FTC cautions, PBMs ignore

In the Long Long Ago, the FTC made statements saying it opposed efforts to increase PBM transparency — competition, the agency said, would keep them in check. PBMs cite those statements today when they argue against oversight and regulation.

But on Thursday the agency said that times have changed, and it voted unanimously to rescind those statements. PBMs, it said, should no longer rely on FTC statements/guidance from a decade or two ago. Times have changed and the agency is taking a new look at PBMs.

For their part, the PBMs said they’re pretty much going to ignore this new advice. Yes, really.

“In the absence of further FTC guidance, the PCMA [Pharmaceutical Care Management Association] said it “will continue to cite previous FTC studies, statements, and enforcement actions that recognize the risks associated with proprietary pricing disclosure requirements….”

Our number-two story

Got a patient who buys Metamucil by the carton? You might want to suggest a visit to a neurologist. New research out of Harvard Medical School finds that “Constipation May Be a Marker for Dementia Risk.”

Researchers found that among more than 110,000 middle-aged and older U.S. adults, those who were chronically constipated — fewer than three bowel movements a week — also showed signs of an “older” brain.

That’s not to say that constipation causes Alzheimer’s. More likely (but still theoretical) is that problems with the gut biome cause both conditions.

We got through this entire item without a single inappropriate joke, even when the senior researcher’s name is Dong Wang.

Body building the brain

The body-builders’ supplement beta-hydroxy beta-methylbutyrate — aka HMB — might help treat Alzheimer’s. So report Rush University researchers who found that HMB helps stimulate the brain’s production of neurotrophic factors — proteins that are sorely lacking in Alzheimer’s patients.

“Our study found that after oral consumption, HMB enters into the brain to increase these beneficial proteins, restore neuronal connections and improve memory and learning in mice with Alzheimer’s-like pathology, such as plaques and tangles.”

At this point it’s only been tested in mice, but as HMB is considered safe even for long term use, human studies could be around the corner.

Track, trace … and secure

All eyes are on the drug supply chain these days. First off, the Drug Supply Chain Security Act — aka DSCSA aka track ’n’ trace — is supposed to come into effect later this year.

But with the pandemic, factory shutdowns, and Mother Nature wreaking havoc on manufacturing, the issue of making sure there actually is a supply chain is getting a lot more attention.

The latest: A bipartisan group of US senators wants to create a way to collect data on that supply chain. They’re proposing the “Mapping America’s Pharmaceutical Supply Act” so health officials can know what’s where, how much there is, and where it’s coming from.

It would require the Department of Health and Human Services (HHS) to catalog the origin of each drug, quantities available and the location of facilities used to manufacture them. It also would map inspections, recalls and import alerts.

Nobody, I mean nobody does logistics like the USA, so it makes sense to bring that expertise to the drug chain. Our prediction: We’re less than a decade away from the government manufacturing some of its own drugs to fill gaps of critical meds in the market.

CMS pauses Georgia’s Medicaid purge

Georgia is one of six states that CMS has told to stop removing people from Medicaid via “procedural terminations” — where someone is taken off the rolls for not filing paperwork.

Apparently database problems meant these states weren’t able to contact people the way the law requires. In Georgia, New Mexico, and South Carolina more than 90% of people removed from Medicaid were due to lack of paperwork rather than not being eligible, in part because the states couldn’t contact them.

CMS told the states to reenroll those people and fix their database problems so they can give residents the information they needed to complete the paperwork. All the states, the agency said, are on board and working with federal agencies to do just that.

Captain Obvious knows where that aisle is

“How to get vitamin D without spending too much time in the sun” — answer: Eat a balanced diet or take a supplement.

“Boron” rhymes with “moron”

The latest deeply stupid TikTok trend is — no joke — eating borax. The laundry booster. For health.

[S]ome have been claiming that consuming borax can help treat different things, ranging from joint pain to eye swelling to mouth swelling to menstrual cramps to even cancer.

Because, as one genius explained, “Boron, found in borax, is a mineral our body needs.” Fun fact: Cyanide contains carbon, something our bodies need too.

As Forbes’s Bruce Lee put it, “[U]nless you are a pair of dirty underwear, you should actually be limiting your direct exposure to borax as much as possible.”