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Rising stakes for reproductive health, Medicare to cover Wegovy for preventing heart problems, & a ranking of Covid-19 vaccine winners and losers

March 25, 2024
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Reporter & Podcast Producer

Good morning! We're starting the week with a concentration of news on reproductive health. Read on to learn more about emergency abortions in Texas, a Supreme Court abortion pill case, and cervical cancer screenings in rural areas.

reproductive health

From Texas to Washington, the stakes keep rising on reproductive health in the U.S. 

GettyImages-1214355885-1

Misha Friedman / Getty Images

Last week, the Texas Medical Board proposed draft guidance Friday in an attempt to clarify what constitutes emergency grounds for a legal abortion after pressure from the state Supreme Court and widespread uncertainty among physicians. The board's language largely drew from existing state legislation, and its president, Sherif Zaafran, noted that physicians who deem an abortion to be medically necessary would be expected to document how the risk of death or major impairment was determined.

The board would not issue a list of conditions that constitute a medical emergency, arguing that circumstances vary considerably and the same condition could be an emergency or not depending on context. Response to the guidance has been mixed — one woman who was denied an abortion as emergency medical care in Texas told the board she was "hopeful" but "skeptical" the proposal would help physicians. STAT's Olivia Goldhill has more on the details of the guidance.

Meanwhile, the U.S. Supreme Court will hear opening arguments tomorrow in an abortion medication case that pharmaceutical companies warn could upend the industry and paralyze drug development. Mifepristone was first approved by the Food and Drug Administration in 2000 for abortion up to seven weeks of pregnancy. That approval was later extended to 10 weeks, and eventually the in-person dispensing requirement was removed. Now, in the wake of the overturning of Roe v. Wade, both those later changes could be reversed after a Fifth Circuit Court of Appeals' ruling.

In addition to the clear ramifications for reproductive rights across the country, pharmaceutical companies and former health officials have argued that reversing the FDA's decisions would upend and politicize otherwise routine regulatory review processes. "This is a dagger at the heart of the entire industry," said Ovid Therapeutics CEO Jeremy Levin.

Read more from STAT's Sarah Owermohle about the far-reaching ramifications of the case.


obesity revolution

Medicare will cover Wegovy to prevent heart problems — but access could still be an issue

Medicare confirmed last week that it will cover Novo Nordisk's obesity drug Wegovy if prescribed to prevent heart problems. But policy experts say Medicare patients are still likely to encounter significant barriers getting access to the highly popular and expensive drug.

The federal payer previously wasn't reimbursing for Wegovy, since Medicare is legally barred from covering weight loss drugs. But the Food and Drug Administration this month approved Wegovy for preventing heart problems in people with obesity and heart disease, leading many to suspect that Medicare would start covering the drug for this usage. But there are still challenges ahead.

"Even though Medicare is clarifying that they will reimburse for this indication, that does not necessarily mean that patients are going to have widespread access to the drug, at least not right away," said Benedic Ippolito, an economist at the American Enterprise Institute. Read more from STAT's Elaine Chen.


artificial intelligence

Will generative AI actually revolutionize health care? 

Health systems, drugmakers, and insurers are racing to build artificial intelligence technology into their operations, aligning themselves with corporate giants such as Microsoft, Google, and Nvidia, whose executives speak about each incremental advancement of AI as an earth-shattering event. "The generative AI revolution is here," Jensen Huang, 61, Nvidia's leather-jacket-clad CEO, declared during the company's GTC conference in San Jose, Calif., last week.

Maybe. The technology is undeniably getting more powerful and more beneficial to businesses in health care and beyond. But many physicians, chemists, and computer scientists also fear that the overheated rhetoric — and the thinly veiled profit motives behind it — will inevitably result in yet another letdown. And health care should have already learned this lesson a decade ago, STAT's Casey Ross writes. IBM overhyped its Watson supercomputer during the deep learning run-up as a cancer cure, only to have its health care business collapse under the weight of its own exaggerations.

So is it worth holding our breath on generative AI? Read more to find out.



covid-19

Four years later: Were great Covid vaccines bad business?

COVID-vials

Christine Kao / STAT

It's been four years since Covid-19 emerged and I began to spend every day pacing the long hallway of my railroad apartment in Queens. A key factor in taming a pandemic that killed millions of people and brought the world to its knees was the creation of effective vaccines, which have saved millions of lives.

You might assume developing these shots was an unmitigated financial win for companies. And, indeed, for Pfizer and its partner BioNTech, as well as for Moderna, the revenues generated were absolutely staggering. But investors have shrugged those sales off as gains that will not be repeated. STAT's Matthew Herper offers an in-depth assessment of how each major pharmaceutical company fared in the vaccine race. Read more to see the real winners, the winning losers, the biggest loser, and more.


research

A new study explains the rural-urban divide in cervical screening rates

Despite the rate of women dying from cervical cancer being almost a third higher in rural areas than in urban ones, screening rates are actually lower in rural communities. A new study published in Cancer found that this disparity has persisted in the country's community health centers, which serve marginalized populations regardless of their ability to pay. In rural CHCs, 38% of women were up to date on their cervical cancer screenings, compared to 43% in urban ones. 

Researchers found that the disparity could be mostly explained by increased use of CHCs in urban areas by patients who have limited English proficiency, and lower use in rural areas by those with Medicaid or no insurance. Other factors included the proportion of patients with incomes below the poverty line and broader community factors like the area's level of unemployment and the density of primary care physicians. The analysis is based on data including all CHCs in the U.S. from 2014-2021.


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What we're reading

  • The brutality of sugar: Debt, child marriage and hysterectomies, New York Times

  • Pregnancy increases biological age — but recovery and breastfeeding can undo the damage, study finds, STAT

  • My patients think Ozempic is a wonder drug. But it can't fix fat phobia, NPR
  • What the public might learn from Kate Middleton, the latest "famous patient," STAT
  • For people with chronic illness, grief is a frequent companion, Wall Street Journal

Thanks for reading! Until tomorrow — Theresa


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