| | | | | | | Presented By PhRMA | | | | Axios Vitals | | By Tina Reed · May 10, 2023 | | Happy Wednesday, Vitals readers. Today's newsletter is 1,037 words or a 4-minute read. 👋 Tune in today: Our biannual dealmakers event, Axios BFD, kicks off in San Francisco this afternoon! - You'll hear from big names in Silicon Valley and beyond on the news and trends driving headlines, markets and deals. The livestream starts at 2pm PT. Register here to join us virtually.
| | | | | | 1 big thing: New breast cancer guidance adds twist to screening debate |  | | | Illustration: Aïda Amer/Axios | | | | New guidelines changing the recommended screening age for breast cancer to 40 years old from 50 are adding another wrinkle to the confusing discussion over when and how often to get mammograms. Driving the news: The draft guidance the U.S. Preventive Services Task Force released on Tuesday for women with average risk estimated that starting screenings a decade earlier could save 19% more lives. What they are saying: "It's confusing for physicians and providers who are then counseling patients," Vivian Bea, section chief of breast surgical oncology at NewYork-Presbyterian Brooklyn Methodist Hospital and a breast surgeon at Weill Cornell Medicine told USA Today, calling for unified guidance. "It's also confusing for patients." The big picture: The differing recommendations put a burden on clinicians trying to deliver a clean takeaway for sometimes overwhelmed patients. - A 2022 KFF survey found 24% of women between the ages 50 and 64 have not had a mammogram in the last two years and 28% of those said they didn't know they were due for one.
- The task force guidance may help clarify the fact women of average risk should be getting this screening starting at 40, which many were already doing, said William Dahut, chief scientific officer for the American Cancer Society.
- But "there will still be a lot of questions about newer technologies and supplemental screening on top of that," he said. "For higher risk populations, 'Should they be screened at even earlier ages?'"
Between the lines: Among the lingering questions is what's appropriate for women with dense breasts who are at higher risk for breast cancer and for whom mammography is less effective. - Then, there are questions about the technology that's available. For instance, the task force didn't take a clear stance on whether women should be seeking innovations like 3D mammography that are widely touted by health systems, Jessica Paulus, vice president of research for medical research data company OM1, told Axios.
Go deeper. |     | | | | | | 2. Oil and gas health impacts cost $77B annually |  | | | Illustration: Annelise Capossela/Axios | | | | Air pollution from U.S. oil and natural gas production causes roughly $77 billion in health impacts nationwide every year, while also contributing to thousands of early deaths and health flare-ups, Axios' Ayurella Horn-Muller writes off findings from a new study. Why it matters: It puts a price tag on one of the human costs of domestic oil and gas activity. What they found: The pollutants nitrogen oxide, fine particulate matter and ozone from U.S. oil and gas production contributed to 7,500 excess deaths, 410,000 asthma attacks, and 2,200 new cases of childhood asthma across the U.S. in 2016, per the study published Monday in the journal Environmental Research: Health. - Nitrogen oxide was the largest contributor to the overall health impacts, followed by ozone and then fine particulate matter, according to the study led by the Boston University School of Public Health.
- Texas, Pennsylvania, Ohio, Oklahoma, and Louisiana — all states with significant oil and gas activity — saw the highest proportions of associated health damages.
- Cases of premature deaths, asthma attacks and childhood asthma also spread regionally to affect densely populated cities with little to no gas activity, which included Chicago, New York City, Baltimore, Washington, D.C., and Orlando, the authors said.
| | | | | | | | 3. DEA extends COVID telehealth prescribing rules |  | | | Illustration: Gabriella Turrisi/Axios | | | | Telehealth rules created during the pandemic that allowed for the prescribing of controlled substances without an in-person visit will stay in place as is until Nov. 11, Axios' Sabrina Moreno writes. Driving the news: The DEA filed the rule to extend telehealth flexibilities, which will take effect on Thursday when the COVID-19 public health emergency expires. - Any existing provider-patient telehealth relationship established before Nov. 11, 2023 then can continue through November 2024.
- A timeline for when the DEA expects to make a final decision on the future of the policy remains unclear, but a senior agency official said they're working to have clear regulations in place for patients before the extension expires.
Catch up quick: The original draft rules proposed by the DEA in late February to end the flexibilities led to more than 38,000 public comments and significant backlash among patients, groups like the American Society of Addiction Medicine and behavioral health experts who said the proposals would disrupt care and access to treatment. - The covered drugs would include Adderall, testosterone for hormone replacement therapy and buprenorphine, an opioid use disorder treatment.
Read the rest. | | | | | | | | A message from PhRMA | | Middlemen are putting their profits before your medicines | | |  | | | | In recent years, the 3 largest PBMs denied coverage to lower-list priced biosimilar insulin for a higher priced version. This can lead to higher out-of-pocket costs for patients with deductibles. When you're sick, you should be battling your illness — not insurance companies and their PBMs. | | | | | | 4. Docs warn about AI's "existential threat to humanity" |  | | | Illustration: Aïda Amer/Axios | | | | Artificial intelligence poses "an existential threat to humanity" akin to nuclear weapons in the 1980s and should be reined in until it can be properly regulated, an international group of doctors and public health experts warned Tuesday in BMJ Global Health. What they're saying: "With exponential growth in AI research and development, the window of opportunity to avoid serious and potentially existential harms is closing," wrote the authors, among them experts from the International Physicians for the Prevention of Nuclear War and the International Institute for Global Health. The big picture: The warning comes amid increasing calls for improved oversight of artificial intelligence. Zoom in: The physicians say the health care community needs to sound the alarm "even as parts of our community espouse the benefits of AI in the fields of health care and medicine." - They cite AI's ability to rapidly analyze sets of data could be misused to "further undermine democracy by causing a general breakdown in trust or by driving social division and conflict, with ensuing public health impacts."
- They also raised concerns about the development of future autonomous weapons systems and they noted AI's potential impact on jobs.
- "While there would be many benefits from ending work that is repetitive, dangerous, and unpleasant, we already know that unemployment is strongly associated with adverse health outcomes and behavior," they said.
Share this story. | | | | | | | | 5. Catch up quick | | 💊 Drugmakers set strategy for legal fight against U.S. pricing regulation. (Reuters) 🥤 Rubio calls for Congress to bar SNAP purchases of soda and junk foods. (The Hill) 🧪 Minnesota prepares for near-total ban on "forever chemicals." (Associated Press) 🚿 Chicago's lead pipe removal is still lagging. (Axios) | | | | | | | | A message from PhRMA | | Middlemen say they want lower prices | | | | | | | | But the 3 largest PBMs denied coverage of lower-list priced insulin while giving preferential coverage to ones with higher list prices. This might be good for their bottom line, but it can lead to higher costs at the pharmacy. It's time to lower costs for patients by holding middlemen accountable. | | | | 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 | | | | | | Axios thanks our partners for supporting our newsletters.
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