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What your patients are reading: Week of April 22, 2024

April 26, 2024

What happens to patients who can't afford popular weight-loss medications?

To cut costs, certain states like North Carolina have recently discontinued coverage for the prescription weight-loss medications Wegovy and Saxenda. Some patients who are using these GLP-1 receptor agonists are struggling to meet prescription costs, which can run more than $1,300 out of pocket per month. As the medical uses for these drugs expands beyond obesity and diabetes—including for treating heart disease and even sleep apnea—the demand for these prescriptions increases. Meanwhile, employers and health insurance plans are attempting to curb runaway spending on these drugs. Insurers have imposed requirements such as prior authorization or step therapy, which mandates that patients try less expensive drugs first, or they are denying coverage altogether. (Alltucker, 2024)

The new HIPAA final rule: 'No one should have to live in fear'

At a time when 14 states have abortion bans, President Biden finalized the HIPAA Privacy Rule to Support Reproductive Health Care Privacy this week which prohibits the disclosure of a patient’s reproductive health care information as well as strengthens privacy protections for that patient, their family, and their doctors who are providing or facilitating care. The rule prevents medical records from being used against people for providing or receiving certain types of reproductive health care—even if a patient traveled to another state for that care. Overall, “no one should have to live in fear that their conversations with their doctor or that their medical claims data might be used to target or track them for seeking lawful reproductive health care,” said Melanie Fontes Rainer, director of the Office for Civil Rights, in a news conference. (Howard, 2024)

Metformin may slow down aging, but the trial lacks funding

Research suggests the inexpensive generic drug has anti-inflammatory benefits that could help protect against age-related diseases including heart disease, cancer, and cognitive decline. Researchers have designed the TAME trial, which aims to test whether metformin can help prevent these diseases and promote a longer life span in healthy, older adults. Aging researchers have been pushing for a trial like this since 2015 but continue to face challenges with funding. The goal is to enroll 3,000 people between the ages of 65 and 79 for a 6-year period to better understand the mechanisms and pathways that metformin works in the body. But for now, the trial won’t get underway until it gets funded. (Aubrey, 2024)

Can Ozempic change your personality and libido?

Recent reports have highlighted the potential of GLP-1 agonists to help curb alcohol addiction, but patients may also see a decrease in their libido or a shift in their personality. “GLP-1s specifically decrease the amount of dopamine the brain releases after people indulge in behaviors like drinking, smoking or even eating a sweet dessert,” says Dr. Steven Batash, a board-certified gastroenterologist. "Beyond regulating hunger and satiety, GLP-1 receptors are also found in areas of the brain involved in mood regulation, potentially changing one’s personality,” Batash says. Although these personality changes aren’t commonly reported side effects, going off the drug is likely to restore former personality characteristics, according to the weight-loss expert. (Shultz, 2024)

Antipsychotics pose new risks for people with dementia

According to a new study published in BMJ, the use of antipsychotics, which are increasingly prescribed for patients with dementia, doubles the risk of developing pneumonia, the most common cause of death for this population. Additionally, the drugs increased the risk of stroke, acute kidney injury, blood clots, bone fracture, heart attack, and heart failure. Investigators analyzed the health records of nearly 174,000 people diagnosed with dementia in the U.K. and found that the risks appeared greatest in the first week after starting the antipsychotic medications. Roughly 4.5% of people with dementia developed pneumonia in the first 90 days of antipsychotic use, and 10% developed it in the first year. These rates were two to three times that of similar patients with dementia who were not prescribed antipsychotics. (Szabo, 2024)

Sources:

Alltucker, Ken. (2024, April 25). USA Today. Weight loss drugs like Wegovy have taken the country by storm. But who can afford them? https://www.usatoday.com/story/news/health/2024/04/25/employers-wont-pay-wegovy-price/73335259007/

Howard, Jacqueline. (2024, April 22). CNN. Biden administration issues new rule to protect privacy of those seeking reproductive health care: 'No one should have to live in fear'. https://www.cnn.com/2024/04/22/health/biden-administration-new-rule-reproductive-health-care-privacy/index.html

Aubrey, Allison. (2024, April 22). NPR. Shots. A cheap drug may slow down aging. A study will determine if it works. https://www.npr.org/sections/health-shots/2024/04/22/1245872510/a-cheap-drug-may-slow-down-aging-a-study-will-determine-if-it-works

Shultz, Cara Lynn. (2024, April 22). People. Ozempic Can 'Potentially' Change Your Personality — and Sex Life, Expert Says. https://people.com/ozempic-changes-personality-sex-life-alcohol-glp1-8636962

Szabo, Liz. (2024, April 24). AARP. Antipsychotics Pose New Risks for People With Dementia. https://www.aarp.org/health/conditions-treatments/info-2024/dementia-risks-antipsychotics.html