Paying for your mistakes
Lupa raised Romulus and Remus, now we can't figure out healthcare
As in Lupa, the she-wolf who nursed Romulus and Remus (Rome’s co-founders). NOT the Italian restaurant in the Village. Please tell me you know this.
Last week’s healthcare letter is late! We cover a proposed bill that I think is a good idea and an old policy with room for improvement. We supplement this with the latest J&J talc settlement, an MDMA update, raw milk, and AI for suicide risk detection. As usual…..it’s 3AM.
GOOD LEGISLATION PROPOSAL
Biden says that medical debt is fake…kind of (KFF)
Y’all. I’m going to be so real with you. I may or may not have always thought medical debt didn’t impact your credit score. This could be because some credit bureaus were already excluding these debts voluntarily. Now, Biden wants to make that official. The bill won’t erase your medical debt, but it’ll stop it from trashing your financial future. This shows I had my finger on the pulse and my eye to the future.
POLICY WITH ROOM FOR IMPROVEMENT
I’m going to apologize right off the bat. I’ve never played baseball, cricket, or whatever that reference is from, but this is about the 340B Drug Pricing Program. She’s (340B, and me) a 90’s girl, in effect since 1992 to protect safety-net hospitals. AKA hospitals that ensure everyone gets care, whether insured or not (for underserved and low-income populations). But it’s become a double-edged sword.
How many times have you acted in good faith, for it to backfire? The 340B drug program aims for specific hospitals to buy drugs at lower prices, deliver them to patients, and invest savings into better care. Under the 340B program, drug manufacturers must offer discounts to these hospitals, at a much lower rate than the average actual drug price so long as these hospitals keep accurate records and use the drugs for specific patients. This was meant to be a win for public health. However, the program is complex and poorly regulated. Some hospitals work with contract pharmacies/pharmacy benefit managers (PBMs). Thus, savings don’t trickle down to the patients. Instead, it amplifies disparities in access to care. We hate this Reganomics song! This yields unintended financial drawbacks for pharma companies and hurts patient access while boosting hospital and PBMs. Existing evidence questions whether 340B hospitals are reinvesting funds to help patients.
So how do we fix it?
Refined criteria and definition for eligibility
Stricter oversight, transparency, and accountability from 340B-covered hospitals (e.g., data capture and reporting requirements)
Ensuring that benefits and savings reach low-income and vulnerable populations
The 340B ACCESS Act aims to tackle these issues.
J&J is paying up but disagrees with carcinogenic accusations (Reuters)
Fresh off the press: J&J has settled one of its “talc-causes-cancer” challenges, agreeing to pay $700M to the states alleging J&J misled talc consumers into thinking the product was safe. But they still face other lawsuits. They’ve stopped selling talc baby powder altogether, which seems prudent.
Update on last week’s molly submission for PTSD review (NY Times)
Ahead of their advisory panel, the FDA review committee raised concerns about data quality and whether treatment risks would offset treatment benefits for people living with PTSD. Most members of the advisory panel opted against approving the drug. The FDA tends to accept advisory panel outcomes; likely, the drug will not be approved as is. I’m curious about what exactly happened here. All companies running clinical trials know the type of data they need to collect. Unless they’re not engaging the FDA in early phases? Not recommended! It seems that Lykos did seek feedback early on, but didn’t capture all the information the FDA needed. This is not a step back for psychedelics, merely information to learn from. Capture good quality, accurate data. Engage your stakeholders early and often. Ask clarifying questions. I also imagine the FDA is learning from this.
Louisiana added raw milk to its “IN” list in 2024 (Axios)
Last week I shared that Louisiana wants to ban abortion altogether. Do you know what they wish to legalize? Raw milk! I’m not against raw milk. I love buying raw milk cheese from my NoLiTa French-subsidized cheese monger (yes, I know I have access to All The Raw Milk Cheese in France, but I’m less into it when it doesn’t feel clandestine). Yet buying raw milk in the Land of the Free amidst an avian flu outbreak in dairy cows feels…dense. If you’re not convinced, the LA Times reported that cats who drank milk from avian flu-infected cows lost their eyesight and endured neurological symptoms. I’d never tell you what to do, sweetie.
“Noo don't kill yourself your too sexy aha” - AI, maybe? (Fierce Healthcare)
NeuroFlow, a behavioral health tech company, published results from its study testing natural language processing software on journal prompts. They found that they could flag 58% of patients with possible suicidal ideations that could have otherwise flown under the radar. This is so cool, I love seeing practical healthcare use cases for AI that may save lives. AI won’t replace validated assessments and screeners for depression and suicidal ideations (e.g., PHQ9), but it can help supplement in cases where people may not have access to quality psychiatric and mental health care and/or rural communities.
xxsem