From Washington, DC,

• The Wall Street Journal reports,
  • “Senate Democrats demand an overhaul of immigration enforcement, tying it to passing a $1.3 trillion spending package to avert a government shutdown.
  • “Democrats propose changes including: ending roving patrols, tightening warrant rules and requiring ICE coordination with local law enforcement.
  • “The standoff follows two fatal shootings by federal immigration agents in Minneapolis, with Democrats refusing to fund DHS without revisions.”

• The Hill adds,
  • “House Republicans are warning the Senate against making any changes to a government funding package that includes funds for the Department of Homeland Security (DHS), saying any reforms sought by Democrats would not clear the House and would lead to a government shutdown at the end of the week.
  • “Conservatives also say they would seek significant concessions from Democrats if they were to split up the six-bill funding package and tinker with the DHS spending bill — threatening to seek avenues to fund the department without needing support from Democrats.

• The House Budget Committee identified highlights from last week’s hearing on how to reverse the healthcare cost curve. One of the experts that the FEHBlog admires, Avik Roy, observed,
  • “Mr. Avik Roy, Foundation for Research on Equal Opportunity: I’d encourage you to look at the World Index of Health Care Innovation that my organization puts out every year. FREOP, which looks at a lot of these metrics of how we measure the quality of the health care system, what we can learn from other countries, what they can learn from us. On the point about options other than health insurance, first of all, we have to make health insurance more affordable. You can do a lot to have alternatives to health insurance, and I will talk about that, but we, the people, still need affordable options for health insurance. The fact that the Affordable Care Act made health insurance massively more expensive for people who buy it on their own is a huge problem, because the foundation of free market health insurance is you buying that health insurance for yourself, not depending on your employer to buy it for you, not depending on the government to buy it for you. You buy it for yourself, and maybe the government helps you pay for that premium.“
• FEHBlog note — The FEHB Program would be a good model for choice but for the fact that the U.S. Office of Personnel Management has been benefit mandate crazy in recent years. OPM needs to revoke those mandates.

• The Wall Street Journal tells us,
  • “The Census Bureau’s first snapshot of population data for 2025 confirms some big trends, like a major shift in immigration as the U.S. cracks down on border crossings and steps up deportations. 
  • “The estimates, which cover the 12-month period ended in mid-2025, also uncovered some surprises regarding the comings and goings between states. Some places in the Midwest, for example, are seeing a net influx of people from within the U.S. for the first time in years.” ***
  • “The U.S. added slightly more babies, but not enough to move the needle significantly on population growth. Births ticked up about 12,200 on the year to 3.6 million. That is better than the decline of 40,700 in the prior year, but it didn’t shift a still-falling birthrate that has become a concern among some Republicans.”

• The American Hospital Association New informs us,
  • “The Centers for Medicare & Medicaid Services Jan. 28 released a proposed rule that would update conditions for coverage for organ procurement organizations. The proposal would eliminate regulatory requirements that limited the Secretary of Health and Human Services in certifying new OPOs, clarify the OPO designation process, modify the appeals process for OPOs, and update and add certain key definitions, among other changes. CMS also seeks comments on various topics, including a new process to certify OPOs; conflicts of interest in organ and tissue procurement; automated electronic referrals, from donor hospitals to OPOs; and alternative approaches to OPO designation and non-renewal of OPO agreements.”
    
• Per an HHS news release,
  • “The U.S. Department of Health and Human Services (HHS) today announced the appointment of 21 new members to the Interagency Autism Coordinating Committee (IACC). These appointments reflect the commitment of Secretary Robert F. Kennedy, Jr. to support breakthrough innovations in autism research, diagnosis, treatment, and prevention by bringing the nation’s understanding of and policies concerning autism into alignment with gold-standard science.”

• MedCity News points out,
  • “While the 15 medications selected for the latest round of the federal government’s drug price negotiation program will face steep cuts in what Medicare will pay, the financial impact to pharmaceutical companies is expected to be minimal.
  • “Leerink Partners analyst David Risinger said in a Wednesday research note that Gilead Sciences HIV drug Biktarvy is the only one of the selected products with Medicare exposure that is material to its manufacturer’s sales, accounting for about 8% of Gilead’s 2027 estimated global revenue. Rexulti, a drug approved for schizophrenia among other neurological indications, has the second-largest exposure, with revenue from Medicare estimated to be about 3% of Lundbeck’s global sales. But Risinger said this exposure for Lundbeck is overstated because the company shares in commercialization of the drug with partner Otsuka Pharmaceutical.”

• Avalere Health explains how this week’s “2027 Advance Notice Materially Alters Part D Risk Adjustment.”

• Tammy Flanagan, writing in Govexec, discusses “how federal employees can protect a spouse in retirement”
  • “To better understand their potential benefits and financial risks in retirement, both spouses should be aware of some benefits planning realities.”

From the Food and Drug Administration,

• Fierce Pharma reports,
  • “Even as Johnson & Johnson’s oncology superstar Darzalex Faspro racks up megablockbuster sales and reshapes the multiple myeloma treatment paradigm, the drug is still finding ways to consolidate its position. This week, the drug is doing just that with an FDA nod for a more powerful regimen in newly diagnosed patients who are ineligible for autologous stem cell transplant.
  • “The Jan. 27 approval enables Darzalex Faspro’s use within a quadruplet combination that includes Takeda’s Velcade, Bristol Myers Squibb’s Revlimid and the steroid dexamethasone (VRd), which is altogether referred to as D-VRd. Before that, the triplet regimen of D-Rd has been allowed to treat first-line, transplant-ineligible patients since 2019. 
  • D-VRd is now the only anti-CD38 antibody-based regimen that can treat newly diagnosed patients regardless of transplant eligibility, J&J said in a Jan. 27 press release.”

• BioPharma Dive adds,
  • “Regenxbio lost almost a fifth of its value Wednesday after the Food and Drug Administration placed a clinical hold on two of the company’s experimental gene therapies.
  • “Regulators acted after researchers found a case of brain cancer in a 5-year-old child who had received one of the treatments, RGX-111, four years earlier. The agency decided to extend the hold to the second therapy, RGX-121, because of similarities between the two and “shared risk between the clinical studies,” Regenxbio said Wednesday.
  • “The company said there has been no causal link between RGX-111 and the child’s condition and emphasized that RGX-121 is a separate therapy with years of safety data. “We are surprised by FDA’s decision to place our RGX-121 program on hold while the investigation of this single, inconclusive incident in RGX-111 continues,” CEO Curran Simpson said in the statement.”

From the public health and medical / Rx research front,

• Infectious Disease Advisor reports,
  • “Millions of COVID-19-associated illnesses and outpatient visits as well as thousands of hospitalizations and deaths continued to occur annually in the United States from late 2022 through 2024, despite the formal end of the public health emergency, according to a cross-sectional analysis published in JAMA Internal Medicine.
  • “To provide updated national estimates during a period marked by evolving SARS-CoV-2 variants, changes in testing practices, and increasing population immunity, investigators analyzed data from the COVID-19 Hospitalization Surveillance Network. Using hierarchical Bayesian modeling and probabilistic multiplier methods, the investigators estimated the national burden of symptomatic illnesses, outpatient visits, hospitalizations, and deaths across 2 surveillance periods aligned with influenza seasons: October 2022 to September 2023 and October 2023 to September 2024.”

• The Wall Street Journal informs us,
  • “A recent email ad from a telehealth company selling weight-loss medications features tennis-superstar Serena Williams.  
  • “If you’re carrying 15-20 extra pounds,” it says, “medications like Wegovy can help jumpstart your progress.”
  • “For obesity doctors and researchers, this kind of messaging is problematic. The blockbuster drugs—known as GLP-1s—are increasingly marketed as lifestyle fixes to help take off some weight. But they are actually designed as lifelong treatments for chronic diseases, namely obesity and Type 2 diabetes. 
  • “That distinction matters.
  • “While nearly 18% of U.S. adults have taken a GLP-1 drug for weight loss or to treat a chronic condition, about half of people will stop taking it within a year. Often, they don’t understand what is likely to come next. 
  • “Studies show that after stopping the drugs, people typically regain lost weight within about 1.5 years. And any improvements in blood sugar, blood pressure or cholesterol are reversed.
  • “People who take GLP-1s regain weight four times faster than those who lose weight through lifestyle interventions, according to a recent analysis published in the British Medical Journal.
  • “The depressing results raise the question: Are the drugs worth starting if you can’t stay on them long-term? Doctors largely say yes but caution the need for proper counseling and lifestyle changes.
  • “The medications, which include Ozempic, Mounjaro and Zepbound, mimic naturally occurring gut hormones such as GLP-1, suppressing appetite and making people feel full faster.”

• Cardiovascular Business calls attention to five takeaways from new stroke guideline.
  • “The American Stroke Association (ASA), a division of the American Heart Association, has developed an updated ischemic stroke guideline that highlights the importance of coordinated care and expands patient access to critical treatments. The new document, published in full in Stroke, also includes the first detailed recommendations for treating stroke in pediatric patients.
  • “This update brings the most important advances in stroke care from the last decade directly into practice,” Shyam Prabhakaran, MD, MS, chair of the writing group behind the guideline and chair of the department of neurology at the University of Chicago Medicine, said in a statement. “New recommendations in the guideline expand access to cutting-edge treatments, such as clot-removal procedures and medications, simplify imaging requirements so more hospitals can act quickly, and introduce guidance for pediatric stroke for the first time.”

• MedPage Today lets us know,
  • “Unhealthy alcohol use ranks among the top three causes of preventable deaths in the U.S., yet less than one-third of patients who visit a primary care clinician ever discuss alcohol use.
  • “A tailored practice facilitation strategy was linked to increased adoption of evidence-based screening and counseling for unhealthy alcohol use among adults at small and medium-sized primary care practices.
  • “Studies in two other states documented similarly positive findings.”

From the U.S. healthcare business front,

• Healthcare Dive reports,
  • “Elevance became the second major insurer to predict declining revenue in 2026 on Wednesday, as for-profit payers continue to shave off members to try and recover margins.
  • “The Indianapolis-based insurer estimated its operating revenue will drop by a low-single digit percentage next year. The guidance comes one day after UnitedHealth forecast an annual revenue decline for the first time in more than three decades, sparking a selloff of managed care stocks that continued into Wednesday.
  • “Elevance also projected adjusted diluted earnings per share of at least $25.50, compared to the $30.29 it posted in 2025. Analysts said the insurers are setting attainable guidance to rebuild investor confidence after a difficult few years for the sector.”

• Bio Pharma Dive notes,
  • “Eli Lilly is expanding its footprint in genetic medicine, announcing Wednesday an agreement with Germany-based startup Seamless Therapeutics to develop treatments for hearing loss. 
  • “The alliance gives Lilly access to a type of next-generation gene editing technology. Seamless engineers and programs “recombinases,” or enzymes that rearrange DNA, in such a way that they can precisely pinpoint and modify specific areas of the genome. Through the deal, Seamless will design certain recombinases to correct mutations in unspecified “genes of interest” in hearing loss, the companies said.
  • “Lilly didn’t specify how much guaranteed cash Seamless will receive initially. But the startup is eligible for over $1.12 billion in total payouts, which includes an upfront payment and a variety of unspecified milestones.
  • “The deal adds to a concerted push by Lilly, which recently flirted with a $1 trillion market value thanks to its diabetes and obesity medicines, into the field of genetic medicine.”  

• Per Fierce Healthcare,
  • “Premise Health and Crossover Health plan to merge, creating a large employer-focused advanced primary care company serving more than 400 organizations and operating 900 clinics across the country.
  • “Both companies offer primary care and occupational health services for employers, unions, tribes and health plans with worksite or near-worksite clinics. The companies also offer virtual care services.
  • “Financial details of the agreement were not disclosed. The deal is subject to customary closing conditions, including regulatory approval.
  • “After closing, the combined company will approach $2 billion in annual revenue, according to a Premise Health spokesperson.”
• and
  • “Reperio Health, a provider of at-home health screenings with instant results, is teaming up with Amazon One Medical to expand access to primary care. 
  • “This marks Amazon’s first partnership in the at-home preventive screening space. 
  • “Reperio was founded in 2020, working with employers to offer at-home health screenings with instant results. Now, it is launching ReperioCare, which adds an on-demand virtual visit with a contracted clinician to interpret those results. Employees using the service can then take advantage of an included One Medical membership for ongoing primary care. 
  • The partnership’s goal is to streamline the path from early detection to ongoing primary care, particularly in rural areas.” 
    
• Per Beckers Hospital Review,
  • “Fort Wayne, Ind.-based Parkview Health has signed a letter of intent with Goshen (Ind.) Health to explore a partnership.
  • “The partnership would make Goshen Health Parkview’s largest hospital outside of Fort Wayne and establish it as a regional hub for care, access and growth, according to a Jan. 27 Goshen Health news release.
  • “Goshen and Parkview plan to collaborate to strengthen clinical services, expand care access and build a sustainable healthcare system. The process begins with a 90-day due diligence period, followed by regulatory review and final board approval.”
• and
  • “Walmart has moved 3,000 of its pharmacy technicians into pharmacy operations team lead roles and expanded pay ranges for the workforce.
  • “Pharmacy technician hourly rates average $22, which can increase to $40.50 depending on location and certification, according to a Jan. 28 news release from Walmart. The 3,000 recently promoted pharmacy operations team leads receive an average hourly pay of $28 with the potential to earn up to $42 per hour. Walmart operates about 4,600 locations in the U.S.
  • “The two largest U.S. pharmacy chains by prescription dispensing revenue, Walgreens and CVS, have made similar investments in their pharmacy technicians. In April, Walgreens said it would pay for pharmacy employee’s prerequisite coursework for a PharmD degree. A few months later, CVS opened a workforce development center in Texas for pharmacy technicians, customer service representatives and other pharmacy employees.” 

Notable Obituary

• The New York Times reports
  • “Thomas Fogarty, 91, Who Helped Revolutionize Vascular Surgery, Dies
  • “Drawing on his love of fly-fishing, he developed a balloon catheter that removes blood clots from patients’ limbs in a minimally invasive way. It has saved millions of lives.”
• RIP