GENERAL MEDICAL NEWS
The staff of The Reproductive Times here offers brief referenced notifications on interesting general medical and scientific news with broad relevance to reproductive medicine and biology. Some of these news items may become subjects of more detailed reporting in The Reproductive Times on later occasions. The purpose of these short notifications is to give readers the opportunity to get immediately more detailed information by looking up the reference of the notification.
NEWS ALERT
FDA PUTS HOLD ON EXPERIMENTAL COVID/FLU COMBINATION TRIAL VACCINE
Reuters recently reported that the FDA put a trial of the pharma company Novavax on hold which was testing a combination vaccine against COVID and the flu after one person reported nerve damage (1). The patient demonstrated symptoms of a motor neuropathy and/or damage to nerve cells that control muscles and movement.
Since other similar vaccine combinations had not shown similar risks, the company issued a statement that it did not believe that this case of neuropathy was caused by the vaccine and that it was looking forward to resuming the approval process by starting a Phase 3 trial as soon as possible. The company’s shares, nevertheless, dropped by 24%, per the report, wiping out $400 million from the company’s value.
Moreover, this kind of news does not bode well for the vaccination hesitance the world has been witnessing since the COVID pandemic.
Reference
1. Satija B. Reuters. October 16, 2024. https://www.reuters.com/business/healthcare-pharmaceuticals/us-fda-places-trials-two-novavax-vaccines-hold-2024-10-16/
THE MEDICAL SCHOOL OF THE UNIVERSITY OF CONNECTICUT EXPANDED THE HIPPOCRATIC OATH FOR ITS GRADUATING STUDENTS
Here is interesting news from a prominent medical school. The University of Connecticut (UConn) School of Medicine – after using for two millennia, like most other Western medical schools, the Hippocratic Oath to ‘do no harm’ as the foundation of medicine, has now reached the conclusion that the oath was outdated. According to the leadership of the university, the oath had to be expanded to also pledge to advance DEI in medical practice.
The school announce the new oath as follows: “We have revised our medical school’s Hippocratic oath to include active pledges to identify and mitigate personal biases, to uphold human rights, to respond to medical myths with evidenced based information and without judgment, to actively support policies that promote social justice and specifically work to dismantle policies that perpetuate inequities, exclusion, discrimination, and racism.”
The change was (of course) prompted by the university’s Diversity, Equity, and Inclusion Committee and what is there left to say after two millennia in which the old oath served as one of the pillars of Western civilization, as an article in Do No Harm Medicine pointed out (1).
What is then left to say? One wonders when this committee is planning to adjust the Ten Commandments?
Reference
1. Do No Harm Medicine. 11, 2024. https://donoharmmedicine.org/2024/09/11/uconn-dei-hippocratic-oath/#:~:text=%E2%80%9CWe%20have%20revised%20our%20medical,justice%20and%20specifically%20work%20to
ITALY CRIMINALIZES SURROGACY FROM OUTSIDE THE COUNTRY
Almost unnoticed here in the U.S. except by an article in The New York Times (1), Italy passed a law that criminalizes the pursuit of surrogacy abroad. In Italy surrogacy has already been illegal but the new law even prohibits its pursuit outside the country. For some reason the article appears to emphasize the effect of the law especially on gay fathers, while the problem – of course – affects the whole L.G.B.T.Q+ community, infertile couples, single men, and even some single women.
To pass such a law appears not only inhumane but plainly stupid for Italy, considering that the country is experiencing one of the 10 lowest birth rates in the world (see figure). In the so-called developed world the birth rate required for replacement of the existing population is 2.1 children per woman. Italy’s birthrate of 1.26, therefore, points toward the disappearance of the Italy we all know and love in the not-too-distant future, unless the country finds ways to improve its birth rate.
FIGURE: The 10 countries in the world with the lowest birth rates
Source: Statista, CIA.Gov
As the article notes, it is unclear whether the law will withstand legal challenges. Despite having been at the forefront in some areas of IVF research, the country has had its own complex legal history regarding IVF, usually attributed to the influence of the Roman Catholic Church in the country. Several restrictions on what around the world were considered routine IVF practices, therefore, could be introduced in Italy only after legal challenges to existing restrictive laws. In our opinion, it, therefore, would not be surprising if this new law would be rather short-lived.
References
1. Bubola E. The New York Times. October 16, 2024. https://www.nytimes.com/2024/10/16/world/europe/italy-surrogacy-law.html
U.S. HEALTH CARE COSTS ARE RISING WHILE HEALTH OUTCOMES ARE DECLINING – and infertility is likely an especially good example
A recent article by Heather Landi in Fierce Healthcare (1) noted that in the 10-year period between 2012 and 2022, national health expenditures increased from $2.8 trillion to $ 4.5 trillion (+61%) and is expected by 2032 to have grown to $7.7 trillion (another +71%). If one compares these costs to the national domestic product (GDP), this quite a significant proportion. While insurance coverage during this time period has improved – uninsured declined from 48.6 million to 28 million (-42.4%), life expectancy in the U.S. is only negligibly higher and almost 4 years below OECD countries. Obesity, diabetes, and behavioral health problems have been steadily increasing in prevalence. 30-day mortality rates in hospitals are, moreover, rising sharply, even if COVID deaths are excluded.
So, what is then the conclusion? The article suggests that all stakeholders, whether an employer or payer, life science company or provider, will have to stop extracting value from the health care system in ways that maximize profits. Instead, efforts have to be directed at delivering value for the money spent, in the process optimizing the value for whoever ultimately pays for the medical treatment.
The concept of value-based medical care is, of course, nothing new. To the contrary, it, indeed, has become one of those “fashions of the moment” in recent years; but according to the article value-based care policies so-far implemented, have in principle failed.
Looking at the infertility field from such a viewpoint, this, of course, should not surprise. One just has to look at all the “add-ons” introduced to IVF practice over the last 20 years with no evidence for any outcome benefits. Or how about all the changes in IVF practice that have led to the need for more treatment cycles, like for example routine all-freeze protocols? We, indeed, would argue that a study of value-based care in IVF over the last 20 years would demonstrate a straight line downward for every dollar spent. One strong hint that this, indeed, is likely the case is the declining live birth rate in U.S. IVF cycles since ca. 2010, when the introduction of unvalidated “add-ons” to IVF started to accelerate (2).
References
1. Landi H. Fierce Healthcare. October 1, 2024. https://www.fiercehealthcae.com/providers/new-analysis-points-troubling-trends-us-healthcare-costs-rise-health-outcomes-worsen.
2. Gleicher et al., Hum Reprod Update 2019;(3):hoz017
DECLINE IN BLACK STUDENTS IN TOP COLLEGES FOR THE 2024/2025 ACADEMIC YEAR?
According to a recent article in The New York Times, Amherst College and the Massachusetts Institute of Technology experienced a significant drop in Black student enrollment for the new academic year (1) The University of Virginia also reported a drop, but it was smaller. Other schools reported mixed results. School officials attributed those drops to last year’s Supreme Court decision that prohibited race-conscious admission policies, though final consequences are not yet clear. At least one school administrator suggested that elite schools may, indeed, see a drop, while solid second-tier schools may very well see increases in enrollment of minorities.
Reference
1. Hartocollis A, Saul A. The New York Times. August 31, 2024. https://www.nytimes.com/2024/08/30/us/black-enrollment-affirmative-action-amherst-tufts-uva.html