AngelMD Friday Roundup – October 20, 2017

The Friday Roundup is a collection of five stories that you need to know about each week. From policy to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

Four Genes Linked to OCD

By searching through three sets of DNA (one human, one canine, and one mouse), researchers have found four genes with the strongest link to OCD ever established.

In the dog and mouse genomes, researchers looked for any gene tied to compulsive behavior. In humans, they focused on genes previously thought to be linked to OCD or Autism, which shares some traits with the disorder.

They found four genes of interest that are active in the cortical-striatal loop in the brain, an area that is hyperactive in those with OCD. The researchers believe that the mutations may be preventing neurons from communicating and a stop mechanism from firing, causing a person to repeat their action, like washing their hands multiple times.

Gilead’s CAR-T Gets FDA Approval

Yescarta, a drug used to treat large B-cell lymphoma in adults, is the second CAR-T drug to be approved, following Novartis’ Kymriah which targets leukemia and was approved in August.

Gilead’s CAR-T will cost only $373,000, over $100,000 less than Kymriah. However, Novartis did indicate that if the treatment is not effective within a month, Medicaid will cover the cost. Both companies argue the price is warranted because of the novel benefits of the drug.

The treatments have varied effectiveness, likely due to the fact that they target different forms of lymphoma, with 83 percent of patients given Kymriah becoming cancer free compared to a 51 percent remission rate for Yescarta.

Creating Accessible Mental Health Treatment

Mental health has long been a public health issues, nearly 20 percent of adults in the United States have a mental illness but due to stigma and access, not all can receive treatment. As a result, some in the tech industry have taken to developing alternatives.

Take Woebot for example. A Facebook Messenger plugin, Woebot was developed at Stanford and acts as a Cognitive Behavioral Therapist by using AI. Woebot checks in on its “patients” daily, and offers them strategies to manage depression, a huge problem for college students (over 50 percent suffer from anxiety or depression), the bot’s main audience.

Just a bit to the south, Gale Lucas, a psychologist at USC’s Institute for Creative Technologies, studied the use of a virtual therapist to conduct the Post-Deployment Health Assessment for veterans. Her research suggests that veterans are more likely to share symptoms of PTSD with virtual interviewer.

“We don’t want to replace therapists,” Lucas said to Wired. “We want to get more therapists to the people who need them.”

No, You Can’t CRISPR an Athlete

The World Doping Agency has extended its 2003 “gene doping” ban and updated the definition to include “gene editing agents designed to alter genome sequences and/or the transcriptional or epigenetic regulation of gene expression.”

Here’s the problem: How will they actually be able to tell? Despite the fact that gene doping was outlawed years ago, the World Doping Agency just started testing athletes – and it’s only for one type of gene therapy. Considering the rate of development of such therapies, the agency has a lot to figure out in terms of regulation.

Emergency Care Visits on the Rise

A study in the Journal of Health Services revealed an interested fact about healthcare in the US – nearly half of medical care occurs in Emergency Rooms. Approximately 47.7 percent of care can be attributed to ERs, highlighting just how important they are in the healthcare delivery system.

Over the 14-year study, they found visits to the emergency rose over 40 percent. They also found that vulnerable groups such as women or African Americans account for more visits, which the research notes could be because of the structure of America’s healthcare system.

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AngelMD Friday Roundup – October 13, 2017

The Friday Roundup is a collection of five stories that you need to know about each week. From policy, to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

Will Your Next Pharmacy Visit Be Virtual?

E-commerce giant Amazon is reportedly still considering selling prescription drugs on its site, with a possible announcement expected in a year or two. Recently, Amazon has made a sprinkling of healthcare hires, oh, and they also have a super secret healthcare lab.

Bezos and his empire were previously tied to pharmacy when he invested in Drugtore.com before it was bought and then subsequently shut down by Walgreens. Like with any other industry Amazon enters, they would be perceived as a potential threat, or “disruptor.” However, selling prescription drugs will be a bit more difficult to implement because of its complicated supply chain.

The Evolution Inside You

Immunologist Gabriel Victora was recently awarded a MacArthur Genius Grant for his research on how cells respond to infection in the body, specifically the evolutionary development of antibodies.

Victora and his team have developed an imaging and modeling system so they can nearly visualize the process, which produces valuable data. He doesn’t yet know what he’s going to do with his $625,000, but we’re looking forward to finding out.

Executive Order Takes Aim at ACA

After several failed attempts at repealing and replacing the Affordable Care Act (AKA Obamacare) in Congress, President Trump has signed an executive order removing some regulations the ACA put in place.

Under the new order, fewer benefits and protections are required for customers and small companies can group together to buy “association plans” which do not have to adhere to guidelines laid out by the ACA.

VOX has an interesting look at what the association plans might do to the overall ACA market. Tennessee, where the plans already exist because of a loophole, holds some of the highest average ACA plan pricing in the nation.

NIH Partners with Big Pharma

In a $215 million collaboration, the National Institute of Health announced the start of a five-year research initiative in partnership with 11 pharmaceutical companies to support the Cancer Moonshot program.

The project with a focus on immunotherapy and why certain cancers do or do not respond to the treatment. The collaboration will be known as the Partnership for Accelerating Cancer Therapies, or PACT, and NIH director Dr. Francis Collins has high hope for the initiative.

“A systematic approach like PACT will help us to achieve success faster,” Collins said in a statement.

Another Gene Therapy Moves Forward

A treatment for a rare form of childhood blindness has been unanimously recommended for approval by the FDA. Developed by Spark Therapeutics, the therapy treats Leber congenital amaurosis a disorder with 13 different types depending on cause, amount of vision loss, and other eye abnormalities.

The treatment is called Luxturna, and was previously predicted to be the first gene therapy in the U.S. market before CAR-T claimed that prize earlier this year.

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Friday roundup – October 6

The Friday Roundup is a collection of five stories that you need to know about each week. From policy, to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

Americans Awarded Nobel Prize in Medicine

Jeffrey C. Hall, Michael Rosbash, and Michael W. Young won the prize for their work about the molecular functions behind the circadian rhythm, a powerful element of our biological clocks.

 

Using fruit flies, the trio isolated a gene which encoded a protein that gathers in cells at night, but degrades during the daytime. This degradation of the protein corresponds with the insect’s sleep-wake cycle. The honorees also discovered other contributors in their research which has led to a better understanding of our body clocks and what impacts them.

Do Let it Get Under your Skin

Last week, I wrote about the FDA’s approval of the first prick-free continuous glucose monitor. This week, MIT Technology Review profiled a team of University of Chicago researchers who a working to turn YOU into a continuous glucose monitor.

 

The team has genetically engineering mice skin cells to detect glucose, which can be grafted on the animal and monitor levels 24/7 with no battery or other upkeep. The process definitely needs to be refined, as currently the sensor can only be read using a laser and microscope. So, how’d they do it? CRISPR, of course.

CDC Links US Cancer Diagnoses to Obesity

The Center for Disease Control found that 40 percent of all cancer diagnoses in America are for those affiliated with obesity and being overweight. There are 13 different types of cancer that patients who are overweight are at an increased risk for.

 

Though overall cancer diagnoses in the U.S. have decreased since the ’90s, between 2005 and 2014 rates of cancer linked to obesity rose seven percent. Researchers are not yet sure why obesity is a factor in certain cancers or why the risk associated is not equal across all 13 cancers.

Sharing is Caring

Unless you are an EMR, that is. According to a recent study, only one of three hospitals in the US can send, receive, and find EMRs for patients that receive care elsewhere.

 

There was only about a five percent gain in interoperability between 2014 and 2015, which is slow growth for something that is supposedly going to revolutionize a patient’s care experience. This puts the burden on the patient, as they then need to print out and bring records with them from hospital to hospital.

Gene Therapy Still Debated

In a JAMA study, a child with ALD, a disease which causes nerves in the brain to die, was successfully treated with gene therapy. The typical treatment for ALD is a bone marrow transplant, but at a 20 percent mortality rate, it’s incredibly risky and often difficult to find a donor.

 

The news complicates the narrative surrounding gene therapy, which has been historically negative since the death of Jesse Gelsinger due to an experimental treatment in 1999. A recent death in a CAR-T trial also caused concern, however the FDA’s approval of the gene therapy shows progress.

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Friday Roundup – September 29

The Friday Roundup is a collection of five stories that you need to know about each week. From policy, to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

The Gears of Government Grind … Fast?

On Tuesday, the FDA announced that nine tech companies, including Samsung, Apple, and FitBit, will be put into a program that would reduce regulations on health software development. Companies in the program will have their software evaluated to verify it meets quality standards, and if they pass these audits, would be pre-certified and face a shorter approval process, or none at all.

 

Verily Life Sciences, Johnson & Johnson, and Roche Holding AG are also a part of the program, which commissioner Scott Gottlieb hopes will streamline the process to market, and therefore increase access to theses health products.

Floodwaters Bring Dangerous Disease

Flooding is typically associated with a higher risk of infection, but this can be significantly lowered by minimizing the amount of people displaced and ensuring sanitation systems are function and water sources remain uncompromised. Unfortunately, this isn’t always doable.

 

Harvey brought skin and gastrointestinal infections to Houston along with devastating property damage. Earlier this week, a Texas woman died as a result of a more serious and rare infection: necrotizing fasciitis, a flesh-eating bacteria. Fortunately, no other infections have been identified.

No Need to be Pricky

This week the FDA approved the first ever glucose monitor that does not require a blood sample. Made by Abbott, the FreeStyle Libre Flash Glucose Monitoring System uses a sensor that is implanted under the skin and remains on at all times. Users can view their blood-glucose level by waving a reader over the sensor site. The sensor needs to be replaced every two weeks.

 

The device was only approved for patients 18 and up and Abbott has not yet released pricing information. The company has said pricing should be similar to that of the product in Europe: $69 for the reader and $69 for each sensor.

Still No Official Declaration on Opioid Epidemic

This summer, the Commission on Combating Drug Addiction and Opioid Crisis recommended that the opioid epidemic be declared a national emergency. In August, President Donald Trump did just that, or did he?

 

Despite the verbal declaration, nothing official has come from the White House, which means none of the financial resources given by such an act can be distributed or used. According to the New York Times, the White House is reviewing options to expedite the process.

 

Meanwhile, the commission met on Wednesday and was join by PhRMA CEO Stephen Ubl, who announced they support a reduction in dose dispensing from 30 days down to 7.. The move was applauded by commission head Chris Christie, who is expected to release the commission’s final report on November 1.

Bad Things Come in Threes

APOE4, the genetic marker linked to the development of brain plaques which lead to Alzheimer’s disease, has been found to affect two other characteristics of the disease as well.

 

Researchers at the Washington University School of Medicine discovered that the gene also makes tau tangles and increases brain inflammation which leads to cell death. This information gives scientists a much better understanding of the disease and its potential causes.

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Friday Roundup – September 22, 2017

The Friday Roundup is a collection of five stories that you need to know about each week. From policy, to innovations, look to us to keep you up to date on what’s happening in the healthcare industry.

Progress Comes with Bioethical Concerns

Artificial embryo sounds like something from a Sci-Fi movie, but it’s actually what researcher Yue Shao created during an experiment with stem cells. Shao is a part of a team at the University of Michigan working on human organoids. An organoid is a group of cells that contains characteristics of a specific organ.

 

Though Shao’s initial artificial embryo did not contain the necessary cells for full development (it didn’t contain cell types for the brain or heart), the fact that it was able to progress provides scientists with great opportunity as embryonic cells use in research has been a highly politicized subject.

 

There are still ethical concerns though as these embryoids aren’t the same as an actual human embryo. Scientists are cautious, and adhering to the “14-day rule” used when studying human embryos: No human embryo is studied beyond two weeks, or past when the primitive streak forms.

“Hail-Mary” Healthcare Bill Introduced

The new measure was proposed by Senators Lindsey Graham and Bill Cassidy, and is being regarded as republicans’ “last chance” to repeal the ACA. There has been a significant amount of opposition from not only democrats but also healthcare organizations across the country.

 

Critics of the measure argue the widespread restructuring would wreak havoc in insurance markets and loosened regulations would undermine important patient protections, especially those with pre-existing conditions.

Biosimilars Were Approved, But Will They Be Available?

Last week, the FDA approved Mvasi, a biosimilar to Avastin, a drug used to treat multiple cancers. In the release, the FDA touted that biosimilars are a great way to improve access to life-saving drugs while reducing cost, but an article in Bloomberg points out that may not be accurate.

 

Amgen has released no price or market date for the biosimilar and some doctors are also unclear on when a biosimilar should be prescribed (and if patients already on the drug should be switched to the biosimilar). Complicating things more are patent disputes, which slow the drug’s journey to actual patients in need of treatment.

Are Insurers Partially Responsible for the Opioid Crisis?

The toll the opioid crisis has taken has everyone asking challenging questions of the structure of healthcare in the U.S. Doctors and pharmaceutical companies have been criticized for contributing to the overprescription of opioids in the past, but now insurers are taking some of the blame.

 

Almost every plan in the 35.7 million analyzed by ProPublica and the New York Times covered common opioids, and only some required approval. In contrast, only one-third covered Butrans, a skin patch with a less addictive opioid and every plan that covered a similar, more expensive patch required prior approval.

 

What do you think? Should insurers bear some of the blame? Should they modify policies to provide more access to less addictive painkillers? Tag us on Twitter (@angelMD_inc) and let us know.

Puerto Rico Devastated by Hurricane Maria

The Category 4 hurricane hit the island earlier this week with sustained winds of 155 miles per hour and knocked out the country’s power. Now experts are saying its underfunded health system might also be destroyed.

 

In addition to the surface injuries hurricanes cause, infectious diseases also spread easier because of infrastructure damage and increased human contact (via packed shelters). The power outage will also put a strain on the health system and cause reliance on backup generators.

 

If you would like to help the citizen of Puerto Rico, you can donate here.

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