The sleuth who called out Dana-Farber, a sickle-cell patient who worries about costs, & the effects of over-the-counter morning-after pills

"It's like being a dog on a chain and having a steak dangled in front of your face," a sickle-cell patient said of new expensive treatments.

January 29, 2024 Check out STAT+

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By Theresa Gaffney Reporter & Podcast Producer

Good morning! When you read my colleague Andrew Joseph's story on the sleuth Sholto David, take note of the charming dateline — "Pontypridd, Wales." Pontypridd! The newsroom loved that. One editor simply said: "Isn't it incredible?"

in the lab The sleuth behind research allegations against Dana-Farber Sholto David spends his time poring over other people's research papers looking for images with clues that they've been manipulated in some way — duplicated, misleadingly cropped, or partially obscured. In the past three years, David, a scientist with a doctorate in cellular molecular biology, has flagged issues on more than 2,000 papers. Often, his comments go ignored, but earlier this month he wrote a blog post that shook leadership at the Dana-Farber Cancer Institute, one of the world's preeminent cancer research centers, and led the institute to announce six planned retractions and 31 corrections. Some people may view the work as noble, or important, but David doesn't necessarily like that idea. He does it because he enjoys it. The sleuthing is like a puzzle — can you look at this scan of two dozen mice and spot which, if any, of the animals have been duplicated? "I'm the sort of person who writes 2,000 comments on some obscure website just for doing it," he said. "I like a little bit of engagement, but I would do it anyway." Read more from STAT's Andrew Joseph. health care Opinion: Stop asking what country has the best health care Could a single-payer health care system solve all of our problems in the U.S.? Or is it actually a complete and useless fantasy? Here's an idea: stop asking, writes Irene Papanicolas, a professor of health services, policy, and practice at the Brown University School of Public Health, in a new First Opinion. With innumerable crises across health care in the U.S., even people who know better can get sucked into these debates, but Papanicolas emphasizes that we must resist oversimplification that reduces complex systems to easy fixes driven by a singular cause. Instead, she believes we need to spend more time looking closely at the nearly 200 natural experiments running in countries around the world, where each manages tradeoffs differently. Diving deeper into how patients fare in different settings can help the U.S. learn where we excel and what we can do better. Read more on the tradeoffs involved in every health care system. health New sickle cell treatments could save lives — but will people be able to afford them?  Illustration: Christine Kao/STAT; Courtesy: Kourtney Cunningham When the FDA recently approved the first two curative gene therapies for sickle cell, Kourtney Cunningham allowed herself to become hopeful, even though treatment requires chemotherapy that might cause various side effects like lowered immunity, hair loss, and infertility. But the price tags — $2.2 million and $3.1 million, respectively — have dampened her optimism. The Kansas City, Ms., resident wonders whether her state Medicaid program, which she would rely on if she decides to pursue treatment, will be able to cover the cost. "It's like being a dog on a chain and having a steak dangled in front of your face," she said to STAT's Ed Silverman. Across the U.S., policymakers, government officials and patients are uncertain how the Medicaid program will cope with the added budget strain. Anywhere from 30,000 to 40,000 sickle patients on Medicaid might be eligible for one of the new gene therapies. Although not everyone will be eligible or want one of the therapies, the cost over time could still be staggering. Read more on what the impact could be.

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health tech Cognito raises $35 million for Alzheimer's treatment headset Adobe  Amid a new wave of amyloid-fighting drugs for patients with Alzheimer's disease, medical device company Cognito Therapeutics has raised a fresh $35 million to advance its alternative treatment for the neurodegenerative disease. The device is a headset, called Spectris, that patients use for one hour per day in their homes. It uses gamma frequency light and sound stimulation to combat the cognitive decline that's the hallmark of Alzheimer's. It's supposed to stimulate brain activity that's disrupted by neurodegenerative conditions, potentially helping to preserve brain structure. The Cambridge, Mass.-based company has now raised $128 million to develop the treatment and is currently undertaking a large study that they expect to complete and submit to the Food and Drug Administration for review by the end of 2025. Read more from Mario Aguilar on how it may compare to drugs like Leqembi and donanemab. reproductive health Making the morning-after pill OTC cut related hospital visits by 96% The morning-after pill was approved for over-the-counter use in 2006, and by 2020, visits to the emergency room in order to get the medication fell by a whopping 96%. This dramatic decrease in visits was accompanied by an almost complete elimination of related hospital expenses, which dropped from $7.6 million to $385,946, according to a new study in JAMA Network Open. Researchers calculated the changes using a national database of over 2 million emergency department visits. Northeast hospitals made up almost 44% of the decrease in visits. The research was published less than a week after the Biden administration reaffirmed its commitment to protect access to abortion and contraceptives and HHS secretary Xavier Becerra reminded health insurers that they're required to cover contraceptives at no cost. Emergency contraception like the morning-after pill is often used to prevent pregnancy after unprotected sex, rape, or the failure of other contraception like condoms. A previous study from the same lead researcher found that over the same time period, emergency room visits related to sexual assault increased more than tenfold. And last week, a separate study found that in states that issued total abortion bans after Roe v. Wade was overturned, an estimated 64,565 rape-related pregnancies occurred.  "Future policies should reduce barriers to make emergency contraception safe and affordable to all," said Erica Marsh, a professor at the the University of Michigan Medical School who led the new study on emergency contraception, in a press release.

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What we're reading The man in room 117, New York Times Merck, Johnson & Johnson CEOs agree to testify in Congress on high drug prices, avoiding Bernie Sanders' subpoena, STAT How does bad data slip through? Allegations of research fraud raise questions about 'peer review,' Boston Globe Vaccines save lives and generate profits. Why is investment lagging? STAT Poland shows the difficulties of trying to reverse an abortion ban, Washington Post

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Thanks for reading! More tomorrow — Theresa

theresa.gaffney@statnews.com

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