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STAT investigation: conflicts of interest in prescription drug benefits, medical records riddled with errors, & nutrition labels on the front of packages

June 20, 2023
Reporter, Morning Rounds Writer
Good morning. We have the fruits of a yearlong investigation into prescription drug benefits, a preview of what might be coming for the front of food packages, and a Bayer executive's take on the new drug pricing law.

a stat investigation

Opaque conflicts of interest permeate prescription drug benefits

an illustration of a handshake behind a pill bottle

Eros Dervishi for STAT

Employers across the country — from big names like Boeing and UPS to local school systems — pay consulting firms to handle a straightforward task with their prescription drug coverage: Get the best deals possible and make sure the industry's middlemen, known as pharmacy benefit managers, aren't ripping them off with unfair contracts. But a largely hidden flow of money between major consulting conglomerates and PBMs compromises that relationship, a yearlong investigation by STAT's Bob Herman shows.

Some consulting firms often are getting paid a lot more by the PBMs and health insurance carriers that they are supposed to scrutinize than by companies they are supposed to be looking out for. "The broker not only gives bad advice to the employer that's in the broker's self-interest, but the broker also allows the big PBM to write crazy terms into a contract," said Jon Levitt, an attorney at Frier Levitt. "It's beyond unethical." Read more.


drug pricing

What the new drug pricing law means for one pharma executive

Pharma companies have been warning for months that new drug pricing reforms could discourage investment in new medicines. That's not stopping Bayer, which plans to invest $1 billion on R&D to double its U.S. sales by 2030. Sebastian Guth, who leads Bayer's pharmaceutical division in the U.S., Canada, and Latin America, spoke with STAT's Rachel Cohrs about the Inflation Reduction Act's impact.

Americans have a negative view of drug companies and their prices. How does the industry moves forward from that?

To address health care in the United States, it takes more than to only look at the pharmaceutical industry.

You say it's a very exciting time for science, but it's also a very anxious time for the industry.

I don't think that Wall Street determines the timing of great science. … Resilience and grit is actually very important, because none of this comes easy. 

Read the full interview.


Health 

Opinion: It's time to trim medical records of 'chart lore'

Sandeep Jauhar, a doctor at Northwell Health, recently took care of a patient whose medical records included multiple notes about her past open-heart surgery. But she'd never had open-heart surgery. The false information persisted through her chart and into multiple notes, becoming "chart lore," so she was being prepped for an invasive procedure based on it. Of course, that would have been obvious if anyone had seen her scar-free chest.  Jauhar blames this kind of mistake — which is not uncommon — on the copy-and-paste content now dominating bloated electronic health records. 

"I dare say that doctors were more diligent about the accuracy of their notes when they were written freehand in paper charts. Text could not be copied and pasted," Jauhar writes in a STAT First Opinion. "Today, information is readily archived and manipulated, propagating mistakes." That's not to say electronic health records are bad — just in need of some editing. Read more.



Closer Look

FDA wants to bring nutrition labels to the front of food packages. But how?

An illustration of soda, pizza, and other unhealthy foods with a STOP sign speared on a forkAlex Hogan/STAT

Food labels are coming to the front of packages, but when and how are still up in the air. FDA Commissioner Robert Califf said he's been eager since his tenure during the Obama administration to alert American consumers more quickly to foods high in unhealthy components like saturated fat or sodium. That's in addition to current nutrition data less obvious on packages lining supermarket shelves. "We need to get people better information quickly, and those who say the status quo is OK, we're doing fine — I'm sorry, look at the data. We're not doing fine," Califf told STAT's Nicholas Florko. 

The FDA plans to survey 9,000 people on several proposed labels, from a simple graphic showing the grams of saturated fat, salt, and sugar to a color-coded logo noting when a product is high in certain unhealthy nutrients. Read more on how some other countries go further and what the food industry says.


health

Low-dose aspirin linked to anemia in older adults

About half of older Americans take low-dose aspirin to reduce their chances of a heart attack or stroke, advice that's been refined in recent years to target only people at risk for heart disease. While aspirin can limit blood clots, it can also cause dangerous bleeding. A new randomized clinical trial in nearly 20,000 otherwise healthy older adults in Australia (over age 70) and the U.S. (over 65 if Black or Hispanic) concludes there's another risk that should be considered. 

The study, published in Annals of Internal Medicine yesterday, found that after almost five years, the group taking aspirin had a 20% higher risk of anemia than the group taking a placebo. Those who took aspirin also had lower levels of blood iron. The researchers, who say the anemia was likely caused by minor bleeding over time, suggest older people taking aspirin have their hemoglobin levels monitored.


health

Social isolation and loneliness can be deadly

U.S. Surgeon General Vivek Murthy recently called loneliness as dangerous to health as smoking cigarettes. A new review of 90 studies including more than 2 million people around the world links social isolation and loneliness to a higher risk of death from all causes. The Nature Human Behaviour analysis combed through research from 1986 to 2022 to see if either condition was linked to a greater risk of death from cancer, cardiovascular disease, or all causes. 

Social isolation, defined as limited contact with other people, is linked to malnutrition, physical inactivity, and poorer immune function, the researchers noted. Loneliness, defined as the distress between wanting and lacking this social contact, is tied to sleep disorders and immune dysfunction. Both states were associated with a greater risk of death from any cause, including cancer, while social isolation was also associated with an increased risk of death from cardiovascular disease.


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What we're reading

  • Can America's students recover what they lost during the pandemic? ProPublica
  • Huntington's spreads like 'fire in the brain.' Scientists say they've found the spark, NPR
  • Should medicine still bother with eponyms? New York Times
  • EPA sued over reapproval of toxic herbicides using Agent Orange chemical, The Guardian
  • How to separate sound wellness solutions from seductive snake oil, STAT

Thanks for reading! More tomorrow,


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