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A look at the cautious history behind mifepristone, differing versions of a cancer research dispute, & how flu season is sizing up so far

February 27, 2024
Reporter, Morning Rounds Writer
Good morning. Drum roll, please: Today we introduce the 2024 STATUS List, whose members span health and the life sciences across biotech, medicine, health care, policy, and health tech. Some you've heard of, some may surprise you, all have impact. Meet them here.

reproductive health

FDA's original protocols for abortion medication were cautious. Newest case casts them as a sign of riskGettyImages-1481953398

Anna Moneymaker / Getty Images

In today's heated debate over abortion, it may be hard to imagine that a similarly contentious atmosphere prevailed when the first abortion medication was approved in the U.S. Or that the cautious approach taken by the regulatory agency back then appears to have implied heightened risk. Mifepristone has been on the market for more than 20 years, but its FDA approval in 2000 was surrounded by such controversy that members of the advisory committee were escorted to and from the first meeting venue under security. Now a lawsuit is calling for increased restrictions around the drug.

"The FDA wanted everything to be super cautious, politically and scientifically, everything had to be in a formal study," said Beverly Winikoff of research nonprofit Population Council, who analyzed the drug for years. "It's probably one of the most studied pills to ever reach the market." STAT's Olivia Goldhill spoke to committee members who participated in reviewing that 2000 FDA application. Read more.


drug pricing

PBM package bites the (congressional) dust

So much for that. An approach to lowering drug prices will have to wait for another day. Congress has abandoned its attempt to reform how pharmacy middlemen operate in an upcoming package to fund the federal government, 11 lobbyists and sources following the talks told STAT's Rachel Cohrs and John Wilkerson. It's a missed opportunity to pass a health care priority stirring much bipartisan interest and activity this Congress, although lawmakers could revive negotiations on the issues in the future, they report.

Reforming how pharmacy benefit managers operate has been a top lobbying priority for the pharmaceutical industry after Democrats passed a major package aimed at lowering the costs of medicines in 2022. The PBM reform legislation in question was intended to offset costs of a separate effort to renew expiring funding for safety-net hospitals, community health centers, and other public health programs. Negotiations over a final deal to extend those programs are ongoing, Rachel and John explain.


infectious disease

Amid Covid and RSV, here's how flu is hitting us

There has been a lot of respiratory illness this winter, with influenza, Covid-19, and RSV each taking a share of the action. But when it comes to flu itself, 2023-2024 hasn't been a particularly tough season, the CDC says. The agency's preliminary assessment of the flu season ranks this winter as moderate so far, STAT's Helen Branswell tells us. The agency's scale runs from low, moderate, high, to very high severity.

The CDC uses three indicators to assess a flu season's severity, looking at how many people sought medical care for flu-like illness, how many were hospitalized for flu, and how many flu deaths occurred, comparing the highest point in the season for each, by age group, to measurements from previous seasons. This year has been moderate for all ages. Some years, the assessment differs by age group; last year, for example, was a high-severity year for kids, but moderate for adults.



closer look

New documents present differing versions of dispute between MD Anderson researchers  

If you've been following the dispute between a senior faculty member and a junior scientist at MD Anderson Cancer Center, you know it's been both complicated and contentious. STAT's Angus Chen reports that, early last year, the cancer center hired the law firm Ropes & Gray to sort out the conflict involving authorship, credit, and allegations of abuse. That investigation concluded in favor of star cancer scientist Padmanee Sharma over junior researcher Jamie Lin concerning the authorship and scientific credit portions of the dispute. 

But a separate investigation conducted by a former official at the federal Office of Research Integrity tells a somewhat different story. Lin has filed a lawsuit against Sharma alleging retaliation, harassment, threatening, and intellectual theft, as STAT has reported. Angus tells us about key discrepancies that have emerged when comparing the law firm's executive summary, court filings submitted by Sharma and her lawyer, Texas Attorney General Ken Paxton, and other documentation provided to STAT by Lin. Read more.


climate

Extreme heat linked to preterm births, but trees can help, study says

In a large, long-running study conducted in Australia, extreme heat was linked to a greater risk of preterm births in the third trimester of pregnancy, a finding with clear implications for our warming world. The JAMA Pediatrics study, which analyzed 1.2 million births in Sydney, Australia, from 2000 through 2020, looked at births before 37 weeks' gestation in light of both daytime and nighttime high temperatures. Preterm birth rates with high daytime heat exposure were 7.5% compared to 4.9% during normal temperatures and 7.2% vs. 4.9% for nighttime heat.

There were differences depending on the greenness of a neighborhood. The authors say increased tree cover and other vegetation could reduce heat-associated preterm births by 13.7% in the daytime and 13% at night. "These findings highlight the importance of considering heat exposure and greenness to reduce [preterm birth] risks," they write. "Further interventions should prioritize urban green to mitigate detrimental impacts of heat."


health inequity

How Americans view health care8seven-in-ten-u.s.-adults-say-they-trust-doctors-and-other-health-care-providers-almost-all-or-most-of-the-time (1)

One-third of U.S. adults think racism is a major problem in health care, a new KFF survey finds. Although not exactly a vote of confidence in American medicine, it's more favorable than views people expressed on politics, criminal justice, policing, education, housing, or employment. That may reflect greater trust in health care, but individual experiences matter, too. Black adults are much more likely than white adults to say racism is a major problem in these realms; Hispanic, Asian, and American Indian and Alaska Native adults are somewhat more likely than white adults to say so.

People who have recently been treated unfairly or with disrespect by a health care provider are much more likely than those who haven't to call racism a major problem in health care. Black and Asian adults who mostly visit health care providers who share their racial identity are more likely to say they trust providers than those who don't.


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What we're reading

  • $1 billion donation will provide free tuition at a Bronx medical school, New York Times

  • Opinion: Misinformation and the Vaccine Adverse Event Reporting System, JAMA Network Open
  • Private equity firm offers $5.8 billion buyout of hospital billing company R1 RCM, STAT
  • Hours on hold, limited appointments: Why California babies aren't going to the doctor, Los Angeles Times
  • Congress ditches site-neutral hospital pay policy, STAT
  • The quest for psychedelics in the Amazon would push a Harvard botanist to his limits, Boston Globe

Thanks for reading! More tomorrow,


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