Should PBMs be allowed to claim ERISA to preempt state laws?

This is a Very Big Deal — the Supreme Court has agreed to hear a case that will decide whether states have the right to regulate PBMs. Read the details on GPhA.org.

The SCOTUS review is not only huge news, it dovetails with what’s happening in Georgia, where two bills limiting PBM steering took effect at the beginning of the year. GPhA is already hearing that PBMs are ignoring it, so a positive ruling by SCOTUS in the Arkansas case will buoy Georgia’s laws.

Flu update

Almost 10 million cases in the U.S. so far, with 4,800 deaths (22 in Georgia) including at least 32 children.

Not only did the influenza B strain hit early this year, the strain in the vaccine is the wrong version — the vaccine is for the Victoria V1A subgroup, but what’s circulating is the Victoria V1A.3 subgroup. The good news is that “They are close enough so the vaccine offers some protection.”

Insulin, hold the clumps

Australian scientists have developed a new form of insulin that lowers glucose without forming clumps or fibrils the way current insulin analogs do.

Those fibrils can clog insulin pumps, meaning the meds aren’t always delivered properly and the equipment has to be replaced every 24 hours to 72 hours.

In the USA alone, more than US$1 billion could be saved per year if the usage period for insulin increased from two to six days.

Prices in drug ads: back in court

The HHS rule requiring drug prices in TV ads is in court again. Drug makers said the requirement violates their First Amendment rights, and they won when a lower court said HHS doesn’t have the authority to make the rule. But now it’s in front of the U.S. Court of Appeals, so we’ll see what happens next

Diabetes research: Target the proteins

While not studying demogorgons, scientists at the Department of Energy’s Pacific Northwest National Laboratory have identified a single protein — “GDF15” — that appears to be a key in the development of type 1 diabetes. When the pancreas isn’t functioning properly, it’s not producing enough GDF15.

So what? This could open up a new method of preventing the disease: Rather than treating the immune system, it might work to target proteins like GDF15.

“While GDF15 may be one new therapy, we identified other proteins that may work in conjunction with GDF15, so this work really represents a treasure-trove of information that can be mined for new therapies.”

More Medicaid, fewer opioid deaths

States that expanded Medicaid have seen a significant drop in drug overdose deaths, according to a new study published in JAMA Network Open that looked at 383,000 opioid overdose deaths from 2001 through 2017. (Link is to news story; here’s the study itself.)

The study found that Medicaid expansion was associated with…

• a 6% lower rate of total opioid overdose deaths compared to non-expansion states;
• 11% fewer deaths involving heroin;
• 10% fewer deaths involving synthetic opioids other than methadone;
• 11% more deaths involving methadone*.

* Methadone-related deaths are a small fraction of overdose deaths, but the authors do say it “deserves further investigation.”

Antibiotics vs dementia

Could aminoglycosides stop dementia? We wouldn’t be asking unless someone thinks they might.

Those someones are University of Kentucky researchers, who found that — in the kind of dementia where neurons don’t produce progranulin — giving aminoglycosides seems to get those neurons working properly again.

The researchers found two specific aminoglycoside antibiotics — Gentamicin and G418 — were both effective in fixing the mutation and making the functional progranulin protein. After adding Gentamicin or G418 molecules to the affected cells, the progranulin protein level was recovered up to about 50 to 60%.

Stomach acid doesn’t fight pathogens

Conventional wisdom says that the acid in the digestive tract helps get rid of pathogens. Not so fast, say University of Kansas researchers. It turns out that it’s the opposite, at least in C. elegans worms.

It seems that the worms make their digestive tract less acidic when they detect pathogens. Why? The theory is that switching to a higher pH allows a stronger immune response — and that means the worms react to pathogens by deploying defenses as needed, rather than trying to keep inhospitable.

Longer-living worms

Let’s say you have a pet nematode worm that your kids just love. Problem: It’s only going to live about a month before it goes to stay with a nice family in the country.

Scientists in California and China may have a solution. They’ve found a way to genetically tweak the cellular pathways of nematode worms that extends their lifespan by 500 percent.

That means little Squiggles could live half a year (or 400-500 years if he was human) — long enough for your kids to get bored with him.

Workout in a pill

If you have mice (or fruit flies) that simply refuse to get enough exercise, some potential good news: University of Michigan researchers think a protein in the sestrin family “can mimic many of exercise’s effects.”