“White bagging” in Georgia

Cancer patients in Georgia are about to start feeling the effects of “white bagging” (Georgia Health News explains), where insurers use their own pharmacies to deliver specialty drugs, rather than letting hospitals buy them.

Anthem Blue Cross and Blue Shield, Georgia’s largest health insurer, is requiring that oncology infusion drugs for its patients be purchased through CVS Specialty, or through the insurer’s own specialty drug network that has similar pricing. There will be similar restrictions on other infusion/injection drugs.

And the staff pharmacist, the one who would make sure the dose matches the patient? Don’t worry — the insurance company will take care of that!

The best-laid plans

FDA created a program to approve drugs so old they were created before the agency existed. The idea was to be sure they were safe.

The result, though, was that companies branded them and jacked up the prices, making previously affordable medications a lot less affordable. (Colchicine, used for gout for more than 200 years, was about 10¢ a pill until URL Pharma debuted Colcrys — identical but $4.50 a pill.)

Hospital executives are particularly vexed about the price hike for Vasostrict — formerly known as vasopressin and first developed in 1928 — because that drug, used to increase a patient’s blood pressure, has been widely used in intensive care units to treat covid-19 patients. From 2019 to 2020, hospital spending for the drug rose 56%, to nearly $600 million, according to the American Society of Health-System Pharmacists.

FDA commish still up in the air

The Biden administration’s short list of candidates is expanding as pressure mounts to make a permanent pick.

While Janet Woodcock, M.D., the interim commissioner since Biden took office in January, remains in the running for the permanent job, some politicians and advocacy groups have pushed back on her potential nomination over concerns about past opioid approvals under her watch.

Two steps back

Opioid deaths have soared during the pandemic — hitting a record (more than 87,000 Americans in 12 months) and rising 29 percent over the previous year. So figure to pick up this plot thread as the current season winds down.

Many treatment programs closed during that time, at least temporarily, and “drop-in centers” that provide support, clean syringes and naloxone, the lifesaving medication that reverses overdoses, cut back services that in many cases have yet to be fully restored.

Brush your teeth

So let’s say you catch Covid, and you don’t want to die. That’s the time to be thinking, “Maybe I should have brushed more often.”

A study out of McGill University found that bad oral hygiene was linked to bad Covid outcomes.

Covid-19 patients with gum disease were 3.5 times more likely to be admitted to the intensive care unit, 4.5 times more likely to need a ventilator, and 8.8 times more likely to die when comparing to those without gum disease.

Oh no, baby — he’s doomed

Captain Obvious is smiling (but you can’t see it)

A Boston University study found a shocker: “States that required people to mask up last year had lower rates of Covid-19 than those with no mask requirements.”

“This protective effect of mask wearing was evident across four months of the pandemic, even after adjusting the associations for mask policy, distance policy and demographic factors.”

Phenformin vs cancer

Biguanides like metformin are getting new life these days, as researchers find new uses for them. The latest: Phenformin — potent but discontinued as a diabetes treatment — may work as an adjunct with some of the hot new cancer immunotherapies.

Right now it’s all pre-clinical experiments, but it seems that phenformin’s potency may be to its advantage. That makes it better at helping those drugs (e.g., BRAF inhibitors) fight tumors.

And what about phenformin’s side effects? Still better than chemotherapy’s.

Podcast of the week: Diseases that don’t go away

“The viral ghost of long Covid” from Vox. You’ve heard of “long Covid,” but “long” diseases are nothing new (looking at you, measles). In fact, long Covid is finally bringing attention to the millions of people suffering from other “medically unexplained” symptoms long after they’ve had a disease.

(Not a podcast listeners? Here’s the article in words.)

ICYMI: Latest magic mushroom news

Yet another study (this one in London) has found that psilocybin is an effective treatment for depression. In this case it was compared to the SSRI escitalopram, and did pretty darned well. Small and interesting caveat: Psilocybin needs to be combined with psychotherapy; the idea is that the drug helps bring issues to the surface, which can then be worked out professionally.

“With a psychedelic it is more about a release of thought and feeling that, when guided with psychotherapy, produces positive outcomes.” […P]articipants given psilocybin had often reported feeling they had got more fully to the root of why they were depressed.