From Washington, DC,

• The New York Times reports,
  • “Senator Bob Casey, a three-term Democrat from Pennsylvania long seen as an institution in state politics, conceded on Thursday to his Republican challenger, the former hedge-fund executive David McCormick, amid a recount in one of the nation’s top Senate races.
  • “Their Senate contest is the only one that has yet to be called by The New York Times, after heading to a recount because Mr. McCormick led by less than half a percentage point. As Republicans looked to add Pennsylvania to their win column after seizing control of the Senate, the post-election period set off a legal battle between the two sides.” * * *
  • “In his second time running for Senate in Pennsylvania, Mr. McCormick channeled the sour national mood into what appears to be a stunning victory over a well-established incumbent in a top battleground state. Republicans are now set to hold a 53-to-47 advantage in the Senate in addition to narrowly controlling the House, giving President-elect Donald J. Trump more flexibility to pursue his agenda.”
    
• The AP puts the House of Representatives election results at 219 Republicans and 213 Democrats while the DecisionDesk HQ split is 220 Republicans and 213 Democrats. A majority is 218 seats. The AP considers three House elections unresolved and DecisionDeskHQ deems two House elections unresolved two weeks following election day.

• The American Hospital Association News tells us,
  • “The AHA Nov. 20 asked Congress to consider a series of actions to eliminate barriers to addiction treatment. In comments to Reps. Paul Tonko, D-N.Y., and Mike Turner, R-Ohio, the AHA urged Congress to bolster reimbursements for behavioral health providers, repeal the institution for mental diseases exclusion, remove the 190-day lifetime limit of inpatient care in a psychiatric hospital, repeal the in-person telehealth requirement for behavioral health and strengthen the health care workforce, among other recommendations.”
  • Talk about lack of mental health parity.

• The Washington Post reports,
  • “[President elect Trump’s nominee for HHS Secretary] Robert F. Kennedy Jr. and his advisers are considering an overhaul of Medicare’s decades-old payment formula, a bid to shift the health system’s incentives toward primary care and prevention, said four people who spoke on the condition of anonymity to discuss private deliberations.
  • “The discussions are in their early stages, the people said, and have involved a plan to review the thousands of billing codes that determine how much physicians get paid for performing procedures and services.
  • “The coding system tends to reward health-care providers for surgeries and other costly procedures. It has been accused of steering physicians to become specialists because they will be paid more, while financial incentives are different in other countries, where more physicians go into primary care — and health outcomes are better.
  • “Although policymakers have spent years warning about Medicare’s billing codes and their skewed incentives, the matter has received little national attention given the challenge of explaining the complex issues to the public, the technicalities of billing codes and the financial interests for industry groups accustomed to how payments are set.”
    
• Federal News Network tells us,
  • “Over a week into this year’s Open Season, some enrollees in the new Postal Service Health Benefits program are struggling to review and make changes to their health care options for plan year 2025.
  • “It’s unclear how widespread the issues are, but some PSHB participants have experienced difficulties logging in to PSHB’s enrollment platform, according to the American Postal Workers Union and other sources who wrote directly to Federal News Network.
  • “Other issues have included an incorrect premium rate listed for one PSHB plan option, incomplete information in the PSHB plan comparison tool and issues with the provider search tool, APWU said.
  • “The most pressing problem currently is with Login.gov and the actual enrollment process, which does not link employees’ Postal and [Office of Personnel Management] identities and accounts,” APWU President Mark Dimondstein wrote in a Nov. 20 letter to OPM Acting Director Rob Shriver. “These serious problems with the enrollment process are preventing Postal employees and annuitants from enrolling in PSHB plans.”

• Blue Cross FEP, writing in Govexec, explains “Why Health Care Costs are Rising and What We Can Do About It.”

From the public health and medical research front,

• The New York Times reports,
  • “After years of relentless rises in overdose deaths, the United States has seen a remarkable reversal. For seven straight months, according to federal data, drug fatalities have been declining.
  • “Expanded treatment, prevention and education efforts are playing a role, but drug policy experts believe there is another, surprising reason: changes in the drug supply itself, which are, in turn, influencing how people are using drugs.
  • “The fentanyl on the street is starting to become weaker. Anne Milgram, who heads the Drug Enforcement Administration, announced last week that for the first time since 2021, the agency was seeing a decline in fentanyl potency, a development she attributed to the government’s crackdown on Mexican cartels and international supply chains. Last year, seven out of 10 counterfeit pills tested in D.E.A. labs contained a life-threatening amount of fentanyl, she said, but that number has dropped to five out of 10.
  • “Addiction experts say that other interventions contributed to the declining fatalities, including wider distribution of overdose reversal medications like Narcan; an uptick in some states in prescriptions for medication that suppresses opioid cravings; and campaigns warning the public about fentanyl-tainted counterfeit pills.”

• Health Day informs us,
  • “Nearly 1 in every 10 American adults is living with high levels of cholesterol in their arteries, according to the latest report from the U.S. Centers for Disease Control and Prevention.
  • “The data, from 2021 through 2023, found that 11.3% of adults have high total cholesterol — a number that’s held relatively steady since the introduction of cholesterol-lowering statins in the late 1980s and early 1990s.
  • “High total cholesterol prevalence declined from 1999-2000 to 2013-2014 and then did not change significantly” in the years since, according to a team led by CDC researcher Margaret Carroll. 
  • “There wasn’t a big difference in rates of high total cholesterol between men (10.6%) and women (11.9%), the researchers noted.
  • “The new data came from a large ongoing federal survey of Americans’ health.”

• The National Institutes of Health Director, Dr. Monica Bertagnolli, writes in her blog,
  • “In 2018, NIH’s National Cancer Institute launched a research initiative called the Human Tumor Atlas Network (HTAN) to construct detailed, three-dimensional maps of human tumors including their underlying cellular, molecular, and spatial features to better understand cancer biology. I’m pleased to share progress toward this goal through an impressive collection of HTAN studies that elucidate how tumors of various types develop, respond to treatment, and recur.” * * *
  • “Here are some highlights:
    • “One study examined the interactions among cancer and non-cancer cells in breast, colon, pancreas, kidney, uterus, and bile duct cancers. The study team used RNA sequencing within single cells to describe tumor structures and define spatially distinct cancer cell clusters or “microregions.” They also used powerful imaging technologies to reconstruct 3D tumor structures to provide insight into the ways tumors are organized.
    • “Another study in colorectal cancer mapped differences between normal colon tissue, primary cancer tissue, and metastatic tissue to identify changes that drive colorectal cancer’s progression and transition from a primary tumor to metastatic disease.
    • “Two other studies (here  and here ) also focused on colorectal cancer to define early molecular-level events that drive the transformation of precancerous lesions in the colon into cancer.
    • “Another study profiled 93 samples, including healthy, precancerous, and cancerous tissue, from six people with familial adenomatous polyposis, a genetic condition that causes people to develop hundreds of precancerous polyps in the colon, which increases the risk for colorectal cancer. Studies like this not only provide insight into this condition but are also considered ideal models for exploring the transition from early precancerous states to colorectal cancer.
    • “Two studies in the collection focus on breast cancer. One of these uses single-cell RNA sequencing to profile metastatic cancer from 60 individuals with this disease, while another describes the underlying genetic networks that define breast cancer subtypes based on profiles of thousands of cells from each of 37 tumors.
  • “These studies expand upon the first tumor atlas studies reported in 2020 and 2021. Together, they represent a comprehensive, publicly available resource that will enable cancer researchers in the U.S. and around the world to better understand cancer development and progression, with implications for advancing cancer treatment and prevention.”

• STAT News lets us know,
  • “Doctors have been using needles as a way to inject people with drugs since the 1600s. Today they’re often used for biologic drugs, which are too large to deliver via pills because they would be dissolved by stomach acid.
  • “Now a group of bioengineers is hoping to give drug delivery an update with a device that draws inspiration from cuttlefish and other sea creatures.
  • “The blueberry-sized device can be swallowed to deliver orally drugs that would normally have to be injected through a needle. It then uses jets, modeled after the organs cephalopods use to propel themselves through the water and to release ink, to eject drugs into the tissue lining the digestive tract. The researchers report in Nature today a series of experiments that serve as a proof of concept, showing that the device was more efficient at delivering drugs than other methods of delivering drugs orally. 
  • “When we want to deliver drugs, we have to bring real, full innovation and creativity to the table, and that’s exactly what this team has shown,” said Samir Mitragotri, a bioengineer at Harvard University who was not part of the new study. “I’m very excited about the doors this opens up both for research as well as clinical care.”

• The Washington Post reports,
  • “A mysterious byproduct of a chemical used to disinfect the tap water of about one-third of Americans has finally been identified, and the international research team behind the discovery is advocating rapid assessment of its potential toxicity.
  • “The research, reported Thursday in the journal Science, does not claim that tap water containing the byproduct is unsafe to drink or that the finding represents any kind of emergency. All water, including bottled water, contains contaminants.
  • “But the discovery of a new and previously unknown chemical, called chloronitramide anion, could have implications for municipal water systems that use a class of chlorine-based disinfectants called chloramines. For decades these disinfectants, derived from the mixture of chlorine and ammonia, have been added to many municipal water supplies to kill bacteria and prevent waterborne illnesses.
  • “A mysterious byproduct of a chemical used to disinfect the tap water of about one-third of Americans has finally been identified, and the international research team behind the discovery is advocating rapid assessment of its potential toxicity.
  • “The research, reported Thursday in the journal Science, does not claim that tap water containing the byproduct is unsafe to drink or that the finding represents any kind of emergency. All water, including bottled water, contains contaminants.
  • “But the discovery of a new and previously unknown chemical, called chloronitramide anion, could have implications for municipal water systems that use a class of chlorine-based disinfectants called chloramines. For decades these disinfectants, derived from the mixture of chlorine and ammonia, have been added to many municipal water supplies to kill bacteria and prevent waterborne illnesses.
  • “Initial computational modeling of the compound shows similarities to other chemicals with demonstrated toxicity, which “suggests that it is probably not harmless,” Fairey said.”
    
• Per Fierce Pharma,
  • “A bispecific antibody has entered the HER2 fray with a differentiated profile from traditional agents and a chance to challenge AstraZeneca and Daiichi Sankyo’s star antibody-drug conjugate Enhertu.
  • “The new drug, Jazz Pharmaceuticals’ zanidatamab, has won an FDA accelerated approval for adults with previously treated HER2-positive biliary tract cancer. The drug, given as an intravenous infusion once every two weeks, will be available under the brand name Ziihera.
  • “With eyes on larger market opportunities in HER2-positive stomach cancer and breast cancer, Jazz has put Ziihera’s peak annual sales potential at more than $2 billion, CEO Bruce Cozadd told Fierce Pharma in an interview ahead of Wednesday’s approval.”

From the U.S. healthcare business front,

• Healthcare Dive reports,
  • “The average cost of employer-sponsored health insurance climbed to $16,501 per employee in 2024, up 5% from the previous year, according to results from Mercer’s 2024 National Survey of Employer-Sponsored Health Plans released Wednesday. Employers expect it to climb another 6% in 2025, Mercer said. 
  • “That increase is partially driven by prescription drug cost, which is the fastest-growing cost segment, according to a news release. Pharmacy benefit cost increased 7.7% this year, after rising 8.4% in 2023, propelled by greater use of GLP-1 drugs for diabetes and weight loss, the survey of 2,194 employers found.
  • “GLP-1s are nearly universally covered for diabetes but not yet for obesity treatment, although that share is growing. In 2024, coverage for obesity drugs increased to 44% among employers with 500 or more workers, compared to 41% last year, and 64% among the largest companies, up from 56% the previous year, according to the release.”

• The American Hospital Association News relates,
  • “New analysis conducted by Dobson | DaVanzo released Nov. 21 by the Coalition to Strengthen America’s Healthcare found that integration can provide more financial security and resources to rural hospitals, preserving patients’ access to care. 
  • “Although not necessarily the right choice for all hospitals and communities, aligning with a larger hospital system can reduce the financial vulnerability of rural hospitals as demonstrated by the proportion of rural hospitals that are no longer at high financial risk after affiliating with, merging with, or being acquired by a hospital system,” the report said. 
  • “The report found that 55% of rural hospitals that closed between 2011-2021 were standalone hospitals. Two in three hospitals at high risk of closing were no longer so when they became affiliated with a larger hospital system. The report said that 18% of hospitals affiliated with, merged with or were acquired by a larger hospital system had previously been at high risk of closure. In addition, rural hospitals saw average total margins of 1.5% prior to affiliation, compared to 2.3% post-affiliation. 
  • “The report found that integration could also help address staffing shortages, provide logistical support, standardize care protocols that improve outcomes, update technology and spur innovation that can improve quality and reduce costs.”

• Fierce Healthcare points out,
  • “Baxter International this week released the first product – 1-liter IV solutions – manufactured post-hurricane at its North Cove, North Carolina facility. 
  • “The product release is ahead of the company’s original expectations and made possible by the dedication and resilience of the North Cove and broader Baxter teams, working in coordination with FDA, the company said in an update posted to its website.
  • “Baxter announced October 31 it restarted its highest-throughput intravenous solutions manufacturing line at its hurricane-hit North Cove facility.
  • “We are making continued strong progress at our North Cove site, including the recent resumption of two manufacturing lines that represent ~50% of the site’s total pre-hurricane production and ~85% of the site’s production of 1-liter IV solutions, the most commonly used size by hospitals and clinics,” company executives said in the update.
  • “Baxter currently expect that peritoneal dialysis (PD) solutions and irrigation will be the next two manufacturing lines to restart in early December.  
  • ‘The company expects all lines will be restarted by the end of the year, but Baxter does not yet have a timeline for when it expects North Cove production to be fully restored to pre-hurricane levels.” 

• Per BioPharma Dive,
  • “Through a new deal, Novartis has added a handful of experimental gene therapies to its neuroscience research pipeline.
  • “Novartis is betting the gene therapy technologies developed by Kate Therapeutics, a biotechnology startup founded four years ago, can lead to treatments for an array of neuromuscular diseases. The Swiss pharmaceutical giant said Thursday it has acquired Kate, in a transaction that could ultimately be worth as much as $1.1 billion. Novartis did not disclose what it paid upfront, but a spokesperson confirmed the amount was greater than Kate’s Series A round last year.
  • “In buying Kate, Novartis now owns a slate of preclinical gene therapies for rare, muscle-eroding diseases. The biotech’s two most advanced programs respectively target Duchenne muscular dystrophy and a condition known as X-linked myotubular myopathy. Astellas Pharma, one of the largest drugmakers is Japan, has been partnering on that latter program since Kate officially launched in June of last year.”
    
• Per MedTech Dive,
  • “Henry Schein said Wednesday it had agreed to acquire Acentus, a medical supplier specializing in delivering products to patients’ homes.
  • “Henry Schein, a medical and dental supplies distributor, said the acquisition brings its homecare medical products platform’s annual revenue base to approximately $350 million. Financial terms of the deal were not disclosed.
  • “Acentus specializes in delivering continuous glucose monitors (CGMs), a product Henry Schein highlighted several times in the announcement. The deal is expected to close in the first quarter of 2025.”