeypox outbreak spreads around the world, it has disproportionately affected gay, bisexual, and other men who have sex with men. Some public health experts warn that messaging about the outbreak needs to be reframed to take into account other populations. STAT’s Katherine Gilyard discussed this with Stella Safo, a primary care physician at Mount Sinai specializing in HIV treatment and public health.

What do people need to know?
The most important information about monkeypox to understand is it’s a contact-based disease. This messaging — that it’s an STI or it’s primarily for gay men — is deceptive. It is infecting certain populations more right now, but it has the potential to go to the general population.

What will happen if the messaging isn’t right?
When Black and brown people start to get diagnosed with it more, they’re going to start saying things like, well, these people aren’t clean, that’s why they have monkeypox. Women who get it, you know, “Oh well, they’re promiscuous,” and the different stereotypes that are historically present will then be used on top of these groups. So that’s why it matters so much that we’re really addressing the stigma now with this initial group.

You can read the full interview here.

Closer look: ‘Overblown’ or not, telehealth could be hurt by fraud concerns

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Recent federal crackdowns on Medicare fraud linked to telehealth have raised concerns in Washington that virtual care introduces new opportunities for criminals to defraud vulnerable patients. An FBI statement called telehealth “a platform to orchestrate [lawbreakers’] criminal schemes.” But lobbyists and researchers ask if these cases are any different from telemarketing scams we’ve heard about for years. And they warn that fear could drive lawmakers to make virtual care harder to access, just when a bill extending telehealth flexibilities until 2024 passed in the House of Representatives last month.

Kyle Zebley of the American Telemedicine Association told STAT’s Mohana Ravindranath the high profile of those crackdowns creates an “overblown” sense of risk about legitimate uses of telehealth. “Don’t conflate legitimate telehealth with these tele-fraudsters, and don’t make the leap and say telehealth is somehow more prone virtually to fraud than in-person care.” Read more.

Solving 'surprise medical billing' is still a battle

You’ve probably heard about “surprise medical billing” if you haven’t been so unlucky to experience it. The term refers to an often outlandishly high charge for a medical service not covered by your insurance but provided by someone you assumed was in your network. Congress passed a law in 2020 that protects patients from getting ambushed by many types of medical bills.

Here’s what I learned from STAT’s Bob Herman today: There are companies whose businesses had been based on surprise bills, and now they’re fighting how the law is implemented. Case in point: At the air ambulance company Air Methods, only 14% of its medical transports were in-network in 2017, but after the law, that soared to 75%. Read more about how air ambulances, physicians, and hospitals are trying to influence how the law’s new arbitration process to settle out-of-network disputes will work.

Flavored non-tobacco products follow e-cigarettes in popularity among teens

I had to google “nicotine pouches.” They belong to a new group of non-tobacco oral nicotine products that look and sound like candy, with flavors like cherry bomb, fruit medley, and pomegranate. Unlike old-school Nicorette, nicotine pouches, lozenges, chewing gums, and gummies aren’t marketed to help people quit smoking, a new study in Pediatrics says, but their nicotine buzz and easy-to-conceal form may push their popularity.

In a survey from the 2021-2022 school year, just over 3,500 ninth- and tenth-graders in Southern California put e-cigarette use first (ever: 9.6%, past six months: 5.5%), followed by non-tobacco oral nicotine products (ever: 3.4%, past six months: 1.7%), and under 1% for other nicotine and tobacco products. The prevalence appears low, but the researchers say it bears watching because nicotine exposure in adolescence may harm brain development and increase attention, memory, learning, and impulse-control problems.

What to read around the web today

The glaring health equity gap in Democrats’ drug pricing plan, STAT
'We need to take away children,' The Atlantic
He started a movement to help drug users. He couldn’t save himself, Washington Post
Serious liver side effects detour Amgen's effort to expand use of its KRAS-blocking lung cancer drug, STAT
A very dangerous place to be pregnant is getting even scarier, Bloomberg
Opinion: Triple-negative breast cancer highlights the need to act against health inequities, STAT