From Washington, DC,

• Govexec updates us on FY 2024 appropriations actions on Capitol Hill.

• Roll Call tells us,
  • “A consistent drip of members announcing they will not seek reelection combined with a desire to portray Capitol Hill as a toxic place everyone wants to flee can create a narrative that there’s a mass exodus underway from the House. 
  • “But that’s not the real story, at least not yet. 
  • “Up to this point, 38 House members have decided not to seek another term. Indiana Republicans Greg Pence and Larry Buschon and Colorado Republican Doug Lamborn were the latest to announce, just in the last few days. Overall, that’s just a few more than average, and that’s with an asterisk. * * *
  • “In order to make comparisons across cycles, the tally does not include resignations (or expulsions) because those seats will be filled by Election Day and will have new incumbents likely running in the regular election. So the 38 does not include the seats of former Reps. George Santos of New York and Kevin McCarthy of California and soon-to-be former Reps. Bill Johnson of Ohio and Brian Higgins of New York.
  • “North Carolina Democrats Kathy Manning, Wiley Nickel, and Jeff Jackson are included in the 38, but they likely would have run for reelection if Republicans hadn’t redrawn their districts to make them virtually unwinnable for a Democrat. Without redistricting forcing their hands, the number of members not seeking reelection would be remarkably average.”

• The Hill reports,
  • “Sen. Bernie Sanders (I-Vt.) and a group of Senate Democrats on Monday announced an investigation into the high costs of asthma inhalers.
  • “Sanders, chairman of the Senate Health, Education, Labor and Pensions (HELP) Committee, sent letters to the CEOs of the four biggest manufacturers of inhalers sold in the United States — AstraZeneca, Boehringer Ingelheim (BI), GlaxoSmithKline (GSK) and Teva — demanding information and documents on internal strategic communications, patient assistance programs and the costs involved in the manufacturing of inhalers.”

• American Hospital Association News reports,
  • “The Department of Health and Human Services’ Office for Civil Rights Jan. 9 released a final rule that partially rescinds a sweeping 2019 rule that was held unlawful by three federal district courts. The new rule restores the longstanding process for enforcing federal conscience laws, and strengthens protections against conscience and religious discrimination. 
  • “The AHA last year submitted comments supporting the Administration’s approach, adding that conscience protections for health care professionals “are longstanding and deeply rooted in our health care delivery system.”

• HR Dive notes,
  • “The U.S. Department of Labor announced Tuesday a final rule revising its interpretation of the Fair Labor Standards Act’s classification provision to determine whether a worker may be considered an independent contractor.
  • “The final rule largely tracks the agency’s October 2022 proposed rule. It retains the multifactor, “totality-of-the-circumstances” framework for analyzing independent contractors’ status included in that proposal.
  • “Under this framework, DOL will consider six nonexhaustive factors when examining the relationship between a worker and a potential employer:
    • Worker’s opportunity for profit or loss.
    • Investments made by the worker and the employer.
    • Degree of permanence of the work relationship.
    • Nature and degree of control over performance of the work.
    • Extent to which the work performed is an integral part of the employer’s business.
    • Use of the worker’s skill and initiative.
  • “The rule will be published in the Federal Register on Wednesday, Jan. 10, and is slated to take effect March 11, officials said.”

From the public health and medical research front,

• The National Institutes of Health announced,
  • “Researchers have discovered that a protein called phosphorylated α-synuclein, which is associated with several neurodegenerative diseases such as Parkinson’s disease and Lewy body dementia, is also involved in the normal processes of how neurons communicate with each other in a healthy brain. The research, published in Neuron, was funded in part by the National Institute of Neurological Disorders and Stroke (NINDS), a part of the National Institutes of Health.   
  • “Phosphorylation is a process where a phosphate ion is added to a specific amino acid, or building block, of a protein, in this case the protein α-synuclein. This addition can change the shape of that protein, causing it to change its level of activity. Most studies of phosphorylated α-synuclein have studied its role in certain neurological disorders such as Parkinson’s disease and Lewy body dementia, where it builds up in protein clumps called Lewy bodies. These clumps are thought to be toxic to neurons, and one of the prevailing hypotheses is that the phosphorylation of the protein α-synuclein triggers these diseases.
  • “In most studies to date, the mere presence of α-synuclein phosphorylation is assumed to be a marker for pathology for certain disorders, like Parkinson’s and Lewy Body dementias,” said Beth-Anne Sieber, Ph.D., program director, NINDS. “Recently, there has been considerable interest in developing drugs that prevent α-synuclein phosphorylation as a way of treating these disorders. These findings challenge the current hypotheses about how these disorders may originate in the brain and may give insight into how we might better treat them.”

• The Hill reports,
  • “The American Red Cross sounded the alarm Sunday over a severe blood shortage facing the U.S. as the number of donors dropped to the lowest levels in two decades. 
  • “The Red Cross said in an announcement that the number of people donating blood in the U.S. dropped 40 percent over the last 20 years, which can majorly disrupt those needing emergency blood transfusions and other operations. The organization added there was a 7,000-unit shortfall in blood donations between Christmas Day and New Year’s Day alone.  * * *
  • “The organization is urging people to sign up to donate blood and are encouraging people to do so by working with the NFL, which is offering a chance to win a trip for two people to Super Bowl LVIII in Las Vegas.
  • “The organization said anyone who signs up to donate blood in January will be automatically entered for a chance to win.”

• Healio points out,
  • “Two doses of the recombinant zoster vaccine provided strong protection over 4 years, even in patients taking corticosteroids who are at higher risk for herpes zoster, also known as shingles, according to researchers.
  • “Currently, the CDC recommends that adults aged 50 years and older receive two doses of the recombinant zoster vaccine (RZV) separated by a period of 2 to 6 months.”
• and
  • “Rates of HPV vaccine initiation before age 13 increased among boys and girls from 2018 to 2021.
  • “Rates of HPV vaccine series completion also increased but remained below 40% in both groups.”

From the U.S. healthcare business front

• Fierce Healthcare and BioPharma Dive offer summaries of day 2 of the JP Morgan Healthcare Conference ongoing in San Francisco.

• Beckers Payer Issues points out,
  • “Aetna President Brian Kane said CVS Health is still in the “early innings” of integrating the payer into the company, the Hartford Business Journal reported Jan. 8.
  • CVS Health acquired Aetna in 2018. Mr. Kane told the news outlet that Aetna’s integration into the company was slowed by the COVID-19 pandemic. He said significant changes are likely in the next five years and that there will be a “really tight ecosystem between payer, provider and pharmacy.”
  • He said the key to the integration will be leveraging CVS Health’s “various businesses and technology platforms to improve patient care and lower costs.” 

• Per BioPharma Dive,
  • “Over the span of five months, biotechnology startup Aiolos Bio launched, raised initial funding from venture investors and negotiated a $1 billion buyout by GSK.
  • “The acquisition, announced by GSK on Tuesday, marks a rapid return on investment for Aiolos’ blue-chip backers, which included Atlas Venture and Bain Capital Life Sciences. They could receive up to $400 million more if certain regulatory milestones are met.
  • “Based in San Francisco and London, Aiolos was founded last year around an experimental antibody for treating asthma that the company licensed in August from China’s Jiangsu Hengrui Pharmaceuticals. The biologic drug, dubbed AIO-001, shares a target with Amgen and AstraZeneca’s approved medicine Tezspire, but Aiolos claims its version could be given less frequently.”

• Beckers Hospital Review lets us know,
  • “Stephen Dorner, MD, chief clinical and innovation officer of Mass General Brigham Healthcare at Home, told Becker’s that the more home-based care models are scaled, the more opportunity there is to move the needle and flatten the curve of healthcare costs in the U.S.  
  • “Boston-based Mass General Brigham, which runs one of the largest home hospital programs in the country, has had more than 2,500 home hospital admissions since January 2022, saving 13,300 acute care facility-based bed days. 
  • “But, the journey first began with two pilot programs launched in 2017, evolving through iterative processes to identify sustainable models. By 2019, the health system began to recognize the strategic importance of the home-based care model, and prioritized refining best practices and modifying them for scalability.
  • “The core strategies, according to Dr. Dorner, involved transforming manual processes into standardized workflows and focusing on translating strong clinical practices from traditional facilities to home-based care without sterilizing the comfort of the home environment.”

• Healthcare Dive adds,
  • “Medicare patients treated in acute hospital-at-home programs had low levels of mortality and rarely needed to return to facilities for care, according to a new study published in Annals of Internal Medicine. 
  • “Researchers found that 0.5% of patients in the study died while receiving acute care in their homes, while 6.2% had to go back to the hospital for at least 24 hours.
  • “The results could help make the case to continue supporting hospital-level care delivered at home, researchers said. A waiver that expanded the programs at the height of the COVID-19 pandemic is set to expire at the end of the year.”
• and
  • “Most nonprofit hospitals and health systems had enough cash on hand to cover operating expenses for an extended period of time in 2022, according to a new analysis from KFF.
  • “On average, hospitals and systems reported having 218 days of cash on hand in 2022 — S&P Global Ratings generally considers 218 days to be a “very strong” level of cash, according to the report. Nearly three-quarters of nonprofit hospitals had “strong” levels of cash on hand, while about one in 10 had “vulnerable” or “highly vulnerable” levels of cash on hand.
  • “The metric, which estimates the number of days that an entity could cover their cash expenses using available reserves, offers nuance to reports that show struggling nonprofit hospitals, the authors wrote. Though hospitals broadly reported negative operating margins in 2022, the KFF study said many had a “large financial cushion” as of 2022 to help weather challenges.”

• Drug Channels discusses 2024 developments among the big three prescription benefit managers.