Whistleblower Conflicts of Interest; Maternity Services Cut; Tobacco’s Latest Tactic

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Journal Revamps Whistleblower Policy After Alzheimer’s Debacle

Whistleblowers raising concerns about the integrity of journal publications will be asked to disclose potential conflicts of interest when making claims, according to Nature.

Last year, four whistleblowers complained to JCI and other journals about what they said were doctored images and data in a number of published papers, some of which were related to simufilam, an experimental Alzheimer’s drug from Cassava Sciences.

In an editorial, JCI editor-in-chief Elizabeth McNally, MD, PhD, wrote that what she didn’t know at the time was that the whistleblowers were short-selling Cassava stock. McNally alleged the authors profited when the stock price of Cassava dropped 55% after they complained to the journals, including JCI, and filed a petition with the FDA.

The whistleblowers “deny any wrongdoing and stand by their allegations, with three saying that they made only relatively small amounts of money from trading Cassava stock,” according to Nature.

Journals have retracted at least five papers over these concerns, Nature reported, including two of the three papers that bolstered simufilam. The U.S. Securities and Exchange Commission is investigating the matter.

Maternity Services Cut Where They’re Most Needed

Hospitals that were already pressed for resources have continued to close obstetric units, drawing concern in the wake of abortion restrictions and rising pregnancy-related deaths, according to Axios.

In Illinois, Connecticut, Florida, and elsewhere, hospitals recently shuttered obstetrics services, and providers and advocates have raised concerns about existing “maternity deserts” becoming a bigger problem in states where abortion is now banned.

Closures are being driven by low Medicaid reimbursement rates, staffing shortages, and lower birth rates, Axios reported. The worst of the cuts for rural hospitals actually predated the pandemic, from 2014 to 2018, but pandemic funding might be the last string connecting rural mothers to local maternity care in some counties.

Axios spoke to Peiyin Hung, PhD, a professor at the University of South Carolina, who said women in rural areas already have to travel 24 miles to the nearest obstetrics unit, and the closure of one can double the distance someone would have to travel for pregnancy care.

“There’s no one policy that can really solve this,” Hung said, as Medicaid is unlikely to raise reimbursement rates, and states that haven’t expanded the program aren’t expected to do so.

Cigarette Manufacturers Evade California Flavor Bans

The manufacturer of Camel and Newport cigarettes, R.J. Reynolds, is finding new ways around California’s tobacco regulations with a new marketing campaign that hints at menthol flavor without actually selling it, the New York Times reported.

A new law that went into effect in December bans any “distinguishable taste or aroma” in tobacco products other than tobacco itself. The law explicitly mentions menthol and mint.

R.J. Reynolds, however, mailed fliers to customers reading “California, We’ve Got You Covered.” The company will carry non-menthol versions of products that they say have “a new fresh twist” and “a taste that satisfies the senses.” The products use what the New York Times calls a “synthetic cooling agent” called WS-3, that has no odor or flavor — and unknown health effects.

“If you squint at the ads, you’re going to see this as a flavorful product, whether it says it or not,” Pamela Ling, MD, director of the Center for Tobacco Control Research and Education at the University of California San Francisco, told the New York Times. “The colors, the packaging, the associations that your brain makes with the look and feel — that overrides the text that says this is not menthol.”

Critics are calling the advertising campaign outrageous, and warn that cigarette companies will once again evade consequences for flouting government regulations meant to bolster public health. Experts say it’s in line with “racist, predatory marketing” of menthol products that has historically targeted Black people.

Robert Jackler, MD, a professor at Stanford Medicine, told the New York Times, “The thing that surprises me is there’s no camouflage” in the advertising. “They’re saying, ‘This is our menthol replacement. And by the way — wink, wink — it is not really menthol.'”

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