| | | | | | | Presented By PhRMA | | | | Axios Vitals | | By Tina Reed · May 03, 2023 | | Happy Wednesday, Vitals readers. Today's newsletter is 1,062 words or a 4-minute read. 💉 Situational awareness: The FDA is expected to make a final call on GlaxoSmithKline's RSV vaccine today, which could make the vaccine available to older adults for the first time. 👋 Tune in today! Join me and Axios' Maya Goldman today at 12:30pm ET for a virtual event examining ways to address burnout in the health care industry. Guests include Rep. Jen Kiggans (R-Va.) and Johns Hopkins School of Nursing dean Sarah L. Szanton. Register here to attend. | | | | | | 1 big thing: Allergy season is getting longer and worse |  | | | Illustration: Natalie Peeples/Axios | | | | Allergy seasons are becoming more intense and lasting longer, in part due to climate change, Axios' Arielle Dreher writes. Why it matters: Warmer temperatures are fueling longer and more intense pollen seasons, studies find. If those trends continue, places that typically have short or less intense allergy seasons could see them extend. What's happening: Spring allergy season in the U.S. typically starts in late March and lasts through early June. But in recent years, the spring allergy season has expanded on the front and back end in some places: starting early in late February and lasting into late June. - Fall allergy season, when goldenrod, ragweed and other weeds pollinate, might now begin in August too, instead of in September.
- Soaring pollen counts are "really changing the landscape of allergies," says Neeta Ogden, a clinician allergist and spokesperson for the Asthma and Allergy Foundation of America.
- From 1990 to 2018, pollen counts increased by 21% nationwide, with the greatest increases in the Midwest and Texas, per a 2021 study.
The big picture: About a quarter of U.S. adults suffer from seasonal allergies, according to data from the Centers for Disease Control and Prevention, but certain parts of the country have historically had worse allergy seasons. - The Midwest, East Coast and parts of Texas boast many "allergy capital" cities where pollen presence, allergy medication use, and the number of allergy specialists is highest, per a 2023 Allergy and Asthma Foundation report. In 2023, Wichita, Kansas, and Dallas lead the list.
- Seven Florida cities are ranked in the top 20 on the "allergy capital" list. No cities west of Texas were considered "allergy capitals."
Yes, but: That could start to shift with climate change, especially in typically cooler areas where temperatures now dip below freezing fewer days during the winter. Go deeper. |     | | | | | | 2. A UNC antitrust carve out |  | | | Photo illustration: Allie Carl/Axios. Photo: Rolf Schulten/Getty Images | | | | North Carolina's state Senate passed a bill this week that would exempt the UNC Health Care system from federal and state antitrust laws, Axios' Maya Goldman writes. Why it matters: The bill could increase health care consolidation in the state by making it easier for the University of North Carolina-affiliated hospital system to acquire other health care organizations. - Hospital consolidation increases health care costs and does not improve care quality, research shows.
- It now moves to the state's House of Representatives.
The details: Aside from exempting UNC Health from antitrust policies, the policy would also change the system's leadership structure and allow it to shift employees from state health insurance and retirement plans to a new benefits package. - The state employees association and the state's treasurer oppose the bill, but the Senate held almost no debate on the policy, WRAL News reported Monday.
The intrigue: In the U.S. Congress, federal lawmakers are taking the opposite stance on hospital competition. - The House Energy and Commerce Committee held a hearing last week on improving transparency and competition in health care, and particularly among hospitals.
- Lawmakers also introduced a bipartisan bill last week to expand antitrust enforcement of non-profit hospitals.
Read the rest. | | | | | | | | 3. How menopause costs the U.S. |  | | | Illustration: Sarah Grillo/Axios | | | | A new study from the Mayo Clinic finds that women going through menopause are more likely to miss work, cut back hours or even quit jobs because of symptoms associated with the condition, Axios' Emily Peck writes. Zoom out: Long a taboo subject, or a way to dismiss older women, menopause is now finally getting attention — and investor dollars — thanks partly to a generational shift. Zoom in: The study adds a new dimension to the discussion. The researchers surveyed more than 4,400 women aged 45 to 60 at four different clinic sites in 2021. - Overall, 13% of them reported some kind of adverse work outcome related to menopausal symptoms, most typically missing work — an average of three missed days a year.
- This works out to about $1.8 billion in lost productivity, researchers say.
What's next: Employers need to make the workplace environment more supportive, the researchers conclude. That doesn't mean running out and creating some kind of new policy for older women. "That creates hostility and bias," said Julia Beck, founder of the It's Working Project, an organization that focuses on working caregivers. - Employers that accommodate work-life balance for all employees are going to be able to handle these issues well, she said.
| | | | | | | | A message from PhRMA | | PBMs control your health care | | |  | | | | They decide if medicines get covered and what you pay. They often deny or limit coverage of lower-cost generics and biosimilars, instead covering medicines with higher prices. This business model allows PBM profits to soar and can lead to higher costs for everyone. What else are they hiding? | | | | | | 4. Data du jour: Fentanyl overdose death rate spikes |  Data: National Center for Health Statistics; Note: Deaths involving more than one drug are included in both totals; Chart: Axios Visuals The U.S. overdose death rate involving fentanyl nearly quadrupled between 2016 and 2021, according to a report published today, Axios' Sabrina Moreno writes. The big picture: The growing fentanyl crisis has spurred state and federal lawmakers to target the trafficking of the synthetic opioid, expand access to opioid overdose antidote Narcan and decriminalize fentanyl test strips to use as a prevention tool. By the numbers: Using death certificates via the National Vital Statistics System, the CDC report found overdose death rates involving oxycodone — an early driver of the opioid epidemic — continued to decline as the death rate from methamphetamine, cocaine, and fentanyl increased. - The change in the overdose death rate involving heroin wasn't statistically significant, the report notes.
| | | | | | | | 5. Surgeon general fights U.S. loneliness epidemic |  | | | Surgeon General Vivek Murthy. Photo: Valerie Plesch/Bloomberg via Getty Images | | | | U.S. Surgeon General Vivek Murthy wants the nation to recognize loneliness as one of its top health challenges, issuing an advisory warning about it on Tuesday. Why it matters: Studies have estimated the impact of social isolation on mortality is similar to that caused by smoking up to 15 cigarettes a day, according to the advisory. - Loneliness can increase the risk of heart disease, dementia, stroke and premature death.
- It's also expensive, with social isolation among older adults accounting for $6.7 billion in excess Medicare spending annually. That's largely due to increased hospital and nursing facility spending, the advisory notes.
What they're saying: "In the last two decades, there's been about a 50% decline in the amount of face time young people have with other people. That's pretty profound," Murthy told Axios. - "Across the board, we're seeing these kinds of measures that tell us our relationships with one another, our interactions with one another, have diminished over time ... But what I also want people to know is this is a problem that can be addressed."
| | | | | | | | 6. Catch up quick | | 💪 Fight over veterans' benefits rages amid debt limit standoff. (The Hill) 👀 CDC opens probe after 35 test positive for COVID following a CDC conference. (Washington Post) 💰 CVS closes $10.6 billion acquisition of Oak Street Health. (Forbes) 👉 Vermont allows out-of-staters to use assisted suicide law. (Associated Press) 🔬 Lilly's Alzheimer's drug donanemab succeeds in Phase III trial. (Endpoints) | | | | | | | | A message from PhRMA | | PBMs control your health care | | | | | | | | Middlemen like PBMs are charging fees tied to the price of medicines, which means they make more money when the price of a medicine goes up. This business model allows PBM profits to soar and can lead to higher costs for patients. It's time to break the link between PBM fees and medicine prices. | | | | Thanks for reading, and thanks to Alison Snyder, David Nather, Laurin-Whitney Gottbrath and senior copy editor Bryan McBournie for the edits. |  | | Dive deeper into the future of health care | | | | | | Axios thanks our partners for supporting our newsletters.
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