Axios Vitals

A briefcase with a red cross on the front.
May 09, 2022

Good morning, Vitals readers. Today's newsletter is 779 words or a 3-minute read.

Listen in: The Axios Today podcast talks about long COVID and doctors' search for treatments with Chelsea Cirruzzo and me. Listen in.

1 big thing: America approaches 1 million deaths

Illustration: Maura Losch/Axios

The U.S. will likely reach the once-unthinkable milestone of 1 million deaths from COVID-19 this week.

Why it matters: While the actual number of lives lost is likely much higher, the official tally is a reminder of how much the pandemic dwarfed even the grimmest forecasts early in the crisis.

State of play: America is averaging around 300 deaths a day, down from highs that once exceeded 3,000 deaths a day.

What we're watching: With new variants and waning immunity from initial COVID doses and boosters, the gap between the number of people dying who are vaccinated versus unvaccinated is narrowing.

  • Officials are closely watching hospitalizations rise again in certain hotspots.

The bottom line: Behind each of those deaths was a person with a story.

2. The coming long COVID coverage fight

Illustration of a health insurance claim form and a stamp saying "payment due" surrounded by bill envelopes.
Illustration: Gabriella Turrisi/Axios

Americans suffering from long COVID are running into the obstacles presented by health and safety net systems that are difficult to navigate in the best scenarios — and certainly aren't set up to deal with the ambiguity of a new chronic disease, Axios' Caitlin Owens reports.

Why it matters: Long COVID patients can be hit with the financial double whammy of expensive medical bills and a reduction of income, if the condition impairs their ability to work.

  • But they may struggle to receive help, as their condition is difficult to diagnose, no standard treatment guidelines exist and policy hasn't kept up with the pandemic.
  • "We are still understanding long COVID and what all it entails, what services are needed, but we generally know that folks pursuing treatment often have to see a range of physicians," said Audrey Richardson, a policy analyst at Families USA.
  • "That all adds up, when you have a bunch of different appointments you need to pay for."

👉 Read the Axios AM Deep Dive: Long COVID crisis

3. Drug rebates on the rise

Data: Texas Christian University; Chart: Baidi Wang/Axios

Prescription drug rebates from drugmakers to commercial health plans are steadily increasing, a study published in JAMA Health Forum shows.

Why it matters: This is all part of a system in which drugmakers negotiate to get their product on the formularies of middlemen known as pharmacy benefit managers and health plans.

  • "While drug rebates can reduce plans' net costs, rebates do not reduce patients' cost sharing," the authors write.

This can ultimately "incentivize drug manufacturers to inflate list prices and PBMs to distort drug formularies to favor high list price and high-rebate therapies," the authors write.

What they're saying: This is also an equity issue, particularly for patients buying individual plans.

  • "We have the sick people paying more than their fair share for the drug and the rebate goes back to the plan to reduce premiums for the healthy," said Ge Bai, a professor of accounting at Johns Hopkins Carey Business School who was one of the authors of the study.

What to watch: Trump era rules to block rebates for Medicare stalled under the Biden administration.

  • But the issue has been gaining attention on Capitol Hill, with a bipartisan group of lawmakers pushing to outlaw rebates as part of legislation that would cap the price of insulin, FierceHealthcare wrote.

4. Pic du jour

Photo: Matthew Hatcher/SOPA Images/LightRocket via Getty Images

Protesters hold placards, chant, and march through downtown Detroit in support of Roe v. Wade in one of multiple demonstrations around the U.S. over the weekend to protest a leaked U.S. Supreme Court draft opinion that would overturn the landmark decision.

  • Most people who support upholding Roe v. Wade view its demise as a threat to women that could put other rights in jeopardy, Axios' Julia Shapero writes about a CBS News poll out Sunday.
  • On the flip side: Those who support overturning Roe said they believe it will provide "protection for the unborn" (85%) and "be a protection for women" (64%).

5. While you were weekending

Illustration: Aïda Amer/Axios
  • FDA commissioner Robert Califf told CNN that "almost no one" in the U.S. should be dying from COVID-19, but that misinformation was impacting the death toll. (Axios)
  • As nurses demand better wages, major health systems are pushing health insurers to pay up — and it's sparking a big feud. (Wall Street Journal)
  • Another sign of the mental health crisis among teens: There are hundreds of adolescents who've attempted suicide sleeping in emergency rooms every night because there aren't enough inpatient beds to go around. (New York Times)