Midweek Report

David Ermer

I am an attorney who practices law in Washington DC. My practice has involved the Federal Employees Health Benefits Program since 1983.

Midweek Report

David Ermer–Congress, FDA, Medical / Rx research, Patient safety, U.S. Healthcare–

From Washington, DC,

  • Govexec informs us,
    • “President Donald Trump on Friday repealed two late-issued Biden regulations and will likely revoke more in the coming weeks. 
    • “The Congressional Review Act enables Congress and the president, if they are in agreement, to overturn by simple majority regulations that were promulgated during the 60 Senate session days or 60 legislative House days before a session of Congress adjourns, whichever is earlier. In this case, Trump and congressional Republicans can use the CRA to override rules finalized on or after Aug. 16, 2024. 
    • “The resolutions, both of which Congress approved with some Democratic support, would:
    • S.J. Res 11, revoke a September Bureau of Ocean Energy Management rule that required oil and gas companies working on the Outer Continental Shelf to submit a report identifying potential archaeological resources on the sea floor that could be affected by such development. 
    • “H.J. Res 35, repeal a November EPA rule specifying requirements under the Methane Emissions Reduction Program, through which the agency charges oil and gas companies for methane and other greenhouse gas emissions if they surpass certain thresholds. 
    • Six other measures to block late Biden rules have been approved in either the House or Senate, including resolutions targeting EPA emission standards for rubber tire manufacturing (H.J. Res 61), IRS reporting requirements for digital asset sales (S.J. Res 3 / H.J. Res 25) and Energy Department conservation standards for consumer gas-fired instantaneous water heaters (H.J. Res 20). 
    • “In total, 57 CRA resolutions have been introduced, according to a tracker from the Center for Progressive Reform. The resolutions’ most frequent target is rules from the EPA.” 
  • Per MedTech Dive,
    • “Monogram Technologies received Food and Drug Administration 510(k) clearance for its mBôS TKA System for total knee replacements and will now work toward commercializing the system, the Austin, Texas-based company said Monday.
    • “Monogram aims initially to place the robot with surgeons who are key opinion leaders in strategic geographies as it establishes clinical experience and demonstrates the platform in real-world settings. It plans to integrate recent upgrades to the robot’s cutting system and other enhancements into the cleared mBôs device over the coming months.”

From the judicial front,

  • Per FiercePharma,
    • “Previously at the epicenter of the U.S. opioid crisis, Purdue Pharma is looking to reenter the public lexicon as a new public benefit company. After a prior bankruptcy settlement was nixed by the Supreme Court, the drugmaker has come back with a new plan that would deliver more than $7.4 billion to its creditors.
    • “The company hopes to emerge from the Chapter 11 bankruptcy process it entered in 2019 with a new reorganization plan, filed Wednesday with the U.S. Bankruptcy Court for the Southern District of New York. The plan lays out more than $7.4 billion in payments to compensate opioid victims and “abate the opioid crisis,” Purdue said in a press release.
    • “That $7.4 billion sum includes available company cash and payments by the Sacklers, the billionaire family who helmed the company until 2019.” * * *
    • “The plan is subject to confirmation by the bankruptcy court, which is expected to hold a hearing in May. After a potential court approval, Purdue would solicit votes to finalize the plan.”

From the public health and medical research front,

  • STAT News reports,
    • “The expanding measles outbreak that has spread from West Texas into New Mexico and Oklahoma could take a year to contain, a public health leader in the area where the outbreak started warned on Tuesday.
    • “Katherine Wells, director of public health for the city of Lubbock, said the outbreak is still growing, with capacity to transmit both locally and further afield through spread to pockets of unvaccinated individuals. Though the response teams have been stressing the importance of vaccination, uptake of vaccines “has definitely been a struggle,” Wells said.”
    • “This is going to be a large outbreak. And we are still on the side where we are increasing the number of cases, both because we’re still seeing spread and also because we have increased testing capacity, so more people are getting tested,” Wells said during a press conference organized by the Big Cities Health Coalition, a forum for leaders of metropolitan health departments. 
    • “I’m really thinking this is going to be a year-long in order to get through this entire outbreak,” she said.”
  • AHA News relates,
    • The U.S. birth rate fell 2% in 2023 to about 3.6 million, according to final data released March 18 by the Centers for Disease Control and Prevention. The cesarean delivery rate increased 1% in 2023 to 32.3%. The preterm birth rate was 10.41%, essentially unchanged from 2022. Medicaid was the source of payment for 41.5% of births, a slight increase from 2022 (41.3%).
  • Health Day adds,
    • “Young American women are greeting the prospect of pregnancy with a decided “meh,” driving down U.S. fertility rates, a U.S. Centers for Disease Control and Prevention (CDC) study says.
    • “The actual number of U.S. births declined by 14% between 1990 and 2023, and the fertility rate went down by 23%, according to a paper in the CDC’s National Vital Statistics Reports.
    • “This drop in fertility occurred mainly among women younger than 30, statistics show.
    • “Women under 30 accounted for 7 in 10 births (70%) in 1990. But by 2023, this age group accounted for less than half of U.S. births (49%).
    • “The sharp drop in births among young women overwhelmed a slight increase in birth rates among women 30 and older, researchers reported.
    • “In summary, the decline in fertility rates over the past few decades results from declining rates among females younger than 30 that are offset somewhat by smaller increases in rates among older women,” the research team led by senior researcher Brady Hamilton of the CDC’s Division of Vital Statistics concluded.”
  • The Washington Post reports,
    • “Pollen seasons are not the same across the United States. Now, a report released Tuesday by the nonprofit Asthma and Allergy Foundation of America shows where allergy sufferers had it the worst last year.
    • “About a quarter of U.S. adults suffer from seasonal allergies — many experiencing itchy and watery eyes, a scratchy throat and an ever-running nose. Pollen exposure is now lasting longer and intensifying nationwide, data shows, as warmer temperatures take over more of the year. But for some areas, the changes are more dramatic.
    • “The report ranks the top 100 largest U.S. cities by how challenging they were for allergy sufferers to live in last year. These “allergy capitals” are based not only on pollen counts, but also on the use of over-the-counter medication and the number of allergy physicians in the area.”
  • MedPage Today points out,
    • “The simple addition of a deadline to a mailed invitation for fecal immunochemical test (FIT) colorectal cancer (CRC) screening resulted in improved return rates, the randomized TEMPO trial showed.
    • “Across eight study arms, the highest return rate was seen with a 2-week deadline without a problem-solving planning tool, with 68% of usable FIT kits returned by 3 months compared with 66% in the control group (no deadline and no planning tool), reported Kathryn Robb, PhD, of the University of Glasgow in Scotland, and colleagues in The Lancet.”
  • Per BioPharma Dive,
    • “Prime Medicine will test its gene editing technology as treatment for a rare liver and lung disorder, revealing on Tuesday plans for a research program in alpha-1 antitrypsin deficiency. 
    • “The company, which is developing “prime editing” as a way to flexibly edit genes without cutting through both strands of DNA, expects to ask regulators next year for permission to begin human testing of the new treatment. 
    • “The program in alpha-1 antitrypsin deficiency, or AATD, is the first new target Prime has picked since significantly paring back its research plans last September. As with other developers of genetic medicines, Prime has faced investor scrutiny on the pace and cost of its research.:

From the U.S. healthcare business front,

  • Fierce Healthcare reports,
    • “Cigna has officially sealed the deal on the $3.3 billion sale of its Medicare business to Health Care Service Corporation.
    • “HCSC acquired Cigna’s Medicare Advantage, Part D, supplemental benefits and CareAllies units as part of the deal.
    • “While it will no longer operate the Medicare unit directly, Cigna said it will continue to provide pharmacy benefit management and other services through its Evernorth division, as part of an agreement with HCSC.”
  • Healthcare Dive lets us know,
    • “Optum Rx is moving to eliminate prior authorizations on dozens of drugs, the UnitedHealth-owned pharmacy benefit manager said Wednesday, paring back a key pain point for physicians and patients at a time of widespread discontent with middlemen in the healthcare industry.
    • “Starting May 1, Optum Rx will eliminate reauthorizations — when drugs already being used by a patient need to be reapproved by their plan — for roughly 80 drugs. The program will cut up to 25% of all reauthorizations, or 10% of prior authorizations overall, the PBM said.
    • ‘The drugs included treat high cholesterol, lung disease, multiple sclerosis, migraines and more. Optum Rx said it plans to apply the policy to additional drugs in the future.”
  • The Wall Street Journal reports,
    • “Today was supposed to mark the beginning of the end for cheaper, knockoff versions of hot weight-loss drugs. The Food and Drug Administration wants bulk production of the copycats to stop—starting Wednesday for pharmacy-prepared versions of Zepbound and later in the spring for knockoffs of Ozempic and Wegovy.
    • “But telehealth companies and pharmacies that have fueled wide use of copycats have other plans.
    • “Telehealth platform Hims & Hers Health says it will keep offering pharmacy-made, or compounded, versions of Ozempic and Wegovy tweaked to individual prescriptions. And some of the pharmacies making the GLP-1 drug copycats will continue, according to people familiar with the industry.
    • “The firms are seeking to take advantage of current law, which allows compounding pharmacies to make special, individualized versions of drugs that aren’t available commercially. Telehealth firms and pharmacies instead intend to sell versions of the obesity drugs tailored for specific patients whose doctors say they need a different dosage than one of the original drugs or a version with extra vitamins added. 
    • “A lot of these patients won’t be able to afford switching over to a brand-name medication,” said Dr. Taylor Kantor, a co-founder of Ivim Health, a telehealth platform offering obesity drugs. “We’re trying to make sure those patients aren’t left in the dust.”
  • MedTech Dive tells us,
    • Orthopedic device companies gathered last week in San Diego to demonstrate their latest innovations and discuss industry trends at the American Academy of Orthopaedic Surgeons’ annual meeting.
    • Robotic surgery systems remained a focus at the event, with Stryker showcasing the newest version of its Mako surgical robot and Johnson & Johnson displaying a feature that was cleared for its Velys robot last year, allowing it to be used for partial knee replacements. 
    • Company executives also discussed economic trends, expecting procedure volumes and hospital equipment purchases to remain steady despite financial pressures.
    • [The article includes] four takeaways from the event
  • Fierce Healthcare notes,
    • “Instacart is rolling out multiple features it says will make it easier for users to make healthy choices, headlined by its artificial-intelligence-powered Smart Shop.
    • “The tool seeks to make grocery shopping through the platform more “intuitive,” according to an announcement from the company, while leveraging AI and machine learning to personalize the experience. Users can select from 14 dietary preference options, including gluten-free, low-calorie or pescatarian, to tailor their shopping.
    • “For example, take an individual looking for foods low in carbohydrates. There are many food options that are naturally low-carb, which can make recommendations difficult. Through the AI tech, Smart Shop is able to filter these options and delineate the difference between items that are deliberately chosen to be low in carbs.”

Tuesday Report

David Ermer–Congress, FDA, SDOH, U.S. Healthcare–

From Washington, DC

  • Per HHS press releases,
    • “The U.S. Department of Health and Human Services (HHS) announced today that Secretary Robert F. Kennedy, Jr. renewed the public health emergency declaration addressing our nation’s opioid crisis, which will allow sustained federal coordination efforts and preserve key flexibilities that enable HHS to continue leveraging expanded authorities to conduct certain activities in response to the opioid overdose crisis.
    • “Although overdose deaths are starting to decline, opioid-involved overdoses remain the leading cause of drug-related fatalities,” HHS Secretary Kennedy said. “This Administration is going to treat this urgent crisis in American health as the national security emergency that it is. Renewing the Opioid Public Health Emergency Declaration affirms the Administration’s commitment to addressing the opioid overdose crisis and is one of many critical steps we will take to Make America Healthy Again.”
  • and
    • “Today, under the leadership of U.S. Department of Health and Human Services Secretary Robert F. Kennedy, Jr., the U.S. Food and Drug Administration is taking steps to enhance its efforts to ensure the ongoing quality, safety, nutritional adequacy, and resilience of the domestic infant formula supply.
    • “The FDA will use all resources and authorities at its disposal to make sure infant formula products are safe and wholesome for the families and children who rely on them,” said HHS Secretary Kennedy. “Helping each family and child get off to the right start from birth is critical to our pursuit to Make America Healthy Again.”
    • “The FDA is announcing a set of actions and initiatives focused on infant formula, such as beginning the nutrient review process and increasing testing for heavy metals and other contaminants. The agency is also encouraging companies to develop new infant formulas and clarify opportunities to help inform consumers about formula ingredients. These enhanced FDA commitments are focused on making sure a strong supply of the sole source of nutrition for formula-fed babies and children remains available for one of our nation’s most vulnerable populations.”
  • STAT News reports,
    • “In a last-ditch effort to turn its fortunes around, Anson General [ located in Anson, a West-Central Texas town of roughly 2,300 people] applied to be a Rural Emergency Hospital, a new type of hospital Congress created in 2023 to keep rural hospitals afloat. The government pays these hospitals a fixed sum each month — over $3 million annually — instead of reimbursing them for the inpatient services they provide. Medicare also adds 5% to their payments for outpatient services. For Anson General, those monthly checks of roughly $270,000 have brought it back from the brink. 
    • “And yet, just 38 hospitals have taken up the new designation since 2023, fewer than researchers had predicted. Many of them are hospitals like Anson General, whose leaders felt they had no other choice. 
    • “It would seem to be a stopgap to the hospital closure crisis,” said Brock Slabach, chief operations officer of the National Rural Health Association. “In that sense, I think it’s fulfilling its mandate.” * * *
    • “Becoming a REH means giving up inpatient care. These hospitals still operate emergency rooms and treat patients on an observation basis, which can entail overnight stays, as well as provide outpatient care and operate labs.
    • “For most eligible hospitals, though, the cons outweigh the pros. The biggest downside, several hospital leaders said, is the fact that REHs can’t have swing beds. A swing bed is a hospital bed that can be used to provide both acute care and post-acute rehabilitation. They’re especially important in rural communities, which don’t always have nursing homes or rehabilitation facilities. In those areas, patients travel elsewhere for surgeries and return to swing beds in their local hospitals to recover and receive occupational or physical therapy. 
    • “U.S. Sens. Jerry Moran (R-Kan.), and Tina Smith, (D-Minn.), introduced a bill dubbed REH 2.0 that would make several tweaks to the designation, including allowing the hospitals to have swing beds, though it wouldn’t make them eligible for 340B discounts.” 
  • Reuters lets us know,
    •  The U.S. Food and Drug Administration (FDA) issued a warning on Friday, advising consumers against inhaling products containing nitrous oxide, commonly known as ‘laughing gas,’ due to potentially serious side effects, including death.
    • Nitrous oxide is an odorless, colorless gas that leads to euphoria, relaxation, and dissociation from reality when inhaled.” * * *
    • “It is available in compact, affordable cartridges that are easily accessible and sold under various brand names, including Galaxy Gas, Baking Bad, and Miami Magic.
    • “The FDA cautioned against the improper use of these products in any canister, tank, or charger size, as misuse could result in severe health issues, including blood clots, loss of consciousness, paralysis, psychiatric disorders, and even death.”

From the public health and medical research front,

  • Health Day tells us,
    • “Nearly 1 in 3 children live with a chronic condition that could significantly affect their health for the rest of their lives, a new study says.
    • “Chronic illnesses affected more than 30% of children ages 5 to 17 by 2018, up from around 23% in 1999, researchers report in the journal Academic Pediatrics.
    • “This adds up to about 130,000 more children each year being diagnosed with a chronic illness.
    • “This increase has been driven by diagnoses of ADHD/ADD, autism, asthma, prediabetes and mood disorders like depression or anxiety, lead researcher Lauren Wisk, an assistant professor of medicine at the David Geffen School of Medicine at UCLA, said in a news release.”
  • Health Leaders offers “Social Determinant of Health Considerations for CMOs.”
  • Healio relates,
    • “Women with chronic pelvic pain disorders who engaged in moderate to vigorous physical activity had improved mental health scores vs. those who did not, according to study results published in the Journal of Pain Research.
    • “Moderate to vigorous intensity physical activity could be a beneficial way for patients who have a chronic pelvic pain disorder to manage their overall mental health,” Ipek Ensari, PhD, assistant professor in the department of artificial intelligence and human health at the Icahn School of Medicine at Mount Sinai, told Healio. “This seems to be a consistent effect, because even after we adjusted for things like physical pain, physical function and pre-existing psychiatric diagnoses, we still saw this positive significant association between physical activity, behavior and their mental health and well-being at each week as we looked at the results.”
  • Sadly, BioPharma Dive reports,
    • A young man with Duchenne muscular dystrophy has died following treatment with Sarepta Therapeutics’ gene therapy Elevidys, the company said Tuesday.
    • In a short statement, Sarepta said the patient suffered acute liver failure after receiving Elevidys, the only approved gene therapy for the disease. Liver damage is a known risk of treatment with Elevidys as well as other gene therapies that are built around a type of modified virus. The death is the first reported among the more than 800 people in clinical testing and commercially who been treated with the therapy, however.
    • “According to Sarepta, testing showed the patient had a recent infection with cytomegalovirus, a common virus that for most people doesn’t cause symptoms but can lead to serious health issues in those with weakened immune systems. A treating physician cited the infection as a “possible contributing factor” to the death, as cytomegalovirus can infect and damage the liver, leading to hepatitis.
    • “The company reported the death to study investigators, physicians and health authorities. It plans to update Elevidys’ prescribing information to “appropriately represent the event.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “DispatchHealth Tuesday announced a definitive agreement to acquire Medically Home, which would create one of the nation’s largest providers of home-based healthcare services.
    • “The combined company would offer an array of home-based medical services, including urgent care, acute-level care and skilled nursing to patients in 50 metropolitan markets across 23 states and the District of Columbia, with approximately 2,200 employees.
    • “Neither company would disclose financial terms of the deal, which is expected to close by the middle of the year, pending regulatory approval.”
  • and
    • “Patina Health rolled out a new program Tuesday that will provide expanded home-based care to Medicare Advantage members.
    • “The Bala Cynwyd, Pennsylvania-based company said Patina Total Health will provide health assessments, medication management, primary care, urgent care and behavioral health services to older adults in their homes through in-person and telehealth visits. Patina Health is launching the new initiative later this week with a national insurer in Charlotte, North Carolina, the company said in a news release. The company did not disclose the name of the insurer but hopes to ultimately work with multiple Medicare Advantage plans.”
  • and
    • “GE HealthCare announced on Tuesday that it is partnering with Nvidia to work on autonomous X-ray and ultrasound scanners that will leverage artificial intelligence-enabled software to capture and analyze medical images.
    • “The company is developing the technology to help ease the burden of rising patient volumes and staff shortages on healthcare professionals, Roland Rott, president and CEO of imaging at GE HealthCare, said in a news release.”
  • Per Fierce Healthcare,
    • Food delivery and engagement company FarmboxRx will launch Drivers Health, a social determinants of health (SDOH) product line for health plans to better serve their members.
    • FarmboxRx combines food as medicine with health literacy to drive member behavioral change, most notably for members living in food deserts. Drivers Health, starting in June, will act as a care management intervention to connect members to underutilized benefits through food deliveries, founder and CEO Ashley Tyrner-Dolce said in an interview with Fierce Healthcare.
    • “We’ve always had health literacy in the box,” she said. “What Drivers Health is built around is connecting to that care … where we take on that care management piece for the health plan through our member contact center.”
    • “Drivers Health will be an additional product line offered to plans with Medicare, Medicaid and duals members. Many people make difficult financial decisions, having to choose between paying a bill, buying food or refilling a medication. Yet members often don’t realize the full scope of benefits available to them unless there is adequate outreach, said Tyrner-Dolce. These benefits can include transportation, utility or mail-order pharmacy perks.”

Monday Report

David Ermer–CMS, Congress, FDA, Generative AI, Medical / Rx research, NIH, Obesity, Rx coverage, U.S. Healthcare, Uncategorized–
Photo by Sven Read on Unsplash

From Washington, DC,

  • Bloomberg Law reports,
    • “Mehmet Oz, President Donald Trump’s nominee to lead the Centers for Medicare & Medicaid Services, used his Senate confirmation hearing Friday to tout the benefits of artificial intelligence to help streamline the prior approval process for Medicare managed care plans.
    • “But consumer policy watchers were immediately leery, noting the string of recent legal challenges stemming from AI-influenced coverage denials by Medicare Advantage plans.
    • “We are very concerned that increasing the use of AI will only make the prior authorization situation worse,” Alice Bers, litigation director at the Center for Medicare Advocacy, said in a statement.” * * *
    • “Sen. Tina Smith (D-Minn.) expressed similar concerns about lawsuits against MA insurers alleging use of AI to determine length of hospital stays and to deny claims. “This is a big concern,” Smith told Oz. “My view is that a human needs to have a final say in these decisions.”
    • “Oz said he agreed with Smith about the need for humans to make final coverage decisions. But Oz maintained that he thinks “AI can play a vital role in accelerating pre-authorization.”
    • “He also said the CMS should be using AI to identify insurers that are misusing the technology.”
  • Beckers Hospital Review adds,
    • “CMS will not change the Biden administration’s plan to negotiate prices for 15 previously named prescription drugs, and the agency’s next potential leader says he will defend the program in court.
    • “In January, CMS selected Ozempic, Rybelsus, Wegovy, Trelegy Ellipta, Xtandi, Pomalyst, Ibrance, Ofev, Linzess, Calquence, Austedo, Breo Ellipta, Tradjenta, Xifaxan, Vraylar, Janumet, and Otezla to be included in the second round of negotiations aimed at reducing drug costs for Medicare beneficiaries. 
    • “On March 14, CMS said it had signed agreements with manufacturers, who will now participate in meetings and roundtables throughout 2025 to negotiate maximum fair prices for the 15 drugs, with final agreements due by Nov. 1.
    • “Mehmet Oz, MD, President Donald Trump’s pick for CMS administrator, told the Senate Finance Committee March 14 he would defend the negotiation program in court.
    • “It’s the law. I’m going to defend it and use it,” he said, adding that it is one of multiple approaches he would pursue to lower drug costs.
    • “The selected drugs account for approximately $41 billion in total spending under Medicare Part D between November 2023 and October 2024, or about 14% of Medicare Part D’s prescription drug costs, according to CMS. The negotiated prices for the drugs will take effect in 2027.”
  • HUB International tells us,
    • “Following on the enactment late last year of two bills to simplify employer reporting under the Affordable Care Act (“ACA”), the IRS has now released its first bit of guidance in the form of Notice 2025-15. The notice provides guidance on how employers can avoid providing individual Forms 1095-C to their employees. Perhaps unsurprisingly, it essentially piggybacks on existing guidance that applies to insurance carriers and other coverage providers.”
  • STAT News adds, “FTC highlights new concern over ‘pay-to-delay’ deals that determine when generics are sold. The agency noted restrictions on how many drugs a generic company may sell as part of a patent settlement.”
  • Per MedTech Dive,
    • “The Food and Drug Administration warned healthcare providers Friday about interruptions to the supply of hemodialysis bloodlines.
    • “The letter said the disruption is expected to impact patient care, may require adjustments to the management of hemodialysis patients and could continue through the early fall of 2025.
    • “The FDA linked to a letter B. Braun sent to customers in January. B. Braun said “additional supply and labor constraints over the holidays” had reduced production and it would run out of product on Jan. 20.”
  • Per Fierce Pharma,
    • “A trio of drugmakers have issued separate recalls in the U.S. thanks to string of production flubs, including failed impurity and dissolution specifications and incorrect labelling of infusion bags.
    • “The companies behind the product pulls are Dr. Reddy’s Laboratories, Sun Pharma and Zydus Pharmaceuticals, all three of which hail from India. The drugmakers are recalling seizure treatments, painkillers and a chemotherapy drug, respectively, according to the FDA’s online enforcement report, which the regulator uses to catalogue recalls.” 

From the judicial front,

  • A panel of the U.S. Court of Appeals for the Ninth Circuit denied the Justice Department’s request for an immediate stay of the lower court’s decision to reinstate terminated probationary employees from six federal agencies. The panel set a briefing schedule on the Justice’s Department’s underlying motion to stay.
  • Bloomberg Law reports,
    • “Walmart Inc. is suing many of the nation’s largest pharmaceutical companies, alleging they colluded to inflate the price of hundreds of generic drugs and caused the retailer to pay more for the medications than it should have.
    • “Mylan Inc., Teva Pharmaceuticals USA Inc., and Glenmark Pharmaceuticals Inc. are among the defendant companies that exchanged drug price points and bid information as part of a conspiracy that specifically targeted Walmart, according to a nearly 700-page complaint filed Friday in the US District Court for the Eastern District of Pennsylvania.
    • “Walmart is one of the largest pharmacy providers in the US, purchasing hundreds of millions of dollars of prescription drugs every year. 
    • “The suit adds to similar cases against pharma companies brought by independent pharmacies, hospitals, and federal and state law enforcers.”
    • “The case is Walmart v. Actavis Elizabeth LLC, E.D. Pa., No. 2:25-cv-01383, 3/14/25″ 

From the public health and medical research front,

  • The Washington Post reports,
    • “By 2050, there will be an estimated 25.2 million people living with Parkinson’s disease worldwide, a 112 percent increase from 2021, according to a new study published in the journal BMJ.
    • “The World Health Organization estimated that 8.5 million people worldwide were living with Parkinson’s disease in 2019.
    • “Researchers used data from the 2021 Global Burden of Disease Study, pulling information from 195 countries and territories. They identified aging and population growth as the main contributors to the projected increase in Parkinson’s numbers, noting that growth rates would differ at regional and national levels.”
  • The American Medical Association lets us know what doctors wish their patients knew about pertussis.
  • MedPage Today tells us,
    • “A probiotic mixture reduced fever duration by 2 days versus placebo among children with upper respiratory tract infections.
    • “Probiotics have emerged as a new potential approach to managing infectious diseases.
    • “Adverse events were mild, and did not significantly differ between the two groups.
  • and fills us in on which adults need a measles booster in the U.S.
  • Beckers Hospital Review identifies the “10 most, least overweight and obese cities in the U.S.”
    • “McAllen, Texas, topped WalletHub’s 2025 ranking of the most overweight and obese cities in the U.S., published March 17, while Honolulu is the healthiest-weight city.”
  • Per a press release,
    • “The National Institute of Standards and Technology (NIST) has released a human stool reference material that will help scientists accurately measure the gut microbiome. The initiative aims to speed progress in a cutting-edge field of medical research targeting some of humanity’s most serious and intractable diseases.
    • “The human gut microbiome is a rich, teeming ecosystem of microorganisms and their byproducts that line the human gastrointestinal tract. Over the last decade, scientists have linked activity in the gut microbiome to obesity, diabetes, mental illness, cancer and other medical conditions. Researchers believe that a new class of drugs targeting the gut microbiome can treat many of these conditions.”
  • Per National Institutes of Health news releases,
    • “Surgical removal of enlarged tonsils and adenoids in children with mild sleep-disordered breathing (SDB) appears to significantly reduce the frequency of medical office visits and prescription medicine use in this group, according to a clinical study supported by the National Institutes of Health (NIH). The findings, published in JAMA Pediatrics, show that the surgery, called adenotonsillectomy, was tied to a 32% reduction in medical visits and a 48% reduction in prescription use among children with a mild form of the condition.”
  • and
    • In a preclinical study, rodents treated with uric acid showed improved long-term outcomes after acute ischemic stroke. The findings suggest that the treatment may work as an add-on therapy to standard stroke treatments in humans. The study was funded by the National Institutes of Health (NIH) and published in Stroke.
  • Consumer Reports, writing in the Washington Post, informs us about “Everything you need to know to keep your teeth healthy. Toothpaste matters, and you might want to consider adding a tongue scraper to your routine.”
  • Per BioPharma Dive,
    • “An experimental cellular medicine developed by Orca Bio outperformed a standard stem cell transplant in treating people with several types of blood cancer by helping avert a potentially dangerous side effect. 
    • “According to clinical trial results announced by Orca on Monday, about three-quarters of people treated with the company’s T cell immunotherapy did not experience moderate-to-severe chronic graft-versus-host disease through one year, compared to only 38% of those given the standard transplant. 
    • “Graft-versus-host disease, or GvHD, is a serious complication of transplants involving cells sourced from matched donors. Orca aims to develop its therapy, which uses a purified mix of donor-derived T cells and stem cells, as a safer transplant alternative in cancers like acute myeloid leukemia.”

From the U.S. healthcare business front,

  • Beckers Hospital Review relates,
    • “Median hospital margins remained stable to kick off 2025, as many reported higher service volumes and expenses.
    • “Kaufman Hall’s “National Hospital Flash Report” revealed January median operating margins hit 4.4%, up from 3.7% in December and 0.6% last January. Without allocations, the median operating margin grew to 8%, a 12-month high. the averages are based on data from more than 1,300 hospitals and gathered by Strata Decision Technology. 
    • “January was a relatively stable month for hospitals, as more people received care due in part to seasonal challenges like flu and other respiratory diseases. Hospitals are also experiencing more rapid revenue growth from inpatient than outpatient services. Expenses are also rising, driven primarily by drug costs, though the rate of cost growth has slowed,” said Erik Swanson, managing director and group leader, data and analytics, of Kaufman Hall.”
  • Fierce Healthcare notes,
    • “Highmark Health reported $29.4 billion in revenue and $50 million in net income for 2024 as the organization continues to weather notable headwinds that have battered health insurers.
    • “Highmark also posted $209 million in operating losses, according to its earnings report released last week. The full year results “reflect the negative operating performance of Highmark Health Plans,” the company said in a press release, as the team faced cost pressures throughout the year.
    • “United Concordia Dental and HM Insurance Group, the company’s stop-loss division, were bright spots with steady performance. Highmark said that trend was backed by growing dental membership and a disciplined pricing approach.
    • “Its health system, Allegheny Health Network, also saw improvements as patient volumes increased across “all delivery areas.”
    • “While our consolidated revenue improved, we continue to face significant industry headwinds and medical cost trends, including high costs for prescription drugs, especially GLP-1s, the impact of Medicaid redeterminations and nationwide high utilization, especially within the Medicare Advantage portfolio,” said Carl Daley, chief financial officer and treasurer of Highmark Health.” 
  • Fierce Pharma points out “the top 10 drugs losing US exclusivity in 2025.”
    • “While each year features high-profile losses of exclusivity in the pharma industry, this year’s list is something of a doozy.”
  • The Wall Street Journal reports,
    • “Pfizer PFE had a problem. Doctors weren’t prescribing its migraine drug Nurtec because they assumed insurance coverage would be too much of a hassle.
    • “So last year the company created a phone line for doctors and patients to call Pfizer directly for help. Pfizer now credits that and other changes for a 31% increase in Nurtec’s U.S. sales last year.
    • “The beleaguered drugmaker’s shares still haven’t recovered from their post-Covid slump, and shareholders are wary. But sales of products such as Nurtec and the vaccine Abrysvo that the company has been counting on are rising, and an activist shareholder’s push has lost steam. 
    • “Pfizer did it by shaking up its U.S. sales strategy, shifting where it deploys its sales representatives, how they market to doctors and how the company helps patients pay for their prescriptions.”
  • Per Modern Healthcare,
    • “Scripps Health plans to build a $1.2 billion medical campus that will include a 200- to 250-bed hospital and outpatient facilities.
    • “The San Diego-based health system’s board last week approved the 13-acre development in San Marcos, California. The first phase of the project will feature space for specialty and primary care offices, ambulatory surgery, cancer care, imaging, lab and other services, and the second phase includes the hospital, according to a Monday news release.
    • “The outpatient center will be built in two to three years, and the hospital will take about six years, a spokesperson estimated.”
  • and
    • “Sharon Regional Medical Center is set to reopen Tuesday, about two months after the former Steward Health Care facility in Pennsylvania closed.
    • “On Friday, the Pennsylvania Department of Health approved Pasadena, California-based Tenor Health Foundation’s plans to reopen the 163-bed hospital. In January, Judge Christopher Lopez of the U.S. Bankruptcy Court for the Southern District of Texas in Houston signed off on the hospital management company’s takeover of the facility, which employed more than 800 workers“
  • From BioPharma Dive,
    • “AstraZeneca is bolstering its cell therapy capabilities, agreeing on Monday to pay up to $1 billion for a biotechnology startup making treatments that reprogram cells inside the body.
    • “The British drugmaker is buying EsoBiotech, a Belgian startup, for $425 million in cash upfront. EsoBiotech’s investors, among them Invivo Partners and UCB Ventures, could receive up to $575 million in additional payouts should the startup’s programs hit certain development and regulatory milestones, AstraZeneca said in a statement.”

Weekend Update

David Ermer–Congress, Medical / Rx research, OPM, Rx coverage, U.S. Healthcare–

From Washington, DC,

  • Roll Call reports,
    • “President Donald Trump signed the wrapup spending bill for fiscal 2025 on Saturday, heading off a partial government shutdown that would have begun to be felt on Monday when federal agencies are scheduled to open for business.
    • “The six-month stopgap measure, which funds government programs through Sept. 30, cleared the Senate on Friday after enough Democrats crossed the aisle to vote to end debate, defying intense pressure from the left wing of their party. The deadline for Trump’s signature was technically midnight, but shutdown procedures don’t typically begin until the workweek starts.”
  • Here’s a link to the American Medical Association’s view of last week’s MedPAC report to Congress.
    • “Endorsing a stabilizing approach to Medicare reform, the Medicare Payment Advisory Commission (MedPAC) recommended today that Congress link next year’s physician payment update to the growth in the cost of providing care.
    • “The recommendation comes just as Congress failed this week to prevent this year’s 2.8 percent cut, marking the fifth consecutive year of cuts. 
    • “With exquisite timing, MedPAC has highlighted how Congress can strengthen Medicare policy. With uncertainty surrounding the continuing resolution, the report offers a roadmap to Congress on how to address the cuts,” said American Medical Association President Bruce A. Scott, M.D. “The AMA appreciates commissioners and staff for listening to physicians around the country.”

From the judicial front,

  • Bloomberg Law reported last Friday night,
    • “The Trump administration filed an emergency motion Friday asking a federal appeals court to immediately pause an order from a San Francisco judge requiring six cabinet agencies to rehire thousands of terminated employees.
    • “The petition asks the US Court of Appeals for the Ninth Circuit, the largest appeals court in the country, to issue an order on Friday temporarily blocking a preliminary injunction from Judge William Alsup while the case proceeds through the appeals process.
    • “The judge, who sits on the US District Court for the Northern District of California, on Thursday ordered the departments of Defense, Veterans Affairs, Energy, Interior, Agriculture, and Treasury to rehire the probationary employees who were laid off in early February at the direction of the Office of Personnel Management.
    • “The government also filed a notice of appeal on Friday to the Fourth Circuit in a second case that reinstated probationary workers. A Maryland federal judge on Thursday ruled in that case that 18 different federal agencies must rehire the workers.”
  • Govexec adds in a report posted last night,
    • “The Trump administration appears to be preparing to comply with multiple court orders to quickly place tens of thousands of federal workers fired during their probationary periods, according to officials at three agencies briefed on the plans. 
    • “The recently hired, or in some cases recently promoted or transferred, employees will not immediately go back to their jobs but instead be placed on paid administrative leave. The employees are impacted by two separate court rulings issued on Thursday, which could lead to different outcomes for different workers.”

From the public health and medical research front,

  • The Washington Post reports,
    • “How old are your organs? The answer might not match your chronological age — and a new analysis finds that an organ’s biological age might predict a person’s risk of diseases such as cancer, dementia and heart disease.
    • “The research, published in the Lancet Digital Health, analyzed data from Whitehall II, a long-running British study of aging that has followed over 10,000 British adults for more than 35 years. Between 1997 and 1999, the Whitehall study took blood plasma samples from participants when they were 45 to 69 years old.
    • “The current study analyzed those blood samples as well as follow-up data for 6,235 Whitehall participants, who were by then ages 65 to 89. The researchers used the analysis to help measure the gap between a person’s age and the biological age of nine of their organs: heart, blood vessels, liver, immune system, pancreas, kidneys, lungs, intestines and brain. Then they looked at follow-up data that showed the kinds of diseases participants developed as they aged over the next two decades.
    • The organs aged at different rates in different people and even within the body, the researchers write — and those with “fast-aging” organs had an increased risk of 30 of the 45 age-related diseases studied.” * * *
    • “The researchers say the study shows the promise of an organ-specific blood test, which is simpler than past methods.”
  • The Post also offers “The good news about anxiety. In the right amount, anxiety can heighten focus and detail orientation. It also spurs creativity and motivates us to problem-solve.”
  • The Wall Street Journal delves into “Generation Xanax: The Dark Side of America’s Wonder Drug. Amid rising concerns about benzodiazepines, some patients who try to quit are suffering extreme anxiety, memory loss and intense physical pain.”
  • Medscape tells us,
    • “Glucagon-like peptide 1 receptor agonists (GLP-1RA) are linked to a 54% lower risk for developing hematologic cancers than insulin in patients with type 2 diabetes (T2D). The medication shows particular effectiveness in reducing risk for myelodysplastic syndromes and myeloproliferative neoplasms vs metformin.”

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • “A new breed of drug middlemen are pushing an unusual cost-saving strategy that lets their employer clients tap a federal program meant for hospitals that serve the poor.
    • “The government program, known as 340B, allows hospitals that care for many uninsured and low-income patients to purchase outpatient medicines at steep discounts. Hospitals can pocket the savings, but they can also choose to pass the discounts on to patients at their pharmacies.
    • Companies such as Rescription, MakoRx and Liviniti are selling pharmacy-benefit plans that save employers money by funneling workers to those 340B hospital pharmacies instead of traditional drugstores. The workers get the discounted 340B price under these plans. Hospitals participate because it expands their customer base and they receive fees for dispensing prescriptions, the companies say.
    • “The companies count some of the participating hospitals among their clients, providing benefits for hospital workers. They say they are hoping to change the business of pharmacy-benefit managers, or PBMs, which traditionally negotiate prices for their clients with drugmakers and demand rebates to cut net costs.”

Cybersecurity Saturday

David Ermer–Cybersecurity, OPM–

From the cybersecurity policy and law enforcement front,

  • Federal News Network lets us know,
    • “A former Energy Department and National Security Council official has been tapped to lead the Cybersecurity and Infrastructure Security Agency [CISA].
    • “President Donald Trump today [March 11, 2025,] formally nominated Sean Plankey to serve as director of CISA. Plankey’s name was included among a slew of nominations sent to the Senate.
    • “During Trump’s first term, Plankey served as principal deputy assistant secretary for Energy’s Office of Cybersecurity, Energy Security and Emergency Response, known as “CESER,” which leads cyber preparedness in the energy sector. He also served on Trump’s National Security Council as director for maritime and Pacific cybersecurity policy.”
  • Per a March 12, 2025, CISA news release,
    • CISA’s Red Team is among the best in the world and remains laser focused on helping our federal and critical infrastructure partners identify and mitigate their most significant vulnerabilities and weaknesses. This has not changed.
    • Contrary to inaccurate reporting, CISA has not “laid off” our Red Team. CISA has taken action to terminate contracts where the agency has been able to find efficiencies and eliminate duplication of effort. As good stewards of the taxpayer dollar and in accordance with good fiscal governance practices, CISA regularly reviews contracts across the agency to ensure that we have the capabilities that we need and that we are allocating resources in ways that make the most impact. This was a contract action that did not impact the employment status of CISA personnel.  
    • CISA’s Red Teams continue their work without interruption. The team works directly with network defenders, system administrators, and other technical staff to address strengths and weaknesses across critical infrastructure networks and systems. They continue to assist organizations in refining their detection, response, and hunt capabilities to protect the nation’s critical infrastructure from a range of threats.
  • Dark Reading offers context for this release.
  • The National Institute of Standards and Technology announced on March 12, 2025,
    • “The comment period for [draft] NIST Special Publication 1308, NIST Cybersecurity Framework 2.0: Cybersecurity, Enterprise Risk Management, and Workforce Management Quick Start Guide is open through April 25, 2025, at 11:59 PM.”
  • Fedscoop tells us,
    • “Ethan Klein, an emerging technology policy adviser during the first Trump administration, has been nominated to be the White House’s chief technology officer, the Office of Science and Technology Policy confirmed Tuesday. 
    • “After serving in the first Trump White House, Klein completed a PhD in nuclear science and engineering at MIT, where he worked to develop nuclear tech for arms control and nonproliferation with funds from a fellowship through the National Nuclear Security Administration.” 
  • and
    • An Office of Personnel Management watchdog investigation into cybersecurity risks on government networks and the potential exposure of sensitive information will include an examination of DOGE access to those systems.
    • OPM’s Office of Inspector General said in a letter to Democrats on the House Oversight Committee that it would incorporate “parts” of the lawmakers’ February request to probe DOGE’s unauthorized accessing of IT networks and Americans’ data into “existing work.” The watchdog also said it had “initiated a new engagement on specific emerging risks at OPM that are related to issues raised” in Democrats’ letter.
  • Dark Reading relates,
    • “A dual Russian-Israeli citizen working as one of LockBit ransomware group’s lead developers has been extradited from Israel to the US. Rostislav Panev, 51, was arrested in 2023 and had his first US court appearance on March 14.
    • “According to the complaint against him, Panev was a developer for LockBit ransomware group from 2019 to at least February 2024. The ransomware group attacked more than 2,500 victims in 120 countries, 1,800 of them in the US. Victims ranged from individuals to small businesses and even multinational corporations that included nonprofit organizations, educational institutions, hospitals, and critical infrastructure. In targeting them, LockBit was able to garner at least $500 million in ransom payments and cause billions of dollars in losses.”

From the cybersecurity vulnerabilities and breaches front,

  • Security Week reports on March 10, 2025,
    • “More than 560,000 people were impacted across four data breaches disclosed last week to authorities by the healthcare organizations Hillcrest Convalescent Center, Gastroenterology Associates of Central Florida, Community Care Alliance, and Sunflower Medical Group.”
  • CISA added thirteen known exploited vulnerabilities to its catalog this week:
    • March 10, 2025
      • CVE-2025-25181 Advantive VeraCore SQL Injection Vulnerability
      • CVE-2024-57968 Advantive VeraCore Unrestricted File Upload Vulnerability
      • CVE-2024-13159 Ivanti Endpoint Manager (EPM) Absolute Path Traversal Vulnerability
      • CVE-2024-13160 Ivanti Endpoint Manager (EPM) Absolute Path Traversal Vulnerability
      • CVE-2024-13161 Ivanti Endpoint Manager (EPM) Absolute Path Traversal Vulnerability
        • NIST discusses the Advantive CVEs here and here
        • Cybersecurity Dive discusses the Ivanti CVEs here.
    • March 11, 2025
      • CVE-2025-24983 Microsoft Windows Win32k Use-After-Free Vulnerability
      • CVE-2025-24984 Microsoft Windows NTFS Information Disclosure Vulnerability
      • CVE-2025-24985 Microsoft Windows Fast FAT File System Driver Integer Overflow Vulnerability
      • CVE-2025-24991 Microsoft Windows NTFS Out-Of-Bounds Read Vulnerability
      • CVE-2025-24993 Microsoft Windows NTFS Heap-Based Buffer Overflow Vulnerability
      • CVE-2025-26633 Microsoft Windows Management Console (MMC) Improper Neutralization Vulnerability
        • Cyberscoop discusses these CVEs here.
    • March 13, 2025
      • CVE-2025-24201 Apple Multiple Products WebKit Out-of-Bounds Write Vulnerability
      • CVE-2025-21590 Juniper Junos OS Improper Isolation or Compartmentalization Vulnerability
        • Cyberscoop discusses the Apple CVE here.
        • Cybersecurity Dive discusses the Juniper CVE here.

From the ransomware front,

  • Cybersecurity Dive reports,
    • “The Medusa ransomware gang has infected more than 300 organizations in critical infrastructure sectors such as the medical, manufacturing and technology industries.
    • That’s according to a joint cybersecurity advisory published Wednesday by CISA, the FBI and the Multi-State Information Sharing and Analysis Center (MS-ISAC). The agencies noted that Medusa — which is not connected to MedusaLocker ransomware — has been active since 2021 and initially began as a closed ransomware operation.
    • “While Medusa has since progressed to using an affiliate model, important operations such as ransom negotiation are still centrally controlled by the developers,” the [March 12, 2025,} advisory said. “Both Medusa developers and affiliates — referred to as ‘Medusa actors’ in this advisory — employ a double extortion model, where they encrypt victim data and threaten to publicly release exfiltrated data if a ransom is not paid.”
  • and
    • “A newly discovered ransomware strain, tracked as SuperBlack, has been used in a series of attacks targeting critical vulnerabilities in Fortinet since late January, according to a report by Forescout Research-Vedere Labs.
    • “The attacks involved exploitation of two vulnerabilities, CVE-2024-55591 and CVE-2025-24472, which can allow unauthenticated attackers to gain super admin privileges on FortiOS firewalls. 
    • “Researchers link the attacks to a threat actor — tracked as Mora_001 — that has operational overlaps with LockBit ransomware operations.
       
  • and
    • “About six of every 10 ransomware claims in 2024 involved the compromise of a perimeter security device such as a virtual private network or firewall, according to the Coalition Cyber Threat Index report released Tuesday [March 11, 2025]. In two of every 10 cases, remote desktop protocols were exploited for initial access. 
    • “Stolen credentials served as the initial access vectors in almost half of the cases, while software vulnerabilities were exploited in about three of every 10 cases. 
    • “Two thirds of businesses had at least one internet-exposed web login panel at the time they applied for cyber insurance policies, according to the report. The cyber insurance provider said it detected more than 5 million exposed remote management solutions and tens of thousands of exposed login panels.”
  • Dark Reading points out,
    • “A recent analysis of a year’s worth of chat logs from the infamous Black Basta ransomware group revealed that its members used nearly 3,000 unique credentials to attempt to compromise a variety of corporate networks.
    • “The top five uses of the credentials? Targeting remote-desktop software and virtual private networks (VPNs), according to threat intelligence firm KELA, which published its analysis of the chat logs last week.
    • “From Microsoft’s Remote Desktop Web Access to Palo Alto’s Global Protect and from Cisco’s VPN services to general remote login portals, stealing credentials to target remote access is perhaps the most popular technique used by ransomware groups. Once compromised, such services can be used as gateways to the corporate networks and quickly lead to data exfiltration and eventual ransomware deployment, says Irina Nesterovsky, chief research officer for KELA.
    • “Obtaining such credentials and successfully accessing those platforms — either due to lack of MFA or bypassing it — allows the actors a foothold into an organization’s network, which they can then further expand using different tools and reconnaissance,” she says. “KELA observed the Black Basta ransomware actors discussing the sourcing of specifically login credentials to VPN and remote access portals in the context of a ransomware operation — it is very clear what such credentials are abused for.”
  • Bleeping Computer adds,
    • “The Black Basta ransomware operation created an automated brute-forcing framework dubbed ‘BRUTED’ to breach edge networking devices like firewalls and VPNs.
    • “The framework has enabled BlackBasta to streamline initial network access and scale ransomware attacks on vulnerable internet-exposed endpoints.
    • “The discovery of BRUTED comes from EclecticIQ researcher Arda Büyükkaya following an in-depth examination of the ransomware gang’s leaked internal chat logs.”
  • Per Security Affairs,
    • “Microsoft observed a North Korea-linked APT group, tracked as Moonstone Sleet, deploying Qilin ransomware in limited attacks since February 2025. The APT group uses Qilin ransomware after previously using custom ransomware.
    • “Moonstone Sleet has previously exclusively deployed their own custom ransomware in their attacks, and this represents the first instance they are deploying ransomware developed by a RaaS operator.” Microsoft wrote on X.
    • “In May 2024, Microsoft observed the North Korea-linked group “Moonstone Sleet” (Previously tracked as Storm-1789) using known and novel techniques like fake companies, trojanized tools, a malicious game, and custom ransomware for financial gain and espionage.
    • Storm-1789, initially linked to other North Korean threat groups, has since adopted unique tactics, tools, and attack infrastructure.
    • “Moonstone Sleet threat actors target financial and cyberespionage victims using trojanized software, custom malware, malicious games, and fake companies like StarGlow Ventures and C.C. Waterfall to engage victims on LinkedIn, freelancing sites, Telegram, and email.”

From the cybersecurity defenses front,

  • Dark Reading explains why “Healthcare organizations must enhance their cybersecurity arsenal. Doing so can help them prevent financial, compliance, and reputational damage.
  • Here’s a link to Dark Reading’s CISO Corner.

Happy Pi Day!

David Ermer–CDC, CMS, Congress, COVID-19, FDA, Government Contracting, Medical / Rx research, Medicare, Obesity, U.S. Healthcare–

From Washington, DC

  • The American Hospital Association (AHA) News lets us know,
    • “The Senate March 14 approved by a vote of 54-46, a continuing resolution to fund the government through Sept. 30. The House passed, by a vote of 217-213, the bill earlier in the week. President Trump is expected to sign the measure.
    • “The bill extends certain key health care provisions that were set to expire at the end of March, including eliminating Medicaid disproportionate share hospital cuts, and extending the enhanced low-volume adjustment and Medicare-dependent hospital programs; key telehealth waivers; the hospital-at-home program; the Work Geographic Index Floor program; and add-on payments for ambulance services.”
  • Upshot — No government shutdown.
  • Fierce Healthcare adds,
    • “A last-ditch effort to pass a bipartisan healthcare package pushed aside at the end of 2024 that includes telehealth extensions and pharmacy benefit manager reform, reverses doc pay cuts and addresses the opioid crisis has failed.
    • “That legislation was brought to the floor by Senators Ron Wyden, D-Oregon and Bernie Sanders, I-Vermont, March 14 ahead of a key procedural vote [on the continuing resolution]. The senators’ bill required unanimous consent, or it would not advance. Sen. Rick Scott, R-Florida, quickly rejected the bill.”
  • Per a Senate news release,
    • “Today, the Senate overwhelmingly voted to pass the Halt All Lethal Trafficking of (HALT) Fentanyl Act. The bipartisan legislation, led by Judiciary Chairman Chuck Grassley (R-Iowa), Health, Education, Labor and Pensions Chairman Bill Cassidy, M.D. (R-La.) and Sen. Martin Heinrich (D-N.M.), would permanently classify fentanyl-related substances before their temporary Schedule I status expires on March 31, 2025. 
    • “Last month, the HALT Fentanyl Act was passed out of the Senate Judiciary Committee by a bipartisan vote of 16-5. Attorney General Pam Bondi has endorsed the legislation. President Trump’s Office of Management and Budget has confirmed that, if Congress passes the bill in its current form, the president will sign it. The legislation now heads to the House of Representatives.
    • “The HALT Fentanyl Act is a critical step towards ending the crisis that’s killing hundreds of thousands of precious American lives. I thank my Senate colleagues for passing this bill with broad, overwhelming support. I urge my House colleagues to swiftly pass the Senate version of this battle-tested, bipartisan bill to save lives, advance research and support our brave men and women in blue,” Grassley said.: * * *
    • “Download bill text HERE and a fact sheet HERE.”
  • The AHA News tells us,
    • “The Senate Finance Committee March 14 held a confirmation hearing on Mehmet Oz’s nomination for administrator of the Centers for Medicare & Medicaid Services. Oz, a doctor and former television show host, indicated that some of his priorities in the position, if confirmed, would be to reduce health care spending by improving poor health, increasing use of technology, incentivizing providers, and stopping wasteful spending, fraud and abuse. The committee will soon schedule a vote on whether to advance his nomination to the full Senate.”
  • The Wall Street Journal adds,
    • “Mehmet Oz, the Trump administration’s nominee to lead the Medicare agency, said some actions by private insurers in the Medicare Advantage program amounted to fraud and cheating, and he intended to go after them as head of the Centers for Medicare and Medicaid Services. 
    • “His comments, during his Senate confirmation hearing on Friday, were focused on industry practices that can boost insurers’ Medicare Advantage payments by documenting more diagnoses in their patients. Medicare Advantage insurers get higher payouts when patients have certain conditions. 
    • “There’s a new sheriff in town,” said Oz, a heart surgeon known for his long-running television show. He criticized “upcoding” in Medicare Advantage and said, “I pledge if confirmed I will go after it.”
  • Per Senate news releases,
    • “Sen. Chuck Grassley (R-Iowa), a senior member and former chairman of the Senate Finance Committee, laid out his health care priorities during a hearing to consider Dr. Mehmet Oz’s nomination to be Administrator of the Centers for Medicare and Medicaid Services (CMS). Oz committed to supporting Grassley’s efforts to lower prescription drug costs, strengthen rural health care, help kids with exceptional medical needs, preserve transitional health plans and improve the agency’s responsiveness to Congress.”
  • and
    • “At a U.S. Senate Finance Committee hearing to consider the nomination of Dr. Mehmet Oz to be Centers for Medicare and Medicaid Services (CMS) Administrator, Chairman Mike Crapo (R-Idaho) highlighted Dr. Oz’s wealth of firsthand experience as an accomplished physician and his clear vision for creating a healthier nation.  Crapo and Dr. Oz discussed how he would address the nation’s chronic disease epidemic, as well as how he might approach reforming payment programs to improve efficiency.
    • “Crapo concluded the hearing with, “There is no doubt you are qualified to serve as the next Administrator of [CMS], and I look forward to voting in favor of your nomination and am urging all of my colleagues to do the same.”
  • The AHA News informs us,
    • “The Medicare Payment Advisory Commission March 13 released its March report to Congress that includes recommendations for hospital and other Medicare payment systems for fiscal year 2026. Among the recommendations, MedPAC urged Congress to update the base payment rate for hospitals by current law plus 1%.  
    • “An update above current law is necessary given the combination of providers’ continued financial pressures, and almost two decades of sustained and substantial negative Medicare margins,” AHA wrote in a January letter to MedPAC. “Simply put, even after the recommended payment update, Medicare’s payments to hospitals would remain inadequate.” 
  • Per a Food and Drug Administration news release,
    • “Today, a study co-authored by U.S. Food and Drug Administration scientists was released showing the agency’s youth e-cigarette prevention campaign, “The Real Cost,” successfully reduced e-cigarette use among youth. The campaign, which launched in 2018 under the leadership of President Trump, was found to have prevented an estimated 444,252 American youth (age 11 to 17 at study recruitment) from starting to use e-cigarettes between 2023 and 2024.
    • “The new study, published in the peer-reviewed scientific journal American Journal of Preventive Medicine, found evidence that the campaign contributed to the nearly 70% decline in e-cigarette use among American youth that has occurred since 2019. According to the National Youth Tobacco Survey, the number of U.S. middle and high school students who currently use e-cigarettes has declined from 5.38 million in 2019 to 1.63 million in 2024, the lowest level in a decade.”

From the judicial front,

  • Politico reports,
    • “A federal appeals court has given President Donald Trump’s administration the go-ahead to enforce a pair of controversial executive orders that seek to root out diversity, equity and inclusion efforts in federal agencies and government contractors.
    • “The three-member appeals panel — including two judges appointed by Democratic presidents — lifted a lower court’s injunction that had put the policy on hold last month.
    • The ruling Friday from the panel of the Richmond, Virginia-based 4th Circuit Court of Appeals is not a final decision on the legality of Trump’s anti-DEI policy. It merely allows the government to administer the policy while litigation continues.
    • “In separate opinions explaining their votes, the three judges suggested the Trump administration should be allowed to demonstrate that it will abide by anti-discrimination laws and respect First Amendment rights as it implements the executive orders, which Trump issued on the first two days of his new term.”

From the public health and medical research front,

  • The Center for Disease Control and Prevention announced today,
    • “Seasonal influenza activity remains elevated nationally but has decreased for four consecutive weeks. COVID-19 activity is declining nationally but elevated in some areas of the country. RSV activity is declining in most areas of the country.
    • “COVID-19
      • “COVID-19 activity is declining nationally but elevated in some areas of the country. Wastewater levels and emergency department visits are at low levels, and laboratory percent positivity is stable. Emergency department visits and hospitalizations are highest in older adults and emergency department visits are also elevated in young children.
      • “There is still time to benefit from getting your recommended immunizations to reduce your risk of illness this season, especially severe illness and hospitalization.
      • “CDC expects the 2024-2025 COVID-19 vaccine to work well for currently circulating variants. There are many effective tools to prevent spreading COVID-19 or becoming seriously ill.
    • “Influenza
      • “Seasonal influenza activity remains elevated nationally but has decreased for four consecutive weeks. Data to date suggest the season has peaked, however, flu-related medical visits, hospitalizations, and deaths remain elevated, and CDC expects several more weeks of flu activity.
      • “Additional information about current influenza activity can be found at: Weekly U.S. Influenza Surveillance Report | CDC
    • “RSV
      • “RSV activity is declining in most areas of the country. Emergency department visits and hospitalizations are highest in children and hospitalizations are elevated among older adults in some areas.
    • “Vaccination
      • “Vaccination coverage with influenza and COVID-19 vaccines is low among U.S. adults and children. Vaccination coverage with RSV vaccines remains low among U.S. adults. Many children and adults lack protection from respiratory virus infections provided by vaccines.”
  • The University of Minnesota’s CIDRAP reports,
    • “The measles outbreak in Texas has risen by 36 cases, pushing the US case count for the year past the number for all of 2024.
    • “The outbreak of the highly contagious virus, which began in late January and is centered in the western part of the state, now stands at 259 cases, according to the latest update from the Texas Department of State Health Services (DSHS). Of those patients, 257 are either unvaccinated or have unknown vaccination status, and 201 are children ages 17 or younger. Thirty-four patients have been hospitalized, with one death in an unvaccinated child who had no known underlying conditions.
    • “Eleven counties to date have reported cases, but two thirds of the cases (174; 67%) are in Gaines County, which has one of the highest rates of school-aged children in Texas who have opted out of at least one vaccine. The county is home to a large Mennonite community with low vaccination rates.
    • “DSHS officials said they have determined that three of the case-patients previously listed as vaccinated were not vaccinated. Two had received their measles, mumps, and rubella (MMR) vaccine doses 1 to 2 days before their symptoms started and after they had been exposed to the virus. The third had a vaccine reaction that mimicked a measles infection and has been removed from the case count.”
  • The University of Minnesota CIDRAP also notes,
    • “The US Food and Drug Administration (FDA) yesterday announced the strains it recommends manufacturers include in seasonal flu vaccines for the 2025-26 flu season, and [as usual] they mirror recommendations announced by the World Health Organization (WHO) last month.” 
  • Gallup reports,
    • “Americans’ assessments of their mental and physical health are the least positive they have been in Gallup’s 24-year trend, reflecting a decadelong decline that began around 2013 and accelerated sharply with the onset of the COVID-19 pandemic in 2020.
    • “Three in four U.S. adults in Gallup’s latest annual reading rate their mental health (75%) and, separately, their physical health (76%) as either “excellent” or “good.” This contrasts with a record-high 89% rating their mental health positively as recently as 2012, and a high of 82% for physical health in 2003.
    • “As fewer Americans have rated their mental and physical health positively, most of the change has been in the percentages rating each aspect “excellent” — shrinking to 31% for mental health and 24% for physical health.”
  • The National Science Foundation points out,
    • “A team of researchers led by the recipient of a U.S. National Science Foundation Faculty Early Career Development grant has developed a new storage method for protein-based drugs that could potentially eliminate the need for refrigeration of important medicines. Using an oil-based solution and a molecule acting as a coating to enclose the proteins in these drugs, researchers demonstrated a technique to prevent the proteins from degrading rapidly — a protection that traditionally requires refrigeration.
    • “The research is led by Scott Medina at Pennsylvania State University and published in Nature Communications. It demonstrates a possible practical application to eliminate the need to refrigerate hundreds of life-saving medicines like insulin, monoclonal antibodies and viral vaccines.
    • “The work could eventually reduce the cost of refrigerating such drugs throughout the supply chain and enable greater use of protein-based therapies where constant refrigeration isn’t possible, including military environments. 
    • “Over 80% of biologic drugs and 90% of vaccines require temperature-controlled conditions. This approach could revolutionize their storage and distribution, making them more accessible and affordable for everyone,” says Medina.”
  • Per a National Institutes of Health news release,
    • “Researchers at the National Institutes of Health (NIH) have determined that dermatitis resulting from topical steroid withdrawal (TSW) is distinct from eczema and is caused by an excess of an essential chemical compound in the body. Scientists from NIH’s National Institute of Allergy and Infectious Diseases (NIAID) identified treatments that could be studied in clinical trials for the condition based on their potential to lower levels of the chemical compound—called nicotinamide adenine dinucleotide (NAD+), a form of vitamin B3. The findings were published today in the Journal of Investigative Dermatology.
    • “Dermatitis is characterized by inflammation, itching, or burning sensations on the skin, and can result from various conditions including TSW and eczema. Eczema, also known as atopic dermatitis, is a common cause of dermatitis and affects 10 to 30% of children and 2 to 10% of adults each year in the United States. Topical steroids—specifically glucocorticoids or topical corticosteroids—have long been used as a first-line treatment for dermatitis caused by eczema because the drugs are safe, effective, easy to apply, and considered well-tolerated.” * * *
    • “The scientists provisionally established criteria that can be used by health care providers to identify TSW in people. People who have stopped topical steroid treatment and meet the criteria may be diagnosed by practitioners as having TSW. The researchers suggest that patients identified as having TSW could be treated using the proposed mitochondrial complex I-blocking drugs.
    • “The results of this study may help practitioners identify TSW in patients and work towards developing safe and effective treatments. According to the researchers, more research is needed to determine whether all patients with TSW have an excess of NAD+, or if there are other features that define TSW. Additionally, the diagnostic criteria will help health care providers and researchers to better understand the prevalence of TSW and evaluate the effects of using topical steroids.”

From the U.S. healthcare business front,

  • The New York Times reports,
    • “It’s easy to make a medical case for blockbuster weight loss drugs like Wegovy and Zepbound, which have been shown to prevent heart attacks and strokes and save lives.
    • “But for the employers and government programs being asked to pay for the medications, the financial case for them is less clear. Are the drugs’ benefits worth their enormous cost?
    • “The answer right now is no, according to a new study published on Friday in the journal JAMA Health Forum, by researchers at the University of Chicago.
    • “To be considered cost effective by a common measure used by health economists, the price of Novo Nordisk’s Wegovy would need to be cut by over 80 percent, to $127 per month, the researchers concluded. And Eli Lilly’s Zepbound would be cost effective only if its price fell by nearly a third, to $361 per month. (Zepbound warranted a higher price, the researchers said, because it produced greater benefits in clinical trials.)”
  • Per STAT News,
    • “Biotech company Altimmune announced in an investor call yesterday that it will study its obesity drug, which targets receptors of the GLP-1 and glucagon hormones, in alcohol use disorder, as mounting evidence supports the potential of GLP-1 drugs to help with addiction.
    • “Altimmune executives think that their molecule, called pemvidutide, could be particularly helpful for liver conditions, since there are glucagon receptors located in the liver. The company has already been studying the drug in weight loss and in the liver disease MASH, and are now expanding into alcohol-related conditions.
    • “The company plans to start a study in alcohol use disorder in the second quarter of this year, and another study in alcohol-related liver disease in the third quarter.
    • “Eli Lilly has also started studying mazdutide, a GLP-1/glucagon drug it’s developing with Chinese biotech Innovent, in alcohol use disorder. Lilly CEO Dave Ricks has said the company also plans to test obesity drugs in other areas of addiction, like nicotine and drug use disorders.
    • “Novo Nordisk is running a study of its obesity drugs in alcohol-related liver disease but has not yet started any trials in addiction.”
  • Per Beckers Hospital CFO Report,
    • As healthcare organizations continue to navigate shifting financial and operational landscapes, new data from Kaufman Hall and Strata highlights significant trends in physician productivity, compensation, and costs.
    • In the fourth quarter, median work relative value units per full-time physician varied across specialties, with medical specialties leading at 7,139 wRVUs. Physician compensation followed a similar pattern, with surgical specialists earning the highest median paid compensation at $491,000 per FTE.
    • Despite an encouraging increase in net revenue per physician, rising expenses remain a challenge. These figures underscore the mounting financial pressures and workforce challenges facing healthcare organizations. For executives, balancing rising costs, evolving productivity demands, and compensation structures will be critical in sustaining financial stability and operational efficiency.
  • Beckers Hospital Review points out ten drugs poised to be top sellers next year.

Thursday Report

David Ermer–CDC, Congress, FDA, NIH, U.S. Healthcare–
Photo by Josh Mills on Unsplash

From Washington, DC,

  • The Wall Street Journal reports,
    • “Senate Democrats took the threat of a government shutdown off the table, following a grueling intraparty fight in which lawmakers struggled with how best to resist President Trump’s fast-paced efforts to slim down federal agencies.
    • “Senate Minority Leader Chuck Schumer (D., N.Y.) said he would vote to advance a Republican measure, set for Friday morning, to fund the government through September. Earlier, in a closed-door lunch, he also said that enough Democrats would join him to help the Republicans clear the chamber’s critical 60-vote hurdle, people familiar with the matter said.
    • “I will vote to keep the government open and not shut it down,” Schumer said on the Senate floor, characterizing Democrats’ alternatives as a Hobson’s choice with no good option. He said that in a shutdown, Trump could decide “to cherry pick which parts of the government to reopen in a protracted shutdown.”
  • The American Hospital Association News tells us,
    • “The White House March 13 withdrew the nomination of former Republican congressman Dave Weldon for director of the Centers for Disease Control and Prevention.
    • “Meanwhile, the Senate Committee on Health, Education, Labor and Pensions advanced the nominations of Jay Bhattacharya for director of the National Institutes of Health and Marty Makary for commissioner of the Food and Drug Administration. Both nominees will next be considered by a full Senate vote.”
  • Federal News Network informs us,
    • “The Postal Service is letting a team from the Department of Government Efficiency take a closer look at its reform plans.
    • “Postmaster General Louis DeJoy, in a letter sent to congressional leaders Thursday, said he signed an agreement last night with DOGE representatives and the General Services Administration to “assist us in identifying and achieving further efficiencies.”
    • “DeJoy told lawmakers that USPS is heading in the right direction under his 10-year Deliverying for America reform plan and that DOGE’s work is “aligned with our efforts.”
    • “While we have accomplished a great deal, there is much more to be done. We are happy to have others to assist us in our worthwhile cause,” DeJoy wrote.”

From the judicial front,

  • The Wall Street Journal relates,
    • “A federal judge has ordered six federal agencies to reinstate thousands of probationary employees who were fired last month, dealing a blow to the Trump administration’s efforts to rapidly scale back the size of the federal workforce.
    • “The Trump administration has encountered a number of legal challenges in its push to slash the government’s size and spending, including a lawsuit from a coalition of 20 states over plans to eliminate nearly half of the staff of the Education Department.
    • “The Education Department, with around 4,500 employees as of last year, is the smallest cabinet-level agency. Polls show most Americans oppose eliminating the department.”
  • FEHBlog note — The Justice Department has noticed an appeal of the reinstatement order to the U.S. Court of Appeals for the Ninth Circuit.
  • Bloomberg Law adds,
    • “A US judge in Maryland directed 18 agencies to temporarily rehire thousands of terminated employees, dealing another judicial defeat to Trump administration efforts to shrink the federal sector.
    • “The government gave no advance notice before firing newer workers, known as probationary employees, and conducted no individual assessments to justify their discharge based on performance, Judge James Bredar of the US District Court for the District of Maryland said Thursday in granting a temporary restraining order. 
    • “Bredar, an Obama appointee, found the terminations were unlawful workforce reductions that negatively impacted 19 states and the District of Columbia, which sued to challenge the firings.
    • “The ruling will apply for 14 days to workers at agencies including the Labor, Health and Human Services, Education, and Energy departments; the Environmental Protection Agency; the Consumer Financial Protection Bureau; and the US Agency for International Development. 
    • “It comes after a separate federal judge in California ordered six federal agencies to rehire probationary employees they fired since Feb. 13. Both decisions add to mounting setbacks for President Donald Trump and billionaire Elon Musk, who have attempted to cull the federal workforce in the name of efficiency.”

From the public health and medical research front,

  • Cardiovascular Business points out,
    • “U.S. patients are significantly less likely to die from heart failure-related cardiac arrest now than they were 25 years ago, according to new data published in the American Journal of Cardiology. However, the authors noted, certain disparities still exist, suggesting cardiologists and other healthcare providers have much more work to do. 
    • “Heart failure currently affects over 64 million adults worldwide, with about 6 million impacted in the United States, a number expected to rise to 8 million by 2030, wrote corresponding author Sivaram Neppala, MD, an assistant professor with the cardiology division at The University of Texas Health Sciences Center, and colleagues. “Patients diagnosed with heart failure face a significantly higher risk of cardiac arrest, contributing to 30-50% of mortality cases within this population. Those with systolic dysfunction are six to nine times more likely to experience sudden cardiac death. Cardiac arrest and heart failure can lead to irregular heart rhythms and myocardial fibrosis, increasing the risk of ventricular arrhythmias and highlighting the need for urgent care.”
    • “Neppala et al. explored U.S. Centers for Disease Control and Prevention data from 1999 to 2023, tracking changes in the overall age-adjusted mortality rate (AAMR) for cardiac arrest in patients with heart failure. All patients included in their analysis were 25 years old or older.
    • “Overall, the researchers found that the AAMR for heart failure-related cardiac arrest dropped from 25.3 per 100,000 adults in 1999 to 20.6 in 2023. The reduction was the most pronounced from 1999 to 2011, with an annual percentage change of -2.95%, but then remained largely unchanged from 2011 to 2018. The overall AAMR then increased from 2018 to 2021—a time when the COVID-19 pandemic was at its most severe—before dropping yet again from 2021 to 2023. 
    • “The subsequent decline from 2021 to 2023 (APC: -4.05%) indicates recovery and improved access to healthcare, highlighting the pandemic’s effects on cardiovascular outcomes and the necessity for resilient healthcare systems,” the authors wrote.”
  • STAT News discusses the importance of improving the availability of HIV self-testing.
    • “In May 2024, the Massachusetts Department of Public Health released a troubling report on a cluster of HIV infections, with more than 200 new cases since 2018 attributable to injection drug use in the Boston region. These findings have national implications: Similar HIV outbreaks have been described nationwide during the overdose crisis, including in West Virginia, Indiana, and Ohio. The increase in HIV cases amid the U.S. drug overdose crisis underscores the urgent need for a comprehensive response tailored to the unique challenges faced by people who use drugs. The importance of such efforts cannot be understated. In fact, in Massachusetts, 14% of new HIV diagnoses every year are attributed to injection drug use — nearly twice the national average.
    • “One potential solution is HIV self-testing, which would allow for rapid identification and treatment. Identifying HIV cases is the first step in addressing clusters, and quickly learning one’s status allows people to rapidly seek both treatment and prevention. Unlike traditional laboratory-based testing, which may take several days for results delivery, HIV self-testing relies on saliva and provides results in 20 minutes. The test is easily performed outside of a clinical setting by swabbing gums and collecting a sample of saliva. HIV self-testing has been available since 2012 and is recommended by the Centers for Disease Control and Prevention for accurate HIV diagnosis. It’s even part of the Department of Health and Human Services’ plan for Ending the HIV Epidemic (EHE) by 2030.
    • “But HIV self-testing remains underutilized among not only the general public, but especially people who use drugs. As the nation emerges from the Covid-19 pandemic, during which self-testing for infectious diseases became commonplace, increasing HIV self-testing among people who use drugs may limit the spread of a virus that, while manageable with medication, can lead to significant health risks if left untreated.”
  • MedPage Today lets us know,
    • “Better midlife diet was tied to better brain connectivity and white matter integrity later in life.
    • “Lower waist-to-hip ratio was associated with better memory and executive function at 70.
    • “Diet improvements over time were linked with better white matter integrity in several brain regions.”
  • The National Cancer Institute aggregated its latest research news while the National Institute of Diabetes and Digestive and Kidney Diseases reflects on its 75th anniversary.
  • Per Beckers Hospital Review,
    • “A recently approved drug for acute ischemic stroke works as well as the treatment used in most U.S. hospitals and may offer advantages for some patients, according to a study led by a researcher from Dallas-based UT Southwestern Medical Center. 
    • “The study, published March 12 in JAMA Network Open, compared the newly approved tenecteplase in a single quick injection to alteplase, the stroke treatment that has been used for decades and requires an hourlong infusion. “

From the U.S. healthcare business front,

  • Healthcare Dive reports,
    • “Cigna is revamping its C-suite and consolidating oversight of its two main businesses — insurance and health services operations — under one executive, the company announced Thursday.
    • “Brian Evanko, currently chief financial officer and the head of Cigna’s health insurance division Cigna Healthcare, will serve as Cigna’s chief operating officer, managing both Cigna Healthcare and health services division Evernorth. Ann Dennison, who was deputy CFO under Evanko, will step up as enterprise CFO. The changes are effective at the end of this month.
    • “Meanwhile, Eric Palmer, the current CEO of Evernorth, is departing the company at the end of April, an apparent victim of the restructuring. A spokesperson for Cigna did not respond to a request for comment on the reason behind Palmer’s departure.”
  • Modern Healthcare notes,
    • “Highmark Health’s insurance business challenges weighed on the organization’s overall financial performance in 2024, the company reported Thursday.
    • “The nonprofit Blue Cross Blue Shield licensee saw its net income plummet 90.6% to $50 million while revenue rose nearly 9% to $29.4 billion. The company also reported operating losses of $209 million, compared with an operating gain of $338 million in 2023.
    • “Our entire industry faces strong financial headwinds. That underscores the need for a more economically sustainable approach that delivers better health experiences and outcomes,” Highmark Health President and CEO David Holmberg said on a telephone briefing announcing the financial results.”
  • Per BioPharma Dive,
    • “Mallinckrodt and Endo Pharmaceuticals, which have struggled through bankruptcies related to opioid litigation, said Thursday that they will merge in a cash and stock transaction that will leave a combined company valued at $6.7 billion.
    • “Shareholders of Mallinckrodt will end up with 50.1% of the combined company and current Mallinckrodt CEO Siggi Olafsson will take the top job at the new entity as well. Per deal terms, Endo shareholders will receive Mallinckrodt stock and a share of $80 million in cash.
    • “After the merger, a business made up of Endo’s sterile injectables and both companies’ generic pharmaceuticals will be separated out. The companies haven’t yet decided what that separation will look like, Olafsson told analysts and investors on a conference call. The board will “make the best decision going forward” after the combination of the businesses, he said.”
  • Per MedTech Dive,
    • “Vivani Medical said Wednesday it plans to spin off its neurostimulation business to form an independent, publicly traded company. 
    • “Formerly Second Sight Medical Products, the independent company will trade as Cortigent and advance brain implants to help people recover body functions such as vision and movement.
    • “Vivani, which is focused on GLP-1 implants, acquired the neurostimulation technology through a merger in 2022 and first filed paperwork to list Cortigent as an independent company in 2023.”

Midweek Report

David Ermer–CDC, CMS, Congress, FDA, Generative AI, Medical / Rx research, Medicare, NIH, Obesity, Patient safety, U.S. Healthcare–

From Washington, DC

  • The Wall Street Journal reports,
    • “Senate Minority Leader Chuck Schumer (D., N.Y.) threw a wrench into a Republican plan to avert a government shutdown this weekend, saying there wasn’t enough Democratic support to advance the measure funding federal agencies through Sept. 30.
    • “Republicans “do not have the votes in the Senate,” to move the resolution forward, Schumer said on the Senate floor, indicating that his party was prepared to block it. He blamed Republicans, saying they “chose a partisan path” in their bill without any input from congressional Democrats.  
    • “As an alternative, Schumer floated a shorter-term plan that would fund the government for a month. “I hope my Republican colleagues will join us to avoid a shutdown on Friday,” he said.
    • “Government funding will lapse at 12:01 a.m. Saturday if Congress doesn’t act. The GOP-led House left town after it approved Republicans’ resolution on Tuesday, effectively giving the Senate no time to revise the bill—but to simply pass it or reject it.”
  • The Hill adds,
    • Some Democrats floated the idea that an amendment vote on the 30-day CR, which would fail, could be won in exchange for the requisite number of votes to advance the GOP bill. Some Republicans could support it, according to Sen. Tim Kaine (D-Va.), but not enough that it would be adopted. 
    • “It remains unclear whether Republicans would go along with that though. Senate Majority Leader John Thune (R-S.D.) did not fully shoot down the idea. 
    • “I think there would have to be some understanding,” he told The Hill on Wednesday evening. “We’ll see. I’m not sure exactly what their demand is — if they just need a vote on that, and if in exchange for that they’ll give us the votes to fund the government.”
    • “Thune added that discussions are “going on right now” on a path forward, but he also panned the idea of a full shift to a 30-day CR in order to finish 2025 appropriations bills.”
  • The Wall Street Journal further tells us,
    • “The Centers for Medicare and Medicaid Services plans to terminate four demonstration projects at the end of 2025, closing out models affecting primary care, kidney care and healthcare payments in the state of Maryland.
    • “The agency will also make changes to other projects, including dropping a planned initiative that would offer certain generic drugs to Medicare enrollees for $2. CMS said its planned terminations would save nearly $750 million, and an agency official said the projects would affect millions of patients.”
  • Per Modern Healthcare,
    • “Johnson & Johnson MedTech said Wednesday its Monarch Quest robotic platform received clearance from the Food and Drug Administration.
    • “Robotic-assisted bronchoscopy is a minimally invasive technique that allows surgeons to reach airways and suspicious lung nodules.”

From the public health and medical research front,

  • The New York Times reports,
    • “Measles continues to spread in West Texas and New Mexico, with more than 250 people infected — many unvaccinated school-age children. Two cases in Oklahoma, for which state officials have not provided a location, have also been linked to these outbreaks. Twelve other states have reported isolated measles cases, typically linked to international travel.”
  • The American Medical Association lets us know what doctors wish patients knew about measles.
  • STAT News reminds us,
    • “The 2020s have inarguably been Covid-19’s decade. 
    • “Since the coronavirus outbreak was acknowledged as a pandemic exactly five years ago, the pandemic has killed well over 1 million Americans, derailed the global economy, and sparked political upheaval that continues today. It also yielded what many hail as the greatest scientific accomplishment in human history: the development of effective vaccines in under a year. 
    • “Yet in dominating the early 2020s, Covid-19 also distracted from what is arguably a more significant public health emergency. Even at the height of the pandemic, more young Americans died of drug overdose than Covid. And in the last year, the overall death toll from the country’s drug crisis has exceeded the Covid-19 pandemic as the deadliest health event this generation.”
  • MedPage Today notes,
    • “Using only targeted models of syphilis screening in the emergency department (ED) would miss large proportions of active syphilis cases as well as new HIV diagnoses and acute HIV cases, according to new research.
    • “Only screening patients for syphilis who came to the ED for gonorrhea and chlamydia testing would have missed 76.4% of positive syphilis screens as well as 68.7% of new HIV diagnoses, reported Kimberly Stanford, MD, MPH, of the University of Chicago Medical Center.”
  • Healio informs us,
    • “An increase in depressive symptoms was observed among U.S. teenagers without, rather than with, behavioral risk factors, underscoring the need for greater screening in this population, data show. 
    • “Over the last decade, national survey data has revealed a sharp rise in depressive symptoms among U.S. adolescents,” Tanner J. Bommersbach, MD, MPH, child and adolescent psychiatrist and assistant professor at the University of Wisconsin School of Medicine and Public Health, told Healio regarding the research presented in The Lancet Regional Health Americas. “Yet, surprisingly little is known about what is driving this increase and which adolescents are most affected.”
  • Consumer Reports, writing in the Washington Post, explains what to do about ear pain.
  • Per a National Institutes of Health press release,
    • “The antiviral drug tecovirimat used without other antivirals did not reduce the time to clinical resolution of clade II mpox lesions or improve pain control among adults in an international clinical trial sponsored by the National Institutes of Health (NIH). The trial enrollment was stopped in late 2024 when an interim analysis showed that tecovirimat monotherapy was ineffective in the study population. Detailed results were presented at the 2025 Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco.
    • “This study brought us a step forward in better understanding mpox disease and potential treatment strategies,” said Jeanne Marrazzo, M.D., M.P.H., director of NIH’s National Institute of Allergy and Infectious Diseases (NIAID), which sponsored and funded the trial. “We are grateful to the study team and participants for their contributions to groundbreaking research on a disease that we still do not know enough about.”
  • The National Cancer Institute’s Cancer Information Highlights cover the following topics this week: “AI and Immunotherapy | Breast Reconstruction | Multiple Myeloma Research.”
  • Food Safety Magazine alerts us,
    • “The U.S. Centers for Disease Control and Prevention (CDC) has released a summary analyzing the causes of foodborne illness outbreaks that occurred between 2014 and 2022. Data included in the analysis was drawn from the Foodborne Disease Outbreak Surveillance System (FDOSS), via the National Outbreak Reporting System (NORS).
    • “According to CDC, approximately 800 foodborne illness outbreaks occur in the U.S. each year, causing an estimated 15,000 illnesses, 800 hospitalizations, and 20 deaths, annually.
    • “An overall trend revealed in the FDOSS data for 2014–2022 included that many foodborne illness outbreaks occur because of contamination of food by an animal or environmental source before arriving at the point of final preparation. Additionally, most viral outbreaks are caused by contamination from ill food workers. The data showed that common contributing factors to bacterial outbreaks are 1) allowing foods to remain out of temperature control for a prolonged period, and 2) inadequate time and temperature control during cooking.”
  • The American Hospital Association News relates,
    • “The AHA and Press Ganey March 12 released a new report showing hospital and health system patients reporting improvements in overall care experience and perception of safety alongside gains in key safety outcomes. It also shows that the health care workforce has had a rebound in their reported experience, resilience and perceptions of safety culture.
    • “The insights report, “Improvement in Safety Culture Linked to Better Patient and Staff Outcomes,” highlights how hospitals that foster a strong culture of safety also report a better experience for patients and the health care workforce.
    • “Key report findings include: 
      • “13 million patients surveyed after hospital stays report improvements in their overall care experience and perception of safety.
      • “Surveys of 1.7 million members of the health care workforce show a rebound in their reported experience, resilience and perceptions of safety culture, following the enormous strain of the COVID-19 pandemic.
      • “Improvements in key safety outcomes like falls and infections across more than 25,000 units in 2,430 hospitals.”
  • Per MedTech Dive,
    • “Capstan Medical says it has notched a first in the treatment of structural heart disease, employing a robot to implant two people with mitral valve replacement devices.
    • “Current treatment options for heart valve disease exclude too many patients who are not good candidates for existing procedures, said Capstan CEO Maggie Nixon, and the company hopes its approach will provide them with a new alternative.
    • “The Santa Cruz, California-based startup is developing a valve implant, catheter and robotic delivery platform to expand structural heart intervention to a broader group of people.
    • “There need to be more percutaneous, minimally invasive options to help treat valve disease,” Nixon said in an interview.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Blue Shield of California President and CEO Lois Quam is out at the company two months after taking the helm.
    • “The company declined to explain the circumstances of Quam’s immediate departure.
    • “Chief Financial Officer Mike Stuart will serve as interim president and CEO until the board names a permanent successor, the company said in a news release Tuesday. Stuart has worked at the nonprofit insurer for more than a decade, the company said.
    • “Quam joined the company as president in August after having served as CEO of Pathfinder, a nonprofit global health organization. She was named CEO in early January as part of a corporate restructuring and was touted as its first female CEO.”
  • Fierce Healthcare reports,
    • “Health technology company Innovaccer launched a new platform that seeks to make it easier for insurers to manage risk adjustment and quality improvements.
    • “On Wednesday, Innovaccer unveiled the 360-Degree Gap Closure Solution, which assist payers in improving coding accuracy and patient outcomes. The tool comes at a time when the industry is under significant scrutiny from regulators over coding practices.
    • “The platform enables better engagement across different care settings, greater automation and data governance, Innovaccer said. Health plans can deploy one-click campaigns that address care gaps in a way that reaches provider offices, pharmacies and home healthcare.”
  • Per BioPharma Dive,
    • “Roche has raised its bet on obesity, agreeing to pay Zealand Pharma $1.65 billion to license an experimental shot the Danish company put into a Phase 2b trial in December, Zealand said Wednesday.
    • “Per deal terms, Roche will pay $1.4 billion immediately and $250 million in anniversary payments to license petrelintide. With further milestone payments, Zealand could receive up to $5.3 billion. Roche and Zealand will co-commercialize the shot in the U.S. and Europe, and share in any profits and losses.
    • “The deal gives Roche access to a type of experimental drug known as an amylin analog, a class the Swiss pharmaceutical company didn’t obtain when it acquired Carmot Therapeutics 15 months ago. Roche plans on testing petrelintide with one of those drugs, for which Zealand could reimburse Roche $350 million.”
  • Per MedTech Dive,
    • “Labcorp will pay up to $225 million to acquire the oncology diagnostics businesses of BioReference Health, a subsidiary of Opko Health, to expand its portfolio of tests used in cancer care.
    • “The deal, announced Tuesday, includes $192.5 million to be paid at closing and a payment of up to $32.5 million based on performance. 
    • “The assets, including certain customer accounts, generate about $85 million to $100 million in annual revenue, according to the announcement. Labcorp expects the acquisition to be accretive to earnings in the first year after closing.”
  • Healthcare Dive relates,
    • “Hospital operator Landmark Holdings of Florida filed for Chapter 11 bankruptcy protections on March 9, becoming the latest in a growing number of embattled providers to restructure amid financial headwinds. 
    • “In first day court filings, Landmark, which owns or operates six long-term acute care hospitals across three states, said rising labor and pharmaceutical costs, as well as stagnating Medicare reimbursements, had dinged Landmark’s profitability and threatened the provider’s ability to make timely loan repayments.”
    • “Still, Landmark told the court it expects to have enough cash on hand to keep its hospitals open through the bankruptcy process.:
  • STAT News lets us know,
    • While there are no official statistics on the number of end-of-life doulas in the United States as this emerging field is still largely unregulated, Fortune reports that the National End-of-Life Doula Alliance (NEDA) has significantly grown its membership, especially after the pandemic. In 2024, NEDA had over 1,500 registered members, compared to about 250 in 2019. 
    • “The term “end-of-life-doula” was first formally used in the early aughts. In 2001, the Jewish Board of Family and Children’s Services launched the “Doula to Accompany and Comfort Program,” a pilot program that trained volunteers to aid and support people who would otherwise die alone. 
    • “Sometimes known as “death doulas,” [these] professionals * * *help people navigate what can be a confusing and overwhelming time.”

Tuesday Report

David Ermer–Congress, COVID-19 testing, FDA, Federal employment benefits, Medical / Rx research, NIH, Obesity, OPM, Rx coverage, Telehealth, U.S. Healthcare–
Photo by Michele Orallo on Unsplash

From Washington, DC

Capitol Hill News

  • The Wall Street Journal reports,
    • The House [of Representatives] narrowly approved a Republican proposal to fund the government into the fall, as GOP lawmakers remained largely united following a last-minute push from the White House, overcoming Democratic opposition and setting up a fight in the Senate. 
    • Funding for the federal government expires this weekend. The GOP proposal would extend funding through Sept. 30 at fiscal 2024 spending levels, but it includes $13 billion in cuts in nondefense spending and $6 billion in increased military spending. It allocates additional money for border enforcement and forces Washington, D.C., to cut $1 billion from its budget. 
    • The measure passed 217-213, with Rep. Thomas Massie of Kentucky being the only Republican to vote against it. Democrats were largely united in opposition, with one Democrat, Rep. Jared Golden of Maine, voting yes. * * *
    • “The matter now heads to the Senate, where Republicans will need Democratic support to advance the bill. Senate Democrats were wrestling over the matter Tuesday. Some saw the funding deadline as their only leverage to push back against GOP efforts to dismantle federal programs, while others were wary of playing hardball and triggering a government shutdown. 
    • The House left town after Tuesday’s vote, effectively giving the Senate the option of approving or blocking the House measure—but not revising it.” 
  • Fierce Healthcare adds,
    • “Rep. Greg Murphy, M.D., R-N.C., posted on X Monday night that Johnson and Senate Majority Leader John Thune have agreed to include a doc pay fix in Congress’ budget reconciliation, which is expected to be finished in May to align with President Donald Trump’s first 100 days.
    • “A doc pay fix, which would counteract a 2.83% cut to Medicare physicians’ payment rates that went into effect Jan. 1, has been a central focus for provider lobbying groups as well as for physician members of the legislature. It was seen as the driving force behind passing an expanded healthcare package.
    • “The Energy and Commerce committee has an $880 billion deficit reduction target. E&C will identify those cuts from programs within its jurisdiction like Medicaid and other healthcare programs. It could identify some of those savings from items in the December healthcare package that did not make it into last year’s funding bill, such as PBM reform.”
  • Per Govexec,
    • “Also on Tuesday, Sen. Jerry Moran, R-Kan., who chairs the Senate Veterans Affairs Committee, announced during a hearing he will put forward legislation that will also seek to put some constraints on the Trump administration’s efforts to remake the Veterans Affairs Department’s workforce. He said VA must work closely with Congress and stakeholders such as veterans service organizations when seeking to make staffing cuts. The Republican chairman added he has voiced his reservations to VA Secretary Doug Collins.”

HHS News

  • The Washington Post reports,
    • Robert F. Kennedy Jr. is making one of his first official moves aimed at increasing oversight of the chemicals found in the nation’s food supply — a key component of his “Make America Healthy Again” agenda to root out chronic disease and childhood illness.
    • On Monday, Kennedy, who serves as the nation’s top health official, announced he was directing the Food and Drug Administration to “explore potential rulemaking” to tighten a decades-old loophole allowing food companies to put chemicals in their products without notifying the nation’s food regulators.
    • The practice Kennedy is targeting, known as “generally recognized as safe” (GRAS), can occur when companies self-certify the safety of a food additive. Companies aren’t required to tell the FDA when they include some chemicals and substances in their products, meaning there are probably hundreds of such ingredients added to the food supply without government oversight.
  • Per a March 10, 2025, CMS news release,
    • “Today, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule to address the troubling amount of improper enrollments impacting Affordable Care Act (ACA) Health Insurance Marketplaces across the country. CMS’ 2025 Marketplace Integrity and Affordability Proposed Rule includes proposals that take critical and necessary steps to protect people from being enrolled in Marketplace coverage without their knowledge or consent, promote stable and affordable health insurance markets, and ensure taxpayer dollars fund financial assistance only for the people the ACA set out to support.” * * *
    • “View the 2025 Marketplace Integrity and Affordability Proposed Rule (CMS-9884-P) here: https://www.cms.gov/files/document/MarketplacePIRule2025.pdf
    • “For additional information on the rule and its proposals, view the CMS fact sheet:  https://www.cms.gov/newsroom/fact-sheets/2025-marketplace-integrity-and-affordability-proposed-rule” 
  • Per Modern Healthcare,
    • “The U.S. Department of Health and Human Services increased its voluntary buyout offer for some employees for further layoffs this week as the agency faces pressure to reduce headcount, according to an email viewed by Bloomberg. 
    • “In addition to a $25,000 lump-sum buyout offer, some HHS workers would also receive around two months of paid administrative leave if they chose to accept the buyout. * * *
    • “The buyout offer was available to employees this week and expires Friday. The original buyout offer was extended to a “broad population of HHS employees,” according to an email. However, the Food and Drug Administration told staff Monday that employees responsible for reviewing drugs, medical devices and tobacco products aren’t eligible for the buyout program. 
    • “The HHS buyout offers are in addition to an early retirement program that relaxed service requirements for retirement.”
  • The U.S. Preventive Services Task Force issued a final recommendation on screening for food insecurity which received an inconclusive “I” grade.
    • “For children, adolescents, and adults:
      “The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for food insecurity on health outcomes in the primary care setting.”
  • Per Axios,
    • “The federal government’s free at-home COVID test distribution program has been suspended and is no longer accepting orders” as of March 9, 2025.
    • “For some previously distributed tests, expiration dates were extended to account for data that revealed a longer-than-expected shelf life.
    • “A full list of approved tests and their revised expiration dates is posted on the FDA website.”

FDA News

  • Per Cardiovascular Business,
    • “Google has received U.S. Food and Drug Administration (FDA) for Loss of Pulse Detection, a new smartwatch feature that detects when a person’s heart stops beating and then automatically alerts emergency services. 
    • “Loss of Pulse Detection asks the user if they are OK when it first detects the loss of pulse. If no response is provided, it triggers an audio alarm and countdown to when emergency services will be notified. If the countdown reaches zero, the alert is officially sent out.
    • “This feature is already available in 14 different countries. It will be made available in the United States for Google’s Pixel Watch 3 in the weeks ahead.”
  • Per Modern Healthcare,
    • “Siemens Healthineers has received clearance from the Food and Drug Administration for its Naeotom Alpha class of photon-counting computed tomography scanners.
    • “The company unveiled the two scanners in December, touting the Naeotom Alpha.Pro and Naeotom Alpha.Prime as more affordable options to its original Naeotom Alpha photon-counting CT, which received FDA clearance in September 2021.
    • “Photon-counting CT is a new technology that uses lower radiation doses than conventional CT and produces clearer images with fewer distortions.
    • “Siemens Healthineers’ photon-counting CTs are the only commercially available scanners of their kind available for clinical use but competitors are working to bring their versions to market.”

From the judicial front,

  • Govexec reports,
    • “A federal judge has ordered the acting head of the Office of Personnel Management to testify at a court hearing examining the legality of the Trump administration’s mass firings of federal employees, but the key workforce official has informed the court he will ignore the order. 
    • “Acting OPM Director Charles Ezell was slated to appear in a U.S. District Court in San Francisco on Thursday after Judge William Alsup ruled Monday on Monday that he must do so, but he will now face a to-be-determined sanction. The Trump administration had sought to block his testimony, saying it would raise constitutional concerns, but the judge rejected the argument. Ezell has already submitted written testimony, Alsup said, and now must be subject to cross examination. 
    • “After initial publication of this story, the Trump administration Tuesday evening informed the court Ezell would not testify and withdrew his written declaration suggesting he did not order the probationary firings across government. It called live testimony “not necessary” for Ezell or any other official. The plaintiffs in the case are seeking testimony from human resources personnel throughout government.” 

From the public health and medical research front,

  • Healio lets us know,
    • “The diabetes mortality rate in the U.S. dropped from 28.1 deaths per 100,000 people in 2000 to 19.1 deaths per 100,000 in 2019.
    • “Reductions in diabetes mortality were observed for all racial and ethnic groups.”
  • The Wall Street Journal reports,
    • “GLP-1s, including Ozempic, show promise in preventing age-related conditions like Alzheimer’s, osteoarthritis and certain cancers.
    • “GLP-1s work by suppressing appetite and reducing inflammation, potentially contributing to their preventive health benefits.
    • “While promising, more robust studies are needed to confirm the causal effects of GLP-1s on longevity and healthspan.”
  • The National Institutes of Health offers a research bulletin on the following topics: “Predicting preeclampsia | Liver gene editing | Mapping MS-like brain lesions.”
  • MedPage Today tells us five things that patients with low back pain need from their doctors and
    • “BMI was lower in kids whose mothers received a responsive parenting intervention in the INSIGHT randomized clinical trial.
    • “Across ages 3 to 9 years, children in a responsive parenting group had a lower mean BMI than those in a control group.
    • “The impact appeared significant only for girls.”
  • Per a news release,
    • “The Institute for Clinical and Economic Review (ICER) announced today that it will assess the comparative clinical effectiveness and value of brensocatib (Insmed Incorporated) for the treatment of non-cystic fibrosis bronchiectasis (NCFB).
    • “The assessment will be publicly discussed during a meeting of the CTAF in September 2025, where the independent evidence review panel will deliberate and vote on evidence presented in ICER’s report.
    • “ICER’s website provides timelines of key posting dates and public comment periods for this assessment.”
  • The National Cancer Institute informs us,
    • “For men with metastatic castration-resistant prostate cancer, an initial treatment that combines enzalutamide (Xtandi) and talazoparib (Talzenna)may help them live longer than just getting enzalutamide alone, according to updated results from a large clinical trial. Enzalutamide is a type of drug known as an androgen receptor antagonist and talazoparib is part of a group of drugs called PARP inhibitors.” * * *
    • “More information about the trial, which was funded by Pfizer, the maker of talazoparib, is available in this Cancer Currents story.”
  • Fierce Pharma adds,
    • “After Gilead Sciences’ lenacapavir made waves with stellar clinical results as a twice-yearly HIV prevention candidate, the drug has shown promise being dosed even further apart at only once a year.
    • “Two different once-yearly formulations of lenacapavir achieved blood concentrations that exceeded those associated with the strong HIV prevention efficacy that twice-yearly lenacapavir showed in phase 3 preexposure prophylaxis (PrEP) studies.
    • “The pharmacokinetic results came from a small phase 1 trial presented at the Conference on Retroviruses and Opportunistic Infections and simultaneously published in The Lancet.
    • “Based on the early-stage data, Gilead plans to start a phase 3 program for once-yearly lenacapavir in the second half of this year, with the potential for regulatory filings in 2027, Jared Baeten, M.D., Ph.D., Gilead’s vice president of HIV clinical development, told Fierce Pharma.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Hinge Health filed Monday for a proposed initial public offering.
    • “The virtual musculoskeletal health company, which contracts with employers, pharmacy benefit managers and large insurance companies to provide physical therapy and pain relief services, has been considered a potential IPO candidate since last year.”
  • and
    • “Tampa General Hospital and Mass General Brigham are teaming up to open a radiation oncology center in Florida.
    • “The 10,000-square-foot facility in Palm Beach Gardens will be co-branded and jointly owned. Tampa General will handle daily operations, while Mass General Brigham will provide oversight on quality and safety, according to a Tuesday news release.
    • “The center is scheduled to open in early 2026, the release said.”
  • Per Fierce Pharma,
    • “At its sprawling complex in Durham, N.C., Merck has opened a new $1 billion, 225,000-square-foot manufacturing plant slated to produce bulk substance for its megablockbuster HPV vaccine Gardasil.
    • “Merck built the new plant on the 262-acre campus it has occupied since 2004, where the pharma giant produces a variety of vaccines including shots to prevent chickenpox, measles and rubella.
    • “The complex manufactured more than 70 million doses last year, with the figure expected to increase this year, a Merck spokesperson said in an email. The campus now employs more than 1,000 people.”
  • Per STAT News,
    • “In the last two years, hundreds of businesses have cropped up to meet the surge in demand for the obesity and diabetes medications known as GLP-1s. The majority prescribe compounded copies of the drugs — a tenuous business strategy as shortages of the branded versions of the medications have come to an end. 
    • “Now, some businesses are setting their sights on another opportunity in compounding: hormones.
    • “Dozens of wellness and direct-to-consumer telehealth companies offering GLP-1s have begun marketing cash-pay hormone replacement therapy to women in perimenopause and menopause, and testosterone replacement therapy to men. Noom, best-known for its weight loss app and more recent GLP-1 offering, launched an HRT program for menopause in late February, and telehealth company Hims & Hers plans to roll out at-home testing over the next year to enable care for low testosterone, perimenopause, and menopause.
    • “Patients and physicians have long advocated for better access to hormone-based care. Men with low testosterone levels due to hypogonadism can face stigma as they seek care, and many women struggle to receive medically appropriate estrogen and progesterone to address serious hot flashes and help prevent osteoporosis. But clinicians and health policy researchers expressed concern that the emerging commodification of hormone replacement therapies — often marketed as a personalized fix for low energy, libido, and other age-related concerns — could lead to inappropriate prescriptions and put patients at risk.” 
  • Beckers Hospital Review points out,
    • “In August, Kaiser Permanente embarked on the largest rollout of generative AI in healthcare to date.
    • “The Oakland, Calif.-based health system offered Abridge, an ambient AI listening tool that drafts clinical notes for the EHR, to tens of thousands of providers.
    • “Becker’s caught up with Brian Hoberman, MD, executive vice president of IT and CIO at the Permanente Federation, at the HIMSS conference in Las Vegas to find out how the implementation is going.”
    • Here’s a link to that interview.
  • The Wall Street Journal adds,
    • “Last year, some cancer patients in Tennessee and Mississippi got a startling offer: Instead of videoconferencing with oncology specialists located hours away, they could see a hologram doctor, courtesy of the same special effects that have projected the Jonas Brothers and other celebrities at concerts and live events.
    • “The offer came from West Cancer Center & Research Institute, a health system that employs about 61 doctors and serves about 19,240 new patients a year across 12 locations in Tennessee, Mississippi and Arkansas. The system’s main clinic is in Germantown, Tenn., a suburb of Memphis.
    • “Its doctors typically spend hours on the road each week getting to the satellite clinics to see patients in more rural locations, while also relying heavily on videoconferencing for check-ins. Now, however, two of those clinics are replacing the video calls with life-size hologram-like displays, part of a cross-industry push to take videoconferencing to the next level.”

Monday Report

David Ermer–Congress, FDA, Medical / Rx research, Patient safety, Rx coverage, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington, DC

  • Roll Call lets us know,
    • “President Donald Trump alleged Sunday that “the Democrats want” a government shutdown at the end of this week, but he predicted that a lapse in appropriations probably will not take place this time.
    • “I think the CR is going to get passed. We’ll see. But it could happen,” Trump told reporters aboard Air Force One, referring to a continuing resolution that would extend current funding until the end of the fiscal year on Sept. 30. The current funding extension expires at the end of Friday.”
  • Modern Healthcare adds,
    • “Physicians looking to Congress for relief from falling Medicare payments may have to keep waiting.
    • “House Speaker Mike Johnson (R-La.) unveiled what’s known as a continuing resolution, or CR, on Saturday to keep the government open through the end of fiscal 2025 on Sept. 30, and Congress may vote on the measure as soon as Tuesday. The legislation does not address the 2.9% Medicare reimbursement cut for physicians that took effect Jan. 1.
    • “The Johnson legislation would, however, extend telehealth and hospital-at-home authorities under Medicare and delay cuts to Medicaid disproportionate share hospital payments for safety-net providers. The bill also includes six-month funding extensions for community health centers, graduate medical education and other health programs that are due to expire on March 31.”
  • The Senate confirmed Lori Chavez-DeRemer to be Secretary of Labor by a 67-32 vote.
  • The Associated Press reports,
    • “Most of the 80,000 federal workers responsible for researching diseases, inspecting food and administering Medicare and Medicaid under the auspices of the Health and Human Services Department were emailed an offer to leave their job for as much as a $25,000 payment as part of President Donald Trump’s government cuts.
    • “Workers cannot start opting in until Monday and have until 5 p.m. on Friday to submit a response for the so-called voluntary separation offer. The email was sent to staff across the department, which includes the Centers for Disease Control and Prevention in Atlanta, and the National Institutes of Health as well as the Food and Drug Administration, both in Maryland.
    • “The mass email went out to a “broad population of HHS employees,” landing in their inboxes days before agency heads are due to offer plans for shrinking their workforces. HHS is one of the government’s costliest federal agencies, with an annual budget of about $1.7 trillion that is mostly spent on health care coverage for millions of people enrolled in Medicare and Medicaid.”
  • Govexec offers us the opportunity to meet the 2025 inductees into the Government Hall of Fame.

From the judicial front,

  • The Washington Post lets us know,
    • “The Supreme Court on Monday agreed to take up a Christian therapist’s challenge to a state law barring “conversion therapy” that attempts to change a young person’s sexual orientation or gender identity.
    • “Kaley Chiles, who practices in Colorado, says the state law banning such treatment is unconstitutional and has forced her to deny counseling to potential clients who share her faith, in violation of her religious beliefs.
    • “More than 20 states and the District of Columbia restrict mental health counseling that attempts to change a young person’s gender identity or sexual orientation.” 

From the public health and medical research front,

  • GoodRx informs us,
    • “Women consistently spend nearly 30% more out of pocket on prescriptions than men, totaling $8.5 billion more in 2024 alone.
    • “Women visit doctors more often, fill more prescriptions, and manage more chronic conditions — leading to higher total out-of-pocket costs across the board.
    • “Women 18 to 44 years old face the steepest price gap, spending up to 64% more than men — all while balancing career, family planning, and caregiving.
    • “Women also significantly outspend men on mental health treatments. Women spend 113% more on depression medications and 103% more on anxiety treatments.”
  • Health Day points out,
    • “Getting essential vitamins and minerals during pregnancy can help a woman maintain healthy blood pressure into middle age, new research suggests.
    • “High levels of the minerals copper and manganese in pregnant women were associated with lower blood pressure decades later, as well as a reduced risk of high blood pressure, researchers reported.
    • “Higher levels of vitamin B12 also were associated with lower blood pressure in later life, according to findings published March 6 in the journal Hypertension.”
  • The American Medical Association relates “What doctors wish patients knew about prostate cancer.”
  • The Washington Post points out that “Over 15 percent (15.5) of young adults ages 21 to 24 used electronic cigarettes in 2023, according to a report from the National Center for Health Statistics.”
  • Per Cardiovascular Business,
    • “New technology that directly visualizes inflammation in a patient’s coronary arteries could potentially transform the preventive cardiology landscape. It can evaluate a patient’s risk of a heart attack in a way that goes beyond what we learn from traditional cholesterol readings.
    • “Researchers at Oxford University developed the novel imaging technology, which detects coronary inflammation using coronary computed tomography angiography (CCTA) scans and artificial intelligence (AI) to show inflammation in the perivascular fat surrounding the vessels. It is now being commercialized by Caristo and pending U.S. Food and Drug Administration (FDA) final review. 
    • “It has always been the holy grail of cardiovascular prevention to be able to pick up coronary inflammation, because if you know which artery is inflamed and which patient needs treatments to prevent heart attacks. Up until now, we had only simply biomarkers like high sensitivity C-reactive protein (CRP), which are nonspecific. So, we have developed a technology the last few years that allows you to measure coronary inflammation by analyzing the fat that surrounds arteries,” explained by Charalambos Antoniades, MD, the British Heart Foundation Chair of Cardiovascular Medicine at the University of Oxford. He spoke with Cardiovascular Business about the technology at the American Heart Association (AHA) 2024 meeting, where he presented data on it at multiple sessions.”
  • ECRI lists the top ten threats to patient safety in 2025:
    • “Dismissing patient, family and caregiver concerns
    • “Insufficient governance of artificial intelligence
    • “Spread of medical misinformation 
    • “Cybersecurity breaches 
    • “Caring for veterans in non-military health settings
    • “Substandard and falsified drugs
    • “Diagnostic errors in cancers, vascular events and infections 
    • “Healthcare-associated infections in long-term care facilities 
    • “Inadequate coordination during patient discharge
    • “Deteriorating working conditions in community pharmacies” 

From the U.S. healthcare business front,

  • Beckers Hospital Review tells us,
    • “CVS is rolling out a dozen new stores focused primarily on pharmacy services, reducing retail offerings as the company responds to a prolonged decline in retail sales, The Wall Street Journal reported March 8. 
    • “The new stores, averaging less than 5,000 square feet, or less than half the size of a normal CVS store, will open over the next year across the U.S.” 
  • BioPharma Dive reports,
    • “Novo Nordisk’s experimental drug CagriSema helped people who are overweight or obese and have diabetes lose about 14% of their body weight over 68 weeks, or 11 percentage points more than those given placebo, the company said Monday.
    • “The Danish company aims to position CagriSema as a more potent successor to its popular obesity drug Wegovy, which recorded sales of 58 billion kroner, or about $8.4 billion, in 2024. But earlier trial results in people without diabetes also fell short of expectations, casting doubt on CagriSema’s potential.
    • “Novo Nordisk shares fell nearly 10% following the announcement, continuing a monthslong stock slide fueled by concerns over the company’s competitive standing versus top rival Eli Lilly. The company has already outlined plans for a new Phase 3 trial to test whether CagriSema can generate greater weight loss at higher doses.”
  • and
    • “An experimental drug from Mineralys Therapeutics succeeded in a pair of trials in people with stubbornly high blood pressure, the biotechnology company said Monday.
    • Mineralys has been developing the drug, dubbed lorundrostat, in people whose high blood pressure can’t be adequately treated with existing medications. The company says more than half of people with hypertension have this “uncontrolled” and “resistant” form, which in many cases is linked to high levels of a blood pressure-regulating hormone released by the kidneys.”