Biden's health care agenda, why bird flu worries scientists, & Verily's turnaround specialist

Verily CEO Stephen Gillett has made a career out of navigating unfamiliar terrain.

February 8, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. Let's turn first to President Biden's State of the Union address and its health care highlights.

politics At SOTU, Biden picks health care policies that might attract bipartisan support Patrick Semansky/AP President Biden's State of the Union address last night showcased health care priorities he still hopes Congress could achieve, seeking bipartisan support for battling the addiction crisis by targeting fentanyl and bolstering support for at-home caregivers. His speech — punctuated by calls to "finish the job" — also looked back at the Inflation Reduction Act and the revamped cancer moonshot initiative. Some highlights: Drug pricing: The president touted Medicare's coming power to negotiate drug prices, the $2,000 limit on Medicare members' annual retail drug costs, and a $35 monthly cap on seniors' out-of-pocket costs for insulin. And he went further: "Let's cap the cost of insulin for everybody at $35." Abortion: "Make no mistake about it: If Congress passes a national ban, I will veto it." Covid: "Thanks to the resilience of the American people, and the ingenuity of medicine, we have broken the Covid grip on us. … Soon we'll end the public health emergency. … We still need to monitor dozens of variants and support new vaccines and treatments. So Congress needs to fund these efforts and keep America safe." Cancer: Biden invoked President George W. Bush and PEPFAR for transforming the global fight against HIV/AIDS. "I believe we can do the same with cancer." STAT's Sarah Owermohle has more coverage here. infectious disease As bird flu reemerges, scientists try to chart its path Fears of bird flu are back, but you could make the case they never went away. Veteran influenza epidemiologist Keiji Fukuda told STAT's Helen Branswell he remembers vividly when he first worried that a virulent bird flu virus, H5N1, might be close to triggering a devastating pandemic. That was in 1997, in Hong Kong. Some 25 years later, a mid-January outbreak at a Spanish mink farm has rekindled the latest fears of another pandemic ready to take off.  Seven experts who have been studying either the epidemiology, the ecology, the genetic characteristics, or the transmission kinetics of the virus told Helen they've been worried about H5N1 the whole time. And they don't like what they're seeing now. "Trying to predict what H5N1 will do in the human population absolutely requires a great deal of scientific humility," said Michael Osterholm of the University of Minnesota. Read why. in the lab Changing which genes are active — not the genes — can pass on obesity, study in mice shows We've all heard people say "it's all in your genes," whether talking about height or chances of developing cancer that we inherit from our parents and their ancestors before them. New research in mice makes a compelling argument that it's not just the genes, but which ones get turned on generations before that get passed on, determining traits once thought impossible to affect descendants. This dogma-defying field is called transgenerational epigenetics and the mouse study, published yesterday in Cell, focuses on mice made obese or given high cholesterol via chemical modifications that changed which genes were active, all without altering the DNA sequence. Both these modifications and their metabolic effects were shown to have persisted for at least three to six generations — something scientists once believed was impossible. STAT's Jonathan Wosen has more on the experiment, some history dating to Lamarck and Mendel, and implications for the future.

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Closer Look Verily picks a turnaround artist as its new CEO Mike Reddy for STAT His job description as Verily's COO was to move the 1,100-employee company from a loose federation of moonshots to a cohesive business with clear commercial goals. Promoted to CEO, his next act will be leading a company-wide restructuring — and its mission to transform American health care with technology. Stephen Gillett isn't a doctor or Ph.D. scientist, but he has made a career out of navigating unfamiliar terrain. Some history: He took a top position at Best Buy with no background in consumer electronics, other than being an accomplished gamer. When he joined Starbucks in 2008, he didn't even drink coffee. At both companies, he executed dramatic business turnarounds. People who've worked with him told STAT's Casey Ross that Gillett has a striking capacity for managing complexity. Read more on what he brings to the challenges ahead. Pharma Drugmakers spend more to promote products with lower added benefits Drugs ads may be annoying. They're also expensive for drug companies, but they work to prompt patient requests ("ask your doctor …"). A new study in JAMA that analyzed where advertising dollars go found that among top-selling prescription drugs in the U.S. in 2020, more of a drugmaker's promotional budget went to drugs rated as having a lower added benefit compared to existing medicines than went to drugs with more benefit. "Benefit" was assigned based on how Canada and France assess these drugs for their health systems.  As the study authors note in the first sentence of their paper, the U.S. and New Zealand are the only countries that allow direct-to-consumer drug advertising. But they also remind us the Inflation Reduction Act, signed into law last year, will require Medicare to consider the comparative effectiveness of drugs chosen for price negotiations starting in 2026. health Opinion: Marketing from formula companies continues to undermine breastfeeding "Breast is best," the saying goes, and most expectant mothers do want to breastfeed, although many don't. One reason: marketing tactics of companies selling formula. A new series of papers published in The Lancet describes how formula companies sell their products as scientifically "closer" to human milk, suggesting that formula makes babies settle, digest with ease, sleep better, and even become more intelligent. These marketing messages paint typical fussiness or crying as problems solved with their specifically formulated products. And mothers believe them. These claims are based on selective, misleading, or poor-quality evidence that is often marked by industry influence, Cecília Tomori, a co-author of the Lancet series, writes in a STAT First Opinion that compares the formula industry's playbook to tactics more familiar from tobacco and fossil fuels. "Breastfeeding is a human right, and so should access to evidence-based information to be able to make informed decisions about it," she writes. Read more. by the numbers

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Thanks for reading! More tomorrow,

elizabeth.cooney@statnews.com

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