Instead of saving money, some Medicare patients will pay more for medicines.

Others may not be able to get their medicines – 89% of insurers and PBMs say they plan to reduce access to medicines in Medicare Part D because of the Inflation Reduction Act.

Higher costs and less access. That’s not what seniors were promised.

from STAT:

connectionsThe mounting evidence for a viral cause of dementiaEros Dervishi for STATThe idea that viral infections can play a role in at least some dementia cases goes back decades. It’s still controversial in the Alzheimer’s field, but as more researchers and funders have begun to take the idea seriously, the connections between pathogens and dementia have been slowly strengthening. Just in the last couple years, two papers have contributed evidence that the shingles vaccine helps to protect people’s brains from dementia. Part of this recent shift has to do with Covid-19. There’s been a growing appreciation for the role of viruses in neurodegenerative disease since the pandemic. Paul Harrison, a psychiatry professor at Oxford who authored one of the shingles papers, has also researched how rates of mood disorders, strokes, and dementia alarmingly increase following Covid infection.“I’ve always been a vaccine believer, but the Covid vaccine reinforced to me that there may be long-term benefits to vaccination beyond simply stopping short-term effects,” he said.Read more from STAT’s Megan Molteni on the growing body of evidence around viral infections and dementia. Then check out her Q&A with an ophthalmologist who is working to develop an antiviral to address shingles-induced blindness — a condition that ended her own career as a cornea surgeon.

Heart health

3 new recommendations to prevent a first stroke

You probably know strokes can be deadly, but did you realize that up to 80% of the 600,000 first strokes Americans suffer each year may be preventable? That startling figure appears with updated screening guidelines published this morning by the American Stroke Association in its journal Stroke. Health care providers already monitor people for high blood pressure, elevated cholesterol, high blood sugar, and obesity. These are all well known to raise the risk of blood flow to the brain being blocked by a blood clot or cut off when a blood vessel ruptures. But for the first time the guidelines also recommend:

• Considering GLP-1 drugs not only to manage type 2 diabetes but also to lower weight and reduce the risk of cardiovascular disease and stroke. 
• Recognizing and addressing social determinants of health: Structural racism, lower access to health care, less availability of healthy food, and lack of walkable neighborhoods.
• Focusing on sex- and gender-specific factors that raise risk: Oral contraceptives, high blood pressure during pregnancy, premature birth, endometriosis, premature ovarian failure, early onset menopause, and taking estrogens for gender affirmation in transgender women and gender-diverse people.

— Liz Cooney, cardiovascular reporter

gene therapy

Pfizer’s Duchenne data rattle gene therapy makers

Pfizer suffered a blow earlier this month when new data showed that its gene therapy for Duchenne muscular dystrophy failed to help participants demonstrate significant improvement in motor function — even though they produced significant amounts of microdystrophin, a lab-built miniature version of the gene mutated in the disease.

But the results could also pose a much broader problem, STAT’s Jason Mast and Adam Feuerstein write. The Food and Drug Administration approved Sarepta Therapeutics’ Duchenne therapy on the basis of a belief that increasing microdystrophin levels were a sign the treatment was effective. Companies including RegenxBio and Solid Biosciences are developing their own treatments on this basis.

“The point is not only the level of expression of microdystrophin, but how functional it is,” the head of a gene therapy nonprofit told STAT. “A probable conclusion from these data is that this particular microdystrophin is not as efficient in humans as [Pfizer] had expected.

Cigna is reviving efforts to merge with Humana after talks fell apart late last year, Bloomberg News reported, quoting people familiar with the matter.Why it matters: The combined company would be one of the nation’s biggest health insurers, but would also likely attract antitrust scrutiny.Driving the news: The companies have held informal, early-stage discussions about a potential deal, but Cigna is looking to close the sale of its Medicare Advantage business before moving on to other transactions, Bloomberg reported.While that could eliminate one area of overlap, Cigna still is facing scrutiny from regulators and Congress over its Express Scripts pharmacy benefit business. A recent Federal Trade Commission report blamed the nation’s biggest PBMs for rising drug prices. Express Scripts has since sued over the report, calling for a retraction.Humana recently took a hit on Medicare quality ratings that are linked to payments, a setback that threatens billions in revenue for 2026 and poses what one analyst called a “worst-case scenario” for the company, per Bloomberg.