Breaking News

Justice Dept. is investigating UnitedHealth, a 'renaissance in neuroscience' drugs, & why doesn't Medicare send food to sick patients?

February 28, 2024
Reporter, Morning Rounds Writer

Good morning. Exciting news: It's time to meet the contenders for the STAT Madness 2024 crown. The teams include a Nobel laureate and biotech big shots, but also up-and-comers. Just sayin'.

Voting begins March 1, as in Friday. 

insurance

U.S. antitrust officials are investigating UnitedHealth 

The Department of Justice launched an antitrust investigation into UnitedHealth Group last October and has been interviewing numerous groups that compete with the conglomerate, according to new reports from the Wall Street Journal and Examiner News.

The DOJ has not alleged any wrongdoing. But this is a major step by federal antitrust officials, STAT's Bob Herman tells us, and a signal that concerns about "vertically integrated" health care companies have reached a tipping point. UnitedHealth is no longer just an insurance company — over the past decade, it has acquired doctors, surgery centers, technology companies, and scores of others, all as a way to capture more of its insurance premiums as profit.

UnitedHealth's buying spree of physician practices appears to be in DOJ's crosshairs, according to the reports. The company's executives have said in the past that its physicians and insurance company don't favor each other and exclude others. But to get a sense of what anticompetitive allegations can look like, Brittany Trang reported about one such case against UnitedHealth in November.

Worth noting: UnitedHealth has not yet filed its annual report, called a 10-K, with the Securities and Exchange Commission. That likely will be filed within the next two weeks, and it's a near-certainty the company will publicly acknowledge the investigation there. 


politics

Why doesn't Medicare deliver food to sick patients?AdobeStock_284323072

Adobe

Some 12% of traditional Medicare beneficiaries have heart failure. Roughly a quarter have diabetes. There's early evidence suggesting these and other conditions could be successfully managed with pre-made healthy meals — and save Medicare money to boot. So why doesn't Medicare try out delivering food to sick seniors?

If only it were that simple. The debate underscores how hard it is to integrate food into traditional health care. While medically tailored meals have been successfully tested in small clinical trials, they have never been part of a federal program as big as Medicare. "We need to get creative and we need to find a way to make this happen. And it needs to happen now," Rep. Jim McGovern (D-Mass.) said at a recent summit on the issue. In an interview with STAT's Nicholas Florko, he said, "I just want them to get this goddamn thing done." Read more about the battle.


infectious disease

Cholera vaccine shortage leaves experts fearing more outbreaks

When we hear of cruise ship quarantines, we may be more likely to think of Covid-19 or norovirus outbreaks. But it was cholera that temporarily stranded passengers aboard a Norwegian cruise ship this week off the coast of Mauritius. Cholera is deadly if untreated, a clear danger to the thousands of people in at least 16 countries in Asia, Africa, and the Caribbean dealing with ongoing outbreaks. The situation is likely to worsen amid the worst vaccine shortage since the oral vaccine was introduced in the 1990s. 

There are three oral cholera vaccines prequalified for use during cholera outbreaks and for prevention through the global stockpile, but it's running dry. Only one of three vaccine makers, EuBiologics, is producing doses. "The only way to maintain a healthy market is to have more than one manufacturer," said Daniela Garone of Medécins Sans Frontières, Garona. "You need global investment because it's not an attractive market." STAT's Annalisa Merelli has more.



closer look

What a 'renaissance in neuroscience' could mean for psychiatric treatmentsSTAT_Neuroscience_Pharma_F1_2000x1125

Mike Reddy for STAT 

Remember Zoloft, Prozac, and Paxil?  Those drugs were launched during the glory days of psychiatric drug development, but by the early 2000s, generic counterparts had supplanted them and newer drugs that generated similar revenues failed to appear. While the need for new, effective treatments has only grown, it's only lately that a crop of biotech and some large pharma players have shown signs of renewed life in a notoriously difficult field. "This is a renaissance in neuroscience," said securities analyst Marc Goodman of Leerink Partners. "Everything has come together really nicely. And once Big Pharma takes an interest and M&A happens, that just wakes everybody up."

There are important differences this time around. An earlier generation chased the next Lipitor, but now small biotechs have shown they can succeed with a drug indicated for only a select group of patients. STAT's Damian Garde tells us which ones have promising candidates in the queue — and what they do.


in the lab

'I do this because I care about science'

Meet Elisabeth Bik, a microbiologist by training who has become one of the world's most influential science detectives. She first became interested in plagiarism as a hobby while working as a researcher at Stanford University in 2013, later specializing in image duplication. She spoke with STAT's Deborah Balthazar after becoming a member of the STATUS List.

What made you want to focus directly on images?

The first case of image duplication that I found myself, I just thought that was more serious for science as a whole. I felt plagiarism is bad for scientists, or to be plagiarized, but it doesn't necessarily bring a new or false narrative into science. Well, if a scientist photoshopped something, or has two images that overlap but presents them with two different experiments, that is actually cheating. 

Anything you'd like people to know?
I don't do this to break people's careers. I do this because I care about science.

Read the full interview.


chronic disease

Bariatric surgery improves type 2 diabetes compared to lifestyle changes, long-term study says

In the decades since it became mainstream, bariatric surgery became noted not just for substantial weight loss, but also for improving the health of people with type 2 diabetes. Long before the current wave of weight-loss drugs, its benefits in glycemic control were remarkable. A new pooled analysis of four randomized controlled trials published in JAMA compared the long-term glycemic control and safety of bariatric surgery to medical and lifestyle management of type 2 diabetes. Surgery was superior up to 12 years later.

Patients who had one of three kinds of surgery — gastric bypass, sleeve gastrectomy, or adjustable gastric banding — needed to take less diabetes medication or went into remission from diabetes, the study of 262 patients found, which the authors believe is the largest pool analysis with the longest followup. A companion editorial suggests a clinical trial comparing bariatric surgery with the new weight-loss drugs, but until then, encourages doctors to consider bariatric surgery, "a vastly underutilized intervention."


More around STAT
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Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

  • A doctor's lifelong quest to solve one of pediatric medicine's greatest mysteries, New York Times

  • There's a cheap and effective way to treat childhood diarrhea. So why is it underused? NPR

  • Viking Therapeutics obesity drug hits target in key study, raising hopes for a competitor to existing medicines, STAT
  • FTC says pharmacy benefit managers are stonewalling requests for information, STAT

Thanks for reading! More tomorrow,


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