Is the GLP-1 party running down for Hims, and a study for the weekend

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Good morning and happy Thursday! Yesterday it was announced that my colleague Usha Lee McFarling won the 2024 Victor Cohn Prize for Excellence in Medical Science Reporting. I’m genuinely so honored to work in the same newsroom as Usha. Her stories — read them all — have elucidated so many under-covered, unresolved racial health inequities within in our health care system.

Could the GLP-1 party end for Hims & Hers?

You probably know the brand Hims & Hers. Especially if you live in a city like New York, where the company’s ads for weight loss drugs with “the same active ingredient as Ozempic and Wegovy” are plastered all over subway walls. It’s one of the largest publicly traded telehealth companies in the country, offering compounded GLP-1s in more than 30 states and spending nearly $145 million in a single quarter on marketing.

For now, the company can legally sell these copycat versions of the drugs because there’s a shortage of the originals. But “as the brand-name GLP-1 drugs come off of the shortage list, I would expect this to be a hot area for litigation,” health law professor Anjali Deshmukh said to STAT’s Katie Palmer and Nick Florko.

There are some legal maneuvers that could help the company continue selling compounded drugs even after the shortage. But challenges from manufacturers Lilly and Novo, or a crackdown by the FDA, could bring the party to an end. Read more from Katie and Nick about the company’s plans moving forward and the obstacles that may stand in its way.

Kidney donor deaths are lower than ever

Between 1993 and 2022, more than 164,500 people donated kidneys. In all that time, only 36 donors died within three months of the procedure. The risks have always been low, but new research published yesterday in JAMA found that the risk for donors has drastically declined over the last three decades.

Analyzing national transplant registry data, researchers found that 13 donors died in the first 10 years of the study, 18 in the next decade, and just 5 people in the most recent decade. It’s tough to measure relative risk with such a low number of deaths, but the researchers found no statistically significant differences when it came to age or race. Mortality was also consistent among people with different BMIs.

What spurred the improvement in survival? The study authors pointed to improvements in donor selection, better care pre- and post-operation, and improved surgical techniques as potential influencing factors.

Trans and nonbinary people give birth, too

Gavin Fraser always dreamed of having children — so much so that they assumed they must be a cisgender woman. Who else would want so badly to carry and birth a child? But they aren’t cisgender, something they only realized long after giving birth.

Now, Fraser wishes they could have experienced pregnancy and childbirth while living openly as a nonbinary transgender man, they write in a First Opinion essay. They’re not alone in this desire, but it’s often a difficult journey. Birthing trans and gender diverse people are almost always excluded from important conversations about access to high-quality, compassionate prenatal care.

Read more in Fraser’s essay about bringing trans and gender diverse people into “maternal” health.

Three cardiology studies to watch at an annual meeting in Europe

The annual meeting of the European Society of Cardiology starts on Friday. These presentations typically happen before official peer review, but these studies caught our eye:

• A point for all or nothing thinking: In a French study analyzing an international database of more than 32,000 people with stable coronary artery disease, patients who quit smoking at any point after their diagnosis cut their risk of a major event almost in half. But those who simply reduced their smoking saw limited benefits.
• A point against endometriosis: On the other hand, women with this painful, underdiagnosed reproductive disorder had 20% higher risk of heart attack or stroke compared to other women, according to a Danish study matching more than 60,000 women with endometriosis to about 242,032 controls.
• A round of applause for sleeping in on the weekends: People who are sleep deprived during the week but “catch up” over the weekend may be reducing their risk of heart disease by up to 20%. That’s according to a British study of more than 90,000 people who are part of the UK Biobank.

A deeper look at Eli Lilly’s lauded announcement on cheaper obesity drugs

And in more GLP-1 news: Eli Lilly garnered widespread praise Tuesday for launching discounted versions of its blockbuster obesity drug Zepbound. It used to only be available as an injectable pen at the steep list price of $1,060 per month. Now, starter doses in vials will be available at almost half the price.

In the company’s press release, one patient group called it “an innovative solution that brings us closer to making equitable care a reality.” But the reality is more complicated, STAT’s Elaine Chen reports. On the same day as these discounted vials became available, the company increased the price of the pens for people who have commercial insurance but no coverage for the treatment. This news wasn’t in the press release, but rather in a change to the fine print on Lilly’s webpages for the savings coupons that these patients use. Read more on the caveats.

What we’re reading

• Nudge theory is making inroads in health care, to mixed results, Undark

• With only gloves to protect them, farmworkers say they tend sick cows amid bird flu, KFF Health News

• Invisible in the data: Broad ‘Asian American’ category obscures health disparities, STAT
• Surgeon General: Parents are at wits’ end. We can do better, New York Times

Correction: Wednesday’s issue misstated how many cases of Triple E have been confirmed in the U.S. this year. The CDC has confirmed five cases in five states: NH, VT, MA, NJ, and WI.