One of a few good men

Regardless of what you think of his time as president, Jimmy Carter was one of the few truly good people to hold the post — something that was made more obvious once he left office. A national day of mourning is more than just a formality for a fallen leader. In this case it’s well earned.

Here’s hoping President Carter enjoys his time with Mr. Rogers and Charles Schulz.

Driving stimulation

Ritalin can make you a better driver. For reals, according to Australian researchers.

If a person has ADHD, this is apparently a given — “For a medicated person with ADHD, driving without it can feel a bit like driving without their glasses^*.” But what about the rest of people? That’s what Aussies wanted to find out. They collected 25 healthy people who fit that description and gave them either 10 mg of methylphenidate or a placebo, then put them in driving simulators.

“Methylphenidate significantly improved driving performance by reducing lane weaving and speed variation, particularly in the latter half of the drive,” the authors report.

Importantly, they note that subjects were given a low dose. People who get Ritalin from the kid who mows their lawn often take higher doses, but that can lead to “a ‘tunnel vision’ effect […] that could limit a driver’s ability to respond to sudden or unexpected obstacles.”

^* As someone with ADHD who takes methylphenidate, I can report that this is just silly. 

Two more pharmacies close

Within a month of each other, two independent pharmacies in the Habersham area — Crossroads Pharmacy and Habersham Drug — have closed their doors thanks, the owners say, to the reality of a pharmacy market controlled by PBMs.

Hackers gonna hack

Sure, you probably heard about the Change Healthcare data breach that affected 100 million people and caused a lot of headaches. And you may have heard about the Kaiser Foundation Health Plan’s breach affecting 13.4 million people.

But those are just the two largest in 2024. In fact, there were a lot more; HHS reports a total of “677 major health data breaches affecting more than 182.4 million people” as of late December.

Here are just the 10 biggest:

1. Change Healthcare (100 million patients affected)
2. Kaiser Foundation Health Plan (13.4 million)
3. Ascension Health (5.6 million)
4. HealthEquity (4.3 million)
5. Concentra Health (4 million)
6. CMS (3.1 million)
7. Acadian Ambulance Service (2.9 million)
8. Sav-Rx (2.8 million)
9. WebTPA Employer Services (2.5 million)
10. Integris Health (2.4 million)

As of Dec. 20, some 6,584 major health data breaches affecting more than 746.6 million people had been posted on the HHS OCR website since September 2009. That’s about the equivalent of every American having their PHI compromised at least twice in a major health data breach.

On that note…

The HHS Office for Civil Rights is proposing a new rule that would require businesses and other entities covered by HIPAA to strengthen their cybersecurity measures. In general, it would require more testing, written assessments, “and vulnerability scanning at least every six months and penetration testing at least once every 12 months.”

I can’t wait to see the 2024 numbers

The US spent $4.9 trillion on healthcare in 2023, according to the numbers crunched by CMS’s Office of the Actuary. That includes what private insurers paid, what the government paid, and what individuals paid. It’s 7.5% above 2022, and GLP-1 drugs were only just getting started.

In fact…

Zepbound is expected to lead the GLP-1 juggernaut in 2025, which alone is expected to add a full percentage point to the cost of insurance premiums. And that’s just the start:

These GLP-1 drugs are adding to general healthcare inflation that is projected to increase employer-sponsored health insurance coverage by 9%, eclipsing $16,000 per employee in 2025.

They’re not bribes, they’re pledges of support

Pfizer and PhRMA (the pharma industry trade group) are among the businesses donating a heck of a lot of money to the Trump inauguration and political agenda.

[S]everal industry leaders — including Pfizer’s CEO Bourla — have been cozying up to Trump personally as they attempt to navigate potential changes to the healthcare landscape under his incoming administration.

Telehealth company Hims has donated $1 million, saying, “[W]e stand with leaders and advocates who are committed to improving America’s broken healthcare system.”

In an effort at one-upmanship, after meeting with Trump at Mar-A-Lago, Pfizer pledged to christen its headquarters with Trump’s name and erect a statue in his honor, while PhRMA offered to have its members rename the days of the week for Trump’s family. “We expect to hear back from the incoming administration on Ericsday,” said board chair Daniel O’Day

Admit it: For a moment — just a moment — you thought that last part could be true.

It’s time to rise!

It’s January, which means it’s time for drugmakers to raise their prices more than the rate of inflation … at least in the US.

Inflation here is about 2.75%, but manufacturers are raising the list prices of at least 250 meds by a median of 4.5% this January. There’s some good news: That’s about half of how much they used to raise them, and it’s (so far) about the same as last year.

Oh, that 2.75% is only for existing drugs. New drugs tend to be a lot more expensive. In 2024, for example, the price of debut drugs was 35% higher than in 2023.

As always, prices for brand-name drugs in the US are the highest in the world. Price hikes are needed for executive bonuses, to fund stock buybacks, and to pay for marketing. On the other hand, prices for generic drugs are among the lowest, so … yay?

Bird flu follow-up

In Canada, the teenager who was in critical condition with H5N1 flu in British Columbia has made a recovery — possibly a full recovery. Her discharge info isn’t being shared, but her diagnosis and treatment is: “She had respiratory failure, pneumonia in the left lower lobe, acute kidney injury, thrombocytopenia, and leukopenia.”

Her treatment included oseltamivir (Tamiflu), but she still required intubation. Then she was given amantadine (Gocovri) followed by baloxavir, along with 3 days of daily plasma exchange among other treatments — you can read the details here.

You are permitted to say “Yikes.” But again, she’s recovered and been discharged.

The news wasn’t as good for the patient in Louisiana, whose death was announced Monday. Unlike the Canadian teen, the Louisiana patient “was over the age of 65 and was reported to have underlying medical conditions.”

Side note: The Louisiana patient contracted the bird flu after exposure to “a non-commercial backyard flock,” which might refer to backyard poultry. The Canadian teen? Health officials still don’t know where she contracted it.

Short takes

Waiting for the savings

The widespread use of GLP-1 drugs was supposed to save money in the long run by reducing spending on a host of other medical conditions, from diabetes to kidney issues to knee replacements. But two years into the boom, we’re not seeing it. Both PBM Prime Therapeutics and the Congressional Budget Office say “there does not appear to be any direct empirical evidence pointing to a medical cost offset.” At least not yet.

Thinking, Slow and Slow

You might connect to the Internet at 40, 50, or 100 Mbps (aka 100 million bits per second), but your brain? Not so fast. According to CalTech researchers, your 7 lbs of meat is processing information at a rate of — wait for it — 10 bits per second. Not megabits — bits.

[insert joke about your favorite politician here]

That said…

[O]ur bodies’ sensory systems gather data about our environments at a rate of a billion bits per second, which is 100 million times faster than our thought processes.

In other words, we’re 10-bit brains in a gigabit world.