PBM bill inches along

Slowly but surely, the House’s PBM smackdown bill is moving through the Capitol. It passed the Energy and Commerce Committee’s subcommittee on health 27-0 (W00t!) and is now headed to the full committee.

The bill’s major impact is “Imposing new transparency requirements on PBMs and banning ‘spread pricing’ in Medicaid, where PBMs charge more than they pay for a drug and keep the difference.”

Congrats (again) to Lindsey Welch!

Not only has GPhA member Lindsey Welch been named UGA’s Faculty Advisor of the Year, this is her second time receiving the honor. Way to go, Dr. W!

Here she is with members of the UGA’s APhA-ASP chapter

Semaglutide’s compounding confusion

With Ozempic in shortage, FDA rules seem to say that it can be compounded by compounding pharmacies (although the FDA hasn’t exactly been clear about that, according to the folks at the Alliance for Pharmacy Compounding^*).

That means that some pharmacies are selling compounded versions of semaglutide, which would be fine — that’s what compounding is all about.

Problem: There online … businesses (not actual 503A compounding pharmacies — APC calls them “sketchy websites”) that are selling what they claim to be the same semaglutide as in Ozempic. Those might be ineffective or worse; when you buy from Cousin Jimmy’s Gud-E-Nuf Mail Order Drugs, you can’t be sure what you get.

Then the waters get muddier. Some compounding pharmacies use the salt form of semaglutide — semaglutide sodium — which the science isn’t 100% clear works the same way, although it probably does. [insert hand-wringing here]

Oh, and Novo Nordisk says it doesn’t sell generic semaglutide [more hand-wringing], which is true but misleading: Novo sources the semaglutide API “from FDA-registered manufacturers (just as pharmacy compounding API wholesalers and compounding pharmacies do).”

All of this leads to click-bait headlines like the one from the New York Times, “Ozempic Is Hard to Find. Some Pharmacies Are Offering Unauthorized Alternatives.” (sigh)

^* Disclaimer: I do consulting work for APC.

A travelling biome lab

What’s happening in the gut is important, but finding out what’s going on in the digestive system, especially the small intestine, is tough without invasive surgery.

So why not send a sensor in instead?

Researchers at UC Davis and Stanford have developed a swallow-able capsule called CapScan (sorry, no points for originality) that makes its way through the digestive system “and collects a small volume of biofluids and microorganisms on the way from the upper intestine to the colon.” Bingo: an easy way to study “the gut metabolome and its interactions with the gut microbiome.”

The Long Read: Green edition

Johnson & Johnson is tweaking the formula for its bedaquiline anti-TB drug as a way of getting around patent law and keeping its monopoly. Never mind that public funds paid for the drug’s research and development.

John “The Fault in Our Stars” Green explains why this is sentencing millions of people to death.

I’m glad Johnson & Johnson has profited from manufacturing and selling bedaquiline. Pharmaceutical companies need to see the value of investing in new tuberculosis treatments. But a decade after the drug’s emergence, it is high time for the company to relinquish its extended patent claims.

Short Takes

Coverage expands … for now

The US uninsured rate fell 18% from 2019 to 2022, according to the latest CDC data. Note that it fell by 18%, not to 18%. The latest figure is that 8.4% of Americans don’t have health insurance, including about 3 million children. Of course, with the lifting of pandemic-era Medicaid requirements that uninsured figure will climb again, but we can at least enjoy the moment.

Radiologists look over their shoulders

The ChatGPT AI passed the Canadian Royal College and American Board of Radiology exams. (In testing, that is.) The latest version of the software scored 81% overall, including on higher-order thinking questions, describing imaging findings (85%), and even applying concepts (90%). Yikes.