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The Federal Trade Commission on Tuesday sharply criticized pharmacy benefit managers, saying in a scathing 71-page report that “these powerful middlemen may be profiting by inflating drug costs and squeezing Main Street pharmacies.” The regulator’s study signals a significant ramping up of its scrutiny of benefit managers under the agency’s chair, Lina Khan. It represents a remarkable turnabout for an agency that has long taken a hands-off approach to policing these companies. (Abelson and Robbins, 7/9)

Drug middlemen, known as pharmacy-benefit managers, have accomplished something rare in Washington: Their business practices have led to a bipartisan consensus of sorts around the need for more regulation. Yet successfully cracking down on the tactics that drive health costs higher won’t be easy. That is because PBMs operate in a highly complex and opaque world where key information is kept from the public. (Wainer, 7/10)

Generic versions of erectile dysfunction drugs Viagra and Cialis, among other medications, were allowed on the US market using potentially problematic data that call into question their safety and efficacy, a Bloomberg analysis found. The US Food and Drug Administration alerted brand-name and generic companies June 18 about a research company in India that had falsified the data used in key studies to gain approval of their medications. Data from the researcher, Synapse Labs Pvt. Ltd., may have been used in hundreds of drugs, which remain available for sale on pharmacy shelves and in Americans’ medicine cabinets. (Edney, 7/9)

Jim Cox had heard of people with Type 2 diabetes who were unable to get Ozempic because the drug was being used off-label for weight loss. He just didn’t think the shortage would affect him. He has the disease too, but he takes a different drug called Trulicity, which is in the same class of GLP-1 drugs as Ozempic. But “then I went up to my local pharmacy to get my Trulicity and they said, ‘Sorry, we're out,’” Cox says. “I couldn't renew my prescription.” (Lupkin, 7/10)

Purdue Pharma LP secured a two-month window to negotiate a new pact with members of the Sackler family as the OyxContin maker and its owners brace for a potential wave of civil opioid lawsuits after the US Supreme Court scuttled an earlier $6 billion settlement. Judge Sean Lane said during a Tuesday court hearing in New York that he’d extend for 60 days an injunction that, for years, has paused opioid litigation against the billionaire family while Purdue, government authorities and victims lawyers attempted to effectuate the earlier settlement. (Randles, 7/9)

The first trial against Similac baby formula maker Abbott over claims that its formula for preterm infants used in neonatal intensive care units causes a potentially deadly bowel disease got underway with opening statements on Tuesday, as a lawyer for a mother suing the company urged jurors to hold it liable for her child's lifelong injuries. Jake Plattenberger of TorHoerman, a lawyer for Illinois resident Margo Gill, told the St. Louis, Missouri state court jury that Abbott made "no attempt to tell physicians in a clear and direct way" that its products could cause necrotizing enterocolitis (NEC) in premature babies. (Pierson, 7/9)

One of the most notorious insider trading schemes in U.S. history has led to a $75 million fight between drugmaker Pfizer and the U.S. Securities and Exchange Commission. That sum is what remains of a fund to compensate victims of insider trading by the now-shuttered hedge fund SAC Capital, which reaped more than $275 million in profits in 2008 from trading on unlawfully obtained clinical data about a prospective Alzheimer's drug. SAC Capital and related entities paid more than $600 million in 2013 to resolve the SEC's case in the largest insider trading settlement in U.S. history. (Frankel, 7/9)

Pfizer said on Tuesday Chief Scientific Officer Mikael Dolsten, a key figure behind the development of its COVID-19 vaccine, would step down after a more than 15-year career at the drugmaker. Dolsten, aged 65, served as the head of Pfizer's research and development after he joined the company through its $68 billion acquisition of Wyeth in 2009. He became the company's chief scientist in 2010. (7/9)

After getting laid off from Bristol Myers Squibb last December, Jennifer Ariazi is trying her best to be a Vulcan. Ariazi, a former BMS senior principal scientist, is a devout “Star Trek” fan. And she has made a personal mantra out of emulating the stoicism and tough-minded logic that define the fictional humanoid species. Layoffs happen. It’s a business. You’ve gotten through this before. (Wosen, 7/10)

The portion of physicians surveyed by the American Medical Association (AMA) who report at least one symptom of burnout has dropped below 50%, a first since the onset of the COVID-19 pandemic. The group’s annual survey shows consistent declines in doctor burnout in the wake of an all-time high of 62.8% in 2021. Reported burnout dropped to 53% in 2022 and, as of the most recent 2023 survey, now sits at 48.2%. (Muoio, 7/9)

Nico Olalia had just finished her initial nurse training in the Philippines when she realized her aspirations were growing bigger than her home archipelago. “There are a lot of trans Filipinos, but they’re always known in the beauty industry, and they’re very seldom found in the professional side,” Olalia said. So she moved back to the United States, where she was born, for better career prospects. Today, she is a clinical nurse at Cedars-Sinai, one of the largest hospitals in Southern California, where she assists new hires and cares for patients in the neurology division. (Deng, 7/10)

Most of Johns Hopkins University’s medical school students will have free tuition starting this fall, thanks to a $1 billion gift from Bloomberg Philanthropies, a longtime donor of the university, whose school of public health is named after Michael Bloomberg. The largesse is striking, but, even combined with other recent moves to relieve future doctors of crushing medical debt, the move may not reverberate to bring improvements to the broader health care system, experts say. According to the announcement, part of the gift will go toward increased tuition aid for health care students other than future doctors, such as public health and nursing. For future doctors attending the school, the impact will be more significant. (Merelli, 7/10)

Michael Dandorph wants to make something particularly clear: Tufts Medicine, the Massachusetts hospital chain he leads as CEO, is not Steward Health Care. Yes, the two hospital chains both serve mostly poorer patients and have struggled with big financial losses in recent years. And given the severe shortage of hospital beds in Massachusetts, a problem heightened by concerns that Steward could close hospitals amid Chapter 11 bankruptcy proceedings, public and industry officials alike have been anxiously watching the health of other troubled hospital systems throughout the state. (Lee, 7/9)

Ardent Health Partners seeks to raise up to $314.6 million through an initial public offering, which the for-profit health system said would give it a valuation of $3.15 billion. In documents filed with the Securities and Exchange Commission Monday, Ardent said it planned to sell 14.3 million shares priced at $20 to $22 each. (Hudson, 7/9)

CMS has launched a dementia care program that will be piloted by 400 organizations. The Guiding an Improved Dementia Experience Model focuses on comprehensive, coordinated care that is designed to improve the lives of people with dementia, reduce strain on their unpaid caregivers and enable people with dementia to remain in their homes, according to the agency's website. It is a voluntary, nationwide model that began July 1 and will run for eight years. (Taylor, 7/9)

Credit scores — used to gauge a person's ability to fulfill their financial commitments — can also be an early warning sign of cognitive decline, according to research from the New York Federal Reserve and Georgetown University. A person's credit score, on average, starts to weaken in the five years ahead of a dementia diagnosis, while mortgage delinquencies start increasing three years prior, researchers found in an analysis of a nationally representative sample of credit reports and Medicare data on more than 2.4 million people spanning 2000-2017. (Gibson, 7/10)

About 13% of individuals diagnosed with dementia may suffer instead from reversible cognitive decline caused by advanced liver disease, according to researchers from the Virginia Commonwealth University’s School of Medicine and the Richmond VA Medical Center. Published recently in the American Journal of Medicine, the new analysis of nonveteran patients corroborates and extends the research group’s earlier work showing that about 10% of U.S. veterans diagnosed with dementia may suffer instead from cirrhosis. Those findings appeared in the journal JAMA Network Open in January. (Hostetler, 7/9)

A team of investigators looked at possible dementia clinical trial requirements that could exclude people based on race and ethnicity. Overall, 82% of the trials they examined had criteria that weren’t well-defined and could reduce diversity, according to a July 1 report in Scientific Reports. The authors said that the analysis was the first overview of eligibility criteria currently used in trials funded by the US federal government. (Fischer, 7/10)

Before Dr. Kevin O’Connor was appointed White House physician at the beginning of the Biden administration, he discussed a business venture with the president’s brother James Biden, but the doctor ultimately received no compensation, Mr. Biden’s lawyer said. The discussions revolved around James Biden’s involvement with a health care company called Americore, which was looking to expand a network of hospitals in underserved rural areas of the United States. (Vogel, 7/9)

Doubts about the mental fitness of President Biden and Donald Trump to hold the White House in their 80s have highlighted tests that could reveal whether an older adult is experiencing cognitive decline. Biden has not taken a cognitive test during his presidency and dismissed calls to take one arguing during his recent ABC News interview that leading the country amounts to a daily test. Trump has bragged about passing a short screening test in 2018, and his personal physician said last year that his cognitive exams were “exceptional” but did not explain what those exams entailed and when they were conducted. (Ortega and Nirappil, 7/9)

A U.S. sailor has been disciplined by the Navy for attempting unsuccessfully to access President Biden’s medical records without authorization, officials disclosed Tuesday amid ongoing scrutiny of the president’s health and fitness for office. The incident occurred in late February, well before Biden’s halting performance during last month’s presidential debate set off a panic among Democrats, and it was not immediately clear whether the actions were politically motivated. (Lamothe, 7/9)

The military would not be able to pay for surgeries for transgender troops under the Senate's version of the must-pass annual defense policy bill, legislative text released Monday evening revealed. Transgender military kids could also lose access to hormone therapy, puberty blockers and other medication if the treatment "could result in sterilization" under another provision that was also added to the bill during the Senate Armed Services Committee's closed-door consideration of the measure last month. (Kheel, 7/9)

The Department of Veterans Affairs has ended a seven-year-old policy that required claims processors to work mandatory overtime, a move enabled by increased hiring and efficiency, according to the VA's top benefits executive. Under Secretary for Benefits Joshua Jacobs announced Tuesday that most staff will no longer be required to work up to four hours extra each week, although they still may volunteer to work up to 20 hours of overtime each week. (Kime, 7/9)

A Microsoft-based Veterans Affairs account was accessed in January by Russian hackers, but no personal information or other data was compromised, an agency official confirmed. The Russian state-sponsored hacker infiltrated a Microsoft platform called Microsoft Azure Government, which provides storage, databases and other services to the VA and other government agencies. (Perez, 7/9)

Dr. Shereef Elnahal has gone all in on virtual and augmented reality since joining the Veterans Health Administration. ... In his two years running the nation's largest integrated health system, Elnahal has championed the use of immersive technology. The system has deployed more than 3,500 virtual and augmented reality headsets at more than 170 medical centers, a 250% increase from around 1,000 headsets deployed in 2023. (Perna, 7/9)

The rural hospital collaborative in North Dakota has secured two value-based contracts with commercial insurers and more are expected this year, building momentum for those considering similar alliances. Cibolo Health in October created the Rough Rider High-Value Network comprised of 23 critical access hospitals in North Dakota. The rural hospital advisory firm has since helped launch a similar venture in Minnesota and is in early talks to expand the model in several other states, CEO Nathan White said. (Kacik, 7/9)

The judge dismissed the state's lawsuit against two federal agencies and said the case should instead be an administrative challenge. Next stop is the 11th U.S. Circuit Court of Appeals in Atlanta. (Saunders, 7/9)

Colorado stands out among the 10 states that have disenrolled the highest share of Medicaid beneficiaries since the U.S. government lifted a pandemic-era restriction on removing people from the health insurance program. It’s the only blue state in a cluster of red states with high disenrollment rates — a group that includes Idaho, Montana, Texas, and Utah — in the Medicaid “unwinding” underway since spring 2023. (Bichell, 7/9)

Virginia Gov. Glenn Youngkin (R) called for policies restricting cellphone use in schools in an executive order Tuesday, citing rising concerns about the effects of phone usage and social media on youth mental health. Under the order, the state Education Department will create guidance for school districts to develop policies for a “phone-free” education environment. The goal, the order says, is to limit the amount of time children are on phones “without parental supervision.” The order is not an outright ban on the use of phones in class. (Elwood, 7/9)

Chicago has an estimated 400,000 lead lines, the most of any US city. While the scale of the problem in Chicago eclipses other cities, the hurdles it faces to remove known toxic lines reflect the broader funding and logistical challenges of making America’s tap lead-free. Nationally, an estimated 9 million lead lines remain buried underground. Ten years after the lead water crisis in Flint, Michigan, the Environmental Protection Agency is now working to finalize new rules requiring most cities and public water systems to remove all lead pipes within a decade beginning in 2027, at a pace of 10% of total lines annually. (Poon and Porter, 7/9)

�鶹Ů�� Health News: Why The Election May Slow Plans To Replace Lead Pipes

With the Environmental Protection Agency’s latest — and strictest — plan to minimize the risk of Americans drinking lead-contaminated water on the horizon, the debate over whether the rules go too far or not nearly far enough is reaching a tipping point. Although lead was banned from new water service lines in 1986, it’s estimated that more than 9 million such lines still carry drinking water to homes and businesses throughout the country. Under the EPA’s Lead and Copper Rule Improvements proposal, water utilities would be required to replace all lead-containing lines within 10 years. (West, 7/10)

How much do heatwaves cost? The hidden costs of extreme heat — from lost productivity to healthcare for heat-related illnesses — totaled more than $7.7 billion over the last decade, a new report from the California Department of Insurance found. It concluded that there are gaps in traditional insurance coverage for losses due to extreme heat events and recommended the creation of new insurance solutions. (Pender, 7/9)

The state legislature earmarked $50 million in the 2022 budget for “officer wellness” programs, with an eye toward improving the mental health of police, and documents show law enforcement has been spending that money on items that range from gym equipment to saunas and Himalayan salt. Some departments chose more offbeat ways to use the money. The Yuba City Police Department put some of its $1,328 toward out-of-work social events and an “emotional support service animal,” an adopted bunny named Officer Percy. (Lange, 7/9)

A hospital closure in the heart of the San Joaquin Valley a year and a half ago underscored something that people in the region have long known: They don’t have enough doctors or access to medical care. Madera County’s lone acute care hospital is expected to reopen later this year. But the issues around medical access that patients in this county and neighboring ones experience will likely continue long after Madera Community Hospital reopens. (Ibarra, 7/8)

Alando Williams, a fixture for years selling the Street Spirit newspaper outside the Berkeley Bowl supermarket on Oregon Street, was admitted to Oakland nursing home Brookdale Wellness in December 2022. Less than a month later, he was dead, aged 64. Now his daughter is suing the facility on Fruitvale Avenue and its owner, claiming the drugs used to keep Williams from wandering contributed to his death. (Baron, 7/9)

Emma Craig was outside the Beverly Hills Medical Center on Wilshire Boulevard, spoiling for a fight. Armed with a bullhorn, sidewalk chalk and “giant photos of dead babies,” the Bay Area art teacher and antiabortion activist had arrived with her confederates last summer to pray and protest against a clinic seeking to expand its services to California amid a flurry of national restrictions on reproductive care. (Sharp, 7/9)

Jo Franco still remembers the moment she realized that her nose worked. Growing up in Wilmington, a Los Angeles neighborhood dotted with oil refineries and next to one of the largest port complexes in the country, she’d always assumed she had a fever, or allergies: “I could never breathe through my nose at all,” she told me. But when she moved away from the city for college, her breathing suddenly got easier. “It was this wonderful surprise,” she said. “I could smell lemons.” (Unzueta, 7/9)

Congressman and longtime California politician John Garamendi said Monday that he has been diagnosed with a rare form of blood cancer called multiple myeloma. In a statement and a video posted on the social media platform X on Monday afternoon, Garamendi (D-Walnut Grove), 79, said doctors found the cancer early. He recalled his doctor calling him to say: “When will you be back in California? You need to come in for a series of tests.” (Nelson, 7/8)

Public health officials seeking a better view of how bird flu is spreading in cows have a new pitch for resistant dairy farmers: anonymized testing. Many farmers are refusing to test their herds, fearing the economic consequences, while concern builds that the relatively benign virus could morph into a much bigger risk to humans. (Reed, 7/10)

The new study finds that the H5N1 virus currently circulating in U.S. cows also charts a path to mammary glands, suggesting that the tissue unique to mammals is a more common target for the virus than originally thought. (de Jesus, 7/8)

A study published Monday provides new evidence that the H5N1 virus currently causing an outbreak of bird flu in U.S. dairy cattle may be adapted to better infecting humans than other circulating strains of the virus, a result that is already courting controversy among the world’s leading flu researchers. (Molteni, 7/8)

California’s COVID-19 emergency room visits and test positivity rate are rising sharply as the summer coronavirus wave gains momentum with some people reporting more severe symptoms than in previous encounters with the illness. However, there are signs of hope. Current figures remain far lower than in previous years, and health officials have now recommended an updated fall vaccine to protect against the latest coronavirus variants during the anticipated winter surge. (Vaziri, 7/9)

The storage unit at Doctors of Waikiki is out of Covid vaccines. “Like everything, when there’s a higher demand, you have issues with getting certain products,” said Dr. Tony Trpkovski. “And right now because we’re seeing an uptick in Covid, we’re seeing an increased demand for the vaccine.” Experts say that demand increased because of timing with graduations, summer-time get-togethers and peak travel season. (7/9)

Colorado public health officials have confirmed a human case of plague in a Pueblo County resident, according to the Pueblo Department of Public Health and Environment. Plague is very rare, with an average of seven human plague cases reported annually in the U.S., according to the CDC. (Reinstein, 7/10)

State health officials have identified a case of measles in an unvaccinated New Hampshire resident. This and another recently confirmed case in Vermont are linked to an international traveler who visited Hanover in late June. Health officials say the New Hampshire resident may have exposed others to the highly contagious disease while visiting several public places. (Cuno-Booth, 7/9)

Mosquitoes collected from Orono have tested positive for Jamestown Canyon Virus. The town said it got verbal notice of the positive test from the Maine Center for Disease Control and Prevention before the state agency confirmed the news on Tuesday. The Maine CDC said this mosquito pool, a group of up to 50 mosquitoes collected for regular testing, is the first in the state this year to test positive for any virus transmitted by mosquitoes. (Bartow, 7/9)

A 54-year-old New Jersey woman who was the second person to receive a kidney transplanted from a genetically modified pig, and who lived with the organ for 47 days, died on Sunday, surgeons at NYU Langone Health announced on Tuesday. The patient, Lisa Pisano, was critically ill, suffering from both kidney failure and heart failure. She received the pig kidney on April 12, just eight days after implantation of a mechanical heart pump. (Rabin, 7/9)

The first trials using pig organs in people, two heart transplants at the University of Maryland in 2022 and 2023, followed by a kidney transplant at Massachusetts General Hospital at NYU in April, were supposed to turbocharge the field. But none of the patients survived more than two months with their pig organs. (Weintraub, 7/9)

A Massachusetts man has regained his voice after surgeons removed his cancerous larynx and, in a pioneering move, replaced it with a donated one. Transplants of the so-called voice box are extremely rare, and normally aren’t an option for people with active cancer. Marty Kedian is only the third person in the U.S. ever to undergo a total larynx transplant – the others, years ago, because of injuries – and one of a handful reported worldwide. (Neergaard, 7/9)

Eight weeks of acupuncture was found to reduce the dose of methadone needed to control opioid cravings, which could make patients likelier to stick with their treatment. Why it matters: Methadone is one of the most effective medications for curbing opioid addiction, but uncomfortable side effects can cause people to stop treatment. (Goldman, 7/10)

Darryl Collins owns a zero-proof bottle shop called Hopscotch in Baltimore, Md., selling over 200 options of nonalcoholic spirits, beer, wine and canned cocktails. ... Collins set his own age limit, and he’s free to set it however he wants because in Maryland — as in the majority of states — there are no state age restrictions on who can buy adult non-alcoholic beverages. Now, some health researchers are calling for clear, consistent age limits for non-alcoholic beers, wines and liquors, likening them to candy cigarettes. (Huang, 7/9)

Don't get hysterical about your child's screen time or yank away their cellphone protectively, says Dr. Michael Rich, a pediatrician who runs a leading treatment program for kids with so-called "internet addictions" (a term he detests). Children will go through life with a smartphone, he points out — and it's important for the adults in their lives to teach them to use one wisely. (Kingson, 7/10)

�鶹Ů�� Health News: Listen To The Latest '�鶹Ů�� Health News Minute'

“Health Minute” brings original health care and health policy reporting from the �鶹Ů�� Health News newsroom to the airwaves each week. (7/9)

A company has installed computerized vending machines to sell ammunition in grocery stores in Alabama, Oklahoma and Texas, allowing patrons to pick up bullets along with a gallon of milk. American Rounds said their machines use an identification scanner and facial recognition software to verify the purchaser’s age and are as “quick and easy” to use as a computer tablet. But advocates worry that selling bullets out of vending machines will lead to more shootings in the U.S., where gun violence killed at least 33 people on Independence Day alone. (Chandler, 7/9)

�鶹Ů�� Health News: These Vibrant, Bigger-Than-Life Portraits Turn Gun Death Statistics Into Indelible Stories

Zarinah Lomax is an uncommon documentarian of our times. She has designed dresses from yellow crime-scene tape and styled jackets with hand-painted demands like “Don’t Shoot” in purple, black, and gold script. Every few months, she hauls dozens of portraits of Philadelphians — vibrant, bold, bigger-than-life faces — to pop-up galleries to raise an alarm about gun violence in her hometown and America. (Spolar, 7/10)

Stocks of cisplatin are now able to meet demand for the widely used chemotherapy drug that had been in short supply in the U.S. over the last year, the FDA's top official said. FDA Commissioner Robert Califf, M.D., announced Friday on social media that the cisplatin drug shortage was over. The agency had previously said it would continue to work with drugmakers and other interested parties to address shortages of cancer treatments. (Keenan, 7/1)

Shares of HilleVax plunged as much as 87.6% to a record low of $1.75 on Monday after the biotech company said it will discontinue the development of its norovirus vaccine candidate for infants. The vaccine, named HIL-214, showed an efficacy of only 5%, failing to meet the main goal in the mid-stage study conducted on more than 2,800 infants. It also did not show any clinical benefits across secondary goals of the study. (7/8)

Emergent BioSolutions said on Monday Johnson & Johnson has agreed to pay $50 million to settle claims related to a terminated manufacturing deal for the latter's COVID-19 vaccine. In 2022, J&J informed Emergent of its decision to terminate the deal, citing breaches including failure to supply COVID-19 vaccine drug substance on the part of the contract manufacturer. (7/8)

Eli Lilly agreed to buy Morphic Holding for $3.2 billion in cash, the companies said on Monday, beefing up its portfolio of inflammatory bowel disease (IBD) drugs and expanding its footprint in the multi-billion dollar market. (Roy, 7/8)

A systematic review and meta-analysis of 12 studies suggests meningococcal vaccines show moderate effectiveness against gonorrhea infection, researchers reported yesterday in the Journal of Infection. (Dall, 7/9)

By many measures, the Orphan Drug Act has been a resounding success. Yet many rare diseases still lack treatments, and some manufacturers have used the law in ways that diverge from its original intent. (Michael S. Singha, M.D., J.D., M.P.H., et al, 7/6)

It is absurd for a mother to be reported to child welfare authorities for taking medication prescribed by her doctor. It harms the mother and baby because it creates a perverse incentive for the mother to go off medication while pregnant — which can lead to relapse, overdose, and worse health outcomes for mom and child. (7/10)

Using AI to improve the accuracy and timeliness with which doctors recognize illness can mean the difference between life and death. Ischemic stroke, for example, is a life-threatening emergency where a blocked artery impedes blood flow to the brain. Brain imaging clinches the diagnosis, but that imaging must be performed and interpreted by a radiologist quickly and accurately. Studies show that AI, through superhuman pattern matching abilities, can identify strokes seconds after imaging is performed — tens of minutes sooner than by often-busy radiologists. (Gaurav Singal and Anupam B. Jena, 7/9)

Getting high—and overdosing—is after all, as American as apple pie. Over 46 million people in the U.S. have an alcohol- or drug-use disorder. Everyone knows someone who died, or who lost a son or daughter, mother or father, to a drug overdose, one of the 100,000-plus now yearly recorded nationwide. (Zachary Siegel, 7/9)

The lodestar for the anti-abortion movement has always been a constitutional guarantee of fetal personhood, which would outlaw abortion and threaten the legality of both IVF and hormonal birth control. (Jamelle Bouie, 7/9)