Private equity’s profit fixation is short-changing kids with autism, parents and clinicians say

(NICOLE CRAINE FOR STAT)

A few months ago, Laura Zambrano (above) noticed that her son E, who was getting a form of autism therapy called applied behavior analysis, started having meltdowns. The therapy is designed to cut down on unwanted behaviors and improve language and social skills, but E’s provider told his mom he was being manipulative, and to expect even more meltdowns.

Those weren’t the only red flags. More than three dozen other families, clinicians, and experts interviewed by STAT’s Tara Bannow outlined many more. ABA has long been viewed as the gold standard for kids with autism, so every state mandates insurance coverage. But like other pockets of health care, this one has been transformed by investments from private equity firms. Families and clinicians say the financial investors’ fixation on profit has degraded the quality of services kids receive. Read Tara’s investigation.

Polioviruses detected in New York City wastewater suggest transmission

It’s not clear whether the polioviruses detected in New York City wastewater are related to viruses found in nearby counties, but the danger to unvaccinated people is certain. The New York City samples didn’t contain enough genetic material to determine if they were linked to the paralytic polio case diagnosed last month in a man in his 20s from Rockland County. If the cases aren’t linked, the New York City detections could be new importations of vaccine viruses from other parts of the world.

The newly detected viruses come from oral polio vaccine, not used in the U.S. since 2000. That means they were brought into the country by someone who had received oral vaccine or encountered the vaccine viruses elsewhere. Unvaccinated children or adults are at risk of being infected and potentially becoming paralyzed. STAT’s Helen Branswell has more.

Cancer disparities in Pacific Islanders within 'Asian' as a health category

STAT’s Usha Lee McFarling brings us this report: Cancer is the leading cause of death for Asian, Native Hawaiian, and Pacific Islander people in the United States, but a new analysis of the hospital records of nearly 6 million adults with cancer showed that for nearly all of the nine most common cancers, Asian individuals were as likely or more likely to survive than white individuals. Native Hawaiian and Pacific Islander individuals, however, were less likely to survive than white individuals for most cancers.

The study, published in JAMA Network Open, shows the danger of lumping Native Hawaiian and Pacific Islander people within the larger Asian category that includes East, South, and Southeast Asians because it may mask health disparities and affect critical care decisions such as whether a patient needs surgery or would benefit from a clinical trial. “The continued aggregation of these 2 groups perpetuates the impression that Native Hawaiian and other Pacific Islander patients with cancer have better outcomes,” the authors write.

Closer look: How the ‘animal rule’ allows monkeypox treatment

(YUKI IWAMURA/ GETTY IMAGES)

Sometimes you just can’t test a treatment or vaccine in people. The condition might be rare, or even eradicated in the case of smallpox, but others are so rarely seen it’s hard to research them. STAT’s Andrew Joseph takes us through the evolution of the Animal Rule, an FDA policy that gives it the authority to approve treatments without efficacy data from human clinical trials in instances when those trials aren’t possible. Instead, regulators rely on data from animal models to give the treatments the green light.

Tpoxx, or tecovirimat, was approved under the rule to treat smallpox and is now being used to treat people infected with monkeypox in the unprecedented global outbreak. But the animal rule both does and doesn’t connect to Tpoxx or to Jynneos, the main vaccine being used in the current outbreak. Read why.

After six years fighting for drug-pricing reform, no victory lap yet for this cancer survivor

David Mitchell isn’t done yet. A cancer survivor and former political public relations expert who volunteered six years ago to become the face of the opposition to the pharmaceutical industry during Washington’s lengthy debate on drug pricing, he’s been working twelve-hour days, straining to get reform across the finish line. He deflects credit sent his way to the patient advocacy group he founded, Patients for Affordable Drugs, and thousands of patient stories the group has accumulated.

Next up: insulin pricing, how long patent protection lasts, limits on pharmacy benefit managers. Meanwhile, four expensive cancer drugs are keeping Mitchell alive right now. “In your life, you can go work on something that is very important to you, and you kill yourself, and maybe you don’t get to achieve even a part of it,” Mitchell told STAT’s Rachel Cohrs. “And today we’re achieving an important part of it.” Read more.

Opinion: Whether abortion is medically necessary is not a question for ethicists

Doctors and the institutions where they work are struggling to provide care in a post-Roe world. While abortion raises many ethical questions, Holly Fernandez Lynch, Steven Joffe, and Emily Largen of the University of Pennsylvania write in a STAT First Opinion, determining whether an abortion is needed to save a pregnant person’s life or health is not among them. “That’s a factual question requiring medical — not ethical — judgment.”

They point to Julie Rhee, an OB-GYN who waited half a day for an ethics committee to sign off on an abortion for a patient who could have died from an ectopic pregnancy. Because abortion is health care, they assert, decisions should belong to patients, their loved ones, and their clinical team. “Politicians, judges, and others may seek to intrude on that privacy, but ethics consultants and committees should refuse to go along.” Read more.

What to read around the web today

How gender-affirming care may be impacted when clinics that offer abortions close, NPR
A flaw in the VA’s medical records platform may put patients at risk, Wired
WHO renames lineages of monkeypox, moving away from geographic links, STAT
How a deadly disease saved Jewish lives and fooled the Nazis during WWII, The Forward
In a momentous vote for Pelosi, House sends drug pricing reforms to President Biden’s desk, STAT