Brainstorm Health: Shutdown and the FDA, Microsoft Walgreens Deal, Walmart CVS Split

The federal government shutdown—the longest in U.S. history—has now reached its 25th day. Government workers are missing paychecks or working for free, TSA agents are quitting their jobs, and the Trump administration has been resorting to stopgap measures to make sure that services like IRS tax refunds and food stamps aren’t hampered in the short term.

Government shutdowns are complicated and have wide-reaching consequences. That includes the services of the Food and Drug Administration (FDA), as the agency’s own commissioner, Scott Gottlieb, has taken pains to point out over the past few weeks.

Reports that the FDA would have to severely cut back on food safety inspections as a consequence of the shutdown understandably elicited blowback. A stunning 40% of the FDA workforce is currently furloughed, and the agency is redirecting funds in order to keep essential services going.

There was a temporary blip of good news on Tuesday, when Gottlieb said on Twitter that about 400 workers are returning to their posts from furlough (including about 150 focused on food safety).

“About 400 total staff are being engaged in this mobilization. The vast majority are inspectors and others are professionals who work in support inspectors. About 150 of the 400 are focused on food inspections, the rest are focused on other aspects of our mission,” said Gottlieb.

Additionally, some of the returning staff is centered on the other critical issues the FDA is tasked with, including medical device and drug manufacturing inspections.

“This includes about 100 staff focused on inspections of high risk medical device manufacturing facilities; about 70 staff focused on inspections of high risk drug manufacturing facilities; and about 90 staff focused on inspections of high risk biological manufacturing facilities,” said Gottlieb.

But these are extraordinary measures. Many of these returning employees are coming back to work despite the knowledge they won’t be paid for it. It’s a stopgap measure in the most literal sense.

Read on for the day’s news.

DIGITAL HEALTH

Microsoft, Walgreens pen a huge deal. In a striking shift, retail and pharmacy giant Walgreens has signed a multi-year contract with Microsoft—a sign that conventional pharmacies are changing their business models as the specter of Amazon looms in the space. The Walgreens-Microsoft deal centers on Microsoft's cloud offerings and services like Windows 10 and Office 365; but statements from Microsoft CEO Satya Nadella teased the possibility that this collaboration could lead to new programs and product development by harnessing data into a unified system. (CNBC)

INDICATIONS

Walmart ditches CVS. The drug benefits wars just got real. Walmart is officially breaking away from CVS Health's drug benefits arm following a long-standing dispute over reimbursements. "This issue underscores the problems that can arise when a PBM can exert their unregulated power to direct members on where to fill their scripts, disrupting patients’ health care," said Walmart in a statement. "Walmart is standing up to CVS’s behaviors that are putting pressure on pharmacies and disrupting patient care." CVS' response? "Walmart’s requested rates would ultimately result in higher costs for our clients and consumers. We simply could not agree to their recent demands for an increase in reimbursement." (Fortune)

THE BIG PICTURE

Get. Your. Flu. Shot. Influenza is a bit of a favorite hobby horse for health reporters. There's a reason for that—it's one of those things that's extremely easy to protect against, and yet overwhelmingly ignored. Yes, the flu shot's efficacy is pretty volatile from year to year; that's a simple reality of flu vaccine development, which depends on predicting which strains are going to be floating around in any given year. But it's still the most effective form of protecting both yourself and others—including those who have compromised immune systems, are elderly, or young, or allergic to flu shots—from the virus. There have already been some 7 million Americans sickened by the flu this season; but it's not too late to get a shot. Influenza peaks in February, and it takes just two weeks for an immunization to take effect.

REQUIRED READING

How Microsoft CEO Satya Nadella Fueled a Humble Comeback, by Adam Lashinsky

A Small Step for a Startup. A Giant Leap for the BioChip? by Vivienne Walt

The Best Time to Land a Job This Year Is Right Now, by Chris Morris

Most Americans Say U.S. Health Care Is in a 'State of Crisis', by Erik Sherman