Midweek update

Mental health care

Midweek update

David Ermer–Congress, End of the PHE, NE, Mental health care, Rx coverage, U.S. Healthcare–
Photo by Manasvita S on Unsplash

From Washington DC, Roll Call informs us,

“Negotiators tapped by President Joe Biden and Speaker Kevin McCarthy to hash out a debt limit compromise were racing against the clock Wednesday to get some principles down on paper that could be written into legislative text in time for votes as early as next week.

“Both the president and his chief GOP counterpart on Capitol Hill said they thought a deal was possible. Biden is scheduled to return Sunday from his trip to Japan for the G-7 summit, telling reporters at the White House on Wednesday he’d be back for “final negotiations” and that he’d hold a press conference upon his return.

“I’m confident that we will get the agreement on the budget, that America will not default,” Biden said. “Every leader in the room understands the consequences if we fail to pay our bills.”

The FEHBlog offers less encouraging news from the public health front —

  • The Wall Street Journal reports
    • “For decades, advances in healthcare and safety steadily drove down death rates among American children. In an alarming reversal, rates have now risen to the highest level in nearly 15 years, particularly driven by homicides, drug overdoses, car accidents and suicides.
    • “The uptick among younger Americans accelerated in 2020. Though Covid-19 itself wasn’t a major cause of death for young people, researchers say social disruption caused by the pandemic exacerbated public-health problems, including worsening anxiety and depression. Greater access to firearms, dangerous driving and more lethal narcotics also helped push up death rates.
    • “Between 2019 and 2020, the overall mortality rate for ages 1 to 19 rose by 10.7%, and increased by an additional 8.3% the following year, according to an analysis of federal death statistics led by Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University, published in JAMA in March. That’s the highest increase for two consecutive years in the half-century that the government has publicly tracked such figures, according to Woolf’s analysis. * * *
    • “Many public-health experts say they don’t think the end of the pandemic will reverse the rise in death rates among young people. Rivara predicts these problems will continue due to persistent issues around mental health and the accessibility of guns.
    • “[Dr. Elizabeth] Wolf said demand for child and adolescent psychiatric services still outstrips supply in her Richmond, Va., office. Patients are on months long waiting lists to see a psychiatrist that accepts insurance.”  
  • Digging deeper, the Journal informs us,
    • “Overdose deaths in the U.S. edged higher in 2022, a federal estimate showed, marking only the second time drugs killed more than 100,000 people in a year. 
    • “The Centers for Disease Control and Prevention on Wednesday released a provisional count of overdose deaths last year that indicated the toll of the fentanyl crisis leveling off after two years of surges during the Covid-19 pandemic. The CDC counted 109,680 overdose deaths in 2022 compared with 109,179 deaths from a similar 2021 projection. For overdose deaths to hover at such a high level demonstrates how fentanyl’s ubiquity and potency continue to threaten the lives of illicit drug users. 
    • “I’m glad to see us not get worse, but it’s hard to celebrate,” said Dr. Chad Brummett, an anesthesiologist and co-director of the Opioid Research Institute at the University of Michigan.”
  • STAT News adds
    • “More than a quarter of American adults are depressed, a 10% surge from nearly a decade ago, according to the latest Gallup survey.
    • “The data come as the Biden administration tries to overhaul mental health care costs and boost the number of health care workers licensed to practice behavioral health care. Congress in this year’s budget also allotted hundreds of millions of dollars to mental health care grants and programs, many of them trained on children or substance misuse.”
  • On a related note
    • McKinsey Consulting explores how virtual hospitals could offer respites to overwhelmed health systems.
    • Health Affairs Forefront discusses approaches to integrating behavioral health with primary care.
    • Employee Benefits News identifies three coverage categories that can reduce healthcare disparities and lower costs — 1) Colon cancer screening (Hey OPM, the article suggests giving a free day off to employees who undergo screening colonoscopies); 2) Basic dental care, and 3) fertility coverage.

From the Rx coverage front, the New York Times reports,

“Thousands of patients are facing delays in getting treatments for cancer and other life-threatening diseases, with drug shortages in the United States approaching record levels.

“Hospitals are scouring shelves for supplies of a drug that reverses lead poisoning and for a sterile fluid needed to stop the heart for bypass surgery. Some antibiotics are still scarce following the winter flu season when doctors and patients frantically chased medicines for ailments like strep throat. Even children’s Tylenol was hard to find.

“Hundreds of drugs are on the list of medications in short supply in the United States, as officials grapple with an opaque and sometimes interrupted supply chain, quality and financial issues that are leading to manufacturing shutdowns.

“The shortages are so acute that they are commanding the attention of the White House and Congress, which are examining the underlying causes of the faltering generic drug market, which accounts for about 90 percent of domestic prescriptions.”

No bueno.

From the human resources front, HR Dive relates,

  • “Employers cannot automatically revoke reasonable accommodations related to COVID-19, despite the dissolution of the “public health emergency” status for the pandemic, the U.S. Equal Employment Opportunity Commission cautioned employers Monday. “Employers may evaluate accommodations granted during the public health emergency, and, in consultation with the employee, assess whether there continues to be a need for reasonable accommodation based on individualized circumstances,” the agency said. 
  • “The warning came as EEOC announced updates to its technical guidance, “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws,” including additional accommodation examples and tips for preventing COVID-related harassment.
  • “The EEOC highlighted that accommodations include low-cost or free measures, such as uninterrupted work time, a quiet workspace or noise-canceling headphones to facilitate that.”

Friday Factoids

David Ermer–CDC, COVID-19, End of the PHE, NE, Mental health care, U.S. Healthcare, Uncategorized–
Photo by Sincerely Media on Unsplash

From Washington DC —

  • The Wall Street Journal reports
    • “Rochelle Walensky will be stepping down as director of the Centers for Disease Control and Prevention in June, the agency said Friday.
    • “Dr. Walensky decided to step aside, after more than two years in the job, as the Biden administration prepares to end the national health emergency around Covid-19 next week and just hours after the World Health Organization declared the crisis was over.
    • “Her departure is another indication the U.S. is moving into a new phase of its response to the virus, which health experts say is still a threat but not spreading like it had, and hospitalizations and deaths are nearing new lows.”
  • The Washington Post adds
    • “Neera Tanden will replace Susan Rice as head of President Biden’s Domestic Policy Council, the White House announced Friday, becoming the first Asian American to serve in the role.
    • “I am pleased to announce that Neera Tanden will continue to drive the formulation and implementation of my domestic policy, from economic mobility and racial equity to health care, immigration and education,” Biden said in a statement.
    • “Tanden, 52, has served as senior adviser and staff secretary to Biden since 2021, overseeing aspects of the president’s domestic, economic and national security teams. Tanden also held policy advising positions in the Clinton and Obama administrations, and was the former president of the Center for American Progress, a liberal think tank.”

From the public health front —

  • The Wall Street Journal informs us,
    • “The World Health Organization declared an end to the Covid-19 emergency, signaling that one of the most deadly and economically devastating pandemics in modern history is receding as the disease that caused it becomes a routine illness. 
    • “Covid-19 is here to stay, but the pandemic has been in a downward trend for more than a year because people around the world have built up immunity to the virus, the WHO said on Friday. Mortality has decreased, and there is less pressure on health systems. The trends have enabled most countries to return to prepandemic life, even as Covid-19 continues to spread.
    • “It’s therefore with great hope that I declare Covid-19 over as a global health emergency,” said WHO Director-General Tedros Adhanom Ghebreyesus.
  • Here are links to the CDC’s Covid Data Tracker and Weekly Fluview which continue to support the ending of U.S. Covid public health emergency next Thursday, May 11.
  • U.S. News and World Report ranks U.S. states by mental health depression rates.
    • “Around 1 in 5 American adults have dealt with a form of depression, with data also indicating symptoms are most prevalent among young adults and women.
    • “According to the most recent survey data collected through the Behavior Risk Factor Surveillance System, which is administered by the Centers for Disease Control and Prevention, a median of about 21% of the U.S. adult population in 2021 had ever been told they have a form of depression. That’s the highest the share has been in comparative data collected since 2011.”
  • NBC News points out that
    • “Prolonged and unexplained bouts of diarrhea, stomachaches and spots of blood during bowel movements may be signs of early-onset colorectal cancer — a disease that’s increasingly found in young adults not old enough to qualify for colonoscopies.
    • “The most troubling early symptom is rectal bleeding, a possible sign of colon cancer that’s not comfortably discussed beyond the bathroom.
    • “It can be difficult or embarrassing to talk about,” said Dr. Matthew Kalady, the director of the division of colon and rectal surgery at the Ohio State University Comprehensive Cancer Center. “But the reality is everybody deals with something like this,” and it’s important to understand what’s normal and what’s not, he said.
    • “The new research from Washington University School of Medicine in St. Louis, published Thursday in the Journal of the National Cancer Institute, included 5,075 people with early-onset colorectal cancer.”

From the U.S. healthcare business front —

  • Healthcare Dive tells us,
    • “Cigna Group raised its full-year guidance for adjusted earnings per share, revenue and customer growth as it reported first-quarter results Friday, including total revenue up 6% year over year at $46.5 billion. The insurer’s net income, at $1.3 billion, increased from $1.2 billion in the year-ago period. 
    • “Cigna posted a medical loss ratio of 81.3%, down from 81.5% in the prior-year quarter and better than internal expectations. This was partly based on lower COVID-19 costs. Claims for COVID, flu and respiratory syncytial virus were lower than expected in the quarter while non-viral care needs were more normalized, executives said on a call with investors Friday. * * *
    • “In discussing pharmacy benefit management arm Express Scripts, executives said they are aware of public and political pressure to lower drug costs, but are prepared to adapt as needed. “We are confident in our ability to earn sustainable and attractive margins for our services under a variety of legislative scenarios,” [CEO David] Cordani said.”
  • Fierce Healthcare relates that
    • “Option Care Health, a provider of post-acute care and infusion services, will shell out $3.6 billion to acquire home health and hospice firm Amedisys.
    • “The deal will create a massive provider of post-acute care services encompassing more than 16,500 employees and 674 care centers in 46 U.S. states, with a projected $6.2 billion in annual revenue. The combination of the two will enable the companies to beef up capabilities and expand their footprints as care options increasingly move into patients’ homes.
    • “Combining Amedisys’ home health, hospice, palliative and high-acuity care services with Option Care Health’s home and alternate site infusion services will create a leading independent platform for home and alternate site care, according to the executives in a press release.”

Thursday Miscellany

David Ermer–CDC, COVID-19, Mental health care, Telehealth, U.S. Healthcare, Uncategorized–
Photo by Josh Mills on Unsplash

From the public health front —

  • MedPage Today tells us
    • “COVID-19 dropped to the fourth leading cause of death in 2022, down from third place in 2020 and 2021, according to provisional mortality data from the CDC.
    • “Taking its place was “unintentional injury,” which followed heart disease and cancer as the longstanding top killers, reported Farida B. Ahmad, MPH, and colleagues in Morbidity and Mortality Weekly Report (MMWR).”
  • The New York Time reports
    • “Births and pregnancies in the United States have been on a long-term decline. A new data analysis provides one reason: It’s becoming less common for women to get pregnant when they don’t want to be.
    • “The analysis, released Thursday in the journal Demography by researchers at the Guttmacher Institute, estimates the number of pregnancies in the United States — there is no single official count — and examines women’s feelings about the timing of their pregnancies.” 
  • The New York Times Morning column points out that state legislatures are embracing harm avoidance approaches to drug addiction. ” The approach focuses on mitigating the potential dangers of drugs, not necessarily encouraging users to abstain, e.g., legalizing fentanyl testing strips.”

From the mental healthcare front —

  • The Department of Health and Human Service recognizes “this Mental Health Awareness Month, [by] bringing attention to mental health and how essential it is to overall health and wellbeing [via] a fact sheet providing a snapshot of various efforts made by HHS over the past year.
  • Per Govexec,
    • “The Office of Personnel Management encouraged agencies to highlight the variety of mental health resources available to federal employees, and highlighted a new interagency effort to connect feds with mental health-related tools and events.
    • “In a memo to agency heads marking the start of Mental Health Awareness Month, OPM Director Kiran Ahuja said protecting the physical and mental well-being of federal workers is a “top priority” for the administration.
    • “We encourage agency leaders to remind employees about the importance of cultivating healthy wellness habits, which include caring for one’s mental health on a proactive rather than reactive basis,” she wrote. “Initiating regular conversations surrounding mental and emotional well-being is instrumental in normalizing and destigmatizing receiving mental health treatment and fostering a healthier workforce.”
    • “Ahuja said a new interagency listserv called Mindful Fed will offer tools and activities that federal employees can use to maintain their mental health. * * *
    • “Federal workers seeking to join the new listserv can email Mindful-FED-subscribe-request@listserv.gsa.gov, Ahuja wrote.”

From the U.S healthcare business front —

Healthcare Dive informs us,

  • Hospital margins continued to stabilize in March, but remained razor thin as inflation drove up supply and drug costs, according to Kaufman Hall’s national hospital flash report.
  • Hospitals reported flat median year-to-date operating margins, an improvement from almost a year of negative margins, according to the report.
  • “While it appears that hospital finances are stabilizing, that doesn’t mean that all is well,” said Erik Swanson, senior vice president of Data and Analytics with Kaufman Hall, in a statement.
  • Expenses, driven by economic inflation, hampered hospitals and outpaced a 24% month-over-month increase in profitability and a 12% increase in revenue.

and

  • “U.S. telehealth use totaled 5.5% of medical claim lines in February, a drop of 6.8% from January, according to Fair Health’s monthly telehealth tracker.
  • “In February, telehealth use declined in the four U.S. census regions: It dropHelaped by 8.7% in the Midwest, 8.3% in the South, 6.2% in the West and 1.5% in the Northeast.
  • “COVID-19 dropped out of the top five telehealth diagnoses nationally. The top diagnosis on telehealth claim lines was mental health conditions.”

From the miscellany front —

  • Fierce Healthcare relates, “It’s official: Medicare Advantage (MA) enrollment accounts for just over half of all Medicare beneficiaries, according to a new analysis from the Kaiser Family Foundation.”
  • Healthcare Innovation tells us,
    • “A year ago, officials from the Center for Medicare and Medicaid Services unveiled a National Quality Strategy. In a May 1 update on the strategy, CMS officials discussed several goals, including annually increasing the percentage of digital measures used in CMS quality programs. CMS officials also said the organization would build one or more quality data systems that can receive data using the FHIR data standard by 2027.”
  • The Segal consulting firm offers a five step strategy for improving wellness programs.
  • Mercer Consulting delves into employer health benefit planning ideas for 2024.

Tuesday’s Tidbits

David Ermer–Congress, Mental health care, NIH, U.S. Healthcare–
Photo by Patrick Fore on Unsplash

From Capitol Hill —

Roll Call tells us, “Senators are so far standing firm on letting Speaker Kevin McCarthy and President Joe Biden work out how to address the debt limit.” The President’s meeting with Congressional leaders will be held on May 9.

Fierce Healthcare informs us,

  • “A key Senate panel has postponed a markup hearing on several bills aimed at drug pricing until after the heads of three major drug companies and three pharmacy benefit managers appear before legislators.
  • “The Senate Health, Education, Labor and Pensions Committee convened Tuesday morning to discuss four pieces of legislation aimed at tackling the rising costs of drugs in the U.S., including a bill that would push significant reforms to the PBM industry.
  • “Instead, the committee will markup the bills on May 11, one day after hosting a blockbuster hearing on insulin and other drug pricing issues. The hearing will include testimony from Eli Lilly CEO David Ricks, Novo Nordisk CEO Lars Fruergaard Jorgensen, Sanofi CEO Paul Hudson, CVS Health President of Pharmacy Services David Joyner, Express Scripts President Adam Kautzner and OptumRx CEO Heather Cianfrocco.”

From the public health front —

  • The National Institutes of Health announced
    • Women aged 55 years and younger have nearly double the risk of rehospitalization in the year immediately after a heart attack compared to men of similar age, according to a study supported by the National Institutes of Health. Higher rates of risk factors such as obesity, heart failure, and depression among women most likely contributed to the disparity.
    • “The findings suggest a need for closer health monitoring of the approximately 40,000 American women aged 18 to 55 years who have heart attacks each year following hospital discharge, and a better understanding of the reasons behind the different outcomes. The study, funded by the National Heart, Lung, and Blood Institute (NHLBI), part of NIH, was published today in the Journal of the American College of Cardiology.”
  • The U.S. Preventive Services Task Force updated its recommendation for screeening asymptomatic adults at increased risk of latent tuberculosis infection (LTBI) with the same grade B that it last gave in 2017. The FEHBlog is impressed by the USPSTF’s routine re-evaluation of its decisions.
  • The Department of Health and Human Services announced
    • “awarding the 15 winners for Phase 1 of the HHS Endocrine-Disrupting Chemicals (EDC) Innovator Award Competition. This competition was developed to identify gaps in knowledge and innovative solutions to improving women’s health by reducing EDC exposure risk.  
    • “For far too long, Black women have been overexposed to harmful endocrine-disrupting chemicals in personal care products. We created this competition to help find innovative solutions to meet this challenge, and I want to congratulate all the winners for their incredible ideas,” said HHS Secretary Xavier Becerra. “We will continue to prioritize the health of Black women by addressing the exposure risks caused by this environmental justice issue.”
  • Kaiser Family Foundation discusses community paramedic programs.
    • Most community paramedicine programs rely on paramedics, but some also use emergency medicine technicians, nurses, social workers, and other professionals, according to the 2017 survey. Programs can offer home visits, phone check-ins, or transportation to nonemergency destinations, such as urgent care clinics and mental health centers.
    • Many programs support people with chronic illnesses, patients recovering from surgeries or hospital stays, or frequent users of 911 and the ER. Other programs focus on public health, behavioral health, hospice care, or post-overdose response.
    • Community paramedics can provide in-home vaccinations, wound care, ultrasounds, and blood tests.

From the mental health care front

  • CVS Health calls our attention to
    • “A recent CVS Health® (NYSE: CVS)/Harris Poll survey found that young adults and physicians continue to see the country struggling with mental health, but most Americans aren’t seeking care.
      • “Six in 10 (60%) respondents aged 18-32 say they are concerned about their mental health, and two thirds (67%) say they know a lot of people in their community that are struggling with mental health issues.
      • “Most physicians (56%) also report declining mental health among their patients.
      • “However, only 1 in 10 (12%) Americans regularly see a mental health professional like a psychiatrist, psychologist, psychotherapist, or well-being therapist.” * *
    • “The survey also found that generations have different views of how to access mental health care.
      • “Ninety-five percent of respondents age 57+ agreed that mental health and illnesses should be taken more seriously by society, compared to 8 in 10 respondents aged 18-32 (83%).
      • “About six in 10 (58%) respondents aged 18-32 report that social media has negatively impacted their mental health, compared to just 22% of respondents age 57+.
      • “A higher number of respondents aged 33-40 believe in using technology to access care, with 85% agreeing that digital health services have made mental health more accessible.
  • The U.S. Surgeon General issued an advisory on the healing effects of social connection.
    • “Connection plays a critical role in individual, community, and societal health. This advisory calls attention to that role and offers a framework for how we can all contribute to improving social connection.”

From the U.S. healthcare business front —

  • BioPharma Dive relates
    • “Pfizer on Tuesday reported first quarter revenue that beat Wall Street forecasts despite declining by more than one-fourth compared to the same period in 2022 due to plummeting sales of the company’s COVID-19 vaccine.
    • “Sales of the COVID antiviral Paxlovid, at $4 billion for the quarter, were substantially higher than analysts expected, although the total was tied to the timing of the final delivery under a U.S. supply contract. CFO David Denton told investors that 2023 will be a “transitional” year as Paxlovid distribution shifts from government purchasing to commercial insurance.
    • “Executives affirmed guidance of 7% growth in non-COVID revenues for the full year, higher than the 5% growth in the first quarter. Hitting that target will require successful new drug launches, such as for a respiratory syncytial virus vaccine now under regulatory review and an experimental multiple myeloma treatment. Investors are also looking for better performance from drugs bought via dealmaking, such as the migraine pill Nurtec.”
  • and
    • “Johnson & Johnson has acquired rights to two experimental cell therapies for blood cancer in a move meant to build on the success it’s had developing a CAR-T treatment for multiple myeloma.
    • “The deal, announced Tuesday with the Maryland-based Cellular Biomedicine Group, has J&J paying $245 million upfront to gain access to two CAR-T therapies that have shown positive early-phase results in patients with recurrent diffuse large B cell lymphoma, or DLBCL, the most common form of non-Hodgkin lymphoma.
    • “The agreement increases J&J’s presence in the field of cell therapy. The big drugmaker already sells one treatment, known as Carvykti. The newly added therapies are in early testing or soon will be.  
  • Healthcare Dive reports
    • CVS has closed its acquisition of Oak Street Health for $10.6 billion in cash, pushing the retail health giant further into direct care delivery, CVS announced on Tuesday.
    • With the deal’s completion, CVS adds a multi-state chain of doctor-staffed medical clinics for seniors to its primary care roster.
    • CVS first announced the acquisition, which values Oak Street at $39 a share, in February.
  • On Monday,  “Blue Cross Blue Shield of Michigan and Blue Cross and Blue Shield of Vermont announced an agreement to formally affiliate and work together across both companies. The affiliation will enable the organizations to broaden the range of health plan and service solutions that will further benefit members and customer groups, while remaining within and committed to local communities in both states. The agreement is pending approval of state regulators.”

From the healthcare spending front —

  • Buck Consultants announced
    • “The impact of inflation is not yet fully reflected in medical trend factors, according to Buck, an integrated HR, pensions, and employee benefits consulting, technology, and administration services firm. The findings were released today in Buck’s 44th National Healthcare Trend Survey, a report that identifies trend factors that are used to project employers’ healthcare costs for 2023-2024.
    • “Buck’s annual survey of nearly 100 health insurers and health plan administrators covering more than 100 million plan participants found that while medical trend factors have yet to fully adjust for recent inflationary increases, they continue to increase at a rate consistent with trends reported in the prior survey, which will likely drive healthcare premiums higher in the coming year.
  • Health Payer Intelligence informs us,
    • “Payers with larger market shares tend to have lower prices nationally, a study published in Health Affairs confirmed.
    • “The researchers used data from Turquoise Health, a company that collects hospital price data from the hospitals’ websites, to determine the impact that payer market share can have on prices. The study covered prices for 14 potentially shoppable services with data from 1,446 acute care hospitals. The data was collected through the end of 2021.
    • “Prices were stable within hospitals but not across different payers. And the pricing was dependent, at least in part, on the payers’ market shares. * * *
    • “just as payers can use their market share to negotiate lower prices, the Congressional Budget Office (CBO) found that providers with higher market shares can use their market position to get higher reimbursement out of payers. Hospital consolidation was a key factor in price increases, the CBO report found.”

Friday Factoids

David Ermer–CDC, Congress, COVID-19, FDA, Mental health care, Rx coverage, U.S. Healthcare, Uncategorized–
Photo by Sincerely Media on Unsplash

From the public health front —

  • Here are links to the CDC’s Covid Daily Tracker and its Fluview. It turns out that the CDC is planning one more issue of its Covid statistics review on May 12. All signs continue to support ending the PHE on May 11.
  • ABC News reports on the latest results of the Youth Risk Behavior Survey, published Thursday by the Centers for Disease Control and Prevention.
  • The GAO issued a report on government efforts to curb antibiotic resistance. The Wall Street Journal adds
    • A bipartisan group of U.S. senators and representatives introduced legislation aimed at encouraging drugmakers to develop antibiotics and antifungal drugs to address a growing public health threat. 
    • Bills that lawmakers proposed in the House and Senate on Thursday would commit $6 billion to purchasing new drugs to treat drug-resistant bacteria and fungi that federal officials designate as critically important targets. 
    • Nearly three million people in the U.S. are infected each year with bacteria immune to many antibiotics, the Centers for Disease Control and Prevention said. Some 35,000 of them die. The manufacturers of some promising antibiotics have gone bankrupt because sales of drugs needed only in emergencies are small, public-health experts said. Many big pharmaceutical companies got out of the antibiotic business years ago. 
  • The Hill tells us,
    • A record-low number of adults reported cigarette use in 2022, while reported usage of electronic cigarettes rose among adults. 
    • Preliminary survey results from the Centers for Disease Control and Prevention (CDC) found just 11 percent of American adults — or about 1 in 9 — reported they are smokers, which is a drop from 12.5 percent reported in 2020 and 2021. 
    • The new data, which is based on responses from 27,000 adults, captured an uptick in e-cigarette use among adults, from 4.5 percent who reported use in 2021 to 6 percent in 2022.
  • Fierce Pharma informs us.
    • With its next-generation pneumococcal vaccine, Pfizer has been playing catch-up with Merck in the indication’s key age group—infants. Thursday, Pfizer got to the finish line 10 months after its rival, but with a shot that offers more protection.
    • The FDA approval of Prevnar 20 covers children ages 6 weeks to 17 years and gives Pfizer a chance to continue to control a market it has dominated for two decades.
    • Prevnar 20 is Pfizer’s follow-on to Prevnar 13, offering protection against seven additional serotypes. Merck’s next-gen shot, Vaxneuvance, is a 15-valent vaccine.
    • In the U.S., the seven additional serotypes covered by Prevnar 20 have shown to be associated with antibiotic resistance and heightened disease severity, according to Pfizer. In children five and younger, the seven serotypes account for 37% of the incidence of pneumococcal disease.
  • STAT News points out
    • “To equip both clinicians and patients with the tools to prevent these [maternal health] tragedies, a group of experts * * * have developed a new, evidence-based preventive care plan for those who are at moderate to high risk of preeclampsia, a pregnancy complication that can drive blood pressure dangerously high and is a leading cause of maternal and infant deaths. The care plan, published Friday in the American Journal of Obstetrics and Gynecology, recommends a range of interventions to lower a patient’s risk, including at-home blood pressure checks, treatments like low-dose aspirin, and continuing to take any other needed heart medication, which people are often wary to do when pregnant. The plan also includes lifestyle recommendations for patients like eating a Mediterranean diet, exercising, and getting at least 7 hours of sleep per night.”

From the U.S. healthcare business front —

  • BioPharma Dive report
    • “AbbVie withstood the first months of U.S. copycat competition to its lucrative arthritis drug Humira about as Wall Street had expected, conceding on price to maintain insurance coverage in response to Amgen launching the country’s first biosimilar rival in January.
    • “U.S. Humira sales totaled nearly $3 billion, a decline of 26% from the same period one year ago and just over analysts’ consensus forecasts. AbbVie executives told investors on a Thursday conference call that most of that impact was driven by price changes.
    • “Amgen, which recorded $51 million in U.S. revenue for its biosimilar Amjevita, is selling its Humira rival at two different prices: a 5% discount to Humira’s nearly $90,000 annual list price, and a 55% discount. The approach is meant to address the unique demands of the U.S. healthcare system, in which insurers rely on manufacturers providing rebates off of a drug’s sticker price.”
  • Becker’s Health IT provides more details about this week’s Kaiser Permanente deal with Geisinger, while Beckers ASC Review explores Optum’s physician acquisition strategy.

Midweek update

David Ermer–Congress, HIPAA Privacy and Security Rules, Medical / Rx research, Mental health care, Rx coverage–
Thanks to Alexandr Hovhannisyan for sharing their work on Unsplash.

From our Nation’s capital —

  • STAT News reports
    • “Senators are slightly delaying their latest legislative push on health care, but as they do, a clearer picture is emerging about what’s in — and out — of the mix.
    • “The Senate health committee was expected to mark up legislation related to generic drugs, pharmacy benefit managers, and some leftovers from the Food and Drug Administration’s user fee agreements next week, but leaders are planning to reschedule the meeting, several sources told STAT.
    • “But 17 health care industry lobbyists and Senate staffers said Democratic leadership is targeting relatively low-hanging fruit that is bipartisan, and already has established history in legislation [i.e., a $35 copay on insulin in the commercial market]”.
  • Beckers Payer Issues tells us that “the Justice Department has decided to seek a stay pending appeal of a Texas federal judge’s ruling that struck down an ACA provision requiring insurance companies to provide coverage for preventive services, CNN reported April 11.”
  • The Department of Health and Human Services proposed a HIPAA privacy rule change “to strengthen its protections by prohibiting the use or disclosure of protected health information (PHI) to investigate, or prosecute patients, providers, and others involved in the provision of legal reproductive health care, including abortion care.” The public comment period will end sixty days after April 17, 2023, the day on which the proposed rule will be published in the Federal Register.

From the public health front —

  • MedPage Today informs us
    • Fentanyl adulterated with xylazine is an “emerging drug threat” in the U.S. and requires immediate action, the Biden administration warned.
    • “This is the first time in a nation’s history that a substance is being designated as an emerging threat by any administration,” said Rahul Gupta, MD, director of the White House Office of National Drug Control Policy (ONDCP), during a phone call with reporters late Tuesday afternoon. “And it couldn’t come at a more critical time.”
  • ABC News reports
    • The number of sexually transmitted infections (STIs) in the United States shows “no signs of slowing,” new federal data shows.
    • A total of 2.53 million cases of chlamydia, gonorrhea and syphilis were recorded in 2021, according to a new report published Tuesday from the Centers for Disease Control and Prevention.
    • That’s a 5.8% increase from the 2.39 million cases reported in 2020 and a 7% increase from five years ago when 2.37 million STIs were recorded in 2017.
    • “I’d like people to understand that this data actually impacts them whether they think it does or not and it’s because STIs happen to everyone, regardless of socioeconomic, religious, political lifestyle,” Dr. Kameelah Phillips, an OBGYN in New York City, told ABC News. “I’d like them to really understand that routine testing at their health care office is super important … gonorrhea doesn’t care who you are.”
    • While certain STIs did not reach pre-pandemic levels, others — such as syphilis — are recording the highest numbers seen in more than 70 years.

From the mental healthcare front —

  • Benefits Pro highlights a survey finding that
    • 21% of workers at ‘high mental health risk’ and unaware of available [employer sponsored] counseling.
    • Employees often do not know the range of resources available to them in their benefits packages and are often unaware of counseling included in the company’s employee assistance program, according to a TELUS survey.

Federal agencies and the Postal Service sponsor EAPs, but the FEHBlog is unaware of OPM creating a connection between those programs and the FEHBP.

From the Rx coverage front —

  • Drug Channels offers a report on specialty pharmacies which informs us that “Drug Channels Institute (DCI) estimates that in 2022, retail, mail, long-term care, and specialty pharmacies dispensed about $216 billion in specialty pharmaceuticals prescriptions. That’s an increase of 12% from the 2021 figure.”  
  • The Institute for Clinical and Economic Research released
    • a Protocol outlining how we will conduct our third annual assessment of how well major insurers’ prescription drug coverage policies align with a set of fair access standards developed by ICER with expert input from patient advocates, clinician specialty societies, payers, pharmacy benefit managers, and life science companies, and
    • a Draft Evidence Report assessing the comparative clinical effectiveness and value of exagamglogene autotemcel (“exa-cel”, Vertex Pharmaceuticals and CRISPR Therapeutics) and lovotibeglogene autotemcel (“lovo-cel”, bluebird bio) for sickle cell disease.  The draft report represents the midpoint in ICER’s eight month long review process.

From the medical research developments front

  • STAT News reports, “A Parkinson’s ‘game changer,’ backed by Michael J. Fox, could lead to new diagnostics and, someday, treatments.” It’s a heartening medical research story about Mr. Fox’s productive efforts.
  • Medscape reports
    • Phototherapy is a safe, effective, noninvasive, and inexpensive way of boosting cognition for patients with dementia, new research suggests. It may be “one of the most promising interventions for improving core symptoms” of the disease.
    • A new meta-analysis shows that patients with dementia who received phototherapy experienced significant cognitive improvement compared to those who received usual treatment. However, there were no differences between study groups in terms of improved depression, agitation, or sleep problems.

Weekend update

David Ermer–Congress, FDA, Mental health care, Rx coverage, SDOH, Telehealth, U.S. Healthcare–
Photo by Eric Heininger on Unsplash

Congress remains on a District / State work break which concludes next Monday following the Easter and Passover holidays.

OPM has rescheduled the second day of the 2023 OPM AHIIP carrier conference for April 20, 2023 from 11 am to 4:15 pm ET.

From the public health front —

  • NPR Shots discusses the simple intervention that may keep Black moms healthier — daily home-administered blood pressure readings.
    • Blood pressure is just one way to measure a person’s health, but during pregnancy and soon after, it’s a critical metric. Unchecked, high blood pressure can contribute to serious complications for the pregnant woman and baby, and increase the risk of death.
  • Politico tells about new efforts underway to solve the crisis in mental health problems among children and adolescents that accompanied the Covid pandemic.
    • Sen. Bob Casey (D-Pa.) plans to introduce three bills aimed at improving mental health care for kids, one of his aides told POLITICO. One bill, set to be reintroduced soon, would create grants for children’s mental health services and make them more accessible. Another would help gather more accurate national data on mental health and children, and the third would focus on the mental health of kids in foster care.
    • And children’s health providers tell government leaders it’s now critical that the federal government step up support for an overburdened system, arguing for increased funding for graduate medical education programs and boosted government reimbursement rates for mental health services.

From the Rx coverage front —

  • USA Today discusses challenges related to using the new generation of weight loss drugs. “Drugmakers are working hard to convince Americans they need their next-generation weight loss medications. But many come with side effects – and the fact we don’t really know what happens long-term.”
  • The Wall Street Journal offers an essay about potential uses for inhalable therapies beyond asthma.
    • “We’re pushing the boundaries of delivery,” said Philip Santangelo, a professor of biomedical engineering at Emory University. 
    • Respiratory diseases that spread through the air are a key target. Dr. Santangelo and colleagues are developing inhalable drugs that use an RNA-editing tool known as CRISPR-Cas13 and messenger RNA to kill viruses such as Covid-19, influenza and respiratory syncytial virus or RSV. Using nebulizers that dispense medicine as mist via a mask, they have tested the delivery of some of the medicines on rhesus monkeys, cows, horses and pigs. The tests in pigs showed that getting the drugs to the lungs reduces the severity and spread of infections, Dr. Santangelo said. 

From the medical research front —

  • Forbes reports, “Researchers have uncovered an unusual way some cancer cells make nutrients they need to grow, a discovery that could hold the key to starving one of America’s deadliest cancers [pancreatic] with a drug we already possess and raising hopes for a powerful new treatment against a disease that is often caught late and has one of the lowest survival rates of any cancer.”
  • Fortune Well discusses new developments in cancer testing via blood studies.

Thursday Miscellany

David Ermer–ACA, Congress, COVID-19 vaccine, FDA, Medicare, Mental health care, OPM, Rx coverage, Telehealth, U.S. Healthcare–
Photo by Josh Mills on Unsplash

The Senate Finance Committee held a hearing today on “Pharmacy Benefit Managers and the Prescription Drug Supply Chain: Impact on Patients and Taxpayers.” Fierce Healthcare reports

Sen. Ron Johnson, R-Wisconsin, said during the hearing that “this whole area is ripe for gamesmanship.” He then asked Matthew Gibbs, PharmD and Capital Rx President, what Capital Rx’s model would bring to the table that sets it apart from other players like Amazon or Mark Cuban Cost Plus Drug that are aiming to shake up the traditional PBM space.

Gibbs emphasized Capital Rx’s focus on transparency, something that sets it apart in the broader market.

“Using a price index like NADAC, which is published by CMS, they actually do the survey of the pharmacies, and getting it more robust so that it’s not voluntary—today it’s a voluntary survey—and getting responses to that will lead us to the actual drug costs,” Gibbs said. “And then you can have your nuances of Costco, Mark Cuban. And the person can actually go in and look and actually be informed about the real prices once and for all. The only way is to level set.”

“We have the tools already,” he said. “We just need to employ them.”

Meanwhile, the National Council of State Legislatures discusses the wide variety of state laws being imposed on PBMs, which only complicates matters.

In Affordable Care Act New, MedPage Today reports, “A federal judge on Thursday struck down the Affordable Care Act (ACA) provision requiring all insurers to cover certain preventive services free of charge, angering the law’s supporters.” The FEHBlog won’t delve into this case now because he expects the U.S. Court of Appeals for the Fifth Circuit to promptly stay this decision.

From the Omicron and siblings front, WebMD tells us

The CDC has updated its COVID-19 booster shot guidelines to clarify that only a single dose of the latest bivalent booster is recommended at this time. 

“If you have completed your updated booster dose, you are currently up to date. There is not a recommendation to get another updated booster dose,” the CDC website now explains.

16.4% of people in the U.S. have gotten the latest booster that was released in September, CDC data shows.

MedPage Today opines on a World Health Organization “Booster Update: Here’s What They Got Right and Wrong.”

In FDA / drug development news —

  • Beckers Hospital Review reports
    • On May 9 and May 10, an FDA advisory panel will discuss whether to recommend the agency approve what could be the first over-the-counter birth control pill. 
    • The pill, a 0.075-milligram norgestrel tablet [manufactured by French drugmaker Laboratoire HRA Pharma], “is proposed for nonprescription use as a once-daily oral contraceptive to prevent pregnancy,” according to a document published March 29 on the Federal Register.
  • BioPharma Dive informs us
    • “Johnson & Johnson will stop developing its experimental vaccine for respiratory syncytial virus in an unexpected retreat from a high-profile research effort that had put the pharmaceutical giant among the leading companies seeking to win the first approval of a preventive shot.
    • “The company said Wednesday it will discontinue a 23,000-person Phase 3 trial, called Evergreen, of its RSV vaccine in adults following a review of its drug pipeline. The company does not plan to develop the shot for pregnant women or infants, a spokesperson confirmed.
    • “J&J’s pullback comes amid a restructuring of its infectious disease division, which was reported by Fierce Pharma in February. Its decision also thins the RSV vaccine competition, leaving GSK and Pfizer in the lead with shots that are currently under review by the Food and Drug Administration. Moderna is also developing an RSV vaccine and could file for approval this year.”

From the U.S. healthcare business front —

Healthcare Dive relates

  • Walgreens’ growing U.S. healthcare segment is continuing to bolster the retail health chain’s financial performance. The business, which includes value-based provider VillageMD, recorded $1.6 billion in sales in the second quarter, an increase of $1.1 billion from last year.
  • VillageMD sales were up 30%, including a boost from its recent acquisition of medical group Summit Health. Specialty pharmacy Shields Health Solutions grew sales 41%, while at-home care provider CareCentrix’s sales were up 25%.
  • Thanks in part to a jump in revenue in its healthcare segment, Walgreens’ results beat Wall Street expectations even as profit declined more than 20% amid lower COVID-19 vaccine volumes and test sales, higher salary costs, opioid litigation charges and costs associated with its $3.5 billion investment in its Summit acquisition.

and

  • Oak Street Health disclosed on Thursday that the antitrust waiting period for its planned sale to CVS Health has expired.
  • CVS and Oak Street filed the required notification forms under the Hart-Scott-Rodino Act with the Department of Justice and Federal Trade Commission on Feb. 24. The waiting period under the HSR Act ended Monday, according to a new proxy filing from Oak Street.
  • The disclosure means the $10.6 billion deal has cleared one regulatory hurdle — companies can’t consummate mergers until the HSR waiting period expires — but regulators could still challenge the acquisition on antitrust grounds in the future.

From the healthcare studies front —

  • Bloomberg tells us the story behind a breast cancer scare. Last week, I noticed a breast cancer study report that struck the FEHBlog as overblown, and it turns out that this report is the breast cancer scare that Bloomberg discusses.
  • NBC News reports
    • “Losing weight — even if some pounds are gained back — may help your heart over the long term, according to a study published Tuesday in the journal Circulation: Cardiovascular Quality and Outcomes.
    • “The findings may be welcome news to those who have found it difficult to keep weight off and feared the risks thought to be associated with gaining weight back.
    • “In the new study, researchers analyzed data from 124 clinical trials with a total of more than 50,000 participants. They found that risk factors for heart disease and Type 2 diabetes decreased for people who lost weight through intensive behavioral programs. The diminished risk persisted for years after they were done with the programs, even if some, but not all, of the weight came back.”
    • “The whole time your weight is less than it would otherwise have been, your risk factors for heart disease are lower than they would have been,” co-author Susan Jebb, a professor of diet and population health at the University of Oxford in the United Kingdom, said in an email.
  • The Centers for Disease Control announced 
    • The expanded availability of opioid use disorder-related telehealth services and medications during the COVID-19 pandemic was associated with a lowered likelihood of fatal drug overdose among Medicare beneficiaries, according to a new study.
    • “The results of this study add to the growing research documenting the benefits of expanding the use of telehealth services for people with opioid use disorder, as well as the need to improve retention and access to medication treatment for opioid use disorder,” said lead author Christopher M. Jones, PharmD, DrPH, Director of the National Center for Injury Prevention and Control, CDC. “The findings from this collaborative study also highlight the importance of working across agencies to identify successful strategies to address and get ahead of the constantly evolving overdose crisis.”

From the healthcare quality front, Beckers Hospital Review relates

CVS and Optum have struggled to integrate behavioral health into their payer-provider models, Behavioral Health Business reported.

For Optum, the challenges lie in integrating all the different IT systems from the providers the company has bought, Trip Hofer, the CEO of Optum Behavioral Health Solutions, said at the news outlet’s VALUE conference. For example, Optum in 2022 acquired Kelsey Seybold Clinic, a medical group in Houston with 500 healthcare professionals.

“Kelsey Seybold says, ‘Trip, here’s my issue. I have access problems for depression, stress and anxiety for adults.’ And I’m like, ‘Well, we have a ton of solutions for you,'” Mr. Hofer said, according to the March 27 story. “Six months later, we still can’t get it implemented because it’s like, ‘Well, how do I get data back to them?'”

Deborah Fernandez-Turner, DO, deputy chief psychiatric officer of CVS payer subsidiary Aetna, said at the conference that it’s time-consuming and complex to build behavioral health into payer-provider companies.

CVS, for instance, has started bringing mental health providers and virtual behavioral health access into its MinuteClinics, according to the story.

Keep on truckin’

The FEHBlog had planned to discuss the OPM-AHIP carrier conference in this post. However, the second day of the conference was postponed today due to a power outage affecting the webinar operations. The second day will be rescheduled, and the FEHBlog will bring readers up to date then.

Friday Factoids

David Ermer–COVID vaccine mandate, COVID-19, Mental health care, No Surprises Act, Rx coverage, U.S. Healthcare–
Photo by Sincerely Media on Unsplash

From the public health report, here are the CDC’s Covid Data Tracker and the CDC’s FluView this week. Covid cases and hospitalizations continue to trend down, while Covid deaths leveled off after reaching a pandemic low last week. FluView notes, “CDC estimates that, so far this season [which runs from October through April], there have been at least 26 million illnesses, 290,000 hospitalizations, and 18,000 deaths from flu.”

The American Hospital Association adds

The Food and Drug Administration today released final guidance for transitioning medical device enforcement policies and emergency use authorizations established during the COVID-19 public health emergency to normal operations. The Biden Administration plans to end the COVID-19 PHE declaration on May 11. The COVID-19 EUA declaration for COVID-19 diagnostics, personal protective equipment, other medical devices, and drug and biological products will remain in effect until there is no longer a “significant potential” for a COVID-19 PHE or the authorized devices or products have been approved.

From the Covid vaccine mandate front, per Fierce Healthcare, the U.S. Court of Appeals for the 5th Circuit held en banc (all of the active judges not a three judge panel), held that Feds for Medical Freedom have standing to challenge the Covid vaccine mandate on federal employees. This means that the nationwide preliminary injunction that has blocked enforcement of the mandate remains in force.

As you may recall, earlier this week, a panel of the U.S. Court of Appeals for the D.C. Circuit reached the opposite result. Such a split in decisions from different circuits is grounds for the Supreme Court to review the case, if requested (cert petition). It remains to be seen whether the end of the public health emergency also will bring down the curtain on the various Covid vaccine mandate challenges.

In other litigation news, Beckers Hospital Reviews brings us up to date on Cigna’s efforts to prevent a former executive from joining CVS Health.

From the opioids PHE front, the Wall Street Journal reports that the U.S. government has begun deploying X-ray scanners for trucks crossing the border from Mexico, first in Brownsville, Texas:

The scanners in Brownsville beam energy at a truck in varying levels of intensity. Beaming less energy at the cab allows drivers to stay inside, speeding the process. Directing more energy at the trailer produces an image of the truck that officials can use to spot suspect material within. Sometimes the payload is illicit drugs including fentanyl. * * *

The U.S. aims to deploy 123 large-scale scanners along the border by fiscal 2026, growing its ability to perform nonintrusive scans to 70% of cargo vehicles and 40% of passenger vehicles, according to the White House Office of National Drug Control Policy. Historically, the U.S. has only performed such scans on 17% of cargo vehicles and 2% of passenger vehicles, the office said.

Adding more scanning technology has to be part of an effort that includes trying to reduce drug demand and the odds overdoses will prove fatal, said David Luckey, a senior Rand Corp. researcher. He co-led a team that produced a report last year for a commission on synthetic opioids that includes members of Congress and law-enforcement agencies.

“There’s no silver bullet,” he said.

From the No Surprises Act front, HHS Secretary Xavier Becerra told the Senate Budget Committee on March 22

Becerra said the agency has received more than 10 times as many No Surprises Act claims than it expected when the law was first implemented. Many of these claims are frivolous, he said, because there is no cost to payers or providers to file a claim. 

“Everyone’s just filing all sorts of claims, and these arbitrators are trying to figure out what cases to handle,” Mr. Becerra said. “That’s what’s bogging down the system. 

The  agency is staying true to Congress’ intent with the law, Mr. Becerra said, but more legislative action is needed to deal with the high number of claims. 

“What we’re trying to do is have a system that works. I plead with you to help us make sure that we get to the legitimate cases, so a provider that’s looking for real payment, or an insurer that’s saying, You’re asking for too much,’ we can adjudicate that,” Mr. Becerra said. 

The FEHBlog is metaphysically certain that providers are submitting 99.4% of the faulty arbitration claims. While the law is working for patients, Congress should tweak that law as the good Secretary requests.

From the U.S. healthcare business front, Fierce Healthcare informs us

Average physician pay fell by 2.4% from 2021 to 2022, and that decline in physician compensation comes at a time when U.S. healthcare workers are facing significant challenges, including economic strains, a growing physician shortage issue and high rates of work-related burnout, according to the sixth annual Physician Compensation Report from professional medical network Doximity. 

Fierce Healthcare’s report is chock-a-block full of summary data from this report.

In other news

  • The New York Times reports
    • The prevalence of autism spectrum disorder in American children rose between 2018 and 2020, continuing a long-running trend, according to a study released by the Centers for Disease Control and Prevention on Thursday. In 2020, an estimated one in 36 8-year-olds had autism, up from one in 44 in 2018. The prevalence was roughly 4 percent in boys and 1 percent in girls.
    • The rise does not necessarily mean that autism has become more common among children, and it could stem from other factors, such as increased awareness and screening.
    • “I have a feeling that this is just more discovery,” said Catherine Lord, a professor of psychiatry at the University of California, Los Angeles medical school, who was not involved in the research. “The question is what’s happening next to these kids, and are they getting services?”
  • HR Dive discusses a recent survey on employee use of employer-sponsored mental health benefits.
  • CNBC tells us
    • Drugmakers Sanofi and Regeneron * * * released data on a jointly developed drug that shows promise in treating COPD.
    • The drug is already approved for asthma and some skin conditions, such as eczema, but it could become the first new treatment in over a decade for COPD. 
    • The results are a win for Dupixent, as competing COPD drugs from drugmakers such as AstraZeneca and GSK struggle to make successful strides toward approval. 

Monday Roundup

David Ermer–COVID-19, Mental health care, U.S. Healthcare–
Photo by Sven Read on Unsplash

    From the Omicron and siblings front, the Washington Post reports

    Americans infected with the coronavirus’s omicron variant are less likely to develop symptoms typical of long covid than those who had covid-19 earlier in the pandemic, according to the largest-ever study of who is most vulnerable to being sickened — or debilitated — by the virus’s lingering effects.

    The analysis of nearly 5 million U.S. patients who had covid, a study based on a collaboration between The Washington Post and research partners, shows that 1 in 16 people with omicron received medical care for symptoms associated with long covid within several months of being infected. Patients exposed to the coronavirus during the first wave of pandemic illness — from early 2020 to late spring 2021 — were most prone to develop long covid, with 1 in 12 suffering persistent symptoms.

    In other public health news, the Wall Street Journal reports

    A rare and often deadly fungus is spreading rapidly across the U.S., federal researchers said, raising pressure to find new treatments for severe fungal disease. 

    Candida auris, a fungus discovered about 15 years ago in Japan, infected at least 2,377 people in the U.S. in 2022, up from 53 in 2016, the Centers for Disease Control and Prevention said. Its swift spread into most states and more than 40 countries has prompted the CDC and World Health Organization to label it a growing threat to public health. Candida auris has a mortality rate of up to 60% and is particularly risky for people who are older or have compromised immune systems, the CDC said.

    “To see a new species arrive on the scene and then suddenly emerge as a global pathogen less than 15 years later—that’s really remarkable,” said Dr. Peter Pappas, an infectious-disease specialist at the University of Alabama at Birmingham.

    From the obesity treatment front

    • NBC News informs us that Americans are turning to local compounding pharmacies for lower-cost versions of Ozempic and Wegovy, the new wave of semaglutide-base obesity drugs, which is a patient safety issue.
    • STAT News, as part of its continuing series on these new drugs, tells us
      • When, in January 2023, the American Academy of Pediatrics released its first formal clinical practice guidelines centered on the screening and treatment of young patients with obesity, many eyes turned to the document.
      • Unlike earlier, more general guidance that recommended a progression of treatment through various stages, the new guidelines say there shouldn’t be “watchful waiting.” They call for early diagnosis, intense counseling, and two new aggressive options for children with obesity: weight loss drugs for children as young as 12 who are in the 95th weight percentile, and consultation for weight loss surgery for teenagers who have severe obesity (120% of the 95th percentile or a body mass index of 35 or more).
      • Now that experts have had a couple of months to comb through the 100-page document, from executive summary to supporting material, one thing is clear: There is still no consensus on how best to approach obesity in children.
    • Beckers Hospital Review identifies the ten most overweight cities in the country. All of them are located in the southeast. McAllen, Texas, is number one.

    In other relevant survey/study news —

    • Per Kaiser Family Foundation News, “Young adults in the United States continue to be more likely than their older counterparts to be experiencing symptoms of anxiety or depression, according to the latest federal data analyzed by KFF researchers.”
    • The Kaiser Family Foundation / Peterson Health System Tracker evaluates preventive services utilization.
    • The AP reports “A Pentagon study has found high rates of cancer among military pilots and for the first time has shown that ground crews who fuel, maintain and launch those aircraft are also getting sick.”

    Health Affairs offers plan design guidance intended to help resolve the maternal health crisis.