CVS ponders breaking up

Could CVS Health commit mitosis? Maybe. The company’s investors are apparently “exploring options that could include a break-up of the company to separate its retail and insurance units.”

The plan to potentially split the company’s pharmacy chain and the insurance business has been discussed with the board of directors, which is yet to decide on the best course of action for CVS to pursue, the sources said, cautioning that the plans have not been finalized and CVS may opt for a different strategy.

It’s not that CVS isn’t incredibly profitable — it’s that investors are annoyed it isn’t more profitable. And we all know how important profit motive is for the companies that decide what health care we’re allowed.

Stopping the step

Migraine sufferers are pushing Congress to curtail step therapy by passing the Safe Step Act. The bill would require insurers to make exceptions to their normal ‘try everything that’s cheaper’ approach when a doctor says there’s no point, and when delaying the right treatment “would lead to irreversible consequences” including preventing a patient from, you know, living a normal life.

GLP-1s’ real world reality check

For all the hype about how much weight people can lose on GLP-1 drugs — 15%! 17%! 20% — it seems a lot of that might just be, well, hype.

When researchers look at real-world experience (i.e., outside of drugmakers’ studies) they find that weight loss from Ozempic, Zepbound, and kin are more like two to four percent.

The latest of these real-world studies, out of the Cleveland Clinic, looked at about 3,400 people with obesity. Those taking semaglutide for a year lost an average of just over 5% of their weight. Not bad, of course, but far short of what people have been led to believe.

Can you imagine the shakeup if GLP-1s turned out to be not such a big deal after all?

Short Takes

Mercer to study tranq-induced skin lesions — fun!

Two Mercer CoP researchers scored themselves a $388,000 grant from the NIH to look into xylazine — aka tranq — the latest Drug Scourge Affecting Our Communities. Specifically, the grant is “to explore how xylazine affects the human body, especially its role in causing dangerous and life-threatening skin lesions.”

Respiratory season’s slow start

Good news from the latest CDC report: “seasonal influenza and RSV activity are low nationally, and Covid-19 activity is elevated but declining.” It’s still early, of course, but we’ll take the good news where we get it, especially with vaccination rates looking to be low.

Senators push for more PBM oversight

Two US senators have asked the FDA and the FTC to keep up their scrutiny of PBMs. The FTC lawsuit in September was a good start, they said, but now they “urged the com­mis­sion to ex­am­ine ‘new PBM tac­tics that ap­pear to cre­ate fur­ther bar­ri­ers to com­pe­ti­tion and harm the abil­i­ty of con­sumers to ac­cess low­er cost pre­scrip­tion drugs’.”

What new tactics? They’re referring to how at least two PBMs (CVS and Express Scripts) are also getting into biosimilar manufacturing which may be “a veiled at­tempt by PBMs to con­trol ad­di­tion­al parts of the sup­ply chain.”

AI tackles rare diseases (in a big way)

Repurposing existing drugs, the ancient method: Notice anecdotal reports over years that indicate a drug might have an off-label use, then test it against other diseases.

Recent method: Train an AI on a rare disease or two, then have it go through a list of existing drugs to see if any might treat it.

New method: Give an AI a list of thousands of ‘untreatable’ rare diseases, a list of thousands of medications, and let it find matches.

That’s what researchers at Harvard did with a tool they call TxGNN — they trained it to “[identify] shared features across multiple diseases, such as shared genomic aberrations” and extrapolate how an existing drug might work on a different disease.

[T]he tool identified drug candidates from nearly 8,000 medicines (both FDA-approved medicines and experimental ones now in clinical trials) for 17,080 diseases, including conditions with no available treatments. It also predicted which drugs would have side effects and contraindications for specific conditions.

Hey, students, there’s an AI study-buddy for you

It’s called Pharm Tutor AI, and it’s basically ChatGPT that’s been additionally trained on pharma-specific info. The company describes it as “Your AI assistant for Pharmacy School,” and it’s apparently meant to be your know-it-all friend for those late night study sessions:

[T]his application serves as an interactive study partner, capable of delivering comprehensive knowledge across a range of pharmaceutical subjects. It is purpose-built to aid in the understanding and retention of complex concepts, facilitate extensive subject exploration, and help students excel in their academic endeavors.

Disclosure: We didn’t look into pricing (it seems to be free) or even how good it is, but the idea seems kinda cool and worth exploring.