1 big thing: Employers drill down on perks

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2. Women's higher health costs 

3. Harsh review for ALS therapy

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4. Costco joins primary care push

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5. Staffing crunch hit federal health facilities 

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6. Catch up quick 

Happy Tuesday, Vitals crew. Maya's back today and steering the ship solo for the rest of the week.

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Data: CDC; Graphic: Rahul Mukherjee/Axios

A record number of people in the United States died of suicide last year, while the country's suicide rate reached the highest level in over 80 years, according to new federal data.

The big picture: The startling statistics underscore the toll of the nation's mental health crisis coming out of the COVID-19 pandemic, amid rising rates of anxiety and depression. But there were some encouraging signs among young people, who were especially affected by the pandemic. 

By the numbers: Nearly 50,000 Americans took their own lives last year, a 3% increase from 2021, according to provisional data from the Centers for Disease Control and Prevention's National Center for Health Statistics. That number is likely to grow when data are finalized, the agency said.

The suicide rate of 14.3 deaths per 100,000 people was 1% higher than in 2021 and is the highest rate since 1941.

The suicide rate increased more among females (4%) than males (1%) last year, but men are about four times more likely to die by suicide.

Suicide rates significantly decreased among younger people — by 18% for kids ages 10-14 and by 9% for people ages 15-24 — possibly indicating that efforts to address the youth mental health crisis are working.

But the rates increased significantly for most age groups 35 and older, rising the fastest among people ages 55-64 (9%).

The suicide rate among American Indian and Alaska Native people, while declining 5% last year, remains far higher than any other racial or ethnic group.

Context: Suicides have been steadily increasing this century, prompting U.S. Surgeon General Vivek Murthy in 2021 to lay out an updated national strategy for preventing suicide, the federal report notes.

Murthy has especially called attention to the crisis among America's youth, who were facing mounting mental health challenges that were exacerbated by the pandemic.

The government also rolled out a new suicide prevention and mental health hotline last year, 988, hoping that the three-digit service would be easier for people in crisis to call or text. 

Contacts to the hotline increased significantly in 988's first year, but there is still limited awareness and funding remains a challenge.

Meanwhile, a shortage of behavioral health providers and reportedly inadequate coverage of mental health services mean that many people struggle to find the mental health care they need.

If you or someone you know may be considering suicide, call or text the National Suicide Prevention Lifeline at 988. Ayuda disponible en español.

Number of suicides reached record level last year, CDC says

The startling statistics underscore the toll of the nation's mental health crisis coming out of the pandemic.

Suicide

A bar chart showing the change in suicide rates in the U.S. from 2021 to 2022. All groups 35 years and above saw an increase, with 55-64 year olds seeing the biggest jump, a 9% increase.

Public health

A record number of people in the United States died of suicide last year, while the country&#x27;s suicide rate reached the highest level in over 80 years, according to new federal data.The big picture: The startling statistics underscore the toll of the nation&#x27;s <a class="gtmContentClick" data-vars-link-text="mental health crisis" data-vars-click-url="https://www.axios.com/2023/07/15/therapy-mental-health-addiction-depression" data-vars-content-id="49a45edd-4222-4b59-ad9a-b96a7bb3ece8" data-vars-headline="Number of suicides reached record level last year, CDC says" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/07/15/therapy-mental-health-addiction-depression" target="_self">mental health crisis</a> coming out of the COVID-19 pandemic, amid rising rates of <a class="gtmContentClick" data-vars-link-text="anxiety" data-vars-click-url="https://www.axios.com/2021/10/06/cdc-anxiety-depression-symptoms-pandemic" data-vars-content-id="49a45edd-4222-4b59-ad9a-b96a7bb3ece8" data-vars-headline="Number of suicides reached record level last year, CDC says" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2021/10/06/cdc-anxiety-depression-symptoms-pandemic" target="_self">anxiety</a> and depression. But there were some encouraging signs among young people, who were especially affected by the pandemic.

The U.S. faces a range of health care flashpoints — unaffordable drugs, opioids, vaping — as we debate whether to adopt universal care. For now, the Affordable Care Act is the law of the land, but Republicans want to issue it a final death blow.

Health

Measles cases and deaths surged worldwide last year, according to a new report from the World Health Organization and Centers for Disease Control and Prevention that points to a worsening immunization gap that most affects kids in poor countries.

The big picture: Global immunization efforts that were disrupted during the pandemic haven't fully recovered, exposing countries to greater threat from vaccine-preventable diseases.

"The increase in measles outbreaks and deaths is staggering, but unfortunately, not unexpected given the declining vaccination rates we've seen in the past few years," John Vertefeuille, director of the CDC's Global Immunization Division, said in a statement.

By the numbers: Cases of the highly contagious disease increased by 18% to 9 million between 2021 and 2022, according to the report. Deaths increased 43% to 136,000 — mostly among children.

37 countries, most in Africa, had "large or disruptive" outbreaks last year, up from 22 countries in 2021. 

Measles can sometimes lead to severe complications in children. As many as 1 in 20 kids with measles gets pneumonia, the most common cause of death.

The WHO and CDC have previously warned the world is far from reaching the immunization level for herd immunity against measles, which is estimated to be at least 95% of the population.

There was some "modest" improvement in administration of the two-dose measles vaccine last year, but 22 million kids missed their first dose and 11 million missed their second.

The first dose is usually given at 9 months in countries where measles is common and between 12-15 months elsewhere, according to WHO. The second dose is usually given at 15-18 months.

Globally, 83% of kids received a first dose, and 74% received a second dose.

But there hasn't been any progress in reversing the pandemic-driven decline in vaccinations in low-income countries, where the risk of death from measles is highest. 

The vaccination rate in those countries is just 66%.

"The lack of recovery in measles vaccine coverage in low-income countries following the pandemic is an alarm bell for action," said Kate O'Brien, WHO director for immunization.

Measles cases and deaths rose at "staggering" rate last year, WHO and CDC report

The report points to a worsening immunization gap that most affects kids in poor countries.

A hospital in Afghanistan last year during a measles outbreak. Photo: Sayed Khodaiberdi Sadat/Anadolu Agency via Getty Images

Children's health

Measles cases and deaths surged worldwide last year, according to a new report from the World Health Organization and Centers for Disease Control and Prevention that points to a worsening immunization gap that most affects kids in poor countries.The big picture: Global immunization efforts that were <a class="gtmContentClick" data-vars-link-text="disrupted" data-vars-click-url="https://www.axios.com/2023/04/20/childhood-vaccines-hesitancy-immunization-unicef" data-vars-content-id="aebfcc3c-fac3-488f-b9e6-478002f3972e" data-vars-headline="Measles cases and deaths rose at &quot;staggering&quot; rate last year, WHO and CDC report" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/04/20/childhood-vaccines-hesitancy-immunization-unicef" target="_self">disrupted</a> during the pandemic haven&#x27;t fully recovered, exposing countries to greater threat from vaccine-preventable diseases.

The Biden administration on Thursday laid out instances in which the federal government could break the patents of costly drugs developed with taxpayer funding in order to lower their prices. 

Why it matters: Progressives have long advocated for so-called march-in rights, and President Biden's embrace of this authority plays into campaign messaging about taking on big pharma.

Yes, but: The administration isn't endorsing widespread use of the authority, and officials said that the framework isn't being immediately applied to any specific drug. The strategy could draw legal challenges from pharmaceutical companies. 

Driving the news: The Commerce Department this morning proposed a framework for when agencies should consider using march-in rights for pricey treatments. For the first time, it specifies that price can factor into the decision. 

The guidance enumerates factors to guide agencies' decision on whether to activate march-in rights. 

"Nothing in this framework should be treated as a mandate that an agency exercise its march-in right, as a requirement that an agency collect facts to answer every question posed here, or as a limitation on the facts and questions an agency can consider," the proposed guidance says. 

Between the lines: The power to invoke march-in rights stems from a 1980 law that allowed developers of inventions to maintain a stake in products developed with taxpayer funds. No government agency to date has used the authority to break a patent. 

Biden, in a 2021 executive order on promoting competition, reversed a Trump administration policy to bar march-in rights on federally funded drugs. 

But the Biden administration has resisted calls to exercise the rights, most recently when the National Institutes of Health in March refused to use the authority for a prostate cancer drug, Xtandi.

Senate health committee chairman Bernie Sanders (I-Vt.) for months held up Biden's nominee to lead NIH, partly over the march-in rights issue. 

Now-confirmed NIH director Monica Bertagnolli didn't rule out using march-in rights on Wednesday — but she didn't commit to doing so either. 

"I will use every tool I possibly can with the goal of obtaining the access that our patients need," Bertagnolli told reporters. 

What they're saying: Drugmakers and Republican allies in Congress said the use of march-in rights would undermine innovation.

"This would be yet another loss for American patients who rely on public-private sector collaboration to advance new treatments and cures," said Megan Van Etten, spokesperson for the trade group PhRMA.

What's next: The federal government will accept public comment on the Commerce proposal for 60 days. 

Maya Goldman and Tina Reed contributed reporting. 

Biden embraces power to break patents of costly drugs

Progressives have long advocated for so-called march-in rights to lower the price of drugs developed with taxpayer dollars.

Illustration of a gavel made of a pill bottle, touching a gavel rest made of a white pill.

Drug prices

Health care costs

The Biden administration on Thursday laid out instances in which the federal government could break the <a class="gtmContentClick" data-vars-link-text="patents" data-vars-click-url="https://www.axios.com/2022/10/07/becerra-drug-price-march-in-rights" data-vars-content-id="b3854809-f450-47f4-993a-7b08efbd36ab" data-vars-headline="Biden embraces power to break patents of costly drugs" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2022/10/07/becerra-drug-price-march-in-rights" target="_self">patents</a> of costly drugs developed with taxpayer funding in order to lower their prices. Why it matters: Progressives have long advocated for so-called march-in rights, and President Biden&#x27;s embrace of this authority plays into campaign messaging about <a class="gtmContentClick" data-vars-link-text="taking on big pharma." data-vars-click-url="https://www.axios.com/2023/06/30/pharma-another-term-without-friend-white-house" data-vars-content-id="b3854809-f450-47f4-993a-7b08efbd36ab" data-vars-headline="Biden embraces power to break patents of costly drugs" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/06/30/pharma-another-term-without-friend-white-house" target="_self">taking on big pharma.</a>

Health Tech Deals

The Department of Veterans Affairs says it's committed to studying the effectiveness of psychedelics like MDMA and psilocybin for post-traumatic stress disorder ahead of a House hearing expected to touch on the substances.

Why it matters: Confronted with a worsening mental health crisis and a shortage of psychiatrists, stakeholders ranging from government agencies and venture capital are recognizing psychedelics' potential role in treating mental illness.

What they're saying: "VA is committed to studying interventions that promote the health of the nation's veterans," VA assistant undersecretary for health Carolyn Clancy said in written testimony submitted to the committee.

By the numbers: Investment in the hallucinogenics-for-mental-health sector rose from just $62 million in 2019 to $617 million in 2020, and hit a peak of $1.6 billion in 2021, per Bloomberg.

State of play: Dozens of psychedelic startups have received venture funding in recent years, from those providing support for traditional providers to take on psychedelic-assisted therapy to those applying AI to psychedelic drug development. For example...

Psychedelic startup incubator Beckley Waves in September dosed $3.3 million in seed funding.

Ketamine-assisted therapy infrastructure startup Journey Clinical in January closed an $8.5 million Series A round.

Last December, Enthea, a benefits provider for psychedelic-assisted therapy, raised $2 million in seed funding.

Mindstate, an AI-powered psychedelic drug discovery startup, last February collected $11.5 million in seed funds.

Meanwhile, startups with a focus on non-psychedelic treatments for trauma and other forms of serious mental illness have also attracted venture attention of late:

Virtual trauma therapy provider Nema Health earlier this month collected $4.1 million in seed funding.

Stella, a provider of treatments for severe mental illness including PTSD, in May raised $7 million.

Author Health in June booked $115 million to support Medicare Advantage users with various forms of serious mental illness (SMI).

What's next: Psychedelics research being conducted at VA facilities is funded by outside organizations, not the department itself. However, the VA is "closely" following growing research literature to determine if further study is warranted.

VA commits to studying psychedelics for PTSD as startups in sector mushroom

A growing array of institutions is recognizing psychedelics' potential role in treating mental illness.

Illustration of a large cap mushroom inside of a pill bottle. 

Health tech deals

The Department of Veterans Affairs says it&#x27;s committed to studying the effectiveness of psychedelics like MDMA and psilocybin for post-traumatic stress disorder ahead of a House hearing expected to touch on the substances.Why it matters: Confronted with a worsening mental health crisis and a <a class="gtmContentClick" data-vars-link-text="shortage" data-vars-click-url="https://link.axios.com/click/33350616.174/aHR0cHM6Ly93d3cuYWFtYy5vcmcvbmV3cy1pbnNpZ2h0cy9ncm93aW5nLXBzeWNoaWF0cmlzdC1zaG9ydGFnZS1lbm9ybW91cy1kZW1hbmQtbWVudGFsLWhlYWx0aC1zZXJ2aWNlcz91dG1fc291cmNlPW5ld3NsZXR0ZXImdXRtX21lZGl1bT1lbWFpbCZ1dG1fY2FtcGFpZ249cHJvX2RlYWxzX2hlYWx0aHRlY2hfc3VicyZzdHJlYW09dG9w/61b8a591584bc520355bcf4fB1fc8b063" data-vars-content-id="c5ded309-c1c9-44b5-8d00-49fa1748965d" data-vars-headline="VA commits to studying psychedelics for PTSD as startups in sector mushroom" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://link.axios.com/click/33350616.174/aHR0cHM6Ly93d3cuYWFtYy5vcmcvbmV3cy1pbnNpZ2h0cy9ncm93aW5nLXBzeWNoaWF0cmlzdC1zaG9ydGFnZS1lbm9ybW91cy1kZW1hbmQtbWVudGFsLWhlYWx0aC1zZXJ2aWNlcz91dG1fc291cmNlPW5ld3NsZXR0ZXImdXRtX21lZGl1bT1lbWFpbCZ1dG1fY2FtcGFpZ249cHJvX2RlYWxzX2hlYWx0aHRlY2hfc3VicyZzdHJlYW09dG9w/61b8a591584bc520355bcf4fB1fc8b063" target="_blank">shortage</a> of psychiatrists, stakeholders ranging from government agencies and venture capital are recognizing psychedelics&#x27; potential role in treating mental illness.

About 6 in 10 adults who previously got a COVID-19 vaccine have not received an updated shot this fall — and about half of them don't plan to get one, according to a new KFF survey.

Why it matters: The survey shows decreasing public concern about COVID near the beginning of respiratory virus season, including among people who've previously protected themselves against COVID.

By the numbers: Overall, about 2 in 10 adults say they have received the updated shot that was released two months ago, while about half say they don't plan to get it, per the survey.

Partisanship continues to be a major predictor of whether someone gets the shot — even for those who've been vaccinated before.

19% of Democrats in this group said they won't get the updated vaccine, while about twice as many Republicans (43%) say the same.

Democrats who were previously vaccinated were much more likely than their Republican counterparts to already have received the latest shot (32% vs. 12%).

Between the lines: This fall's vaccination campaign got off to a rocky start, as supply chain and insurance issues made things difficult for early shot seekers. But no one's expecting a major uptick in demand, after just 17% of the U.S. population received last year's formulation.

About half of people who were previously vaccinated but didn't receive the latest one said their lack of concern about getting COVID is at least partly why they haven't gotten a shot this fall. 

Go deeper: About 1.8 million people got a COVID shot in late September

About 1.8 million people got a COVID shot in late September

Why some people who got the COVID-19 vaccine aren't getting boosted now

About 6 in 10 adults who previously got a COVID-19 vaccine have not received an updated shot this fall.

COVID-19 vaccines

Coronavirus

About 6 in 10 adults who previously got a <a class="gtmContentClick" data-vars-link-text="COVID-19 vaccine" data-vars-click-url="https://www.axios.com/2023/09/11/fda-approves-updated-covid-19-vaccines" data-vars-content-id="fcf2a30d-1aaf-418e-9449-9d223a7b611a" data-vars-headline="Why some people who got the COVID-19 vaccine aren&#x27;t getting boosted now" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/09/11/fda-approves-updated-covid-19-vaccines" target="_self">COVID-19 vaccine</a> have not received an <a class="gtmContentClick" data-vars-link-text="updated shot" data-vars-click-url="https://www.axios.com/2023/09/15/cdc-covid-vaccine-booster-insurance-appointments" data-vars-content-id="fcf2a30d-1aaf-418e-9449-9d223a7b611a" data-vars-headline="Why some people who got the COVID-19 vaccine aren&#x27;t getting boosted now" data-vars-event-category="story" data-vars-sub-category="story" data-vars-item="in_content_link" href="https://www.axios.com/2023/09/15/cdc-covid-vaccine-booster-insurance-appointments" target="_self">updated shot</a> this fall — and about half of them don&#x27;t plan to get one, according to a new KFF survey.Why it matters: The survey shows decreasing public concern about COVID near the beginning of respiratory virus season, including among people who&#x27;ve previously protected themselves against COVID.

Jason Millman

Stories

Biden embraces power to break patents of costly drugs

Number of suicides reached record level last year, CDC says

Why some people who got the COVID-19 vaccine aren't getting boosted now

Measles cases and deaths rose at "staggering" rate last year, WHO and CDC report

VA commits to studying psychedelics for PTSD as startups in sector mushroom

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