Abortion post-Roe v. Wade, how much people would pay for weight-loss drugs, & postpartum patients falling through the cracks

We all may have heard of postpartum depression, but we are a long way from understanding and predicting it.

June 26, 2023 Check out STAT+

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By Elizabeth Cooney Reporter, Morning Rounds Writer

Good morning. We have news from a major diabetes meeting over the weekend, we mark one year since the overturning of Roe v. Wade, and we look at how much people told us they would pay for a weight-loss drug.

reproductive Health A year later, how the abortion landscape has changed A year after the Supreme Court's landmark decision striking down Roe v. Wade, a shifting legal landscape has dramatically altered abortion access. A patchwork of state laws now ban or restrict abortions, making it unavailable in 14 states and restricted in 11 others, according to a KFF dashboard. But an emerging area of legal dispute concerns the extent to which states can prohibit residents from seeking health care in other states.  Seven states have passed an abortion "shield law," in response to attempts by legislators in restrictive states to limit out-of-state travel. Courts are also reviewing challenges to new abortion restrictions, overturning or temporarily blocking some laws. That means seven states currently have some form of abortion restriction or ban that remains in limbo. All told, abortions have declined significantly. STAT's J. Emory Parker charts the changes, and the reverberations in ob/gyn residency applications and interest in contraception. Read more. Q&A An abortion doctor thinks of unseen patients A few months after the Supreme Court ended the constitutional right to abortion in the United States, Christine Henneberg published a memoir on carrying her first pregnancy during her first year performing abortions. She talked recently with STAT's Ambar Castillo about her work. What fascinated you as a medical student visiting an abortion clinic? The situation was very clear. It was just a matter of what the woman decided to do, and then the doctor was just there to treat her with respect and kindness and empathy as she went through with that decision. When you hear women's stories of hardship now, what do you think?  I think it can be a distraction from the silenced women for whom nobody knows their story, because they're just the pregnant woman you see walking around and don't know. Read the full interview. obesity revolution STAT-Harris Poll: Nearly half of U.S. adults would pay $100 a month for weight-loss drugs How much do Americans want to get their hands on one of the new weight-loss drugs? Nearly half say they'd be willing to spend up to $100 a month for Wegovy, Ozempic, or Mounjaro, and one-third say they would pay whatever they can afford indefinitely to get the injectable medicines, according to a new survey by STAT and The Harris Poll. That 47% willing to spend $100 would do so only until they'd reached a goal; one-quarter said they'd pay $250 a month and 17% said they're fine with $500 a month. The majority (84%) believe their insurance should cover the price, which ranges from $900 to $1,300 a month. So far, fewer than a quarter of insurance companies offer coverage. And the jury is still out on long-term effects. "We need to see the data," Elevance CEO Gail Koziara Boudreaux said last week. STAT's Ed Silverman and Elaine Chen have more, and scroll down for news on a pill version being tested.

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Closer Look Still waiting: Postpartum depression lacks understanding and treatment Courtesy Kyleigh Wegener  We may have heard of postpartum depression, but we are a long way from understanding and predicting it. The neuroscience isn't there yet for depression, anxiety, psychosis, and other disorders after birth. Half of women with postpartum depression, the most common of these disorders, go undiagnosed. In contrast, STAT contributor Kate Gammon writes, 99% of pregnant patients are screened for gestational diabetes, which occurs in fewer than 6% of pregnancies. There's no test for postpartum depression; obstetricians and pediatricians are advised to screen women for depression and anxiety symptoms at least once. Digital health tools are being explored to catch warnings of future troubles, and broader mental-health treatment supports are being tested. "I don't want moms to feel ashamed that they're struggling with this, because there's literally nothing that we could do to prevent it," Kyleigh Wegener (above) said of her experience after her second child was born. Read more. In the lab ADA advises people with diabetes to get screened for nonalcoholic fatty liver disease All adults with type 2 diabetes or prediabetes should be screened for nonalcoholic fatty liver disease, the American Diabetes Association said yesterday, highlighting an increasingly prevalent condition that can seriously damage the liver after excess fat builds up in the organ. It's estimated to affect about 24% of U.S. adults, much more than a rarer, severe form called nonalcoholic steatohepatitis, or NASH, in which there's inflammation and scarring of the liver.  There are no approved medications for nonalcoholic fatty liver disease, but among available diabetes drugs, the ADA singled out GLP-1 treatments as an option doctors should consider. Those are the same drugs that not only lower blood sugar, but also cut weight. Among the limited evidence, one trial showed semaglutide, the active ingredient in Ozempic, reduced inflammation but didn't significantly improve liver scarring. STAT's Elaine Chen explains what the ADA recommends and what newer drugs are in the pipeline. Pharma Lilly's obesity drug in pill form performs well in trial An experimental pill from Eli Lilly led to 14.7% weight loss on the highest dose in a 36-week Phase 2 trial, heating up the growing competition among drugmakers to develop an effective oral obesity therapy. The results, published in NEJM and presented at the American Diabetes Association conference Friday, showed by the end of trial, participants' weight loss had not plateaued, suggesting potential for even greater weight loss if given longer. Orforglipron, taken daily, is a GLP-1 drug. It mimics the effects of the glucagon-like peptide 1 hormone that helps people feel full after eating. The injectable GLP-1s Wegovy and Mounjaro have shown up to 15% and 21% weight loss in trials, respectively. If pills can ultimately prove to work as well, they could be more convenient. The pill showed similar side effects (nausea and vomiting) as injectables. Read more from STAT's Elaine Chen.

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Thanks for reading! More tomorrow,

elizabeth.cooney@statnews.com

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