| | | |   By Elizabeth Cooney | Good morning. Today is the deadline to submit nominations for STAT Madness, the bracket-style tournament that honors the best innovations in science and medicine. Apply here today. | | | Hospitals struggle with spike in heart infections among people who inject drugs 
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Increased injection drug use has led to a spike in cases of the life-threatening heart condition endocarditis, with cases rapidly accelerating since Covid-19 emerged, new research tells us. The inflammation of the heart lining is caused by infection and requires complex care, but hospitals often have few protocols for treating endocarditis patients who use drugs and for managing the withdrawal they’ll likely experience.
Most endocarditis infections stem from non-sterile syringes that allow bacteria to enter the bloodstream and then the heart. Care typically consists of antibiotics delivered by IV drip, and many cases require surgery to repair or replace damaged heart valves. What happens next is the problem. “They may leave the hospital against medical advice, because they’re not being treated for the severity of the withdrawal symptoms,” Nora Volkow, director of the National Institute on Drug Abuse and a study co-author, told STAT’s Lev Facher. Read more on the implications. | Hospitals look to expand their reach and raise their prices Get ready. Higher costs in 2022 slowed them down, but the country’s large not-for-profit hospital systems are determined to increase revenue by expanding their footprints and hiking prices. Speaking at this year’s J.P. Morgan Healthcare Conference, hospital executives said a variety of moves — mergers, new outpatient centers, more physicians in profitable specialties — will bolster their market share. Their message comes as Americans struggle to pay their hospital and doctor bills, based on the highest prices in the world — prices that vary wildly based on where someone lives and the type of insurance one has.
Insurers, especially the major publicly traded ones, reaped windfalls throughout the Covid-19 pandemic, hospital leaders noted. “As we go back to the table this year and next year, we will be asking the payers to pay their fair share,” Intermountain Healthcare CFO Janie Wade said during her system’s presentation. STAT’s Bob Herman has more. | Flu appears to have peaked already This year’s flu season got off to an early and roaring start in the autumn, taking off in the Southeast and South Central part of the country in early October. Now it appears the early start could be capped by an early end, with the CDC reporting Friday that flu activity in the country continues to decline. STAT’s Helen Branswell reports that while it’s always a little iffy to make too many predictions about this mercurial family of viruses, it currently looks like flu activity peaked the week of Thanksgiving.
Virtually all the illness so far has been caused by influenza A viruses; some late winter flu B activity remains a possibility. The CDC reported Friday that another five children have died from flu, bringing the season’s total to 79 pediatric deaths. That’s the highest figure since the Covid pandemic began, but it is lower than the death tolls seen in pre-pandemic flu seasons. | Acceleration vs. Evolution: An iterative approach to personalizing digital experiences for healthcare providers Healthcare technology platforms of health should adapt to people, not the other way around. Leaders must listen to what their end-users are saying about how technology helps (or hinders) their ability to work at the top of their license. The digitization of healthcare should be an evolution, not just an acceleration. Learn more about Altera Health’s iterative approach to personalizing digital experiences for healthcare providers. | Closer look: Telehealth patients scramble amid crackdown on online controlled substances Catherine was getting nervous about her ADHD prescription. In 2022, the 29-year-old New Yorker had started using Done, a direct-to-consumer telehealth company that treats attention deficit hyperactivity disorder. The stimulant Vyvanse was helping her manage distraction so severe that she frequently had car accidents. But big box pharmacies are now cracking down on prescriptions from online-only providers like Done and Cerebral as their practices face intense scrutiny.
When the pandemic hit, patients like Catherine flocked to telehealth — obtaining prescriptions for controlled substances previously available only in-person. But as those channels close, many face the challenge of transferring their prescriptions to in-person providers. They may see more questions — Catherine (who asked that only her first name be used) told STAT’s Katie Palmer she “flat-out lied” about other diagnoses to get the ADHD prescription. Read more on what the future may hold for telehealth, hybrid models, and patients. | Liquid biopsy study charts a way to say who needs chemo after colorectal cancer surgery Circulating tumor DNA — tiny specks too small for medical imaging devices to see — are the target of liquid biopsies that promise to reveal cancer. A new paper published in Nature Medicine on Monday suggests another potential use for the blood tests, saying colorectal cancer patients who had tumor DNA detected in their blood after surgery were much more likely to have their cancer return — and to benefit from chemotherapy, regardless of cancer stage or other risk factors. What’s more, patients without this DNA didn’t benefit from chemo.
If results from this 1,000-person study in Japan are confirmed in larger groups, it could change the way cancer patients are treated, representing another move away from one-size-fits-all therapies. “It is exactly the right next step in the direction of using [liquid biopsy] for treatment stratification,” Peter Kuhn of the University of Southern California, who was not involved in the study, told STAT’s Jonathan Wosen. Read more. | Most drugs in TV ads aren’t better than existing therapies, study says Most people find drug ads annoying, moving some TV viewers to vent their objections to the FCC, as STAT’s Kate Sheridan recently reported. A new study looks at whether drugs promoted in direct-to-consumer advertising are any better than medications already on the market. Writing in JAMA Network Open, researchers say the answer is no. Fewer than a third of drugs commonly advertised on TV have “high therapeutic value,” offering at least moderate improvement for patients compared to existing therapies.
The researchers based their conclusion on value ratings for each drug from at least two independent health technology assessment agencies from Canada, France, and Germany. Only 20 of 73 commonly marketed drugs, representing $6.4 billion in advertising spending, were rated by any agency as having high therapeutic value. Manufacturers spent $15.9 billion from 2015 to 2021 on TV ads for products rated as low in therapeutic value. | | | | | What we're reading - China’s Covid wave has probably peaked, model suggests, Nature
- A fake death in Romancelandia, New York Times
- Biden Covid adviser David Kessler to exit as pandemic response winds down, STAT
- Medical residents unionize over pay, working conditions, Wall Street Journal
- Congressional Medicare advisers warn of higher drug prices, despite new price negotiation, STAT
| Thanks for reading! More tomorrow,  | | | | Have a news tip or comment? Email Me | | | | Kendall Square February 9 | | | | | New York City February 16 | | | | | | | |
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