Wednesday, May 4, 2022

Axios Vitals: Abortion in America

Plus: A Biogen shakeup | Wednesday, May 04, 2022
 
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Axios Vitals
By Tina Reed · May 04, 2022

Good morning, Vitals readers. Today's newsletter is 978 words or a 4-minute read.

 
 
1 big thing: The state of abortion in America
Data: Guttmacher Institute; Map: Thomas Oide and Erin Davis/Axios

The number of U.S. women who get abortions has decreased dramatically in recent decades, with typical patients now tending to be in their 20s and living in blue states, Axios' Caitlin Owens writes.

Why it matters: Abortion access is likely to be drastically curtailed in red states should a leaked draft of a U.S. Supreme Court decision hold, gutting the federal right to an abortion.

  • But the profile of abortion patients has trended older since that right was established, and the vast majority of procedures tend to be early in pregnancies.

State of play: In 2019, nearly 630,000 abortions were reported to the CDC, reflecting a rate of about 11.4 abortions per 1,000 women aged 15–44 years.

  • Around 18% of all pregnancies in the U.S. end in abortion, according to the CDC.
  • Women in their 20s accounted for the majority of abortions between 2010 and 2019
  • That year, more than three-quarters of abortions were performed by nine weeks of a pregnancy, and rates were higher among Black and Hispanic women than among white women.
  • Factors influencing the abortion rate include access to health care services and contraception; the availability of abortion providers; state regulations, such as mandatory waiting periods; parental involvement laws and legal restrictions on providers, the CDC writes.
  • The state of the economy and resulting impact on family planning decisions and contraceptive use also play a role.

The big picture: Abortion rates have been declining for years, particularly among adolescents. The overall birth rate has also declined since 1973, according to the Guttmacher Institute.

  • Many of the states in the South and Midwest most immediately poised to act to eliminate access should the high court rule against a federal abortion right already have lower-than-average abortion rates.
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2. The far-reaching impacts of Roe v. Wade

Illustration: Aïda Amer/Axios

 

The implications of Roe v. Wade being overturned could stretch far beyond accessing an abortion.

Why it matters: Patients experiencing early miscarriages, ectopic pregnancies or life-threatening medical conditions could also lose access to timely care.

  • Legal protections for birth control and in vitro fertilization treatments are also at risk, experts said Tuesday.

What they're saying: "What's important to understand is Roe is really built on a whole web of rights and they all kind of tie back to, or are premised on privacy," said Neel Shah, chief medical officer at Maven, a virtual women's health clinic.

  • "That's why, beyond abortion, this could create a precedent that could impact the spectrum of reproductive rights," Shah told Axios.

Related: Companies face abortion test

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3. Medicare cost savings from COVID shots

COVID vaccines saved the nation $2.6 billion from reduced hospitalizations of Medicare beneficiaries from January 2021 to May 2021, according to an HHS report released first to Axios.

Driving the news: HHS Secretary Xavier Becerra plans to highlight the savings today as he testifies before a Senate Appropriations subcommittee about President Biden's proposed 2023 budget.

Zoom in: The cost savings reflect 107,000 fewer Medicare hospitalizations than projections if no vaccines were available at that time.

  • Medicare beneficiary cost-sharing was reduced by an estimated $207 million due to reduced COVID-19 hospitalizations during this period.
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A message from PhRMA

Voters want Congress to address health insurance
 
 

Many Americans reject so-called government "negotiation" once they learn it could sacrifice access, choice and innovation.

Respondents find health care coverage costs unreasonable and a top priority health care issue for policymakers to address today.

Read more in the new survey.

 
 
4. Biogen shakeup could shift research

Photo: John Tlumacki/The Boston Globe via Getty Images

 

Biogen's decision Tuesday to replace its CEO and largely give up marketing the controversial Alzheimer's drug Aduhelm could refocus attention on drugs that target disease processes that contribute to Alzheimer's, Axios' Adriel Bettelheim writes.

The big picture: Aduhelm's effective demise means we'll likely need multiple drugs and diagnostic tools to tailor combination treatments for individual patients, according to experts.

Background: The first Alzheimer's drug to win approval in about two decades, Aduhelm targeted a brain plaque called amyloid thought to contribute to the condition and spurred excitement and an intense advocacy push from patient groups.

  • But it was panned within the medical community over unproven clinical benefits, serious side effects and $28,000 annual price tag.

Look ahead: Researchers now are evaluating a broader approach to target underlying pathologies of Alzheimer's.

  • The could entail repurposing old drugs for other conditions, like bumetanide, a diuretic that's been shown to reverse signs of the disease in mice and human cells in labs.
  • "More than three in four of today's Alzheimer's clinical trials are testing treatments that work on non-amyloid targets, like inflammation, vascular dysfunction, and genetic alterations," said Howard Fillit, co-founder and chief science officer of the Alzheimer's Drug Discovery Foundation.
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5. Most parents will wait on young kid COVID shot

One in five parents of children under age 5 are ready to get their kids vaccinated as soon as COVID-19 shots are available for that age group while about twice as many parents are taking a wait-and-see approach, Adriel writes about a Kaiser Family Foundation survey.  

Why it matters: Public frustration with the timeline for authorizing vaccines for young children — and parents' complaints they don't have enough information — haven't significantly dampened public confidence that the shots are safe.

By the numbers: Though the FDA has still not authorized any COVID-19 vaccine for young children, 18% of parents of children under 5 said they'll vaccinate their kids right away once a shot is authorized.

  • Another 38% said they'll "wait and see," and four in 10 others are more reluctant.
  • 56% said they don't have enough information about the safety and effectiveness of COVID-19 vaccines for young children.

Yes, but: Views on vaccine safety don't appear to have changed significantly in the face of FDA delays in the authorization process.

  • 22% said the delay has made them more confident while 13% said it made them less confident.

Workplace issues: With more employees returning to workplaces, the survey found Black and Hispanic respondents and those with lower incomes less likely to report feeling safe when they go to work.

  • Black and Hispanic parents also are less likely than white parents to say they feel their child is very safe at school and more likely to say their child usually wears at a mask while there.

The survey of 1,889 adults was conducted April 13 to 26, before Moderna requested the FDA authorize its COVID vaccine for children under 5.

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A message from PhRMA

Insured Americans face barriers to care
 
 

Nearly half of insured Americans who take prescription medicines encounter barriers that delay or limit their access to medicines.

Learn more about the abusive insurance practices that can stand between patients and the care they need in PhRMA's new report.

 
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