From Washington, DC —

• Federal News Network tells us
  • “Almost 33,000 federal civilian employees are a step closer to a bigger pay raise in 2024 after the Office of Personnel Management published a proposal to establish four new locality pay areas for the General Schedule.
  • “OPM’s proposed rule, added to the Federal Register Wednesday, comes after the President’s Pay Agent in December approved recommendations from the Federal Salary Council to establish the four new locality pay areas.
  • “The four new proposed locality pay areas are:
    • Fresno-Madera-Hanford, California
    • Reno-Fernley, Nevada
    • Rochester-Batavia-Seneca Falls, New York
    • Spokane-Spokane Valley-Coeur d’Alene, Washington-Idaho.”

• The Congressional Budget Office released its 2023 Long-Term Budget Outlook. In short,
  • “The U.S. faces a challenging fiscal outlook in the coming years, according to CBO’s projections. Measured as a percentage of GDP, large and sustained deficits lead to high and rising federal debt that exceeds any previously recorded level.”
• Roll Call adds
  • “This month’s law suspending the debt ceiling and capping appropriations has lowered projected spending, deficits and debt over the long haul, the Congressional Budget Office said in its latest long-term budget outlook.
  • Compared to the agency’s report issued last year, overall spending and deficits are higher over the next several years in the updated forecast released Wednesday. But in part because of the spending caps in the debt limit law, estimated spending in the latter part of the 30-year projection period will be lower than the agency estimated last summer.”

• The Justice Department announced,
  • “The Justice Department, together with federal and state law enforcement partners, announced today a strategically coordinated, two-week nationwide law enforcement action that resulted in criminal charges against 78 defendants for their alleged participation in health care fraud and opioid abuse schemes that included over $2.5 billion in alleged fraud.
  • “The defendants allegedly defrauded programs entrusted for the care of the elderly and disabled, and, in some cases, used the proceeds of the schemes to purchase luxury items, including exotic automobiles, jewelry, and yachts. In connection with the enforcement action, the Department seized or restrained millions of dollars in cash, automobiles, and real estate.  * * *
  • “Health care fraud is a complex and ever-evolving threat that negatively impacts the American people,” said Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division. “Today’s nationwide coordinated law enforcement action is a testament to the tenacity of the FBI and our partners, as well as our combined efforts to pursue anyone who conspires to exploit our health care system for financial gain.”

From the public health front —

• Beckers Payer Issues informs us,
  • “UnitedHealthcare executives recently warned of rising healthcare utilization rates as they saw a higher-than-expected number of hip replacements, knee surgeries and other elective procedures. Analysts from UBS Group AG are suggesting that pickleball could be one factor driving the higher rate of injuries, Bloomberg reported June 26. “UnitedHealthcare executives recently warned of rising healthcare utilization rates as they saw a higher-than-expected number of hip replacements, knee surgeries and other elective procedures. Analysts from UBS Group AG are suggesting that pickleball could be one factor driving the higher rate of injuries, Bloomberg reported June 26. 
  • “The firm estimates that there could be between $250 million and $500 million in medical costs attributable to pickleball injuries this year, according to the report. Analysts said that the number of pickleball players is expected to grow by 150 percent this year  to 22.3 million. They estimate about a third of the core players who play at least eight times per year are older adults.   
  • “The analysts looked at two studies regarding pickleball injuries and concluded that players go to the emergency department at a rate of about 0.27 percent, with the majority of injuries occurring among those 60 and older, according to the report. The most common injuries are strains, sprains, and fractures. The wrist and lower legs are the most likely areas to be injured. “

From the Rx coverage front —

• The Wall Street Journal features an article titled “Ozempic Can Make You Thin, Not Necessarily Healthy; Diet and exercise still matter when you take drugs for weight loss, and not only for the reasons you expect.”
  • “For those taking these drugs, exercise is still vital to keep your heart healthy and muscles strong. Exercise lowers your risk of cardiovascular disease, cancer, Type 2 diabetes and Alzheimer’s disease, according to scientific studies. And strength-training is especially important when you lose a lot of weight quickly.
  • “People taking these drugs to lose weight also need the right foods to provide nutrients, fuel their body and keep them healthy. This approach isn’t just about eating better. It’s about eating a specific diet tailored to these drugs. If you don’t, that could lead to health problems down the road or exacerbate side effects.” 

• STAT News reports offers a new perspective on the country’s shortage of cancer drugs, which is a big bowl of wrong.
  • “A young girl, maybe 5 or 6 years old, had come into Yoram Unguru’s clinic with acute lymphoblastic leukemia, the most common of all childhood cancers. One of the drugs needed for treatment was methotrexate. The only problem was that the drug was in short supply.
  • “Oftentimes we can cure kids of their disease, but we can’t do that without the drugs,” said Unguru, a pediatric hematologist oncologist at Children’s Hospital at Sinai in Baltimore and the Johns Hopkins School of Medicine. “It’s just so, so maddening.” * * *
  • “Methotrexate isn’t the only essential chemotherapy clinicians are having a hard time getting their hands on right now. Two other key chemotherapies, cisplatin and carboplatin, which are also generic injectable drugs, have been in shortage for the last few months. But Unguru didn’t see this particular patient recently or even in the last year. He saw her over a decade ago, when the country was facing a different methotrexate shortage back in 2012.
  • “For me, it was my first real world encounter with shortages. That was back when more of this was darker, and I had more of it on my head,” he said, gesturing to his graying beard. * * *
  • “Since then, he’s dealt with countless drug shortages in not only essential cancer medicines but many crucial generic drugs including injectables and antibiotics — nearly all of which have been around and off patent for decades. At any given time, there are dozens or hundreds of generic drugs on the Food and Drug Administration’s shortage list.
  • “These shortages are really omnipresent. In the modern era, it’s not even the new normal. It’s the normal. From 2011, they have really never gone away,” Unguru said. “It’s like Groundhog Day.”
  • “The underlying problem for this hasn’t really changed either — which is that the economics of the generic drug market drive hospitals and producers to emphasize low prices and profits rather than the reliability of the drug supply. The worst part, Unguru said, is that “these shortages are preventable. They’re absolutely preventable.”

• Reuters relates,
  • “The U.S. Food and Drug Administration has approved Pfizer Inc’s (PFE.N) drug to treat hair loss caused by an autoimmune disease, the company said on Friday [June 23].
  • “The drug, branded as Litfulo, has been approved for people aged 12 years and older suffering from severe alopecia areata (AA), a condition where the immune system attacks hair follicles and causes hair to fall out, often in clumps.
  • “The FDA’s decision makes Litfulo the first to be allowed for the treatment of the condition in adolescents.”

• Fierce Healthcare points out,
  • “Pharmacy benefit managers and their role in the drug supply chain have been under the microscope, and a new playbook aims to arm employers with strategies to strengthen their negotiating power.
  • “The guide, released by the National Alliance of Healthcare Purchaser Coalitions, identifies several key strategic recommendations that employers can adopt when looking to better navigate their relationship with PBMs.”

From the U.S. healthcare business front —

• Healthcare Dive reports
  • “In May, the median year-to-date operating margin index for hospitals hit 0.3%, marking the third consecutive month of positive performance, according to a new hospital report from Kaufman Hall.
  • “Hospitals’ financial stabilization is attributable in part to patients’ increased utilization of outpatient hospital services and decreased labor costs, the consultancy found.
  • “To keep the positive momentum, hospitals should pay attention to the trend toward outpatient services, Erik Swanson, Kaufman Hall SVP of data and analytics, said in a statement, calling the shift “particularly important.”

• Benefits Pro notes
  • “Increased investment in urgent care centers is needed as health care delivery models change and patients with non-life-threatening conditions opt for ease of access, according to a recent analysis by Colliers.
  • “The analysis notes several data points to back up its message. The Urgent Care Association found that since 2019 patient volume has spiked by 60%, while Data Bridge Market Research has predicted a compound annual growth rate of 5.35% between 2022 and 2029.”

• STAT News explains why “After a late start, Eli Lilly has the momentum in battle for $30 billion weight loss market.”
  • “It was Novo Nordisk’s Ozempic and Wegovy that set off a new era in obesity medicine, delivering unprecedented levels of weight loss and working its way into popular culture, inescapable ads, and hundreds of thousands of medicine cabinets.
  • “But Eli Lilly has been following close behind with new treatments, and after dropping result after result from successful trials at the American Diabetes Association conference here this past weekend, the Indianapolis-based drugmaker looks to be gaining an edge over its Danish competitor in the race to supply obesity drugs.”