Friday report

David Ermer–CDC, CMS, COVID-19, FDA, Federal employment benefits, Medical / Rx research, OPM, U.S. Healthcare–

From Washington, DC,

  • OPM Director Scott Kupor reflects on the shutdown in his Secrets of OPM blog.
  • CMS announced 2026 Medicare Parts A & B Premiums and Deductibles and 2026 Medicare Part D Income-Related Monthly Adjustment Amounts. Of note,
    • “The standard monthly premium for Medicare Part B enrollees will be $202.90 for 2026, an increase of $17.90 from $185.00 in 2025. The annual deductible for all Medicare Part B beneficiaries will be $283 in 2026, an increase of $26 from the annual deductible of $257 in 2025. 
    • “The increase in the 2026 Part B standard premium and deductible is mainly due to projected price changes and assumed utilization increases that are consistent with historical experience. If the Trump Administration had not taken action to address unprecedented spending on skin substitutes, the Part B premium increase would have been about $11 more a month. However, due to changes finalized in the 2026 Physician Fee Schedule Final Rule, spending on skin substitutes is expected to drop by 90% without affecting patient care.”
  • Federal News Network reports,
    • “The Postal Service is seeing deeper financial losses than expected this year, but does not expect to veer much from a 10-year reform plan that it is nearly midway through completing.
    • “USPS, however, is far from the plan’s “break-even” goal, and is calling on Congress and the Trump administration to take a familiar wish list of reform efforts that are outside the agency’s control.
    • “The agency saw a $9 billion net loss in fiscal 2025 — significantly higher than the nearly $7 billion net loss it expected.
    • “USPS said it saw increased compensation costs, including offering early retirement incentives to more than 10,000 of its employees, which contributed to higher operating expenses this year.”
  • and
    • “More than 30,000 federal insurance enrollees may be in for some sticker shock next year, if they choose to do nothing during Open Season.
    • “With eight plan options being discontinued in the Federal Employees Health Benefits (FEHB) program, participants currently enrolled with those carriers — most of whom are enrolled in plans from the National Association of Letter Carriers — will, in some cases, face more than a 200% spike in premium costs, if they accept the auto-enrollment plan option for 2026.
    • “Typically, participants whose plans leave the FEHB program are automatically enrolled in the lowest-cost nationwide plan the following year. But for 2026, the Office of Personnel Management chose a different path forward.
    • “The specifics behind OPM’s decision remain unclear, but an OPM spokesperson told Federal News Network the agency chose a plan that’s not the lowest-cost nationwide plan “because we determined it was in the best interest of the program to do so.” * * *
    • “For 2026, the lowest cost nationwide plan that fits the statutory requirements is GEHA Elevate. But OPM made the decision to “exercise its authority” to make GEHA High the auto-enrollment plan instead.”

From the Food and Drug Administration front,

  • Cardiovascular Business reports,
    • “Withings, a French medtech company, has received U.S. Food and Drug Administration (FDA) clearance for BeamO, a new artificial intelligence (AI)-enabled device it describes as the “thermometer of the future.” BeamO includes electrocardiogram sensors, a stethoscope and a thermometer, providing users with a single check-up tool that evaluates a body temperature, cardiac health and pulmonary health in less than one minute—all from the comfort of home.
    • “BeamO is equipped with highly innovative sensors, meeting the challenge of miniaturization to bring together so many functionalities in such a small device,” Xavier Debreuil, product research director at Withings, said in a statement. “These sensors record the heart’s electrical activity as well as measure infrared light to interpret body temperature. On the other hand, they capture acoustic waves to study the activity of the heart and lungs. All the data is analyzed by artificial intelligence algorithms to identify anomalies.”
    • “BeamO brings access to key vital signs, typically measured during medical consultations, into everyday life,” added Eric Carreel, founder and president of Withings. “All this new data on the heart, lungs, and temperature provides an overview of the state of each user’s health. This data promotes a much more precise and reliable diagnosis, and it marks a revolution in telemedicine, transforming it into a true medical consultation by integrating the data collection component.”
    • “With FDA clearance now secured, BeamO is officially for sale in the United States. The price is $249.95. 
    • ‘By early 2026, the new-look thermometer will be available on Amazon and a variety of other retail partners.” 
  • Per Fierce Pharma,
    • “As Roche works to switch certain patients with breast cancer over to a fixed-dose combination of two medicines, its 13-year-old drug Perjeta is inching toward the end of its exclusive run in the U.S.
    • “The FDA said Thursday that it has approved Poherdy as an interchangeable biosimilar to Perjeta. The agency’s endorsement covers the Roche drug’s existing HER2-positive breast cancer indications. 
    • “Perjeta’s label currently includes its use in combination with trastuzumab and chemo for first-line HER2-positive metastatic breast cancer and as a neoadjuvant or adjuvant treatment for early-stage disease.”
  • and
    • “The FDA has officially limited the label of Sarepta Therapeutics’ Elevidys, putting an end to a whirlwind few months that saw the abrupt departure—and reinstatement—of top agency official Vinay Prasad, M.D.
    • “Duchenne muscular dystrophy (DMD) patients who are no longer able to walk independently can no longer receive the one-time gene therapy, the FDA said Friday. In addition, the drug’s indication now only covers ambulatory DMD patients who are at least 4 years of age.
    • “The official label restriction comes five months after Sarepta and its ex-U.S. partner Roche voluntarily suspended giving Elevidys to non-ambulatory patients following the report of a second recipient who died after developing acute liver failure.
    • “The updated label now includes a new boxed warning, the FDA’s most serious safety warning, describing the potentially deadly risks of serious liver injury and acute liver failure.”

From the judicial front,

  • The New York Times reports,
    • “The drugmaker Purdue Pharma, which along with its owners came to symbolize greedy indifference to surging opioid overdose deaths, will soon cease to exist, after a bankruptcy judge said Friday that he would give final approval to a plan to settle thousands of lawsuits against the company.
    • “The agreement comes more than two decades after the first legal actions were filed against Purdue over its aggressive sales tactics and promotion of the opioid painkiller OxyContin as largely nonaddictive. It requires members of the billionaire Sackler family to relinquish ownership of the company and pay as much as $7 billion over 15 years to states, communities, tribes and others harmed in what became a decades-long national opioid addiction crisis.
    • “I will tell you now that I’m going to confirm the plan,” Judge Sean H. Lane of the United States Bankruptcy Court for the Southern District of New York said Friday afternoon at the conclusion of three days of testimony. He said he would issue a formal ruling on Tuesday.
    • “Purdue will immediately contribute $900 million and then be dissolved. It will be reborn as a public benefit company called Knoa Pharma, which will manufacture limited quantities of opioid painkillers and also opioid overdose-reversal medications. Profits will go to programs to remediate the continuing devastation related to opioids.”

From the public health and medical / Rx research front,

  • Guess what’s back now that the shutdown is over? The Centers for Disease Control and Prevention announced today,
  • Beckers Hospital Review identifies the hospitals that received the best and the worst patient safety grades from the LeapFrog Group this week.
  • CNN Health tells us,
    • “As colon and rectal cancers in young people are on the rise globally, especially in the United States, consumption of ultraprocessed foods has been in lockstep. The fare now makes up roughly 70% of the US food supply and nearly 60% of US adult caloric intake, and several studies have linked this growing trend with the risk of such cancers.
    • “A new, first-of-its-kind study adds to the growing evidence by suggesting eating ultraprocessed foods may significantly raise the odds of developing early-age noncancerous colorectal adenomas — growths, or polyps, in the colon and rectum that can lead to cancer.”
    • “In the new study, ultraprocessed food intake was primarily from ultraprocessed breads and breakfast foods; sauces, spreads and condiments; and sugar- or artificially sweetened beverages.
    • “Participants with the highest intake of ultraprocessed foods — about 10 servings daily — had a 45% higher risk of developing those growths by age 50 when compared with those with the lowest consumption, a bit over three servings daily. The study, which followed more than 29,100 female nurses for a median period of 13 years, published Thursday in the journal JAMA Oncology.”
  • NBC News points out,
    • “One of the most common viruses in the world could be the cause of lupus, an autoimmune disease with wide-ranging symptoms, according to a study published Wednesday.
    • “Until now, lupus was somewhat mysterious: No single root cause of the disease had been found, and while there is no cure, there are medications that can treat it.
    • “The research, published in the journal Science Translational Medicine, suggests that Epstein-Barr virus — which 95% of people acquire at some point in life — could cause lupus by driving the body to attack its own healthy cells.
    • “It adds to mounting evidence that Epstein-Barr is associated with multiple long-term health issues, including other autoimmune conditions. As this evidence stacks up, scientists have accelerated calls for a vaccine that targets the virus.”
  • MedPage Today adds,
    • “Low levels of vitamin D and its principal circulating form 25-hydroxyvitamin D (25-OH-D) have been linked to many types of adverse outcomes beyond bone health, such as cardiovascular disease.
    • “How vitamin D levels may affect outcomes in lupus patients has not been well studied, especially over the long term.
    • “This prospective cohort study, with many years of follow-up, showed markedly increased risk for all-cause mortality and cardiovascular events in lupus patients with low levels at enrollment.”
  • Per Health Day,
    • “People facing a major surgery might understandably think they need to conserve their energy, both for the procedure as well as the rehabilitation to follow.
    • “But they’d be better off if they engaged in “prehabilitation.” And a new study found prehab works best if a patient receives some one-on-one attention.
    • “Patients who got a personalized prehab program with twice-weekly coaching wound up better prepped for surgery than those offered standard pre-surgery advice without any direct guidance, researchers reported Nov. 12 in the journal JAMA Surgery.
    • “Those who got personal coaching improved significantly on every test of physical and mental fitness prior to their procedure, researchers found.
    • “The patients also experienced changes in their immune system that aided their post-surgery recovery and wound up with fewer major complications.”
  • Per Medscape,
    • “The first global randomized trial of the PCSK9 inhibitor evolocumab for the prevention of a primary major adverse cardiovascular event (MACE) found a relative reduction in risk similar in magnitude to that previously seen for secondary prevention. 
    • “The VESALIUS-CV trial showed a risk reduction over a median of 4.6 years of follow-up of 19% and 25% (P < .001 for both) for the dual composite primary MACE endpoints. These were accompanied by a 20% reduction (P = .0005) in all-cause death, a result characterized as “nominal” because it was not among the prespecified composite endpoints.
    • “The reduction in MACE in this trial supports intensive LDL-C lowering in high-risk patients whether or not they have had a prior event,” said Erin A. Bohula, MD, DPhil, an associate physician in cardiovascular medicine at Brigham and Women’s Hospital in Boston, who led the study.
    • “The findings were presented at the 2025 Scientific Sessions of the American Heart Association and published simultaneously in The New England Journal of Medicine.”
  • Per MedPage Today,
    • “In patients with angina but no obstructive arteries on angiography, further testing with stress cardiac MRI improved diagnosing the cause of angina, resulting in better management and quality of life, the CorCMR trial showed.
    • “Reclassification of the initial angiogram-based diagnosis occurred in 53% of patients after cardiac MRI (95% CI 46.6-59.3, P<0.001), meeting the primary outcome of the diagnostic phase of the study, reported Colin Berry, MBChB, PhD, of the University of Glasgow in Scotland, at the American Heart Association (AHA)opens in a new tab or window annual meeting.”
  • Per BioPharma Dive,
    • “Bristol Myers Squibb and Johnson and Johnson have stopped early the first of trio of late-stage trials testing an experimental anticoagulant they hope will become a future blockbuster. 
    • “Trial monitors determined that a regimen involving the drug, milvexian, and standard medications wasn’t likely to be superior to those typical treatments alone at preventing cardiovascular complications in people who’d recently had a heart attack. Despite the failure, the two companies noted that two other large studies are ongoing and milvexian still has “multibillion-dollar potential.” 
    • “Still, the result is the latest setback for drugs in milvexian’s class, called Factor XIa inhibitors and viewed as potentially safer alternatives to widely used medicines like Eliquis and Xarelto. It’s also another recent negative readout for Bristol Myers, which has reported late-stage stumbles for drugs in cancer, mental health conditions and other diseases this year.” 

From the U.S. healthcare business front,

  • Kaufman Hall reports,
    • “The number of physicians exiting traditional Medicare has accelerated, especially since the Covid-19 pandemic, with the annual exit rate climbing from less than 1% in 2013 to nearly 5% in 2023, a new JAMA study has found. The study, a review of Medicare fee-for-service claims data, found that while the total number of physicians in fee-for-service Medicare rose modestly over the decade, from about 586,000 to 622,000, departures have accelerated sharply in recent years. Participation peaked in 2019, then began a steady decline that has continued. Researchers found higher exit rates among older doctors, women, primary care physicians and those practicing in rural or underserved areas but stopped short of making a claim about the impact of the pandemic. The trend raises concern that access to care for Medicare beneficiaries could erode even as the overall physician workforce grows; these patterns could exacerbate existing access gaps for older and rural Americans.”
  • The American Hospital Association News lets us know,
    • Aetna’s new “level of severity inpatient payment” policy is now set to take effect Jan. 1, 2026, the company recently announced, along with providing additional details about the policy. The policy was supposed to take effect Nov. 15. 
    •  Aetna earlier this year said it was creating a new type of inpatient reimbursement for so-called “low severity” inpatient stays that it has said will be “comparable” to observation rates. This policy will take the place of Aetna’s (and essentially every other insurer’s) long-standing approach of denying inpatient stays it deems medically unnecessary and then, in most instances, downgrading them to outpatient observation status. Instead, Aetna will approve these inpatient stays but reimburse hospitals at a lower rate it determined unilaterally outside of the good faith contract and rate negotiation process. This policy only will apply to Aetna’s Medicare Advantage and dual eligible lines of business. 
    •  In its Nov. 6 announcement, Aetna clarified that:
      • The level of severity review will apply only to urgent/emergent inpatient stays of at least one midnight but less than five midnights.
      • Stays of five midnights or greater will not be subject to level of severity review and will be paid at the inpatient DRG (diagnosis related group) rate.
      • For inpatient stays of at least one midnight but less than five midnights that do not meet MCG criteria, providers may request a severity review and engage in a severity discussion with an Aetna medical director.
    • The AHA appreciates Aetna’s decision to delay implementation of its level of severity policy for inpatient hospital admissions from November to January,” the AHA said. “This pause provides additional time for hospitals and health systems to prepare and for continued dialogue on the policy’s impact.” 
  • BioPharma Dive informs us,
    • “Merck & Co. is spending billions of dollars to gain rights to a new kind of preventive flu medicine, hoping that the treatment is poised to become a top seller in the years ahead. 
    • “The pharmaceutical giant on Friday agreed to acquire Cidara Therapeutics, the San Diego-based developer of that medicine, in a deal worth $9.2 billion. Merck is paying $221.50 per share for the company, a 109% premium to its closing price on Thursday. 
    • “News of the pending buyout was first reported by The Financial Times on Thursday.
    • “The deal revolves around a prospect currently known as CD388. It’s an antiviral that combines a small molecule with a protein fragment. Cidara has been evaluating it as a long-acting, preventive therapy for seasonal influenza, one of the world’s most common respiratory infections.”
  • and
    • “Last month, Avadel Pharmaceuticals agreed to sell to fellow Dublin-based drugmaker Alkermes in a deal potentially worth around $2.1 billion. Terms held that Avadel investors would receive $18.50 per share up front, but could eventually take home another $1.50 per share if the company’s main asset — a marketed narcolepsy drug called Lumryz — also gets approved within the next few years to treat a different sleep disorder known as idiopathic hypersomnia. “Wall Street analysts described Lumryz as a “clear” strategic fit for Alkermes, which has been developing its own narcolepsy medicine that’s part of an emerging drug class expected to generate billions of dollars.
    • “But that deal may not materialize, now that another company has submitted a bigger, unsolicited proposal to buy Avadel.
    • “Lundbeck, a Danish drug developer, is offering to pay $21 up front, in cash for each Avadel share, while also providing a “contingent value right” that could be worth as much as $2 per share if certain milestones are met. With that right, half of the value would come from the combined annual net sales of Lumryz and another Avadel asset, valiloxybate, reaching at least $450 million in the U.S. by the end of 2027. The other half would come if annual net sales from those drugs hit $700 million in the U.S. by the end of 2030.”
  • Per Beckers Payer Issues,
    • “As part of the ongoing enterprise-wide recalibration effort to improve financial performance, UnitedHealth Group leadership shared in late October that it would be moving its finance business at Optum under the umbrella of Optum Insight, the company’s data and analytics arm.
    • “We are realigning Optum Financial Services within our Optum Insight Services platform. Many of these actions are underway, and we believe they will improve both our focus and long-term performance,” CEO Stephen Hemsley told investors on the company’s third quarter earnings call.
    • “Optum Financial offers a portfolio of financial products and solutions, including health savings accounts (HSAs), flexible spending accounts (FSAs), payment and claims management services and financial education tools. 
    • “The business unit includes Optum Bank, which serves around five million customers. In 2023, the bank recorded more than $400 million in brokered deposits and almost $600 million in interest income.”
  • Per Fierce Healthcare,
    • “Fabric, a healthcare tech and care enablement company, inked its fifth acquisition in less than three years, acquiring UCM Digital Health.
    • “The deal adds 400 new payer and employer customers and 1 million covered lives across all 50 states. Fabric executives said the acquisition will integrate its AI-enabled virtual care technology and nationwide clinical network with UCM’s deep expertise in serving payers and employers.
    • “For Fabric, it’s about making healthcare more accessible,” said Aniq Rahman, CEO and Founder of Fabric, in a statement. “We’ve already made meaningful progress in the payer and employer markets, and this acquisition allows us to deepen that impact. By bringing more payers and employers onto our platform, we’re creating a connected experience that streamlines workflows, reduces friction and costs, and ultimately drives better outcomes for members and our partners.”