Antiviral Covid drug, no surprise...
Merck's antiviral Covid drug looks extremely promising | The No Surprise Medical Bills Act starts to go into effect | Alagille syndrome induced cholestatic pruretis treatment gets FDA approval
Merck’s Antiviral COVID Drug
Furthermore, Merck has finished preliminary trials on it’s oral antiviral drug. They claim that it reduced the risk of hospitalization or death from COVID-19 by around 50% in its clinical trial that was expanded to include over 1,500 participants.
The drug is called molnupiravir, and Merck is applying to get emergency use authorization (EUA) just like the COVID-19 vaccines.
Oral antiviral drugs could be critical to combatting the pandemic since many people are refusing to get vaccinated and some countries do not have the facilities for vaccination.
For more details, read this article by Axios!
No surprise…
On Thursday, the Biden administration released a rule clarifying how health care providers and insurers will negotiate “surprise” medical bills as well as providing protections for uninsured or self-paying individuals. This new rule is a part of the implementation of the No Surprises Act, a law passed in 2020 to protect individuals from large, unexpected “surprise” bills following treatment. The No Surprises Act will take effect on Jan. 1, 2022, and additional clarifications are expected to be announced in the coming months.
What are “surprise” medical bills?
When enrolled in a health insurance plan, insurance companies give you a list of healthcare providers (doctors, hospitals, etc.) that are considered in-network. All other providers are out-of-network. In-network providers have a contract with the insurance company to provide their services for a cheaper price. As a result, going to an out-of-network provider is almost always more expensive. Depending on the type of plan, the insurer may not even pay for out-of-network care at all, leaving the patient with the full cost of the treatment.
“Surprise” medical bills occur when a patient unknowingly receives care from an out-of-network provider. This occurs in two different ways. First, in an emergency situation, patients usually go to the nearest hospital, unaware of its out-of-network status. Second, patients in in-network hospitals during non-emergency situations can receive care from certain types of providers who are out-of-network. About 1/5 emergency claims and 1/6 in-network hospitalizations result in a “surprise” bill for out-of-network treatment.
What is the No Surprises Act?
At the end of 2020, a large omnibus spending bill was passed with broad bipartisan support and signed into law by President Trump. Included in this bill was the No Surprises Act, which bans most surprise medical billing. The No Surprises Act stipulated that out-of-network providers, rather than billing patients directly, must negotiate with insurers. Although there are already bans on surprise billing in 25 states, the act extends this protection nationwide, taking effect on Jan. 1, 2022.
In the announcement by the Biden administration on Thursday, the Department of Health and Human Services outlines the behind-the-scenes process of the new system. If insurers and out-of-network providers can’t come to an immediate agreement on costs, they can first initiate a 30-day negotiation process, then enter arbitration. If this seems confusing, just know that the patient is not a part of this process and will not receive any extra bill.
The new rule also provides protections for uninsured individuals, requiring healthcare cost estimates and a payment dispute resolution process.
Alagille’s induced cholestatic pruritus treatment
Cholestatic pruritus is an extremely severe itch induced by liver diseases. One such liver disease that causes it is Alagille syndrome. The FDA recently approved LIVMARLI (maralixibat), a drug by Mirum Pharma (CA, USA) to treat cholestatic pruritus caused by Alagille syndrome.
Alagille syndrome is a genetic disease wherein there are not enough ducts to drain bile from the liver due to mutations in bile duct development in one's infancy. The buildup of bile leads to liver damage and eventually failure which often progresses to other organs.
This drug, LIVMARLI, is meant for use in children over the age of 1 and is shown to improve the symptoms of cholestatic pruritus (itchiness).
In its clinical trials, there were five studies that had a total of 86 participants who were treated for an average of 30 months and up to 60 in some cases. The most common side effects were diarrhea, abdominal pain and vomiting. These were experienced by about 40-50% of the patients.
Overall, this drug like many others for diseases of such complexity follows a band-aid like approach and treats the symptoms instead of the disease.
This highlights the need to understand the disease better to develop effective treatments for it. But, this also raises the question whether we should prioritize developing less effective therapies that can reach patients earlier or work on developing more effective ones which would take much much longer to have a clinical impact?
Study Highlight
Fun fact: Chickens are more attracted to beautiful people!
A research group trained chickens to react to physically attractive faces of either sex and then showed them faces of people of the opposite sex. They found that the chickens reacted to attractive faces of the opposite sex showing that they were able to identify characteristics that make humans attractive.
How did the researchers decide what an attractive face was? They had 14 undergraduate students pick attractive faces. The researchers found that the characteristics that made a face attractive for both the undergraduate students and the chickens were very similar.
While this sounds like a funny thing to do, the underlying goal was to understand how human attraction works and whether animals and humans would be attracted to people with similar characteristics.
Featured Fake News
The above TikTok has been circulating this week claiming that the American Red Cross no longer accepts convalescent plasma from those who have received a COVID-19 vaccine because the vaccine wipes out natural antibodies.
This is false. The Red Cross did not stop accepting plasma donations from vaccinated individuals.
The American Red Cross called these claims “not accurate” in a statement earlier this week.
Additionally, vaccines do not get rid of antibodies your body makes via natural immunity. Dr. Sabrina Assoumou at the Boston University School of Medicine said that “vaccination after natural immunity enhances the immune response,” citing this study.
COVID-19 Updates
COVID cases are down this week by about 20%
24 states reported fewer COVID cases per 100,000 people this week
Deaths from COVID rose by 33% though
Physicians believe we are at the peak of delta cases now. Don’t destroy their optimism folks…