Axios Vitals: The post-Roe battlefield

Another challenge for ACA | Tuesday, July 26, 2022

Open in app View in browser   Presented By Pharmaceutical Care Management Association   Axios Vitals By Adriel Bettelheim · Jul 26, 2022 Welcome back, Vitals readers. Today's newsletter is 789 words, or a 3-minute read. Join me and Axios' Caitlin Owens tomorrow at 12:30pm ET for a virtual event examining the path forward for health care in a post-pandemic world. Guests include Centers for Medicare and Medicaid Services administrator Chiquita Brooks-LaSure and Rep. Fred Upton (R-Mich.). Register here.     1 big thing: Post-Roe fight reaches pharmacies Illustration: Sarah Grillo/Axios   The post-Roe battlefield is spreading to pharmacies, where drugs that can cause fetal abnormalities or that have multiple uses that include ending pregnancies are being put through more scrutiny, Axios' Arielle Dreher writes. The big picture: Some patients with rheumatoid arthritis, lupus and stomach ulcers are facing delays getting critical treatments while providers verify the drugs' intended use to pharmacists and insurers. The concern is that without more legal clarity, providers could face criminal charges for helping provide abortion care. Driving the news: Much of the current focus is on methotrexate, an immunosuppressant used to treat some cancers and inflammatory diseases that also can cause miscarriages and is used to treat ectopic pregnancies. It's part of a cohort of drugs that might be classified as "abortion-inducing" by states that have banned abortion, leading to uncertainty about other uses. Drugs that can cause fetal abnormalities are also caught up in the confusion, including accutane for severe acne, which is only prescribed if patients pledge to be on two forms of birth control. The bottom line: When providers can't prescribe the best treatment for a patient, they are left with "less clinically efficacious drugs or maybe more costly drugs," said Deepak Sisodiya, chief pharmacy officer at UCLA Health Services. Go deeper.     2. Another day in court for the ACA Illustration: Lindsey Bailey/Axios   The Affordable Care Act is once again being challenged in federal court, this time with big implications for the private insurance market that dovetail with concerns about contraception access in the post-Roe world, Axios' Caitlin Owens writes. Why it matters: A pending federal case takes up whether part of the law requiring coverage of preventive services is unconstitutional. If the plaintiffs are successful, millions of people could lose access to such free services as cancer screenings, immunizations and contraception. Driving the news: The plaintiffs of Kelley v. Becerra and the federal government will make their case this morning in a federal district court hearing in Texas before Judge Reed O'Connor. If that name sounds familiar, it's because O'Connor is the same judge who sided with the plaintiffs of the last major ACA court case, ruling that the law is unconstitutional and should be struck down. That case ultimately went to the Supreme Court, where the justices last summer ruled 7-2 against the GOP plaintiffs. What we're watching: If the plaintiffs ultimately win, the ACA's preventive services requirement would become voluntary, and insurers could either drop coverage of these services altogether or start charging enrollees for them. If O'Connor sides with the plaintiffs after today's hearing, a critical question will be whether the decision is effective immediately or put on hold during the appeal process. Go deeper.     3. Parents of young kids hold out on COVID shots More than four in 10 parents of young children say they will definitely not vaccinate them against COVID-19, according to the Kaiser Family Foundation's latest vaccine monitor survey. The big picture: It's the first measure of parents' sentiment since the FDA in June authorized two COVID-19 vaccines for use in children from age 6 months through 4 years old. Findings: Only 7% of parents of children in that age range say they've already had their children vaccinated. A quarter of respondents said they want to "wait and see" how it works in other young children, while one in eight said they would only get their child vaccinated if it were required for school or childcare. 70% of parents surveyed said they haven't spoken to their pediatrician or another health care provider about getting the vaccine for their child. Our thought bubble: The findings could be sobering to school officials weighing vaccine mandates for the coming academic year.     A message from Pharmaceutical Care Management Association PBMs support lower insulin costs for patients     Drug manufacturers alone set insulin prices. The INSULIN Act is a windfall for Big Pharma and will inflate insulin costs by $23 billion for the federal government and billions more for state governments and the health care system. Learn more about PBM's efforts to lower patients' insulin costs.     4. High-potency cannabis linked to psychosis risk Illustration: Brendan Lynch/Axios   Frequent use of cannabis with higher levels of the compound THC could increase the risk of psychosis, Arielle writes about a Lancet Psychiatry analysis of 20 studies covering more than 119,000 patients. Why it matters: Cannabis use has been linked to mental health diagnoses before, but the review is the first of its kind to break down the connection between potency, mental health and addiction. What they found: The findings suggest people who use high potency cannabis are more likely to experience addiction and are more likely to experience a psychotic disorder such as schizophrenia. The authors make the case for more public health guidelines to make cannabis use safer. Yes, but: The strongest evidence of links between marijuana use and psychiatric disorders is in people with a preexisting genetic or other vulnerability, per NIH.     5. Catch up quick Telehealth startup Done's business surged on ADHD prescriptions. Then came complaints and concerns. (Bloomberg News) HHS proposed a rule to strengthen protections against sex discrimination, reiterating that people cannot be discriminated against for seeking reproductive care. (Axios) Sales of Pfizer's antiviral drug Paxlovid could drop off in the next six months on weaker demand and a possible supply glut. (Financial Times)     A message from Pharmaceutical Care Management Association PBMs support lower insulin costs for patients     Drug manufacturers alone set insulin prices. The INSULIN Act is a windfall for Big Pharma and will inflate insulin costs by $23 billion for the federal government and billions more for state governments and the health care system. Learn more about PBM's efforts to lower patients' insulin costs.   Why stop here? Let's go Pro. Join the thousands of professionals reading Axios Pro: Health Tech Deals to better understand the forces shaping their industry.   Axios thanks our partners for supporting our newsletters. If you're interested in advertising, learn more here. Sponsorship has no influence on editorial content. 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