Closer Look
What covering the new weight loss drugs could mean for Medicare — and patients
Adobe
While highly effective and wildly popular weight loss drugs are changing the narrative on obesity, they're also raising concerns about how — and whether — Medicare should pay for older adults to get them. Researchers wrote in a new NEJM perspective piece that if only a small fraction of Americans over 60 who are obese take one of the new drugs, it could cost Medicare anywhere from $14 billion to $27 billion a year. If this sounds familiar from debates about the polarizing Alzheimer's drug Aduhelm, that's because similarly stratospheric estimates were made ($34 billion at its initial price, a STAT analysis found).
The researchers also say these weight loss drugs may have fewer benefits and more risks for older people. It may be too late, for example, to prevent diabetes or heart disease. And if lean muscle mass as well as fat mass melts away in older people, that's a recipe for frailty. STAT's Elaine Chen has more.
health inequities
Infant deaths are down, but disparities are up
At first the news sounds good: Overall, infant mortality in the U.S. continued to fall through 2020. Then there's this puzzling statistic: The rate of sudden unexplained infant deaths (including accidental suffocation and strangulation in bed as well as sudden infant death syndrome) did not decline, rising the most for non-Hispanic Black babies. SIDS climbed by 15% from 2019 to 2020 but the researchers say in their Pediatrics study that the increase was probably related to changes in diagnostic criteria used on death certificates because the overall SUID rate did not go up.
Under that umbrella term of SUID, racial disparities widened. Infants born to non-Hispanic Black families now have a nearly threefold higher death rate than infants born to non-Hispanic white families. The study authors can't prove cause and effect, but point to the disproportionate disruption Covid-19 caused communities, including access to health care, crowded housing, and other social determinants of health.
health
Insurance can modify inequities in cervical cancer, study says
Insurance works, and so does diagnosing cervical cancer at an earlier stage, thanks to Pap tests and other screening tools. A new study in JAMA Network Open looked at disparities in who in the U.S. is diagnosed with and who dies from cervical cancer. Black and Hispanic women are more likely than white women in both cases, but health insurance coverage was linked to diagnosis earlier in the disease.
To reach their conclusion, the researchers analyzed records of nearly 24,000 women under age 65. They found that insurance mattered for more than half of them over the study's span, from 2007 through 2016. Patients with private insurance or Medicare were more likely to be diagnosed with an early, localized cancer than those with Medicaid or no insurance. Lack of access to screening and barriers to follow-up care could explain diagnosis at a later stage, the authors say.
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