Issue 38: The Human Cell Atlas, Generic EpiPen, Netflix's Bleeding Edge, and more

The Human Cell Atlas

The Human Cell Atlas

Thanks to the Human Genome Project and services like 23andMe, many of us have become intimately familiar with our own genetic makeup and ancestry. Now, a new project called the Human Cell Atlas is embarking on a similar undertaking: mapping out every single cell in the human body. While we already have a solid grasp on a few hundred broad categories of human cell types, this international effort hopes to provide a better understanding of every sub-type and how they interact. The project’s completion date is still 5-10 years away, but a new cell type has already been discovered in the lining of the human windpipe, which researchers say could play an important role in cystic fibrosis. This discovery may be just the beginning of what the Human Cell Atlas Consortium delivers in the years to come. 

Generic EpiPen finally hits the market to compete with greedy Mylan 

Artist Adam Zyglis

The price of the lifesaving EpiPen has increased by more than 400% in the last decade since being acquired by Mylan pharmaceuticals. Currently Mylan is selling a pack of two EpiPens for $600, up from the $50 per auto-injector in 2007. Mylan has sued rival pharmaceutical companies to prevent them from bringing cheaper alternative to market all the while paying their executives millions of dollars. From the price hikes Mylan was able to add $1.1 billion dollars to its bottom line while paying CEO Heather Bresch $19 million in 2015. This week, however, Teva Pharmaceuticals received FDA approval for its generic version of the EpiPen. This must have pissed off Mylan since in 2009 they sued Teva for patent infringement preventing them from working on their EpiPen until 2015. The FDA prematurely congratulated themselves on the approval which they claim will lower healthcare costs. Teva has yet to release a price of what their EpiPen will cost and has refused to answer this question when asked. If anything the EpiPen story is a microcosm of what is wrong with the US pharmaceutical industry. 

Netflix's Bleeding Edge causes Bayer to Stop Selling Essure 


Netflix's new documentary the Bleeding Edge dissects the unethical practices of the $400bn medical device industry. The documentary focuses on several different products that have led to catastrophic side effects in patients. An orthopedic surgeon in the film receives a metal-on-metal hip replacement and later develops tremors and psychosis to the point where he starts scribbling all over the walls in his hotel room. After discovering that his cobalt levels are 100x the upper limit of normal he sees another surgeon to take out the hip replacement. It turns out the hip replacement was leaking metallic sludge into his bloodstream. After taking out the hip replacement he recovered. According to the BMJ and BBC Newsnight, hundreds of thousands of patients could be exposed to toxic metals from these leaking metal-on-metal implants. The documentary also focuses on Bayer's birth control device Essure which causes unintended pregnancies and painful bleeding in women using the device. The women who were experiencing problems with the device created an Essure Problems FB support group that has tens of thousands of patients. Bayer has been served with more than 16,800 lawsuits related to Essure as of April 2018. Bayer responded that they were removing Essure from the market for "business reasons" and later criticized the Netflix documentary. 

Congressman Gets Busted for Insider Trading: A Cautionary Tale for Doctors

Corrupt Chris Collins

Last week, NY congressman Chris Collins was charged with insider trading in the biotech space. He is alleged to have contacted his son after receiving negative information regarding a multiple sclerosis trial from a company on which he held a board seat. All this was to avoid ~$800,000 in financial losses—likely not life changing for this politically elite family. So what’s the lesson for physicians-in-training and beyond? Many of us may interface with company-sponsored clinical trials at least once throughout our lengthy careers. This is good because trials are expensive, new drugs are needed in some areas, and companies looking to make profits will open their purses to fund trials. In this situation, however, there is the potential for one to gain access to financially material information which could be tempting to sell in order to make a quick buck. Take a moment to reflect on congressman Collins: embroiled in political scandal with irreversible damage to his and his family’s reputation. Not worth it if you ask me! As physicians, we are held to a high bar, and anything we do has the potential to change the reputation of the profession, thus impacting patient care. Although financial tensions can be high for trainees, always take a moment to ask yourself is what I’m about to do really worth it?

With a perspective, Chris Margono, MS4 @ UCSF

Carbovores aka Pastavores 

PASTA

Carb lovers, rejoice! A lot of health nuts may claim that carbs are the enemy, and many people (sadly including myself) have even tried out low carb or even no carb diets. But a new study published in the The Lancet has shown that as with most things, moderation is key. In fact, people on both extremes of the spectrum —those who got more than 70% or less than 40% of their day’s calories from carbs—both had higher mortality risks. It might be because people on the higher end of the spectrum end up eating a lot of refined flour, while those on the lower end substituted them with meat and dairy items that ended up increasing the risk for heart disease. However, substituting carbs for plant derived foods can circumvent this complication. In any case, having a balanced diet still seems to be the healthiest option!

NYU Medical School Offers FREE tuition

NYU is free now

You heard that right. NYU announced this week that current and future medical students would not have to pay for tuition. Tuition which previously costed more than $50k/year will be subsidized by the school's endowment. NYU states that by removing the specter of high student loan debt - medical students will be free to go into a speciality that they are actually interested in vs. just doing it for the $$$.