New Medicare drug prices, antimicrobial-resistant meningitis, unlucky American women

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Almost exactly two years ago, the Inflation Reduction Act was signed into law, allowing Medicare to negotiate drug prices for the first time. Today, the agency announced how much it lowered the costs for 10 drugs in the first year of negotiation. Our incomparable DC team gives news and analysis here and examines the implications for the presidential campaign.

Arthritis patients on Medicare are getting cornered on treatment

One rheumatologist calls it the “birthday story.”  Someone with arthritis has been stable for years taking Humira, an injection that they can self-administer at home. Then they turn 65. When people switch from private health insurance to Medicare, certain medications become unaffordable overnight due to the way the program structures its pricing of at-home prescription drugs. One patient, Linda Kaser, learned her pills would cost more than $4,000 a month after she turned 65. If an arthritis patient wants to avoid a cost increase, the only workaround is to switch treatments to regular, hour-plus-long visits to a hospital or infusion center for intravenous drug treatments.

As many as 40,000 chronically ill seniors are choosing to endure these uncomfortable, time-consuming infusions because Medicare doesn’t sufficiently cover far more convenient treatments. Read more on how the opaque drug pricing process leads patients to choose this lackluster hack.

NY tells providers to stop using ciprofloxacin for meningitis

An increase in antimicrobial resistance has led the New York State Department of Health to issue an advisory to health care providers to stop using the antibiotic ciprofloxacin for patients who may have been in contact with someone who has meningococcal disease (aka meningitis). Instead, providers should use the other first-line antibiotic medications, rifampin and ceftriaxone, as prophylactic treatment.

Meningitis is a rare but serious condition that can cause brain swelling or blood and joint infections. About 10-15% of cases in the U.S. are fatal, and it’s critical for people who may have been exposed to the disease to start antibiotic treatment. Last year, four out of 20 cases of the disease in the state (but outside NYC) were found to be resistant to ciprofloxacin. In the city, six of 25 cases since last summer were resistant.

(It’s always a good idea to keep up with STAT’s coverage of antibiotics.)

WHO declares mpox a global health emergency

The WHO declared a public health emergency of international concern yesterday regarding the outbreak of mpox in multiple African countries. This is the second time the agency has made such a declaration in two years in response to the transmission of this virus.

What does this mean, you might be asking?  A public health emergency of international concern (PHEIC) can be called when the risk of cross-border spread is considered high, and international cooperation will likely be needed to contain the threat. Here, cross-border transmission of mpox has already occurred multiple times. The declaration also gives the WHO director-general the authority to issue what are known as temporary recommendations — guidance to countries on steps they should take to address the problem. Read more from STAT’s Helen Branswell.

Is HHS climate washing? (What is climate washing?)

The Department of Health and Human Services has stated it will do all that it can to mitigate the health care industry’s greenhouse gas emissions. But in a new First Opinion essay, health care consultant David Introcaso argues that the agency is actually just “climate washing.”

If the term is unfamiliar to you, climate washing is basically when a government or company simultaneously engages in positive communications about climate performance and negative climate practices.

Introcaso comes with evidence: Three years ago, HHS established the Office of Climate Change and Health Equity (OCCHE). But so far, OCCHE has done nothing regulatorily to mitigate health care emissions. And since the office’s inception, HHS Secretary Xavier Becerra has never argued for funding it in congressional budget testimony.

Read more on whether the agency is putting enough of its money where its mouth is on climate change.

How does women’s health care in the U.S. stack up to other nations?

You may not like this answer, but women in the U.S. have worse health care access and outcomes than those living in 13 other high-income nations like Australia, Canada, Japan, and South Korea, according to a new study from the Commonwealth Fund. What outcomes? Oh, you know, like life expectancy, “avoidable deaths,” and mental health. Here are some highlights:

• Women in the U.S. have the lowest life expectancy and the highest rate of avoidable deaths. If prevention measures had been in place or the right treatment had been provided, 70 out of every 100,000 women who die in the U.S. could live. This rate is more than three times the rate of avoidable death in South Korea.
• All 13 other countries in the analysis provide some form of government health care coverage to all residents. None have a substantial portion of people who are uninsured. In the U.S. last year, 14% of women ages 19-64 said they were uninsured, including more than a quarter of Hispanic women.
• The U.S. and Australia are the two countries where women most often report having a mental health care need. But they’re also the two countries where women are most likely to skip getting mental health services due to the cost. One in four women in each country reported skipping mental health care. (At least we aren’t alone on this one?)

How one ALS patient used a brain-computer interface at home for seven years

Brain-computer interfaces won’t be available to the general public anytime soon. For now, disabled people are the first ones to test-drive new technology like this. It can help people who have been paralyzed to communicate, and could prove particularly fruitful for ALS patients as their eye muscle control wanes, leading eye-gaze devices to lose utility.

Mariska Vansteensel is a neuroscientist who has spent most of the last decade experimenting with BCI at-home use. Her team followed one ALS patient who used such a device for more than seven years. When the study began, nobody with motor impairment had ever tried to use a BCI implant at their home, she told STAT’s Timmy Broderick. The team found that the person’s usage of the BCI increased as time passed and paralysis increased.

Read Timmy’s interview with Vansteensel about what her team learned after observing almost a decade of real-world BCI use.

What we’re reading

• The veterinarians preventing the next pandemic, The New Yorker
• They all got mysterious brain diseases. They’re fighting to learn why, New York Times
• Can AI help ease medicine’s empathy problem? STAT
• WHO to scrap weak PFAS drinking water guidelines after alleged corruption, The Guardian
• Surgeons cut a giant tumor out of my head. Is there a better way? Bloomberg