Finally, it’s over

After literally years of knowing it doesn’t do a bleepin’ thing, the FDA is finally proposing to revoke its approval of oral phenylephrine — the ingredient that replaced pseudoephedrine in cold and flu products when pseudoephedrine went behind the counter. (It used to be used in meth production.)

Thing is, phenylephrine doesn’t work. We’ve written about it several times, and it’s not a secret that it’s a placebo with a fancy name. There have even been lawsuits about its marketing.

Annnnnnyway, the agency is seeking comments, and in the meantime it’s still legal to include it. Oh, and if phenylephrine is pulled, it will still be allowed in nasal sprays for people who enjoy deluding themselves.

The drugs we’re buying

What drugs do Americans spend the most on? Glad you asked. In a shocker, the number one in 2023, in terms of dollars spent, was … brand-name semaglutide (Ozempic and Wegovy). That’s according to data from the AARP, and it found Americans spent about $38.6 billion on that alone.

Semaglutide bumped adalimumab (aka Humira) from the top spot; we spent a mere $35.3 billion on adalimumab. The rest of the top 5 are apixaban (Eliquis), dulaglutide (Trulicity), and empagliflozin (Jardiance). Tirzepatide comes in at number 8, if you’re curious.

Overall drug spending jumped 14% from 2022 to 2023, driven by greater use of drugs, expensive new meds, and of course drug company’s raising prices.

Flovent fallout

Earlier this year, GSK pulled its Flovent inhaler from the market and replaced it with an identical generic version. You wouldn’t think this is a big deal … unless you live in a country where access to medications is controlled by profit-driven pharmacy benefits managers.

The result of the Flovent change “was that the generic alternative was actually more expensive than the previous brand,” as one pediatrician put it. PBMs pushed patients to other, branded inhalers that made them more money, but that weren’t as effective for kids.

Result: More kids are ending up in the hospital because they can’t get their asthma under control.

“The combination of Flovent going off the market and the increasingly restrictive formularies from payers has just made caring for asthma in 2024 much more of a challenge than in previous years.”

Next time someone says, “Do you want a health system where the government decides what drugs you can get?” ask them, “Do you want one where insurers and PBMs do?”

Short Takes

Expanding bird flu testing

Despite pushback from the dairy industry, the USDA is starting to take bird flu more seriously. It’s now expanding human testing to anyone exposed to sick animals, not just people with symptoms.

The change to the agency’s testing recommendation comes as the U.S. Department of Agriculture is also expanding its testing of milk for bird flu, signaling concern by both agencies about the ongoing spread of the virus on dairy and poultry farms.

ICYMI: Diabetes is everywhere

The latest CDC figures show that almost 16% of Americans have diabetes — 1 in 6. (The vast majority have type 2.) And those are the diagnosed cases; there are probably a lot more out there.

Contrast the previous figures from 2000, when only about 9.7% had diabetes, so something is pushing the numbers up. (Age is certainly a factor, though.)

Isn’t this how a horror film starts?

“Police hunt 43 monkeys that escaped from a South Carolina research facility”

The Long Read: Detective work

It didn’t take long for health officials to figure out that it was tainted onions making McDonald’s customers sick. How’d they find the answer so quickly? Let’s just say these people — the CDC and state health departments — really know what they’re doing. Enjoy “How disease detectives’ quick work traced deadly E. coli outbreak to McDonald’s Quarter Pounders.”