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Aaron Mitchell

@thewonkologist.bsky.social

Medical oncologist and health services researcher. Focusing on health care costs, physician-industry COI, and oncology reimbursement reform. Opinions mine.

1,135 Followers  |  342 Following  |  297 Posts  |  Joined: 21.09.2023  |  2.28

Latest posts by thewonkologist.bsky.social on Bluesky


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Prasad overruled FDA staff to reject Moderna's flu vaccine application The rejection is the latest instance of Vinay Prasad overruling career FDA scientists to place vaccines under harsher scrutiny.

The flu and pneumonia kill over 45,000 people a year. Moderna developed a new mRNA flu vaccine for people 50 and older--who are most at risk. Prasad, unilaterally, against the recommendation of experts within the agency, denied Moderna's appplication. www.statnews.com/2026/02/11/m...

11.02.2026 16:08 β€” πŸ‘ 624    πŸ” 334    πŸ’¬ 20    πŸ“Œ 35
Research Data Request & Access Policy Changes Update | ResDAC In February 2024, the Centers for Medicare & Medicaid Services (CMS) announced plans to change how researchers access Medicare and Medicaid data to better protect controlled unclassified information. ...

🚨🚨🚨
Since we need all the good news we can get these days!

CMS reverses plan to end physical data requests and transition all researchers to the VRDC platform:
resdac.org/cms-news/res...
cc @basucally.bsky.social @aschwartz.bsky.social @academyhealth.bsky.social @wschpero.bsky.social

11.02.2026 19:50 β€” πŸ‘ 5    πŸ” 2    πŸ’¬ 0    πŸ“Œ 0

It is really, really sad and angering when one of your own switches sides and joins Team Disease full-on

11.02.2026 17:58 β€” πŸ‘ 3    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0
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NIHCM Awards $500,000 to Support Research on AI Scribes, Perinatal Market Concentration, Specialty Drug Pricing, and More. Ten new grantees have been selected for NIHCM's 2026 Research cohort. They will generate novel, policy-relevant evidence on health care affordability,...

Honored to be among this year's cohort of grant awardees from the @nihcm.bsky.social !

Drs. Aaron Winn, Pragya Kakani, and I will be studying trends in provider profit margins on cancer drugs.

@mskcancercenter.bsky.social @ascocancer.bsky.social
nihcm.org/news/nihcm-a...

10.02.2026 23:59 β€” πŸ‘ 3    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0
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New study finding regional variation in adoption of PSMA PET imaging for prostate cancer. As we often see, Southeast is lagging. As this scan is prerequisite to radioligand therapy, could result in treatment disparities

ascopubs.org/doi/10.1200/...

@carygross.bsky.social @ascocancer.bsky.social

04.02.2026 17:46 β€” πŸ‘ 2    πŸ” 1    πŸ’¬ 0    πŸ“Œ 0
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The best coffee in midtown @cafegrumpy.bsky.social is donating 10% of proceeds today to the @immdefenseproject.bsky.social

30.01.2026 14:15 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
Novel Solutions to Address the Rising Cost of Oncology Drugs: Targeting the Demand Side | Center for Personalized Therapeutics

Looking forward to speaking on cancer drug prices at this upcoming symposium at Georgetown. March 5th for those of you in the DC area!

cpt.uchicago.edu/program/

27.01.2026 21:30 β€” πŸ‘ 3    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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Changes in pharmaceutical industry payments to physicians after New Jersey's 2018 restriction The federal government and several states have implemented measures to restrict, ban, and increase transparency of promotional payments from pharmaceutical

New Jersey told doctors to stop accepting more than $10K per year from the drug industry.

...looks like we didn't stop. 😑

Great work by Neeraj Patel, @reshmagar.bsky.social @jsross119.bsky.social

academic.oup.com/healthaffair...

16.01.2026 13:59 β€” πŸ‘ 3    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

"Of these 52 drugs, 36 (69.2%) experienced any FDA postmarketing safety action, including 33 (63.5%) new warnings and precautions, 6 (11.5%) new boxed warnings, 4 (7.7%) drug safety communications, and 2 (3.8%) safety-related market withdrawals"

14.01.2026 22:09 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

Summary findings:

Post-market safety actions are very common.
SERIOUS safety actions (new black box warnings or market withdrawal) were much less common.

14.01.2026 22:09 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0
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Postmarket Safety Actions for Novel Oncology Drugs Granted Accelerated Approval This cross-sectional study examines postmarket safety actions for novel oncology drugs that received accelerated Food and Drug Administration (FDA) approval.

New study in @jamanetworkopen.com this week: frequency of post-market safety issues for cancer drugs with accelerated approval.

Happy to collaborate on this study with Dr. Mooghali, @reshmagar.bsky.social @jsross119.bsky.social

jamanetwork.com/journals/jam...

14.01.2026 22:09 β€” πŸ‘ 6    πŸ” 2    πŸ’¬ 1    πŸ“Œ 0

Congrats!

14.01.2026 17:00 β€” πŸ‘ 2    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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David Mitchell, Who Led Fight on Drug Prices, Dies at 75

Sorry to learn of the passing of David Mitchell, founder and leader of @p4ad.bsky.social who played large role in helping get the Inflation Reduction Act to the finish line.

His voice will be very missed.

www.nytimes.com/2026/01/12/h...

13.01.2026 14:16 β€” πŸ‘ 5    πŸ” 1    πŸ’¬ 0    πŸ“Œ 1

We hope to have more findings regarding the interaction of competing industry payments - and on payments promoting the less-than-optimal treatment options - forthcoming soon!

This work led by rockstar student Helen Keetley!
Thanks to @profgenkanter.bsky.social for all your input.

6/

12.01.2026 16:48 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

We also saw some concerning signals regarding payment bias.

My understanding is that osimertinib is superior to earlier-gen EGFRis.

We observed that MDs who received payments for osimertinib AND afatinib were more likely to Rx afatinib (vs. those with payments for osimertinib alone)

5/

12.01.2026 16:48 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0
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Are Financial Payments From the Pharmaceutical Industry Associated With Physician Prescribing? : A Systematic Review - PubMed National Cancer Institute.

And these payments DO cause biased prescribing, as we have written about extensively:

pubmed.ncbi.nlm.nih.gov/33226858/

pubmed.ncbi.nlm.nih.gov/37879723/

archinte.jamanetwork.com/article.aspx...

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12.01.2026 16:48 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

...at the same time, a larger proportion of oncologists received payments from only 1 or 2 of the 3 competing companies, leaving more than enough room for "unbalanced" payments (and potentially biased prescribing).

3/

12.01.2026 16:48 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0
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We found that this actually does happen relatively frequently.
We looked at 3 sets of 3 competing drug.
For CDK4/6i and BCR-ABL TKIs, about 1/4-1/3 of oncologists had received $$$ from all companies over a 3yr period.
(less often for EGFRi, due to gefitinib payments being rare)

12.01.2026 16:48 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0
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How Often Do Oncologists Receive Industry Payments from Competing Companies? AbstractBackground. Payments from pharmaceutical companies to oncologists can influence prescribing practices. However, some physicians believe that receiv

Our latest study on physician-industry COI, out last week in The Oncologist.

I have often heard the rationale that "if I'm conflicted with all the companies, then I'm unbiased."

So we asked, how often DO oncologists receive payments from all competing companies?

academic.oup.com/oncolo/advan...

12.01.2026 16:48 β€” πŸ‘ 1    πŸ” 1    πŸ’¬ 1    πŸ“Œ 0
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Make it viral.

08.01.2026 03:22 β€” πŸ‘ 47653    πŸ” 21399    πŸ’¬ 361    πŸ“Œ 528

lol, β€œproliferating healthy connection at scale”

07.01.2026 06:34 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

Green Purple

30.12.2025 05:01 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

Smashing the Blowfish

30.12.2025 05:00 β€” πŸ‘ 2    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0
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Oncology Drug Revenue and Price Negotiation This Viewpoint examines the potential impacts of the Inflation Reduction Act and negotiation of oncologic drug prices on payments to oncology specialists.

Oncologists should support - not oppose - Medicare drug price negotiation. Lower drug prices benefit patients; this should supersede revenue concerns.

So @dusetzinas.bsky.social @rachelsachs.bsky.social and I argue today in @jamaoncology.com

jamanetwork.com/journals/jam...

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26.12.2025 17:09 β€” πŸ‘ 17    πŸ” 6    πŸ’¬ 1    πŸ“Œ 0

2006

27.12.2025 01:33 β€” πŸ‘ 1    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

@portalresearch.org @julierovner.bsky.social @megtirrell.bsky.social @djvanness.bsky.social @yalecrrit.bsky.social @reshmagar.bsky.social

26.12.2025 17:09 β€” πŸ‘ 2    πŸ” 0    πŸ’¬ 0    πŸ“Œ 0

cc @peterbachmd.bsky.social @relentleshealth.bsky.social @charlesornstein.bsky.social @hollylynchez.bsky.social @kffhealthnews.org @icer-review.bsky.social @sarahkarlin-smith.bsky.social @lorenadler.bsky.social

Thank you to our funders!
@commonwealthfund.org @arnoldventures.bsky.social

26.12.2025 17:09 β€” πŸ‘ 5    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

Such alternative payment models have been proposed.
We fought and killed them.
We should stop doing that.

6/

26.12.2025 17:09 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

2) Lower drug prices are good for our patients, and for the health care system.

If we don't like the consequences of declining drug prices, then we should advocate for alternative payment models that doesn't leave us financially dependent on sustained high prices.

5/

26.12.2025 17:09 β€” πŸ‘ 2    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

And oncologists have already managed (and survived) competition-induced price declines to numerous high-revenue drugs:
Neulasta
Avastin
Herceptin
Rituxan
Neupogen

So qualitatively, IRA price negotiation is nothing new. Drug prices eventually come down, and balance sheets adjust.

4/

26.12.2025 17:09 β€” πŸ‘ 0    πŸ” 0    πŸ’¬ 1    πŸ“Œ 0

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