health tech
Strange bedfellows: Obesity drug makers are working with some former telehealth foes
Powerful obesity drugs have scrambled more than medicine and society, changing views and challenging budgets. Now the two leading obesity drugmakers are rewriting the rules for how they work with telehealth companies to offer compounded and branded versions of their medications. Back when shortages allowed compounders to sell versions of the diabetes and obesity blockbusters, Eli Lilly and Novo Nordisk saw telehealth companies as enemies.
Lately the companies have turned to some of these telehealth providers to become marketing partners. Last month Novo Nordisk said it will work with three telehealth companies to offer Wegovy through its own mail-order pharmacy at a lower cash-pay price. Yesterday it unveiled a limited-time coupon — simultaneously promoted by two of telehealth companies, Ro and LifeMD.
Lilly also recently started selling Zepbound directly to patients through its own LillyDirect pharmacy at a lower cash-pay price, while Ro and Noom later marketed their ability to fulfill those prescriptions. But the moves are not without controversy, STAT's Katie Palmer reports, including questions about regulations on drug advertising. Read more.
health equity
New budget bans Medicaid coverage of trans gender-affirming care
In the budget reconciliation bill passed by House Republicans early yesterday morning, there was one small adjustment with major implications for trans people. Earlier iterations of the bill banned Medicaid coverage of gender-affirming care for trans minors, but the updated bill cut the words "for minors" — meaning the ban now applies to trans people of all ages. The ban targets "gender transition procedures," explicitly defining "procedures" as inclusive of medication like puberty blockers, testosterone, and estrogen. The bill still needs to pass in the Senate before it becomes law. If it does, the Trump administration will be well on its way to dismantling trans health care, as promised throughout his campaign.
There are 180,000 trans adults in the U.S. who rely on Medicaid for health insurance, according to analysis of federal survey data from the Williams Institute. For many, coverage was already uncertain depending on how states allocate their own dollars, and the ban on federal funding would likely lead to an even weaker patchwork system of coverage across the country. If the budget is passed, it will not only limit people's access to lifesaving medication and procedures, but it could also have a chilling effect on the field as a whole. Gender-affirming surgeries were rarely performed in the U.S. before Medicare lifted a ban on coverage just over a decade ago. — Theresa Gaffney
infectious disease
FDA asks vaccine makers to widen age range on warning of rare heart risk
Covid-19 is still with us, and so is the controversy about its origin, pandemic response, and vaccines to prevent it. That last category garnered renewed attention Wednesday when the FDA asked mRNA vaccine makers Moderna and Pfizer to change their warning labels about a rare side effect, heart inflammation, by widening the age range of males at risk to 16 to 25 years old. That reaction is a known one: myocarditis, triggered by an immune system on high alert.
How rare?
"You're much more likely to die of Covid than you are to die of myocarditis," cardiologist Steven Nissen of the Cleveland Clinic told me. "I have buried people from Covid, young people. I lost a 25-year-old nurse to Covid-related myocarditis."
In recent weeks FDA Commissioner Marty Makary has shown a willingness to use his power and position to more harshly scrutinize vaccines and to shift vaccination policy. The two letters to the vaccine makers were sent after Makary and Vinay Prasad, who oversees vaccine policy at FDA, said on Tuesday that they plan to limit Covid vaccine boosters to people over age 65 or at risk of becoming seriously ill if infected.
We have more on vaccine policy:
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