Morning Rounds: Why health care costs are nearly a fifth of the GDP

Understand how science, health policy, and medicine shape the world everyday. Sign up for our Morning Rounds newsletter here.

Good morning. Don’t miss Nicholas Florko’s jaw-dropping investigation into medical marijuana businesses marketing their products for cancer or depression with no regulatory oversight.

Medical marijuana companies are following pharma’s playbook, except for the rules

Medical marijuana companies borrow a lot of marketing tactics from pharmaceutical companies. But because they don’t follow the same rules, patients are put at risk, STAT’s Nicholas Florko tells us in a new STAT investigation. Big players like Trulieve, Curaleaf, and Verano advertise their products as treatments not just for muscle aches, but for cancer and depression, without evidence to back up those claims.

How can they get away with this? Therein lies the paradox: Cannabis companies don’t have to abide by rules over the claims they make or freebies they give to doctors because for the most part, cannabis medicine isn’t regulated federally. The U.S. government has deemed pot too dangerous to be considered a medicine, so it’s ceded almost all responsibility to the states. “They’re able to call it a medicine without the necessary rigor of determining whether or not it is truly a medicine,” James Berry of West Virginia University said about the businesses. Read more, including company responses.

SNL skit on sickle cell therapy draws outrage

Maybe you’ve already seen (and if you’re like me, cringed at) last weekend’s skit from “Saturday Night Live” about the new gene therapies for sickle cell disease. If you haven’t, the gist is this: At an office white-elephant-style gift exchange, a white employee (Kate McKinnon) gives a Black employee with sickle cell (Kenan Thompson) enrollment in “Vertex Pharmaceutical and CRISPR Therapeutics’ exa-cel program for sickle cell anemia. ” He says no thanks, declaring, “I’m just going to swap this out for a Boogie Woogie Santa.” Later, another Black employee (Punkie Johnson) also rejects the treatment in favor of the singing, trumpet-playing Santa figurine.

Now the Sickle Cell Disease Foundation, the Sickle Cell Disease Association, and Sick Cells all condemned the sketch. “It’s how they had the sickle cell characters: They made them look stupid, they made them look unintelligent,” said Ashley Valentine, head of Sick Cells. “Those two caricatures that they put on national TV is how people view us,” Valentine said. NBC did not respond to a request for comment. STAT’s Jason Mast has more.

Drug companies need to tell FDA how they’ll diversify clinical trials. Will it work?

Leaving people of color out of clinical trials hampers health care and drug development. Starting next year, drug and medical device companies will have to tell the FDA how they intend to make their clinical trials better represent the diverse U.S. population. But planning isn’t the same as doing, the industry’s track record isn’t great, and it’s not clear whether the FDA will twist arms, experts told STAT’s John Wilkerson.

It’s a myth that people of color are reluctant to join clinical research, Steve Smith of the clinical trial consulting firm WCG told John. A recent poll by Research America found that people of color were only slightly more wary of clinical trials than white Americans. Low clinical trial participation among people of color is mostly due to logistics, Smith said. Read more.

STAT’s best photos of 2023

I don’t know how they narrowed down their list to just 14. Alissa Ambrose,  STAT’s director of photography and multimedia, worked with Crystal Milner, STAT’s picture editor, to choose the most memorable photos of 2023 from STAT’s many contributing photographers. The one above shows Bat-Erdene Namsrai performing an experiment on a rat for new research on cryogenic organ preservation, described in this story by contributor Marion Renault.

You’ll find more images here of people whose stories we told, among them investors and researchers moving their industries forward, a man working to escape the cycle of addiction, and physician who has taken his career on the road after the abortions he provides were made illegal in his home state.

Lessons on the power of contact tracing

Remember contact tracing for Covid-19? A new study in Nature looking at 7 million contacts in England and Wales notified by the NHS COVID-19 app concludes that how much time someone spent with an infected person was the single biggest predictor of whether they would become infected with Covid-19 themselves. The authors say their analysis also shows the power of contact-tracing apps like this one to deliver precise information on risk in future epidemics.

Here’s how it worked: The app relied on Bluetooth signal strength to measure how close and how long smartphones were nearby, and then notified the contacts of confirmed cases. The researchers combined that data with 240,000 positive tests reported after notification. Duration and proximity mattered: Fleeting contacts (less than 30 minutes) made up half of reported contacts but very few transmissions. Household contacts were just 6% of contacts, but they accounted for 40% of transmissions.

Health care cost increases aren’t exceeding inflation for one good reason

Yesterday we told you the U.S. government spent more on health care in 2022 than six countries with universal health care, combined. Today, oncologost Ezekiel Emanuel notes that while health care spending in the U.S. has historically exceeded overall inflation, that’s changed in recent years.

With the exception of 2020’s Covid spike, health care costs have remained at or below 18% of GDP since 2010, when Obamacare began. Medicare’s spending per person has been flat for more than a decade, and premiums for private employer-sponsored insurance have been increasing at 3.7% in the past decade, much slower than the 8.4% between 1999 and 2011. Why? “The mindset of American physicians and other clinicians has changed, from ignoring costs to trying to cut them,” Emanuel writes in a STAT First Opinion. Read his explanation.

What we’re reading

• Parents of children sickened by lead linked to tainted fruit pouches fear for kids’ future, Associated Press
• How a tobacco giant changed a global anti-tobacco treaty, The Examination
• SEC charges former CEO of pain relief device company with $41 million fraud, STAT

• A baroness’s lies bring Britain’s Covid spending scandal to a boil, Washington Post

• Obesity drugs’ next tests, and rising threats: 3 chronic disease stories to watch, STAT