REVIEWS AND COMMENTARY on recent literature in reproductive medicine and biology
The staff of THE REPRODUCTIVE TIMES under this heading offers commentaries on recently published articles, in the positive and negative, primarily chosen for educational value.
NEWS ALERT
U.S. GOVERNMENT EXPANDS BIRD FLU VACCINE SUPPLY
The so-called bird flu (H5N1) is causing increasing concerns. Not only has the virus infected hordes of cows, and with it the milk industry and a good number of its employees, but Reuters (1) (and other news organizations) recently also reported the first case of H5N1 bird flu in a pig in Oregon. This has significance because pigs were implicated in transmissions to humans in the H1N1 flu pandemic in 2009-2010. The farm has been quarantined.
Related, Reuters also reported a few days earlier that Sanofi, GSK, and CSL were tapped by the U.S. government to expand the supply of bird flu vaccine (2), a sign that concerns about a possible bird flu pandemic are growing.
References
1. Douglas L, Polansek T. Reuters. October 30, 2024. https://www.reuters.com/business/healthcare-pharmaceuticals/us-detects-h5n1-bird-flu-swine-first-time-2024-10-30/
2. Reuters. October 4, 2024. https://www.reuters.com/business/healthcare-pharmaceuticals/sanofi-gsk-csl-tapped-expand-us-bird-flu-vaccine-supply-bloomberg-news-reports-2024-10-04/
Local, National & International News
Has the popularity of private equity in medicine peaked?
Indeed, one can get the impression that this is the case. Chris Cummings recently reported in The Wall Street Journal that some physician groups are trying very hard to limit the further expansion of private equity into U.S. healthcare (1). Moreover, as the article notes, many of these groups are also trying to influence legislatures to restrict further takeovers in medicine by private equity.
Reproductive medicine – and especially the infertility field – has, of course, been a primary target, with over half of all U.S. IVF cycles apparently already “owned” by private equity. This fact was noted in an article about several class-action lawsuits that recently were filed in the U.S. accusing the genetic testing industry of fraudulently misrepresenting to the public the advantages of preimplantation genetic testing for aneuploid (PGT-A). We are pointing to that article because its author, Norbert Gleicher, MD, suggests that should these lawsuits reduce the utilization of PGT-A in association with IVF, as he expects, current financial models of IVF clinics which have been so enticing for private equity to enter the fertility field may change. And a change in involvement and, even more so, a substantial withdrawal of private equity from the infertility field, would, of course, greatly affect practice values.
According to a Professor at Oregon Health & Science University quoted in The Journal article, 61% of physicians have a negative view of private equity, and fewer than 11% look at private equity positively. We suspect that these 11% are probably older physicians close to retirement who are planning on selling their practices to private equity.
Reference
1. Cummings C. The Wall Street Journal. September 22, 2023. https://www.wsj.com/articles/doctors-organize-to-push-back-against-private-equity-takeovers-16aa2c94 or in print September 23, 2024. pB8
California expanded the definition of infertility to same sex couples and single women and men
In a formal statement on behalf of the American Society for Reproductive Medicine (ASRM), its president at the time, Paula Amato, MD (now the society’s immediate past president) expressed how “thrilled” the Society was about Governor Gavin Newsom having signed into law SB 729, which greatly expanded the availability of IVF by defining same sex couples and single individuals who need IVF to have a child as “infertile.” The news release also noted that this new state law “brought California to the forefront of IVF coverages” while expressing the hope that neighboring states Oregon and Washington will soon follow (1).
Reference
1. Amato P., ASRM Press Release. September 29, 2024. https://www.asrm.org/news-and-events/asrm-news/press-releasesbulletins/fertility-care-gets-win-california/
Research misconduct reaches the highest echelons of the NIH
Especially over the past year, the rapidly growing number of reports about research misconduct in medicine has become of substantial concern worldwide. Now this scourge has reached the highest levels of the National Institutes of Health (NIH), with the director of the neuroscience division at the National Institute of Aging (NIA), Eliezer Masliah, MD, having been “relieved of his position” because of research misconduct, as was formally announced by the NIH (1).
And it does not seem to have been just “little mistakes,” like when a prominent dean at an even more prominent university was forced to resign because—being busy as a dean—he had failed to properly supervise his laboratory which published a few papers (his name on them) demonstrating similar “errors” to the papers from Masliah’s laboratory. In an investigation at the NIH, Masliah was found guilty of falsifications and/or fabrications and the reuse and relabeling of figures representing two different studies (3). In other words, not only little guys cheat in their research to advance their careers; biggies very obviously do the same, and it would be interesting to study what their motivations are.
After labs run by famous university deans and other senior academicians were found to have cheated, and after presidents of famous universities were found to have plagiarized the work of others, they all were given the opportunity to resign from their prestigious positions, while maintaining salaries and other perks by staying on the faculty, but Masliah was outright fired. He either did really terrible things or we still have a two (or even more)-tiered system that protects the more prominent boys and girls over those a little less prominent. Considering that Masliah’s misconduct allegedly involved no fewer than 123 published papers (1), maybe both was the case in this instance.
Reference
1. National Institutes of Health, News Release. September 26, 2024. https://www.nih.gov/news-events/news-releases/statement-nih-research-misconduct-findings
Why health insurance for infertility treatments is still very disappointing
According to a recent report in The Wall Street Journal, the average annual cost of family coverage health insurance reached approximately $25,000 (1). This compares to roughly $6,000 in the year 2000 and reflects a 2024 increase alone of 7%. And while most of this increase affects employers, workers’ contributions have, of course, increased in parallel and so have deductibles (see the figure below). The latter, moreover, increased significantly especially in small companies (1).
Source: WSJ (1)
As well, the article specifically broke out data regarding so-called family building benefits, which included coverage for fertility medications, IVF, intrauterine inseminations (IUIs), adoption, cryopreservation, and “others,” and they were still more than disappointing. Specifically, even among companies with over 200 employees, barely ca.12% covered IVF, only approximately 15% covered fertility medications, roughly 10% covered IUIs, and 5% or fewer covered adoptions, cryopreservation (i.e., egg-freezing), and other fertility treatments. The article also noted that most employers are still holding off on weight loss drugs which, of course, also has potential relevance for fertility treatments.
With the numbers regarding fertility coverage still being so disappointing among large companies, one can assume that they are even worse in smaller companies with fewer employees. These numbers very obviously reemphasize what the fertility field in the U.S. has been aware of for some time: infertile couples in a large majority are underserved. This fact, indeed, has been one reason why the CHR in 2023 started to offer smaller employers in the New York tristate area with up to 100 employees significantly discounted infertility coverage, including IVF (Advertisement). Human resources and/or benefit managers of smaller-size companies in our area seeking competent fertility coverage for their employees, therefore, should contact Ms. Jolanta Tapper, COO of the CHR at jtapper@thechr.com or 212-994-4400 (Advertisement).
REFERENCE
1. Evans M, Ulick J. The Wall Street Journal. October 9, 2024. https://www.wsj.com/health/healthcare/health-insurance-inflation-charts-612812ed