Axios Vitals: STIs soar

Plus: Ruling could fuel mistrust in the FDA | Wednesday, April 12, 2023

Open in app View in browser   Presented By PhRMA   Axios Vitals By Tina Reed · Apr 12, 2023 Happy Wednesday, Vitals readers. Today's newsletter is 854 words or a 3-minute read. Situational awareness: The White House is declaring xylazine an emerging drug threat today and will send Congress a plan to better detect, treat and prevent its misuse, Axios' Sabrina Moreno writes. It comes as Congress presses the DEA to designate xylazine a controlled substance.     1 big thing: Abortion drug ruling could fuel mistrust in the FDA Data: Ipsos poll; Chart: Alice Feng/Axios Last week's federal court ruling overturning the FDA's approval of a commonly used abortion drug was unprecedented, but experts say it's evidence of an escalation of mistrust in the agency that's been building for years, Axios' Caitlin Owens writes. Why it matters: The ruling — which calls into question the drug's safety in a way that is at odds with scientific consensus — could further fuel skepticism about public health agencies that was fomented by anti-vaccine activists and amplified during the pandemic by misinformation about COVID vaccines. The ruling can be seen as both an extension of growing public distrust as well as new fuel for it. By the numbers: There's a strong partisan divide when it comes to trust in the FDA, according to new Ipsos polling provided to Axios. Democrats report much higher levels of trust in the agency than Republicans. When asked how well "guided by facts and science" describes the FDA, only 6 percent of Republicans said very well, compared with 29 percent of Democrats. 17 percent of Republicans said not well at all, compared with 4 percent of Democrats. The partisan divide is reflected at the congressional level, where Republicans are navigating a thorny divide between pandemic oversight — including of the vaccine approval process — and questions that have been debunked by data. What they're saying: "This is another assault on FDA and its expertise that isn't, in this case, particularly based on strong data, but does the job of effectively promoting mistrust in the agency decision," said Ameet Sarpatwari, an assistant professor at Harvard Medical School and the assistant director of the Program On Regulation, Therapeutics, and Law at Brigham and Women's Hospital. Related: Survey finds majority of Americans say abortion pills should be legal     2. Safety net clinics still rely on audio-only telehealth Illustration: Annelise Capossela/Axios   Technology barriers and payment policies have kept safety net clinics relying on audio-only telehealth for primary care and behavioral health when its use has declined elsewhere, according to a RAND study published in JAMA, Axios' Arielle Dreher writes. Why it matters: The findings raise questions about the quality of care and equity for low-income patients, researchers say, because the effectiveness of audio-only telehealth has not been established. "It appears likely that audio-only visits in these settings will remain widespread in coming years," said Lori Uscher-Pines, lead author of the study and a senior policy researcher at RAND. What they found: Telehealth use dramatically increased during the pandemic. But while many federally qualified health centers took steps to expand video visits, they continued to rely on audio-only, possibly because they lacked access to the technology or patients experienced barriers to using video. California's Medicaid program additionally granted permanent payment parity for audio-only visits, meaning there were no financial incentives for the clinics to limit audio-only visits. By mid-2022, more than two years into the pandemic, 1 in 5 primary care visits and 2 in 5 behavioral health visits were audio-only, and audio-only visits were still more common than video visits. Read the rest.     3. America's STI problem Data: CDC; Chart: Tory Lysik/Axios Visuals The number of sexually transmitted infections, including chlamydia, gonorrhea and syphilis, surged in the U.S. in the second year of the pandemic, reaching more than 2.5 million cases in 2021, according to a CDC report released Tuesday. Why it matters: STI's have been on the rise since 2017 — and the number of syphilis cases recorded in 2021 was the highest in 70 years. State of play: Undetected spread of the diseases could worsen if courts uphold a recent ruling striking down the Affordable Care Act's full coverage requirement of certain preventative services, including STI screening. Concern is also growing around antibiotic-resistant strains of gonorrhea. In January, U.S. officials reported two cases of a particularly worrisome strain, CBS News reported. By the numbers: The CDC focused on four nationally notifiable conditions, finding cases of syphilis jumped 32% in 2021 over 2020, and have increased by 74% over the past five years. Syphilis among newborns, has increased more than 203% in five years. Gonorrhea and chlamydia rates increased more than 4% between 2020 and 2021. The intrigue: CDC officials are eyeing a potential solution for slowing the spread of infection in an old antibiotic, doxycycline, following a promising study in the New England Journal of Medicine, the Associated Press reports. The agency is drafting recommendations for using it as a "kind of morning-after pill for preventing STDs," they write. Share this story.     A message from PhRMA Did you know that just 3 PBMs control 80% of all prescriptions?     And all three own or are owned by insurance companies. They often own your pharmacy too. This extreme market consolidation steers you toward pharmacies that make them more money — regardless of what's best or convenient for you. Haven't heard about this? That's by design.     4. Quote du jour: Congress, state AGs file amicus brief Photo: Celal Gunes/Anadolu Agency via Getty Images   "Congress intended to — and did — vest authority in FDA to evaluate and ensure the safety and efficacy of drugs in the United States, and Amici call on this Court to give due weight to that intent." — An amicus brief filed Tuesday by 240 members of Congress in support of the Biden administration's appeal of the court ruling that suspends the FDA's approval of the abortion pill mifepristone. It followed a similar filing by a number of Democratic state attorneys general.     5. Catch up quick 💉 Moderna's flu vaccine trial fell short of enough flu cases to declare early success. (Endpoints) 💰 PE health care deal value robust in 2022. (Axios) 👉 Icahn gets tough on Illumina. (Axios) 🦵 A knee replacement that talks to your doctor? It's just the beginning. (WSJ)     A message from PhRMA The 3 largest PBMs denied coverage to over 1,150 medicines last year     And all three own or are owned by insurance companies. They often own your pharmacy too. That includes medicines that could lower your costs at the pharmacy. Pharmacy benefit managers (PBMs) are putting their profits before you. Haven't heard about this? That's by design.   Thanks for reading, and thanks to senior health care editor Adriel Bettelheim and copy editor Azi Najafi for the edits. Dive deeper into the future of health care Axios Pro is your personal health care industry analyst, here to help you make the news actionable and anticipate future outcomes. Subscribe today.   Axios thanks our partners for supporting our newsletters. Sponsorship has no influence on editorial content. Axios, 3100 Clarendon B‌lvd, Arlington VA 22201   You received this email because you signed up for newsletters from Axios. 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