The X for Y Files: BP drug twist

If you have a roundworm you want to live longer, you might consider getting it a prescription for rilmenidine. It seems (found British researchers) that the hypertension drug might have the same effect as a calorie-restrictive diet, which is considered one of the best ways to increase lifespan.

And even if it doesn’t pan out in humans, the research identified the receptor that rilmenidine binds to, meaning it’s at least a big step towards an eventual pharmacological treatment.

AI’s latest trick

Protein molecules each have a unique 3-D structure, and that’s the target of drugs. The trick is finding what chemicals might interact with what proteins, and that can take a lot of work. Well, unless you turn AI onto the problem.

Swiss researchers did just that, and they say the result was “a real breakthrough for drug discovery.” Rather than spending weeks of computer and meat-brain time trying to fit a potential drug molecule into the protein, the AI speeds through it. But the biggest benefit is that the AI knows what can actually be synthesized, so it doesn’t bother suggesting impossible chemicals.

For any protein with a known three-dimensional shape, the algorithm generates the blueprints for potential drug molecules that increase or inhibit the activity of the protein. Chemists can then synthesise and test these molecules in the laboratory.

Quit vaping to get pregnant

Ladies, give up vaping if you want to get pregnant. With what they say is “the first piece of evidence to show a link between fertility and vaping across a large population,” British molecular geneticists found…

…that people who vape or smoke tobacco had lower levels of anti-Müllerian hormone (AMH), which indicates how many eggs women have left in their ovaries.

Women trying to get pregnant should be told “no drinking, no vaping, no smoking, no drugs,” they say. Plus there’s the whole nicotine-addiction, chemicals-in-your-lungs angle as well, but one battle at a time.

Side note: Vaping has gotten so bad over there that Welsh health authorities are talking about offering nicotine patches or gum to help kids break their nicotine habits.

PBMs vs grandma

It seems PBMs have found a new way to stick it to Medicare recipients: Moving their old generic drugs to higher formulary tiers — the ones that require a larger co-pay.

Seniors are finding that the meds they’ve been taking for years suddenly cost more out of pocket for no reason other than someone at a PBM threw a dart and decided to move it up a tier.

In 2011, 73% of generic drugs analyzed by Avalere were placed on Tier 1, which has a zero-dollar copay on average. Ten years later, only 15% of those drugs were still on Tier 1, despite the average price of those medicines falling by 38%.

Why would a PBM make cheaper drugs more expensive? The idea is to drive patients not to the best medications or the least expensive, but to the drugs that give the PBMs the highest kickback. That’s one reason biosimilars haven’t taken off, and why patients can be pushed to brand-name medication.

The Long Read: Prior Denial edition

Some investigative reporting, plus a former insurance company doctor, reveals the culture of “deny deny deny” inside health insurance companies.

All a Cigna doctor had to do was cut and paste the denial language that the nurse had prepared and quickly move on to the next case.