From Washington, DC

• MedPage Today tells us,
  • “A majority of House members urged House leaders to not only reverse a proposed 2.8% cut in the Medicare Physician Fee Schedule (MPFS), but also to pass a law that would avoid such cuts in the future.
  • “Increased instability in the healthcare sector due to looming cost hikes impacts the ability of physicians and clinicians to provide the highest quality of care and threatens patient access to affordable healthcare,” read a bipartisan letter signed by 233 House members and spearheaded by Reps. Mariannette Miller-Meeks, MD (R-Iowa) and Jimmy Panetta (D-Calif.). “In lieu of these harmful cuts, which, absent federal legislation, will take effect on January 1, 2025, Congress must pass a bill providing physicians and other clinicians with a payment update that takes into account the cost of actually delivering care to patients.” The letter, which was dated October 11 and made public on Tuesday, was sent to House Speaker Mike Johnson (R-La.) and House Minority Leader Hakeem Jeffries (D-N.Y.).”

• KFF issued a report on trends in Medicaid outpatient prescription drug spending. Medicaid drug spending is a bellwether because federal law requires that Medicaid receives best pricing from drug manufacturers.

• The Wall Street Journal offers advice on navigating the Medicare open enrollment period which began today.

From the public health and medical research front,

• Beckers Hospital Review tells us,
  • “Baxter International started to import IV fluids last week from two of its international manufacturing facilities to address supply shortages in the U.S. 
  • “In coordination with HHS, the FDA and the Administration for Strategic Preparedness and Response, Baxter said it has activated seven plants globally to increase inventory. Recent FDA authorization permits the temporary importation from five Baxter facilities located in Canada, China, Ireland and the U.K., covering 19 IV solution and dialysis production codes. 
  • “The company is also ramping up production and utilizing air and other transportation methods to expedite delivery, according to an Oct. 14 update from the company.”

• The Washington Post offers more details on “10 million pounds of meat recalled over listeria concern. BrucePac, which produces precooked meat and poultry items, is recalling some products from retailers including Walmart, Target, Aldi, Trader Joe’s and Kroger.”

• STAT New shares eleven expert opinions “on why gains in cardiovascular disease are stalling and what we can do about it.”
  • “[T]he consensus of the experts interviewed — including Pinney — is that heart disease is far higher than it should be given the tools we have. This is compounded by a disconnect that has formed in the public’s mind between threat and perception. This year, an American Heart Association survey revealed that just over half of Americans are unaware that heart disease remains the leading cause of death, outstripping cancer. 
  • “Nor are most people aware of the vulnerability of particular groups.  “People don’t know that cardiovascular disease is actually the leading cause of mortality in pregnant or postpartum women,” said Janet Wei, assistant medical director of the Biomedical Imaging Research Institute at Cedars-Sinai Medical Center in Los Angeles.
  • “If current trends continue, the heart association estimates, by 2050 at least 6 in 10 U.S. adults will live and die with cardiovascular disease of some type, reflecting an older population burdened by high blood pressure and obesity, despite what we know about those conditions predicting disease.”

• The Washington Post reports on “digital twinning” of human body organs.
  • “Doctors can create a “digital twin” of your heart and other organs to reduce guesswork during surgery. The technology may transform health care.
  • “Digital twinning has come of age in medicine during the last several years, moving into models for lungs, livers, brains, joints, eyes, blood vessels and other body parts. A virtual twin of an entire human being is somewhere in the future. The technology is also being used to test new medical devices and even drugs, with computer models powerful enough to predict a new molecule’s impact on organs and cells. It holds the potential to scale back, or even replace, the use of animals in experiments and humans in clinical trials.
  • “The technology “is revolutionary,” said Ellen Kuhl, a Stanford University professor of engineering, who is modeling the way a heart translates electrical impulses into physical pumping. “If you do this right, the models you create generalize to a wide population.”

• Per NIH press releases,
  • “Alzheimer’s disease may damage the brain in two distinct phases, based on new research funded by the National Institutes of Health (NIH) using sophisticated brain mapping tools. According to researchers who discovered this new view, the first, early phase happens slowly and silently — before people experience memory problems — harming just a few vulnerable cell types. In contrast, the second, late phase causes damage that is more widely destructive and coincides with the appearance of symptoms and the rapid accumulation of plaques, tangles, and other Alzheimer’s hallmarks.
  • “One of the challenges to diagnosing and treating Alzheimer’s is that much of the damage to the brain happens well before symptoms occur. The ability to detect these early changes means that, for the first time, we can see what is happening to a person’s brain during the earliest periods of the disease,” said Richard J. Hodes, M.D., director, NIH National Institute on Aging. “The results fundamentally alter scientists’ understanding of how Alzheimer’s harms the brain and will guide the development of new treatments for this devastating disorder.”
• and
  • An FDA and NIH Joint Public Meeting on advancing smoking cessation priorities is being held on Monday, Oct. 21, from 9 a.m. to 4:30 p.m. EDT. Registration for the meeting is available here. A related commentary was published in advance of the meeting — H Warraich, et al. Opportunities for Innovation in Smoking Cessation Therapies: A Perspective from the NIH and FDA. Annals of Internal Medicine. DOI: 10.7326/ANNALS-24-02318 (2024).
    
• NIH also shares “Research in Context: Can we slow aging?”

• KFF released an issue brief about “Teens, Drugs, and Overdose: Contrasting Pre-Pandemic and Current Trends.”
  • “This issue brief analyzes CDC WONDER data – including provisional data from 2023 – and data from national surveys of adolescent youth to highlight trends in substance use and overdose deaths. It explores how and where teenagers receive substance use information and treatment and how school settings can be leveraged to enhance prevention measures. Lastly, it examines federal and state prevention efforts and social media’s role in the drug crisis.”

From the U.S. healthcare business front,

• Healthcare Dive informs us,
  • “UnitedHealth Group lowered the top end of its adjusted profit guidance for 2024 on Tuesday as the healthcare giant continues to deal with the fallout from a cyberattack on subsidiary Change Healthcare.
  • “The company decreased its adjusted net earnings outlook to $27.50 to $27.75 per share for this year, compared with its previous $27.50 to $28 range. The updated guidance includes $0.75 per share in impacts from the cyberattack on technology firm and claims professor Change, about a $0.10 per share increase from UnitedHealth’s estimate last quarter. 
  • “But the insurer still beat investor expectations on revenue and earnings per share in the third quarter, driven by expansion in people served in UnitedHealthcare and its health services unit Optum.”
• and
  • “CVS Health is discontinuing certain infusion services offered through its Coram business and also plans to close or sell 29 pharmacies in the coming months, a spokesperson confirmed to Healthcare Dive.
  • “The retail giant stopped accepting new patients for its antibiotics, inotropic medications, total parenteral nutrition and acute home infusion therapies programs last week. Coram will continue to provide infusion services for specialty medications and enteral nutrition. 
  • “CVS Health may conduct layoffs as part of the reduction in services. Impacted employees would be notified in mid-November and terminated in the new year, according to the spokesperson. Any workforce reductions are separate from CVS Health’s announcement last month that it would lay off 2,900 employees.”
• and
  • “Continuing its belt-tightening, Walgreens will close about 1,200 storesover the next three years, starting with about 500 in the current fiscal year, which just commenced.
  • “That’s more than half the number of stores the drugstore retailer acquired from Rite Aid seven years ago, after they called off their planned merger.
  • “Retail operations were a drag on results: Q4 retail sales fell 3.5% year over year, with comps down 1.7%, while full-year retail sales fell 4.6%, with comps down 3.4%, per an earnings presentation. Beauty, seasonal and general merchandise siphoned about 150 basis points from Q4 comps, and elevated shrink levels offset positive impacts on retail adjusted gross margin from category mix and private labels.”

• Per BioPharma Dive,
  • “Sales of Johnson & Johnson’s cancer therapy Carvykti and immune disease drug Tremfya grew strongly during the third quarter, the pharmaceutical company reported Tuesday, as new approvals helped broaden the two medicines’ market reach.
  • “The growth from Carvykti and Tremfya comes as J&J prepares for biosimilar competition to its second best-selling drug, Stelara, in January 2025. Biosimilars have already arrived in Europe and, alongside larger-than-expected insurer rebates, drove Stelara’s third quarter sales down 7% compared to last year.
  • “While analysts viewed the performance of J&J’s medical device division as underwhelming, J&J was still confident enough in its outlook to raise operational sales guidance for the full year slightly.”

• Beckers Hospital CFO Report offers 22 statistics on inpatient length of stay.
  • “The average length of stay at hospitals across the U.S. is dropping slightly, while observation days have big declines year over year, according to Kaufman Hall’s National Hospital Flash Report. 
  • “The report includes data from 1,300 hospitals in August, which are tracked monthly for operational and financial trends. The length of stay dropped one to two percentage points on average for most hospitals, regardless of region and size. There was a wider variation in the observation days as a percentage of patient days, as patients are leaving the hospital quicker this year compared to last year.
  • “This development indicates less severe patient acuity and efficient care transition pathways,” the report authors noted.”