Morning Rounds: Why health care costs are nearly a fifth of GDP

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Good morning. Don’t miss Nicholas Florkos’ investigation into medical marijuana businesses selling their products for cancer or depression without regulatory oversight.

Medical marijuana companies follow the pharmas’ playbook, except for the rules

Frederic J. Brown/AFP via Getty Images FREDERIC J. BROWN/AFP via Getty Images

Medical marijuana companies have borrowed many marketing tactics from pharmaceutical companies. But because they don’t follow the same rules, patients are at risk, STAT’s Nicholas Florko told us in a new STAT investigation. Big players like Trulieve, Curaleaf, and Verano advertise their products as treatments not only for muscle pain, but for cancer and depression, without evidence to back up the claims that.

How can they escape from it? Therein lies the irony: Cannabis companies don’t have to follow rules on the claims they make or the freebies they give to doctors because, for the most part, cannabis medicine isn’t federally regulated. The US government deemed pot too dangerous to be considered a drug, so it gave most of the responsibility to the states. They are able to call it a drug without the unnecessary difficulty of determining whether it is a real drug, James Berry of West Virginia University said of the businesses. Read more, including company responses.

SNL skit on sickle cell therapy draws outrage

You probably saw (and if you’re like me, freaked out over) last weekend’s skit from Saturday Night Live about new gene therapies for sickle cell disease. If you haven’t already, the synopsis is this: In an office white-elephant-style gift exchange, a white employee (Kate McKinnon) gives a Black employee with sickle cell (Kenan Thompson) an enrollment at Vertex Pharmaceuticals and CRISPR Therapeutics exa-cel program for sickle cell anemia. He says no thanks, declaring, I’ll just trade it for a Boogie Woogie Santa. Later, another Black employee (Punkie Johnson) also turns down the treatment in favor of a singing, trumpet-playing Santa figurine.

Now the Sickle Cell Disease Foundation, the Sickle Cell Disease Association, and Sick Cells have all condemned the sketch. Its how they had the sickle cell characters: They made them look stupid, they made them look unintligent, said Ashley Valentine, head of Sick Cells. The two caricatures they put on national TV are what people think of us, said Valentine. NBC did not respond to a request for comment. STATs Jason Mast has more.

Drug companies must tell the FDA how they will vary clinical trials. Will it work?

Leaving people of color out of clinical trials hinders health care and drug development. Starting next year, drug and medical device companies will have to tell the FDA how they intend to make their clinical trials better represent the diverse US population. But planning isn’t the same as doing, the industry’s track record isn’t great, and it’s unclear whether the FDA will roll its arms, STAT experts John Wilkerson said.

It’s a myth that people of color are reluctant to participate in clinical research, Steve Smith of clinical trial consulting firm WCG told John. A recent poll by Research America found that people of color are slightly more wary of clinical trials than white Americans. Low clinical trial participation among people of color is often due to logistics, Smith said. Read more.

STATs best photos of 2023

landscape shot of mission hospital at sunset in Asheville, NC
Mission Hospital, part of the nation’s largest hospital chain, HCA Healthcare, is located in downtown Asheville, North Carolina. Read the story: HCA doctors say its cost-cutting puts Appalachian patients at risk a warning for the entire US health care system. Mike Belleme for STAT

I don’t know how they narrowed their list down to just 14. Alissa Ambrose, STATs director of photography and multimedia, teamed up with Crystal Milner, STATs photo editor, to select the most memorable photos of 2023 from STATs many contributing photographers. Above shows Bat-Erdene Namsrai conducting an experiment on a rat for new research on cryogenic organ preservation, described in this story by contributor Marion Renault.

You can find more photos here of people whose stories we’ve told, among them investors and researchers advancing their industries, a man working to escape the cycle of addiction, and a physician who walked the his road career after the abortions he was providing were made illegal in his hometown.

Lessons in the power of contact tracing

Remember contact tracing for Covid-19? A new study in Nature looking at 7 million contacts in England and Wales who were notified by the NHS COVID-19 app concluded that how long someone spent with an infected person was the single biggest predictor of whether they himself will be infected with Covid-19. The authors say their analysis also shows the power of contact-tracing apps like this to deliver accurate risk information in future epidemics.

Here’s how it works: The app relies on Bluetooth signal strength to measure how close and how long smartphones are nearby, and then notifies contacts of confirmed cases. The researchers combined that data with 240,000 positive tests reported after the notification. Duration and proximity matter: Short-term contacts (less than 30 minutes) account for half of reported contacts but very few transmissions. Household contacts are only 6% of contacts, but they account for 40% of transmissions.

Health care cost increases are not outpacing inflation for a good reason

Yesterday, we told you that the US government will spend more on health care in 2022 than the six countries with universal health care, combined. Today, oncologist Ezekiel Emanuel said that while US health care spending used to exceed overall inflation, that has changed in recent years.

Except for the 2020s Covid spike, health care costs have remained at or below 18% of GDP since 2010, when Obamacare began. Medicare spending per person has been flat for more than a decade, and premiums for private employer-sponsored insurance have been rising at 3.7% over the past decade, slower than the 8.4% between 1999 and 2011 .Why? The thinking of American physicians and other clinicians has changed, from ignoring costs to trying to reduce them, Emanuel wrote in a STAT First Opinion. Read his explanation.

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