First Edition: March 17, 2023

KHN: Temp Nurses Cost Hospitals Big During Pandemic. Lawmakers Are Now Mulling Limits
To crack down on price gouging, proposed legislation in Missouri calls for allowing felony charges against health care staffing agencies that substantially raise their prices during a declared emergency. A New York bill includes a cap on the amount staffing agencies can charge health care facilities. And a Texas measure would allow civil penalties against such agencies. These proposed regulations — and others in at least 11 more states, according to the American Staffing Association industry trade group — come after demand for travel nurses, who work temporary assignments at different facilities, surged to unprecedented levels during the worst of the covid-19 pandemic. (Sable-Smith, 3/17)

KHN: California’s Covid Misinformation Law Is Entangled In Lawsuits, Conflicting Rulings
Gov. Gavin Newsom may have been prescient when he acknowledged free speech concerns as he signed California’s covid misinformation bill last fall. In a message to lawmakers, the governor warned of “the chilling effect other potential laws may have” on the ability of doctors to speak frankly with patients but expressed confidence that the one he was signing did not cross that line. Yet the law — meant to discipline doctors who give patients false information about covid-19 — is now in legal limbo after two federal judges issued conflicting rulings in recent lawsuits that say it violates free speech and is too vague for doctors to know what it bars them from telling patients. (Wolfson, 3/17)

KHN: KHN's 'What The Health?': Judging The Abortion Pill 
This week, the eyes of the nation are on Texas, where a federal judge who formerly worked for a conservative Christian advocacy group is set to decide whether the abortion pill mifepristone can stay on the market. Mifepristone is half of a two-pill regimen that now accounts for more than half of the abortions in the United States. (3/16)

The New York Times: New Data Links Pandemic’s Origins To Raccoon Dogs At Wuhan Market 
An international team of virus experts said on Thursday that they had found genetic data from a market in Wuhan, China, linking the coronavirus with raccoon dogs for sale there, adding evidence to the case that the worst pandemic in a century could have been ignited by an infected animal that was being dealt through the illegal wildlife trade. ... The jumbling together of genetic material from the virus and the animal does not prove that a raccoon dog itself was infected. And even if a raccoon dog had been infected, it would not be clear that the animal had spread the virus to people. Another animal could have passed the virus to people, or someone infected with the virus could have spread the virus to a raccoon dog. (Mueller, 3/16)

The Atlantic: The Strongest Evidence Yet That An Animal Started The Pandemic
This week, an international team of virologists, genomicists, and evolutionary biologists may have finally found crucial data to help fill that knowledge gap. A new analysis of genetic sequences collected from the market shows that raccoon dogs being illegally sold at the venue could have been carrying and possibly shedding the virus at the end of 2019. It’s some of the strongest support yet, experts told me, that the pandemic began when SARS-CoV-2 hopped from animals into humans, rather than in an accident among scientists experimenting with viruses. (Wu, 3/16)

Science: Unearthed Genetic Sequences From China Market May Point To Animal Origin Of COVID-19
A scientific sleuth in France has identified previously undisclosed genetic data from a food market in Wuhan, China, that she and colleagues say support the theory that coronavirus-infected animals there triggered the COVID-19 pandemic. Several of the researchers presented their findings on Tuesday to the Scientific Advisory Group for the Origins of Novel Pathogens (SAGO), an expert group convened last year by the World Health Organization. “The data does point even further to a market origin,” says Kristian Andersen, an evolutionary biologist at Scripps Research who attended the meeting and is one of the scientists analyzing the new data. If so, the findings weaken the view of a vocal minority that a virology lab in Wuhan was the likely origin of SARS-CoV-2, perhaps when the coronavirus infected a lab worker, who spread it further. (Cohen, 3/16)

Roll Call: Energy Department Briefs Senators On COVID-19 Origins
Department of Energy and intelligence community officials briefed members of the Senate Energy and Natural Resources Committee on classified information related to COVID-19’s origins Thursday but offered no definitive revelations, according to lawmakers. The briefing follows the news that the department now concludes with “low confidence” that the virus more likely originated in a lab in Wuhan, China, rather than through natural evolution. (Clason, 3/16)

Reuters: Sanofi To Cut US Price Of Its Most-Prescribed Insulin By 78% 
In addition to Lantus, Sanofi said it will cut by 70% the list price for its fast-acting insulin, Apidra. Sanofi said it already offered a lower priced version of Lantus but that it had not been taken up widely by insurance programs. The branded list price of Lantus is $438.07 for the pre-filled pens and $292.07 for a 10 ml vial. Those would come down to $96 and $64, respectively. (Wingrove, 3/16)

NBC News: Sanofi Announces Insulin Price Cap Of $35 Per Month Out-Of-Pocket
Sanofi will cap the out-of-pocket cost of its most popular insulin, Lantus, at $35 per month for people with private insurance, the French drugmaker said Thursday. The change will take effect Jan. 1, 2024. Sanofi is the last of three major insulin makers in the United States to cut or cap the price of the drug. Both Eli Lilly and Novo Nordisk announced changes to how they price their insulin this month. Together, the three drugmakers make up roughly 90% of the insulin market in the U.S. (Lovelace Jr., 3/16)

The Bismarck Tribune: North Dakota Supreme Court Upholds Temporary Block Of State's Abortion Ban
The North Dakota Supreme Court has upheld a temporary block of the state's abortion ban. The ruling came Thursday in the lawsuit brought last summer by the Red River Women's Clinic, formerly the sole abortion provider in North Dakota. The clinic moved from Fargo to neighboring Moorhead, Minnesota, last year after the U.S. Supreme Court's Dobbs decision, which overturned the constitutional right to an abortion in Roe v. Wade. (Dura, 3/16)

Tampa Bay Times: After Emotional Testimony, Bill Banning Abortion At 6 Weeks Of Pregnancy Moves Forward
A Florida House committee on Thursday voted to advance a bill that would restrict abortion to the first six weeks of pregnancy in nearly all cases, before some women know they’re pregnant — despite an ongoing lawsuit challenging a 15-week abortion cutoff that legislators passed last year. Unlike the current 15-week ban, the six-week legislation (HB-7) does have exceptions for rape and incest, but only up until 15 weeks of gestation, and only if there is “documentation proving” the rape or incest, such as a restraining order, police report, medical record or court order. (Farrington, 3/16)

AP: California Bill To Protect Doctors Who Mail Abortion Pills 
Doctors in California who mail abortion pills to people in other states would be protected from prosecution under a new bill to be unveiled Friday in the state Legislature. The bill would not let California extradite doctors who are facing charges in another state for providing abortion medication. It would also shield doctors from having to pay fines. And it would let California doctors sue anyone who tries to stop them from providing abortions. (Beam, 3/17)

Roll Call: OB-GYN Workforce Shortages Could Worsen Maternal Health Crisis
A patchwork of state laws in the aftermath of a Supreme Court decision overturning the right to an abortion, combined with pandemic-related burnout and low reimbursement rates, could exacerbate an already looming national shortage of obstetrician-gynecologists, experts say. (Raman and Cohen, 3/16)

CIDRAP: Paxlovid 80% Effective Against Severe COVID When Taken In First 5 Days
The antiviral drug combination nirmatrelvir–ritonavir (Paxlovid) was estimated to be 54% effective against SARS-CoV-2 Omicron BA.2, BA.4, and BA.5 hospitalization or death but was 80% when taken within 5 days of symptom onset, according to an observational study published yesterday in The Lancet Infectious Diseases. (Van Beusekom, 3/16)

Modern Healthcare: Why Health Systems May Never Recover Pre-COVID Inpatient Volumes
Many hospitals and health systems struggled to maintain inpatient admissions in 2022, adding to financial woes already compounded by labor shortages and higher operating costs. (Hudson, 3/16)

The (Cleveland) Plain Dealer: 600 Hospitals In Danger Of Closing, Per Study: Is Yours On The List?
More than 600 rural hospitals in the United States are either at immediate or high risk of closure as a result of persistent financial losses on patient services or low financial reserves, a study found. Almost every state is home to hospitals with these characteristics, according to the report by the Center for Healthcare Quality and Payment Reform, based in Pittsburgh. In more than half of the states, 25% or more of the rural hospitals are at risk of closing, and in 12 states, 40% or more are at risk. (Higgs, 3/16)

Philadelphia Inquirer: Match Day: Emergency Medicine Residency Spots Empty As Unmatched Students, Programs Scramble Through SOAP
Emergency medicine physicians at Einstein Medical Center Montgomery huddled in a room for the last few days, scrambling to fill unclaimed residency spots. Colleagues dropped by with snacks from Wawa. Others rallied on social media to support the program: “Please check us out.” (Gutman, 3/17)

Reuters: Three Former Virginia Hospital Staff Charged With Murder In Death Of Black Man
Three former employees of a mental hospital in Virginia were arrested and charged with second-degree murder on Thursday, a prosecutor said, over the death of a Black man who was transported to the facility from jail earlier this month. Irvo Otieno, 28, died on March 6 as he was being admitted to Central State Hospital in the city of Petersburg, according to Dinwiddie County Commonwealth Attorney Ann Cabell Baskervill. (Clifford and O'Brien, 3/16)

The Washington Post: Video Shows Deputies Smother Va. Man For 11 Minutes Before Death, Family Says
Relatives of Irvo N. Otieno on Thursday watched video of his “traumatic” death at Central State Hospital as a local prosecutor brought second-degree murder charges against three of the facility’s employees — on top of the seven sheriff’s deputies already charged in his death. “My son was treated like a dog, worse than a dog,” Otieno’s mother, Caroline Ouko, tearfully told reporters outside the Dinwiddie County Courthouse. ... Two lawyers for Otieno’s family, who watched the video with them, said the three hospital workers dressed in blue uniforms could be seen joining the deputies in brown — putting their weight on him as he lay prone on the hospital floor for 11 minutes, handcuffed, his feet shackled. They called on the Justice Department to investigate. (Vozzella and Rizzo, 3/16)

The Washington Post: Disabled Woman Starved To Death At Michigan Group Home, Family Says
Charlene Jones thought her aunt had been eating three meals a day. During her visits last year with Aunt Bertha, who was physically and developmentally disabled, Jones said, she had that noticed the 71-year-old looked more frail, her face sunken in. But the staff at Hoeft Home in Belleville, Mich., reassured Jones that her aunt was eating normally, she said. ... Bertha Jones died May 2, less than a month later, of protein-calorie malnutrition. (Somasundaram, 3/16)

CIDRAP: Shortages Of 4 Drugs May Complicate Cancer Care
Amid shortages of three generic drugs widely used to treat common cancers in both adults and children, hospital officials worry that they may have to treat patients with less-effective medications or lower-than-recommended doses, Endpoints News reports. Injectable methotrexate, cisplatin, and fluorouracil are all in shortage, according to the American Society of Health-System Pharmacists (ASHP). Methotrexate comes in both oral and injectable forms, while the other two drugs are available only as injectables. (Van Beusekom, 3/16)

CBS News: Drug Used To Treat Advanced Prostate Cancer In Short Supply, Novartis Says
Pluvicto, a drug used to treat advanced prostate cancer, is in short supply, the Food and Drug Administration reported last week. Novartis, the pharmaceutical company that manufactures Pluvicto, outlined the causes behind the supply issues in a letter posted by the FDA last month. (Howard, 3/16)

Stat: Califf Criticizes Insurers For Doing Too Little On Drug Research
FDA Commissioner Robert Califf wants private insurers to chip in on doing post-approval clinical research on drugs. It’s a new request from the agency chief, who’s long pushed to find new ways to test drugs. “I’m not aware of a major effort by the insurance plans to help people get studies done,” he said at America’s Health Insurance Plans conference on Thursday. “In fact, what I’m hearing from clinicians out there is just the opposite, that it’s very hard to do research in the current environment.” (Wilkerson, 3/16)

Reuters: Pfizer To Replace Migraine Drug Packaging Over Child Safety Concerns 
Pfizer Inc said on Thursday it was working on a new child-proof packaging for its migraine drug, Nurtec ODT, after safety concerns led to a recall alert from the U.S. Consumer Product Safety Commission. Consumers should immediately secure the recalled product out of the sight and reach of children and contact Pfizer for a free child-resistant pouch to store it, the CPSC said. (3/16)

Reuters: Alzheimer's Association Lobbies For Medicare Coverage Of Leqembi And Other Drugs
The Alzheimer's Association has deployed 1,000 people diagnosed with, or caring for someone with the disease, to meet with all 535 members of Congress across the United States and urge them to press Medicare for early access to a new class of drugs, beginning with lecanemab, that promise to slow the disease. The grassroots lobbying campaign, which has not been reported in detail, is being led by state-based chapters, according to interviews with four Association national and local officials. (Aboulenein, 3/16)

AP: Mississippi Governor OKs Longer Postpartum Medicaid Coverage 
Mississippi Republican Gov. Tate Reeves signed legislation Thursday to solidify a full year of Medicaid coverage for women after they give birth, saying it’s part of a “new pro-life agenda” to help mothers now that abortion access is restricted. Mississippi usually allows two months of postpartum Medicaid coverage. The state has allowed a full year of the coverage since the COVID-19 public health emergency started in 2020, although many patients have said the state did little to let them know postpartum coverage continued after the usual two months. (Pettus, 3/16)

Stat: Federal Medicaid Officials Cajole States To Auto-Enroll Beneficiaries
Federal Medicaid officials are working unusually closely with states to avoid enrollment glitches and remove excuses states might have for not doing their job once the pandemic-era requirement to maintain Medicaid enrollment ends. “We meet every week with 300 of our best state friends Friday afternoons,” Medicaid head Daniel Tsai said Thursday. “There are countless meetings, one on one, with states right now negotiating, working through individual issues.” (Wilkerson, 3/16)

AP: Kentucky Lawmakers Pass Ban On Youth Gender-Affirming Care 
Republican lawmakers in Kentucky passed a measure Thursday to ban gender-affirming care for transgender minors, completing whirlwind voting on a repackaged proposal that triggered outrage and tears among opponents unable to stop the sweeping policymaking on a culture wars issue. Supporters of the proposal — which affects how gender is discussed in schools — beat a Thursday deadline to retain their power to override an expected gubernatorial veto. (Schreiner, 3/17)

The Boston Globe: N.H. Senate Passes Bill That Would Force Teachers To ‘Out’ Transgender Kids To Their Parents
In a party-line vote, the New Hampshire Senate signed off Thursday on a Republican-backed bill that would require schools to answer “truthfully and completely” when parents ask about their child’s gender expression. (Porter, 3/16)

AP: Kentucky Senate Passes Bill To Legalize Medical Marijuana 
The Kentucky Senate voted Thursday to legalize medical marijuana in the state, delivering a breakthrough endorsement after years of resisting access to cannabis for people suffering from a series of debilitating illnesses. The measure was passed by the Senate on a 26-11 vote, sending it the House, which has supported medical cannabis measures in the past. Republicans have supermajorities in both chambers. (Schreiner, 3/17)

AP: Military Moves To Cut Suicides, But Defers Action On Guns 
Defense Secretary Lloyd Austin ordered a number of improvements in access to mental health care on Thursday to reduce suicides in the military, but held off on endorsing more controversial recommendations to restrict gun and ammunition purchases by young troops, sending them to another panel for study. An independent committee in late February recommended that the Defense Department implement a series of gun safety measures, including waiting periods for the purchase of firearms and ammunition by service members on military property and raising the minimum age for service members to buy guns and ammunition to 25. (Copp and Baldor, 3/17)

The Washington Post: Narcan Over-The-Counter Cost May Be Too High To Curb Drug Deaths, Experts Say
Before month’s end, federal regulators are poised to allow over-the-counter sale of a nasal spray that reverses the potentially lethal effects of an opioid overdose. ... “It’s a step in the right direction but I don’t think it’s enough,” said Colin Miller, a co-founder of the Twin City Harm Reduction Collective, which hands out sterile needles and anti-overdose medicines to drug users in Winston-Salem, N.C. “No drug user is going into a pharmacy and paying $47 a kit.” (Ovalle, 3/16)

The Washington Post: Lunchables In School Cafeterias Have Child Nutrition Experts Concerned 
Kraft Heinz, the company that makes them, has developed two styles of Lunchables that meet the federal nutritional guidelines set out for the National School Lunch Program, which provides meals to nearly 30 million kids across the country. The company says the two offerings — turkey and cheese, as well as pizza — are distinct from the products sold in grocery stores, retooled to increase the serving size and reduce saturated fats and sodium. (Heil, 3/16)

The Washington Post: Here Are The Worst Cities In The U.S. For Allergies 
A report released Wednesday by the nonprofit Asthma and Allergy Foundation of America revealed last year’s U.S. “allergy capitals.” These were the most challenging places to live for those with pollen allergies. The rankings were based on pollen counts and took into account use of over-the-counter medication and the number of allergy physicians in the area. ... The most difficult spot to live with allergies last year was Wichita, according to the report, followed by Dallas; Scranton, Pa.; Oklahoma City; and Tulsa to round out the Top 5 locations. Seven cities in the Top 20 were in Florida. (Patel, 3/16)

The New York Times: Babesiosis, A Tick-Borne Disease, Is On The Rise In The Northeast, C.D.C. Reports
Cases of a tick-borne disease, called babesiosis, more than doubled in some Northeastern states between 2011 and 2019, researchers from the Centers for Disease Control and Prevention reported on Thursday. Although many people with babesiosis are asymptomatic, others develop flulike symptoms, including fevers, chills, sweats and muscle aches. The disease can be severe or even fatal in people who have compromised immune systems or other risk factors. (Anthes, 3/16)

NBC News: Having A Pet May Take A Toll On Your Sleep, Study Suggests
Your beloved pet may be hurting your sleep, research published Thursday finds. Though pets can have many positive effects on health, pet ownership was linked with poorer sleep, according to the study published in the journal Human-Animal Interactions. (Sullivan, 3/16)

The Washington Post: 5-Minute Breathing Exercises Can Improve Your Mood And Reduce Anxiety 
A study in Cell Reports Medicine showed that just five minutes of breathwork each day for about a month could improve mood and reduce anxiety — and these benefits may be larger than from mindfulness meditation for the same amount of time. (Sima, 3/16)

Stat: Polio Cases Derived From New Oral Vaccine Reported For First Time
Experts have long understood that a new polio vaccine developed to try to minimize the risks associated with the oral polio vaccine made by Albert Sabin might also cause the problem it was created to sidestep. It’s now clear that theoretical risk is a real one. The Global Polio Eradication Initiative announced Thursday that six children in the Democratic Republic of the Congo and one in Burundi have been paralyzed by viruses from the new vaccine, which is referred to as novel oral polio vaccine, or nOPV2. (Branswell, 3/16)

CIDRAP: WHO Reports Mpox Decline In Most Regions, But More Deaths
In an update covering the past 2 weeks, the World Health Organization (WHO) said today that it has received reports of 323 new mpox cases and 11 more deaths. Cases are slowly declining in most regions but with no clear downward trend in Africa, where the virus spreads with a mixed pattern of both human-to-human and zoonotic spillovers. Outside of Africa, countries continue to report sporadic cases and small clusters. (Schnirring, 3/16)