Consulo Indicium - 10/28/25
Information for your Consideration…
Medication Accessibility Enhanced For Those In Need – The Gary and Mary West Foundation recently announced a major initiative that deserves some attention. Most of us in the healthcare community are aware of the high cost of many medications – even common generic drugs. The foundation took the lead as a Co-Founding Partner in starting a new pharmaceutical company, CivicaRx. The intent of the effort is to expand access to low-cost generic insulin and make it available for all American patients. As healthcare providers know, one of the major issues related to diabetes for low-income patients who are on the margin is the cost of insulin. Through CivicaRx, insulin glargine – a long-acting form of the medication – will launch nationwide on January 1, 2026. Furthermore, the first state due the efforts of Governor Gavin Newsom is that the Medicaid population of California will be the first state to go live with the new “white-label” insulin drug. Kudos to the Gary and Mary West Foundation. We should anticipate similar efforts for other drugs in the future as a result of initiatives by CivicaRx.
An Alzheimer Update – I recently reviewed a Scientific American overview on the state of anti-amyloid therapies for the treatment of Alzheimer’s, the scourge on the horizon for many of us elder types. At the present time, it affects about 7.2 million people over the age of 65 in the USA, and three-quarters of that group (74%) are over the age of 75. Since 2018, there have been four major drug studies reviewing the effectiveness of the anti-amyloid therapies, and the results have been marginal for reducing the rate of cognitive decline. The drugs are used primarily for those in the early stages of the disease article noted that “…Some experts say that [anti-amyloid medications] could offer perhaps an additional year of independence.” Furthermore, there are some important side effects from the medications, like brain swelling (40%) and brain bleeds (28%) in those taking the medications. However, neurologists are generally quite careful in prescribing the medication. They manage the decision by conducting a series of tests, including cognitive assessments, PET (positron-emission tomography) scans, and other tests to ensure the need for treatment. But, when you get older – a year is a year!! Finally, there are ongoing evaluations of the anti-amyloid theory. For example, the AHEAD 3-45 study is ongoing and is testing the effectiveness of drug treatment for the pre-symptomatic cohort that is at risk of Alzheimer’s (i.e. before the amyloid plaques get laid down in the brain).
Cybersecurity Shield In Limbo – One of the more notable problems with the current shutdown of government operations is the fact that the Cybersecurity Information Sharing Act of 2015 (CISA 2015) expired on September 30th. The law provided legal protections for the last decade that enabled private-sector organizations - including healthcare facilities – to “share” cyber threat data with the federal government without any fear of potential liability. The shareable information included such areas as malware signatures, malicious IPs, vulnerabilities, and other similar technical issues. Liability protections expired on September 30, 2025. The healthcare community has been fairly assertive in testimony before the Senate Committee on Health, Education, Labor and Pensions (HELP) in urging Congress to provide additional federal support (funding, workforce training, regulatory relief) given the heightened risk and the looming expiration. Through those efforts, planning was initiated for the Cybersecurity and Infrastructure Security Agency to develop a plan to support the sharing. They have been “in process” for developing the Automated Indicator Sharing (AIS) system at a cost of about $1 million per month. Now, not to be cynical, but $1M/month is “chump change” in the healthcare community. The last available data from 2023 estimated that the total USA health care spend had reached approximately US $4.9 trillion, or about 17.6% of GDP = $US 14,570 per person. So, in fact, $1M/month is indeed “chump change”. In essence, it’s a complicated – but very important – issue in the healthcare community, as well as for other sectors of the economy. There are multiple considerations that need to be addressed. Funding, scope – especially for rural health systems – regulatory implications (HIPAA, vendor liability) remain areas of debate. For example, rural hospitals – my ongoing area of healthcare advocacy – often do not have the technical expertise for participating in CISA. Therefore, special funding needs to be provided. But, it requires that Congress but up and running – which it is not!! I pass along the information because when Congress reconvenes, there is going to be a plethora of issues that percolate to the top. Those of us in healthcare need to recognize that we will not be the only ones standing in line. Besides, this is a coalition issue that cuts across sectors.
The Evolving Phenomenon of Digital Addiction – First, there was alcohol for many millennia. Then, came drugs in the couple of centuries (that we know of 😊). Now, it seems we are experiencing a dramatic increase in “digital addiction” in the forms of excessive social media interaction, internet gaming, online gambling, online shopping, online pornography, and, no doubt, other “online” activities. Why? It increases accessibility in the first place, such as the case for pornography and gambling, which can occur anytime, anyplace, for those in need of a fix! In addition, according to Psychiatry.org, “those with high levels of internet use for socialization, education, and entertainment” are especially vulnerable. They experience a compulsion to check their notifications and spend inordinate amounts of time on the internet (Oh no!! Perhaps my wife is correct about my behavior…Naw!) I don’t think so, especially since I don’t seem to become “restless, moody, depressed or irritable” when I’m not able to access the internet.
So, how do the websites work on capturing our attention? They evidently use what is described as the “Hook Model” where the individual is triggered to interact via some sort of notification, which causes them to enter the app, where they are “rewarded” in some fashion. Then, the user will either like, send, or enter the app. It’s at this point that some type of “reward” is offered to the user to encourage them to continue using the app, where more scrolling results in more rewards. Another approach for capturing interest in the app is through gamification – which, as you may have noticed – is increasingly used on many sites. It’s becoming especially prominent on “shopping” sites as a way of promoting products to shoppers. The more you buy, the more bonuses and coupons you get! This approach makes the problem more subtle.
The other addiction that I’ve seen increasingly in lots of different public forums is the addiction to cell phone reviews. It really became apparent to me several years ago when I was at the airport awaiting a departure. In the lounge where I was sitting, there were about 10 youngish individuals sitting in a circle – all looking at their mobile phones. As I watched them, there were long periods of silence interrupted by periodic, simultaneous laughter from the group. The “addiction” to our devices was one of my thoughts at the time. And, it’s become even more prominent over the last couple of years. Psychiatry.org notes that more than 50% of Americans believe they are “addicted” to their phones, more than 60% of teens have the same problem, and at least 10% of American social media users have the same problem. However, the younger generation is not the sole problem user. Another report found that about 50% of Baby Boomers who were polled in the same reported that they were “addicted” and spent more than 3 hours a day on their devices. So, as is often offered when such information becomes available, it seems that “Houston, we have a problem.”
