Latest / Morning Medical with Dr. Chow / Mpox Outbreak, Drug Pricing Debates, and Obesity-Related Healthcare Costs

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Mpox Outbreak, Drug Pricing Debates, and Obesity-Related Healthcare Costs · Morning Medical with Dr. Chow

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  Good morning and welcome to Morning Medical with Dr.
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  Chow, your daily update on the latest medical and health news from around the world.
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  I am your host, Dr.
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  Chi-Ming Chow.
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  Today, we have a very important topic to discuss: Is mpox the next COVID-19?
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  With the recent declaration of mpox as a global public health emergency, there is growing
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  concern about its potential to become a pandemic.
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  Let's dive into the details.
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  The World Health Organization officially declared the mpox outbreak a 'public health
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  emergency of international concern' on August 14.
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  This decision was based on a surge of cases in the Democratic Republic of the Congo and
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  multiple other African countries.
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  As of August 17, there have been 545 reported cases of mpox since the outbreak was declared,
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  with 474 of those cases confirmed.
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  Symptoms of mpox include a sometimes painful rash on various parts of the body, fever,
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  chills, exhaustion, muscle aches, headache, swollen lymph nodes, and respiratory symptoms.
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  According to the United States Centers for Disease Control and Prevention, there are two
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  types of mpox: Clade 1 and Clade 2.
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  The World Health Organization noted that Clade 2 was responsible for the 2022 global outbreak
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  and has survival rates of more than 99.9 percent.
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  On the other hand, Clade 1, which is causing the current outbreak in the Democratic Republic
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  of the Congo and Africa, results in more severe illness and higher mortality rates.
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  Some outbreaks of Clade 1 have killed up to 10 percent of those infected, although more recent
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  outbreaks have had lower death rates.
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  World Health Organization Director-General Dr.
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  Tedros Adhanom Ghebreyesus emphasized the urgency of the situation, stating, 'The
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  emergence of a new clade of mpox, its rapid spread in eastern Democratic Republic of the
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  Congo, and the reporting of cases in several neighboring countries are very worrying.'
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  Dr.
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  Ghebreyesus continued, 'People are not going to catch mpox by being on the same bus or running
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  into someone at the grocery store.
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  On top of outbreaks of other mpox clades in the Democratic Republic of the Congo and other
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  countries in Africa, it is clear that a coordinated international response is needed to
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  stop these outbreaks and save lives.'
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  So, is mpox the next COVID-19?
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  While health officials are concerned about the spread of this new strain, the consensus is
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  that mpox is not likely to become a pandemic like COVID-19.
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  One of the main reasons is that mpox does not spread in the same way.
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  Dr.
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  Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital in Boston,
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  explained, 'Certainly not.
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  What made COVID-19 so contagious is that it is a respiratory virus spread by aerosols, so that
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  even casual contact—being in the same room with someone for a reasonable period of time—meant
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  you could catch the virus.'
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  Another difference is that COVID-19 is contagious starting from a day or so before
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  someone develops symptoms.
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  By contrast, mpox requires close contact, usually skin-to-skin, for transmission in the
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  vast majority of cases.
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  Rarely, heavily contaminated material such as bedding can be infectious, but people are not
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  going to catch mpox by being on the same bus or running into someone at the grocery store.
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  While mpox is far less contagious than COVID-19, it could potentially cause a widely
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  distributed epidemic through sexual contact, according to Dr.
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  Kuritzkes.
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  He compared it to HIV, which is pandemic but not transmitted by casual contact.
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  The same is true for mpox.
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  To prevent transmission of mpox, the United States Centers for Disease Control and
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  Prevention recommends vaccination for men who are gay, bisexual, or have sex with men, are
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  age 18 or older, and have other specific risks.
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  These risks include new diagnoses of sexually transmitted diseases and a recent history of
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  multiple sex partners, among others.
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  Dr.
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  Marc Siegel, senior medical analyst for Fox News and clinical professor of medicine at New
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  York University Langone Medical Center, echoed that mpox is 'not the new COVID.' He emphasized
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  that mpox spreads via direct contact, sexual contact, and very close respiratory droplets,
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  but not over longer distances by respiratory spread.
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  Dr.
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  Brad Perkins, chief medical officer at Karius, a California-based life sciences company,
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  reiterated that mpox is 'considerably less infectious' for person-to-person spread than
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  COVID-19.
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  He noted that while mpox can affect anyone, data has shown that men who have sex with men
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  are disproportionately impacted, with a notable disease burden among Black and Hispanic men.
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  This highlights the importance of early recognition, diagnosis, and targeted
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  vaccination for those at highest risk.
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  As with other viral infections, those who are immunocompromised or very young are at the
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  greatest risk of severe infection.
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  For mpox, the main concern is for people with HIV who are not currently receiving effective
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  antiretroviral therapy.
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  Even after the infection has cleared, survivors can face long-term effects and complications,
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  such as vision impairment, encephalitis, and scarring.
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  The United States Agency for International Development has sent 50,000 doses of the
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  JYNNEOS mpox vaccine to the Democratic Republic of the Congo, but there is still a worldwide
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  shortage of this vaccine.
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  This shortage will prove crucial to stop the spread, especially if the outbreak widens.
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  In addition to the current vaccines and antiviral treatments available, Dr.
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  Perkins stressed the need for new innovations in mpox diagnostics, therapeutics, and
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  preventive measures.
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  'We need deeper research into characterizing and addressing these long-term sequelae,' he
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  said.
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  The CEO of Novo Nordisk defended the high cost of Ozempic and Wegovy in the United States,
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  saying the blockbuster drugs are ultimately saving taxpayers money on obesity-related
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  costs.
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  Lars Fruergaard Jørgensen stated in an interview on NBC Nightly News, 'If you look at
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  just the cost of obesity in the United States, it is a disease that costs Americans more than
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  four hundred billion dollars a year.
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  And we are actually providing products that are actually helping take that cost burden off.'
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  Jørgensen, who spoke to NBC News before the company's 'quiet period' ahead of its last
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  earnings report, called accusations that the company is operating as a drug cartel
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  'unfounded.' He is scheduled to testify about the United States pricing of the drugmaker’s
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  hugely popular diabetes and weight loss drugs at a highly anticipated Senate committee
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  hearing next month.
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  Senator Bernie Sanders, chair of the Health, Education, Labor and Pensions Committee, told
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  NBC News in June that he plans to ask Jørgensen why Novo Nordisk charges up to ten to fifteen
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  times more for Ozempic and Wegovy in the United States than it does in other countries.
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  According to a Health, Education, Labor and Pensions Committee report, Novo Nordisk charges
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  around one thousand three hundred dollars a month for Wegovy in the United States, while
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  the drug can be purchased for one hundred eighty-six dollars a month in Denmark, one
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  hundred thirty-seven dollars in Germany, and ninety-two dollars in the United Kingdom.
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  Senator Sanders said, 'It is clear that Novo Nordisk is ripping off the American people.'
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  The cost of obesity-related care in the United States is substantial.
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  A report published last year from KFF, a nonprofit group that researches health policy
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  issues, found that in 2021, people with employer-based health insurance who were
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  overweight or had obesity had an average of twelve thousand five hundred eighty-eight
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  dollars in total annual health costs.
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  This is more than double the four thousand six hundred ninety-nine dollars in health spending
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  for those who were not overweight or did not have obesity.
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  People who are overweight or have obesity also face higher out-of-pocket costs: an average of
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  one thousand four hundred eighty-seven dollars, compared with six hundred ninety-eight dollars
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  for those without those conditions.
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  Stacie Dusetzina, a health policy professor at Vanderbilt University in Nashville, Tennessee,
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  said that at Ozempic’s and Wegovy’s current prices, the savings that could be gained from
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  reducing the burden of obesity-related care are not enough to make up for the large increase in
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  spending on the drugs.
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  Dusetzina explained, 'For many people, these drugs might be a very good option for improving
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  their health, but it is unlikely that they will reduce total spending.
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  In general, the price of these drugs would need to come down a lot in order to have a chance
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  for them to produce overall savings in health care spending.'
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  Jørgensen said he 'volunteered' to speak with the committee about the cost of Ozempic and
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  Wegovy at the hearing next month.
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  His announcement to do so came three days after Senator Sanders threatened to hold a vote to
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  subpoena Novo Nordisk’s president, Doug Langa.
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  Jørgensen said he plans to talk about the 'complexities of the United States health care
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  system, which is a system we take part in but we cannot change.'
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  He pointed out that it takes policy change to address these issues, blaming insurance
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  companies and pharmacy benefit managers, or PBMs, for the high out-of-pocket costs patients
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  pay for the drugs.
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  Pharmacy benefit managers work with insurers to negotiate rebates, or discounted prices, from
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  the drug companies in exchange for including the drugs in their coverage.
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  However, as pharmacy benefit managers consolidate and hold more influence over what
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  drugs are covered, experts say they may be inflating drug costs.
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  In July, the Federal Trade Commission published an interim report about how pharmacy benefit
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  managers are driving up costs for patients.
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  Jørgensen acknowledged, 'I do acknowledge that some patients have poor insurance.
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  And if you have poor insurance, it can be difficult to afford your medicines.
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  And for those, we have patient support programs where we try to help them out.'
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  Jørgensen also said the United States needs to have a 'discussion around what is the value of
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  these medicines' for patients.
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  Cynthia Cox, a vice president at KFF and the director of its program on the Affordable Care
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  Act, said that while the drugs can prevent and reduce a number of obesity-related diseases,
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  they remain expensive and it is unclear how long people will need to stay on them to
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  maintain weight loss and improved health.
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  'The widespread use of these drugs for weight loss is still relatively new, so I am not sure
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  there is enough long-term data to fully weigh the costs and benefits,' Cox said.