Ripple effects

The opioid epidemic has led to an increase in heart infections — infective endocarditis — especially among young, poor, white men. And it’s nationwide.

These patients underwent cardiac or valve surgery more often, had a higher median length of stay, and a higher hospitalization cost, but a lower inpatient mortality.

Herpes vaccine for rodents

If you worry that your mice or guinea pigs might contract genital herpes, good news: UPenn researchers have apparently developed a vaccine that prevents it — i.e., “the immunization led to ‘mostly sterilizing immunity’ from the virus—the strongest type of immunity.”

This vaccine stimulates three types of antibodies: one that blocks the herpes virus from entering cells, and two others that ensure the virus doesn’t “turn off” innate immune system protective functions.

Holy grail for type 2?

The FDA approved Novo Nordisk’s oral semaglutide (its friends call it Rybelsus) as a once-daily pill to treat type 2 diabetes.

The company, and some pharma wonks, are calling the GLP-1 receptor agonist the holy grail (small “g”) of diabetes treatment … which you can believe will mean it’s priced accordingly.

While we’re talking about diabetes…

Researchers from Australia and Canada have found how the gut biome affects serotonin production. The bacteria, for reasons of their own, communicate with serotonin producers, which affects glucose production. (Or, as they put it, “The gut microbiome regulates host glucose homeostasis via peripheral serotonin.”

Finding which bacteria do that is the next step, so there’s a chance to use the knowledge to regulate blood-sugar levels.

A drink for cancer patients

Nestlé, which has long had a reputation for caring about people’s health, is introducing a new drink for cancer patients: Boost Soothe. What’s the gimmick? It’s designed with patients’ side effects in mind, specifically “oral discomfort and taste alteration.”

What color ribbon are you supposed to wear?

Surprise — docs fight billing proposal

Stopping surprise medical bills — when hospital patients are treated by an out-of-network provider without their knowledge and find themselves on the hook for thousands of dollars — looked liked it was going to be solved in a bipartisan way.

Not so fast! Physicians are fighting back because they don’t like the proposed solution, which would set benchmark prices for OON payments.

Bonus: The article quotes our own Buddy Carter.

E-cig updates

Walmart won’t sell them anymore.

Senators wants the FDA to ban them, at least temporarily.

TV networks are refusing to run their ads.

There’s a Smurf joke here somewhere

A Rhode Island woman was diagnosed with “acquired methemoglobinemia” when she walked into a ER because she was turning blue. It turned out to be a rare reaction to benzocaine, which she had used for a toothache.

The ironic treatment: methylene blue.

Look! Up in the sky! It’s my Benadryl delivery!

Walgreens, partnering with Alphabet*, is about to start testing drone delivery. Next month it will begin tests of sending foods, beverages, over-the-counter meds, and more by autonomous drone. No, it won’t deliver prescription meds … yet.

* Google’s parent company

Our number two story

Add to the list of reasons to help patients who are obese: A new study by researchers at Beth Israel Deaconess Medical Center found that obesity directly correlates with chronic diarrhea — the higher the BMI, the greater the risk.

“Our research confirms a positive association between obesity and chronic diarrhea and reveals for the first time that this relationship is not driven by confounding factors such as diet or physical activity level.”

Diabetes: Monitoring FTW

If you want to help patients control their diabetes, the answer is CGM. A three-year study finds that continuous glucose monitoring — the emphasis is on continuous; we’re not talking about “flash” monitoring — was the most important factor in controlling diabetic reactions.

Pumps are great, fo’ sure, but CGM gives the best outcomes.

Above link goes to the news story; here’s the paper.

CBD studies get some research cash

Can CBD treat pain? The National Institutes of Health is spending about $3 million to find out. (It’s actually looking at other components of cannabis as well, including cannabigerol, cannabichromene, and terpenes — everything but THC.)

Taking polypills to heart

A combination drug — a polypill — with low doses of amlodipine (2.5 mg), atorvastatin (10 mg), losartan (25 mg), and hydrochlorothiazide (12.5 mg) lowers the risk of heart attack, stroke, and heart disease. It’s been used in low-income countries, so can it be used for low-income Americans as well?

Private problems

Privately run Medicare plans mean some patients can’t get their drugs. When there are so many payors involved — not to mention PBM middlemen — prescribers can’t find out what’s covered. And patients suffer — “as many as 84 million pharmacy claims were rejected in 2017 by the private health insurers that run Medicare’s drug benefit, known as Part D,” according to HHS.

The bureaucratic hiccups can delay or prevent people from getting needed medications. It’s a consequence of the administrative complexity of American health care. An intricate chain of middlemen and third-party payers links suppliers of medicine with patients, so a snag anywhere along the way can create headaches for patients and their families.

There’s a target all right

If you were worried that senior management at Purdue Pharma might not get their bonuses if the company declares bankruptcy, fear not. The company is hoping to pay about $34 million in bonuses to people who have met “target performance goals.”

Come work at GPhA

Are you organized, discreet, and able to lift up to 30 pounds occasionally? GPhA is looking for an executive assistant and
governance manager to succeed our outgoing staff member (whose name we won’t use because we’re angry at her for leaving).

The official description:

Provides operational, organizational and administrative support to effectively manage all aspects of the CEO’s office, including the administrative operation of the governance committee, board of directors, nominating committee, and other groups as assigned.

The basic requirements:

• Five years of increasingly responsible secretarial and administrative support work for management personnel.
• Experience in working for a CEO or top manager in an organization preferred.
• Associates degree or equivalent experience required; bachelor’s degree preferred.

Click here for a PDF with all the details and requirements of the position. Anyone interested should send a thoughtful cover letter describing how your skills and experience
meet the qualifications of this position to hr@gpha.org. Reference “Executive Assistant &
Governance Manager” in the subject line.

A dog means a healthier heart

Owning a dog seems to be good for your heart. Czech researchers found that dog owners — despite the fact that they were more likely to smoke than people with different or no pets — were “more active, had better levels of blood fat and blood sugar, and were less likely to be obese, giving them an overall better cardiovascular health profile than the rest.”

Correlation/causation check: It might not be the dog itself, but the fact that it has to be walked; exercise helps.

Look at my zits!

If you’ve got teenage patients/customers with acne, one company thinks they ought to draw attention to their spots rather than try to cover them up — while healing them at the same time. We wish Hydro-Stars luck with that plan.

Dermatologists say that the key to treating zits is to protect them from outside bacteria. […] Hydro-Stars are made from hydrocolloid, a substance used in surgical dressings that has been proven to accelerate zit healing.

It’s only teenage vaping

But it’s on the rise. It’s almost as if nicotine is addictive or something.

Preliminary figures from a national survey show that the prevalence of e-cigarette use among minors has doubled from 2017 through this year.

Let’s keep going with vaping news

The House Committee on Oversight and Reform has sent a strongly worded letter to Juul: ‘We asked you for documents several times. You haven’t delivered. This is your last chance before you feel the power of this fully operational battle station.’ (I.e., don’t make us force you to testify.)

Juul’s record is woefully inadequate and appears to directly contradict the testimony of your co-founder and chief product officer….

And in Georgia…

The state is up to five cases of the Mysterious Vaping Illness that has popped up in 36 states, affecting at least 380 people.

Elsewhere: Subcontinent Edition

Yesterday we told you that China had banned Juul without explanation. Today, it’s India that has banned all e-cigarettes — immediately. As in “Those with stocks of e-cigarettes are being told to declare and deposit them with the police.”

Elsewhere: Land o’ Lincoln Edition

Illinois is looking to set a cap on insulin prices: $100 for a 30-day supply.

Georrrgia agrees to Purdue deal

Georgia joins 23 other states in agreeing to a proposed settlement from Purdue Pharma, according to state Attorney General Chris Carr.

ICYMI: Purdue offered to declare bankruptcy, with the sale of the company — plus another $3 billion from the Sackler family — going to states, counties, cities, and towns to help alleviate the financial cost of the opioid crisis.

Stumbling blocks: While Georgia is willing to accept the Purdue offer, those who oppose the deal are among the largest, including California, Massachusetts, New York, Pennsylvania, and Virginia. And it’s also not clear how the money will be divided, and who will control that — states, cities, or the feds.

Arrr … Medical-data breaches in Georgia

At least 14 Georgia companies, hospitals, and other medical organizations are under investigation by the U.S. Department of Health and Human Services for “breaches of unsecured protected health information*.”

Most involve the use of e-mail to send patient records, but some, like that of North Atlanta Medical Clinic this past January, are due to unauthorized access to a computer.

The largest breach was that of the Georgia Department of Human Services 10 months ago, which affected more than 439,000 individuals; close behind was a breach at Augusta University Medical Center (417,000 individuals affected).

Many breaches across the country are categorized as “Hacking/IT Incident.” While that may sound sinister, in reality the records might be more easily accessible than you would expect in the Age of HIPAA.

* You can look up breaches across the country at https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf

ABAC + PCOM = faster PharmDs, matey

Abraham Baldwin Agricultural College is partnering with PCOM Georgia on a program that will allow ABAC students to get their PharmDs from PCOM a year early.

[A]fter completion of the second year of pharmacy school, these students will be eligible to receive their bachelor’s degree from ABAC having earned the required credits during their first two years at PCOM Georgia.

Avast! Pharmacists continue vaccine push

Pharmacists for Healthier Lives (of which GPhA is a proud sponsor) is launching a new campaign to spread the word that immunization is critical. It features six videos from pharmacist — called “Impact Stories” — explaining why. You can view them at the PhHL site.

Snakes. Blimey, why did it have to be snakes?

Snake bites are on the rise in Georgia, sending more people to the hospital — we’re talking 98 so far this year who have needed an antivenin shot (last year at this time it was only 79), and 300 more who were bitten.

“Of those, we’re seeing more venomous snakebites,” said Dr. Robert Geller, medical director of Georgia Poison Center. “Get up close and personal with snakes you’re asking for trouble.”

Batten the hatches, it’s diabetics vs insurers

It’s bad enough that insulin is so overpriced these days that some diabetics have to ration their meds (or, if they’re lucky to live close to a border, to get it in Mexico or Canada).

Others, it seems, have to fight with insurers over prior authorization for their continuous glucose monitoring supplies.

Of the 1,000 physicians surveyed, 91 percent said prior authorizations “have a negative impact on patient clinical outcomes;” 75 percent said the requirements “can at least sometimes lead to patients abandoning a recommended course of treatment;” and 28 percent said the prior authorization process had “led to serious or life-threatening events” for their patients.

Artist’s conception

What do they be knowin’ that we don’t?

China has halted all sales of Juul e-cigarettes without explanation.

Heave to! The long read: Short-term insurance

Remember those “short-term” insurance plans that don’t meet Obamacare requirements? The ones the Trump administration said “can provide a much more affordable option for millions of the forgotten men and women left out
by the current system”?

Well … as expected, they’re coming back to bite the people who signed up for them.

Who’s the biggest thorn in pharma’s side?

It could very well be AARP. It’s got deep pockets, growing clout, and it’s very, very angry about drug prices — and it knows who to blame.

If there was any doubt of its target, the group’s first commercial cleared that up: An ominous voice declared, “The big drug companies don’t see us as people.”

Don’t vape CBD

Just don’t. Because even the stuff sold in stores might not actually contain CBD — it might have synthetic marijuana, fentanyl, or worse. There’s little oversight about what’s actually in them, and the same brand might have different ingredients from store to store.

At least 128 samples out of more than 350 tested by government labs in nine states, nearly all in the South, had synthetic marijuana in products marketed as CBD.

A break from measles

For the first time since January, there were new new measles cases in a week, according to the CDC. But 2019 is still on track to have more than double the cases of the last year with an outbreak: 2014, with 667 cases.

Trade war: Medication in peril?

As the Trump administration’s trade war with China continues, it’s not just farmers and manufacturers being hit — drug makers and health officials are concerned because so many ingredients come from China.

“If China shut the door on exports of medicines and their key ingredients and raw material, U.S. hospitals and military hospitals and clinics would cease to function within months, if not days.”

Flu patch for mice

If you know a mouse who doesn’t like getting shots, good news: A patch-based flu vaccine appears to do the trick sans side effects. Unfortunately, it appears to work only if the mouse has already been exposed to a flu virus — then again, it’s still in the early stages.

More Purdue

If you’re confused about the (proposed) Purdue bankruptcy settlement, the New York Times has you covered. The big questions: 1) Can a company in solid financial condition declare bankruptcy to settle/avoid lawsuits? and 2) Will the settlement protect the Sackler family, or just Purdue Pharma? Read on, MacDuff.

How ya doin’?

APhA and the Mayo Clinic would love you to check on yourself. They’ve got a six-minute quiz — The Well-Being Index that “provides you immediate individualized feedback including tools and local and national resources to address your well-being.”

Give it a shot, why doncha? Head over to mywellbeingindex.org/signup, use “APhA” as your participation code, then register and take the survey. What you do with the result … well, that’s up to you.

Max Mason passes

We were saddened to learn of the passing of Max Mason, who served as 1985-86 GPhA president, on September 7. A service celebrating his life will be held at Patriot Hall, 320 Emberson Drive in Ringgold [map] this coming Sunday, September 22, at 2:00 p.m.

Help Mercer students help the Bahamas

A year ago, Gil Arquisola and four other student pharmacists from Mercer planned a rotation in the Bahamas. Little did they know that they would be helping with recovery from a catastrophic hurricane.

Before they leave in a few weeks, Gil and his colleagues are hoping to raise some funds for the relief efforts there. They’ve set up a GoFundMe page with the hopes of raising just $5,000.

“Before we head off towards our rotation, my colleagues and I humbly request your help with financial donations that can help us to provide clothing, supplies, and various items that are being requested to help with relief efforts. ANY donation is greatly appreciated and will be utilized to purchase items from a list that has been provided by our preceptor.

Visit the page to make a donation, or drop him a note at gillian.cenon.arquisola@live.mercer.edu if you have questions.

Purdue goes bankrupt … maybe

Well, it’s trying. The company want to shield itself — and more important, its owners, the Sackler family — from more than 2,600 lawsuits over its role in igniting and furthering the opioid crisis.

But wait: The states aren’t on board, in part because they’re suing both Purdue and the Sackler family, which has more money than the company. Purdue is worth at most about $10 billion, which isn’t much when spread across the states, towns, and cities hit by the crisis. The proposed deal would protect the Sacklers themselves.

Fun fact you might have missed: The Sacklers were caught over the weekend having tried to take at least $1 billion out of Purdue Pharma and sneak the money into offshore accounts. And that info comes from just a single subpoena (out of 33) from the New York attorney general; more are pending to uncover the family’s money-laundering operations.

Legal maneuvers

In the other opioid trial (the one in Ohio), the drug distributors and retail chains being sued are trying a surprise legal move: They want to disqualify the judge overseeing the case. Why? He had said he is hoping for a speedy resolution to (as the New York Times put it) “bring relief as quickly as possible to local governments and individuals hit hard by crisis.” That, say the defendants, proves Judge Dan Polster wants them to lose.

This is the second unusual move in the case. Previously, attorneys general from several states tried to stop the trial because the plaintiffs are towns and cities — they say only states should be involved.

Ranitidine recall?

Remember the valsartan recall because of potential cancer-causing impurities? Now those same impurities turned up in ranitidine — aka, Zantac. No recalls … yet.

Walmart Health update

In case you’re curious about the Walmart Health center opening in Dallas, Georgia, International Supermarket News reprinted the press release for your enjoyment. Our favorite part: The pharmacy. It’s not just a pharmacy — it’s a “reimagined experience.” (Seriously*.)

Got concerns about seeing a physician or dentist in a Walmart? “The Walmart Health center,” the company makes clear, “will be operated by qualified medical professionals.”

* “I can imagine quite a bit.” —Han Solo

Office-based physicians write a lot of off-label scripts

So finds a new study out of Rutgers. A few fun facts:

• 18.5% of visits ended with an off-label prescription.
• 83% of newborns got one.
• Girls were more likely to get one, as were kids who were already taking other meds.
• Over the 10 years studied, “[O]ff-label orders for antihistamines and several psychotropics increased
  over time, whereas off-label orders for several classes of antibiotics were stable or declined.”

“Therapeutic medical gas”

People who invested in “molecular hydrogen” water machines, which they heard about on social media, are shocked — shocked! — to find that this ‘health miracle’ is far, far from miraculous.

Trusii operates in the largely unregulated $40 billion-a-year U.S. market for dietary supplements, where pseudoscience and bogus assertions are rampant. The claims and promises can spread virally to millions of people on social networks, the same way that anti-vaxxers have advanced baseless notions about the dangers of vaccinating children.

Elsewhere: Big cheeses

So Wisconsin had itself a big ol’ bust: A couple of suburban guys who were selling THC-filled vaping cartridges out of their home. (Such “street-made vaping products” are a prime suspect in the Mysterious Vaping Illness that continues to confound health officials.)

The Long Read: RICO edition

“Inside the drug industry’s
plan to defeat the DEA” from the Washington Post.

The industry enlisted members of Congress to limit the powers of the Drug Enforcement Administration. It devised “tactics” to push back against the agency. And it commissioned a “Crisis Playbook” to burnish its image and blame the federal government for not doing enough to stop the epidemic.

Senators to administration: End DIR fees

We love a bipartisan story, especially when it’s good for pharmacists like this one. More than 80 percent of the Senate Finance Committee — 11 Republicans and 14 Democrats — sent a letter to HHS and CMS asking that they “close a Medicare regulation loophole – known as pharmacy direct and indirect remuneration (DIR) fees – that inflates patients’ out-of-pocket drug costs and that is pushing pharmacies out of business.”

DIR reform was initially part of a 2018 plan from the Trump administration, but it ended up being cut in the final Medicare rule. It’s time, the senators said, to bring that back. Just about every major national pharmacy organization gave its “Amen!” to the letter.

Why can’t we make better cancer drugs?

The answer might be that the drugs we have are hitting more than one target — and leading to incorrect conclusions.

For example, scientists might think that protein A is critical for cancer cells, and make a drug to attack it. It works. But they don’t realize that the drug is also affecting proteins B and C, and those (not the attack on protein A) are what’s making the drug effective. It’s called “off-target toxicity.”

The result is drugs that work, but not for the reasons we think … and that makes improvements harder to create.

This is more about reminding you that this product exists

Albertsons will now sell DisposeRx packets at all its pharmacies. Each packet — which costs about a dollar — lets a patient mix leftover pills with a powder that turns them into an unusable “thick, nontoxic and nonhazardous gel.”

Automating insulin gets popular

In case you’re curious, a new paper in Diabetes Care reports that, since 1995, insulin pumps have been continuously getting more popular (usage went from 1% to 53%!), and — especially for kids — continuous glucose monitoring has also become more common. That is all.

Will patients talk to robots?

Pfizer wants to know. It’s starting a pilot program with a little yellow robot called Mabu from Catalia Health. The idea is that patients will talk to Mabu, and the robot will work with caregivers to manage treatments.

Mabu uses voice interactions powered by conversational AI to assess a user’s mood, record data, manage symptoms, and provide helpful information. The robot then supplies information back to medical professionals — like caregivers or clinicians — such as the frequency of medication usage or questions the robot was unable to answer.

You don’t say?

Shocking revelation: If you don’t have Celiac disease, gluten won’t cause you any kind of GI problem. We appreciate getting health advice from celebrities as much as anyone, but sometimes it’s nice to live in the real world too.

Purdue might settle

Purdue Pharma has (tentatively) agreed to a settlement for the thousands of lawsuits against it for the company’s role in the opioid crisis. Bankruptcy is involved, and the company — but not the Sackler family — would be dissolved. it still needs to be approved by the Purdue board — and the court. As Georgia is part of the lawsuit, Attorney General Chris Carr is evaluating the proposal as well.

New diabetes resources

The National Diabetes Prevention Program has unveiled a bunch of new resources for pharmacists looking to help fight diabetes — videos, printable brochures, a template to promote their services, and more.

Check them out at the NDPP’s site.

Redacting the evidence?

Did a judge hide evidence about the dangers of a drug? Legal documents obtained by Reuters seem to say so — and it’s part of a widespread issue of evidence being hidden from the public under the cover of “product secrecy.”

Judge Brian Cogan allowed the medical secrets contained in the documents to be kept out of public view. Reuters is able to report this confidential information now only after discovering filing errors that left some of it exposed.

Court secrecy has become pervasive even though, as a matter of law, court records are presumed to be public.

Flavored e-cig ban?

The FDA says it’s drawing up a plan to ban flavored e-cigarettes in the wake of A) a spike in teen use of the nicotine-delivery devices, and B) the emergence of a still-mysterious vaping disease that has already killed at least six people*.

* And caused thousands of writers and editors to wonder if the word “disease” is correct

Make like a tree

Dutch researchers at the Eindhoven University of Technology have cribbed from Mother Nature’s toolkit: They made artificial leaves that produce pharmaceuticals. Translucent material allows sunlight to hit microfluidic channels in the leaves, which triggers a chemical reaction.

The team put it to the test and found that it was able to successfully produce two different drugs: artimensinin, which is effective against malaria, and ascaridole, which is used against certain parasitic worms.

The idea is that leaves like that could be used in remote locations — making malaria treatment in the tropics, for example.

Longer lasting livers

It’s really that simple: NIH scientists have found a way to make a donated liver last 27 hours in a vat, rather than just nine. As anyone who has sat in traffic or seen their flight delayed knows, this could be a game-changer for people waiting for that transplant.

The trick: Cooling the liver to 6℃ in an airtight bag, and using antifreeze to keep it from being damaged by the cold. (Don’t try this at home.)

Stop us before it’s too late

Even as they race to create human embryos from stem cells, scientists (well, at least some of them) say there need to be legal guidelines in place.

For now, scientists say, these aren’t true embryos and lack the capacity to turn into a person. However, as similar research races forward in Europe and China it is raising questions about how close scientists really are to synthetically creating viable human embryos in their labs.

Cipro vs the heart

Cipro and its fluoroquinolone friends might have a dangerous downside: Tests show that patients who take those antibiotics “face a 2.4 times greater risk of developing aortic and mitral regurgitation, where the blood backflows into the heart, compared to patients who take amoxicillin.”

CAR-T vs heart disease

Mice with a particular kind of heart failure might be helped by CAR-T — the immunotherapy that’s being used to treat cancer. Instead of looking for proteins in cancer cells, it targets a protein present in scar-tissue cells in the heart, then clears out that scarring. The downside is that a full course of CAR-T treatment can cost $1 million, and few mice have that kind of money.

GPhA fights Centene-WellCare merger

Centene and WellCare — two of Georgia’s Medicaid managed care organizations (MCOs) — want to merge. And, GPhA is urging Insurance Commissioner John King not to approve the merger.

During what turned into an almost four-hour hearing, the commissioner heard arguments for and against the merger. GPhA went to bat both in person and with a detailed follow-up letter, laying out just how bad this merger will be for the state by diving deep into the numbers to rebut Centene’s arguments for expansion. (You can read the letter here.)

GPhA built a coalition of support with our friends from the Medical Association of Georgia and the Georgia Society of Clinical Oncology, both of which joined in the case against the merger. That is our advocacy team at work, fighting for pharmacists and patients.

It doesn’t take an economics degree to see that giving one company control of 61 percent of Georgia’s Medicaid patients’ healthcare is a recipe for skyrocketing costs and wasteful spending. Yet that’s what Centene was asking for, and that’s why GPhA was there, fighting to prevent a bad deal for the state.

With CEO Bob Coleman in attendance, VP of Public Policy Greg Reybold pulled together a formidable team to testify against the merger. (A big thank you to Benji Black, Laura Ko, and Loren Pierce, for coming to speak out against the merger!)

What Centene is proposing would create the nation’s largest Medicaid managed care organization. It’s bad enough that PBMs already take a huge chunk of the state’s Medicaid dollars to “administrate” prescription drug benefits*. MCOs have their fingers in the pie as well: For every Medicaid dollar the state spends, it pays Centene Management Services (or one of the other MCOs) between 10.5% and 11.5%.

That’s hundreds of millions of dollars Georgia spends on “healthcare” that just pays private corporations to manage the process. Now Centene and WellCare want to merge to get a larger market share, less competition, and a bigger slice of the taxpayers’ pie … and they have the nerve to say this will somehow be good for patients.

Just trust them.

But apparently even they aren’t quite sure of the economic results. In one document, Centene says that “economies of scale” will make this mega-MCO cost less. (Hint: That’s not how economies of scale work.) Then, in another, it flip-flops and says it won’t really know the impact on Georgia Medicaid until after “an initial transitional period.” And Centene repeatedly claimed there would be no layoffs … so where will these economies of scale come from?

Finally, if you got this far and haven’t been shaking your head, here’s another bit of information to consider: According to survey data, Centene and WellCare aren’t even very good at what they do. In half of performance measures, both companies were ranked below average.

Now they want to merge. And Georgians will pay for it.

Here’s the story from GeorgiaPol. Read it. Share it. We’ll continue to keep you informed.

* A staggering 25 percent of Georgia Medicaid’s prescription drug spending didn’t go to pay for drugs — it went to pay PBMs. We’re talking $27 million for “administration.”

** By the way, Centene has an ownership stake in two PBMs … but please don’t call it “double-dipping.”

And then there were six

Deaths from the ‘mysterious lung disease related to vaping,’ that is. Lots of ideas about the cause, but no firm answers.

Nutrition help for Medicare patients

Got Medicare patients with diabetes? Did you know that Medicare covers “personal nutritional counseling” with a dietician? A lot of people don’t realize there’s a benefit waiting to be taken.

The estimated 15 million Medicare enrollees with diabetes or chronic kidney disease are eligible for the benefit, but [the program] paid for only about 100,000 recipients to get the counseling in 2017.

Two minutes on health insurance

The number of uninsured Americans has risen for the first time since the Affordable Care Act took effect.

The uninsured rate rose from 7.9 percent in 2017 to 8.5 percent last year, amounting to nearly 2 million more uninsured people, as experts said the Trump administration’s efforts to undermine the Affordable Care Act were partly to blame.

Georgia has slipped (sort of) — it now has the third worst rate of uninsured people, behind only Texas and Oklahoma; 13.7 percent of Georgians don’t have health coverage. (I say “sort of” because we’ve always been either third or fourth from the bottom depending on which stats you use.)

That said, a lot of them are eligible for either Medicaid or federal subsidies, but aren’t taking advantage of them. (That percentage is obviously higher in states with expanded Medicaid, but still.)

Why not? Many say they still can’t afford one, but others don’t think they need insurance or don’t realize they’re eligible for free or discounted plans.

The long read: Insurance fraud

Medicare and Medicaid are pretty good about going after fraud. But private insurers? Not so much.

“We Asked Prosecutors if Health Insurance Companies Care About Fraud. They Laughed at Us.“

If Buzz is late, this may be why

“New Study Suggests That a Nap Can Save Your Life”

The researchers indicate there’s still quite a bit of research to do before we’ll understand how naps and cardiovascular health are related, but they feel this study is a good start.

Dems channel Trump with drug-pricing proposal

An early draft of the Democrats’ drug-pricing proposal has some familiar ideas — because they sound a lot like ones Donald Trump has supported: giving Medicare authority to negotiate drug prices (at least for the 250 most-costly meds that don’t have generic or biosimilar versions) and linking U.S. prices to those in other countries (which already negotiate prices).

But also in the plan is a requirement that drug companies keep their price hikes to within the rate of inflation or face some serious penalties.

The version out there is an early one, but it gives an idea what’s going to be on the table.

Fred’s closes

The retailer and pharmacy is closing its remaining 300 stores and declaring bankruptcy.

Ernie your BHRT

In case you forgot that we’re living in a science-fiction world, check this out: You can take a CE course in “bio-identical hormone
replacement therapy” (BHRT). Seriously, roll that on your tongue: bio-identical hormone
replacement therapy. Way cool!

Anyway, the course will cover a lot — from “basic pharmacology and
physiology of the sex steroids” through developing a plan for a BHRT clinical practice.

It’s being held at Integrity
Compounding Pharmacy in Sandy Springs (8601 Dunwoody Place, Suite 750 [map]) and taught by the acclaimed Jim Paoletti.

Click here for all the deets and to register!

Opioid treatment funding cliff

States just got $1.8 billion in funding to help fight the opioid epidemic. The problem: It’s a one-time grant with no follow-through (yet). That means states that have not expanded Medicaid will be using those funds for people who can’t afford treatment. And when that money runs out ….

“We have a huge population of uninsured that can receive treatment from these funds, but how are they going to continue to receive treatment? We know [opioid abuse] is a condition that requires many years, if not a lifetime, of treatment and recovery support.”

Google refuses ads for unproven medical treatments

Google says it will no longer accept ads for treatments that have “no established biomedical or scientific basis,” e.g., “speculative or experimental medical techniques.” Notably, that includes stem-cell therapies; here’s the news story behind that.

The new policy also includes treatments that are rooted in basic scientific findings and preliminary clinical experience, but currently have insufficient formal clinical testing to justify widespread clinical use.

New FDA commish?

Outgoing FDA Commissioner Scott Gottlieb recommended that Ned Sharpless succeed him. At least four other former commissioners agreed. But the White House has different ideas, and is looking at Stephen Hahn: “a 59-year-old oncologist, is an accomplished researcher and longtime GOP donor” who has an interesting trail of controversies following him — but with “political savvy” and a open, even gregarious personality.

Elsewhere: British addiction

A new review of Brits’ prescription use finds a lot of potential addiction — and a desire not to end up like the U.S. when it comes to opioids.

[L]ong-term antidepressant use is necessary for some. More worrying, say the experts, are the half a million people who have been on opioid painkillers for more than three years for chronic conditions such as lower back pain and joint pain. The drugs are addictive and paracetamol or ibuprofen work as well or better, say experts. Opioids should be kept for acute pain, such as in cancer.