Effective therapies for menopause symptoms are largely unused

Why? It starts with one study. The Women’s Health Initiative was a 2002 landmark study that suggested hormone therapy came with an increased risk of heart disease and breast cancer. The study specifically focused on older, postmenopausal women, most of whom were not experiencing symptoms like hot flashes anymore. But in its aftermath, both the media and policymakers construed the data as demonstrating a higher risk for menopausal women as well. 

The use of hormone therapy subsequently plummeted. In 1999, almost 27% of menopausal women in the U.S. used estrogen. By 2020, less than 5% did. In my latest story, I talked to doctors about the latest research on the risks and benefits of hormone therapy, and about why patients might still be hesitant. Read more.

ON THE HILLCyber Monday for Congress: Coverage of GLP-1s is on saleLawmakers on Capitol Hill have long cited the hefty price tag of allowing Medicare to cover buzzy anti-obesity medications as the primary reason why the policy hasn’t passed. But now that the Biden administration has proposed a regulation to allow coverage, the policy would essentially be on sale for Congress, Rachel Cohrs Zhang reports.When a regulation is proposed, the Congressional Budget Office updates its baseline budget to include part of the cost of the rule (often 50%, according to CBO). That means if Congress were to pass a law codifying Medicare coverage of anti-obesity medications like Wegovy and Zepbound, the cost estimate could be roughly half off of the normal price tag for the federal government.Congress is known to play games with budget estimates, given Congress funded significant chunks of the Biden administration’s domestic policy agenda by rolling back a Trump-era drug payment rule.But Congress’ window of opportunity may be small, as Robert F. Kennedy Jr. could choose to cancel the rule if he’s confirmed as HHS secretary. It’s unclear whether there is the will to enact a major coverage expansion in Medicare in the coming weeks