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| Presented By PhRMA |
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| Axios Vitals |
| By Tina Reed · May 11, 2023 |
| Happy Thursday, Vitals readers. Today's newsletter is 1,193 words or a 4½-minute read. Situational awareness: In a major development that could help researchers to find and better understand genetic variations linked to diseases and disorders, researchers on Wednesday published a first draft of a human "pangenome" that captures more of the genetic diversity in the human population, Axios' Alison Snyder writes. |
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| 1 big thing: End of COVID emergency leaves a black hole of health data |
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| Illustration: Sarah Grillo/Axios |
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| The expiration of the COVID-19 public health emergency today will cut off a pipeline of data that tallied the pandemic's human toll and offered a view of how the stealthy virus spread, Axios' Sabrina Moreno writes. The big picture: More than 1.1 million Americans have died from COVID over the course of the public health emergency, or about 980 people a day. - The CDC will stop tracking COVID community levels, part of an effort launched in March 2020 to help individuals gauge their infection risk.
- The government has also scaled back what hospital and local health departments are required to report, including patients' age, race and ethnicity.
- And without an emergency, states no longer have to divulge public health data, though wastewater surveillance and hospital admissions will continue to offer some clues.
What they're saying: "It's this continued trend of loss of information and that's going to make it harder and harder to understand exactly what's going on with the virus," said Justin Lessler, an epidemiologist at the University of North Carolina who has helped lead the COVID-19 Scenario Modeling Hub. By the numbers: COVID deaths — seen as a lagging indicator to how fast the virus spread — peaked during the week of Jan. 13, 2021, when the U.S. was averaging nearly 3,400 fatalities per day, according to CDC data. As it stands, the U.S. is "likely to delay effective measures to be able to control whatever the next pandemic outbreak is" and repeat its COVID response failures, said Robert Pearl, a Stanford University professor and former CEO of The Permanente Medical Group. - "Given the wealth our nation has," Pearl told Axios. "We should not have had as many mortalities as we did."
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| 2. Insulin makers, PBMs face fire in Senate |
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| Sen. Bernie Sanders, chairman of the Senate HELP Committee, holds a vial of insulin medicine during a hearing on May 10. Photo: Al Drago/Bloomberg via Getty Images |
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| A Senate HELP Committee hearing on insulin costs on Wednesday yielded some expected finger-pointing between pharmacy benefit managers and drugmakers — but also brought clarity to the drug pricing battles ahead, Axios' Peter Sullivan writes. The big picture: Senate HELP Chair Bernie Sanders (I-Vt.) asked the PBMs if they would commit to covering the lowest list price insulins. The executives largely responded they look for the lowest negotiated price, once discounts are taken into account. - "This committee is going to stay on this issue," Sanders said, noting the "very modest" PBM reform and generic drug bills the committee will consider Thursday are not the ends of his efforts.
On the drugmaker front, Eli Lilly CEO David Ricks seemed to agree under questioning from Sanders his company would not raise insulin prices, saying: "We'll leave our prices as they are." - The Sanofi CEO Paul Hudson and Novo Nordisk CEO Lars Jørgensen didn't seem to make quite the same pledge, but noted that they have recently been lowering their insulin prices.
The other side: Sen. Rand Paul (R-Ky.) may be PBMs' biggest defender. - "Nobody's forcing anybody to hire them," Paul said of PBMs, arguing that employers and insurers wouldn't use PBMs if they didn't bring savings.
A version of this story was published first on Axios Pro. Get news like this by subscribing. Use code POLICY100 which gives you $100 off. |
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| 3. Crimes rise against abortion clinics |
 Data: National Abortion Federation's 2022 Violence & Disruption Report; Note: 80% of member clinics reported data. Chart: Axios Visuals The Supreme Court's decision to overturn Roe v. Wade was followed by a "sharp increase" in violence directed against abortion providers and patients, according to a new report from the National Abortion Federation, Axios' Oriana González writes. Zoom in: The report found that states that protect abortion access saw a "disproportionate" increase, including a ninefold increase in reported cases of stalking, a doubling of burglaries and a 29% increase in assaults and batteries from 2021 to 2022. - Bomb threats also increased in these states by 133% and obstruction rose more than fivefold.
The report says there was a decrease in other incidents, such as trespassing, but the authors said that it is "likely attributed to clinic closures." - In the first 100 days since the Supreme Court's Dobbs ruling last June, more than 80% of abortion clinics in states with bans either shut down or stopped offering the procedure.
What they're saying: The fall of Roe and the "cascade of abortion bans that followed" has "emboldened" people to go after abortion providers and patients, said Melissa Fowler, the National Abortion Federation's chief program officer. Share this story. |
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| A message from PhRMA |
| Middlemen say they want lower prices |
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| Yet they often deny or limit coverage of lower-cost generics and biosimilars while giving preferential coverage to medicines with higher prices. This might be good for PBMs' bottom line, but it can lead to higher costs for patients. What else are they hiding? |
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| 4. Data du jour: Doc lawsuits |
 Data: American Medical Association analysis; Chart: Axios Visuals Nearly a third of doctors have been sued by a patient during their career and, by the time they're 55 years old, nearly half of doctors have faced a lawsuit, according to a new analysis from the American Medical Association. Why it matters: The physicians' group said it shows how real the threat of litigation is — much of which is either dropped or unsuccessful in court — and is evidence of the need for medical liability reform. By the numbers: Fewer than 10% of physicians younger than 40 have been sued. - Generally, physicians in surgical specialties had the highest risk of a lawsuit (48.9%), with 62% of obstetricians/gynecologists and 59% of general surgeons facing a lawsuit during their careers.
- Internal medicine subspecialties had the lowest risk (24.5%) with about 7% of allergies/immunologists and 8% of hematologists/oncologists facing lawsuits during their careers.
- Fewer than 1 in 4 female physicians had been sued compared to 36.8% of male physicians.
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| 5. White House team quietly works on drug shortages |
| The White House has assembled a team that is working to address lingering shortages and quality problems in the U.S. drug supply, Bloomberg reports. Why it matters: The vulnerabilities in the U.S. food and drug supply chain have come into stark view during the pandemic from recalls and shortfalls of baby formula, to closures of domestic manufacturing sites and a supply chain crunch for commonly used generic medicines. Per Bloomberg, the group is led by the Domestic Policy Council and National Economic Council with Biden's domestic policy adviser Susan Rice serving as a driving force behind the team. - Sources tell Bloomberg the FDA "has refused to fully answer questions" and indicated it does not have the authority or funding to support the ideas of the team.
- The White House did not respond to a request for comment, but a senior administration official told Bloomberg the team's work is a continuation of the administration's focus on the drug supply.
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| 6. Catch up quick |
| 💊 FDA experts unanimously endorse over-the-counter birth control pills. (Axios) 👉 Patients are at greatest risk of self-harm right after starting antidepressants, study finds. (Axios) |
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| 📸 7. Look back: The start of the COVID emergencies |
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| Traders fill orders in the S&P options pit on the Cboe Global Markets trading floor on Jan. 31, 2020 in Chicago. Photo: Scott Olson/Getty Images |
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| A lot has happened in the more than three years since U.S. officials first declared the coronavirus outbreak a public health emergency on Jan. 31, 2020. Look back: Stocks dropped sharply around world markets that day and and several U.S. airlines announced they would be suspending flights to China amid fears of the global spread of the coronavirus. - Flanked by the then-still maskless top health officials, President Trump went on to declare the start of a COVID national emergency on March 13, 2020.
- President Biden signed GOP-led legislation ending the national emergency last month.
Photo: Chip Somodevilla/Getty Images |
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| A message from PhRMA |
| PBMs control your health care |
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| Middlemen like PBMs are charging fees tied to the price of medicines, which means they make more money when the price of a medicine goes up. This business model allows PBM profits to soar and can lead to higher costs for patients. What else are they hiding? |
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| Thanks for reading, and thanks to senior health care editor Adriel Bettelheim and senior copy editor Bryan McBournie for the edits. |
 | | Dive deeper into the future of health care | | |
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