CVS leaves NACDS

The company says it’s parting ways with the National Association of Chain Drug Stores. Why? No idea. Both of their press releases are empty — they just repeat the standard platitudes about helping people and doing Good Things, but don’t address the question.

The answer, wonks believe, is that CVS owns the nation’s largest PBM, and NACDS isn’t exactly PBM-friendly.

SCOTUS and the FDA

A Supreme Court decision* could have some interesting effects on pharmacy.

A quick-and-dirty explanation: SCOTUS ruled that the EPA couldn’t create regulations that seem to set policy, even if Congress charges it with a task (e.g., keep the air clean). Regulations of “major economic and political importance” need to be based on specific laws passed by Congress, not broad mandates.

Because this was the Supreme Court, obviously this decision — which goes against decades of How the Government Works — is going to apply to other agencies … like the FDA.

The FDA is going to have trouble using its broad authority, thanks to the major questions doctrine the Court invoked. It will have to “point to specific Congressional authorization for [its] actions.”

[I]f new regulations go against existing practice and conflict with certain stakeholders’ interests, they could be subsumed under the major questions doctrine. Accordingly, these regulations could be subject to litigation.

In short, any ruling that smacks of regulatory overreach is likely to be challenged until Congress passes a law, and Congress isn’t exactly known for being subject-matter experts.

* Again, did you think we meant a different decision?

A different target for tomorrow’s Covid vaccines

I’ve been watching too much cheesy science-fiction.

“Our Covid-19 vaccines were working great, but the virus is mutating faster than we can keep up!”

“Have you tried adding the new spike-protein variants to the mRNA mix?”

“Of course! But the spike protein is the problem — that’s what’s mutating! Eventually we’ll get a variant that will evade the vaccine entirely. What can we do?”

“Wait … wait just a second. What if we targeted the virus’s nucleocapsid protein instead? We could do it as either a “homologous prime boost or as a heterologous prime boost in combination with spike-based vaccines!”

“My gosh, you’re right! And it sounds scientific enough that it just … may … work!”

Smooth as a baby’s (supplemented) skin

Do you want eczema-free babies? Sure you do. The trick (per British researchers) is easy:

[B]abies had a lower risk of developing atopic eczema in their first year if their mothers took 1000 international units of Vitamin D a day from when they were 14 weeks pregnant until they delivered.

Oh, and the study also found that “taking the Vitamin D supplement during pregnancy also had lasting benefits for the child’s bone density at four years old.”

Kids and their weight

A new study out of Emory University found that the childhood obesity rate in the U.S. is higher now than it was 12 years ago — and that’s with all the push toward healthier eating. Fail.

If we can’t smack the Oreos out of their hands (or in the case of Son of Buzz, those Swedish Trollis), there’s always Qsymia*, a chronic weight management drug just approved by the FDA for kids over 12. (It was previously approved for adults.)

Here’s an interesting tidbit from that same article:

The CDC also found that, between 2011 and 2014, pediatric obesity rates are inversely proportional to the education level of the head of the household. Similarly, as the average household income increased, the rate of pediatric obesity decreased.

* Be careful. If you mispronounce it, you might accidentally summon an elder god.

Double-duty drug

This will be a new category soon, because there seem be so many: a drug for condition A that also (surprise!) works for condition B.

In this case, Canadian researchers found that a CSF1R inhibitor, normally used to treat some cancers, also seems to help treat Duchenne Muscular Dystrophy “by changing the type of muscle fibers to be more resilient.”

[W]hen they depleted the macrophages of mice, they found that the animals’ muscle fibers surprisingly changed into a type that’s more resistant to the damage induced by muscular dystrophy.

And they described that improvement in muscle resiliency as “profound,” which has to be good news for DMD sufferers.

Viruses are evil (reason #481)

Mosquito-borne viruses (like Zika and malaria) have a nasty trick up their sleeves: They can increase the amount of acetophenone a host (that is, you) produces, which then attracts more virus-carrying mosquitoes.

How? By altering the microbiome of your skin, introducing bacteria that release acetophenone and turning you in to a neon sign for the local skeeter population.

What might be done about this? Well, the UConn researchers studying this found that vitamin A can help the skin produce more of a molecule that kills acetophenone-producing bacteria. So vitamin A supplements might be the ticket.

At least, in theory. More studies, as always, are needed.

The Long Read: Good Company edition

“How Pfizer Won the Pandemic, Reaping Outsize Profit and Influence”