Midweek Report

CDC

Midweek Report

David Ermer–CDC, CMS, Medical / Rx research, Medicare, Mental health care, Rx coverage, U.S. Healthcare–
Photo by Thought Catalog on Unsplash

From Atlanta, Georgia

  • MedPage Today brings us news from the April 15-16 ACIP meeting,
    • “Last June, CDC’s Advisory Committee on Immunization Practices (ACIP) unanimously recommended that all adults ages ≥75 years and adults ages 60 to 74 years who are at increased risk of severe RSV disease receive a single dose of RSV vaccine; the committee did not endorse one vaccine over another. That vote supplanted the committee’s earlier recommendation that adults ages 60 and older may receive RSV vaccination “after engaging in shared clinical decision making with their healthcare provider.”
    • Today, “[t]he ACIP voted 14-0, with one abstention, on Wednesday to recommend that high-risk patients ages 50 to 59 be vaccinated for respiratory syncytial virus (RSV) and also added a new option for meningococcal vaccination.
    • “I don’t think I can say it enough, but [we need] more studies in moderate-to-severe immunocompromised patients who are at highest risk for RSV disease,” ACIP member Mini Kamboj, MD, of Weill Cornell Medical College, in New York City, said after she voted for the recommendation. This is “a call to action,” she said.”
  • and
    • “The CDC’s vaccine advisors [also] are considering options that would narrow the recommendations for the fall COVID vaccine to only include groups at higher risk for severe illness.
    • Seasonal COVID shots are currently recommended for everyone 6 months and older, but CDC’s Lakshmi Panagiotakopoulos, MD, MPH, presented findings from a recent poll of the ACIP COVID-19 Work Group showing that 76% of its members supported a non-universal (risk-based) recommendation for the 2025-2026 respiratory virus season.
  • and
    • At its meeting on Tuesday, the [ACIP] considered whether the U.S. should move to single-dose human papillomavirus (HPV) vaccination instead of the currently recommended schedule.
    • At present, the U.S. recommends two doses of HPV vaccine if they are started before age 15, and three doses if they are started at age 15 or older, and for people who are immunocompromised. Routine vaccination starts at age 11 or 12 — though it can be started at age 9 — while catch-up vaccination is recommended through age 26. Shared clinical decision making is advised for those 27 to 45.
    • “However, global HPV vaccination schedules have shifted in recent years, with the World Health Organization recommending in 2022 a two-dose schedule for those 9 and older, with an option for a one-dose schedule for those between 9 and 20. The U.K. and Australia have adopted this schedule, too.”
  • and
    • “The number of cases reported in the ongoing measles outbreak in the southwestern U.S. is likely an undercount, according to the CDC scientist leading the response to the outbreak.
    • “We do believe there’s quite a large amount of cases that are not reported,” David Sugerman, MD, CDC’s senior scientist for the 2025 measles response, said during the Advisory Committee on Immunization Practices meeting on Tuesday.”

From the judicial front,

  • Federal News Network tells us,
    • “A federal judge on Tuesday issued a preliminary injunction that prevents the U.S. Department of Labor from requiring government contractors and grant recipients to certify they do not operate any diversity, equity and inclusion programs that run afoul of anti-discrimination laws until further order from the court.
    • “Judge Matthew Kennelly of the U.S. District Court for the Northern District of Illinois issued the ruling in response to a lawsuit filed by Chicago Women in Trades, a nonprofit dedicated to training and retaining women in skilled construction trades that receives several grants from the Department of Labor.
    • “The certification provision is a key part of President Donald Trump’s executive orders aimed at curbing DEI programs because contractors and grant recipients could be subjected to crippling financial penalties under the False Claims Act if they are found in violation of it.” * * *
    • “Kennelly had already issued a temporary restraining order against the Labor Department last month that was shorter in duration. His order is limited in scope because he declined to extend the injunction to other federal agencies beyond DOL.”
  • The American Hospital News informs us,
    • “A Minnesota state court April 15 dismissed a lawsuit filed by PhRMA challenging the state’s law protecting 340B pricing for contract pharmacy arrangements. The court ruled that the state law is not preempted by federal law, does not engage in unconstitutional extraterritorial regulation and that the law does not violate Minnesota’s Single Subject and Title Clause.
    • “The AHA filed an amicus brief in the case last year and filed others in similar cases for multiple states, in defense of those states’ 340B contract pharmacy laws.”
  • Beckers Payer Issues reports,
    • “CMS has denied an appeal from Humana to raise its 2025-star ratings, the company disclosed in an April 15 court filing. 
    • “Humana saw its Medicare Advantage star ratings drop significantly from 2024 to 2025, which will hurt the company’s 2026 revenues. Star ratings determine the bonuses CMS pays to MA plans. 
    • “Humana filed its lawsuit in October 2024 challenging the ratings in federal district court in Texas.”
  • In September 2019, WHYY, a Philadelphia PBS news outlet, reported
    • “Seventeen local defendants, including five medical professionals, are among those ensnared in a coordinated health care fraud enforcement action across Pennsylvania, New Jersey, New York, Connecticut and Washington, D.C., involving more than $800 million in loss and the distribution of over 3.25 million opioid pills in so-called pill mill clinics, the U.S. Justice Department said Thursday.”
    • A Justice Department press release states that on April 15, 2025, “a federal jury convicted a medical doctor [who was one of the medical professionals ensnared in September 2019], for his participation in conspiracies to commit health care fraud and wire fraud and to unlawfully distribute controlled substances.” Those crimes impacted FEHB plans, among other health plans.
  • Govexec points out,
    • As federal employees continue to face widespread layoffs, unions and advocacy groups on Wednesday launched a network to provide legal advice to government workers. 
    • The goal of the Rise Up: Federal Workers Legal Defense Network is to recruit attorneys to provide individual guidance to federal employees who fear losing their jobs or have already lost them. 
    • “Our network is already fighting back against illegal firings and other abuse of federal workers, but thousands of federal workers still need legal advice and representation,” according to the coalition’s website. “That means we need thousands of lawyers to help.” * * *
    • Federal employees can request legal assistance here.

In State government news,

  • STAT News reports,
    • “Arkansas Gov. Sarah Sanders has signed a first-in-the-nation law (HB 1150) that prohibits pharmacy benefit managers from operating both retail and mail-order pharmacies, a move designed to eliminate a conflict of interest that has been blamed for boosting the price of medicines and forcing independent pharmacies to close.
    • “At issue is an ongoing concern that the largest pharmacy benefit managers — which are controlled by CVS Health, Cigna, and UnitedHealth Group — favor their own pharmacy operations. Critics say that by doing so, these companies not only dominate the design of health plans for tens of millions of Americans but also distort the distribution and pricing for prescription medicines.” * * *
    • “The Arkansas bill has gone further than other states. The legislation would force the owners of the pharmacy benefit managers to make a choice — continue operating these industry middlemen or relinquish the right to run retail or mail-order pharmacies that operate in the state. By doing so, state lawmakers have argued they will reduce costs for state residents.”
  • KARK, a Little Rock television station, adds,
    • “CVS Health welcomes a good faith discussion with policy makers in Arkansas and across the country on ways to make medicine more affordable and accessible,” CVS shared in a statement. “Unfortunately, HB1150 is bad policy that accomplishes just the opposite: it will take away access to pharmacy care in local communities, hike prescription drug spending across the state by millions of dollars each year, and cost hundreds of Arkansans their jobs.”
    • “According to CVS, they have 23 pharmacies across the state. They also noted that this law will close more than 100 mail-order pharmacies in Arkansas.”

From the public health and medical research front,

  • Per BioPharma Dive, “New research kindles excitement around stem cell therapies for Parkinson’s Disease. Two studies published in Nature found stem cell-derived products can not only be safely transplanted into the brain but also show promising — albeit unproven — signs of efficacy.”
  • The National Academy of Sciences announced,
    • Oral health is an essential part of overall health, but issues around insurance coverage, workforce, and more, are leaving millions of Americans without sufficient oral health care. The @NASEM Health and Medicine Division hosted a workshop in November 2024 to address some of the barriers to care. Read a recap of the event here: https://tinyurl.com/5epd9rcs
  • Per MedCity News,
    • “Drugs have been the standard migraine treatment for decades. The severe headaches, nausea, and other problems associated with this common disorder now have a digital treatment option, a mobile app developed by prescription digital medicines startup Click Therapeutics.
    • “The FDA marketing authorization announced Tuesday permits use of the Click digital therapeutic for the prevention of episodic migraine in patients age 18 and older. Episodic migraine is defined as having fewer than 15 headache days per month. The Click migraine app, known in development as CT-132, does not replace migraine drugs. The FDA authorization covers use of the app as an adjunct to standard migraine treatments, which is how it was evaluated in clinical trials.
    • “Click’s research is based on mapping of the entire brain. The company has found faulty brain circuits implicated in many diseases, Chief Medical Officer Shaheen Lakan said in a 2023 interview. For various indications, the New York-based startup develops software that takes users through a series of tasks that have the effect of retraining and rewiring the brain over the course of weeks.”
  • Per Cancer Network
    • The incidence of pancreatic and colorectal adenocarcinoma has increased among young adults, highlighting a need for heightened awareness of this trend when evaluating younger patients with possible symptoms, according to findings from a retrospective cohort study published in JAMA Network Open.1
    • Findings from the trial revealed that a total of 275,273 patients with pancreatic adenocarcinoma were reported between 2000 and 2021, 51.8% of whom were male and 87.1% of whom were 55 years or older. An overall increasing incidence trend was noted, with the highest annual percentage change (APC) observed in those aged 15 to 34 years (4.35%; 95% CI, 2.03%-6.73%). The APC for the aforementioned age group was significantly higher than in those 55 years or older (1.74%; 95% CI, 1.59%-1.89%; P = .007) and those aged 35 to 54 years (1.54%; 95% CI, 1.18%-1.90%; P = .004).
  • Medscape lets us know,
    • “Can long-term physical activity influence mortality and biological aging? Researchers at the University of Jyväskylä in Jyväskylä, Finland, set out to answer this question and uncovered a surprising finding: Moderate physical activity had the most significant positive effect on longevity, reducing mortality by 7% over a 30-year period.
    • “Interestingly, higher levels of physical activity did not confer additional mortality benefits. The study was published in the European Journal of Epidemiology.”

From the U.S. healthcare business front,

  • Beckers Payer Issues tells us why “patient expectations will push healthcare to evolve by 2030, according to 21 payer executives.” 
  • Fierce Healthcare informs us,
    • “The Peterson Center on Healthcare released a new report that recommends policymakers narrow payment guidelines for a service they think could rocket spending in the public sector. 
    • “The costs of remote monitoring on Medicare have grown significantly in the years since the codes became available to providers, from $6.8 million in 2019 to $194.5 million in 2023. The services can be used for a host of chronic conditions that many Americans suffer from, including diabetes, hypertension and heart disease. 
    • “The Peterson Center takes issue with the increasing number of Medicare, Medicaid and Medicare Advantage patients who have been prescribed remote monitoring and the increasing amount of time their providers keep them using the technology. 
    • The report finds that chronic conditions only benefit from intense monitoring by providers for a short period of time, which varies by condition. Without additional guardrails, the report says public spending on remote monitoring could increase dramatically.
    • Under the current requirements for remote monitoring, CMS does not dictate which conditions should be monitored or for how long. Because CMS currently does not limit the amount of time that a provider can charge Medicare, Peterson calls them “forever codes.” 
    • The codes have only been in existence since 2019, but Peterson recommends policymakers steer providers towards high-value services and away from ongoing monitoring with no discernible clinical benefit.
  • Healthcare Dive notes,
    • “Ascension Health has inked a definitive agreement to acquire full ownership of a Texas hospital and its ancillary businesses from Community Health Systems for $460 million, the health system said Tuesday.
    • “Ascension Seton, a subsidiary of Ascension Texas, will purchase the remaining 80% stake in 126-bed Cedar Park Regional Medical Center. Although the system already owned a minority interest in Cedar Park, Ascension said acquiring full ownership would represent a “significant step” toward expanding medical services and care access in the Central Texas community.
    • “The deal is expected to close this summer, subject to regulatory approvals.
  • Per Modern Healthcare,
    • “The Permanente Medical Group and Northwest Permanente said Wednesday they have formed an affiliation.
    • “The medical groups will remain separate but will collaborate clinically and share innovations as part of the agreement. The groups will work together on telehealth, population health and workforce wellness, in addition to pursuing more subspecialty partnerships and scaling IT initiatives, a spokesperson said.” * * *
    • “The Permanente Medical Group and Northwest Permanente are independent, physician-led groups that partner with the Kaiser Foundation Health Plan to serve patients in Oregon, Washington and California. The Permanente Medical Group has nearly 10,000 physicians across 116 specialties, while Northwest Permanente has more than 1,300 physicians across 54 specialties. The groups collectively care for 5.2 million members.”
  • and
    • “Abbott Laboratories will make new investments in U.S. manufacturing, with the impact of tariffs on medical devices and diagnostics looming over the industry.
    • “It expects to spend $500 million on two facilities, located in Illinois and Texas, Abbott said in a statement Wednesday. The investments are to expand existing plants and boost U.S. research and development, a spokesperson said. The company will hire as many as 200 people in Illinois and as many as 100 people in Texas to support the work.”
  • Beckers Clinical Leadership relates,
    • “Mark Cuban’s latest move to disrupt the pharmaceutical supply chain is expanding — this time, tackling the injectable drug market through a new partnership with distributor Morris & Dickson.
    • “His company, Mark Cuban Cost Plus Drug Co., is partnering with Morris & Dickson, a full-line and specialty pharmaceutical distributor, to improve access to injectables nationwide. 
    • “The collaboration, announced April 14, aims to mitigate drug shortages, streamline procurement and provide equitable access to providers of all sizes. It also promotes sourcing flexibility by removing volume commitments, according to a news release.”

Tuesday Report

David Ermer–AHRQ, CDC, Congress, FDA, Generative AI, Medical / Rx research, Mental health care, NIH, Obesity, Telehealth, U.S. Healthcare–

From Washington, DC,

  • Bloomberg Law reports,
    • “President Donald Trump wants Congress to change a policy that gives certain drugs longer protection from drug price negotiations in Medicare, a fix that could address one of the drug industry’s top complaints with the Biden-era law.
    • “Trump directed his health secretary to work with lawmakers to end the differential treatment for small molecule drugs, typically pills, that face Medicare price negotiations sooner that more complex biologic medications.
    • “The directive came in an executive order Trump signed at the White House Tuesday. The order was light on specifics and included a grab-bag of other health policy goals.”
  • Modern Healthcare adds
    • “A bipartisan group of state attorneys general wants Congress to pass legislation that would break up healthcare conglomerates such as UnitedHealth Group, CVS Health and Cigna.
    • “Under the auspices of the National Association of Attorneys General, more than three dozen officials wrote congressional leaders on Monday asking them to ban companies from owning both pharmacy benefit managers and pharmacies, citing anticompetitive effects of consolidation in the healthcare system.”
    • Here is a link to that letter.
  • Fierce Pharma tells us,
    • “A two-day meeting of the Advisory Committee on Immunization Practices (ACIP), which was originally scheduled for February but was postponed by new HHS Secretary Robert F. Kennedy Jr., is underway today [April 15] in Atlanta and will conclude with panel votes on several vaccines on Wednesday afternoon.
    • “The independent advisers, who meet three times a year to inform vaccine policies in the U.S., today will discuss (PDF) the effectiveness of vaccines that defend against COVID-19, Mpox, chikungunya, HPV, cytomegalovirus (CMV) and the flu.
    • “The last item on Tuesday’s agenda will be an update on the U.S. measles outbreak. On Friday, the Centers for Disease Control and Prevention (CDC) reported 712 cases in more than 20 states, with the most concentrated spread underway in West Texas.”
  • Per a Senate news release,
    • “Sen. Chuck Grassley (R-Iowa), a member of the Senate Agriculture Committee and a lifelong family farmer, joined Sens. Pete Ricketts (R-Neb.) and Deb Fischer (R-Neb.), along with Reps. Randy Feenstra (R-Iowa) and Mark Alford (R-Mo.), in a letter urging the Make America Healthy Again (MAHA) Commission to use sound science and risk-based analysis in its policy decisions, particularly on crop protection tools and food-grade ingredients.
    • The letter was sent to Health and Human Services (HHS) Secretary Robert F. Kennedy Jr, Department of Agriculture (USDA) Secretary Brooke Rollins and Environmental Protection Agency (EPA) Administrator Lee Zeldin.
      • “We write to express our strong appreciation for your leadership and interest in working with each of you to ensure America has the healthiest people in the world. In recent decades, chronic illness rates have risen. This warrants our careful scrutiny to support better health outcomes. It is essential that policies supported by sound science and risk-based analyses are used to accomplish this goal,” the lawmakers wrote.
      • “We have concerns that environmentalists are advancing harmful health, economic, or food security policies under the guise of human health. Despite insinuations to the contrary, regular testing by FDA and USDA finds that more than 99% of all pesticide residues meet extremely conservative limits established by EPA according to the best available science,” they continued.”
    • Here’s a link to the letter.

From the judicial front,

  • Bloomberg Law tells us,
    • “The Central States, Southeast and Southwest Areas Health and Welfare Fund and participant Charles A. Whobrey sued Arkansas Insurance Commissioner Alan McClain April 11, arguing a law requiring health plans to report pharmacy cost data and pay pharmacies a minimum amount violates the Employee Retirement Income Security Act. 
    • “The multiemployer benefit plan serves 500,000 people via local chapters of the International Brotherhood of Teamsters.
    • “It’s the latest in a broader legal fight over states’ attempts to regulate pharmacy benefit managers, which oversee the prescription drug benefit for health plans. The US Supreme Court is weighing whether to accept a case challenging an Oklahoma law regulating pharmacy benefit managers after determining that ERISA did not preempt a separate Arkansas PBM law in 2020.” * * *
    • “The case is Central States, Southeast and Southwest Areas Health and Welfare Fund et al v. McClain, in his official capacity as Insurance Commissioner of Arkansas et al., N.D. Ill., No. 1:25-cv-03938, complaint filed 4/11/25.”

From the public health and medical research front,

  • The National Academy of Sciences announced,
    • “Bird flu has infected livestock, wildlife, pets, and humans. Most people have general questions about the looming threat of this highly pathogenic virus, and we have answers. Join @NASEM Health and Medicine Division and @NASEM Earth & Life Sciences on April 29, 2025, for the first public webinar of a special series addressing H5N1 avian influenza. Learn how we got here, who’s at risk, and what’s at stake. Can’t make the date/time? All registrants will receive a link to the recording. Register here: https://tinyurl.com/bdhrywv2
  • The New York Times reports,
    • “The number of children living with autism in the U.S. is growing.
    • “About 1 in 31 children aged eight years old in 2022 had autism—an increase from previous years, according to a report from the Centers for Disease Control and Prevention published Tuesday. 
    • “Increased awareness and screening of the disorder partly explains its rise over time. Health and Human Services Secretary Robert F. Kennedy Jr. has said he is assembling a team of researchers to focus on the root causes of the increase and expects to begin to have answers by September. 
    • “The autism epidemic has now reached a scale unprecedented in human history because it affects the young,” he said Tuesday. “Autism is preventable and it is unforgivable that we have not yet identified the underlying causes. We should have had these answers 20 years ago.”
    • “The idea that vaccines cause autism, which Kennedy has pushed, has long been debunked by scientists, after multiple studies have failed to find a link.”
  • The Rand Organization informs us,
    • “Specialized hospital services that aid people with opioid use disorder regardless of why they are admitted can boost the number of patients who begin treatment with FDA-approved medication for opioid use disorder and increase the likelihood they remain engaged in that care once discharged, according to a new study.
    • “Reporting results from the first parallel assignment randomized clinical trial of a hospital-based addiction consultation service for people with opioid use disorder, researchers found that people who received treatment from a specialized addiction consultation service were about twice as likely to begin medication treatment for opioid use disorder as patients who received the normal course of care.
    • “In addition, those who received care from the special program were significantly more likely to link to care for opioid use disorder once they were discharged.
    • “Researchers say the study contributes to growing evidence that an inpatient addiction consultation service can have a positive effect on treatment initiation and linkage to post-discharge care. The findings are published in the journal JAMA Internal Medicine.”
  • AHRQ offers advice on “Implementing [US Preventive Services Task Force] Recommended Mental Health and Substance Use Screening and Counseling Interventions in Primary Care Settings for Children and Adolescents.”
  • Per Medscape,
    • “New data confirmed the safety and efficacy of AXS-05, a combination of dextromethorphan and bupropion, for the treatment of agitation associated with Alzheimer’s disease (AD).
    • “In the phase 3 ACCORD-2 study, AXS-05 (Axsome Therapeutics) met the primary and key secondary endpoints by statistically significantly delaying and preventing AD agitation relapse compared with placebo and was generally well tolerated.
    • “Overall, the data “build on the previous positive phase 2/3 studies and support the use of AXS-05 as a safe and effective treatment for Alzheimer’s disease agitation,” George Grossberg, MD, Saint Louis University School of Medicine, St. Louis, said at a press briefing announcing the results.
    • “Grossberg presented the late-breaking findings from ACCORD-2 on April 7 at the American Academy of Neurology (AAN) 2025 Annual Meeting.”
  • Per a National Cancer Institute news release,
    • “Many adolescents and young adults (AYAs) with advanced cancer don’t have discussions with their clinicians about how they want to approach palliative care until the final weeks of life, a study of medical records of nearly 2,000 young patients showed.
    • “The researchers also found that, as of more than 2 months before their deaths, few AYAs in the study had documented goals for care of any kind in their medical records, including things such as how aggressive they would like to be with their cancer treatments.
    • “The findings come from an NCI-funded study that analyzed how documented discussions between AYA patients with advanced cancer and their providers about the goals of care change over the patients’ last few months of life.  The study results were published December 19 in JAMA Network Open.”
  • Per an NIH news release,
    • “New studies in rats suggest the drug reserpine, approved in 1955 for high blood pressure, might treat the blinding disease retinitis pigmentosa. No therapy exists for this rare inherited disease, which starts affecting vision from childhood. A report on the studies, conducted at the National Institutes of Health (NIH), published today in eLife.
    • “The discovery of reserpine’s effectiveness may greatly speed therapeutics for retinitis pigmentosa and many other inherited retinal dystrophies, which can be caused by one of more than a thousand possible mutations affecting more than 100 genes. Reserpine’s neuroprotective effect is independent of any specific underlying gene mutation,” said the study’s lead investigator, Anand Swaroop, Ph.D., senior investigator at NIH’s National Eye Institute.”
  • STAT News reports,
    • “U.S. researchers will soon test whether livers from a gene-edited pig could treat people with sudden liver failure — by temporarily filtering their blood so their own organ can rest and maybe heal.
    • “The first-of-its-kind clinical trial has been cleared by the Food and Drug Administration, according to pig producer eGenesis, which announced the step Tuesday with its partner OrganOx.” * * *
    • “The new study, which is expected to get underway later this spring, is a twist on the quest for animal-to-human organ transplants. Researchers won’t transplant the pig liver but instead will attach it externally to study participants.
    • “The liver is the only organ that can regenerate, but the question is whether having the pig’s liver filter the patient’s blood for several days could give it that chance.”

From the U.S. healthcare business front,

  • Beckers Payer Issues notes,
    • “CMS’ payment increase of 5.03% in 2026 “will likely significantly support the recovery” of Medicare Advantage plans as they continue to face rising medical costs, according to Fitch Ratings.
    • “Increased government scrutiny, reduced base payments and rising utilization in the last couple of years has put pressure on the program, leading plans to reduce benefits or pull back from unprofitable markets. CMS’ rate hike will increase payments to MA plans by more than $25 billion in 2026.
    • “While the higher 2026 payment rates do not resolve all the challenges facing MA insurers, they help relieve some pressures from increased healthcare utilization in the program,” Fitch analysts wrote April 14. “Depending on the insurer, the higher rates could enable a mix of enhancement of benefits in certain geographies, mitigation of Star Ratings pressure, or partial margin recovery.”
    • “Fitch expects MA to remain a key focus for insurers, and a clearer picture on the success of course correction measures will become available in the next few weeks as Q1 earnings reports are released.”
  • Per Fierce Pharma,
    • “Even as tariffs start to take a toll on Johnson & Johnson’s medtech business—with the threat of pharmaceutical duties not far behind—the New Jersey drug giant is confident it can weather any upcoming trade war turbulence. In fact, the company is boosting its sales guidance for the year following the close of a new neuroscience acquisition.
    • “J&J now expects to generate total operational sales of $91.6 billion to $92.4 billion in 2025, representing a $700 million increase over the forecast it initially unveiled in January, the company said in a Tuesday earnings release (PDF).
    • “J&J’s finance chief, Joseph Wolk, attributed the bump to J&J’s recent acquisition of neuroscience player Intra-Cellular Therapies for $14.6 billion. The deal, which closed earlier this month, allowed J&J to get its hands on the approved schizophrenia and bipolar disorder med Caplyta.”
  • Per Beckers Hospital Review,
    • “At the end of 2023, more than one-third of new prescriptions to treat Type 2 diabetes were GLP-1s, such as Mounjaro and Ozempic, among others, according to a study published April 15 in Annals of Internal Medicine. 
    • “Researchers at Mass General Brigham, based in Somerville, Mass., reviewed claims data from January 2021 to December 2023 to evaluate utilization trends among diabetes medications. 
    • “The drugs included glucagon-like peptide-1 receptor agonists (Ozempic), glucose-dependent insulinotropic polypeptide receptors (Mounjaro), glucose-lowering medications (metformin and insulin) and weight-lowering medications (phentermine). 
    • “Over those three years, use of Mounjaro, Ozempic and sodium-glucose cotransporter-2 inhibitors increased among adults with Type 2 diabetes. Use of other glucose-lowering drugs, including metformin, rapidly declined.
  • and
    • “Houston-based Texas Children’s has experienced “astounding” results from AI projects in recent months, its IT leader told Becker’s.
    • “Myra Davis, executive vice president and chief information and innovation officer of Texas Children’s, was recently recognized for her work when she was nominated for an ORBIE award for the nation’s top healthcare CIO.
    • “Becker’s caught up with Ms. Davis to discuss her most innovative IT projects — and what comes next.”
  • The New York Times reports,
    • “The quest to create an A.I. therapist has not been without setbacks or, as researchers at Dartmouth thoughtfully describe them, “dramatic failures.”
    • “Their first chatbot therapist wallowed in despair and expressed its own suicidal thoughts. A second model seemed to amplify all the worst tropes of psychotherapy, invariably blaming the user’s problems on her parents.
    • “Finally, the researchers came up with Therabot, an A.I. chatbot they believe could help address an intractable problem: There are too many people who need therapy for anxiety, depression and other mental health problems, and not nearly enough providers.
    • “Fewer than a third of Americans live in communities where there are enough mental health providers to meet the local demand. According to one study, most people with mental health disorders go untreated or receive inadequate treatment.
    • “So the team at Dartmouth College embarked on the first clinical trial of a generative A.I. therapist. The results, published in the New England Journal of Medicine-AI, were encouraging.
    • “Chatting with Therabot, the team’s A.I. therapist, for eight weeks meaningfully reduced psychological symptoms among users with depression, anxiety or an eating disorder.”
  • Per BioPharma Dive,
    • “Bristol Myers Squibb on Monday said its drug Camzyos failed a Phase 3 trial in people with a progressive heart condition, closing off an opportunity to expand use of a medicine it sees as a future blockbuster.
    • “According to Bristol Myers, Camzyos missed the dual main goals of a study focused on the non-obstructive form of “HCM,” or hypertrophic cardiomyopathy. It failed to meaningfully improve peak oxygen consumption as well as scores on an assessment of heart health. The company didn’t provide study details, but said more information will be shared “with the scientific community in the future.”
    • “Camzyos was acquired through the $13 billion buyout of MyoKardia in 2020 and two years later became the first drug cleared for use in the “obstructive” and more common form of the disease. Biotechnology companies Cytokinetics and Edgewise Therapeutics are developing similar medicines that are both in the advanced stages of clinical testing. Cytokinetics’ drug, aficamten, could be approved in the U.S. later this year.”

Friday Report

David Ermer–AHRQ, CDC, CMS, COVID-19, FDA, Federal employment benefits, Medical / Rx research, Medicare, NIH, Obesity, Rx coverage, SCOTUS, U.S. Healthcare–

From Washington, DC.

  • Medical Economics reports,
    • Health care is in crisis, but tying physician reimbursement to inflation is one way to stabilize the American health care system, according to the American Medical Association (AMA).
    • On April 10, the Medicare Payment Advisory Commission voted unanimously to recommend Congress replace current law updates to the physician fee schedule with an annual change based on the Medicare Economic Index, such as MEI minus 1%.
    • That is “a timely recommendation as lawmakers wrestle with how to handle yet another cut in physician pay,” according to AMA. Association President Bruce A. Scott, MD, issued a statement of support similar to previous ones because the issue has been under discussion for months. In fact, Scott noted MedPAC has suggested the same to Congress at least three consecutive years.
      The current baseline increase to physician reimbursement is 0.25%, or 0.75% for doctors participating in an alternative payment model. MedPAC said Congress should consider setting reimbursement at the rate of the Medicare Economic Index minus 1%, every year for the foreseeable future.
  • Fierce Healthcare lets us know,
    • “A new assessment of 18 Center for Medicare and Medicaid Innovation models reaffirms recent criticism of the agency’s aggregate cost savings—or more accurately, losses—while highlighting several individual payment models that appear effective in cutting down federal spending and improving care quality.
    • “The white paper published Wednesday by healthcare consulting and advisory firm Avalere Health looked at newer quality metrics for outcomes than prior CMMI model analyses and also dug into whether the agency had been transparent and provided opportunities for feedback when designing the models.
    • “The findings come in the wake of a damning late 2023 Congressional Budget Office assessment of the agency’s work, which found CMMI increased indirect spending by $5.4 billion between 2011 and 2020 (0.1% of net Medicare spending during that time) and spurred sharp scrutiny from cost-conscious lawmakers.”
  • and
    • “Disability protections against gender dysphoria implemented via rulemaking during the Biden administration will not be supported going forward, the Department of Health and Human Services (HHS) announced April 10.
    • “In a two-page clarification, HHS Secretary Robert F. Kennedy Jr. signed off on a rule update that declares language characterizing gender dysphoria as a disability to not be enforceable because its inclusion was in the preamble—not the regulatory text—to a final rule from May 2024.
    • “The Department is nonetheless concerned there has been significant confusion about the preamble language referencing gender dysphoria in the [final rule],” the update (PDF) in the Federal Register reads. “It is well-established that where, as here, the language included in the regulatory text itself is clear, statements made in the preamble to a final rule published in the Federal Register, lack the force and effect of law and are not enforceable.”
  • Federal News Network tells us, “OPM lacks funds to relocate ‘significant’ number of remote employees in return-to-office plans. OPM is joining many agencies in giving employees another chance to take a “deferred resignation” offer before it proceeds with nonvoluntary layoffs.”
  • Tammy Flanagan, writing in Govexec, informs us about “What to know about early retirement offers to federal employees.

From the Food and Drug Administration front,

  • Fierce Pharma relates
    • “Bristol Myers Squibb has received the FDA’s green light to introduce another immunotherapy-based treatment in first-line liver cancer.
    • “The company’s combination of Opdivo and Yervoy is now approved for patients with newly diagnosed unresectable or metastatic hepatocellular carcinoma, the FDA said Friday.
    • “The immunotherapy regimen combines two well-established agents and may offer the potential for a longer life compared with traditional targeted therapy, Wendy Short Bartie, Bristol Myers’ senior VP of U.S. oncology commercialization, said in an interview with Fierce Pharma.
    • “The first-line approval also converted a previous accelerated approval for Opdivo-Yervoy as a second-line liver cancer treatment. Further, it puts BMS toe to toe with two other immuno-oncology regimens—Roche’s Tecentriq and Avastin, and AstraZeneca’s Imfinzi and Imjudo.”
  • Per MedTech Dive,
    • “Intuitive said Thursday the Food and Drug Administration has cleared a stapler for use with its single-port robotic surgery system.
    • “The device, which Intuitive said is the first stapler designed for single-port robotic surgery, shares features found in the company’s multi-port products to reduce the risk of tissue damage.
    • “CFO Jamie Samath said in January that the stapler nod would trigger the start of “broad commercial efforts” for the single-port system in two indications recently authorized by the FDA.”
  • and
    • “Dexcom received Food and Drug Administration clearance for a 15-day version of its G7 glucose sensor, the company announced Thursday.
    • “Dexcom claims its continuous glucose monitor is the most accurate and has the longest wear time. The company also expects the shift from a 10-day to a 15-day sensor to improve its margins, executives said in a February earnings call.
    • “The announcement alleviated investor concerns that a recent FDA warning letter might delay the decision. Dexcom expects a full launch in the second half of 2025, giving the company time to integrate the updated device with insulin pumps.”

From the judicial front,

  • The Congressional Research Service offers a legal sidebar about the impending April 21 oral argument in the Kennedy v Braidwood Management case which concerns the Affordable Care Act’s preventive care services coverage mandate.
  • Bloomberg Law reports,
    • “A Maine woman can’t proceed with a suit claiming that her health insurance plan’s coverage exclusion for weight loss drugs unlawfully discriminates against obese people, a federal court said.
    • “Rebecca Holland didn’t allege any facts showing that Elevance Health Inc. ever regarded her or other obese plan members as disabled, the US District Court for the District of Maine said Wednesday. Her “bare conclusory allegations to the contrary” didn’t support a ruling that the exclusion was discriminatory, Chief Judge Lance E. Walker said.
    • “Medicare and private insurers generally cover the cost of drugs like Ozempic when used to treat Type 2 diabetes but have been reluctant to pay for it when used for weight loss purposes. Several state and federal plaintiffs are trying to change that by claiming that obesity qualifies as a disability, and the exclusions violate discrimination laws.”

From the public health and medical research front,

  • The Center for Disease Control and Prevention announced today,
    • “Seasonal influenza activity continues to decline. COVID-19 and RSV activity are declining nationally to low levels.
    • “COVID-19
      • “COVID-19 activity is declining nationally. Wastewater levels are at low levels, emergency department visits are at very low levels, and laboratory percent positivity is stable. Emergency department visits and hospitalizations are highest in older adults and emergency department visits are also elevated in young children.
      • “There is still time to benefit from getting your recommended immunizations to reduce your risk of illness this season, especially severe illness and hospitalization.
      • “CDC expects the 2024-2025 COVID-19 vaccine to work well for currently circulating variants. There are many effective tools to prevent spreading COVID-19 or becoming seriously ill.
    • “Influenza
    • “RSV
      • “RSV activity is declining in most areas of the country. Emergency department visits and hospitalizations are highest in children and hospitalizations are elevated among older adults in some areas.
    • “Vaccination
      • “Vaccination coverage with influenza and COVID-19 vaccines is low among U.S. adults and children. Vaccination coverage with RSV vaccines remains low among U.S. adults. Many children and adults lack protection from respiratory virus infections provided by vaccines.”
  • The American Hospital News points out,
    • “There have been 712 confirmed cases of measles reported by 25 states so far this year, according to the latest figures released April 11 by the Centers for Disease Control and Prevention. The agency said 93% of those cases (660 of 712) are outbreak-associated and 11% of cases have been hospitalized. The vaccination status of 97% of cases is classified as “unvaccinated or unknown.”
  • ProPublic adds,
    • “In the past six months, two babies in Louisiana have died of pertussis, the disease commonly known as whooping cough.
    • “Washington state recently announced its first confirmed death from pertussis in more than a decade.
    • “Idaho and South Dakota each reported a death this year, and Oregon last year reported two as well as its highest number of cases since 1950.
    • “While much of the country is focused on the spiraling measles outbreak concentrated in the small, dusty towns of West Texas, cases of pertussis have skyrocketed by more than 1,500% nationwide since hitting a recent low in 2021 amid the COVID-19 pandemic. Deaths tied to the disease are also up, hitting 10 last year, compared with about two to four in previous years. Cases are on track to exceed that total this year.”
  • The New York Times reports,
    • “Surgeons removed a genetically engineered pig’s kidney from an Alabama woman after she experienced acute organ rejection, NYU Langone Health officials said on Friday.
    • “Towana Looney, 53, lived with the kidney for 130 days, which is longer than anyone else has tolerated an organ from a genetically modified animal. She has resumed dialysis, hospital officials said.
    • “Dr. Robert Montgomery, Ms. Looney’s surgeon and the director of the NYU Langone Transplant Institute, said that the so-called explant was not a setback for the field of xenotransplantation — the effort to use organs from animals to replace those that have failed in humans.
    • “This is the longest one of these organs has lasted,” he said in an interview, adding that Ms. Looney had other medical conditions that might have complicated her prognosis.
    • “All this takes time,” he said. “This game is going to be won by incremental improvements, singles and doubles, not trying to swing for the fences and get a home run.”
  • Health Day notes,
    • “About one in 10 U.S. adults with substance use disorder (SUD) report past-year hospitalizations, according to a research letter published online April 1 in the Annals of Internal Medicine.
    • “Eden Y. Bernstein, M.D., M.P.H., from the University of Colorado School of Medicine in Aurora, and colleagues described the prevalence of hospitalizations among U.S. adults with SUD. Adults were classified into non-mutually exclusive groups by presence of any SUD, individual SUD, and two or more SUDs. The proportion and number of U.S. adults who reported hospitalizations was estimated for each group.
    • “The researchers identified 60 million U.S. adults with SUD, of whom 5.8 million (9.7 percent) reported past-year hospitalizations. The proportion of hospitalized adults ranged from 7.3 to 23.6 percent among those with alcohol use disorder (AUD) and opioid use disorder (OUD), respectively. Among adults with SUD, those with versus without past-year hospitalizations were more likely to be older and more likely to have two or more medical comorbid conditions. Hospitalized adults with AUD, cannabis use disorder, and tobacco use disorder were also more likely to have serious mental illness. Across all groups apart from AUD, hospitalized adults were less likely to be uninsured. Hospitalized adults with OUD were less likely to be non-Hispanic Black.”
  • Per a National Cancer Institute news release,
    • “Why do some cancers come back many years after treatments had eliminated all signs of the disease? The answer may involve rogue cancer cells that spread to other parts of the body early in the disease and then enter a sleeping, or dormant, state, according to a growing body of research. 
    • “These dormant cancer cells can survive in the body undetected for months, years, or even decades, the research suggests. At some point, however, the cells may awaken and begin the process of forming metastatic tumors.  
    • “What causes disseminated cancer cells to enter, and then to leave, a dormant state is not known. 
    • “But recent studies of tumor dormancy have yielded clues that scientists believe could one day help them find ways to prevent metastases, which account for most cancer deaths.”
  • Genetic Engineering and Biotechnology News adds,
    • “Cancer vaccines have been a tantalizing idea for decades, but the vast complexity of the human immune system has posed significant challenges. Now, technological advances like rapid DNA sequencing, lymph node targeting, and AI-informed antigen selection are enabling the creation of precision vaccines that target cancers effectively while minimizing harmful side effects.”
  • AHRQ’s Effective Health Care Program shares a paper about “Management of Suicidal Thoughts and Behaviors in Youth: A Systematic Review.”
  • The University of Minnesota’s CIDRAP relates,
    • “A new smartphone-sized device can deliver tuberculosis (TB) test results at the point of care in less than an hour, an innovation that could improve diagnosis of the deadly disease in settings in which access to healthcare facilities and lab equipment is limited, its Tulane University developers reported yesterday in Science Translational Medicine.
    • “Over 90% of new TB cases occur in low- and middle-income countries.” 

From the U.S. healthcare business front,

  • Beckers Hospital Review calls attention to the fact that CMS has approved seven new health systems to offer hospital at home programs.
  • Beckers Payer Issues informs us,
    • “CVS Health has named Benjamin Kornitzer, MD, as Aetna’s chief medical officer. 
    • “Most recently, Dr. Kornitzer was chief medical officer at agilon health, a primary care physician services company primarily serving Medicare Advantage patients.
    • “He also previously served as CMO of Mount Sinai Health System in New York.”
  • Fierce Healthcare reports,
    • “A better consumer experience has implications for clinical improvements, according to a new report from CVS Health.
    • “The healthcare giant is putting a focus on innovation in this area, and to identify opportunities conducted an analysis that compared Net Promoter System (NPS) scores with clinical outcomes. It found that, for example, patients who were highly satisfied with the experience at their pharmacies were more likely to be adherent to their medications.
    • “The white paper notes that nonadherence to prescribed medications drives 16% of U.S. health spending each year, or about $500 billion.” 
  • Modern Healthcare tells us,
    • “Eli Lilly is partnering with digital health companies to boost sales of its weight loss medications.
    • “The drugmaker added hybrid weight loss startup Knownwell to its third-party marketplace of telehealth offerings earlier this month. Eli Lilly has also signed deals with Ro, Form Health and 9am Health.” 
  • BioPharma Dive recently updated its prescription drug patent tracker.
  • Bloomberg Law adds,
    • “Novo Nordisk A/S and Eli Lilly & Co. are using dense clusters of patents to extend monopolies on blockbuster diabetes and weight-loss drugs including Ozempic, Wegovy, and Mounjaro, fueling high prices and health inequities, according to an advocacy group report.
    • “The pharmaceutical companies’ adoption of a “financialized business model” prioritizes profits and shareholder returns through an aggressive strategy for securing additional patents for minor changes to extend their drugs’ market exclusivity well beyond the expiration of its original patents, according to a report released Thursday by the Initiative for Medicines, Access and Knowledge on “the heavy price” of those glucagon-like peptide 1 therapies.” * * *
    • In a statement Friday, Lilly said the “report is grossly inaccurate and includes patents that have nothing to do with tirzepatide.”
    • “To date, Lilly has only listed three patents in the Orange Book for” its two tirzepatide products, it added.
    • “Our business model is built on the fact that patents are limited in scope and duration, and when they expire, we welcome generic and biosimilar manufacturers to develop lower-cost alternatives,” the statement continued. “Lilly is already focused on developing the next innovation for patients that will eventually become generic.”
    • “The Orange Book is a US Food and Drug Administration registry listing patents that cover approved drugs that allows branded-drug makers to trigger a 30-month delay of FDA approval by filing a suit alleging infringement of a listed patent.
    • “Novo in a Friday statement said it has no more than four patents listed in the Orange Book for Ozempic , no more than eight for Wegovy, and 11 for Rybelsus.
    • “While the US healthcare system is complex and there are many factors that play a role in determining what people will pay for medicines,” Novo said, “the net price of Ozempic has declined by 40% since launch in the US and Wegovy is following a similar trajectory.”

Thursday Report

David Ermer–CDC, CMS, Congress, FDA, Medical / Rx research, Medicare, Rx coverage, U.S. Healthcare–
Photo by Michele Orallo on Unsplash

From Washington, DC,

  • Yesterday, the Senate Homeland Security and Governmental Affairs Committee favorably reported the President’s nominee for OPM Director, Scott Kupor, by a 7-4 vote. Mr. Kupor’s nomination will be headed for the Senate floor following the upcoming two week break from Capitol Hill.
  • Today, the American Hospital Association News let us know,
    • The House, by a vote of 216-214, passed the revised budget resolution for fiscal year 2025. This follows the Senate’s passage of the bill last week. Reps. Victoria Spartz, R-Ind., and Thomas Massie, R-Ky., joined all Democrats today in voting “no.”  
    • Notably, the resolution instructs the House Energy and Commerce Committee, which has primary jurisdiction over Medicaid and other health care programs, to cut a minimum of $880 billion in spending. * * *
    • With the House and Senate’s passage of the resolution, Congress can move forward with the reconciliation process. The next step calls for specific committees to begin drafting legislation consistent with their instructions in the budget resolution. This is where the hard work begins, as House and Senate committees must decide on the specific policies to be included within the reconciliation bill.  
    • The budget resolution gives Senate and House committees until May 9 to report legislation, but this is not a binding deadline. 
  • The approved budget resolution (page 47) calls for the House Oversight and Government Reform Committee to “submit changes in law within its jurisdiction to reduce the deficit by not less than $50,000,000,000 for the period of fiscal years 2025 through 2034.”
  • The AHA News further informs us,
    • The Trump administration yesterday [April 9] released executive orders on reducing anti-competitive regulatory barriers and repealing certain regulations deemed unlawful.  
    • The order on reducing anti-competitive barriers directs federal agencies to review all regulations subject to their rulemaking authority and identify those that create de facto or de jure monopolies, create barriers to entry for new market participants, create or facilitate licensure or accreditation requirements that unduly limit competition, or otherwise impose anti-competitive restraints or distortions in the market.   
    • The order on repealing unlawful regulations is linked to a Feb. 25 executive order that directed agencies within 60 days to identify unlawful and potentially unlawful regulations to be repealed. The new order instructs agencies to take steps to immediately repeal regulations and provide justification within 30 days for any identified as unlawful but have not been targeted for repeal, explaining the basis for the decision not to repeal.
  • Govexec adds,
    • “On Feb. 19, Trump signed an executive order requiring agencies, within 60 days and in coordination with the Office of Management and Budget and Elon Musk-backed Department of Government Efficiency, to identify for elimination or modification regulations that are unconstitutional or unlawful. 
    • “With roughly a week-and-a-half before that deadline, the president on Wednesday [April 9] declared that such regulations can be repealed without going through the notice and comment period. When an agency promulgates a new rule, or revokes one, it must seek, respond to and potentially incorporate public comment on the proposal. The process usually takes at least a year. 
    • “The Trump administration, however, is arguing that it does not have to take this step because of the “good cause” exception in the Administrative Procedure Act, which is the law that sets rulemaking requirements. The exception provides that agencies do not have to perform notice and comment if doing so would be “impracticable, unnecessary or contrary to the public interest.”
    • “Retaining and enforcing facially unlawful regulations is clearly contrary to the public interest,” the memo said. “Furthermore, notice-and-comment proceedings are ‘unnecessary’ where repeal is required as a matter of law to ensure consistency with a ruling of the United States Supreme Court. Agencies thus have ample cause and the legal authority to immediately repeal unlawful regulations.”
  • Fierce Healthcare notes, “The American people, more than any Federal official, know which regulations stifle entrepreneurship and economic growth,” the White House wrote in its fact sheet. “You are invited to tell us which regulations impede competition and should be changed or repealed.” The FEHBlog is a big fan of deregulation.
  • The AHA News was full of Washington, DC, news today.
    • “The Government Accountability Office yesterday [April 9] released a report calling for the Department of Health and Human Services to improve its efforts responding to drug shortages. The report found that although drug shortages have decreased since 2020, shortages are lasting longer. HHS responded to the GAO report, informing the GAO that its coordinator position overseeing medical product supply chains would be eliminated in May, leaving HHS without leadership to coordinate its drug shortage activities. The GAO recommended HHS implement a method to formally conduct any drug shortage activity and collaborate with other federal agencies.”
  • and
    • “The National Counterintelligence and Security Center, the FBI, and the Defense Counterintelligence and Security Center yesterday released guidance on mitigating deceptive online recruitment activities by foreign intelligence entities, particularly groups in China, that target current and former federal government employees. The agencies said the entities are posing as legitimate consulting firms, corporate recruiters, public policy institutions and other organizations on social and professional networking websites. The actors are said to be using deceptive online job offers and other virtual approaches to target individuals with federal backgrounds who may be seeking new employment.”
  • Beckers Hospital Review adds,
    • “More than one-third (41%) of active drug shortages began in 2022 or earlier, according to a new report from the American Society of Health-System Pharmacists. 
    • “The report tracks national drug shortage trends from January 2001 through March 2025. So far this year, the ASHP has reported 26 new drug shortages. Since an all-time high of 323 active drug shortages in early 2024, the number of active shortages is now 270. 
    • “The “[w]orkload required to manage shortages, including work to change pharmacy automation and electronic health records, adds to the challenges of pharmacy staff shortages,” the report said. 
    • “In 2024, 17% of shortages were related to manufacturing issues, 9% to Hurricane Helene, 9% to business decisions, 8% to supply and demand, and 2% to a raw material problem. Manufacturers did not or refused to provide a reason for 55% of shortages.” 
  • In an HHS press release, the new CMS Administrator, Dr. Mehmet Oz, shares his vision for CMS.
    • “I want to thank President Trump and Secretary Kennedy for their confidence in my ability to lead CMS in achieving their vision to Make America Healthy Again,” said Dr. Oz. “Great societies protect their most vulnerable. As stewards of the health of so many Americans – especially disadvantaged youth, those with disabilities, and our seniors, the CMS team is dedicated to delivering superior health outcomes across each program we administer. America is too great for small dreams, and I’m ready to get work on the President’s agenda.”
  • Per an FDA press release,
    • “Today, the U.S. Food and Drug Administration is taking a groundbreaking step to advance public health by replacing animal testing in the development of monoclonal antibody therapies and other drugs with more effective, human-relevant methods. The new approach is designed to improve drug safety and accelerate the evaluation process, while reducing animal experimentation, lowering research and development (R&D) costs, and ultimately, drug prices.
    • “The FDA’s animal testing requirement will be reduced, refined, or potentially replaced using a range of approaches, including AI-based computational models of toxicity and cell lines and organoid toxicity testing in a laboratory setting (so-called New Approach Methodologies or NAMs data). Implementation of the regimen will begin immediately for investigational new drug (IND) applications, where inclusion of NAMs data is encouraged, and is outlined in a roadmap also being released today. To make determinations of efficacy, the agency will also begin use pre-existing, real-world safety data from other countries, with comparable regulatory standards, where the drug has already been studied in humans.”

In State government news,

  • STAT News reports,
    • An Arkansas bill that would prohibit pharmacy benefit managers from operating retail and mail-order pharmacies was passed by the state senate and is now headed to Gov. Sarah Sanders, the first time such a bill has gotten this far down the legislative path in the United States.
    • “The bill is designed to eliminate what state — and some federal — lawmakers have called a conflict of interest that has forced residents to pay more for medicines and hastened the demise of independent pharmacies. And it arrives as scrutiny of pharmacy benefit managers and their role in the opaque pricing of prescription drugs has increased dramatically. A spokesman for Sanders declined to say whether she would sign the bill and, if so, when.” * * *
    • “As for CVS, the company sent us a statement saying “This bill rips medicine away from sick patients and makes it harder for people to achieve better health. A veto will protect communities, improve care, and help hundreds of thousands of Arkansans get the medicines they need. Governor Sanders should choose people over misguided policy that will lead to serious consequences.”
    • “A spokeswoman for Express Scripts directed us to a web site where the company argues state residents will lose the convenience of home delivery as well as focused care for certain diseases that are treated by medicines distributed through a specialty pharmacy operation called Accredo.”

From the public health and medical research front,

  • Tech Target tells us,
    • “Only half of Americans are getting regular cancer screenings and routine medical care, signaling a need for more public awareness of the importance of primary and preventive care, according to the Prevent Cancer Foundation’s 2025 Early Detection Survey.
    • “The survey of 7,000 U.S. adults aged 21 or older showed that only 51% of people are accessing routine medical care and cancer screening, a significant 10 percentage-point downswing from a similar 2024 survey.
    • “There are numerous reasons patients miss their cancer screenings, but most generally center on public awareness and information, the survey continued. For example, 43% of respondents said they weren’t aware that they needed to be screened for a certain type of cancer. Likewise, 40% said they didn’t have any symptoms of disease and another 40% said they had no family history of the illness.”
  • Per Health Day,
    • “Stroke, dementia and depression share 17 common risk factors
    • “Improving any of the risk factors can improve odds against any of the three brain health problems
    • “High blood pressure and kidney disease had the biggest impact on risk.”
  • Per the American Journal of Managed Care,
    • “Newer glucose-lowering medications glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 (SGLT2) inhibitors significantly reduced the risk of major cardiovascular events and heart failure in older adults with type 2 diabetes (T2D), according to one study.1 The findings suggest these treatments outperform dipeptidyl-peptidase-4 (DPP-4) inhibitors, regardless of age, and support their use in clinical guidelines for elderly populations.”
  • Per MedCity News,
    • “Solu Therapeutics, a company developing a new type of antibody drug, unveiled $41 million in financing on Wednesday for clinical testing of a therapy with the potential to bring a safer and more effective approach to blood cancers.
    • “Boston-based Solu has already begun dosing patients in a Phase 1 test of lead program STX-0712 in resistant or refractory chronic myelomonocytic leukemia (CMML) and other hematologic malignancies. The target of the drug is CCR2, a receptor that plays a role in cancer development and progression. The Solu drug is intended to eliminate CCR2-positive cells. It does so in a novel way.”

From the U.S. healthcare business front,

  • The New York Times reports,
    • “Seniors across the country are wearing very expensive bandages.
    • “Made of dried bits of placenta, the paper-thin patches cover stubborn wounds and can cost thousands of dollars per square inch.
    • “Some research has found that such “skin substitutes” help certain wounds heal. But in the past few years, dozens of unstudied and costly products have flooded the market.
    • “Bandage companies set ever-rising prices for new brands of the products, taking advantage of a loophole in Medicare rules, The New York Times found. Some doctors then buy the coverings at large discounts but charge Medicare the full sticker price, pocketing the difference.
    • ‘Partly because of these financial incentives, many patients receive the bandages who do not need them. The result, experts said, is one of the largest examples of Medicare waste in history.
    • “Private insurers rarely pay for skin substitutes, arguing that they are unproven and unnecessary. But Medicare, the government insurance program for seniors, routinely covers them. Spending on skin substitutes exceeded $10 billion in 2024, more than double the figure in 2023, according to an analysis of Medicare data done for The Times by Early Read, a firm that evaluates costs for large health companies.
    • “Medicare now spends more on the bandages than on ambulance rides, anesthesia or CT scans, the analysis found.”
  • The KFF Peterson Health System Tracker identifies health spending issues to watch this year.
  • Fierce Pharma reports
    • “On the heels of similar investment pledges from Eli Lilly and Johnson & Johnson, Switzerland’s Novartis is stepping up to the plate with a major plan to grow its U.S. footprint.
    • “Novartis will spend $23 billion to build and expand 10 U.S. facilities over the next five years, the company said in a Thursday press release. Reuters first reported the news following an interview with Novartis’ CEO Vas Narasimhan.
    • “The outlay is the latest in a series of moves seemingly spurred on by the threat of import tariffs on pharmaceuticals under the second Trump administration.
    • “On the production front, Novartis will build four new manufacturing facilities in “soon-to-be-determined states,” plus establish new radioligand therapy plants in Florida and Texas. The company will also expand existing radioligand manufacturing facilities in Indiana, New Jersey and California.”
  • Per MedCity News,
    • “Teladoc Health, a virtual care company, unveiled its new Cardiometabolic Health Program on Tuesday to prevent the advancement of diabetes, hypertension and obesity.
    • “Purchase, New York-based Teladoc Health serves both employers and health plans. In addition to support for weight management and diabetes, it offers mental health care, primary care and specialty services.
    • “The new program provides a premium subscription to BetterSleep, an app that’s focused on improving sleep quality. Patients also gain access to one-on-one support with a registered dietitian, outreach from health coaches, at-home testing for cardiometabolic measures and health insights from connected devices (like blood glucose meters). The program is available to those with a body mass index of 25 or above.”
  • Healthcare Dive relates,
    • “Kandu Health and Neurolutions have merged and raised $30 million to support stroke recovery and rehabilitation, the companies said Tuesday.
    • “The merger brings together Neurolutions’ brain computer interface technology and Kandu Health’s telehealth services to try to improve stroke patients’ outcomes after they leave the hospital. 
    • “Patients will have access to Neurolutions’ IpsiHand, a device that is cleared for use in the U.S. The system translates brain signals to enable stroke patients to open and close their hands.”
  • Per Beckers Hospital Review,
    • “West Orange, N.J.-based RWJBarnabas Health and the Rutgers Cancer Institute of New Jersey plan to open the state’s first freestanding cancer facility in May.
    • “Three things to know:
      • “The $750 million, 520,000-square-foot project broke ground in 2021. It is a 12-story facility that will house inpatient and outpatient cancer services, along with research laboratories. 
      • “The freestanding cancer facility is adjacent to the Robert Wood Johnson University Hospital and Rutgers Cancer Institute of New Jersey campus in New Brunswick, N.J.
      • “The cancer pavilion is designed to serve as a leading model for cancer care on the East Coast, uniting research, education and patient care under one roof.”

Midweek Report

David Ermer–CDC, Congress, Medical / Rx research, Mental health care, Obesity, Rx coverage, SCOTUS, U.S. Healthcare–
Thanks to Alexandr Hovhannisyan for sharing their work on Unsplash.

From Washington, DC

  • The Wall Street Journal reports
    • “President Trump told Republicans wavering on the party’s fiscal framework to “close your eyes and get there.” GOP opponents of the plan say they are heading into the budget showdown with eyes wide open, and some appear willing to block the president’s push, setting up a too-close-to-call vote late Wednesday.
    • “Trump and House GOP leaders have routinely melted internal party opposition this year with promises and appeals to Republican unity. This time, they face dug-in critics of the budget passed by the Senate on Saturday.
    • “Republican leaders are optimistic they can get the measure through the House, and Speaker Mike Johnson (R., La.) told reporters that he thought it would pass. The House advanced the measure past a procedural hurdle in a 216-215 tally, setting up the final debate and vote. That procedural vote contained an unrelated provision that will make it harder this year for the House to reverse Trump’s tariffs.”
  • Politico adds,
    • “House Republican leaders canceled a vote on the Senate’s budget resolution Wednesday night, as Speaker Mike Johnson came to terms with what had been clear for many hours: Too many Republicans would vote in opposition and the measure was bound to fail.” * * *
    • “Lawmakers are slated to head back to their districts Thursday for a two-week recess, meaning that the president could have to wait to see any forward motion on his “big, beautiful bill” if a compromise can’t be reached soon.
    • “Johnson said Wednesday night that House leadership will now explore either amending the Senate-adopted budget or going straight to conference with the Senate and working out differences there.
    • “We’re going to make that decision,” he told reporters just after the resolution was pulled.”
  • The American Hospital Association News tells us,
    • “President Trump announced on April 9 (https://tinyurl.com/2t463edy) that reciprocal tariffs that went into effect after midnight for certain nations will be paused for 90 days, while tariffs for China would be increased to 125%. A 10% universal tariff on imported goods from all countries that began April 5 remains in effect.”
  • and
    • “The Office of Management and Budget April 9 released a notice seeking public input on rules to potentially be rescinded, requesting detailed reasons for their rescission. Comments must be received by OMB no later than 30 days after publication of the notice in the Federal Register. The notice will be published April 11. Comments can be submitted at www.regulations.gov.”

From the judicial front,

  • Federal News Network lets us know,
    • “For the second time in as many days, a higher court has paused a judicial ruling that ordered the reinstatement of federal employees who were fired en masse, leaving thousands of probationary workers vulnerable once again to potential termination.
    • “In a 2-1 ruling Wednesday, a three-judge panel of the Fourth U.S. Circuit Court of Appeals temporarily set aside a Maryland judge’s injunction that had ordered agencies to reinstate employees in 19 states and the District of Columbia. The majority found the government was likely to succeed in proving that the Maryland district court had no jurisdiction over the states’ claims that federal agencies had engaged in an illegal Reduction in Force (RIF).
    • “The panel’s ruling comes one day after the Supreme Court issued a separate stay that had a similar effect on a California court’s ruling that had also ordered the reinstatement of some agencies’ fired probationary workers. In that case, the high court, in an unsigned order Tuesday, also put the preliminary injunction on hold while claims of illegal firing work their way through the appeals process.” * * *
    • “And in California, the judge is considering whether to issue another preliminary injunction that could withstand the ruling the Supreme Court issued Tuesday. In that order, the justices found that the outside organizations harmed by the mass firings didn’t have standing to sue, but explicitly left open the possibility that other plaintiffs, including federal unions, could win an injunction of their own.
    • “In a San Francisco courtroom Wednesday, Judge William Alsup heard arguments over whether unions had standing to sue and win another injunction. However, he postponed issuing a ruling until attorneys in the case provide more information, including data about how many employees were affected by the mass terminations, their relationships with the union plaintiffs, and possible evidence that would show that agencies’ firing decisions were made at the behest of the Office of Personnel Management.”
  • Bloomberg Law points out,
    • “US Chief Justice John Roberts let President Donald Trump temporarily oust top officials at two independent agencies while the Supreme Court decides how to handle a new showdown over presidential power.
    • “Roberts’ order Wednesday puts on hold a federal appeals court decision that had let National Labor Relations Board member Gwynne Wilcox and Merit Systems Protection Board member Cathy Harris go back to work. Roberts said his order will last until either he or the full court issues a longer-term decision.
    • “The case is testing a 1935 Supreme Court ruling that let Congress shield high-ranking officials from being fired, paving the way for the independent agencies that now proliferate across the US government. The legal wrangling ultimately could affect whether Trump has the power to fire Federal Reserve Chair Jerome Powell.”
  • Beckers Payer Issues notes, “A New York federal [district] judge dismissed an antitrust lawsuit against UnitedHealthcare and MultiPlan that alleged the companies conspired to reduce reimbursement rates for an anesthesia services provider.”

From the public health and medical research front,

  • AP reports,
    • “A day care facility in a Texas county that’s part of the measles outbreak has multiple cases, including children too young to be fully vaccinated, public health officials say.
    • “West Texas is in the middle of a still-growing measles outbreak with 505 cases reported on Tuesday. The state expanded the number of counties in the outbreak area this week to 10. The highly contagious virus began to spread in late January and health officials say it has spread to New Mexico, Oklahoma, Kansas and Mexico. 
    • “Three people who were unvaccinated have died from measles-related illnesses this year, including two elementary school-aged children in Texas. The second child died Thursday at a Lubbock hospital, and Health Secretary Robert F. Kennedy Jr. attended the funeral in Seminole, the epicenter of the outbreak. 
    • “As of Friday, there were seven cases at a day care where one young child who was infectious gave it to two other children before it spread to other classrooms, Lubbock Public Health director Katherine Wells said.”
  • Per Newsweek,
    • “Cabot Creamery is recalling 1,700 pounds of butter after testing found elevated levels of coliform bacteria in the product, a marker of potential fecal contamination.
    • “The voluntary recall, initiated by Agri-Mark Inc, Cabot Creamery’s parent company, affects the brand’s 8-ounce Extra Creamy Premium Sea Salted Butter and was distributed in seven states.”
  • The New York Times reports,
    • “During a recent five-year period, a substantial portion of maternal deaths in America — almost one-third — took place more than six weeks after childbirth, at a time when most new mothers think they are in the clear, researchers reported on Wednesday.
    • “The study, published in JAMA Network Open, is one of the first to track maternal health complications during pregnancy and in the year after delivery.
    • “Pregnancy-related death rates in the United States rose almost 28 percent from 2018 to 2022, the researchers found, surging at the height of the Covid-19 pandemic in 2021 before subsiding somewhat.
    • “Our study illustrates why we can’t take our eyes off maternal health,” said Dr. Rose L. Molina, an associate professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and one of the study’s authors.
    • “Women need “access to high-quality care from the moment of conception to a full year after birth,” she added. While there has been a growing emphasis on care in the year after childbirth, “we’re not there yet.”
  • The National Cancer Institute’s Cancer Information Highlights discusses “Targeting a Gene Fusion | Fat Cells to Starve Tumors | TIL Shrinks Solid Cancers.”
  • Per an NIH news release,
    • “In a massive scientific effort funded by the National Institutes of Health (NIH), hundreds of researchers have helped to map the connections between hundreds of thousands of neurons in the mouse brain and then overlayed their firing patterns in response to visual stimuli. This breakthrough is a critical piece of foundational science to build toward understanding how our brains process visual information to reconstruct the images we see every day.
    • “Information processing in the human brain occurs via electrical firing of 86 billion neurons that make trillions of connections with each other. The secrets of how our brain enable us to think, feel, and act lie hidden in the complexity of its wiring diagram and the barrage of electrical signals that move across it in millisecond time frames. While the current findings focus on a tiny fraction of the brain, they reveal the complex connections between the cells and show how those connections are wired to produce functional responses. This information, which was previously beyond our reach, could help us understand how the brain functions normally and offer a guide to what goes wrong as the result of various disorders or injuries.”  
  • Per UPI,
    • “Emergency room visits attributed to popular weight loss drugs such as Ozempic and Wegovy remain quite rare overall, but do show an unexpected link to hypoglycemia, according to a study released Monday.
    • “Semaglutide brand names include Ozempic, Rybelus, and Wegovy, all made by Novo Nordisk, and Mounjaro from Eli Lilly.
    • “The study, led by the Centers for Disease Control and Prevention and Cambridge Health Alliance, was published in the Annals of Internal Medicine. It provides reassuring evidence that serious adverse events associated with the burgeoning use of the drugs are uncommon.
    • “That’s impressive given the overwhelming popularity of semaglutides, which are among a class of “wonder drugs” known as GLP-1 agonists.”
  • STAT New informs us,
    • Since 2021, when the information blocking rules kicked in, health systems and patients have been reckoning with the impact of electronic medical records that allow instant access to test results — good, bad, and in between — sometimes before a doctor has ever seen them. Patients overwhelmingly prefer having their health information as soon as possible, even before it’s interpreted. But there’s a tradeoff between medical transparency and the worry that can be caused when a result is unclear, or even inaccurate.
    • A new study published in JAMA Network Open on Tuesday aims to understand how health systems might find the right balance. “We were curious if refresh, refresh, refresh behavior could be measured,” said senior author Trent Rosenbloom, who directs the patient portal at Vanderbilt University Medical Center. Over two years, researchers and physicians at Vanderbilt tracked how 290,000 patients at the medical center viewed their test results online. In 2022 and 2023, more than 100,000 patients — 37% of the total — refreshed the portal as they waited for results to appear. Some patients clicked to check their results as many as 16 times.  * * *
    • “Across health systems, information officers are working on other ways to ensure automatic test results are more of a benefit than a burden. At Stanford Medicine, said chief medical information officer Christopher Sharp, every primary care practice now uses large language models to generate interpretations of test results, which a doctor can sign off on to send to a patient. The system is also being piloted in specialties with more high-sensitivity results, and Stanford hopes to have it implemented across the entire organization by September.”

From the U.S. healthcare business front,

  • Beckers Payer Issue lets us know,
    • “Blue Cross and Blue Shield of North Carolina reported a net income of $69 million in 2024, Business North Carolina reported April 7. 
    • “The company recorded $11.9 billion of revenue in 2024, compared to $12.2 billion in 2023.
    • “Claims and medical expenses increased 7.2% to $10.4 billion in 2024, and the company’s reserves are equal to 3.3 months of claims and administrative expenses.”
  • Per Beckers Hospital Review,
    • “Despite economic volatility, Fitch still expects healthcare providers to experience a “modest margin expansion” this year due to easing inflationary pressures and reimbursement increases, according to an April 9 report.
    • “The firm anticipates healthcare providers will see Medicare and commercial rate bumps 3% to 4% this year as rates increase and the volume of high acuity cases grows with the aging population.
    • “The workforce challenges plaguing healthcare providers over the last several years are lessening as well, according to the report.
    • “Chronic personnel shortages will continue to ease, suppressing wage inflation and reducing reliance on costlier external agency labour,” the report notes. “Wages are unlikely to exert pressure on provider margins in 2025, with revenue growth likely to match or exceed wage growth.”
    • “The healthcare providers in a more stable financial situation will be in the best position to grow over the next few years. Struggling hospitals will continue to have challenges, and some may seek merger or acquisition partners to stay operational.”
  • Per Modern Healthcare,
    • “A court ruling striking down a federal nursing home staffing mandate brought a sigh of relief from nursing home operators even as the industry still faces financial uncertainty.
    • “An end to the mandate could bring stability to nursing home budgets and valuations. However, some nursing homes still face challenges, such as tougher state staffing minimums, as well as the threat of potential Medicaid rate cuts.
    • “A federal judge in Texas on Monday tossed the controversial nursing home mandate the Biden administration rolled out last year that required nursing homes to have a registered nurse onsite 24 hours a day, seven days a week. The court also blocked a requirement that nursing homes provide at least 3.48 hours of care per resident, per day.
    • “The Health and Human Services Department said in an email it does not comment on legal matters when asked about a possible appeal. However, many in the industry had been expecting the Trump administration to roll back the regulation.”
  • and
    • “Nonprofit health insurance company CareSource has invested more than $400 million to buy struggling nonprofit insurer Commonwealth Care Alliance. 
    • “The deal adds nearly 50,000 Dual Special Needs Plan members who are eligible for both Medicaid and Medicare to CareSource’s book of business, the companies said in a news release Wednesday. CareSource also acquired Commonwealth Care Alliance’s two primary care clinics and its home care practice through the transaction. CareSource counts 2 million Medicaid, Medicare and exchange plan enrollees across seven states.
    • “CareSource CEO Erhardt Preitauer will take over as head of Commonwealth Care Alliance, replacing current CEO Chris Palmeri, who will depart the company. Palmeri currently serves on the board of directors of the insurance lobbying group AHIP. At the start of the year, he stepped down from his role as board chair of the Association of Community Affiliated Plans, a nonprofit Medicaid insurer trade group.
    • “The deal had not been previously announced.” 

Tuesday Report

David Ermer–AHRQ, CDC, Congress, FDA, Generative AI, Medical / Rx research, Mental health care, SCOTUS, U.S. Healthcare–

From Washington, DC

  • NBC News reports,
    • “Speaker Mike Johnson, R-La., is facing a growing rebellion from conservative hard-liners in the House as Republicans seek to take up a budget blueprint that was recently adopted by the Senate to pass President Donald Trump’s agenda.
    • “House GOP leaders are eyeing a vote this week on the measure, which would unlock the path for committees to craft a massive bill to cut taxes, boost immigration enforcement and defense spending and lift the debt limit without Democratic votes.
    • “But a slew of House conservatives have blasted the Senate’s version for requiring just $4 billion in spending cuts. The House’s version, by contrast, called for $1.5 trillion to $2 trillion in spending cuts while largely steering clear of specifics.”
  • CBS News informs us,
    • “The Centers for Disease Control and Prevention has begun redeploying staff to respond to the deadly outbreak of measles in Texas, a spokesperson said Monday, a week after steep layoffs at the agency impacted its response to the spread of the virus. 
    • “A team of three deployed yesterday to meet with county and state officials to assess the immediate needs to respond to this outbreak. The team is meeting with officials again today,” CDC spokesperson Jason McDonald said in an email. 
    • “Health and Human Services Secretary Robert F. Kennedy Jr. first said Sunday that the CDC would be redeploying to Texas at its governor’s request, after another unvaccinated child died in the measles outbreak. An 8-year-old girl was the second fatality there this year.
    • “Once the assessment is complete, more CDC staff will be sent to Texas per Sec. Kennedy’s order and the governor’s request. The first teams deployed to Texas arrived on March and returned to CDC on April 1,” McDonald said.”
  • Per MedPage Today,
    • The U.S. Preventive Services Task Force (USPSTF) still recommends primary care behavioral counseling for breastfeeding, mostly in line with its 2016 guidelines.
    • In the updated recommendation statement published in JAMA, USPSTF wrote that “providing interventions or referrals, during pregnancy and after birth, to support breastfeeding” received a B grade, indicating moderate certainty these interventions will have moderate net benefit.

From the judicial front,

  • The Wall Street Journal tells us,
    • “The Supreme Court lifted a lower-court order that directed the Trump administration to reinstate about 16,000 federal employees it fired, handing the White House the third victory in a row as it seeks the justices’ emergency action to stop district judges from slowing its policies. 
    • “The justices on Tuesday said that environmental groups and other nonprofit organizations who say they were harmed by the reduction in public services caused by the layoffs didn’t have legal standing to bring suit. 
    • “The brief order was unsigned, as is typical when the court acts on emergency requests. Two liberal justices, Sonia Sotomayor and Ketanji Brown Jackson, said they voted to deny the Trump administration’s request.” * * *
    • “The Supreme Court on Tuesday agreed with the Trump administration that the nonprofits lacked legal standing to bring the case. The court added, though, that the order didn’t address other plaintiffs in the suit, including several labor unions and the state of Washington. Alsup’s injunction wasn’t based on their claims, although those parties may face other questions regarding their standing to bring suit.
    • “Tuesday’s order doesn’t resolve broader legal disputes over the administration’s mass layoffs of federal employees.”
  • Bloomberg Law relates,
    • “A string of lawsuits targeting the use of artificial intelligence and algorithms in claims denials is raising risks for private health insurers and employers, even as the litigation encounters early obstacles.
    • “A California federal judge’s recent decision to partially allow a case to proceed over Cigna Corp.’s alleged use of algorithms to improperly deny benefits signals that automation tools come with legal hazards.” * * *
    • “To the extent that these tools are being used to block or deny coverage across the board for medically necessary services and to a large number of beneficiaries—if that is the case and that’s how these have been used, that could expose insurers to significant risk,” said David Greenberg, partner at ArentFox Schiff LLP.
    • “Courts have allowed several lawsuits to proceed, but plaintiffs still face significant challenges in making their cases. In some instances, the insurance companies denied that the plaintiffs’ medical claims were even handled by an algorithm. Proving otherwise can be difficult.”

From the public health and medical research front,

  • The American Hospital Association News points out,
    • The Centers for Disease Control and Prevention April 8 sent an alert to health care providers on measles prevention and treatment. The agency said that risk remains low for most individuals across the U.S. and that the measles, mumps and rubella vaccine is the best way to protect against the disease. 
  • and
    • “The incidence of invasive group A strep infections increased from 3.6 to 8.2 cases per 100,000 people from 2013 to 2022, according to a study authored by the Centers for Disease Control and Prevention published April 7 by JAMA. The authors concluded that accelerated efforts to prevent and control these infections are needed, especially among groups at highest risk of infection, which includes individuals 65 years or older, American Indian or Alaska Native persons, residents of long-term care facilities, people experiencing homelessness, and people who inject drugs.” 
  • Per Medscape,
    • “Around 38 million people in the United States — or slightly over 11% of the population — have diabetes, according to the National Diabetes Statistics Report. Experts only expect that number to increase, and research suggests that the burden will be especially significant in low to low-middle socioeconomic areas.
    • “Consider the Mississippi Delta, a swath of fertile land in the floodplain of the Mississippi River. It has a rich and diverse cultural heritage, with a minority-majority population, along with significant economic challenges and a persistently high poverty rate. The region also has one of the highest diabetes rates in the country, which has put the healthcare community on alert.
    • “We are more intensely screening almost everybody,” said Brent Smith, MD, a family physician in Greenville, Mississippi, and a member of the board of directors of the American Academy of Family Physicians.”
  • AP reports,
    • “Health care systems can reduce suicides through patient screening, safety planning and mental health counseling, a new study suggests, an important finding as the U.S. confronts it 11th leading cause of death.
    • “The “Zero Suicide Model” was developed in 2001 at Detroit-based Henry Ford Health, where the focus on people considering suicide included collaborating with patients to reduce their access to lethal means such as firearms and then following up with treatment.
    • “The approach made a difference, and for all of 2009, the health system saw no suicides among patients. The researchers then studied what happened when a different health system, Kaiser Permanente, adopted the program in four locations from 2012 through 2019.
    • “Suicides and suicide attempts fell in three of the locations, while the fourth maintained a low rate of suicides and attempts. Suicide attempts were tracked in electronic health records and insurance claims data. Suicides were measured using government death records.”‘
  • The Washington Post notes,
    • “Those who exercised the most had a 26 percent lower cancer risk than those who exercised the least in an analysis of biomedical data, according to research published in the British Journal of Sports Medicine.
    • “The article drew upon data from UK Biobank, a longitudinal study that enrolled 500,000 adults in Britain between 2006 and 2010. After enrolling, more than 106,000 adults were invited to participate in the sub-study on physical activity. The final sample, stratified into five groups, or quintiles, of physical activity levels, included about 85,000 participants with a median age of 63 years.” * * *
    • “The research identified an inverse relationship between overall daily physical activity and cancer risk, indicating that even modest increases in activity levels were sufficient to significantly reduce the risk of the 13 cancers. Individuals in the second-highest quintile of physical activity had a 16 percent lower risk compared with those in the lowest quintile. Higher levels of activity had a more protective effect.”
  • Per MedTech Dive,
    • “Johnson & Johnson said Monday it has enrolled the first patient in a pivotal study of a device for clearing “difficult-to-cross” coronary arteries.
    • “Like other products made by J&J’s Shockwave Medical, the Javelin intravascular lithotripsy catheter uses sound pressure waves to break up calcium deposits that are blocking blood flow. 
    • “The device is differentiated from other Shockwave products, and rival catheters from Abbott and Boston Scientific, because it emits waves from its tip. Other devices send waves from a balloon catheter that must cross the blocked part of the artery to be effective.” * * *

From the U.S. healthcare business front,

  • Per Beckers Hospital Review,
    • “Hospital average operating margins dropped from 3.4% in January to 2.5% in February, but are still above 2024 averages, according to Kaufman Hall’s “National Hospital Flash Report.”
    • “Kaufman Hall, a Vizient company, gathered financial performance data from 1,300 hospitals. The average operating margin dropped 11% month over month but grew 5% year over year. The average operating EBITDA margin decreased 7% month over month but grew 1% year over year.
    • “Net operating revenue per calendar day increased 8% year over year, driven by an 11% jump in inpatient revenue. Outpatient revenue grew just 8% compared to February 2024.
    • “Expenses were also on the rise, with total expenses also up 8% year over year driven by a 10% growth in supply expenses per calendar day. Drug expenses and non-labor expenses both jumped 9% while labor expenses grew 6% year over year. Purchased services expenses also increased 13% from February 2024.
    • “Patient volume held steady, as discharges per calendar day were up 6% year over year in February. Observation days dropped 9% and the average length of stay was flat compared to the same period last year. Emergency department visits increased 4%.”
  • Modern Healthcare adds,
    • “Health systems announced five hospital merger and acquisition proposals in the first three months of the year, the lowest quarterly amount in more than a decade.
    • “Providers were reluctant to wade into hospital transactions amid the uncertainty surrounding tariffs, federal funding concerns, state and federal regulatory changes and economic volatility, according to a new report from consultancy Kaufman Hall. Four of the five proposed hospital deals involved financially distressed facilities, the report found.”
  • Specifically, Fierce Healthcare reports,
    • “Northwell Health and Nuvance Health’s 28-hospital merger has cleared its final regulatory hurdle and is expected to close within the next 30 days.
    • “Tuesday, Connecticut’s Office of Health Strategy announced it had reached an agreement with the two health systems after just over two months of negotiations over their Certificate of Need application. The pair’s merger, announced 14 months ago, had received a similar all-clear from New York’s Public Health and Health Planning Council last September as well as sign-offs from each state’s attorneys general during the summer.
    • “Alongside price constraints tied in part to state and regional cost growth benchmark, Northwell—the acquirer—will invest at least $1 billion into Nuvance’s Connecticut and New York hospitals and refrain from any real estate sale leasebacks over a five-year period.”
  • Fierce Healthcare also lets us know,
    • “Rural hospital leaders are questioning whether they can continue to afford to do business with Medicare Advantage (MA) companies, and some say the only way to maintain services and protect patients is to end their contracts with the private insurers.
    • “MA plans pay hospitals lower rates than traditional Medicare, said Jason Merkley, CEO of the Brookings Health System in South Dakota. Merkley worried the losses would spark staff layoffs and cuts to patient services. So, last year, Brookings Health dropped all four contracts it had with major MA companies.
    • “I’ve had lots of discussions with CEOs and executive teams across the country in regard to that,” said Merkley, whose health system operates a hospital and clinics in the small city of Brookings and surrounding rural areas.
    • “Merkley and other rural hospital operators in recent years have enumerated a long list of concerns about the publicly funded, privately run health plans. In addition to the reimbursement issue, their complaints include payment delays and a resistance to authorizing patient care.
    • “But rural hospitals abandoning their MA contracts can leave local patients without nearby in-network providers or force them to scramble to switch coverage.”
  • Per Healthcare Dive,
    • “CVS Health named a new CFO Tuesday as the healthcare giant continues to shake up its leadership team. 
    • “Brian Newman, most recently CFO of shipping and logistics firm UPS, will start at CVS on April 21. Tom Cowhey, who took on the permanent CFO position at CVS early last year, will become a strategic advisor to CEO David Joyner, effective May 12. 
    • “In addition to the leadership change, CVS said it expects financial results for 2025 to meet or exceed its previously issued guidance. In February, the company reported expected adjusted earnings for the year between $5.75 and $6 a share.” 
  • Per Beckers Hospital Review,
    • “Walgreens Boots Alliance reported a $5.6 billion operating loss in its fiscal second quarter, an improvement from the $13.2 billion loss in the same period last year as the troubled retailer continues to prepare for a private equity buyout. 
    • “Operating losses included a $3 billion impairment charge tied to its Village MD business, according to an April 8 company news release. 
    • “Despite ongoing challenges, Walgreens reported better than expected results in sales, with sales rising 4% to $38.59 billion. In addition, pharmacy sales rose 12% while retail sales fell by 3%. 
    • “The company announced last month that it would be acquired by Sycamore Partners in a deal valued at $10 billion. Walgreens also recently suspended its quarterly dividend part of a broader cost cutting effort.”
  • Per Fierce Pharma,
    • “While much of the recent GLP-1 saga has been written in the U.S., Novo Nordisk continues to expand its semaglutide empire across the globe and make inroads into large markets like Brazil.
    • “Now, in a bid to boost its production capacity in Latin America’s most populous country, Novo is plugging 6.4 billion Brazilian reais (roughly $1.09 billion) into an expansion of its manufacturing plant in the Brazilian city of Montes Claros.
    • “The investment, which marks one of the largest ever for pharmaceuticals in Brazil, will “significantly” bolster the facility’s capacity to crank out a variety of injectables, including GLP-1 medicines like Ozempic and Wegovy, Novo said in a Portuguese-language press release.”

From the artificial intelligence front,

  • Cardiovascular Business reports,
    • “Powerful Medical, a New York-based artificial intelligence (AI) company, has received the FDA’s breakthrough device designation for its AI model designed to detect signs of an ST-elevation myocardial infarction (STEMI) in electrocardiography results.
    • “The company’s PMcardio STEMI AI ECG model, nicknamed “Queen of Hearts,” identifies STEMI and STEMI-equivalent patterns in a patient’s ECG. It was trained by Stephen W. Smith, MD, an emergency physician at Hennepin County Medical Center and founder of Dr. Smith’s ECG Blog.
    • “For the last 20 years, life-saving treatment exists for heart attack patients, yet far too many still don’t receive the urgent care they need due to delays in diagnosis and inefficient triage,” said Robert Herman, MD, PhD, chief medical officer of Powerful Medical, said in a statement. “By equipping physicians and allied providers with an AI-powered tool for accurate and immediate STEMI detection, available around the clock, we can bridge this gap, ensure timely treatment, and improve patient outcomes, often preventing avoidable deaths.”
  • and
    • “Artificial intelligence (AI)-assisted mammography may be able to predict a woman’s risk of developing cardiovascular disease, according to new data being presented at ACC.25, the American College of Cardiology’s annual conference.
    • “Breast artery calcifications are already visible when radiologists review mammograms, but nothing typically happens with those findings. Researchers aimed to see if AI could do some of the heavy lifting and help translate those findings into an easy-to-understand cardiovascular risk score.
    • “The group trained an advanced AI model to segment calcified vessels in mammography images and produce a risk score that calculates the patient’s risk of developing heart disease. To help make the new-look algorithm as accurate as possible, they developed it using mammography images and electronic health record data from more than 56,000 patients. The patients were all treated from 2013 to 2020 within the Emory Healthcare health system, and at least five years of follow-up data were available for each of them.
    • “Advances in deep learning and AI have made it much more feasible to extract and use more information from images to inform opportunistic screening,” lead author Theo Dapamede, MD, PhD, a postdoctoral fellow at Emory University in Atlanta, said in a statement.”
  • Per Beckers Clinical Leadership,
    • “An AI tool that analyzes nurses’ notes for subtle clinical changes helped reduce patient risk of death by 35.6%, length of stay by 11.2% and sepsis risk by 7.5%, according to research published April 2 in Nature. 
    • “In a yearlong, multisite study, researchers assessed the tool across 74 clinical units in two health systems. Among 60,893 hospital encounters, about half involved the early warning system and the other half did not. 
    • “The system, dubbed COmmnuticating Narrative Concerns Entered by RNs (CONCERN), is a machine learning algorithm that uses real-time nursing surveillance notes and data patterns to detect all-cause deterioration risks. 
    • ‘Other EWSs often “rely on late and noisy physiologic indicators of deterioration” such as lab results and vital signs, according to the researchers. In contrast, this tool leverages nurses’ “subtle, yet observable, clinical changes that may not be captured in physiological data or well displayed in EHRs,” including small changes in mental status from baseline or slower recovery of arterial blood pressure after turning a patient.” 

Friday Report

David Ermer–CDC, CMS, Congress, COVID-19, FDA, Generative AI, Medical / Rx research, Medicare, Rx coverage, U.S. Healthcare–
Photo by Sincerely Media on Unsplash

From Washington, DC,

  • The American Hospital Association News reports,
    • “The Senate over the weekend is expected to cast a final vote on its revised budget resolution for fiscal year 2025. Senate Republicans April 3 voted to proceed on the resolution which kicked off debate. Today the Senate was slated to debate and process a number of amendments before holding a final vote on the resolution. The budget resolution is expected to pass and move to the House for consideration next week.” 
  • Per a CMS fact sheet,
    • The Centers for Medicare & Medicaid Services (CMS) issued a final rule on April 4, 2025, that modernizes and improves Medicare Advantage (MA), Medicare Prescription Drug Benefit (Part D), Medicare cost plan, and Programs of All-Inclusive Care for the Elderly (PACE) programs. The Contract Year (CY) 2026 MA and Part D final rule implements changes related to prescription drug coverage, the Medicare Prescription Payment Plan, dual eligible special needs plans (D-SNPs), Star Ratings, and other programmatic areas, including the Medicare Drug Price Negotiation Program. This final rule also codifies existing sub-regulatory guidance in the MA and Part D programs. 
    • CMS is not finalizing certain provisions from the proposed rule at this time. CMS may address these proposals in future rulemaking, as appropriate. CMS is also announcing that it is not finalizing three provisions from the proposed rule (Enhancing Health Equity Analyses: Annual Health Equity Analysis of Utilization Management Policies, Procedures and Ensuring Equitable Access to Medicare Advantage Services—Guardrails for Artificial Intelligence, and Part D Coverage of Anti-Obesity Medications (AOMs) and Application to the Medicaid Program). 
    • This fact sheet discusses the major provisions of the CY 2026 MA and the Part D final rule. The final rule can be downloaded here: https://www.federalregister.gov/public-inspection/2025-06008/medicare-and-medicaid-programs-contract-year-2026-policy-and-technical-changes-to-the-medicare. 
  • The Wall Street Journal emphasizes,
    • “The Trump administration said Friday that Medicare and Medicaid won’t expand coverage of popular anti-obesity drugs, rejecting a proposal issued late last year by the Biden administration.
    • “The decision deals a blow, at least for now, to Americans who are covered by the government health-insurance programs and wanted their help paying for the popular but pricey drugs. 
    • “Yet the administration left open the possibility of revisiting the decision later.
    • “Expanding coverage of the obesity medications “is not appropriate at this time,” a Centers for Medicare and Medicaid Services spokeswoman said.
    • “She said CMS may reconsider the policy after more review of the drugs’ “potential benefits” and “relevant costs,” including costs to state Medicaid agencies.”
  • For perspective, STAT News pointed out last September
    • A new report from congressional budget experts this week estimated that it would cost Medicare an additional $35 billion over nine years if the program began covering GLP-1 drugs for obesity. But the report also noted that half of seniors who would qualify for obesity coverage already have access to the drugs for other conditions.
  • Per a House Budget Committee news release,
    • “House Budget Committee Chairman Jodey Arrington (R-Texas) today appointed Budget Committee Member Rep. Blake Moore (R-Utah) to chair the Committee’s Health Care Task Force. 
    • “The Task Force will build on its work from the 118th Congress by examining opportunities to modernize and personalize the health care system and support policies to fuel innovation and increase patient access to quality and affordable care. One of the initial areas of focus for the Budget Health Care Task Force will be examining the budgetary effects of chronic disease and opportunities to Make America Healthy Again.” 
  • Per an HHS news release,
    • “HHS Secretary Robert F. Kennedy, Jr. will embark [next Monday through Wednesday] on a multi-state tour to celebrate MAHA initiatives in the Southwest. He will meet with elected officials, tribal leaders, nutrition experts, and charter school visionaries as he works to fulfill President Trump’s promise to Make America Healthy Again.

From the public health and medical research front,

  • The Center for Disease Control and Prevention announced today,
    • “Seasonal influenza activity continues to decline. COVID-19 and RSV activity are declining nationally to low levels.
    • COVID-19
      • “COVID-19 activity is declining nationally to low levels. Wastewater levels and emergency department visits are at low levels, and laboratory percent positivity is stable. Emergency department visits and hospitalizations are highest in older adults and emergency department visits are also elevated in young children.
      • “There is still time to benefit from getting your recommended immunizations to reduce your risk of illness this season, especially severe illness and hospitalization.
      • “CDC expects the 2024-2025 COVID-19 vaccine to work well for currently circulating variants. There are many effective tools to prevent spreading COVID-19 or becoming seriously ill.
    • Influenza
    • RSV
      • “RSV activity is declining in most areas of the country. Emergency department visits and hospitalizations are highest in children and hospitalizations are elevated among older adults in some areas.
    • Vaccination
      • “Vaccination coverage with influenza and COVID-19 vaccines is low among U.S. adults and children. Vaccination coverage with RSV vaccines remains low among U.S. adults. Many children and adults lack protection from respiratory virus infections provided by vaccines.”
  • The AHA News tells us,
    • “There are 607 confirmed cases of measles across the U.S., according to the latest data released April 4 by the Centers for Disease Control and Prevention. The majority of cases are in Texas, as an outbreak in the state has grown to 481 cases, according to the Texas Department of State Health Services.  
    • “Cases have been reported by 21 states, with 93% being outbreak-associated, according to the CDC. The vaccination status of 97% of cases is classified as “unvaccinated or unknown.” 
  • Per Health Day,
    • “Strokes caused by an artery tear are landing five times as many Americans in the hospital these days, a new study says.
    • “Cervical artery dissection involves a small tear in the inner lining of an artery in the neck that supplies blood to the brain.
    • “Blood can clot at the site of the tear. If the clot breaks loose, it can travel to the brain and cause a stroke.
    • “Hospitalizations for this sort of stroke have increased nearly fivefold during the past 15 years, according to findings published April 2 in the journal Neurology.
    • “Cervical artery dissection is an important cause of stroke, especially in people under 50, so it is crucial to detect it right away,” senior researcher Dr. Shadi Yaghi, a vascular neurologist at Brown University in Providence, R.I., said in a news release.
    • “Strokes that are not fatal can lead to long-term disability, poor mental health and reduced quality of life,” he said. “Our research found a dramatic increase in the number of hospitalizations for cervical artery dissection, with rates rising steadily year over year.” 
    • “These sort of tears in the cervical artery are most often caused by a motor vehicle crash or other accident that causes neck strain, researchers said. However, activities as simple as heavy lifting has been known to cause a cervical artery tear in some people.”
  • The New York Times shares “10 Small Things Neurologists Wish You’d Do for Your Brain. Easy everyday habits can help keep you sharp. And it’s never too late to start them.”
  • Per MedTech Dive,
    • “Boston Scientific’s pulsed field ablation catheter, Farapulse, was noninferior to Medtronic’s Arctic Front cryoballoon in a randomized trial, researchers found in a study published in The New England Journal of Medicine.
    • “The study, which was published Monday and funded by a Swiss hospital, randomized 210 patients with symptomatic paroxysmal atrial fibrillation to undergo PFA or cryoablation. Atrial tachyarrhythmia, a heart rhythm disorder where the atria beat too fast, recurred in 39 patients in the PFA cohort and 53 people in the cryoablation group.
    • “Medtronic reported declines in its cryoablation business last year but said the losses were offset by growth of its PulseSelect single-shot catheter, which competes with Farapulse for the growing PFA market.”

From the U.S. healthcare business front,

  • Fierce Healthcare informs us,
    • “Rural areas are quickly losing independent physicians and medical practices amid the corporatization of healthcare, a new report finds.
    • “The report was commissioned by the Physicians Advocacy Institute (PAI), a nonprofit advocacy organization focused on fair and transparent payment policies. The research, conducted by Avalere Health, used the IQVIA OneKey database, which contains physician and practice location information on health system ownership.
    • “The number of independent doctors in rural areas fell 43% from January 2019 to January 2024, with rural areas losing 5% of all practicing physicians. Meanwhile, people in rural areas had access to 11% fewer medical practices as of January 2024.
    • “Nearly 9,500 doctors left independent practice in rural areas, predominantly in the Midwest and Northeast. States like Indiana, Massachusetts, New Jersey and Ohio lost more than 50% of independent docs.
    • “This decline in rural healthcare providers has been primarily driven by a drop in independent docs and practices as well as the acquisition of these practices by hospitals and corporate entities, the report said.” 
  • Beckers Hospital Review lets us know,
    • “South Bend, Ind.-based Beacon Health System has signed a definitive agreement to acquire Ascension Michigan’s southwest region, which includes four hospitals, 35 outpatient clinics and an ambulatory surgery center.
    • “The hospitals include:
      • “Ascension Borgess Hospital (Kalamazoo)
      • “Ascension Borgess Allegan Hospital
      • “Ascension Borgess-Lee Hospital (Dowagiac)
      • “Ascension Borgess-Pipp Hospital (Plainwell)
    • “Expanding our reach deeper into southwest Michigan broadens access to high-quality, affordable care for communities served by Ascension, extends our service area and provides growth opportunity to further strengthen the health system,” Beacon Health CEO Kreg Gruber said in an April 3 news release. “This acquisition will create a bright future for these communities by ensuring access to quality healthcare services for generations.”
  • Per Fierce Pharma,
    • “With a label expansion for Uplizna pushing the drug into an untouched rare disease market, Amgen is getting its money’s worth out of another drug from its $27.8 billion Horizon Therapeutics buy. 
    • “Uplizna is the first drug to win an FDA approval for immunoglobulin G4-related disease (IgG4-RD), a chronic inflammatory condition that can present in multiple organs and cause fibrosis and permanent organ damage, with or without symptoms.
    • “The CD19-targeted therapy made strides in treating the disease in its phase 3 MITIGATE trial. In the study, Uplizna demonstrated an 87% reduction in the risk of IgG4-RD flares over placebo during the 52-week placebo-controlled period, with 10.3% of those on Uplizna experiencing a flare-up compared to 59.7% of those taking placebo.
    • “With the approval, patients and physicians now have a “proven treatment that targets a key driver of the disease, reducing the risk of flares and reliance on harmful long-term steroid use,” Amgen’s executive vice president of R&D Jay Bradner, M.D., said in a company release. “This approval underscores Amgen’s ongoing commitment and leadership in developing innovative treatments targeting CD19+ B-cells across multiple therapeutic areas.”
    • “Now, the road ahead for Amgen’s success in IgG4-RD lays in raising awareness of the rare disease, which was only recently established with an International Classification of Diseases code in 2023. About 20,000 people are estimated to have the disease in the U.S., but the exact number is hard to pinpoint due to limited data, according to Amgen.”
  • and
    • “As the respiratory syncytial virus (RSV) vaccine field grapples with a significantly reduced market size thanks to regulatory uncertainties, GSK and Pfizer have decided to lay to rest their patent feud.
    • “GSK and Pfizer have moved to scrap a patent lawsuit around their respective RSV vaccines, according to a filing in the U.S. District Court in Delaware.
    • “The settlement comes after a U.K. high court in November sided with Pfizer, ruling that two GSK RSV vaccine patents were invalid.”

From the artificial intelligence front,

  • Beckers Payer Issues discusses how health plans can use “AI to Drive Patient Outcomes & Health Plan ROI.”
  • Modern Healthcare adds,
    • “Artificial intelligence and other cutting-edge innovations could radically reshape how care is delivered, but tapping technology’s full potential and getting a return on investments is far off, according to industry executives.
    • “We need enduring, ambitious vision,” said Dr. Vivek Garg, chief medical officer at Humana’s CenterWell healthcare services division, during Modern Healthcare’s 2030 Playbook conference in Nashville Wednesday. “You’re going to need the leadership and the board to make trade-offs and to make investments. …They’ve got to do it because they know what they stand for, and they want to see what they can become and how much further they can go in their vision.” * * *
    • “More collaboration between payers and providers is imperative, said Mike Bennett, chief strategy and transformation officer at Highmark Health.
    • “If we both don’t start working together and using the tools we both have, we’re going to end up leaving [our populations] behind,” Bennett said. “AI doesn’t care whether you’re a payer or provider.”

Happy National Employee Benefits Day!

David Ermer–ACA, CDC, Congress, FDA, NIH, Rx coverage, SCOTUS, U.S. Healthcare–

“National Employee Benefits Day is celebrated each year in April. The day recognizes trustees, administrators, benefits practitioners and professional advisors for their dedication to providing quality benefits and the important role they play in their colleagues’ well-being.”

From Washington, DC,

  • The Wall Street Journal reports
    • “Senate Republicans rallied behind a fiscal framework that allows more than $5 trillion in tax cuts over a decade, taking a crucial step toward turning President Trump’s agenda—tax cuts, border security and national defense—into law. 
    • “But the GOP budget resolution released Wednesday won’t be the final word along the complicated path to a major tax and spending bill. The plan employs a controversial accounting maneuver, postpones decisions about spending cuts and conflicts with a competing House plan. 
    • “The Senate is likely to vote on its budget later this week, but key House members are already objecting, warning that the Senate’s approach doesn’t guarantee the deep spending cuts they see as necessary.”
  • Modern Healthcare adds,
    • “The Senate Budget Committee unveiled a budget resolution Wednesday that could pave the way to less draconian cuts in health programs than House lawmakers previously proposed.
    • “The Senate proposal includes the House’s earlier recommendations that could lead to billions in health program cuts — but it also includes instructions for the Senate to go a different route while renewing tax cuts passed during President Donald Trump’s first term. The upper chamber’s resolution would delay sorting out differences with the House.
    • “The Senate’s budget resolution and negotiations with the lower chamber could provide for greater flexibility around healthcare cuts, which moderate Republicans in the House said they would not support if they were too steep. It also means the healthcare sector will have to wait to see what healthcare cuts — or spending — could be on tap until the Senate has done its work.”
  • Per a news release, “Today, Health, Employment, Labor, and Pensions Subcommittee of the House Education and Labor Committee held a hearing titled “A Healthy Workforce: Expanding Access and Affordability in Employer-Sponsored Health Care.”
  • Modern Healthcare points out,
    • “The Health and Human Services Department is restructuring agencies that enforce regulation, handle claims disputes, and investigate potential civil rights violations as part of a department-wide reorganization.
    • “A new assistant secretary for enforcement will oversee three parts of HHS — the Departmental Appeals Board, the Office of Medicare Hearings and Appeals and the Office of Civil Rights — as part of a sweeping overhaul announced last week. The new role raises questions about how HHS plans to handle billions of dollars in claims disputes and appeals resolutions, as well as how the offices will operate within the new structure. Healthcare attorneys are also watching for how HHS handles the operational elements of the reorganization, including staffing decisions and the chain of command at the affected offices.”
  • Fierce Healthcare lets us know,
    • “President Donald Trump made good on his threat of announcing new and steeper tariffs during a Wednesday afternoon White House event, setting the stage for higher prices and supply chain uncertainty for numerous industries including healthcare.
    • “The tariffs, set to go into effect at midnight, are the largest trade policy shift for the U.S. in decades and an end to the so-called free-trade era. They include a minimum 10% tariff that affects “all countries,” according to the White House. 
    • “Additionally, a slew of higher, individualized reciprocal tariffs will go into effect for dozens of countries with which the U.S. has a large trade deficit, the White House said. These are broadly designed to be around half of those imposed by most trade partners, including longtime allies.
    • “A 39% European Union tariff rate, for instance, will be matched by a 20% rate, the president explained. A 67% tariff imposed by China will see a reciprocal 34% tariff from the U.S.
    • “Pharmaceuticals are among a select list of goods that will not be subject to the higher reciprocal tariffs, according to a fact sheet released shortly after the signing ceremony and affirmed in the signed executive order. 
    • “The president also signed an order to close the “de minimis loophole,” a trade policy signed into law by Congress that allows shipments valued at less than $800 to be duty-free, for Chinese imports.”
  • Healthcare Dive points out,
    • “Enrollment in the Affordable Care Act marketplaces reached a new high in 2025, boosted by growth in states won by President Donald Trump in last year’s election, according to a research brief by KFF. 
    • “Sign-ups in the insurance marketplaces have more than doubled over the past five years, increasing from 11.4 million in 2020 to 24.3 million in 2025, the health policy research firm said Wednesday. 
    • “Much of the growth is linked to more generous federal financial assistance for the health plans first made available in 2021, according to KFF. But those enhanced premium subsidies are set to expire at the end of the year absent congressional action.”
  • The Wall Street Journal relates,
    • “Federal drug regulators have missed the deadline for making a key decision regarding a Covid-19 vaccine from Novavax, days after the Food and Drug Administration’s vaccine chief was pushed out.
    • “The agency was set to give full approval to Novavax’s shot, but senior leaders at the agency are now sitting on the decision and have said the Novavax application needed more data and was unlikely to be approved soon, people familiar with the matter said. 
    • ‘The FDA has allowed emergency use of Novavax’s Covid-19 vaccine. It set an April 1 deadline for a decision on whether to grant a normal, full approval, the people said.
    • “The decision would have cleared the vaccine’s continuing use though the pandemic emergency has passed. The FDA gave full approval to Covid-19 shots from Pfizer and its partner BioNTech and from Moderna in 2021 and 2022, respectively.
    • “Novavax said it is “continuing to communicate with the FDA and dialogue to ensure they have all the information required to complete our” application. 
    • “A Health and Human Services Department spokesman declined to comment. The FDA didn’t immediately respond to requests for comment.”

From the judicial front,

  • Bloomberg Law reports,
    • “Portions of a Tennessee law aimed at increasing pharmacy access are preempted by the federal employee benefits statute and can’t be enforced against certain self-funded employer health plans, a federal judge ruled.
    • “The law’s “any-willing-provider” requirement—which limits a plan’s ability to exclude pharmacies from its network—has an “impermissible connection” with benefit plans governed by the Employee Retirement Income Security Act, Judge Charles E. Atchley Jr. said Monday for the US District Court for the Eastern District of Tennessee. That’s because it dictates the scope of provider networks eliminates plans’ “discretion to shape benefits as they see fit,” he said.
    • “ERISA also preempts the Tennessee law’s prohibition on using financial incentives to promote or discourage use of a particular pharmacy, Atchley said, explaining that the law prevents ERISA-governed plans from “designing and providing benefits in a way that the plan determines best serves participants.”
    • “The decision is a victory for commercial bakery McKee Foods Corp., which initially filed suit to counter a campaign by defendant Thrifty Med Plus Pharmacy to be reinstated in the pharmacy network for McKee’s employee health plan.” * * *
    • “The case is McKee Foods Corp. v. BFP Inc., E.D. Tenn., No. 1:21-cv-00279, 3/31/25.”
  • The Wall Street Journal reports,
    • “The Federal Trade Commission’s [internal] lawsuit against three large pharmacy-benefit managers over insulin prices is on hold after President Trump fired two of the agency’s commissioners. 
    • “The FTC this week halted a lawsuit against the country’s largest drug middlemen, which negotiate drug prices for employers and insurers. The FTC said it needs to pause the litigation because its two remaining commissioners, both Republicans, are recused from the case, leaving none to oversee it.
    • “The antitrust enforcer in September 2024 sued Cigna’s Express Scripts, UnitedHealth Group’s Optum Rx and CVS Health’s CVS Caremark, accusing the firms of inflating the price of insulin. The lawsuit said firms profited by pocketing the discounts they had negotiated for the higher-priced insulin products they steered their customers to buy.
    • The FTC said in a court filing that the companies had agreed to put the case on hold for at least 105 days.”

From the public health and medical research front,

  • The AHA News informs us,
    • “A National Institutes of Health study published today found that blood pressure patterns observed during the first half of pregnancy can determine a woman’s risk of developing hypertension up to 14 years after giving birth. The study found that women showing certain blood pressure patterns during the first 20 weeks of pregnancy were more likely to develop hypertension years later. Researchers identified six risk groups of blood pressure trajectory that ranged from ultra-low to elevated-stable patterns. Women with elevated-stable patterns were at the highest risk.” 
  • Per Beckers Hospital Review,
    • “Lung cancer screening more than tripled after the U.S. Preventive Services Task Force expanded screening eligibility in 2021, according to a March 20 research letter published in JAMA Oncology.” * * *
    • “Read the full analysis here.” 
  • Nevertheless, MedPage Today cautions,
    • “Among eligible populations, screening for breast and colorectal cancers was nearly four times more common than for lung cancer.
    • “Among those who never had lung cancer screening, roughly 60% had undergone screening for breast and colorectal cancers.
    • “The findings suggest individuals eligible for low-dose CT screening may be receptive to efforts aimed at increasing uptake.”
  • Per Medscape,
    • “Two recent studies have added to the growing body of research suggesting consuming more dairy reduces a person’s risk of getting colorectal cancer.
    • “A prospective cohort study in Nature Communications published in January looked at the incidence of colorectal cancer (CRC) in more than 540,000 UK women over 16 years and found a 14% reduced risk for the cancer for every 200 g of dairy milk consumed per day. It also found an 8% reduced risk per 50 g of yogurt per day.
    • “The other study, from GutMicrobes, also published in January, looked specifically at yogurt intake with a focus on Bifidobacterium, a bacteria commonly found in yogurt. The researchers found that people who had at least two servings per week of yogurt had a 20% lower risk for Bifidobacterium-positive tumors than those who had less than one serving per month of yogurt, “suggesting the antitumor effect of yogurt intake on the specific tumor subgroup.” 

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Jobs in the health insurance industry fell last year, something that hasn’t happened since 2009 and bucked an uptick in overall employment.
    • “It is a turning point for the industry, after years of profit growth and strategic expansions into pharmacy and provider businesses that increased headcount. Some of the largest publicly traded insurers reported steep workforce declines, according to a Modern Healthcare analysis of regulatory filings.
    • “Elevance Health, Humana, UnitedHealth Group and Centene cut their workforces, with the biggest reductions coming from the latter two companies. CVS Health and Molina Healthcare kept their workforce steady. Cigna grew its headcount nearly 1.4%.
    • “Across the seven companies, employment dipped 4.6% in 2024. Moreover, when not accounting for UnitedHealth Group, which reported a major reduction overseas, staffing among the other six still slipped 1.4%. National employment across all industries grew 1.2% last year, according to the Bureau of Labor Statistics.
    • “It was such a growth story for many years, and that’s tapered a little bit,” said Judy Busby, senior vice president and managing director of insurance staffing company The Jacobson Group.”
  • Per Beckers Hospital Review,
    • “Nonradiologists interpreted 43.6% of office-based imaging studies in 2022, according to a study published April 2 in the American Journal of Roentgenology. 
    • “Researchers from the Harvey L. Neiman Health Policy Institute analyzed more than 1.6 million Medicare physician office-based imaging claims ordered by nonradiologists. They found that just 36.4% of the studies were interpreted by a radiologist.” * * *
    • “For imaging type, nonradiologists interpreted 52% of ultrasound images, 5.3% of CT scans and 6.1% of MRIs. Smaller practices — those with one to nine providers — had a higher rate of self-interpretation than practices with 500 or more physicians.”Our results raise potential implications for quality of patient care,” Vijay Rao, MD, senior vice president of enterprise radiology at Philadelphia-based Jefferson Health and one of the study’s authors, said in a news release. “The large differences between radiologists and nonradiologists in interpretation training could lead to differences in diagnostic accuracy.”
  • Per MedTech Dive,
    • “Artis BioSolutions emerged from stealth Wednesday, announcing that it has acquired Landmark Bio, an alliance of academic institutions, hospitals and biotech companies founded in 2021 to help turn research ideas into broadly available genetic medicines.
    • “Landmark will continue to operate as a distinct entity, based in Watertown, Massachusetts. The acquisition by Artis BioSolutions will allow Landmark to scale up operations and “bring breakthrough therapies to more patients” Landmark CEO Ran Zheng said in a statement.
    • “Artis BioSolutions, backed by the venture capital firm Oak HC/FT, is now well positioned as a contract development and manufacturing organization for advanced therapies, the company said Wednesday. Artis BioSolutions said it can help customers speed up timelines, lower manufacturing costs and improve both product quality and supply chain management.”
  • The Wall Street Journal reports,
    • “Hims & Hers’s addition of obesity drug Zepbound won’t do much to bolster its weight-loss business, analysts say.
    • “Hims & Hers has been selling a compound GLP-1 for around $165 a month but will now offer the brand-name Zepbound for around $1,900 a month. Investors worry patients won’t make that price leap and that Hims, which has built its business on affordable healthcare, will struggle to meet its revenue goal.
    • “It’s probably unlikely that a compounded GLP-1 customer at Hims that’s paying $165 per month is going to transition to paying $1,900 per month for the fully branded,” Needham analyst Ryan MacDonald said. “There’s a question about how achievable the weight-loss revenue guidance is for 2025.”

Tuesday Report

David Ermer–CDC, CMS, Congress, FDA, Medical / Rx research, NIH, Obesity, Patient safety, Rx coverage, U.S. Healthcare–

From Washington, DC,

  • The Wall Street Journal reports
    • “The Trump administration began broad staff cuts at the Health and Human Services Department, locking some workers out of federal buildings and reassigning others to new agencies including the Indian Health Service.
    • “Emails notifying employees of cuts and reassignments flooded inboxes on Monday night and Tuesday morning. The move is part of Health and Human Services Secretary Robert F. Kennedy Jr.’s strategy to shrink and reshape the nation’s health agencies.
    • “The cuts extend far and wide, from the Food and Drug Administration and the National Institutes of Health to the Centers for Disease Control and Prevention. 
    • “On the social-media platform X, Kennedy said what the government had been doing wasn’t working: “We must shift course. HHS needs to be recalibrated to emphasize prevention, not just sick care. These changes will not affect Medicare, Medicaid, or other essential health services.” 
    • “An HHS spokesman said the cuts wouldn’t affect drug or food reviewers or inspectors. “This critical work continues,” he said.”
  • Per a Senate committee press release,
    • “Today, U.S. Senators Bill Cassidy, M.D. (R-LA), chair of the Senate Health, Education, Labor, and Pensions (HELP) Committee, and Bernie Sanders (I-VT), ranking member of the HELP Committee, sent a letter to Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., inviting him to participate in a[n April 10, 2025,] HELP Committee hearing on the reorganization of HHS.”
  • Federal News Network adds,
    • “The departments of Agriculture, Defense, Energy, Transportation and Housing and Urban Development, as well as the Small Business Administration and the General Services Administration, have all restarted their deferred resignation programs, Federal News Network has confirmed.
    • “The “fork in the road” relaunch at those seven agencies comes at the same time many agencies are beginning to take on plans for conducting reductions in force (RIFs).”
  • Fierce Healthcare discusses what’s going on with Dr. Mezmet Oz’s efforts to be confirmed as CMS Director.
  • Healthcare Dive reports,
    • “Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., sent letters to HHS officials last week demanding the CMS and the Health Resources and Services Administration look into the growing problem of “line skipping” in organ donation, after media reports suggested patients were being passed over in the organ donation process in favor of less sick recipients.
    • “Reports from The New York Times, cited by the senators, found line skipping occurred in nearly 20% of transplants from deceased donors last year. For comparison, patients received out of order organ donations in about 2% of such donations in 2016, the letter said.
    • “The senators have charged the CMS and HRSA, which oversee organ procurement organizations, with explaining their process for monitoring organ distribution, and asked officials to provide transparency into any complaints the agencies might have received about line skipping since 2019.”
  • Per a Justice Department news release,
    • Today, Attorney General Pamela Bondi released the following statement:
      • “Luigi Mangione’s murder of Brian Thompson — an innocent man and father of two young children — was a premeditated, cold-blooded assassination that shocked America. After careful consideration, I have directed federal prosecutors to seek the death penalty in this case as we carry out President Trump’s agenda to stop violent crime and Make America Safe Again.”
      • “As alleged, Luigi Mangione stalked and murdered UnitedHealthcare executive Brian Thompson on Dec. 4, 2024. The murder was an act of political violence. Mangione’s actions involved substantial planning and premeditation and because the murder took place in public with bystanders nearby, may have posed grave risk of death to additional persons.   
      • “Following federal murder charges handed down on Dec. 19, 2024, Attorney General Bondi has now directed Acting U.S. Attorney Matthew Podolsky to seek the death penalty in this case.
      • “This is in line with Attorney General Bondi’s Day One Memo as Attorney General entitled Reviving The Federal Death Penalty And Lifting The Moratorium On Federal Executions.”

From the patient safety front,

  • The American Hospital Association News lets us know,
    • “As part of the AHA’s Patient Safety Initiative, a dedicated webpage features case studies showing how hospitals and health systems across the nation are implementing effective and innovative programs to create a culture of safety, improve staff well-being and connect with their communities. READ NOW.”

From the public health and medical research front,

  • Cardiovascular Business reports, “Embracing a healthy plant-based diet can help patients with obesity, diabetes and heart disease live longer, according to new research presented during ACC.25, the annual conference of the American College of Cardiology (ACC).”
  • Per MedPage Today,
    • “A diet involving fasting on three nonconsecutive days per week yielded a 6.37 lbs greater weight loss after a year than a daily caloric deficit.
    • “Both groups aimed for a total weekly energy deficit of 34%.
    • “Weight-loss differences were likely due to greater adherence to the intermittent fasting diet.”
  • This week’s issue of NIH Research Matters discusses “Diet and healthy aging | Peptide eye drops | Bacteria use antimicrobial agent.”
  • The Washington Post takes “a closer look at vitamin D’s role in gut health. Health-care providers often recommend meeting your vitamin D requirements through food rather than sun exposure.”
  • Per an NIH news release,
    • “A new form of tumor infiltrating lymphocyte (TIL) therapy, a form of personalized cancer immunotherapy, dramatically improved the treatment’s effectiveness in patients with metastatic gastrointestinal cancers, according to results of a clinical trial led by researchers at the National Institutes of Health (NIH). The findings, published April 1, 2025 in Nature Medicine, offer hope that this therapy could be used to treat a variety of solid tumors, which has so far eluded researchers developing cell-based therapies.”
  • Health Day informs us,
    • “Surgery might not be needed in breast cancer patients whose tumors are wiped out by chemotherapy and radiation therapy
    • “31 women who had surgery after successful chemo and radiation treatment remained cancer-free five years later
    • “As many as 60% of early-stage breast cancers are completely eliminated by chemo and radiation prior to surgery, researchers noted.”
  • Consumer Reports, writing in the Washington Post, discusses “How to keep your memory sharp as you age. Simple habits can reduce your risk of memory loss and dementia — and slow cognitive decline.”
  • Per MedPage Today,
    • “A new blood-based test reflected Alzheimer’s tau tangle pathology.
    • “The assay measured a new plasma tau species known as endogenously cleaved MTBR-tau243.
    • “The test distinguished various stages of Alzheimer’s and separated it from non-Alzheimer’s tauopathies.” * * *
    • “This blood test clearly identifies Alzheimer’s tau tangles, which is our best biomarker measure of Alzheimer’s symptoms and dementia,” [Dr. Randall] Bateman said in a statement. The test also provides a good indication about whether a patient’s symptoms are due to Alzheimer’s or another disorder, he noted.

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • “Hims & Hers is expanding its weight-loss offering on its telehealth platform with the addition of Eli Lilly’s LLY  Zepbound prescription and generic liraglutide.” * * *
    • “The telehealth-consultation platform on Tuesday said its aim is to bring customers more treatment options that best suit their needs.
    • “We’ve now expanded that choice even further by adding access to generic liraglutide and branded tirzepatide through our platform,” the company said.
    • “Hims & Hers’ platform already offers weight-loss brands including Novo Nordisk’s NOVO.B Ozempic and Wegovy.
    • The company said it plans to continue expanding its weight loss offering to deliver a more personalized experience to its customer base.
  • Per Beckers Hospital Review,
    • “Eli Lilly is broadening its direct-to-consumer approach by partnering with a digital health company, Noom, which is focused on weight management. 
    • “The collaboration connects Noom users with Eli Lilly’s pharmacy provider, GiftHealth, to facilitate access to Zepbound single-dose vials for individuals with a prescription, according to a March 31 Noom news release. 
    • “The integration also allows users to track prescription fill statuses and shipping dates within an app. Eli Lilly’s decision to offer Zepbound in a single-dose vial format for cash-paying patients is part of a broader effort to increase access to the weight loss drug.”
  • and
    • “Durham, N.C.-based Duke University Health System has completed its $284 million acquisition of Lake Norman Regional Medical Center and related businesses in Mooresville, N.C., from subsidiaries of Franklin, Tenn.-based Community Health Systems.
    • “Duke finalized the acquisition April 1. The 123-bed acute care hospital will be renamed Duke Health Lake Norman Hospital, according to a Duke Health news release.
    • “This is an exciting day for Duke Health and the Lake Norman team,” DUHS CEO Craig Albanese, MD, said in the release. “We have a bright future ahead and look forward to bringing the excellence and innovation of Duke Health to enhance the care offered at Duke Health Lake Norman Hospital and clinics.” 
  • Modern Healthcare relates,
    • “Novant Health, with MedQuest Associates, has signed an agreement to acquire 18 OrthoCarolina imaging centers in the Carolinas.  
    • “The deal, which closed March 31, involves 13 locations in the Charlotte region in North Carolina, three locations in the Winston-Salem region in North Carolina and two locations in South Carolina. MedQuest, which is owned by Novant, will manage day-to-day operations at the sites, according to a Tuesday news release.
    • “Financial details of the deal were not disclosed. 
    • “Winston-Salem-based Novant operates more than 900 care locations in the Carolinas, including 19 hospitals, about 750 physician clinics and other outpatient facilities. MedQuest operates more than 50 outpatient centers and mobile radiology units.”

Weekend Update

David Ermer–CDC, CMS, Congress, FDA, Medical / Rx research, OPM, Telehealth–
Texas bluebonnets now blooming in central Texas

From Washington, DC,

  • On April 3, 2025, at 10 am, ET, the Senate Homeland Security and Governmental Affairs Committee will hold a confirmation hearing for Scott Kupor, the President’s nominee for the position of OPM Director. The FEHBlog looks forward to Mr. Kupor’s confirmation.
  • Fierce Healthcare reports,
    • “Over three dozen healthcare associations and organizations penned a letter this week calling on House and Senate leaders for action on a bill bolstering foreign-born physician recruitment to underserved regions.
    • “The letters—which include the American Medical Association, the American Hospital Association and the Association of American Medical Colleges as signatories—speak to the Conrad 30 Waiver Program and its role in alleviating the nation’s worsening clinical workforce shortage.
    • “It allows foreign students who come to the U.S. for medical training immediately begin practicing in the U.S. by foregoing visa requirements that would force them to return to their home country for at least two years. In exchange, program participants are required to work full-time for at least three years in a medically underserved community.” * * *
    • “A pair of bills introduced in the House and Senate late last month and referred to their respective judiciary committees would reauthorize and “make necessary updates to strengthen the program,” the groups said.”
  • CMS is holding a virtual town hall meeting on April 30, 2025, from 10 am to 3 pm ET “for clinicians and researchers as well as other interested parties, such as patient advocacy organizations, patients, and caregivers, to share input relevant to the clinical considerations related to drugs selected for the second cycle of negotiations [under the Inflation Reduction Act].”

From the judicial front,

  • Govexec reports,
    • “President Trump can once again fire a key appointee who hears appeals of firings and suspensions of federal employees, putting the board on which she sits at risk of losing its functionality as the administration is pushing out large swaths of the federal workforce. 
    • “Cathy Harris, a Democrat nominated to the Merit Systems Protection Board by President Biden, was fired by Trump last month but quickly won reinstatement from a district judge. On Friday, a panel on the U.S. Court of Appeals for the D.C. Circuit in a 2-1 decision paused the lower court’s decision and said Trump could fire Harris. 
    • “The decision also applied to Gwynne Wilcox, a member of the National Labor Relations Board who Trump had fired, and a district court also reinstated. 
    • “If Harris is removed, MSPB would be left without a quorum. From 2017 to 2022, the board also lacked a quorum, which created a 3,500-case backlog that was only just recently eliminated. Due to an interim final rule established that same year, MSPB can conduct some actions without a quorum, though it cannot issue final decisions appealed to its central board.
    • “Zac Kurz, an MSPB spokesman, confirmed Friday evening that that the central board no longer has a quorum. While regional administrative judges can still issue initial rulings, the central board can no longer hear appeals of those rulings.”  

From the public health and medical research front,

  • The New York Times reports,
    • “As many as one in five people — an estimated 64 million in the United States — have elevated levels of a tiny particle in their blood. It can greatly increase the risk of heart attacks and strokes.
    • “But few know about it, and almost no doctors test for it, because there was not much to be done. Diet does not help. Neither does exercise. There have been no drugs.
    • “But in the near future, that may change.
    • “On Sunday [today], cardiologists announced that an experimental drug made by Eli Lilly, lepodisiran, could lower levels of the particle, Lp(a), by 94 percent with a single injection. The effects lasted for six months and there were no significant side effects.
    • “But it is not yet confirmed that reducing Lp(a) levels also reduces the risk of heart attacks and strokes. That awaits large clinical trials that are now underway.
    • “The Lilly research was presented Sunday at the annual meeting of the American College of Cardiology and simultaneously published in the New England Journal of Medicine. At least four other companies are also testing innovative drugs that block the body’s production of Lp(a), a mix of lipids and a protein.
    • “Dr. David Maron, a preventive cardiologist at Stanford not involved in the Lilly research, said the evidence of profound and long-lasting reduction in lipoprotein levels with lepodisiran was “thrilling.”
    • “Dr. Martha Gulati, a preventive cardiologist at Cedars-Sinai Medical Center also not involved in the trial, said the study was “really elegant.”
  • and
    • “Many people use a smartwatch to monitor their cardiovascular health, often by counting the number of steps they take over the course of their day or recording their average daily heart rate. Now, researchers are proposing an enhanced metric, which combines the two using basic math: Divide your average daily heart rate by your daily average number of steps.
    • “The resulting ratio — the daily heart rate per step, or DHRPS — provides insight into how efficiently the heart is working, according to a study conducted by researchers at the Feinberg School of Medicine at Northwestern University and published today in the Journal of the American Heart Association.
    • “The study found that people whose hearts work less efficiently, by this metric, were more prone to various diseases, including Type II diabetes, hypertension, heart failure, stroke, coronary atherosclerosis and myocardial infarction.
    • “It’s a measure of inefficiency,” said Zhanlin Chen, a third-year medical student at the Feinberg School of Medicine at Northwestern University and lead author of the new study; his coauthors included several Feinberg faculty physicians. “It looks at how badly your heart is doing,” he added. “You’re just going to have to do a tiny bit of math.”
  • NPR Shots tells us,
    • “As a measles outbreak in West Texas and New Mexico continues to grow, and other states report outbreaks of their own, some pediatricians across the U.S. say they are seeing a new trend among concerned parents: vaccine enthusiasm.
    • “Our call center was inundated with calls about the MMR [measles, mumps, rubella] vaccine,” says Dr. Shannon Fox-Levine, a pediatrician in Broward County, Fla. She says parents are asking if their child is up to date on their vaccinations. Or “should they get another vaccine? Should they get an extra one? Can they get it early?” * * *
    • “Interest in vaccinations has ramped up ahead of the spring break travel season, says Dr. Susan Sirota, a primary care pediatrician in the Chicago area.
    • “We have many patients calling us because they are traveling to either Texas or places near Texas, or states where they suspect that vaccination rates are lower than we have in Illinois,” Sirota says. “Many families are requesting early MMR [vaccines].” 
  • MedPage Today lets us know, “Transcatheter aortic valve replacement (TAVR) continued to hold its own against surgery for younger patients at low surgical risk, with the Evolut Low Risk trial now halfway to its goal of 10-year follow-up.”
  • Per Medscape,
    • “GSK said on Tuesday that it is studying a group of more than a million older adults in the UK to examine whether its best-selling shingles vaccine lowers the risk of dementia.
    • “The British drugmaker is using the health data of some 1.4 million people, aged 65 to 66, some of whom received its Shingrix shot and some who did not. 
    • “GSK’s chief scientific officer Tony Wood said the data, from the state-run National Health Service’s (NHS) large database, is a unique set of information because due to a tweak in the UK’s shingles immunization program there is effectively a naturally randomized trial already taking place.”
  • and
    • “High-dose oral cholecalciferol (vitamin D3) supplementation significantly reduced disease activity in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS) in the randomized, controlled D-Lay MS trial.
    • “Combined with data from previous studies on vitamin D as an add-on therapy, the results of the D-Lay MS trial, which show a stronger effect of vitamin D in patients with vitamin D deficiency compared to others, strongly suggest that patients with vitamin D deficiency should be supplemented, regardless of whether they are already under disease-modifying therapy,” Eric Thouvenot, MD, PhD, University Hospital of Nimes, Neurology Department, Nîmes, France, told Medscape Medical News.
    • “The study was published online on March 10 in JAMA.” 

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Health Care Service Corp. was limited to selling Blue Cross and Blue Shield policies, including Medicare Advantage plans, in Illinois, Montana, New Mexico, Oklahoma and Texas before the deal.
    • “After the Cigna acquisition, Health Care Service Corp. has a much bigger footprint and can offer Medicare Advantage in 25 more states and the District of Columbia, Part D nationally, and Medigap in 48 states and the District of Columbia. The insurer now counts 830,000 Medicare Advantage members, about four times as many as prior to the Cigna purchase.” * * *
    • “Moving up a weight class means facing dominant for-profit Medicare Advantage carriers such as UnitedHealth Group subsidiary UnitedHealthcare, Humana and CVS Health subsidiary Aetna head on. Those three insurers collectively cover 57% of Medicare Advantage enrollees, according to an analysis of Centers for Medicare and Medicaid Services data the investment bank Stephens published in February.”
  • Beckers Payer Issues adds,
    • “Moody’s has downgraded Health Care Service Corporation’s insurance financial strength rating to A3 from A2 following the company’s acquisition of Cigna’s Medicare business on March 19.
    • “Moody’s cited likely challenges with the integration of the MA business into the company’s primarily commercial insurance operations, along with ongoing headwinds within the MA industry more broadly.  
    • “Another concern is the limited experience the company has with making and integrating major acquisitions in the recent past,” analysts wrote. “The company expects to invest an estimated $1 billion over the next two years into updating systems and for working capital to ensure its success, but this may prove to be insufficient.”
  • Kauffman Hall explains how health systems can create a sustainable approach to corporate shared services.