Wednesday Shorts: Mpox, digital obesity treatment, COEs, and no baby bump from Ozempic
November 27, 2024
1. More deadly strain of mpox detected in California
The Centers for Disease Control and Prevention reported that a California resident who had traveled to East Africa had been diagnosed with Clade 1 mpox, which is more deadly than Clade 2, which caused illness in Africa and globally beginning in 2022. Here’s a link to an article by Patricia Toro from Harvard Business Review (2022), and a review from Dr. Toro this fall about what employers should know about mpox. Most plan members at risk should be able to obtain an mpox vaccine through their pharmacy benefit plan without cost sharing.
2. Digital treatment decreased early childhood obesity
A randomized trial of a health literacy digital intervention published in JAMA evaluated the impact of a digital intervention on infant weight. Control families received standard advice from their pediatrician, and intervention families received “health literacy–informed, individually tailored, responsive text messages to support health behavior goals and a web-based dashboard.” Those whose parents received this intervention were 44% less likely to be diagnosed with obesity at 24 months of age (7.4% vs. 12.7% in the control group). This app was available in both English and Spanish and was used in a diverse population that was 16% Black (non-Hispanic) and 40% Hispanic. Digital interventions like this can scale, and preventing obesity in early childhood is clinically far better than treating obesity later. This intervention is not yet commercially available.
3. Patients treated for esophageal cancer in high volume centers lived longer
Overall survival at 5 years
Source: Sakowitz, JAMA Surgery, November 13, 2024
Patients who traveled the furthest to receive surgical care for esophageal cancer at high volume centers were 31% more likely to be alive at one year, and 20% more likely to survive for five years compared to patients who did not travel and were cared for at the lowest volume centers. High volume centers were in the top quartile of volume (19 or more cases a year), and low volume centers were in the bottom quartile of volume (4 or fewer cases per year.)
Employers and health plans should encourage plan members to receive intensive surgical interventions like esophageal cancer (and pancreatic cancer) surgery and get that care in high volume centers, even if that means traveling further from home. Centers of Excellence can help with this, and travel benefits improve health equity by making it easier for those with fewer financial resources to get care at high volume centers. This is an observational study which was adjusted for clinical risk factors, and the researchers note that Black race and low educational levels were associated with receiving care at low volume centers.
4. Ozempic doesn’t cause an increase in pregnancy rates
This spring, there were reports of an “Ozempic baby boom,” as some who had started GLP-1 medications unexpectedly discovered that they were pregnant. Epic Research Network published a large electronic medical record review last month that demonstrated that pregnancy rates were no higher among women ages 18-50 who took GLP-1 drugs compared to those who did not. Women who have sex with men and wish to avoid pregnancy should use contraception regardless of GLP-1 status.
Hope you and yours have a happy Thanksgiving. This newsletter will return on Monday, December 2 with a post on tirzepatide and progression to diabetes.
Thanks for reading. You can find previous posts in the Employer Coverage archive
Please subscribe, “like” and suggest this newsletter to friends and colleagues. Thanks!
Illustration by Dall-E