Today's News and Commentary

Dear Subscriber,

As you have noticed, I recently added a daily link to Kaiser Health News and supplemented items that it did not cover. Many of those non-covered items made it into the next day’s news.
As a result, I have decided to suspend my daily News and Commentary and urge you to read the Kaiser publication.
I will post periodic comments on LinkedIn and hope you will feel free to contact me for special issues that may arise.
With grateful appreciation for your interest and loyalty,

Joel Shalowitz, MD, MBA, FACP

Read today’s Kaiser Health News

About Covid-19

COVID Vaccines Still Effective Against Severe Outcomes, VA Study Suggests: Key Takeaways:

• The severity of SARS-CoV-2 infections has waned since 2020, and uncertainty about the value of annual COVID shots has helped drive down adult vaccination rates.

• Among veterans who received a 2024-2025 COVID shot, estimated vaccine effectiveness was 29.3% against emergency department visits, 39.2% against hospitalizations, and 64% against deaths.

• Vaccines were effective across age groups, and the presence or absence of major chronic conditions and immunocompromised status. 

About health insurance/insurers

CMS posts 2026 Medicare Advantage star ratings: CMS released Medicare Advantage star ratings on Sept. 9, showing an average score of 3.65 for 2026, compared to 3.92 last year.
Plans were evaluated by the agency across 40 quality criteria spanning outcomes, experience, access, operations, and pharmacy. Plans that receive 4 stars or higher earn quality bonus payments that can be used to invest in benefit design and boost 2027 revenue, while persistently low-rated plans can face more oversight and potential contract cancellation.

About pharma

How Private Equity Oversees the Ethics of Drug Research An excellent piece of investigative journalism.

BMS latest to enter in vivo CAR-T field with $1.5B Orbital buy: Bristol Myers Squibb agreed to buy Orbital Therapeutics for $1.5 billion in cash, expanding its cell-therapy portfolio with the addition of an experimental in vivo CAR T-cell therapy.

GoodRx is looking to link up with TrumpRx FYI

About the public’s health

The hidden reason scientists say bottled water may not be the cleaner choice: A new study published in the Journal of Hazardous Materials analyzed 141 existing scientific papers on microplastics and nanoplastics from single-use plastic water bottles to gauge how much plastic people may be ingesting.
Researchers at Concordia University in Montreal, Canada, discovered that the average person consumes 39,000 to 52,000 microplastic particles per year, according to a university press release.
Individuals who drink bottled water regularly ingest up to 90,000 more particles each year than those who drink mainly tap water, the study found.

About healthcare IT

Trump Called Digital Equity Act ‘Racist.’ Now Internet Money for Rural Americans Is Gone: The Digital Equity Act is part of the sweeping 2021 infrastructure law, which included $65 billion to build high-speed internet infrastructure and connect millions without access to the internet.
This year, Congress once again pushed for a modern approach to help Americans, mandating that state leaders prioritize new and emerging technologies through its $50 billion Rural Health Transformation Program.
A KFF Health News analysis found that nearly 3 million people in America live in areas with shortages of medical professionals and where modern telehealth services are often inaccessible because of poor internet connections. 

About healthcare personnel

American workforce burnout reaches 6-year high:Burnout among Americans in the workplace has escalated to a six-year high, according to the 15thannual Aflac WorkForces Report released by Aflac Incorporated, a leading provider of supplemental health insurance and products in the U.S.2The report tracks the state of the American workplace among employees and employers — shining the light on trends, attitudes, needs and experiences in health care and benefits administration.

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About Covid-19

CDC, its advisers quietly expand access to Covid-19 shot for pregnant women: The CDC’s Advisory Committee on Immunization Practices voted in September to advise that adults get the Covid-19 shot through shared clinical decisionmaking between patients and providers. It did not specifically vote on whether the shot should be administered during pregnancy, yet the vote appears to encompass pregnant women, according to an update this month on the CDC website that reflects the new guidance. 

About pharma

Novo buying Akero and its MASH hopeful for $4.7B upfront: Novo Nordisk is splashing out $4.7 billion in cash upfront to buy Akero Therapeutics and its experimental metabolic dysfunction-associated steatohepatitis (MASH) treatment, the FGF21 analogue efruxifermin. The deal announced Thursday also includes a contingent value right (CVR) worth around $500 million linked to US approval of efruxifermin, which is in late-stage development. 

About healthcare personnel

A new model to measure nursing’s economic value: Researchers from the Johns Hopkins University School of Nursing in Baltimore and Marquette University College of Nursing in Milwaukee introduced the Nursing Human Capital Value Model Oct. 7, during a preview event for the American Nurses Enterprise’s annual Research Symposium…
Historically, investments in nurses’ education, training and work environment have been viewed primarily as costs. Nurse leaders say the new model is meant to shift that perspective by demonstrating how nursing investments can drive better care and revenue growth. 

Today's News

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Also, from The KFF: KFF’s Health Policy 101: An excellent, up-to-date, free e-book on health policy covering many areas of the field.

In other news:

UK government mulls raising NICE cost-effectiveness threshold:According to media reports on Wednesday, the formula used by the National Institute for Health and Care Excellence (NICE) to determine the cost-effectiveness of drugs is up for review. The body currently deems a medicine worthy of NHS reimbursement if it costs less than £20,000 ($26,798) to £30,000 ($40,198) per quality-adjusted life year (QALY) it delivers.

About health insurance/insurers

Medicare Proposal Would Boost Primary Care Doc Pay, Offer Surgeons Less: Through a proposed rule on physician fees for 2026, the Centers for Medicare and Medicaid Services has signaled its intent to shift resources toward primary care and away from procedures and tests.
In the first step toward transforming how physicians are paid, Medicare has proposed reducing payments for procedures, surgery, and medical tests by 2.5%, contending that physicians have become more efficient at providing these services and no longer need as much time to perform them. 

Court ruling allows Medicare to negotiate prices for larger number of drugs: A federal appeals court unanimously rejected a Novo Nordisk challenge to Medicare’s drug price negotiation program, a ruling that will allow the government to lump together products with the same ingredient for the purpose of choosing drugs for negotiation.

About pharma

Biosimilar Uptake Remains Uneven Across Molecules: IQVIA data show that biosimilars launched to date account for 24% of competitive molecule volume overall. But adoption rates by molecule tell a story of stark contrasts. “Three years after launch, insulin lispro biosimilars captured just 8% of the market, [and] infliximab 13%,” Mr. Biggs reported. “At the other end of the spectrum, bevacizumab [Avastin, Genentech] and trastuzumab [Herceptin, Genentech] are at 82% and 80%, respectively. It’s the same regulatory pathway, but very different adoption curves.”

About healthcare personnel

PHYSICIAN CONSOLIDATION IS GROWING, DRIVING UP COSTS: KEY TAKEAWAYS
Nearly half of physicians were employed by or affiliated with hospitals in 2024, up from less than 30% in 2012, GAO’s research found.
Consolidation most often drives higher spending and prices, especially when hospitals acquire physician practices.
Evidence on quality and access is limited, though stakeholders warn consolidation may reduce competition and weaken independent practices. 
See the full GAO report.

Today's News and Commentary

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In other news:

2025 Trends Shaping the Health Economy From Trilliant Health, Key Takeaways:

• Inexplicable price variation contributes to high healthcare costs. Nationally, commercial negotiated rate for four distinct MS-DRGs vary by a factor of 8.5x, on average.

• Upcoding in emergency departments (ED) results in higher spending. From 2018 to 2024, the share of ED visits coded at a higher complexity increased from 36.6% to 47.8% and 27.6% to 31.9%, respectively.

• Inpatient surgical volume is threatened by the proposed IPO [inpatient only] List removal. After total knee arthroplasty (TKA) was removed from the IPO list in 2018, inpatient volumes declined by 17.9% from 2017 to 2018, with 2024 inpatient TKA volumes 85.4% below 2017.

• Surgical procedures are imperiled by novel drugs. Between 2018 and 2023, GLP-1 patients increased by 744.6%, while bariatric surgery volume was flat to declining.

• Price and quality for common services are not correlated. While the median negotiated rate for MS-DRG 193 in Miami is $22,255, the provider receiving the highest rate has the sixth-highest mortality rate out of the 15 hospitals. 

About pharma

US relies heavily on China, other nations for antibiotics: The study, published late last week in JAMA Health Forum, found that annual importation of antibiotics increased approximately 26-fold from 1992 through 2024. One of the countries that has emerged as a major supplier is India, which has accounted for nearly one third of finished antibiotics imported to the United States since 2020. But of even greater concern is that China provides US domestic drug manufacturers with more than 60% of the active pharmaceutical ingredients (APIs) needed to make the finished product. 

About the public’s health

Acting CDC director calls to 'break up' the measles, mumps and rubella vaccine into three shots: Individual vaccines for each virus aren't available in the U.S., and no published scientific evidence shows a benefit to separating the combined vaccine. 
Comment: RFK Jr wants to decrease the number of shots kids get. What’s going on?

About healthcare IT

Qualtrics to buy Press Ganey Forsta for $6.75B to expand its reach in healthcare: Customer engagement company Qualtrics has agreed to invest $6.75 billion to acquire Press Ganey Forsta, a healthcare market research company.
Qualtrics, a customer survey software maker owned by private equity firm Silver Lake, aims to combine its artificial intelligence technology with Press Ganey's extensive data, benchmarking and healthcare expertise to develop new AI-powered tools and services, the companies said in a press release. 

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Nobel Prize in medicine goes to trio of scientists for discovering how the immune system is kept in check: The 2025 Nobel Prize in physiology or medicine has been awarded to a trio of scientists – two of them American and one Japanese – for unraveling how the immune system protects us from thousands of different microbes trying to invade our bodies.
Mary E. Brunkow, Fred Ramsdell and Shimon Sakaguchi will share the prize “for their fundamental discoveries relating to peripheral immune tolerance,” the Nobel Committee announced Monday at a ceremony in Stockholm, Sweden.
The laureates identified “regulatory T cells,” which function like the immune system’s security guards and prevent immune cells from attacking our own body, a cause of autoimmune diseases. 

 About health insurance/insurers

Major health insurers scaling back Medicare Advantage offerings in 2026 FYI

Commercial Insurers Paid More For Procedures At Hospital Outpatient Departments Than At Ambulatory Surgical Centers:  Overall, in 2024, commercial prices were $1,489 (78 percent) higher in HOPDs than in ASCs, whereas Medicare prices were $633 (97 percent) higher. However, site payment differentials varied substantially across payers: Cigna had the lowest differentials between HOPDs and ASCs ($327), whereas United had the highest ($1,673). Cigna achieved this through provider selection, contracting with only 14 percent of HOPDs in applicable markets compared with an average of 76 percent for United and BlueCross BlueShield. If United and BlueCross BlueShield paid Cigna’s average HOPD rates for these procedures, together they would save approximately $1.4 billion a year.

About the public’s health

CDC Immunization Schedule Adopts Individual-Based Decision-Making for COVID-19 and Standalone Vaccination for Chickenpox in Toddlers: The Centers for Disease Control and Prevention (CDC) today updated its adult and child immunization schedules to apply individual-based decision-making to COVID-19 vaccination and recommend that toddlers receive protection from varicella (chickenpox) as a standalone immunization rather than in combination with measles, mumps, and rubella vaccination. 

Comparing COVID-19 Acute And Postacute Medical Spending By Vaccination Status For Child And Adult Medicaid Enrollees: We examined expenditures during acute (within thirty days after diagnosis) and postacute (at least thirty days after diagnosis) periods from April 2021 through July 2022. Among children, average acute medical expenditures were $194 less for vaccinated than unvaccinated cases and among adults, $1,743 less for vaccinated than unvaccinated cases. Medical expenditures in the postacute period were not statistically different by vaccination status. The findings suggest that COVID-19 vaccination is associated with lower medical expenditures in the acute period. Vaccination continues to be important for reducing the economic impact of COVID-19.

Another reason to give children the Covid-19 vaccine:
Long COVID associated with SARS-CoV-2 reinfection among children and adolescents in the omicron era (RECOVER-EHR): a retrospective cohort study: Children and adolescents face a significantly higher risk of various PASC outcomes after reinfection with SARS-CoV-2. These findings add to previous evidence linking paediatric long COVID to multisystem effects and highlight the need to promote vaccination in younger populations and support ongoing research to better understand PASC, identify high-risk subgroups, and improve prevention and care strategies.

About healthcare IT

Claims Denial Navigator Tool Microsoft now has an AI app that helps hospitals overcome insurance company coding-based denials:
Claims Denial Navigator is an AI-powered tool that helps recover lost revenue and streamline the process of researching and resolving denied Medicare, Medicaid, and Commercial Insurance claims. Claims Denial Navigator is available for free on Github.com.

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 About healthcare quality 

Joint Commission to launch peer learning initiative: The Joint Commission will introduce a new initiative in 2026 aimed at spotlighting high-performing accredited hospitals and encouraging peer-to-peer learning.
Called the Survey Analysis for Evaluating Strengths, or SAFEST, the initiative will focus on identifying and documenting strong performance areas during hospitals’ triennial accreditation surveys. These strengths will be compiled into a report for each organization.
A separate team at The Joint Commission team will then review these reports to develop resources for other hospitals. Participation in resource development is optional, but hospitals that do contribute will be able to review and approve any materials before they are shared.

About health insurance/insurers

Medicare Savings Program Take-Up Estimates and Profile of Enrolled and Unenrolled Individuals: More broadly, our findings show that MSP enrollees tend to be more vulnerable not only in terms of health, but also across socioeconomic dimensions. On one hand, this finding suggests that the MSPs are effectively reaching those most in need. On the other hand, it raises concerns about why eligible individuals who are somewhat better off—but still have low income—are much less likely to enroll in the MSPs. Two structural features of the program may be associated with these patterns and point to policy opportunities. 

The CMS activities that will, won’t continue during the shutdown FYI
In a related article:
Health Centers Face Risks as Government Funding Lapses: The federal funds come through two primary routes, both of which face challenges: grants paid in part through the federal Community Health Center Fund and reimbursements for patients’ care through programs like Medicaid, which provides health insurance for low-income people and people with disabilities. Medicaid is jointly funded by states and the federal government.

About pharma

US Antibiotic Importation and Supply Chain Vulnerabilities: This cross-sectional study analyzed 1992 to 2024 antibiotic importation records and found 50 originating countries of finished dosage forms and 52 countries for active pharmaceutical ingredients as well as a significant increase in annual antibiotic imports and a decrease in importation prices. In the past 5 years, India was the leading originating country for finished dosage forms, with China as the leading originating country for antibiotic active pharmaceutical ingredients.

White House delays 100% drug tariffs to negotiate pricing: The Trump administration will hold off on imposing pharmaceutical tariffs Oct. 1 for companies that do not onshore manufacturing or participate in the president’s “Most Favored Nations” pricing initiative, a White House official told Becker’s.

How Trump’s Drug-Buying Site ‘TrumpRx’ Will Work: The government website will direct patients on where to buy medications directly from manufacturers “often” at the MFN price, and “and always at lower prices than currently available,” said Chris Klomp, director of Medicare. The site is expected to launch in early 2026…
Will I save money buying from the TrumpRx website? It depends, but probably not if you are among the 90% of Americans who have health insurance. Even if you have high copays or deductibles, your out-of-pocket share with insurance is still likely to be cheaper than paying the entire cost yourself, even at a substantial discount.

FDA will not accept submissions requiring fees until funding resumes: The US Food and Drug Administration (FDA) will only conduct vital and mission critical activities amid a government shutdown that began Wednesday after Congress failed to reach a deal to fund the federal government. During the funding lapse, FDA said it will not accept any regulatory submissions that require a fee.

US offers priority review incentive in effort to reshore generic manufacturing: In its latest bid to reshore drug manufacturing, the US on Friday unveiled a pilot prioritisation programme aimed at generics manufacturers. The FDA said that under the initiative, companies that conduct any required bioequivalence testing in the US and whose products are made in the country using exclusively domestic sources for active pharmaceutical ingredients (APIs) are eligible for priority review. 

About the public’s health

Soft Drink Consumption and Depression Mediated by Gut Microbiome Alterations: In this cohort study, soft drink consumption was significantly associated with diagnosis of major depressive disorder, as well as depression severity, across a single-study cohort of 932 clinically diagnosed patients and healthy controls. This association was significantly mediated by Eggerthela abundance in female patients and controls. 

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In other news:

These 6 Charts Explain Why the Government Shut Down Excellent article explaining why the shutdown is largely about healthcare issues.

CMS finalizes guidance for 3rd round of Medicare drug price talks: CMS has finalized several changes for the third round of Medicare drug price negotiations.
The changes, outlined in a final guidance issued Sept. 30, include expanded exclusions for orphan drugs and a new framework for incorporating Medicare Advantage encounter data into drug selection calculations under Part B. 

About health insurance/insurers

How Insurers That Own Providers Can Game The Medical Loss Ratio Rules This tactic has been known for quite a while. [I have taught it in class for many years.] Insurers can pay higher rates to other parts of the same company to avoid penalty payments that would result from a too-high Medical Loss Ratio. That said, I have always wondered why United Health ever pays penalties.

Insurers launch 2026 Medicare Advantage plans: MA open enrollment is from Oct. 15 to Dec. 7, The article explains some major changes from large plans.

About hospitals and healthcare systems

Days cash on hand at 40 health systems  FYI

340B rebate pilot would cost hospitals $400M: AHA: If HHS’ 340B rebate model pilot proceeds as planned, more than 2,700 U.S. hospitals will collectively be saddled with approximately $400 million in operational costs and 11.2 million labor burden hours, according to the American Hospital Association. 
The rebate model, slated to go into effect Jan. 1, will allow drug manufacturers that are part of CMS’ first cycle of negotiated drug prices to provide rebates — rather than upfront discounts — for 340B entities. Congress established the 340B program in 1992 to require drugmakers to sell specific outpatient drugs to eligible providers at discounted prices.  

About the public’s health

High consumption of ultra-processed food [UPF] and risk of colorectal cancer:[CRC]: the Norwegian Women and Cancer cohort study:  A high UPF intake (fourth quartile), compared with a low UPF intake (first quartile), was statistically significantly associated with increased total CRC risk after adjusting for all covariates and energy intake (hazard ratio (HR) = 1·24; 95 % CI 1·04, 1·49, Pfor trend = 0·02). Furthermore, a high UPF intake, compared with a low UPF intake, was statistically significantly associated with right-sided colon cancer (HR = 1·58; 95 % CI 1·19, 2·09, Pfor trend < 0·001). 

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About pharma

Genmab to Buy Cancer-Treatment Developer Merus For $8 Billion in Cash: Danish biotechnology company Genmab agreed to buy Nasdaq-listed cancer-treatment developer Merus for around $8 billion in cash, as it looks to bolster its late-stage pipeline as part of a shift toward commercializing more drugs in-house.

Pfizer to lower US drug prices; White House unveils ‘TrumpRx’ site: Pfizer has become the first drugmaker to lower the price of its prescription medications in the U.S. through a new deal with the federal government, President Donald Trump announced during a Sept. 30 media briefing.
The White House is also launching a direct-to-consumer website for prescription medications, which will carry the discounted drugs.  

Today's News and Commentary

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About health insurance/insurers

Insurance Dynamics During Childhood in the Fragmented US Health System: Based on a microsimulation synthesizing 2015-2019 national data, 61% of US children were ever enrolled in Medicaid or CHIP and 42% were ever uninsured by their 18th birthday. Among children born with Medicaid or CHIP, the share ever uninsured was 59% in states that did not expand Medicaid under the Affordable Care Act vs 36% in expansion states.

CMS expects Medicare Advantage enrollment to dip in 2026: Average premiums, benefits and plan choices for Medicare Advantage and the Medicare Part D prescription drug program should remain relatively stable next year, CMS said in a Sept. 26 news release. But MA enrollment is projected to decrease 900,000 in 2026.
Despite a slight dip in available MA plans nationally, over 99% of Medicare beneficiaries will still be able to access an MA plan. 

About hospitals and healthcare systems

11 Big Tech health system partnerships FYI

Hospital Staffing and Patient Outcomes After Private Equity Acquisition: After private equity acquisition, hospitals on average reduced salaries and staffing relative to nonacquired hospitals, notably in the EDs and ICUs, which are higher-acuity and staffing-sensitive areas. This decreased capacity to deliver care may explain the increased patient transfers to other hospitals, shortened ICU lengths of stay, and increased ED mortality. 

33 systems launching physician residency programs FYI

About pharma

Sanofi extends $35 insulin programme to entire US market: Starting Jan. 1, anyone with a valid prescription — whether uninsured, commercially insured or on Medicare — will be able to buy a 30-day supply of any Sanofi insulin for a flat $35. The programme, known as the Insulins Valyou Savings Program, previously applied only to the uninsured.

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About Covid-19

About health insurance/insurers

About hospitals and healthcare systems

About pharma

About the public’s health

About healthcare IT

About healthcare personnel

About health technology

About healthcare finance

Today's News and Commentary

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In other news:  

About health insurance/insurers

Clinical Quality Performance of Value-Based and Fee-for-Service Models for Medicare Advantage: VBP outperformed FFS for all 15 clinical quality outcomes. Across the risk-sharing continuum, clinical quality performance consistently improved as financial arrangements moved toward 2-sided risk. Incremental clinical quality improvements were observed with increased risk-sharing for 6 measures related to hypertension, diabetes, and cancer—prevalent and costly conditions.
Comment: This study was not ranomized but showed an association, Also it comes from CVS.
However, the findings are consistent with much older data indicating that provider financial risk increases value-based performance.

ACA tax credit sunset could cost healthcare $32B: Analysis: Hospitals, physicians and other healthcare providers could lose more than $32.1 billion in revenue in 2026 should Congress allow ACA tax credits to expire at the end of 2025, according to a new Urban Institute analysis published by the Robert Wood Johnson Foundation.
The analysis found that 7.3 million people could lose subsidized ACA coverage and 4.8 million could become uninsured, pushing a $7.7 billion spike in uncompensated care in 2026. The increase could hit all provider types, including $2.2 billion for hospitals, $1 billion for physician offices, $1.5 billion for prescription drugs and $3.1 billion for other services.

Most regional payers are operating at a loss: Regional, nonprofit health plans are falling behind large national insurers, with 71% recording an operating loss in 2024 and more than half having two years or less before regulatory intervention is triggered, according to a Sept. 24 report from HealthScape Advisors.

Judge sides with Humana, tosses Medicare Advantage audit rule: A federal judge has vacated a CMS rule that would have allowed the agency to claw back billions of dollars in alleged Medicare Advantage overpayments, siding with Humana in a closely watched legal battle.
On Sept. 25, the U.S. District Court for the Northern District of Texas concluded that CMS’ 2023 final rule eliminating the “fee-for-service adjuster” in MA audits violated procedural requirements under the Administrative Procedure Act. 

About pharma

Direct-to-patient programs are in the works at 94% of pharmas, set to become 'standard practice': The vast majority of drugmakers are either considering or have already established direct-to-patient (DTP) programs, cutting out middlemen to offer services like virtual care consultations, payment support, at-home diagnostics and digital pharmacies.
That’s according to a new report from ixlayer, based on a recent survey of about three dozen respondents from pharmas of all sizes. 

Who Will Pay for Prescription Drugs in 2033 Really good review. At minimum, look at the charts.

About the public’s health

The global, regional, and national burden of cancer, 1990–2023, with forecasts to 2050: a systematic analysis for the Global Burden of Disease Study 2023: Risk-attributable cancer deaths increased by 72·3% (57·1 to 86·8) from 1990 to 2023, whereas overall global cancer deaths increased by 74·3% (62·2 to 86·2) over the same period. The reference forecasts (the most likely future) estimate that in 2050 there will be 30·5 million (22·9 to 38·9) cases and 18·6 million (15·6 to 21·5) deaths from cancer globally, 60·7% (41·9 to 80·6) and 74·5% (50·1 to 104·2) increases from 2024, respectively. These forecasted increases in deaths are greater in low-income and middle-income countries (90·6% [61·0 to 127·0]) compared with high-income countries (42·8% [28·3 to 58·6]). Most of these increases are likely due to demographic changes, as age-standardised death rates are forecast to change by –5·6% (–12·8 to 4·6) between 2024 and 2050 globally. Between 2015 and 2030, the probability of dying due to cancer between the ages of 30 years and 70 years was forecasted to have a relative decrease of 6·5% (3·2 to 10·3). 

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About health insurance/insurers

Medicare Advantage struggles cited in 2024 $5.7B underwriting loss: Report: Higher utilization contributed to Medicare Advantage’s $5.7 billion underwriting loss in 2024, a marked reversal from serving as a source of earnings in the last five years, said an AM Best news release covering a Sept. 23 report.
“Changes to the risk-adjustment payment model by CMS, as well as lower star ratings across the industry, also have contributed to recent underwriting losses,” Industry Research and Analytics Associate Director Jason Hopper said.

UnitedHealthcare to pay $359M in ACA rebates: UnitedHealthcare is set to pay $359 million in ACA rebates for 2024, sending checks that are slated to arrive by Sept. 30, according to a news release from the insurer.
Last year, commercial payers were estimated to have spent $1.1 billion on rebates, according to KFF. These rebates are products of the medical loss ratio provision of the ACA, which restricts how much premium income can be used for profits and administrative and marketing expenses. 

Centene to pay $87.5M in ACA rebates to Missouri policyholders: The rebates stem from failing to meet medical loss ratio requirements under the ACA, which outlines how much payers can retain for administrative or marketing costs and profits. For context, payers were expected to issue $1.1 billion in medical loss ratio rebates across all commercial markets in 2024, per KFF.

About hospitals and healthcare systems

What’s driving urban hospital closures? 6 GAO findings: Urban hospitals have faced mounting pressures in recent years, with closures outpacing new openings from 2019 to 2023, according to a recent report from the Government Accountability Office. The GAO reviewed five urban hospitals that closed in 2022 and 2023 to better understand the financial and operational challenges leading to their shutdowns and how those closures reshaped community access to care. 

Hospital Price Markup and Outcomes of Major Elective Operations: Findings  In this national cross-sectional study of 1960 hospitals across the US, approximately 10% marked up the true cost of care by a median of 8.5-fold. Surgical care at such high-markup centers was associated with significantly greater adjusted risk of morbidity and readmissions.
Meaning  High-markup hospitals are associated with significantly inferior quality and value of care and represent an important initial target for national policy aimed at promoting transparency and regulating hospital pricing. 

About the public’s health

4 vaccines linked to a lower risk of dementia, according to science Influenza, Shingles, RSV and Tdap vaccines are discussed.

Simple screening questionnaires better for identifying social needs compared to advanced machine learning, study determines: Simple patient screening questionnaires addressing five different health-related social needs (HRSNs) such as food insecurity, housing instability, financial strain, transportation barriers and legal issues performed better than advanced machine learning methods at tracking HRSNs. This is according to a new study led by researchers at the Fairbanks School and Regenstrief Institute. However, authors emphasized that there was no perfect method; each one had gaps. 
Comment: Sometimes simpler is better.

Global, Regional, and National Burden of Cardiovascular Diseases and Risk Factors in 204 Countries and Territories, 1990-2023: CVDs were the leading cause of disability-adjusted life years (DALYs) and deaths estimated in the GBD [global burden of disease]. As of 2023, there were 437 million (95% UI: 401 to 465 million) CVD DALYs globally, a 1.4-fold increase from the number in 1990 of 320 million (292 to 344 million). Ischemic heart disease, intracerebral hemorrhage, ischemic stroke, and hypertensive heart disease were the leading cardiovascular causes of DALYs in 2023 globally…CVD DALY rates were highest in low and low-middle Socio-demographic Index (SDI) settings and lowest in high SDI settings.

About healthcare personnel

2 annual AMA reports FYI:

Graduate Medical Education, 2024-2025

MD-Granting Medical Schools in the US, 2024-2025

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4% of Health Spending Goes to Primary Care: In both ESI [employer sponsored insurance] and Medicare FFS, the share of primary care spending decreased slightly from 2018 to 2022 (see Figure 1). The share of primary care spending in ESI decreased by 11% (from 4.93% to 4.39%) while the share in Medicare decreased 9% (from 4.24% to 3.86%). 

PROMoting quality of care through patient reported outcome measures (PROMs) From the OECD, a study of 38 countries. See the Executive Summary on page 6.

About health insurance/insurers

Medicaid Demonstrations:Information on Administrative Spending for Georgia Work Requirements: Administrative spending for the demonstration was $54.2 million out of the $80.3 million in total demonstration spending in the first 4.5 years, according to data reported by Georgia to CMS. The majority of the administrative spending ($47.4 million or about 88 percent) was financed by federal dollars.
Comment: Is the cure worse than the alleged disease? 

About hospitals and healthcare systems

Premier to go private in $2.6B deal: Charlotte, N.C.-based Premier, Inc. has entered into a definitive agreement to be acquired by an affiliate of Patient Square Capital in a $2.6 billion all-cash transaction, according to a Sept. 22 news release.
The deal would take the publicly traded company private and end its listing on the NASDAQ. The news comes after Premier reported net fourth quarter revenue of $262.9 million, a 12% drop year over year. Michael Alkire, Premier’s president and CEO, said the company faced contract renewal headwinds in the quarter.

11 most common sentinel events in 2024: Joint Commission: In 2024, healthcare facilities voluntarily reported 1,575 serious harmful events to The Joint Commission, which has been tracking sentinel events since 1996. 
The Joint Commission defines a sentinel event as a patient safety event that results in severe temporary harm, permanent harm or death. Because the reports are voluntary, the organization says its dataset represents a small portion of actual sentinel events and that “no conclusions should be drawn about the actual relative frequency of events or trends in events over time.”
Of the 1,575 events, 21% were associated with patient death, 49% with severe harm, 21% with moderate harm, 5% with mild harm, 2% with psychological harm and 2% with no harm, according to the commission’s report.  
Comment: By far, the most common event is the “falls” category.

More hospitals to face high readmission penalties in fiscal 2026: …preliminary data released Friday by the Centers for Medicare and Medicaid Services showed the number of hospitals set to pay penalties of 1% or more under the Hospital Readmissions Reduction Program will increase to 8.1%, or 240 hospitals, in fiscal 2026 compared to 7%, or 208 hospitals, in fiscal 2025.

Hospital Staffing and Patient Outcomes After Private Equity Acquisition: fter private equity acquisition, hospitals on average reduced salaries and staffing relative to nonacquired hospitals, notably in the EDs and ICUs, which are higher-acuity and staffing-sensitive areas. This decreased capacity to deliver care may explain the increased patient transfers to other hospitals, shortened ICU lengths of stay, and increased ED mortality.

About pharma

Pfizer to buy obesity-focused Metsera in $4.9 billion deal: Pfizer, which has struggled in the race for new obesity drugs, said Monday it would buy the biotech Metsera, picking up a range of experimental weight loss medicines.
Pfizer is paying $47.50 a share in cash for Metsera, a 43% premium on the startup’s closing price on Friday; the price gives the deal an enterprise value of $4.9 billion. The pact also includes a contingent value right worth up to $22.50 a share based on potential clinical and regulatory milestones for Metsera’s medicines.  

About the public’s health

National action plans on antimicrobial resistance have had no impact on antibiotic sales: An analysis of antibiotic sales data from 37 countries found that implementation of national action plans (NAPs) for addressing antimicrobial resistance (AMR) was not associated with changes in antibiotic sales… 

About healthcare personnel

Doctors could qualify for exemptions …from the Trump administration’s new $100,000 fee for high-skilled H-1B visa applications, the White House said Monday, after some of the biggest medical bodies called out the risk to rural America where there’s already a dearth of providers. The executive order released Friday said that the application fees can be waived if the Secretary of Homeland Security determines that the hiring of these workers on an individual basis, or to work for a specific company or industry, is “in the national interest.” 

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About Covid-19

Scenario Projections of COVID-19 Burden in the US, 2024-2025: Question  To what extent could COVID-19 vaccination reduce the likely disease burden in the US from April 2024 to April 2025?
Findings  In this decision analytical model using ensemble-based projections of COVID-19 hospitalizations and related deaths under plausible assumptions of immune escape and vaccine recommendations, the projected disease burden during April 2024 to April 2025 was similar in magnitude to the prior year. Vaccination of all individuals was projected to reduce 10% to 20% of COVID-19 burden compared with no vaccination recommendation, with additional indirect benefits to individuals aged 65 years and older compared with vaccinating high-risk groups only.
Meaning  These findings suggest that vaccines can be an effective tool for limiting COVID-19 burden, with a universal vaccine recommendation potentially saving thousands more lives through direct and indirect effects. 

In a related stories
RFK Jr.’s vaccine panel weakens Covid shot recommendations, calling it an individual decision: Health and Human Services Secretary Robert F. Kennedy Jr.’s hand-picked vaccine panel on Friday weakened Covid shot recommendations in the U.S., advising that all Americans consult a health-care provider before deciding whether to receive the vaccine.
The 12-member panel, called the Advisory Committee on Immunization Practices, or ACIP, recommended that people 6 months and up receive vaccines based on so-called “shared clinical decision-making,” which refers to a decision process between a health-care provider and a patient or their guardian. The group also voted to emphasize that for those under 65, the Covid vaccine is most beneficial for those at high risk of severe illness from the disease.

Federal vaccine panel remade by RFK Jr. votes to maintain insurance coverage for Covid shots: The decision falls short of prior years’ recommendations that the vast majority of Americans get the shots but would preserves insurance coverage for people who decide to do so. It still needs to be signed off on by federal health leaders.

About health insurance/insurers

4.8 Million People Will Lose Coverage in 2026 If Enhanced Premium Tax Credits Expire: You can sort the data by Congressional district.

Seven Years of Participation Churn in the Medicare Quality Payment Program: Using most recent QPP data, this cohort study found that a substantial proportion of clinicians departed MIPS each year, consistently outpacing entrants. Exiters included clinicians who transitioned to A-APM, became ineligible for QPP due to low volume, or retired. A recent MedPAC report documented a 4-fold increase in A-APM participation from 2017 to 2022, suggesting that many exits reflected movement toward A-APM, aligning with CMS goals.
Despite signs of progress, concerns remain. Over one-fifth of clinicians remained in MIPS, and nearly one-half switched tracks 1 or more times. Similarly, more than one-third of continuous MIPS participants changed reporting mode. Persistent MIPS participation and high churn suggest that QPP needs ongoing refinement as value-based payment systems evolve.
Terms:
Quality Payment Program (QPP)
Merit-Based Incentive Payment System (MIPS),
Advanced Alternative Payment Models (A-APM)

About hospitals and healthcare systems

The Impact of Proposed Federal Medicaid Work Requirements on Hospital Revenues and Financial Margins: Hospitals in Medicaid expansion states could see operating margins reduced by an average of 11.7 percent to 13.3 percent. Safety-net hospitals could be disproportionately impacted: their operating margins could fall by an average of 25.9 percent to 29.6 percent, and even more in certain states and in rural areas. Both Medicaid enrollees and the broader communities that hospitals serve would likely be affected, as lower revenues and increased uncompensated care costs could force hospitals to reduce staff or eliminate services.

Hospital price transparency effort losing ground: advocacy group: An interim semiannual report from Patient Rights Advocate, a nonprofit research and advocacy group, reviewed pricing files of the top 2,000 largest hospitals from March 1 to April 19. It found 43% of hospitals posted fewer prices for services than they did when the group researched the issue in November.

10 called-off hospital deals  FYI

About pharma

Drugmakers Have Pledged to Invest $350 Billion in U.S. After Tariff Threat: So far this year, more than a dozen drugmakers have pledged to spend more than $350 billion collectively by the end of this decade on manufacturing, research and development and other functions in the U.S., a Wall Street Journal tally of company announcements showed. 

VillageMD sells 32 Texas clinics: VillageMD sold 32 clinics in Texas to Austin-based primary and specialty clinic group, Harbor Health, in a deal that marks Harbor's expansion into the Austin, San Antonio, El Paso, and Dallas markets. The transaction, announced on September 18, 2025, also brings more than 80 clinicians to Harbor Health. This sale is part of VillageMD's strategy to downsize its operations, following a period of slower-than-expected returns and significant losses associated with its healthcare services division…

2 big “drug company deals:
Switzerland’s Roche strikes $3.5bn deal to buy US drugmaker 89bio

Dutch biotech taps Shape's brain-penetrating capsid in $1.2B deal

About the public’s health

National Academies Publish New Report Reviewing Evidence for Greenhouse Gas Emissions and U.S. Climate, Health, and Welfare: A new report from the National Academies of Sciences, Engineering, and Medicine says the evidence for current and future harm to human health and welfare created by human-caused greenhouse gases is beyond scientific dispute.
The report focuses on evidence gathered by the scientific community since 2009, when the U.S. Environmental Protection Agency found that greenhouse gas emissions threaten public health and welfare. The EPA recently gave notice of proposed rulemaking indicating its intention to rescind this finding.
The report says EPA’s 2009 finding was accurate, has stood the test of time, and is now reinforced by even stronger evidence. Much of the understanding of climate change that was uncertain or tentative in 2009 has now been resolved by scientific research, the report says.

About healthcare IT

Role of the States in the Future of AI Regulation A good topic review.

About health technology

58 best US health tech companies: Time: Time named 58 U.S. health tech companies “outstanding” in its Sept. 18 listing of the top firms in the space globally for 2025.
The publication partnered with market researcher Statista to rank health tech companies — with scores of outstanding, very high or high — on financial performance, reputation analysis and online engagement. 

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About hospitals and healthcare systems

Vizient announces 2025 Top Performers in clinical quality and sustainability excellence FYI

About pharma

Roche to pay $2.4B to acquire 89bio and its MASH hopeful pegozafermin: Roche agreed to acquire 89bio for $14.50 per share in cash, or around $2.4 billion, adding the late-stage FGF21 analogue pegozafermin to its cardiovascular, renal and metabolic disease portfolio. The deal announced Thursday also includes a contingent value right (CVR) worth up to $6 per share in cash, giving the transaction a total potential value of $3.5 billion. Eli Lilly pill outperforms Novo Nordisk’s oral drug in head-to-head diabetes trial: KEY POINTS
Eli Lilly said its experimental pill outperformed Novo Nordisk’s own oral drug in the first head-to-head study comparing the two medicines in patients with Type 2 diabetes. 
Eli Lilly said its pill, orforglipron, was superior at the trial’s main goal of lowering blood sugar levels at 52 weeks compared to Novo Nordisk’s oral semaglutide, and helped patients lose more weight.
But it’s less clear how Eli Lilly’s pill compares to a higher dose of oral semaglutide, especially in patients who are overweight or have obesity without diabetes.

Novo Nordisk shares pop 5% after Wegovy pill trial shows ‘significant’ weight reduction: Results from the phase 3 Oasis 4 trial showed the oral semaglutide pill led to average weight reduction of 16.6% after 64 weeks in patients with obesity or overweight and at least one weight-related comorbidity, the Danish pharmaceutical firm said.

About healthcare IT

“15% of Searches Have Never Been Typed Before”Why AI Safety in Health-Related Search Is Hard: …it turns out that 15% of what gets typed into the search box every day has never been typed in before. It's the first time that it's ever been typed in. That makes it a really interesting space to think about with the intersection of things that. by definition can't be in your training data because people are saying them literally for the first time in human history. 

New AI model predicts susceptibility to over 1,000 diseases: The generative AI system called Delphi-2M was built at the European Molecular Biology Laboratory in Cambridge, using “similar architecture to large language models but with key innovations to work with healthcare data”, said Tom Fitzgerald of EMBL. Delphi was trained on anonymised medical records from 400,000 participants in UK Biobank. The researchers then tested the model successfully on data from 1.9mn patients in the Danish National Patient Registry. The predictions across more than 1,000 diseases generally matched the accuracy of existing tools that have a far narrower focus, such as the QRisk score for heart conditions. Results were published in Nature on Wednesday. 

Toady's News and Commentary for September 17, 2025

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Takeaways from fired CDC director’s Senate testimony: The former CDC chief, who served in the position for only 29 days, told the Senate’s health committee that Kennedy told her that “he spoke to the president every day about changing the childhood vaccine schedule” and that she “needed to be on board” with coming changes in September. The recommendations from the CDC call for administering multiple vaccines at key milestones, and potential changes to the schedule have alarmed major medical associations who worry the nation’s vaccine infrastructure may crack. 

About health insurance/insurers

Major health insurer group says members will continue to cover vaccines, a step that may ease anxiety over access: America’s Health Insurance Plans’ announcement comes just ahead of the first meeting of the Advisory Committee on Immunization Practices’ 12 members handpicked by Health and Human Services Secretary Robert F. Kennedy Jr. The selection of the five newest members was announced Monday, and their meeting is Thursday and Friday. Experts have speculated that, among other steps, the panel will drop the existing recommendation that newborns receive the hepatitis B vaccine, a move that could lead to a resurgence of the virus and, as a result, liver disease and cancer. 

About pharma

St. Jude tests 3D printing for drug formulations: Pharmacists at St. Jude Children’s Research Hospital in Memphis, Tenn., have started using 3D-printing technology to help produce compounded medications starting with hydrocortisone formulations. 
The hospital is working to integrate the printers within existing U.S. Pharmacopoeia standards for nonsterile and hazardous drug compounding, according to a Sept. 11 news release from the American Society of Health-System Pharmacists. 

FDA publishes batch of letters targeting 'misleading' pharma ads: As part of its newly launched crackdown on pharmaceutical advertisements, the FDA has posted 40 letters to its website that were sent this month to 22 different drugmakers who have run "false or misleading" TV spots of medicines that make their distribution "in violation of the Federal Food, Drug, and Cosmetic Act." 

About the public’s health

Global Trends and Disparities in Social Isolation: In this repeated cross-sectional study of 159 countries, the global prevalence of social isolation increased by 13.4% over the 16-year study period (from 19.2 to 21.8), with the entire increase occurring after 2019. The disparity in isolation prevalence between high-income and low-income groups peaked in 2020 at 10.8 percentage points (high-income, 26.4% vs low-income, 15.6%). 

Chagas Disease, an Endemic Disease in the United States Global warming is causing formerly tropical diseases to move to what were temperate climates.

Today's News and Commentary for September 16, 2025

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About health insurance/insurers

The best-rated health plans of 2025: NCQA FYI

About hospitals and healthcare systems

Hospital group pushes Aetna to repeal inpatient reimbursement policy: Aetna’s new “level of severity inpatient payment” policy will take effect in less than two months, and the American Hospital Association said it is “deeply concerned.”
Aetna’s policy, set to go into effect Nov. 15, will approve inpatient stays without a medical necessity review but pay the claim at a lower severity rate. If the inpatient stay meets Aetna’s supplemental guidelines, the insurer will pay the claim according to the hospital’s agreement. This plan will apply to facilities participating in Aetna Medicare Advantage or Special Needs Plans for emergent or urgent inpatient stays greater than one midnight. The change’s goal is to expedite reimbursement, according to an Aetna update.

Hospital profitability: 24 statistics for 2025 so far: While overall operating margins are up 4% year to date compared to 2024, the picture is far from uniform. Large hospitals — particularly those with 300 to 499 beds — are driving much of the momentum, posting margin growth of more than 30%, while small facilities under 25 beds slipped into negative territory.
Geographically, the South and Midwest are emerging as bright spots, reporting double-digit operating margin gains of 21% and 15% respectively. In contrast, hospitals in the Northeast/Mid-Atlantic and Great Plains are struggling, with margins declining 6% and 7%. EBITDA performance reflects similar disparities, with growth concentrated in larger hospitals and declines among smaller facilities. 

About pharma

Novartis inks a second degrader-focused deal with Monte Rosa: Novartis has returned to Monte Rosa Therapeutics to further bulk out its pipeline, this time as part of a deal potentially worth just shy of $6 billion focused on novel degraders to treat immune-mediated diseases. 

Acetaminophen Use During Pregnancy and Children’s Risk of Autism, ADHD, and Intellectual Disability: Acetaminophen use during pregnancy was not associated with children’s risk of autism, ADHD, or intellectual disability in sibling control analysis. This suggests that associations observed in other models may have been attributable to familial confounding. 

About the public’s health

Influenza-Associated Hospitalizations During a High Severity Season — Influenza Hospitalization Surveillance Network, United States, 2024–25 Influenza Season: Among a surveillance sample of the U.S. population, 2024–25 was a high severity influenza season. The cumulative influenza-associated hospitalization rate was the highest since 2010–11. During the 2024–25 season, the percentages of patients admitted to an intensive care unit (16.8%) and who received invasive mechanical ventilation (6.1%) were similar to past seasons’ estimates. Approximately one third of hospitalized patients were vaccinated. Children aged 5–17 years were the lowest percentage of hospitalized patients receiving antiviral treatment (61.6%).
What are the implications for public health practice? All persons aged ≥6 months should receive an annual seasonal influenza vaccine. All hospitalized patients with suspected or confirmed influenza should receive timely antiviral treatment to reduce the risk for influenza-associated complications. 

About healthcare IT

Longitudinal study of the manifestations and mechanisms of technology-related prescribing errors [TRE]in pediatrics: TREs accounted for 32.5% (n = 428) of prescribing errors; an adjusted rate of 1.49 TREs/100 orders (95% confidence interval [CI]: 1.06, 1.92). At 1-year post-CPOE, the rate of TREs was 40% lower than immediately post (incident rate ratio [IRR]: 0.60; 95% CI: 0.41, 0.89). However, at 4-years post, the TRE rate was not significantly different to baseline (IRR: 0.80; 95% CI: 0.59, 1.08). 

Amazon expands healthcare offerings: Amazon has added Fay, a dietitian platform, as the first nutrition care service available through its Health Benefits Connector.
The collaboration allows eligible Amazon customers to discover and enroll in Fay’s insurance-covered nutrition services while browsing for wellness and health benefits, according to a Sept. 16 news release. 

About healthcare personnel

Workforce Education Trends Report  Interesting report and great graphics. For example: OVER HALF of healthcare employees (55%) admit that they’ll look for job openings, interview for, or switch to a new role in the next year, either inside (38%) or outside their organization (40%).

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About health insurance/insurers

Surging health costs bode ill for workers next year Interesting stats and sources for further reading.

About hospitals and healthcare systems

WHY PATIENTS ARE FILING MORE COMPLAINTS AGAINST HOSPITALS: According to the latest State Performance Standards System report from CMS, complaints against hospitals have surged by 79% over the past five years and topped 14,500 in fiscal year 2024. That increase is straining the oversight system designed to ensure hospital quality and safety, while also revealing frustrations from patients about their care experiences.
The report highlights how oversight gaps are contributing to dissatisfaction. State Survey Agencies, which investigate patient complaints and conduct recertification surveys, have had the same funding since 2015, even as their workload and use of resources has gone up. 

60 health systems with strong finances FYI

About the public’s health

Why 1 in 6 U.S. parents are rejecting vaccine recommendations: The American parents who are choosing to skip or delay vaccines for their children are more likely to home-school their children, be White and very religious, identify as Republican or be under 35, according to a wide-ranging Washington Post-KFF poll that sheds new light on what drives vaccine hesitancy.
Comment: Read the whole article. The link is gifted from my account.

Five new members named to influential CDC vaccine advisory committee days ahead of key meeting: The new members are Dr. Catherine Stein, an epidemiologist and professor at Case Western Reserve University; Dr. Evelyn Griffin, an obstetrician-gynecologist from Baton Rouge, Louisiana; Dr. Hillary Blackburn, director of medication access and affordability at AscensionRx and the daughter-in-law of Sen. Marsha Blackburn, a Republican from Tennessee; Dr. Kirk Milhoan, a pediatric cardiologist with For Hearts and Souls Free Medical Clinic in Hawaii; and Dr. Raymond Pollak, a surgeon and transplant immunobiologist.
See the article for their views on vaccines. 

Heart disease, cancer deaths increased in 2024: CDC : Heart disease and cancer were again the leading causes of death in the U.S. in 2024, according to a CDC report published Sept. 10, which analyzed 99.9% of 2024 death records as of June 1, 2025.
At the same time, the overall death rate decreased by 3.8% to the lowest it’s been since 2020, from 750.5 per 100,000 in 2023 to 722 per 100,000 in 2024. 

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House Throws Wrench in Plan to Test Prior Auth in Traditional Medicare: he House Appropriations Committee on Tuesday took aim at defunding a plan that could potentially expand prior authorization in Medicare.
Enough Republicans in the committee joined Democrats in passing an amendment to an HHS funding bill that would block CMS from implementing its recently announced prior authorization pilot programopens in a new tab or window in traditional Medicare. The goal of the plan is to target services including skin and tissue substitutesopens in a new tab or window, electrical nerve stimulator implantsopens in a new tab or window, and knee arthroscopy for osteoarthritis.

Employer health costs to top $17,000 per employee in 2026: What You Need To Know

• Aon projects a 9.5% increase in 2026, marking the third consecutive year with price hikes approaching double digits.

• The continued rise in chronic and high-cost conditions remain primary drivers of escalating medical costs in the United States.

• Prescription drug spending also is rising, driven by greater use of costly brand-name and specialty medications. 

About hospitals and healthcare systems

22 hospital closures in 2025 FYI

About pharma

Novartis' challenge to Medicare price negotiations falls flat on appeal: An appeals court has rejected Novartis' challenge to the Inflation Reduction Act's (IRA) Medicare drug price negotiation programme, adding to a series of defeats for the pharmaceutical industry on this issue.

Vaccine stocks slide on report that Trump team plans to link child deaths to COVID-19 shots: Shares of COVID-19 vaccine developers took a hit Friday after The Washington Post, citing four people familiar with the situation, reported that Trump administration health officials plan to link the preventative shots to the deaths of 25 children in a presentation next week to a vaccine advisory committee for the Centers for Disease Control and Prevention (CDC).  

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22 health systems with boosted outlooks FYI

About pharma

US exempts Japan generics from baseline 15% tariff: As part of a new trade agreement with the U.S. and Japan, the Trump administration is exempting generic pharmaceuticals, their ingredients and chemical precursors from the 15% baseline tariff applied to imports from Japan.

Advent strikes €4.1bn deal to sell generic drugmaker Zentiva to GTCR: Chicago-based private equity group GTCR has struck a €4.1bn deal to buy generic drugmaker Zentiva from Advent International, in Europe’s second big private equity-backed generics deal this year. The takeover, which follows a competitive bidding process, comes a week after CapVest acquired a majority stake in rival generic drugmaker Stada, valuing the business at €10bn. 

About the public’s health

CDC Infectious Disease Data Project Shelved: HHS has put on ice a CDC project that would make information about dozens of diseases available in near real time.  

Medication Adherence in Hypertension:A Cluster Randomized Clinical Trial:
Question  Can a primary care–based multicomponent intervention that includes automated identification of patients with uncontrolled hypertension and medication nonadherence combined with team-based care improve medication fill adherence?
Findings  In this pragmatic cluster randomized clinical trial of 1726 patients seen in 10 primary care clinics, the intervention was not associated with improvement in proportion of days covered for antihypertensive medications or blood pressure compared with usual care.
Meaning  While the intervention was able to automatically identify patients with medication nonadherence in clinical practice, it did not lead to improved medication adherence for patients with uncontrolled hypertension.
Comment: It is important to document what does not work. Articles typically report positive results- leaving researchers to make the same mistakes again. 

About health technology

Patient-Reported Outcomes as Prognostic Indicators for Overall Survival in Cancer: Findings  In this systematic review and meta-analysis of 69 randomized clinical trials that included 44 030 patients with cancer, higher baseline global health status, physical functioning, and role functioning scores were significantly associated with improved overall survival, while greater symptom burden, including nausea and vomiting, pain, fatigue, appetite loss, and dyspnea, was associated with worse overall survival.
Meaning  The study results suggest that patient-reported outcomes capture clinically relevant prognostic information beyond traditional clinical end points and may enhance risk stratification and personalized treatment approaches in oncology.