Weekend update

David Ermer–Congress, Generative AI, Medical / Rx research, Obesity, SCOTUS–

From Washington, DC,

  • Per a Senate news release,
    • “Senate Finance Committee Chairman Mike Crapo (R-Idaho) today [June 22] released the Joint Committee on Taxation’s (JCT) revenue estimate of the Finance Committee’s tax title [of the budget reconciliation bill], which shows that under a current policy baseline, the legislation has a net revenue impact of $442 billion.
    • “Washington has a spending problem, not a tax problem.  Extending the Trump tax cuts prevents a $4 trillion tax increase—this is not a change in current tax policy or tax revenue. This score more accurately reflects reality by measuring the effects of tax policy changes relative to the status quo.”
  • Roll Call discusses expected Congressional activities on Capitol Hill this week.
    • “The budget reconciliation package continues to dominate the agenda in Congress this week, as lawmakers are also expected to debate President Donald Trump’s weekend military strikes against Iranian nuclear targets.
    • “An all-senators briefing on the situation with Iran is slated for Tuesday afternoon, and a war powers resolution from Sen. Tim Kaine, D-Va., could see quick floor action. Kaine wants senators on the record on whether the United States should engage in hostilities against Iran.
    • “While a Senate aide said the measure does not formally ripen for expedited consideration until the end of the week, Republicans may seek to clear it from the decks earlier in the week in order to get their sweeping budget reconciliation package on the floor.” * * *
    • “The House, meanwhile, returns from a Juneteenth recess poised to begin floor debate on fiscal 2026 appropriations, while waiting for the Senate to amend and send back the budget reconciliation package.”
  • The Supreme Court will be releasing more opinions on Thursday June 26 and likely also Friday June 27.
  • Per MedPage Today,
    • “Updated Dietary Guidelines for Americans, which could be released as early as this month, will drop a long-standing recommendation to limit alcohol consumption to one or two drinks per day, Reuters reported this week, citing three sources familiar with the matter.
    • It’s “surprising, especially given what we now understand about how alcohol impacts health,” Lindsay Malone, MS, a registered dietitian nutritionist at Case Western Reserve University in Cleveland, told MedPage Today by email.
    • “In the absence of clear guidance, people are left wondering: how much, if any, is actually safe and healthy?” she said. “I don’t see any upside to this.”
    • “The guidelines will likely still include a brief statement that encourages drinking in moderation or limiting intake due to associated health risks, Reuters‘ sources said.”

From the public health and medical research front,

  • Fortune Well reports,
    • “Millions more Americans should be taking weight-loss drugs to prevent heart disease, according to the American College of Cardiology. 
    • “Exercise and a clean diet aren’t always enough for heart health, the nation’s top cardiology organization said in new recommendations released on Friday. Weight-loss drugs should be used earlier, making them part of the first line of defense for obese patients, the group said.
    • “Novo Nordisk A/S’s Wegovy and Eli Lilly & Co.’s Zepbound should be considered when choosing primary treatments to avert heart disease, the leading cause of death in the US, according to the new guidelines. The popular drugs are more effective than lifestyle changes and have fewer risks than surgery, the nonprofit medical association said.”
  • and
    • I woke up from surgery groggy, with three minuscule incisions in my abdomen and huge peace of mind. I’d just had my fallopian tubes laparoscopically removed, as it’s the best—and possibly only—defense against ovarian cancer, which, though rare, is the most lethal gynecological cancer there is.
    • “There is no detection method for ovarian cancer (a common misunderstanding is that it’s the Pap smear, but that’s for cervical cancer). That’s largely because of something discovered relatively recently: About 80% of the time, cancer of the ovaries forms in the fallopian tubes, which are not easily reached or biopsied. So, the cancer is not found until it spreads beyond the tubes, by which point it has typically reached a later stage and is harder to treat, with cure rates as low as 15%. 
    • “The cancer and its pre-cancer lesions are also not detectable through blood tests. 
    • “I myself had no idea about any of this until 2023, when I wrote about the Ovarian Cancer Research Alliance (OCRA) making sweeping recommendations: that all women get genetically tested to know their risk of the disease, and that all women, regardless of their risk factor, consider having what’s called an opportunistic salpingectomy—the prophylactic removal of fallopian tubes if and when they are already having another abdominal surgery.
    • “The strategy—endorsed by the American College of Obstetrics & Gynecology since 2015—was believed to cut down the risk of ovarian cancer by up to 60%. It was adopted as a wide recommendation after a sobering U.K.-based clinical trial followed 200,000 women for more than 20 years and found that screening and symptom awareness do not save lives.”
  • The New York Times adds,
    • “Doctors call the new weight-loss drugs revolutionary. Game-changing. Unprecedented.
    • “Soon, they may also call them obsolete.
    • “Drugmakers are racing to develop the next wave of obesity and diabetes medications that they hope will be even more powerful than those currently on the market.
    • “I think what we are going to see very quickly is that Wegovy has received a lot of the press attention, because it got there first,” said Simon Cork, a senior lecturer at Anglia Ruskin University in England who has studied obesity. “But it will be rapidly overtaken by much more potent medications.”
    • “On Saturday, researchers presented data at an annual meeting of the American Diabetes Association on perhaps the most anticipated of these medications: a daily pill. A late-stage study showed that the drug, called orforglipron, appeared to be about as effective as a weekly Ozempic injection at inducing weight loss and lowering blood sugar. It is just one of over a dozen experimental medications that researchers will share data about at the conference this weekend.
    • “Some of these drugs are still in early trials, but others could hit the market as soon as next year. They include medications that may lead to more weight loss than the roughly 15 to 20 percent body weight people lose on existing drugs. They may also be easier to take than weekly injections and help people shed pounds without dropping as much muscle. More competition — and, in the case of the pill, lower manufacturing costs — might also mean that, eventually, patients pay less.”
  • and
    • “A single infusion of a stem cell-based treatment may have cured 10 out of 12 people with the most severe form of type 1 diabetes. One year later, these 10 patients no longer need insulin. The other two patients need much lower doses.
    • “The experimental treatment, called zimislecel and made by Vertex Pharmaceuticals of Boston, involves stem cells that scientists prodded to turn into pancreatic islet cells, which regulate blood glucose levels. The new islet cells were infused and reached the liver, where they took up residence.
    • “The study was presented Friday evening at the annual meeting of the American Diabetes Association and published online by The New England Journal of Medicine.
    • “It’s trailblazing work,” said Dr. Mark Anderson, professor and director of the diabetes center at the University of California in San Francisco. “Being free of insulin is life changing,” added Dr. Anderson, who was not involved in the study.
  • Per STAT News,
    • “GLP-1 drugs could treat more than just diabetes and obesity. They may also reduce migraine frequency.
    • “That is according to the findings of a study presented on Friday at the European Academy of Neurology congress. The pilot study found that GLP-1 agonists reduced monthly migraine days by almost half. The authors hypothesized that the drug lowers migraine frequency by reducing intracranial pressure.”
  • The Washington Post reports,
    • “The lung tissue of people with chronic obstructive pulmonary disease contains triple the sootlike particle buildup found in similar tissue in smokers’ lungs, a recent analysis finds.
    • “The study found that COPD patients’ alveolar macrophages — a type of lung cell that removes dust, particles and microorganisms from the lungs — contain more carbon than those of smokers. The carbon-containing alveolar macrophages in COPD patients’ lungs were also larger than macrophages without visible carbon, the study found.
    • “Published in ERJ Open Research, the study looked at carbon deposits in the cells. Alveolar macrophages are an important part of the immune system, activating other immune defense cells to protect the body from inhaled invaders. People with COPD have inflamed airways and more alveolar macrophages than healthy people.” * * *
    • “The study does not prove what caused the changes in the COPD patients’ lung tissue. Those with COPD may be less able to clear carbon from their lungs, the researchers write, or perhaps those with a reduced ability to clear carbon are likelier to develop COPD. Pollution or indoor particulate matter may also be to blame, they conclude.”
  • and
    • “The thought of getting back to an exercise routine after surgery might make you wince. It can be a struggle to know where to begin, especially if your body isn’t working the way it used to.
    • “The good news is that heading to your local pool or aquatic therapy can be a great alternative to land-based physical therapy and exercise. Research, including a 2024 study, says aquatic exercise can significantly help patients recover both mentally and physically after most surgeries.
    • “Water therapy is sometimes even more effective than land-based therapy because surgery patients don’t have the same range of motion and mobility,” says Mara Karamitopoulos, a pediatric orthopedic surgeon at NYU Langone Health in New York.”

From the U.S. healthcare business front,

  • Beckers Payer Issues tells us,
    • “At Becker’s 15th Annual Meeting, leaders from Microsoft and Blue Shield of California shared how AI is one tool to help transform payer operations — not by replacing humans, but by personalizing care, cutting friction and restoring trust.
    • “Christine McKinney, vice president of customer experience and digital transformation at Blue Shield of California (Oakland) emphasized the strategic use of AI as both a data enabler and an engagement enhancer.”
    • The article offers takeaways from the presentation.
  • Kauffman Hall adds,
    • “As AI transformation remains top of mind for healthcare leaders, I’ve noticed two common pitfalls plaguing new entrants and early adopters.
    • “Those in the early stages are often susceptible to the “ready, fire, aim” approach – quickly identifying a tool and searching for a problem to match.
    • “Early adopters are having trouble defining clear return on investment (ROI), which may go beyond financials.
    • “These pitfalls are reflected in our data as well. 36% of health systems lack a formal AI prioritization framework, and a recent Vizient benchmarking survey found the top barrier to implementing AI is a lack of clear ROI.
    • “A successful AI strategy must include a clear prioritization framework and a deeper understanding of value. With this in mind, here is an example of one organization’s success and three steps to move beyond the hype and maximize ROI.”