Monday Roundup

David Ermer–Medical / Rx research, Medicare, Obesity, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington, DC,

  • Healthcare Dive offers its perspective on the final Calendar Year 2025 Medicare payment rule issued last Friday.
  • Cardiovascular Business adds,
    • “The Centers for Medicare and Medicaid Services (CMS) has finalized a new payment policy that more than doubles the Medicare reimbursements hospitals receive for performing coronary computed tomography angiography (CCTA) exams. 
    • “Under its new 2025 Medicare Hospital Outpatient Prospective Payment System, CMS moved CCTA into a higher ambulatory payment classification (APC). CCTA revenue codes 75572, 75573 and 75574 all now fall under APC 5572.
    • “This update raised the CCTA payment rate from $175 all the way to $357.13.
    • “CCTA utilization is expected to skyrocket throughout the United States now that the payment rate has increased. One medical society is already celebrating the news.
    • “We’re thrilled with the CMS’s ruling, which better aligns with the cost of providing CCTA services,” Ahmad Slim, MD, chair of the Society of Cardiovascular Computed Tomography (SCCT) Health Policy and Practice Committee, said in a statement. “This is a huge win for U.S. providers as well as the entire cardiac imaging community, ultimately improving patient access to this essential diagnostic tool, which aligns with the society’s overall mission.”
  • STAT News points out,
    • “Medicare regulators on Friday finalized rules to pay for some mental health apps, a breakthrough for digital therapeutics companies that have struggled for a foothold in the health care system.
    • “The new rule creates codes that allow clinicians to bill Medicare for providing the apps and related services to their patients. Beginning January 1, 2025, the codes will enable payment for mental health apps authorized by the Food and Drug Administration under a specific regulation that includes just a handful of treatments for conditions like depression and substance use disorder. 
    • “The codes to cover the apps, which regulators call digital mental health treatment devices, were first proposed for the 2025 Centers for Medicare and Medicaid Services Physician Fee Schedule in July and were finalized with some minor changes after comments from industry and the public.”

From the public health and medical research front,

  • The Wall Street Journal reports,
    • “AstraZeneca said its experimental weight loss pill was well tolerated by patients in an early-stage clinical trial.
    • “The Anglo-Swedish drugmaker’s closely watched weight loss pill, AZD5004, showed 5.8% weight loss after four weeks of treatment among patients with type 2 diabetes, it said Monday during the ObesityWeek conference in San Antonio, Texas.
    • “The trial of the once-daily drug—which mimics a gut hormone known as GLP-1 to control blood sugar and suppress appetite—showed no severe side effects among patients with dosages of up to 50mg.
    • “Investors are paying close attention to the safety and tolerability profile of experimental weight loss drugs. Roche Holding shares slumped 4.5% in early European trading in September after the company said its oral weight-loss drug candidate was generally well tolerated, but some patients showed gastrointestinal side effects.”
  • What’s more, BioPharma Dive tells us,
    • “New results from a small study of Viking Therapeutics’ oral obesity drug raised expectations among Wall Street analysts that the experimental tablet could prove superior among the growing ranks of would-be competitors to the popular weight loss treatments Wegovy and Zepbound.
    • “The updated data, presented over the weekend at a medical conference, showed treatment with the highest dose of Viking’s drug led to an average weight loss of about 8% after just four weeks. Adjusting for the placebo group’s results, the average change was nearly 7%, Viking said Monday.
    • “Viking had previously disclosed results for the first five doses tested in the study back in March. The new results come from three higher dose groups involving 27 people. Notably, the data showed the higher doses were not associated with meaningfully higher rates of gastrointestinal side effects like vomiting and nausea.”
  • Per Becker’s Hospital Review,
    • “Wegovy may significantly reduce hospital admissions for any cause and overall length of stay, according to a new analysis of data from Novo Nordisk’s phase 3 SELECT trial. 
    • “Compared to patients taking a placebo, those taking Wegovy (2.4 milligrams of semaglutide) were less likely to be hospitalized for any reason. Findings presented Nov. 3 during a session at the annual ObesityWeek conference showed admissions for any cause occurred in 33.4% of patients taking Wegovy, compared to nearly 37% in the placebo cohort. 
    • “The new findings are based on an analysis of data from Novo Nordisk’s multicenter, randomized Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity trial (SELECT), which began in 2018 and enrolled more than 17,000 adults in 41 countries.” 
  • The American Medical Association shares top tips that hematologists want their patients to know.
  • Consumer Reports, writing in the Washington Post, lets us know “How to pick a yogurt that tastes great and is good for you. Beyond traditional and Greek, there’s skyr and kefir, yogurts made with plant milks, and more.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Novant Health has completed its purchase of BlueCross BlueShield of South Carolina’s UCI Medical Affiliates, a company that manages and provides administrative services for urgent care centers and physical therapy facilities. 
    • “The acquisition includes 52 urgent care centers and 20 clinics across South Carolina that are part of UCI Medical subsidiaries Doctors Care and Progressive Physical Therapy, according to a news release. Financial details were not disclosed.”
  • Kaufmann Hall informs us about a recent 14-minute-long podcast,
    • “Following the COVID-19 pandemic, UMass Memorial Health in Worcester, Massachusetts began to pilot a new hospital-at-home program: one for postpartum patients. Benjamin Hamar, MD, Director of the Maternity Center at UMass Memorial and a member of the Maternal-Fetal Medicine Division, joins the podcast to tell host J. Carlisle Larsen more about the first-in-the-nation model.”
  • Per BioPharma Dive,
    • “Novo Nordisk is investing further in obesity and metabolic disease, signing a deal to use Ascendis Pharma’s delivery technology to advance a long-acting GLP-1 drug as well as develop products in diabetes and cardiovascular conditions, Ascendis said Monday.
    • “Per deal terms, Novo could pay up to $285 million in immediate and milestone-based fees to Ascendis for the GLP-1 drug, depending on its progress toward approval. In addition, Ascendis could receive up to $77.5 million for each additional drug developed.
    • “Ascendis has won Food and Drug Administration approval of two products using its extended-release technology, both in rare conditions. In partnering with Novo, Ascendis would gain entry into conditions that have blockbuster sales potential.”
  • The Hill reports,
    • “Supermarket chain Kroger has finalized a nearly $1.4 billion agreement to settle the majority of the claims made by states, counties and Native American tribes that accused the company of helping fuel the opioid epidemic. 
    • “Payments are expected to begin early next year. The amount includes up to $1.2 billion for state and local governments where it operates, $36 million to Native American tribes and about $177 million to cover lawyers’ fees and costs.”  * * *
    • “Kroger is one of the country’s largest grocery chains, operating stores in 35 states.  
    • “The finalization of this settlement, originally reached in September 2023, will deliver over $1.2 billion in support of opioid abatement efforts nationwide while resolving nearly all the outstanding opioid-related claims against the company,” a Kroger spokesperson said in a statement.  
    • “The company previously said the settlement is not an admission of wrongdoing or liability 
    • “In addition to the monetary payments, Kroger has agreed to injunctive relief that requires its pharmacies to monitor, report, and share data about suspicious activity related to opioid prescriptions.”