Axios Vitals

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July 12, 2023

Good morning, Vitals readers. Today's newsletter is 953 words or a 3½-minute read.

📆 Join me tomorrow at 12:30pm ET for a virtual event examining ways to reduce inequities across all aspects of cancer care.

  • Guests include deputy assistant to President Biden for the Cancer Moonshot Danielle Carnival and VCU Massey Cancer Center director and Lipman chair in oncology Robert Winn. Register here to attend.

1 big thing: Health care cyber defenses come up short

Illustration of a wooden and metal shield in the shape of a health plus.

Illustration: Aïda Amer/Axios

A massive data breach affecting 11 million HCA Healthcare patients provided a stark reminder this week of how often the defenses of America's largest health care organizations are hacked.

Why it matters: The hospital industry keeps sensitive personal data that is among the highest value assets on the black market — and experts predict further attacks will get harder to thwart.

What they're saying: "They've got pretty lax security, generally speaking, when compared to a bank as an example," said Ross Brewer, the chief revenue officer of SimSpace, a company that regularly tests the defensive capabilities of large U.S. banks.

  • Health care organizations are major targets because they have so many locations and employees, work with large numbers of outside vendors, and have a complex web of internet-connected technology. Often, they lack full control over systems like X-ray machines and the ability to keep them up to date, Brewer said.

By the numbers: HHS data shows more than 39 million patients' information was exposed in the first half of 2023 in nearly 300 incidents, per Health IT Security.

  • Healthcare breaches have doubled in the last three years, HHS reports.
  • And though regional health systems are frequent targets, the biggest industry players aren't immune.
  • In January, Community Health Systems reported roughly 1 million patients had protected health information was exposed.
  • Commonspirit Healthcare, one of the biggest non-profit health systems in the U.S., reported last October more than 600,000 records were breached. The attack interrupted operations at some hospitals and resulted in about $160 million in losses.
  • In Nashville-based HCA's case, hackers broke into an external storage location used to automate the formatting of email messages. Compromised data lists contained 27 million rows of data, including the protected health information of about 11 million patients who received care at HCA hospitals and doctors’ offices in 20 U.S. states, per the HIPAA Journal.

The bottom line: The threats are only going to get harder to defend against, said Amy Abernethy, Verily's chief medical officer and former principal deputy commissioner of food and drugs at the FDA, told Axios.

  • "Quantum [computing] is coming," she said. "We need to shore up what we're doing now as we think about where this future goes."

Read the rest.

2. Genetic link to long COVID identified

Illustration: Sarah Grillo/Axios

Researchers have identified the first genetic link to long COVID, potentially unlocking new secrets about a condition with hundreds of symptoms that's afflicted millions.

Go deeper: A preprint based on a study of 6,450 patients zeroes in on a DNA sequence near the gene FOXP4, which is found in lung cells and other organs.

  • Researchers for several years have studied genetic factors that can make patients more susceptible to serious cases of COVID.
  • The long COVID study was a spinoff of that work and found a region of the genome linked to about 1.6-fold higher odds of developing long COVID, per Nature.

What they're saying: "It's very important that this type of study is being done," Chris Ponting, who studies medical bioinformatics at the University of Edinburgh, told the journal. "It will gain momentum and greater power as the case number increases."

Catch up quick: Long COVID sufferers report symptoms including brain fog, fatigue, changes in smell and taste, and anxiety and depression.

  • Scientists this spring proposed a standard definition for the condition based on symptoms in a JAMA study.
  • Identifying more genetic factors could help identify at-risk individuals.

3. CVS Caremark teams with GoodRx

Photo illustration by Igor Golovniov/SOPA Images/LightRocket via Getty Images

CVS Caremark will offer its members automatic access to GoodRx's prescription pricing to lower out-of-pocket costs on certain generic drugs starting next year, the companies announced this morning.

Catch up quick: CVS Caremark is one of the three pharmacy benefit managers that collectively control about 80% of the market. It joins ExpressScripts, one of the other big three PBMs, in offering the GoodRx pricing.

Zoom in: Programs like GoodRx work by offering patients discounted prices for certain drugs. But they have to pay in cash, rather than with their insurance, to get the lower prices.

  • PBMs including CVS Caremark have drawn fire for how much members have to pay for drugs compared to those who use discount programs.
  • With this program, officials said members will not have to choose between using their pharmacy benefit or using GoodRx to get a better price. The amount consumers pay will also apply against their deductible.

"You just literally get the better price when you show up at the pharmacy counter," Doug Hirsch, co-founder of GoodRx, told Axios. "That reduces walkaways, it improves medication adherence. It just makes for a better benefit."

4. What they're saying

Illustration: Eniola Odetunde/Axios

"We don't even know if all the contaminated products have been identified."
— Michael Craig, director of the CDC's antimicrobial resistance coordination and strategy unit, told Axios about an outbreak of drug-resistant Pseudomonas aeruginosa traced to three types of artificial tears.

Craig's comments about the outbreak come as infectious disease experts urged Congress on Tuesday to commit $6 billion to incentivize the production of new treatments for drug-resistant infections, Axios' Arielle Dreher writes.

  • The PASTEUR Act would establish a subscription model that would pay drugmakers up front for access to new antimicrobials instead of reimbursing them on volume or quantity of sales. Some think the proposal could be combined with broader pandemic preparedness legislation.
  • In the case of the artificial tears, at least 81 patients were affected across 18 states. Experts say there's the potential for continued transmission, even among patients who haven't used the products for years.

5. Catch up quick

🏛 Illumina to face record EU antitrust fine for Grail deal. (Reuters)

🏥 As nonprofit hospitals reap big tax breaks, states scrutinize their required charity spending. (KFF Health News)

💰 How UnitedHealth's acquisition of a popular Medicare Advantage algorithm sparked internal dissent over denied care (STAT)

👉 An old drug offers a new way to stop STIs. (NPR)

Thanks for reading Axios Vitals, and to senior editor Adriel Bettelheim and senior copy editor Bryan McBournie. Please ask your friends and colleagues to sign up.