Morning Rounds: The ‘very risky business’ of buying weight loss drugs online

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Vice President Kamala Harris interviewed running mates this weekend, but there’s still no word on who she will pick. If you’re the betting type, maybe you want to read up on the leading candidates’ stances on health care.

The best tool we have to treat meth addictions is being held back by politics

When it comes to drugs like methamphetamines and cocaine, highly effective medications like those for opioid addiction don’t exist. But behavioral incentives to treat a meth addiction is settled science, and offering financial rewards like gift cards to people who can show they’ve reduced or stopped their meth use is particularly effective, STAT’s Lev Facher reports. So is the U.S. pursuing this sort of high-quality treatment?

Not really. The Biden administration has expressed support for these types of rewards, known officially as contingency management. But there’s a longstanding $75 annual cap on how much money can be given to patients in programs funded by select federal programs, and the Biden administration has refused to raise it. Read more about the current policy landscape.

45%

That’s the percentage of insured, working-age adults who said they got a bill or were charged a copayment for a medical service in the past year that they thought should have been free or covered by insurance, according to a new report from the Commonwealth Fund. Less than half of those people said they challenged the bills. But nearly two of every five who did challenge their bill said it was eventually reduced or eliminated by the insurer.

The ‘risky business’ of buying weight loss drugs online

As shortages of blockbuster obesity and diabetes medications continue, people have found a “wild west” of online prescribers that provide compounded versions of the drugs, which are not FDA-approved and have not been evaluated for safety or effectiveness. Illegal online pharmacies also offer to mail out the drugs without any prescription at all. But how safe are the products they’re shipping?

In a new study, published on JAMA Network Open, researchers found that semaglutide ordered from illegal sites contained significantly more of the drug than labeled, and one sample even contained signs of potential bacterial contamination during manufacturing.

“It’s just a very, very risky business, going online and buying this product,” study co-author Tim Mackey told STAT’s Katie Palmer. “Just because it’s online and it’s accessible and it can be sold without a prescription, does not mean it’s authentic.” Read more.

Giving patients “the full informed consent” on mental health crises and the police

As both a psychiatrist and as somebody who has been hospitalized while in her own mental health crisis, Rupinder Legha knows the dangers that police can bring to a situation and how carceral the conditions in an emergency room can feel. Yet calling 911 or going to your closest emergency room is the standard advice any clinician will give to somebody in an acute mental health crisis.

In light of the death of Sonya Massey and so many others who have been killed when what they needed was mental health support, Legha proposes a new medical standard for responding to mental health emergencies—a “full informed consent” that gives patients a clearer picture of the potential risks of police involvement and going to the emergency room. Writing in an editorial for PLOS Mental Health, she also recommends exploring other options when possible so that people in crisis can stay at home with their families monitoring them and with a provider’s support.

“As healthcare providers, we can no longer stand by hands in the air while another death moves in and out of the news cycle,” Legha writes. “We owe people more than this.”

WHO director on whether mpox is a public health emergency

Last Monday, we learned that researchers are planning a clinical trial to test whether receiving an mpox vaccine can protect people who’ve been exposed to the infection from getting sick or reduce the severity of the illness. The stakes are high, as hundreds of people in the Democratic Republic of Congo have died from the disease this year. Now, sequencing of the virus shows that this deadly variant has also spread to Uganda and Kenya, according to reporting from ScienceInsider published Saturday.

“I am considering convening an International Health Regulations Emergency Committee to advise me on whether the outbreak of mpox should be declared a public health emergency of international concern,” WHO director-general Tedros Adhanom Ghebreyesus said in a statement to the outlet.

This is the first time that the agency has made a statement about a potential PHEIC regarding this mpox outbreak, STAT’s Helen Branswell told me. Read STAT’s mpox coverage to get up to speed.

How the lab leak theory is damaging science

How did Covid start? The lab leak theory — which posits that the coronavirus was modified or even created in a Wuhan laboratory, then somehow escaped — has gained a lot of traction among politicians and the general public. But most scientists, and especially virologists, believe the virus spilled over from animals to humans.

In a First Opinion essay, microbiologist John P. Moore argues that the lab leak hypothesis is turning public sentiment against virology research at a time when it has an essential role to play in the face of pandemic threats. “Viruses are the real threat to humanity, not virologists,” he writes. Read more from Moore on how the lab leak theory is threatening real science.

What we’re reading

• Many of Gaza’s medical workers have been detained or killed, New York Times

• Since fall of ‘Roe,’ self-managed abortions have increased, KFF Health News

• Performance-enhancing drugs or placebos? The myth at the heart of anti-doping, STAT
• The future of junk food could be healthy food, Bloomberg
• Letters on Sonya Massey’s death, vaccine injuries, and much more, STAT