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A new war over weight loss drugs is catching patients in the crossfire

October 11, 2024
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Health Tech Reporter

Put up another dub for Bob Ross!! 

Last night the teams behind our Obesity Revolution and Denied by AI series gathered in New York City for the Loeb Awards, and Bob Herman and Casey Ross (#BobRoss) took home the prize in the investigative category .

"This series highlights how we're sleepwalking into two really urgent crises, one of which is: More people are being herded into private Medicare plans. And the other is: Those same plans are using these unregulated algorithmic tools in artificial intelligence to determine care. And this is not some kind of harmless digital playground, this is really affecting lives out there," said Bob in his acceptance speech.

We've linked both series below in More Reads; check them out.

Obesity Revolution

The Obesity Revolution has led to another war: Compounders vs. the companies

There's a war brewing over blockbuster weight loss medications — and patients are now getting caught in the crossfire.

When the FDA took Eli Lilly's drug tirzepatide — sold as Mounjaro for diabetes and Zepbound for obesity — off the shortage list last week, it made it illegal for most compounding pharmacies to sell the drug. 

Compounding pharmacies are mad — enough that they're filing lawsuits against the FDA, and that companies like Noom are taking out full-page ads in newspapers to beg Congress to keep compounded drugs on the market.

STAT's Elaine Chen has a story about how patients are the ones who are losing in this fight: Not only are people who are purchasing the drugs from compounders losing that option, but with shortages persisting, it's difficult for people to obtain the drugs from the brand-name manufacturers, too. Read more.


Medical Research

Peer review payments… but not that kind of payment

For years, people have complained that the peer review system meant to keep the scientific literature in check is shadowy and also unfair: The reviewers are usually anonymous and sometimes of dubious expertise, plus they're asked to work for free, which makes them often hard to find.

A new study in JAMA looked at payments to peer reviewers…but not for their peer reviewing work. Highlighting potential conflicts of interest, the study compared lists of physicians who reviewed for The BMJ, The Lancet, JAMA, and the New England Journal of Medicine to the Open Payments database, finding that more than half of them accepted payments from industry for things like travel, consulting, and food. The bulk of the payments — $1 billion of the $1.06 billion made — went toward payments for research, with 32% of the peer reviewers taking payments for research.

STAT's Ed Silverman has more, including responses from journals and caveats to the study.


Science

The Nobel prize for protein AI is a win — and a warning — for open science

Earlier this week, the 2024 Nobel Prize in Chemistry went to three researchers for designing artificial intelligence models capable of predicting the structure of proteins from their sequence as well as designing new proteins from scratch. 

Every Nobel winner stands on the shoulders of giants — but with this one, the winners stand on a human pyramid of extraordinary scale.

As STAT's Katie Palmer and I explain, these AI models were directly trained on thousands of protein crystal structures that were freely shared in an open database. The code also came together after decades of scientists learning from each other at a biennial competition for structure prediction. 

But as companies begin to capitalize on the AI protein buzz, that open culture of data-sharing may be in trouble. Read more here.



Closer Look

Africa CDC head criticizes U.S. CDC recommendation

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AMANUEL SILESHI/AFP via Getty Images

Jean Kaseya, director general of the Africa Centres for Disease Control and Prevention, on Thursday criticized U.S. governmental recommendations that American citizens should steer clear of Rwanda as it battles its first Marburg outbreak. The Level 3 travel advisories were counterproductive and unfair, Kaseya complained, suggesting they could sow panic. A Level 3 advisory urges people to avoid unnecessary travel to a cited country, either for security or disease risk reasons.

For the second day in a row, the case count in the outbreak held at 58 cases and 13 deaths. Rwanda reported it had administered 346 doses of an experimental Marburg vaccine donated by the U.S. government. The vaccine is being used in an open-label approach — in other words, the country is giving it to everyone it deems to have been exposed to a confirmed case, and their contacts. Health Minister Sabin Nsanzimana said a clinical trial which would see some contacts vaccinated quicker than others to test the efficacy of the vaccine might be started later, but for now the goal is to "save as many lives as quickly as possible and also to stop the spread."

Read more from STAT's Helen Branswell.


Public Health

How encampment sweeps hurt the health of the homeless

Imagine if you had a supply of medication for your chronic condition and someone just stole it, leaving you without your medication and no way to get your insurance to cover a refill. 

Now imagine the person who stole your medication was the governor.

This is a very real situation for people who are homeless and have conditions like diabetes and heart failure, writes primary care physician Max Jordan Nguemeni in a STAT First Opinion. He recounts a video of California Gov. Gavin Newsom tossing items from a homeless encampment in Los Angeles in a pile, as well as his experiences of treating homeless people whose medications had been stolen or lost in sweeps of homeless encampments.

These sweeps don't solve any problems, they just create different ones, says Nguemeni, and other solutions are needed. Read more.


Public Health

People with ADHD, already grappling with drug shortages, may further lose access

Jeremy Didier only realized she had ADHD after one, then two, then four of her five children were diagnosed with the disorder. Medication makes life manageable for both her, a mental health clinician and the president of the board of directors at an ADHD advocacy organization, and her kids. 

But legislation that lets ADHD specialists prescribe medication via telehealth is about to expire at the end of the year, and in-person requirements will make it harder for people to get diagnoses and receive prescription renewals. Congress needs to extend these telehealth powers so that people don't lose access to the drugs they need, she writes in a STAT First Opinion.

"In 2023, there was a three-week period when we couldn't get my 16-year-old son's prescription filled due to the shortage," she writes. "During that time, he got into his first car accident (thankfully, everyone was OK), got his first speeding ticket, and failed to turn in 13 homework assignments. ADHD medication works."

Read more about Didier's family, as well as lawmakers' plans and telehealth providers' frustration with the situation.


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Thanks for reading! More on Monday — Brittany


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