Breaking News

Floating Medicare coverage for East Palestine, selling something new to the 'chrono-curious,' & trying to bring patients back to cancer screening

February 24, 2023
Reporter, Morning Rounds Writer
Good morning. Be sure to check out Megan Molteni's close look at the latest entrant in the direct-to-consumer market for genetic tests to estimate biological age.

politics

Medicare for all of East Palestine, Ohio? 

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AP Photo/Gene J. Puskar

Three weeks after a train derailment spewed toxic chemicals in the air, water, and soil of East Palestine, Ohio, there are few answers to explain how the disaster happened. But there's a more urgent question for the thousands of people who could be sickened by the spill: Who covers their care? STAT's Sarah Owermohle unwinds one possibility: an obscure provision of the Affordable Care Act that allows Medicare coverage for Americans exposed to certain environmental hazards.

That provision was inspired by asbestos poisoning in Libby, Mont., that led to hundreds of deaths and an EPA emergency declaration after years of lobbying. The chances of that helping people in Ohio don't look great, Lawrence Gostin of Georgetown University told Sarah about the cumbersome process involved.  "It would take political will for [HHS] to cover some, or even all, residents of East Palestine," Gostin said. HHS did not respond to requests for comment. Read more.


addiction

Trial will compare methadone to buprenorphine prescribed in a doctor's office

Fentanyl's deadly effect on people with opioid addiction is clear. It's also well known that for many Americans seeking treatment for opioid addiction, only methadone truly eases cravings and withdrawal. The catch: Methadone is available only at specialized clinics, not a doctor's office, because the drug itself is an opioid and carries serious risks.

But buprenorphine, the alternative to methadone, brings intolerable withdrawal symptoms. To find a better solution, a clinical trial to start later this year will directly compare methadone and buprenorphine's effectiveness when prescribed in an office setting — the first study of its kind in the fentanyl era, and the first to analyze patients as they begin treatment. "Having the option of getting methadone in an office-based setting is going to be really life-changing for a lot of people," Noa Krawczyk of the NYU Grossman School of Medicine told STAT's Lev Facher. Read more.


Health

Report sounds alarm on missed cancer screenings 

In the pandemic's first year, screenings for cervical, breast, and prostate cancer all dropped, according to a new analysis from the American Cancer Society. Screening levels recovered in 2021, but report co-authors Ahmedin Jemal and Jessica Star told STAT's Angus Chen there's still reason to be concerned. 

Have we seen more cancer diagnoses at later stages?

Jemal: We don't have evidence that this loss in screening led to late-stage diagnosis now, but we'll need to monitor the stage at diagnosis over the coming years.

What can get people to make up missed screening?

Star: The finding that stool-based screening increased is really important and indicates the utility of home-based screening. 

Jemal: We have a test for cervical cancer screening that's home-based, but not been approved yet. So the development of new home-based cancer testing is important to maintain screening and cover disruptions of the healthcare system.

Read the full interview.



Closer Look

For the 'chrono-curious,' another company is selling tests to estimate biological age

Crop copyTally Health

Genetics professor David Sinclair is decidedly bullish: "We can drive aging now forwards and backwards at will," he told STAT's Megan Molteni. His Harvard lab recently outlined a new model to explain how aging works and might be reversed, based on mouse experiments that identified the epigenome — chemical modifications to DNA that flip genes on or off — as the primary driver of aging

Now Sinclair has launched Tally Health to sell "epigenetic clock tests to the chrono-curious," Megan writes. Customers get their biological age (hard miles put on the body, not years lived), plus advice and supplements based on it. Tally, like its competitors, has plenty of skeptics. "These companies are layering on all this scientific language to give these tests a veneer of legitimacy, … when there's not good evidence to say there's a clear health benefit," Timothy Caulfield of the University of Alberta said. Read more.


health tech

Opinion: We need to make sure health companies play fair with patient data

She had me at "health policy wonk." In the first sentence of her STAT First Opinion, Jennifer Hinkel of the Data Economics Company describes herself as a health economist who's worked in pharma around the world, so I take her seriously when she says patients are being seriously exploited for their data, its value, and the profitability others derive from its aggregation and sale.

She thinks it's encouraging, for example, that the FTC fined GoodRx for breaking promises to users about not sharing their data with Facebook and Google. But much more should be done so people can bank the value of their health data, she argues. "People say they want … to freely share their data for scientific or research purposes that help others, but also to share in the upside when their data are highly valuable, such as when they help lead to the discovery of a multibillion-dollar drug." Read more.


coronavirus

Detecting Covid from wastewater at 30,000 feet

It's been almost a year since travelers were required to test for Covid-19 before boarding a plane. Meanwhile, around the world, wastewater testing has filled some gaps in understanding how the pandemic continues to spread and evolve. A new CDC report brings together wastewater testing and air traveler surveillance in — you guessed it — the plane's lavatory. 

Last August and September, samples were collected from 88 international flights bound for the U.S. Of the 80 specimens tested, 65, or 81%, were positive for SARS-CoV-2, whether the flights came from the Netherlands, France, or the U.K. Sequencing identified all the genomes as Omicron lineages consistent with variants then circulating in Western Europe. "Aircraft wastewater monitoring can provide a complementary early warning system for the detection of SARS-CoV-2 variants and other pathogens of public health concern," the researchers say.


by the numbers

feb. 23 cases covid-chart-export - 2023-02-23T173735.437


 feb. 23 deaths covid-chart-export - 2023-02-23T173804.606

 


More around STAT
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What we're reading

  • The puzzling gap between how old you are and how old you think you are, The Atlantic
  • Three years into Covid, we still don't know how to talk about it, New York Times
  • DaVita faces another probe over ties to kidney care charity, STAT
  • Your brain could be controlling how sick you get — and how you recover, Nature
  • Lawmakers urge U.S. patent office to scrutinize Merck over 'abuse' of the system, STAT

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