The Wisconsin Badgers should never be in shotgun from the 1-yard line. Ever.

TWEETORIAL ALERT💵

In this NEJM perspective, Stacie Dusetzina David D. Kim (김대호) Ashley Leech and I write about the costs and questions around new use of antiobesity medications (AOMs) like #Wegovy #semaglutide in the #Medicare #PartD program if #TROA passes.

1/12

nejm.org/doi/full/10.10…

Wherein Sam Burn Timothy Layton Boris Vabson and I take on the unenviable task of defending medical paperwork:

'Rationing Medicine Through Bureaucracy: Authorization Restrictions in Medicare'

on NBER: nber.org/papers/w30878
and ungated: zarekcb.github.io/PriorAuth_Web.…

1/ Super excited about the new primary care model we’ve been working on Carbon Health and have launched in Mass. with Blue Cross MA.

Our model brings together things I’ve been dreaming about since exploring primary care at Apple.

We call it Connective Care, and it’s here now. 🧵

Annual sales of tirzepatide (Mounjaro) may reach $48 billion, far surpassing prior records. I reviewed why these new obesity drugs are a breakthrough, but also a liability
nbcnews.com/health/health-…
erictopol.substack.com/p/the-new-obes…

Many top nonprofit hospital systems avoid communities where more people are likely to need aid. “We have a healthcare desert.” wsj.com/articles/nonpr… via The Wall Street Journal

I’m speaking about #diabetes quality and reimagining quality measurement at the Population Health Colloquium hosted by Population Health, November 7-9, 2022. Join me there! Register at bit.ly/PopHealth22

Important update of US genomic surveillance with noteworthy transition as BA.5 fades, BQ.1.1 quickly gains, along with other variants (BF.7, BA.2.75.2).
covid.cdc.gov/covid-data-tra…

Less than a third of regulatory actions taken by the US Food and Drug Administration (FDA) are corroborated by published research findings or public assessments, finds new research bmj.com/content/379/bm… Reshma Ramachandran Joseph Ross Joshua D. Wallach Xiaoting Shi Meera Dhodapkar

‼️ New Paper ‼️

Our team has spent the last 3 years trying to answer the question: does where you live impact if you receive blood thinners for #AFib .

Short answer: YES!

A journey to what we found, what it means, and what we can do about it.

rdcu.be/cWdBf

1/ 🧵

In this emulation of the GRADE trial, liraglutide was statistically significantly more effective at maintaining glycemic control than glimepiride or sitagliptin when added to metformin monotherapy, find Rozalina (Grubina) McCoy, MD MS and colleagues
bmj.com/content/379/bm…

We are seeing multiple variants with convergent evolution that will drive the next wave.

All variants with 5+ key RBD mutations can be grouped together, I am referring to this group as 'Pentagon' for sharing the 5 mutations.

Thank you Cornelius Roemer for covspectrum collection

Check out our recent clinical trial emulation paper using EHR and claims data to evaluate 4 medications for patients with type 2 diabetes. Some lessons on what can and cannot be identified with clinical records data and the importance of evaluations of assumptions and follow-up

As we compare results of our emulation to those of #GRADE trial, some lessons learned:
✅ RWD can effectively & efficiently emulate prospective pragmatic RCTs in a fraction of time/cost
✅ results reflect real-world practice
❌ RWD can’t emulate what’s not being done

Epic's overhaul of its sepsis prediction algorithm acknowledges many shortcomings of the original version -- chiefly that the whole concept of a global AI model for sepsis was doomed from the start.

Via STAT:

statnews.com/2022/10/03/epi… via STAT

There's a duality to the U.S. FDA's new guidance on health software/AI: On the one hand the agency says it's not changing its regulatory posture, but its examples indicate a big change in regulatory posture.

Via STAT:

statnews.com/2022/09/28/fda… via STAT

When it comes to #SARSCoV2 and Covid, it's important to keep your eyes on the ball. The ball is BA.5 and here is what we know about it
erictopol.substack.com/p/the-ba5-story

NEW: unfortunately it’s time for another international Covid update, as the BA.5 Omicron lineage (and BA.4 to a lesser extent) sends not only cases but also hospitalisations climbing around the world, from South Africa, to Portugal, the UK, Israel and now the US 📈

Surprise? Per Milliman, Inc., #Medicare #PartD plans prefer brand-name long-acting #insulins over Semglee #biosimilar . I think we all know why...

#PBM #DIR #GrossToNetBubble #rebates

P.S Study funded by PCMA (!)

drugch.nl/3xEOtxf

Thoughtful piece by (((Howard Forman))), Jennifer E. Miller & Long Tu on how the contrast shortage should spur changes in medicolegal environment and culture of medicine to support provision of high-value care, making health care more sensible, affordable, and fairer nejm.org/doi/full/10.10…