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Weed, dogs, teeth, and cash

July 23, 2024
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Morning Rounds Writer and Podcast Producer
A round of a-paws to my editor Sarah Todd for the puppy pun in the last item. (I'm sorry ... please don't unsubscribe because of our puns ... but bark at us if you need to?) (I'll see myself out now.)

race

How removing race from a lung test will affect vets' benefits

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Tests and algorithms that include race often have a tendency to create disparities for Black and brown people. That's why, in 2023, the American Thoracic Society announced that race should no longer be a factor in pulmonary function tests, which can determine diagnosis, treatment plans, and disability payments for people with lung disorders. A study published this May estimated that the change could affect more than 400,000 veterans, and out of $2 billion that could be redistributed, more than 17% could go to Black veterans (with just 1% less going to white vets than before).

Now VA officials have launched their own study to determine how much the changed test will affect benefits for veterans. Officials also said that they expected the effect of the changes to be smaller than the previous study predicted, and that they hope to have a new policy in place by September 2025. Read more on how the VA is considering the new test from STAT's Usha Lee McFarling.


money

Giving people cash could keep them out of the ER, study says

Just north of Boston, the city of Chelsea, Mass., piloted a benefit program in 2020 that provided low-income residents with $400 per month for up to nine months. A study published yesterday in JAMA found that people who received the cash benefits visited an emergency room significantly less than those who did not receive money.  

More than 1,700 people were selected from a lottery to receive the cash benefits. That group had 217 ED visits per 1,000 people, as opposed to 317 per 1,000 people for a control group. Those who got cash also had fewer ED visits resulting in hospitalization and fewer visits specifically related to behavioral health and substance use. But interestingly, outpatient visits for a combined number of subspecialties went up for the benefited group, especially for people who didn't have a car and had to travel farther from Chelsea for care. The results indicate that policies providing supplemental income to low-income communities could have important health care benefits, the authors wrote.


first opinion

One way for Medicare to get a fair deal on Wegovy? Buy Novo Nordisk

CMS announced earlier this year that it would cover Wegovy (enter here the explanation about last year's hot new weight loss drugs, which you already know) for people with cardiovascular disease and obesity. But how? Wegovy currently goes for $1,349 per month in the U.S., and Medicare spending on these types of drugs has already increased from $57 million in 2018 to $5.7 billion in 2022. (Enter here one of those easy-to-understand examples of just how big the difference between a million and a billion is.)

Three Yale professors propose a unique solution in a First Opinion essay: CMS could buy Novo Nordisk for its current market capitalization value of $606 billion. It may sound absurd, they acknowledge, but so are the numbers above. Read more on this thought experiment about unprecedented drug prices.



commercial determinants of health

Plan to loosen DEA restrictions on weed divides top medical groups

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The American public overwhelmingly supports the Biden administration's proposal to remove marijuana from a category of controlled substances, including heroin and cocaine, deemed to have no proven medical value and a high risk of abuse. But it turns out that major medical groups are divided in their responses to the proposal, STAT's Nick Florko reports.

While some groups, like the American Nurses Association, support the move, others — including the powerful American Medical Association — have raised questions. The divisions emerged in the groups' public comments on the proposal to regulate the drugs more like anabolic steroids than heroin. 

"Doctors like myself for so many years were pretty much indoctrinated about the harms," one emergency medicine physician told Nick. Read more on where medical professionals stand and what's next for the plan.


teeth

Researchers find a 'significant link' between tooth loss and fatal heart disease

People who have lost a lot of teeth have a 66% higher chance of dying from heart-related issues compared to those who haven't, according to a systematic review of existing research published in the Journal of Endodontics. "The magic number is 10," lead author Anita Aminoshariae said in a press release. "For those who had 10 teeth or less, they're in trouble."

The authors looked at 12 studies that included at least three years of follow-up. Their findings indirectly support the idea that saving teeth with dental care could preventatively lower a person's risk of cardiovascular disease, they write. But they also emphasized a need for more research and methodological standardization of the research surrounding oral and cardiovascular health.


doggos

CDC makes rules on international dogs a little less ruff

Morning Rounds previously discussed the new rules going into effect next month from the CDC that set stringent requirements on importing dogs from foreign countries, especially from places with a high risk of rabies. The rules — which aim to prevent the disease from being reintroduced in the U.S. — include mandatory rabies vaccination and microchips, and a potential month-long quarantine for dogs without high enough levels of rabies antibodies. 

When the requirements were originally proposed, military members urged the CDC to exempt their pets acquired abroad, my colleague Nick Florko reported. The agency has not made a military exception, but announced yesterday that dogs who have been in a country where they are at low risk of contracting rabies for at least six months will have an easier time getting into the U.S. Owners will simply need to fill out a form on the same day as they travel and provide it to border officials.


More around STAT
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What we're reading

  • Rescue from above: How drones may narrow emergency response times, KFF Health News and CBS News

  • Fixing the reimbursement and coverage divide between 'breakthrough' drugs and medical devices, STAT

  • A discontinued asthma medication has patients scrambling, some to the ER, NPR
  • Biotech led by J&J veterans launches with $165 million for cancer, autoimmune therapies, STAT

Thanks for reading! More tomorrow,


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