| | | | |  | | By Erin Schumaker, Daniel Payne, Carmen Paun and Ruth Reader | | | | | 
Storms' toll runs deep. | Phelan Ebenhack/AP | Policymakers should prepare for climate change’s effect on Americans’ medication needs, warns a new report from the RAND Corporation, a nonpartisan think tank. How so? Anticipating that unusual weather events, such as extreme temperatures, rainfall, drought and wildfire pollution will cause more chronic disease, RAND experts used peer-reviewed and other research to develop a model to estimate how that could affect Americans' medication needs. RAND focused its model on four chronic conditions — cardiovascular disease, asthma, end-stage kidney disease and Alzheimer’s disease — because they are among both the most common chronic conditions and the leading causes of death in the U.S. RAND’s report, partly backed by Department of Health and Human Services funding, was released earlier this month. Key findings: While logically a greater disease burden should translate into more demand for drugs across the board, the model’s results present a more complicated picture: — Demand for common drugs that treat asthma and end-stage kidney disease will increase for most age groups. — Demand for the Alzheimer’s drug donepezil will increase for adults ages 55 and older. — Demand for the blood pressure drug metoprolol will increase among younger people due to higher cardiovascular disease prevalence. In severe climate change models, however, metoprolol demand will decrease among older people due to higher death rates from the disease. Severe heat waves can be especially fatal to older people. Why it matters: Greater demand for common drugs due to climate change could further strain the U.S. medical supply chain, driving up health care costs and hurting patients. What’s next? The researchers recommend that policymakers proactively stockpile key drugs and diversify the domestic and international supply chains for high-demand medicines.
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Williamsburg, Va. | Shawn Zeller/POLITICO | This is where we explore the ideas and innovators shaping health care. Bad news: It’ll take a major, and unexpected, technological advance to increase the outer limits of human life spans. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com, or Erin Schumaker at eschumaker@politico.com . Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.
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Some doctors aren't comfortable with AI's help. | Orlin WagnerAP Photo | For all their hope that artificial intelligence will reduce the time they spend pecking away at their keyboards on administrative work, many clinicians don’t want AI’s help, new research in JAMA Network Open suggests. When an AI tool called PAM Chat was tasked with drafting responses to patient questions, doctors, nurses and other care providers used the suggestions only about 12 percent of the time, according to UC Health researchers in Colorado. The researchers monitored 166 clinicians with access to PAM Chat across specialty and primary care clinics. The tool generated more than 21,300 drafts — but clinicians used just over 2,500. Scope divides: How much a clinician used PAM Chat’s drafts varied: Nurses used them more than doctors, nurse practitioners or medical assistants. Nurses were also more likely than their counterparts to say the tool was helpful, with 92 percent saying they believed it helped with efficiency and quality. Other kinds of clinicians were more skeptical, with less than half of medical assistants, advanced practitioners and doctors saying they thought the tool made it easier to write more efficiently or empathetically to their patients. Present imperfect: The AI drafts were hit-or-miss. “Sometimes the answers are astoundingly helpful, other times they are not helpful at all,” one clinician said. And a significant portion of those surveyed said they believed there was more than a minimal risk of the AI system giving incorrect information. But that could be changing. Even within the six-month study period, researchers worked on honing the prompts and information offered to the chatbot, improving outputs. Even so: The research included significantly different sample sizes between clinical groups. Ninety-three advanced practitioners and doctors were included compared with 12 nurses.
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The pandemic prompted a big shift to telehealth. | Shutterstock | The Drug Enforcement Administration is signaling it will again extend temporary rules that allow the prescribing of controlled substances via telemedicine, our Ben Leonard reports. A final rule to continue permitting the prescribing practice reached the White House’s Office of Management and Budget for review Thursday. The proposal didn’t specify the extension’s duration, and it still requires White House approval. Still, it’s a positive sign for telemedicine providers who’ve lobbied for the extension and patients who’ve appreciated the flexibility. The backstory: During the height of the pandemic, the DEA permitted telehealth providers to prescribe many controlled substances, such as Adderall and testosterone, without an in-person visit. But those allowances are set to expire at the end of the year. POLITICO first reported that the DEA intended to impose substantial limits on a provider's ability to prescribe controlled substances virtually in what would have been a significant blow to the telehealth industry. But the DEA’s plan sparked significant blowback from members of Congress, some of whom had been plotting a legislative fix, and from addiction and mental health treatment advocates. More than 300 organizations, including the Alliance for Connected Care and the American Telemedicine Association, called on Congress to extend the rules without further restrictions. Why it matters: If an extension is finalized, this would be the second time the DEA has floated tightened rules and retreated amid backlash. In February 2023, the agency proposed rolling back the eased rules but reversed course and extended them after receiving an agency-record 38,000 comments, many negative, and significant industry pressure. The DEA has raised concerns about overprescribing via telemedicine and said it’s trying to strike a balance between access to treatment and guardrails against misuse. | | | | Follow us on Twitter | | | | Follow us | | | | |
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