Screening patients for bladder cancer could soon be as easy—and painless—as an at-home pregnancy or Covid-19 test, thanks to the recent discovery of proteins that signal the disease’s early stages.

University of Houston (UH) researchers, who analyzed more than 1,300 urine sample proteins from 2020 to 2023, identified biomarkers that could help doctors detect and diagnose the disease via a simple urine test instead of a cystoscopy—an invasive procedure in which a thin camera is inserted into a patient’s urethra.

Chandra Mohan, a Hugh Roy and Lillie Cranz Cullen endowed professor of biomedical engineering at UH and the study’s lead author, told Healthcare Brew that more research is needed before a urine test can replace cystoscopy as the “gold standard” for bladder cancer diagnosis. But if adopted, the method could improve early detection of bladder cancer—one of the most common cancers diagnosed in the US—as well as patient outcomes and medical costs.

“It’s rare for somebody to send a patient for cystoscopy unless the index of suspicion [of cancer] is very high. This is a test that all you need is a urine sample. The chances are this will be done much earlier in larger numbers of patients…resulting in better identification—early identification—of bladder cancer,” Mohan said. “Of course, they would confirm that using a cystoscopy and biopsy.”

The study, which Mohan said was the first to examine such a wide range of urine sample proteins for potential biomarkers, found that one protein fragment, D-dimer, could play a role in cancer diagnosis or recurrence detection. D-dimer displayed the highest accuracy and sensitivity—at a respective 96% and 97%—of 21 urine proteins discriminating bladder cancer from urology clinic controls during the screening.

Keep reading here.—SY

Do you work in healthcare or have information about the industry that we should know? Email Shannon at shannon@morningbrew.com. For completely confidential conversations, ask Shannon for her number on Signal.

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Menopause is overwhelmingly underdiagnosed and undertreated, leading 1+ million patients to incur higher healthcare costs each year, a new study found.

Elektra Health, a telemedicine platform aimed at treating menopause, analyzed 2021 insurance claims data from 2.6 million women between the ages of 40 and 60, and compared the healthcare spending differences between patients who received a menopause-related ICD-10 diagnosis code to those who did not.

More than 1 million people in the US go through menopause each year, but only one in five (19%) receives a menopause diagnosis, according to the study. While menopause is often self-diagnosed, providers can use blood or urine tests to check hormone levels for confirmation.

However, a lack of ob-gyn menopause training has created a “massive care gap”; many patients seeking menopause care do not receive adequate treatment and instead turn to multiple specialists for care, the study found.

“Menopause costs are hiding in plain sight, and engaging women around their menopausal health has far-reaching implications,” Elektra co-founder and CEO Alessandra Henderson said in a statement. “In this way, menopause should be considered akin to other conditions driving significant costs, such as diabetes or hypertension.”

Only 20.8% of ob-gyn residents reported that their program had a menopause medicine training curriculum, according to a 2013 survey of 510 ob-gyn residents in the US published in The Journal of The North American Menopause Society. More than 60% of those surveyed reported having limited knowledge on aspects of menopause medicine, such as understanding bone health and how menopause symptoms progress.

Lack of providers trained in menopause medicine leads to “wasteful spending on specialty visits and tests,” per the Elektra study.

Keep reading here.—KW

Do you work in healthcare or have information about the industry that we should know? Email Kristine at white@morningbrew.com. For completely confidential conversations, ask Kristine for her number on Signal.

Some scientists tout gene therapies—drugs that modify a patient’s genes to treat or cure a disease—as the future of medicine, with the potential to treat the most pressing diseases like cancer, diabetes, and heart disease.

Gene therapies also have massive cost-savings potential, particularly when it comes to treating rare diseases. Most rare diseases are caused by a single gene mutation, which means a gene therapy treatment could fix the root cause of the condition.

The economic burden of rare diseases is staggering. It cost the US almost $1 trillion in 2019 from direct medical costs, non-medical and uncovered healthcare costs, and productivity loss, according to Rachel Salzman, global head of corporate strategy at precision therapeutics company Armatus Bio.

But these gene therapies come with a hefty price tag.

A gene therapy called Hemgenix, developed by CSL Behring and uniQure, costs $3.5 billion per dose. And that’s not far out of the ordinary for gene therapies. The Institute for Clinical and Economic Review estimates the average cost of gene therapy to be between $1 million and $2 million per dose.

The cost of the therapies means many patients lack access, Salzman said, speaking at the American Society of Gene and Cell Therapy’s annual meeting on May 16. Fewer than 10,000 patients received treatment with three gene therapy drugs in 2021, she said.

The three drugs—two from Novartis called Zolgensma and Kymriah, and one from Kite Pharma called Yescarta—brought in a cumulative $3.5 billion in revenue in 2021. If 10,000 patients were treated with the drugs in 2021, that translates to $350,000 in revenue per patient.

Keep reading here.—MA

Do you work in healthcare or have information about the industry that we should know? Email Maia at anderson@morningbrew.com. For completely confidential conversations, ask Maia for her number on Signal.

Today’s top healthcare reads.

Stat: Almost 110,000 people in the US died from drug overdoses last year, according to new CDC estimates. (CNN)

Quote: “For decades, fathers and mothers have been sending children to school with low-fat chicken, turkey deli meat thinking they were doing good. These foods are toxic.”—Dariush Mozaffarian, a cardiologist and professor of nutrition and medicine at Tufts University, on the health risks of processed meats (the Wall Street Journal)

Read: Hospitals that denied abortions to patients having miscarriages are now facing legal scrutiny. (ProPublica)

Catch up on the top Healthcare Brew stories you may have missed:

• The digital therapeutics industry has a lot to figure out to get payer coverage
• Health systems look internally to promote health equity in their communities
• Digital transformation: How the trend is shaping US healthcare