“Simplicity is a great virtue but it requires hard work to achieve it and education to appreciate it. And to make matters worse: complexity sells better.”
– Edsger W. Dijkstra

From Washington, DC,

• Govexec reports,
  • “Rep. James Walkinshaw, D-Va., fresh off his reelection this week, said Thursday that he will press for a 2027 pay raise for federal workers to be part of any deal to keep the government open past December 11.
  • “The congressman, whose district is home to roughly 50,000 federal employees, told Editor-in-Chief Frank Konkel at GovExec’s After the Midterms event that the government must increase compensation in order to compete for talent, particularly after the last two years of buyouts, layoffs and mass firings. In August, President Trump formally proposed freezing most civilian federal workers’ pay next year.” * * *
  • “Walkinshaw told reporters his starting point in spending negotiations will be the 4.1% average pay increase as proposed earlier this year in his Federal Adjustment of Income Rates Act.
  • “Walkinshaw said he was also optimistic that lawmakers would pass legislation restoring the collective bargaining rights of more than 1 million federal employees, though likely not in full until after the new Congress is seated in January. The House this year has passed standalone legislation that would unwind President Trump’s executive orders, which banned unions at most federal agencies on national security grounds, and it has included language in its draft of the annual National Defense Authorization Act that would roll the edicts back for Defense Department workers.”

• Healthcare Finance News adds,
  • “Base physician pay will decrease in 2027 under the Centers for Medicare & Medicaid Services Physician Fee Schedule Final Rule released on Wednesday.
  • “For 2026, the Working Families Tax Cut legislation provided a one-year PFS conversion factor increase of 2.5% that will no longer be in effect for 2027, CMS said. 
  • “This means that current law requires a 2.5% reduction in Medicare payment.
  • “The American Medical Association on Thursday said the lame duck session, along with the continuing-resolution bill that has funded the federal government and is set to expire on Dec. 11, creates an opportunity. 
  • “This creates an opportunity for Republicans and Democrats to unite on an end-of-year legislative package that makes real progress toward fixing the unsustainable Medicare physician payment system,” the AMA said. 
  • “Among other priorities, the AMA wants Congress to extend the 2.5% physician payment update through 2027.”

• The Wall Street Journal relates.
  • “President Trump said on Friday that longtime adviser Stephen Miller would become his chief of staff, replacing Susie Wiles after Republicans suffered far-reaching losses in this week’s midterm election. 
  • “In a Truth Social post, Trump called Miller one of his most trusted advisers and said he would be starting in the new role on Monday. Wiles, who has served as chief of staff since the beginning of his second term, will move to the president’s political operation, Trump said.
  • “I want to thank her for her service as Chief of Staff—She has done a great job!” Trump wrote of Wiles. Wiles was the first female White House chief of staff.”

• Per a Health and Human Services Department news release,
  • “The U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), today announced a Notice of Funding Opportunity (NOFO) for the Women’s Initiative for Screening and Health (WISH) program. The program will award up to $1 million in fiscal year 2027 to establish a multidisciplinary coalition to update the HRSA-supported Women’s Preventive Services Guidelines (Guidelines) to reflect gold-standard evidence and support their use in clinical practice.
  • “The funding opportunity advances priorities outlined in President Trump and First Lady Melania Trump’s Executive Order 14437, Advancing Women’s Health to Improve Outcomes in All Phases of Life, including translating scientific research into improved clinical care and strengthening prevention for women and girls throughout every stage of life.” * * *
  • “Applications are due January 8, 2027, at 11:59 p.m. ET through Grants.gov under opportunity number HRSA-27-072. Applicants must have active SAM.gov and Grants.gov registrations.
  • “For details and application instructions, visit the WISH funding opportunity page.”
    
• Today “the Internal Revenue Service announced the tax year 2027 annual inflation adjustments for almost 70 tax provisions, including the tax rate schedules, standard deduction amounts and other tax changes. Revenue Procedure 2026-35 PDF provides details about these annual adjustments.”

From the U.S. Food and Drug Administration front,

• Radiology Business reports,
  • “The U.S. Food and Drug Administration has cleared a new artificial intelligence-powered intravascular ultrasound imaging system, the product’s developer announced on Wednesday.
  • “San Jose, California-based Evident Vascular says the regulatory win applies to its Guidance System and Evident peripheral imaging catheters. They’re intended for examination of pathology during certain peripheral vascular procedures handled by radiologists and other docs. 
  • “Evident says the system is designed to improve the clinician experience by combining high-fidelity imaging, “purpose-built AI,” and simple workflows without disruptions. Features include flush-less plug-and-play catheters, an “intuitive” user interface, and hands-free voice controls.
  • “FDA clearance marks an important milestone for Evident and the physicians who believed in this platform from our company’s inception,” Howard Rosen, CEO and co-founder of Evident Vascular, said in a statement Nov. 4. “We engineered the entire imaging architecture to deliver the image fidelity physicians need in a system that is both intuitive and easy to use.”

• STAT News relates,
  • “The U.S. Food and Drug Administration conducted more unannounced drug inspections in India and China in Fiscal Year 2026 compared to the previous year, Regulatory Focus tells us. The increase is attributed to an effort by the agency to increase unannounced foreign inspections to achieve inspection parity between domestic and international facilities. The proportion of unannounced inspections in India increased from 47% in FY 2025 to 87% in FY 2026. In China, the percentage of unannounced inspections rose from 19% in FY 2025 to 61% in FY 2026.”
    
• BioPharma Dive tells us,
  • “Eli Lilly will offer its obesity drugs Zepbound and Foundayo on Hims & Hers’ telehealth platform, the companies announced Friday. Under the deal, eligible patients with a prescription can use Hims to gain access to Lilly’s drugs at the same “self-pay” prices available elsewhere. Foundayo carries an initial $149 monthly price tag, while Zepbound starts at $299 per month.
  • “Hims had previously used legal loopholes to make lower-cost, compounded versions of GLP-1 weight loss drugs. But it changed course in March after a legal challenge from Novo, adopting a new strategy based on providing U.S. consumers access to an array of FDA-approved weight loss medicines. Hims struck a similar deal with Novo in March.”

• Fierce Pharma adds,
  • “Eli Lilly has successfully challenged Good Life Meds’ claims about the health benefits and personalization of a compounded tirzepatide product.  
  • “Lilly, which sells the GLP-1/GIP drug tirzepatide as Mounjaro and Zepbound, challenged the telehealth provider’s claims through BBB National Programs’ National Advertising Division (NAD). The drugmaker, the only provider of FDA-approved tirzepatide products, disputed Good Life’s claims about the effect of the compounded drug on body weight, blood sugar, energy and lean muscle. 
  • “After assessing Good Life’s response to the challenge, the NAD recommended that the company stop making the express health benefit and personalization claims challenged by Lilly and modify its ads to remove unsupported implied claims about safety, efficacy and personalization.”

From the public health and medical / Rx research front,

• The Centers for Disease Control and Prevention announced today,
  • “COVID-19, flu, and RSV are key indicators of overall respiratory illness activity.
  • “The amount of acute respiratory illness causing people to seek health care is low.
  • “RSV activity is low in most areas of the country.
  • “COVID-19 activity is declining nationally.
  • “Seasonal flu activity continues to increase in many parts of the country.
  • “Rhinovirus/Enterovirus (RV/EV) is elevated nationally, and respiratory adenovirus (HAdV) is elevated in some regions of the country.”

• The American Hospital Association News lets us know
  • “Nationally, there are now 5,182 confirmed measles cases this year, according to a Nov. 6 update from the Centers for Disease Control and Prevention. The vaccination status of 96% cases is unvaccinated or unknown.”  

• The New York Times tells us,
  • “A resident of Washington State died this week after a severe case of bird flu, a new and worrying sign that the virus continues to be a threat in the United States.
  • “The news followed reports that the bird flu virus had been detected in dairy cattle on dozens of farms across the country over the past month. It has also been spreading unchecked for months at a mink farm in Utah.
  • “The death, in Yakima County, Wash., is the first related to bird flu in the country this year, and the third since 2024. But it was only on Thursday, one day after an inquiry from The New York Times, that the Centers for Disease Control and Prevention updated its website. It still has not made any statements to the public about the death.” * * *
  • “Bird flu is not yet a threat to most humans, but it does pose a significant risk to the millions of agricultural workers and veterinarians in the country, said Kristen Coleman, an expert an airborne infections at the University of Maryland.”

• Genetic Engineering and Biotechnology News adds,
  • “Researchers at the University of Cambridge and Cambridge’s spin-out DIOSynVax, along with collaborators, reported on the development of a broad-spectrum bird flu vaccine that in animal trials provided complete protection against globally circulating, diverse H5Nx variants of the disease. Current pandemic preparedness relies on stockpiling vaccines against individual virus variants that have already emerged. The Cambridge team’s approach uses AI-guided engineering to create broadly protective vaccines intended to remain effective across a wide range of existing and future variants.
  • “The team’s study, described in Cell Reports Medicine, found the new digitally engineered multi-antigen mRNA vaccine to be superior to bird flu vaccines currently stockpiled by many governments for use in the event of a human outbreak. Their preclinical trial results showed that the existing vaccines tested protected only around 50% of animals exposed to multiple H5N1 bird flu variants, compared with complete protection achieved by the team’s new vaccine, DVX-panH5Nx.
  • “The results demonstrate the potential of AI-guided vaccine design in developing broad protective population immunity ahead of evolving biological threats. The researchers say the vaccine represents the third success with their AI-guided technique for designing vaccines against highly infectious viruses that threaten animal and human health. The new study in addition demonstrates that the team’s ‘plug and play’ approach can be used to create safe, highly effective vaccines for a plethora of infectious diseases threatening animal and human health globally.”

• Health Day informs us,
  • “A common test used to diagnose obstructive sleep apnea may miss the condition in Black patients, potentially impacting important treatment decisions.
  • “Sleep studies often use pulse oximeters — small devices that measure blood oxygen levels — to help determine the severity of sleep apnea.
  • “In the new study, oxygen-based scoring counted roughly 20 percent fewer breathing events in Black participants than in white participants.
  • “But heart-rate-based scoring showed no comparable racial difference.
  • “The first author says the findings have “potential implications for diagnosis and severity classification.”
• and
  • “A new study suggests a woman’s reproductive history may play an important role in her brain health later in life.
  • “Women are affected by Alzheimer’s disease more often than men. This may be related, in part, to fluctuations in estrogen levels throughout life,” said study author Anna Marseglia, an assistant professor at the Karolinska Institutet in Stockholm.
  • “Estrogen is known to have protective effects on both neuronal cells and blood vessels in the brain,” she added in a news release. “However, its potential role in women’s cerebrovascular health in later life has been largely understudied.”

• MedPage Today points out,
  • “A retrospective-cohort analysis showed that GLP-1 receptor agonists were associated with a lower risk of obesity-related cancers as compared with insulin or sulfonylurea.
  • “Cancer risk with GLP-1 agonists did not differ significantly from metformin, DPP4 inhibitors, or SGLT2 inhibitors.
  • “The effect of GLP-1 agonists on cancer risk versus other diabetes medications was most noticeable in patients with low-severity diabetes.”

From the U.S. healthcare business front,

• The Wall Street Journal reports,
  • “Humana raised its full-year earnings outlook as consolidated income and revenue rose in the third quarter.
  • “The health insurer now expects 2026 adjusted earnings of at least $9.50 a share, up from its previous forecast of at least $9 a share.
  • “Humana’s third-quarter revenue jumped 26% to $41.16 billion, beating Wall Street estimates of $40.87 billion.”
• and
  • “Moderna raised its full-year revenue growth outlook to 15% to 25% after swinging to a profit and logging higher revenue in the recent quarter.
  • “The higher outlook follows the U.S. approval of mFLUSIVA, Moderna’s mRNA-based influenza vaccine.
  • “Moderna swung to a third-quarter profit of $162 million, beating analyst expectations for a loss.”

• Beckers Hospital Review relates,
  • “Atlanta-based Piedmont Healthcare reported a 10.7% operating margin for fiscal year 2026, generating more than $1 billion in operating income for the second consecutive year as revenue climbed to nearly $9.5 billion.
  • “The health system recorded $1.02 billion in operating income for the fiscal year ended June 30, up slightly from $1 billion in fiscal 2025, according to its financial documents published Nov. 6. However, its operating margin narrowed from 11.4% to 10.7% as expenses increased faster than revenue.
  • “Piedmont also strengthened its liquidity position, ending the fiscal year with $3.8 billion in cash and cash equivalents, while continuing to invest in hospital expansion projects across Georgia.
• and
  • “Grand Forks, N.D.-based Altru Health System’s operating margin fell to -3% through the first nine months of 2026, as expenses outpaced revenue growth and the system moved closer to acquiring three more North Dakota hospitals from Chicago-based CommonSpirit Health.
  • “Altru Health reported an $18.2 million operating loss for the nine months ended Sept. 30, compared with a $1.7 million operating loss and -0.3% margin during the same period in 2025, according to its financial statements published Nov. 2.
  • “Revenue increased 8.3% year over year to $610.4 million, up from $563.6 million, while operating expenses climbed 11.2% to $628.6 million, compared with $565.3 million in the prior-year period.”

• The Wall Street Journal tells us,
  • “The practice of keeping admitted patients in the emergency room while they wait for a bed, known as boarding, is increasing in American hospitals.
  • “One in four admitted patients spent at least four hours waiting in the E.R. for a bed in September 2024, up from one in eight in September 2017.
  • “Studies show that patients stuck boarding in the E.R. face a higher risk of worse care and early clinical deterioration.”

• Fierce Pharma informs us,
  • “Heading into Halloween weekend, both Novo and Lilly saw scripts for their oral obesity medicines tick up. 
  • “In its 30th launch week, Lilly’s Foundayo racked up roughly 65K prescriptions, seemingly topping a record of more than 64K scripts set in week 25 of the rollout, according to IQVIA data cited by Jefferies. Still, the medicine’s performance pales in comparison to Novo’s Wegovy pill at week 30 of its own launch, when the semaglutide tablet reeled in roughly 173K scripts. 
  • “For the last weekly period, the Wegovy pill charted a 0.5% script increase—or around 8K new prescriptions—to land at around 184K total. That’s roughly on par with the height of the pill’s script performance in 2026 so far and marked a rebound from roughly 183K the prior week. 
  • “Novo reported earlier this week that the Wegovy pill generated 5.39 billion Danish kroner (nearly $811 million) in third-quarter sales. Over the same period, Lilly reported $184 million in sales of Foundayo. 
  • “On an analyst call, Novo’s EVP of U.S. operations, Jamey Millar, resurfaced caveats with the data IQVIA is using to track the oral GLP-1 launches, arguing that Novo boasts “a much more extensive ecosystem of partners for Wegovy” than Lilly, and that those partners “don’t report to IQVIA in absolute terms.” 
  • “So we’ve consistently seen a lower capture rate for Wegovy pill than the competitive oral product,” he suggested. 
  • “Based on the latest weekly metrics, Lilly holds a little more than a 26% share of the overall oral obesity market compared to Novo’s nearly 74%, the Jefferies team said in its note.”