First Edition: Oct. 17, 2023

KFF Health News: For People With Sickle Cell Disease, ERs Can Mean Life-Threatening Waits 
Heather Avant always dresses up when she goes to the emergency room. “I’ve been conditioned to act and behave in a very specific way,” said Avant. “I try to do my hair. I make sure I shower, have nice clothes. Sometimes I put on my University of Michigan shirt.” It’s a strategy to combat discrimination the 42-year-old photographer in Mesquite, Texas, has developed over a lifetime of managing her sickle cell disease, a rare blood disorder that affects an estimated 100,000 Americans. The hereditary condition can affect a person of any race or ethnicity, but Black patients, like Avant, make up the majority of those afflicted in the U.S. (Hutchinson, 10/17)

KFF Health News: Michigan Voters Backed Abortion Rights. Now Democrats Want To Go Further. 
Nearly every day, Halley Crissman and her physician colleagues in Michigan must tell patients seeking abortions they’re very sorry that they can’t proceed with their scheduled appointments. “Patients tell me, ‘Doctor, why are you stopping me from getting the care that I need?’” said Crissman, an OB-GYN who provides abortions as part of her practice and is also an assistant professor at the University of Michigan. “The answer is that Prop 3 made access to abortion care a right in Michigan. But these [other] laws remain on the books.” (Wells, 10/17)

The New York Times: Scientists Offer A New Explanation For Long Covid
A team of scientists is proposing a new explanation for some cases of long Covid, based on their findings that serotonin levels were lower in people with the complex condition. In their study, published on Monday in the journal Cell, researchers at the University of Pennsylvania suggest that serotonin reduction is triggered by remnants of the virus lingering in the gut. Depleted serotonin could especially explain memory problems and some neurological and cognitive symptoms of long Covid, they say. (Belluck, 10/16)

Stat: Serotonin Levels Are Depleted In Long Covid Patients, Study Says, Pointing To A Potential Cause For ‘Brain Fog’
If you’ve been following the mystery of long Covid since it emerged in 2020, you’ll recall interferons and serotonin have been clues from the start as combatants in the body’s prolonged battles against the virus. Theories about why symptoms persist long after the acute infection has cleared often point to two suspects: viral reservoirs where SARS-CoV-2 lingers and inflammation sparked by the infection that doesn’t subside. (Cooney, 10/16)

Bloomberg: Prozac Has Potential To Treat Long Covid’s Body-Wide Symptoms, Study Finds
Covid may trigger complex biological reactions from the bowel to the brain, leading to persistent neurological symptoms in some people, according to a study that points the way toward a treatment. Viral vestiges in the gastrointestinal tracts of a subset of long-Covid patients may drive chronic inflammation that interferes with a key chemical messenger involved in nerve activity, brain function and memory, researchers at the University of Pennsylvania reported Monday in the journal Cell. (Gale, 10/16)

CNN: Price Of Lifesaving Covid-19 Antiviral Paxlovid Expected To Rise Next Year, Raising Concerns About Access
The price of the lifesaving Covid-19 medication Paxlovid is likely to rise next year for most patients as the United States continues to transition out of the emergency phase of the pandemic, sparking concerns among doctors that it will become less accessible. ... The new price – the cost before insurance – hasn’t been set but is expected to be higher than the $530-per-course price paid by the US government. (Tirrell, 10/16)

Pennlive.com: PGA Tour Winner Has Died Due To Complications From COVID-19: Reports
Former PGA tour winner Andy Bean died over the weekend after reportedly suffering from complications from COVID-19. According to reports, Bean, 70, had to have a double-lung transplant in September do to the damage the virus related damage. Bean was an 11-time PGA Tour winner and was a runner up in majors three times. He was the winner of the 1986 Byron Nelson Classic. (Linder, 10/17)

NBC News: Covid, Flu, RSV Vaccines Urged During Pregnancy But Fewer Want Them, CDC Finds
"We are meeting more resistance than I ever remember," said Dr. Neil Silverman, a maternal-fetal medicine specialist at UCLA Health. "We didn't get this kind of pushback on this scale before the pandemic." "Now all vaccines are lumped together as 'bad,'" he said. ... However, a recent CDC report found growing doubts about vaccination during pregnancy. Among almost 2,000 women who were pregnant during the height of last year's cold and flu season or when the survey was conducted in March and April, almost a quarter said they were "very hesitant" about getting a flu shot. (Edwards and Weaver, 10/17)

NPR: Medicare Shoppers Often Face A Barrage Of Unsolicited Calls And Aggressive Ads
One minute last December Leslie Montgomery was a medieval warlord pillaging a nearby kingdom. The next she was a retiree drowning in a flood of confusing Medicare sales calls. The 75-year-old had been deeply immersed in her favorite free online game when a banner ad appeared warning her that she might be missing out on money from the federal government. She clicked, and within minutes, she received an avalanche of calls with health insurance quotes she had never requested. ( Walker and Gorenstein, 10/16)

Modern Healthcare: Aetna, Humana See Medicare Advantage Star Rating Boosts
In the aftermath of unwelcome but not surprising news for the health insurance industry about Medicare Advantage star ratings for next year, insurers cited stricter government standards as they look to move forward. On Friday, the Centers for Medicare and Medicaid Services revealed which Medicare Advantage plans earned four or five stars under the quality assessment program and confirmed months of anxiety among health insurers that expected lower scores—and the revenue hits that come from losing lucrative bonus payments. (Tepper, 10/16)

The New York Times: F.D.A. Plans To Ban Hair Straighteners With Formaldehyde 
The Food and Drug Administration has proposed banning hair-straightening products that contain or emit formaldehyde, more than a decade after the cosmetic industry’s own experts declared the products unsafe. Frequent use of chemical hair straighteners has been linked to a possible increase in the risk of developing cancer of the uterus, which is also called endometrial cancer. Women who use the products often face more than twice the risk of those who do not. (Rabin and Jewett, 10/16)

CNN: FDA Takes ‘Momentous’ Step Toward Banning Menthol Cigarettes And Flavored Cigars
The US Food and Drug Administration took a “momentous” step Monday toward banning menthol in cigarettes and banning flavored cigars, proposing a rule that public health experts say could save hundreds of thousands of lives. (Christensen, 10/16)

Stat: White House Moves Closer To A Ban On Menthol Cigarettes
The tobacco industry has already made clear its distaste for the ban, and its plans to sue if the ban is ever formalized. When the proposal was first released in draft form, Altria, the parent company of Marlboro cigarette maker Philip Morris USA, wrote that the policy would “create unregulated, illegal markets, encourage criminal activity, and threaten the integrity of the regulatory system,” “eliminate billions of dollars in tax revenues,” and “lead to the loss of thousands of jobs.” The proposal “​​would fail legal scrutiny if finalized,” the company added. (Florko, 10/16)

MedPage Today: Abortion Info Buried On Many Hospitals' Websites, Study Shows 
Hospitals and their health systems are not advertising abortion in a way that is consistent with other common outpatient procedures, a cross-sectional observational study of U.S. hospital websites showed. Of the 222 patient-facing websites sampled, 79.4% did not mention abortion, while only 11.1% did not mention colonoscopy, reported Ari Friedman, MD, PhD, of the University of Pennsylvania Perelman School of Medicine in Philadelphia, and co-authors. Websites described offering abortion care 6.3% of the time compared with 85.6% for colonoscopy, they noted in the Annals of Internal Medicine. (Robertson, 10/16)

Stat: Measuring The Long-Term Cost Of Restricting Abortion Access
When Diana Greene Foster and her team at the University of California, San Francisco, started their study on the lives of women who were denied abortions in 2008, they sought to investigate a rather commonly held view: That having an abortion hurt women’s mental and physical health, including by leading to PTSD and drug and alcohol use disorder. (Merelli, 10/17)

Modern Healthcare: Rite Aid Bankruptcy Could Mean Pivot Into Healthcare Services
As Rite Aid seeks Chapter 11 bankruptcy protection, some industry watchers say the company's restructuring plans could be an opportunity for big strategy changes. Rite Aid filed for bankruptcy Sunday after being unable to resolve financial woes and opioid-related lawsuits. It has shuttered hundreds of stores in recent years and is expected to close more. Rite Aid also is selling pharmacy benefit manager Elixir Solutions to MedImpact, another PBM, for $575 million. (Hudson, 10/16)

NBC News: What Rite Aid's Bankruptcy Means For Local Retail Pharmacies
Drugstores have done the wrong thing over and over again, said Neil Saunders, the managing director at the consulting company GlobalData. The result is that people don't want to shop at them, and that has made lots of openings for competitors. ... "They've shot themselves in the foot, and now they're reaping the consequences of all those years of poor decisions and underinvestment.” ... "We're still going to have a physical pharmacy retail space, but it's going to be somewhat smaller than it has been traditionally," he said. (Jay, 10/17)

CNN: Why CVS, Walgreens And Rite Aid Are Closing Thousands Of Stores 
Drugstore chains for decades saturated US cities, suburbs and small towns with new stores. Now, they are closing thousands of stores, leaving gaps in communities for medicines and essentials. Researchers find pharmacy closures lead to health risks such as older adults failing to take medication. (Meyersohn, 10/17)

Stat: Teva Sues Colorado Over Plan To Lower Cost Of Epinephrine Injectors
In the latest tussle over the cost of medicines, Teva Pharmaceuticals has filed a lawsuit alleging that a new Colorado program aimed at making epinephrine auto-injectors more affordable violates its constitutional rights. (Silverman, 10/16)

Modern Healthcare: Independent Pharmacies Target PBMs, DIR Fees Through LLC
Independent drugstores are opening up a new front in their battle against pharmacy benefit managers. The National Community Pharmacists Association, which represents more than 19,400 pharmacies, has formed a limited liability company that aims to recover direct and indirect remuneration fees from PBMs. (Berryman, 10/16)

Modern Healthcare: Prior Authorization Cuts From Cigna, UnitedHealth Meet Skepticism
Providers are lobbying Congress, investing in new technologies and renegotiating contracts with insurers in response to rising prior authorization demands—despite of some of the largest carriers promising to cut back on preapproval rules. Their tactics highlight provider skepticism of moves by UnitedHealth Group, Cigna, Blue Cross Blue Shield of Michigan and other insurers to lift some precertification requirements. Providers question whether these new policies will actually reduce administrative burden or if insurers are mostly engaged in a public relations campaign to forestall government intervention. (Tepper, 10/16)

Modern Healthcare: Healthcare Professionals Fleeing Industry, New Data Show
More than 145,000 healthcare practitioners left the industry from 2021 through 2022, threatening access and quality, according to a report published Monday. Physicians accounted for roughly half of the healthcare workers who retired or changed professions over the two-year span, according to an analysis of all-payer claims data from Definitive Healthcare, a healthcare commercial intelligence company. More than 71,000 physicians left the workforce from 2021 to 2022. (Kacik, 10/16)

Stat: Is There Really A Nursing Shortage In The U.S.? 
Hospitals are frustrated with a nationwide nursing shortage that’s only gotten worse since the pandemic. In 2022, the American Hospital Association quoted an estimate that half a million nurses would leave the field by the end of that year, bringing the total shortage to 1.1 million. At the same time, National Nurses United insists there isn’t a nurse shortage at all. There are plenty enough nurses for the country, they say — merely a shortage of nurses who want to work under current conditions. (Trang, 10/16)

Reuters: Merck's Keytruda Gets FDA Nod For Expanded Use In Lung Cancer 
The U.S. Food and Drug Administration on Monday approved the expanded use of Merck & Co's blockbuster immunotherapy Keytruda in early-stage patients with non-small cell lung cancer who can get their tumors removed surgically. The U.S. health regulator's approval extends Keytruda's use in combination with chemotherapy as a treatment given before surgery to shrink the size of the tumor in patients. (10/16)

Reuters: Deadly Indonesian Cough Syrup Was Almost Pure Toxin, Court Papers Show
An Indonesian drugmaker whose cough syrup is among products linked to the deaths of more than 200 children last year used ingredients with toxin concentrations of up to 99% in 70 batches of medicine, prosecutors said in a court filing. The accusations against drugmaker Afi Farma were made in a court in Kediri, in the province of East Java, where the company is based, and Reuters is the first to report the charge that it used highly toxic ingredients. (Widianto, 10/15)

Stat: FDA’S Warning To J&J’s Abiomed Signals A Crackdown On Digital Health Tools
The Food and Drug Administration is following through on its promise to regulate more health software tools, starting with a public reprimand of Johnson & Johnson’s heart pump company, Abiomed. (Lawrence, 10/16)

Stat: Will Ozempic-Type Obesity Drugs Pay Off For Society? Makers Say Yes
Here at ObesityWeek, one of the largest conferences on obesity, Novo Nordisk and Eli Lilly are displaying more than a dozen studies that together carry the message: Our blockbuster weight loss treatments will be worth it for society. (Chen, 10/17)

Stat: Studies Point To Risks Of Excluding People With Obesity From Drug Trials
People with obesity often go underrepresented in drug development trials, a critical gap that researchers say leaves drugmakers and doctors unsure of efficacy or risks in that patient population. (Nayak, 10/16)

Marin Independent Journal: Marin County To Expand Involuntary Medication Of Jail Inmates
Marin County plans to expand a program that allows medications to be administered to jail inmates against their will. Last fall, the Board of Supervisors allowed court-ordered medications to be given to inmates who have been deemed incompetent to stand trial — without their consent, if necessary. Prior to the authorization, inmates had to remain in jail for months until a bed became available at a state hospital. (Halstead, 10/16)

CIDRAP: Wisconsin, Illinois Confirm Measles Cases
Health departments in two Midwestern states—Wisconsin and Illinois—have reported measles cases, according to official statements. In Wisconsin, Milwaukee’s health department last week reported an infection in a Milwaukee resident who works in Waukesha County. City, county, and state health officials are working to identify people who may have been exposed. Meanwhile, the Illinois Department of Public Health (IDPH) on October 13 announced that a measles infection has been confirmed in Cook County, which includes Chicago. The case is the state’s first since 2019. The patient is unvaccinated and had been exposed during international travel. The patient’s rash began on October 9, and the IDPH said the infectious period likely ranges from October 5 through October 13. (Schnirring, 10/16)

Axios Philadelphia: Philly Mayor Jim Kenney To Sign Order Protecting Gender-Affirming Care 
Mayor Jim Kenney will sign an executive order Tuesday protecting access to gender-affirming health care in Philadelphia. Major medical associations consider such care necessary and potentially lifesaving. (D'Onofrio, 10/16)

Houston Chronicle: Weeks After Texas Eliminated Tampon Tax, Advocates Fight For More Accessibility To Period Products
Dana Marlowe, founder of the nonprofit I Support the Girls, said the next step is providing free menstrual products in all city and state buildings, especially public schools. ... "Period poverty is a public health crisis that people don't like to talk about because periods are considered a taboo topic, and if we aren't willing to fully acknowledge and talk about periods, then we can't help women, girls and menstruators in need live their lives with dignity," Marlowe said. (Garcia, 10/16)

Axios: Life Expectancy Gap In America Widens Depending On College Education
The U.S. is failing less-educated people given the dismal life expectancy prospects they face compared to their more educated peers, researchers said. While the U.S. economy outperforms other countries by metrics such as economic growth and inflation rates, two prominent economists argue the life expectancy gap says otherwise. (Rubin, 10/16)

CBS News: Researchers Discover Genetic Reason Why Some People Live To 100
Centenarians are the fastest-growing age group in America, but why do some people reach this milestone and others fall short? Researchers in Sweden followed 12 blood biomarkers for 35 years in more than 1,200 adults who lived to see their 100th birthday. (Marshall, 10/16)

NPR: Soaring Myopia Among Kids—Too Little Time Outdoors, Too Much Time On Screens
The World Health Organization warns that by 2030, 40% of the world's population will be nearsighted. In the U.S. alone, myopia rates have soared over the past 50 years, from 25% in 1971 to nearly 42% in 2017. Many of these myopia cases are in children—who are going nearsighted at increasingly younger ages. In China, where they specifically track early onset myopia, over 80% of teens and young adults are now nearsighted. (Zomorodi, Monteleone, Meshkinpour, and Faulkner White, 10/17)

NPR: Red Dye 3 Appears In Many Foods Kids Eat. Consumer Advocates Want FDA To Ban It
There's new pressure on the Food and Drug Administration to take action on the synthetic food coloring, red No. 3, after California passed a law to ban it last week. California became the first state to ban four food additives, including red No. 3, and public health advocates are pushing to remove the dye from the food supply nationwide. "I think the passage of the bill in California creates undeniable pressure on the FDA," says Dr. Peter Lurie, president and executive director of the Center for Science in the Public Interest. (Aubrey, 10/16)

Axios: Making Sense Of How Social Factors Shape Children's Health
Children who grow up in different environments tend to have distinct physical health, mental health and cognitive outcomes, according to a new study in JAMA Pediatrics. The study offers a comprehensive view of how dozens of social determinants of health interact with one another and affect a child's development — and also could serve as a guide for policymakers to better target policies to address glaring health disparities. (Owens, 10/17)

AP: Gaza's Limited Water Supply Raises Concerns For Human Health
A lack of clean water in the Gaza Strip is raising major concerns for human health. “Gaza is running out of water, and Gaza is running out of life,” said Philippe Lazzarini, chief of the U.N. agency for Palestinians. Gaza normally gets its water supplies from a combination of sources, including a pipeline from Israel, desalination plants on the Mediterranean Sea and wells. Those supplies were slashed when Israel cut off water, along with the fuel and electricity that power water and sewage plants, in the wake of the Hamas attacks. (Burakoff, 10/16)

Reuters: In Gaza, People Resort To Drinking Salty Water, Garbage Piles Up
As Israeli air strikes pounded the Gaza Strip ahead of an expected ground offensive, the enclave's residents were getting more desperate by the hour as water runs out, garbage piles up, explosions flatten homes and hospitals struggle to cope. Desperate to get some drinking water, some people began digging wells in areas adjacent to the sea or were relying on salty tap water from Gaza's only aquifer, which is contaminated with sewage and seawater. (Al-Mughrabi, 10/16)