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Good morning! And happy St. Patrick’s Day. I grew up on the south shore of Boston, around what some call an “Irish riviera” — an area with a high proportion of families with Irish heritage, mine included. Yet somehow, I’ve never been to the city’s St. Patrick’s Day parade.
Dr. Oz says there’s a new sheriff in town (him)
Mehmet Oz used to breathlessly tout private Medicare plans — both on his popular daytime TV show and in the years that followed. But on Friday, the former surgeon and nominee to lead CMS pledged with equal enthusiasm to crack down on widespread fraud within the program.
“Part of this is just recognizing there is a new sheriff in town,” Oz said at a hearing before the Senate Finance Committee. “We actually have to go after places and areas where we’re not managing the American people’s money well.”
Before the hearing, Oz hadn’t spoken much about pressing health policy issues since he was nominated for the crucial post. Read Tara Bannow’s recap of the hearing, which includes details about the most specific policy idea that Oz floated, as well as a recounting of his charm offensive with various senators.
Should measles vaccine recs be updated?
A group of physicians including former CDC director Rochelle Walensky argued in JAMA on Friday that national recommendations for the measles, mumps, and rubella vaccine should be updated to include a third dose (two is standard) for infants 6 to 11 months old who are traveling to any region with a higher probability of measles exposure — something that local and state jurisdictions have already begun to do.
There have been 259 confirmed cases of measles in the West Texas outbreak so far, and at least one death. As the virus continues to spread, vaccinations seem to be the subject of more political contention than ever. Health secretary Robert F. Kennedy Jr. is mincing words around the outbreak and the scientifically-proven vaccine. Trump’s nominee to lead the CDC, Dave Weldon, lost the gig before he even arrived at the hearing last Thursday, due to concerns about his views on vaccines.
A cost-benefit analysis of GLP-1s
We’ve heard about the seemingly endless health benefits of GLP-1 medications like Ozempic and Wegovy. But we’ve also heard a lot about the high costs of the drugs. According to an analysis published Friday in JAMA Health Forum, in order to be cost-effective, the price of tirzepatide would need to go down by 30% from the current estimated annual net price, while the price of semaglutide needs to drop by 82%.
The analysis — which drew data from national surveys of more than 4,800 people eligible for clinical trials of weight loss medications — projected that the drugs could reduce cases of both diabetes and cardiovascular disease long-term. But at the current prices of around $6,200 and $8,400 per year for tirzepatide and semaglutide respectively, the drugs cost far more than the threshold researchers set of $100,000 for every “quality-adjusted life-year,” which is basically academic-speak for each year of good health the medications could add to your life.
It’s possible that the price of semaglutide could be selected for Medicare price negotiation as soon as 2027, the authors note, which could help to bring the cost down. But they called for more policy solutions to increase the availability of generic versions, and cautioned against the unproven safety or efficacy of compounded versions.
‘Everyone is on edge’ at NIH
After two months of stress, uncertainty, shifting funding policies, communications and travel, firings and, in some cases, rehirings, more upheaval is on the horizon for the NIH. Like at other federal agencies, employees have been offered $25,000 buyouts and early retirement. They had until 5:00 p.m. Friday to express interest in those offers. On top of that, the agency is expected to cut between 3,400 and 5,000 positions from its workforce of 20,000 in the coming days.
“Nobody feels like their job is safe,” said Kim Hasenkrug, an NIH scientist emeritus. “Even the top people can’t keep track because they’re hiring and firing so much.” Read more about the mood inside the agency from a great team of STAT reporters.
How to make overdose medication available in a crisis
Strategically placing naloxone kits at transit locations is the best way to make sure that people experiencing an overdose can be treated in time with the lifesaving medication, according to a study published today in the Canadian Medical Association Journal. Researchers analyzed more than 14,000 overdoses in the Vancouver area between 2014 and 2020, finding that the best approach for policymakers involves putting these narcan kits around public transit — and finding those spots by using mathematical optimization models like those used to place AEDs.
Imagine, just like the AEDs placed all around us to treat people in cardiac arrest, a Narcan kit placed on the outside of a building with clear signage. In the U.S., researchers have previously proposed a similar approach, but there is no federally-mandated access to the medication.
Vancouver also has almost 650 existing programs that offer take-home naloxone, most often utilized by people who may be bystanders to an overdose in the future. The researchers noted that making blankets available at those locations, in combination with publicly available Narcan, helped address a major proportion of overdoses in the city.
An NGO director on the ‘devastating’ USAID shutoff
On the first day of his presidency, Donald Trump issued an executive order calling for a pause on funding and disbursement of all foreign aid. By the end of January, hundreds of staffers at the U.S. Agency for International Development had been let go. Last week, the administration announced that 83% of USAID programs had been terminated.
It might be hard to comprehend the effects of all this, if you live in the U.S. In a new First Opinion essay, Jeffrey Okoro, the executive director of an NGO in Kenya, details how the sudden dismantling of the agency has affected the people in his community: “In an instant, more than 1,000 patients at my health care clinic outside Nairobi lost access to lifesaving HIV treatments. Thousands more could no longer receive treatment for tuberculosis or contraception that prevents teenage pregnancies, hurting the well-being of our communities and threatening the progress we’ve made in their medical care.” Read more.
What we’re reading
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Her research grant mentioned ‘hesitancy.’ Now her funding is gone, Washington Post
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An agoraphobe goes to the grocery store, New York Times
- RFK Jr.’s regenerative medicine roundtable on stem cell deregulation raises red flags, STAT
- Generation Xanax: The dark side of America’s wonder drug, Wall Street Journal
- New Stanford tool evaluates AI models on tasks that actually matter in health care, STAT