Good morning! There are two impending deadlines weighing on my mind this week: We’ve got exactly two weeks until the presidential election, and 12 days until daylight savings time ends here in Boston.
Philly hospitals stop using race-adjusted algorithms
A coalition of 12 Philadelphia-area health systems announced yesterday that its members have abandoned the use of race adjustments in four clinical tools commonly used to guide care, a move that health leaders say will improve treatment and prevent delays in diagnosis for Black, Hispanic, and Asian patients. The inclusion of race in dozens of these tools has sparked vigorous debates since 2020, when many clinicians began pointing out that the tools rely on faulty science that depicts race as biological, and that they can harm already marginalized patients by making them seem healthier than they really are.
Many health systems are grappling with this issue, which was the focus of a recent investigation, Embedded Bias, from STAT’s Usha Lee McFarling and Katie Palmer. The work in Philadelphia started last year when Seun Ross, a family nurse practitioner and executive director of health equity at Independence Blue Cross, said she realized that outdated notions about race needed to be removed from clinical tools. Read more on how the Philadelphia hospitals did it.
Clinicians can now ID as nonbinary in hospital systems. Are they doing it?
The National Provider Identifier system assigns health care providers unique numbers that identify them for transactions like insurance claims and prescriptions. In April of this year, the system added two options for gender, in addition to “male” and “female,” that providers could choose along with their identifier: “unspecified or another gender identity” and “undisclosed.” Out of almost 127,000 clinicians who registered for their identifier in the first three months with the new options, 941, or 0.7%, selected either, according to a study published yesterday in JAMA.
Recent data shows that about 1% of US adults are transgender, so overall, those numbers track. But researchers who analyzed the data also found that clinicians in states with negative gender policy environments were half as likely to choose these two options as compared to those in more progressive states. It’s one more piece of evidence about the effects of restrictive legislation around the rights of transgender people.
White House proposes free OTC birth control
The White House proposed new rules yesterday that would require most health insurers to completely cover the cost of over-the-counter contraceptives like birth control pills, condoms, and Plan B. The rule would also require plans to cover more birth control choices overall, like a wider array of pills and IUDs.
Could this get costly for insurers? “This is NOT likely to be an expensive program at all,” Howard Forman, a professor at Yale School of Medicine and School of Management, wrote in an email to STAT. The individual costs of contraceptives would likely decrease over time with competition, he wrote. And of course the cost of paying for the medication could be offset by a reduction in doctor’s visits and other procedures — like giving birth.
The proposal comes just two weeks before the presidential election, at a time when millions of people still struggle to access contraceptives. Access to reproductive care has been a key part of Vice President Kamala Harris’s campaign.
Senators cite STAT in probing letters to pharma companies
A group of senators led by Sen. Richard Durbin sent letters to Pfizer and Eli Lilly demanding answers about the telehealth prescribers they point patients to from their websites, seeking to determine whether the pharma giants are violating the federal anti-kickback statute. Letters sent to the companies were co-signed by Sens. Bernie Sanders, Elizabeth Warren, and Peter Welch.
This year, both Pfizer and Eli Lilly launched websites that allow users to learn about their medications, follow links to “talk to a doctor now,” and fill their prescriptions through an online pharmacy. “We’re driving prescriptions,” said Jeffrey Erb, the co-founder of one of Pfizer’s telehealth partners Populus, in a STAT story that the senators cite in their letter to Pfizer.
Read more in the latest from STAT’s Katie Palmer about the specific questions that senators have for pharma.
In 2024, fewer cholera cases than last year but a spike in deaths
From the beginning of this year to the end of September, there were 439,724 cases of cholera worldwide and 3,432 deaths, WHO announced Friday. The number of cases is 16% lower than last year, but there’s been a 126% spike in deaths.
The increase in deaths may have to do with where the outbreaks have occurred this year, according to the organization — areas affected by conflict and compromised access to health care, hit with massive flooding, or with inadequate medical facilities. Countries particularly struck by the disease include Afghanistan, Sudan, the Democratic Republic of the Congo, and Nigeria.
And there’s one other challenge to note: As of Oct. 14, the global stockpile of cholera vaccine is depleted with no remaining doses available, per WHO. More doses are expected in the coming weeks.
Should PCPs perform abortions?
To be clear: In many places, it’s already happening. Family physicians are currently the second-most common providers of abortion care in the U.S., providing 17% of medication abortions and 7% of procedural abortions. They’re also one of the largest groups of active physicians, and in rural areas, they’re often the only physicians.
In a First Opinion essay, a family physician and OB/GYN argue together that PCPs are in a prime position to provide comprehensive, widespread abortion care. Currently, one in five patients travels out of state to get abortion care. But decades of research show that primary care physicians can provide abortion care safely and effectively, in familiar office settings and with more personalized care. Read more.
What we’re reading
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Survey of trans youth reports high satisfaction with gender-affirming care, Washington Post
- Behind CVS CEO’s ouster, a question: Do a pharmacy and a health insurer make sense together? STAT
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The perverse consequences of tuition-free medical school, Atlantic
- Pharma execs donated more to Democrats in campaign’s final stretch, STAT
- Under a LA freeway, a psychiatric rescue mission, New York Times
- Forcing presidents and candidates to share their medical history is a terrible idea, STAT