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President Trump, poised on Friday to unveil his strategy to lower prescription drug prices, has an idea that may not be so popular abroad: Bring down costs at home by forcing higher prices in foreign countries that use their national health systems to make drugs more affordable. On Tuesday, Mr. Trump rebuffed his European allies by withdrawing from the Iran nuclear deal. Threatened tariffs on steel and aluminum have strained relations with other developed nations. And now the administration is suggesting policies that could hit the pocketbooks of some of America’s strongest allies. (Pear, 5/9)

The speech, which has been twice delayed, is spurring skepticism from industry experts and Democrats who say it won’t make a serious dent in costs. They say the proposals fall short of Mr. Trump’s pledge to go after pharmaceutical companies he said last year were “getting away with murder. ”Some industry officials, for their part, say they are relieved to have been spared moves on a scale that would wreck their industries and, in turn, hamper drug innovation or access. Mr. Trump’s speech on combating high drug prices will be accompanied by proposed rules and a broad request for input from manufacturers, health providers, patients and others, according to people familiar with the plan. (Armour, Radnofsky and Burton, 5/10)

Daniel Best is suddenly leading the government’s campaign to bring down prescription drug prices. But nobody around town seems to know the guy. While he’s a Washington outsider, he’s the very definition of a pharmaceutical industry insider, having spent the last 13 years working for pharmacy benefit managers, the middlemen who negotiate drug prices. Their secretive contracting and business practices have drawn suspicion from lawmakers and administration officials. (Swetlitz, 5/10)

President Trump’s personal lawyer Michael Cohen promised the pharmaceutical company Novartis that it could have access to Trump and his inner circle if they signed a contract with Cohen, a Novartis employee told Stat on Wednesday. The employee told Stat that Cohen contacted then-CEO Joe Jimenez last year, promising that he could get Novartis access to both Trump and top administration officials. Jimenez then reportedly ordered company officials to make a deal with Cohen. (Thomsen, 5/9)

On Wednesday, additional details emerged. Novartis, the Swiss drug maker, said it had paid Mr. Cohen $1.2 million after he approached the company early last year promising insights into Mr. Trump’s views on health care. (McIntire, Vogel, Thomas and Kang, 5/9)

Novartis is one of the world’s largest drug companies, with a business deeply shaped by U.S. government actions — including drug approvals and drug reimbursements. But after an initial meeting with Cohen, Novartis determined that he “would be unable to provide the services that Novartis had anticipated related to US healthcare policy matters and the decision was taken not to engage further,” Mirza-Reid said. But she said the company could not terminate the contract “for cause,” and thus paid the agreed-upon $1.2 million. (Kranish, Helderman, Johnson and Dawsey, 5/9)

“He reached out to us,” the Novartis employee said, providing STAT with the company’s version of events as it scrambles to contain the fallout from being entangled in the investigations surrounding Trump and his inner circle, including Cohen. “With a new administration coming in, basically, all the traditional contacts disappeared and they were all new players. We were trying to find an inroad into the administration. Cohen promised access to not just Trump, but also the circle around him. It was almost as if we were hiring him as a lobbyist.” (Silverman, 5/9)

The $100,000 monthly fee Novartis paid a company set up by President Trump’s personal attorney to help it better understand “U.S. healthcare policy matters” in the Trump era is almost four times more than it paid any actual outside lobbyist in the same time period. None of the contracts for the nearly four dozen external lobbyists Novartis employs to help explain and advocate on health care policy issues came close to the amounts paid Essential Consultants LLC, according to a STAT review of the Swiss drug maker’s 2017 and 2018 filings. (Mershon, 5/10)

The Swiss drug company Novartis on Wednesday revealed that special counsel Robert Mueller contacted the company last year about payments it made to Michael Cohen, President Trump's longtime personal attorney. “Novartis cooperated fully with the special counsel’s office and provided all the information requested,” the company said in a statement. (Manchester, 5/9)

Novartis and AT&T revealed their contact with Mueller’s office after the companies were named in a document distributed by Michael Avenatti, a lawyer representing porn film actress Stormy Daniels. Daniels, whose legal name is Stephanie Clifford, is suing to be released from a contract, inked weeks before Election Day, that paid her $130,000 to keep quiet about an alleged sexual relationship with Trump. (Woellert, 5/9)

The White House on Wednesday largely avoided questions about reports that President Trump’s longtime lawyer, Michael Cohen, received payments from businesses seeking access to the administration. White House press secretary Sarah Huckabee Sanders skirted several questions about the revelation that Swiss drug company Novartis and AT&T each paid Cohen in exchange for insights and access to the president. (Samuels, 5/9)

Thanks to Novartis, the investigations of President Trump and his minions now have a Big Pharma angle: The drug maker admitted to wiring monthly payments to a company controlled by the president’s lawyer — the same one that paid adult film star Stormy Daniels to keep quiet about an extramarital affair with Trump. But in exchange for what? And who thought this was a good idea? (Feuerstein, Garde and Robbins, 5/9)

The Food and Drug Administration said on Wednesday that it was seeking court orders to stop two clinics from using unapproved stem cell treatments that in some cases have seriously harmed patients. The clinics remove fat from patients’ bellies by liposuction and then inject an extract of it into various parts of the body like knees or the spinal cord, on the theory that the extract contains stem cells that can provide replacement cells that will repair the damage from injury or illness. (Grady and Kaplan, 5/9)

The Justice Department says in court filings Wednesday that the firms put consumers at risk by promising benefits from treatments never approved by the Food and Drug Administration. The complaints involve treatments derived from cells taken from patients’ own fat tissue. The lawsuits target Southern California’s Stem Cell Treatment Center and U.S. Stem Cell Clinic of Sunrise, Florida. Mark Berman, director of the California clinics, says he stands by his treatments and looks forward to fighting the lawsuit. (Weber, 5/9)

Hundreds of such clinics have popped up across the country in recent years, many promoting treatments for conditions including Parkinson’s disease, autism and multiple sclerosis. Federal regulators have not approved any of their procedures, and critics liken the facilities to modern-day snake-oil salesmen. Many stem cell researchers and former patients have long urged the FDA to take stronger action against the clinics. Current and former agency officials have acknowledged the need for greater regulation of the booming industry, citing limited resources for the lack of aggressive action in the past. (Wan and McGinley, 5/9)

In separate statements, both US Stem Cell and the California clinic and its affiliates said they intended to fight the lawsuits. They argued that the FDA’s efforts interfered in the doctor-patient relationship and that these clinical decisions should be made without meddling from the government. (Joseph, 5/9)

Different insurers pay widely varying prices for the same procedures at the same hospitals, indicating that insurers' bargaining leverage influences healthcare prices, according to an updated healthcare economics paper. That was one of the new takeaways from a Commonwealth Fund-backed paper that used actual claims data from three national insurers to explain how hospitals get paid. Spending on U.S. hospital care represents about 6% of the entire economy and providers continue to consolidate throughout the country, which underlines the importance of understanding healthcare pricing dynamics. (Kacik, 5/9)

HHS Secretary Alex Azar on Wednesday vowed to make value-based care models easier for providers to build and sustain, specifically praising the CMS' latest idea for direct provider contracting in Medicare. Some providers read into the promise that HHS will ease provider self-referral restrictions that they say inhibit physicians and hospitals from building accountable care organizations. (Luthi, 5/9)

Several physician groups are joining in a new alliance aimed at slowing hospitals from buying doctor practices, by urging independent physicians to embrace value-based payments. The Partnership to Empower Physician-Led Care will lobby to sustain stand-alone practices as Medicare and other health insurers move to alternative payment systems. (Pittman, 5/10)

The financial health of Magnolia Regional Health Center, a 200-bed public hospital in northern Mississippi, has gone from fair to serious condition all because of an accounting rule. Magnolia is in danger of breaching the covenant on a $74 million municipal-bond issue because the rule requires the hospital, whose employees are members of Mississippi’s pension fund, to bring onto its books its share of the retirement system’s $16 billion unfunded liability. The $127 million obligation has pushed its debts above a limit set by bondholders and may cause a default as soon as early next year -- an event that would allow investors to demand immediate repayment or take control of the hospital. (Braun, 5/9)

A $300 million expansion being planned at downtown Fort Worth hospital will be the largest construction project in Texas Health Resources’ history,  the health system said Wednesday. The expansion to Texas Health Harris Methodist Hospital Fort will add a nine-story surgical patient tower, 144 patient beds and boost the center’s capacity for complex cases, the announcement said. (Rice, 5/9)

Chicago is the nation’s epicenter for asthma disparity, with African-American children on the South and West sides dying from asthma at eight times the rate of their white counterparts. In those neighborhoods, the city’s asthma rate among black children — roughly one in four (24 percent) — is twice the national average, according to University of Illinois Hospital Community Assessment of Needs (UI-CAN) survey. (Guys, 5/9)

University Hospitals and accreditation organizations continue to investigate a freezer incident at the fertility clinic in early March that damaged 4,000 eggs and embryos and affected 950 patients. In a written statement, UH said it continues "to carefully review the root causes of the fertility clinic incident" and work with the Ohio Department of Health and the College of American Pathologists as those organizations investigate the fertility clinic failure. (Christ, 5/9)

Recently, gabapentin has started showing up in a substantial number of overdose deaths in hard-hit Appalachian states. The neuropathic (nerve-related) pain reliever was involved in more than a third of Kentucky overdose deaths last year. Drug users say gabapentin pills, known as “johnnies” or “gabbies,” which often sell for less than a dollar each, enhance the euphoric effects of heroin and when taken alone in high doses can produce a marijuana-like high. (Vestal, 5/10)

A federal judge hoping to settle hundreds of lawsuits filed by government entities over the opioid crisis is planning a brief open-court session as settlement talks continue. U.S. District Judge Dan Polster in Cleveland is presiding over lawsuits filed by more than 600 local and county governments and Indian tribes regarding the crisis that killed 42,000 Americans in 2016. Polster plans to open court for an hour on Thursday before closing it again during negotiations. (5/10)

A federal judge in Cleveland overseeing hundreds of federal lawsuits filed against drug companies by local governments over the nation's opioid epidemic ordered the U.S. Drug Enforcement Administration to release additional information about prescription drug sales in the U.S., saying the information is necessary as the litigation and settlement talks proceed. U.S. District Judge Dan Polster wrote Tuesday that information from the Automated Reports and Consolidated Ordering System, or ARCOS, database "has proved to be extremely informative" for the six states that had its data released following an order the judge issued in April. (Heisig, 5/9)

The House Energy and Commerce Committee on Wednesday approved 25 opioid-related bills as part of the panel’s broader work to address the drug abuse crisis. All measures advanced with bipartisan support, despite some complaints from Democrats that the efforts do not provide new money for states. (Ehley, 5/9)

In a speech on Monday, Attorney General Jeff Sessions said the Justice Department is striving to “bring down” both “opioid prescriptions” and “overdose deaths.” But a study published the following day suggests those two goals may be at odds with each other, highlighting the potentially perverse consequences of trying to stop people from getting the drugs they want. (Sullum, 5/9)

Kaiser Health News: For The Babies Of The Opioid Crisis, The Best Care May Be Mom’s Recovery

The halls at UNC Horizons day care are quiet at 5 p.m. Amanda Williammee pauses at the toddler classroom window to watch 2-year-old daughter Taycee. “I like to peek in on her and see what she’s doing before she sees me,” Williammee nearly whispers. “I love watching her, it’s too funny.” There’s a dance party in progress and then Taycee spots her mom, screams and comes running to the door. (Tribble, 5/10)

Contra Costa County is among 30 California counties suing pharmaceutical manufacturers and distributors for their role in creating a widespread opioid epidemic. The lawsuit filed by Contra Costa County seeks reimbursement of taxpayer funds that have been spent responding to the opioid epidemic in the county and for ongoing costs, such as emergency response for overdoses, prevention, monitoring and treatment. (Sciacca, 5/9)

An expensive screening program designed to keep the Zika virus out of the Red Cross’s blood supply has caught fewer than a dozen infected donations, a new study published Wednesday revealed. The program, which costs roughly $137 million a year to operate, detected only eight units that tested positive for the virus between June 2016 and September 2017. And half of those units contained Zika antibodies as well as virus, which suggests they probably would not have been able to infect a recipient, if anyone had been transfused with them, the study suggested. (Branswell, 5/9)

The study was the first large look at the impact of guidelines set two years ago, when the Zika epidemic was an unfolding menace in the U.S. and health officials were scrambling to prevent new infections. The study, published Wednesday by the New England Journal of Medicine, found that the blood donation testing requirements offered little bang for the buck. It also raised questions about whether a cheaper testing method should be used. (Stobbe, 5/9)

First came doctors’ warnings about cigarettes. Then came discoveries about the danger of secondhand smoke. Now, a growing number of scientists are raising the alarm about thirdhand smoke — residual chemicals left on indoor surfaces by tobacco smoke. Mounting research has shown such potentially hazardous residue can be absorbed through the skin, ingested and inhaled months and even years after the smoke has dissipated. (Wan, 5/9)

Pop quiz: If you sampled the air in an empty college classroom where smoking is not permitted, what is the last thing you'd expect to find?If you guessed "cigarette smoke," you're in good company. Peter DeCarlo, an air quality researcher at Drexel University in Philadelphia, would have agreed with you. But when he examined the air from the unoccupied room, he discovered that 29% of the tiny particles suspended within it could be traced to the residue of cigarette smoke. (Kaplan, 5/9)

"The chemistry of this is very interesting," says Neal Benowitz, professor of medicine at the University of California, San Francisco and a leader of the California Consortium on Thirdhand Smoke. He says scientists have known for some time that the nicotine levels in walls and furniture can persist for years. "What this study shows is that thirdhand smoke moves around the room," he says. (Bate, 5/9)

Scientists reported on Wednesday that they have recovered DNA from the oldest viruses known to have infected humans — and have succeeded in resurrecting some of them in the laboratory. The viruses were all strains of hepatitis B. Two teams of researchers independently discovered its DNA in 15 ancient skeletons, the oldest a farmer who lived 7,000 years ago in what is now Germany.Until now, the oldest viral DNA ever recovered from human remains was just 450 years old. (Zimmer, 5/9)

The hepatitis B virus has been infecting people since at least the Bronze Age, according to a new study published in the journal Nature by geneticists who teased the virus from 4,500-year-old human remains. Hepatitis B was discovered in the 1960s, and a vaccine (and Nobel Prize) came swiftly thereafter. Despite the vaccine, the virus still kills people, and chronic infections cannot be cured. Nearly 900,000 people with the virus died in 2015, mostly from liver complications, according to the World Health Organization. An estimated 257 million people carry the virus that targets the liver and can be a risk factor for cancer. (Guarino, 5/9)

Some earlier observational studies have suggested that children who are exclusively breast-fed have higher I.Q.s through adolescence, and even higher incomes at age 30. But a randomized trial, a more rigorous type of study that better controls for socioeconomic and family variables, found that breast-feeding in infancy had no discernible effect on cognitive function by the time children reached age 16. (Bakalar, 5/9)

A new coating for medical devices that are inserted into the body could help prevent infections, according to researchers in the University of Georgia’s College of Engineering. They developed a technology called LINOREL — or liquid-infusing nitric oxide-releasing silicone — that can coat devices such as catheters and surgical tools that sometimes carry infections. (Boss, 5/9)

A new study suggests that many first-time mothers might want to consider an alternative to the traditional "watch and wait" approach of allowing a pregnancy to run up to 41 weeks. For those who are healthy, inducing labor at 39 weeks lowers the risk of serious complications and cesarean delivery, according to a team of researchers led by Dr. Charles J. Lockwood, dean of the Morsani College of Medicine at the University of South Florida. (Griffin, 5/9)

In his final days, David Goodall spoke about his 104 years of life and the legacy he hopes to leave behind when he dies. The Australian scientist, who has traveled from his home in Perth to Switzerland to end his life by assisted suicide, answered questions Wednesday about why he wants to die and how he plans to do it. When asked what song he wanted played at his bedside, he said he has not chosen one but if he had to, it would be Beethoven’s 9th Symphony. (Bever, 5/9)

The Democratic Republic of the Congo declared an Ebola outbreak after two suspected cases tested positive for the Zaire strain of the virus, the World Health Organization reported Tuesday. The outbreak emerged in Bikoro, a town in the northwest area of the country, after local health officials reported 21 patients with symptoms of a suspected viral hemorrhagic fever — rare and life-threatening fevers caused by several families of viruses, according to the Centers for Disease Control and Prevention. (Villagomez, 5/9)

Four more states are reporting illnesses in a food poisoning outbreak linked to romaine lettuce. The Centers for Disease Control and Prevention updated its numbers on the outbreak Wednesday, revealing that 149 people in 29 states had gotten sick. It's unclear if new illness are still occurring. There's a lag in reporting, and the most recent illness began two weeks ago. (Stobbe, 5/9)

This strain of E. coli produces a toxin that causes vomiting and diarrhea and potentially other severe symptoms, including  kidney failure. Information was available on 129 of the people who were sickened. Of those — ranging in age from 1 to 88 — half have been hospitalized. Seventeen have developed severe kidney failure, and one person in California has died. About 65 percent of those sickened are women. There is a time lag in reporting and confirming these cases, however. Officials may not yet be aware of people who have gotten sick in the last two or three weeks. The most recent illness reported started April 25. (Sun, 5/9)

The CDC reported Wednesday that the multistate E. coli outbreak has now sickened 149 people, including five in Georgia. The infections have been linked to romaine lettuce grown in the Yuma, Ariz., area. (Miller, 5/10)

Sen. Claire McCaskill, D-Mo., plans to introduce legislation Thursday that would allow states to regulate the medical costs of air ambulances. The legislation would force air ambulance providers to clearly separate the transportation costs from the cost to provide care on a consumer’s bill. McCaskill’s Air Ambulance Consumer Protection Act partially carves out air ambulances from federal regulation, a step that would open the door for state insurance departments to regulate air ambulances. (Liss, 5/10)

The state's new Child Advocate, Moira O'Neill, is launching an investigation into the Sununu Youth Center following allegations of a pattern of illegal use of restraints on juveniles there. ...O'Neill is also raising questions about how state officials have responded since the allegations were made public earlier this week. (Moon, 5/9)

In Florida, a state with some of the nation’s worst mass shootings in recent years, nearly 20 percent of mental health records are entered late into a background check database, a long-running problem state law enforcement officials now acknowledge could lead to someone with a known mental illness buying a gun. The lapse, which dates back to at least 2014, went unnoticed by state lawmakers and the governor's office until POLITICO asked about the issue. (Dixon, 5/10)

University Medical Center is celebrating the opening of its new Burn Trauma Center this Friday (May 11), making it the only Burn Center and Level 1 Trauma Center between Houston and Mobile, according to hospital officials. The burn unit has been operational for a few weeks. The six people who were injured in an electrical accident last month at the Hampton Inn on North Causeway Boulevard in Metairie were treated at the center, Jefferson Parish Fire Department officials confirmed at the time. (Clark, 5/9)

The legislature overwhelmingly approved a new state budget shortly before their midnight deadline Wednesday that restores aid for towns; reverses health care cuts for the elderly, poor and disabled; and defers a transportation crisis — at least for another year. The $20.86 billion package, which now moves to Gov. Dannel P. Malloy’s desk, does not increase taxes, though it does raise the maximum tax rate cities and towns can levy on motor vehicles. (Phaneuf, 5/9)

Efforts by the Virginia Department of Corrections to cut back on using solitary confinement are not enough, according to a critical but disputed new study of the practice. ...The report was sent to Gov. Ralph Northam on Tuesday along with a letter from Claire Guthrie Gastañaga, executive director of the ACLU of Virginia, who asked the governor to sign an executive order to significantly limit the use of solitary in Virginia’s 30,000-inmate system. (Green, 5/10)

U.S. Magistrate Judge David Duncan said he is still working on an order to show cause why the state should not be held in contempt of court in connection with an ongoing prison healthcare lawsuit. But he said there will be a judgment against the state and fines, although it is unclear where the money will come from, the state or the managed healthcare company that provides care to the Arizona Department of Corrections. (Kiefer, 5/9)

Silicon Valley tech companies like Apple, Google and Uber are known for using technology in new ways to solve old problems, and sometimes, radically changing consumer behavior in the process. These three companies are reportedly pursuing health care investments, which could mean health care is the next industry to be disrupted by technology. Of course, these companies aren’t the first to tackle health care. Health care start-ups have been launched across the country, including in Nashville. (Tolbert, 5/9)

The Patient Care Intervention Center, a nonprofit organization whose mission is to improve health care quality and costs for the community's most vulnerable, has leased 5,130 square feet in the 3701 Kirby Drive building, founder and president Dr. David S. Buck said. The center partners with organizations such as Houston Methodist Hospital, Community Health Choice, Harris Health System, Houston's fire and police departments, Healthcare for the Homeless, Amerigroup RealSolutions, Houston Recovery Center and the Coalition for the Homeless to provide better outcomes for patients and cost savings. (Feser, 5/9)

Minnetonka-based UnitedHealthcare has expanded a program that is changing payment terms for certain hip, knee and spine surgeries in hopes of improving quality while lowering costs. Launched as a pilot in 2015, the program is now saving employers about $18,000 per procedure, the insurer announced Wednesday, and has been expanded this year to nine new markets. (Snowbeck, 5/9)

Federal agents on Wednesday raided the northwest Dallas offices of a healthcare company. The target of the raid was Medoc Health Services, whose website says it provides "healthcare management services to an extensive network of top-tier ancillary service providers." The company occupies the 17th floor in the ClubCorp building at LBJ Freeway and Webb Chapel Road, where, on Wednesday, federal agents kept guard while FBI agents collected enough material to fill at least one of two white vans parked outside. (Wilonsky and Hallman, 5/9)

The Austin Public Health department is investigating after about 17 people got sick with gastrointestinal symptoms this week at the NCAA Austin Regional Tournament. Four golfers could not compete Tuesday and one played while sick. (Huber, 5/9)

The Massachusetts House of Representatives overwhelmingly passed a bill Wednesday raising the minimum legal sales age for tobacco products from 18 to 21. The bill would also set the minimum age for purchasing vaping products at 21. (Miller, 5/9)

Bonnie Castillo’s first experience with organized labor dates to the mid-1960s, when she was just 5. Her father was a railroad worker in Sacramento, Calif., and an active union member. More than once, she and her mom drove him to a picket line, where workers demanded better pay and benefits. “We’d pick him up within a matter of hours because they’d win,” Castillo, 57, recalled with a slight smile. “That was quite a time.” (Ibarra, 5/8)

After more than a year of negotiations, the patient-care and service workers, represented by AFSCME 3299, rejected the university's last-and-best offer of 3 percent across-the-board wage increases and a prorated, lump-sum payment of $750. AFSCME 3299 negotiators have sought wage increases of 6 percent, a freeze on health care premiums and job security that eliminates contracting out jobs for which its members are trained. (Sullivan, 5/9)

On June 5, San Francisco voters will be asked to weigh in on a range of important policy matters, from creating a new tax to raising wages for teachers and banning flavored tobacco products. Here’s a look at the propositions San Francisco voters will consider on election day. (Fracassa, 5/9)

Kaiser Health News: Listless And Lonely In Puerto Rico, Some Older Storm Survivors Consider Suicide

A social worker, Lisel Vargas, recently visited Don Gregorio at his storm-damaged home in the steep hillsides of Humacao, a city on Puerto Rico’s eastern coast near where Category 4 Hurricane Maria first made landfall last September. Gregorio, a 62-year-old former carpenter who lives alone, looked haggard. He said he had stopped taking his medication for depression more than a week earlier and hadn’t slept in four days. He was feeling anxious and nervous, he said, rubbing his bald head and fidgeting with the silver watch on his wrist. His voice monotone and barely audible, he told Vargas he had had thoughts of suicide. (Varney, 5/10)

Should women suffering from morning sickness during pregnancy use marijuana to control their nausea? Colorado health experts, regulatory officials and even industry advocates have consistently answered no, and they’ve backed that message up with studies, public service announcements and warning labels on cannabis packaging. But a new study by doctors at Denver Health and the University of Colorado School of Medicine reports that, when asked for advice on mixing pot and pregnancy, employees at an overwhelming majority of marijuana stores in Colorado will say that it’s OK. And fewer than a third of those stores will recommend that a pregnant woman consult with a doctor about cannabis use — unless they are prompted to. (Ingold, 5/9)

In a 2017 press conference, President Donald Trump said that drug companies were “getting away with murder.” Later this week, he’s going to offer a program for making drugs cheaper. Which policies should he endorse? For branded drugs, patents exclude competitors and allow drug companies to set high prices. For generics, most pricing problems are also attributable to insufficient competition. When only a few companies make a drug, they can raise prices in tandem or play other pricing games. Our insurance-dominated payment system compounds these problems by eliminating any constraints on the prices drug companies can charge. To fix the generic market, we need to change the Food and Drug Administration (FDA) policies on pricing. Congress should give the FDA the resources it needs to clear out the sizable backlog of applications from generic drug makers —  the median length of the FDA approval process for generics was 47 months as recently as 2016. (David A. Hyman and Charles Silver, 5/9)

No one seems to know what President Trump will say when (or if — he has postponed before) he addresses the nation this week on drug pricing. But the content doesn’t matter nearly as much as the implications. The mere fact that drug pricing has become such a populist issue that this president is devoting a policy speech to it will almost certainly roil markets and raise the collective blood pressure of pharmaceutical company CEOs. When it comes to drug prices, an increasingly vocal majority of Americans now feel they’re being treated unfairly and that there is very little transparency about how prices are set. A recent PatientView study, for example, showed that only 13 percent of patients thought pharma companies effectively explain pricing policies. (Craig Martin, 5/10)

Biosimilar developers are trying mightily to bring these more affordable, lifesaving medicines to market in spite of the myriad obstacles. It’s true that the United States has a shorter history with biosimilars. But that isn’t the real problem behind their slow entry into the marketplace — schemes to prolong monopoly profits are to blame. (Christine Simmon, 5/9)

More than once, as a candidate and as president, Donald Trump has promised that “we will not rest until all of America’s great veterans can receive the care they so richly deserve.” This month Congress will have an opportunity to help make this one step closer to reality by passing the VA Mission Act, which provides critical funding for care, new health-care capacity, and new tools to improve employee performance across the Department of Veterans Affairs system. Without this legislation, funding for the popular Veterans Choice Program would run out, making it harder for millions of veterans to receive the care they need. (Anthony Tersigni, 5/9)

Abortion and access to it, is a protected constitutional right. Throughout the country people recognize that fact and a clear majority of Americans want to keep it that way. This week, health care providers, state advocates, faith leaders and other concerned Americans from dozens of states will gather in Washington to make clear they want lawmakers to protect abortion access by supporting legislative solutions like the Women’s Health Protection Act. The renewed effort comes as states are passing harmful abortion restrictions at historically high rates, while a hostile White House is hastily finding ways to chip away at our fundamental reproductive rights. The courts have offered some protection, overturning or blocking egregiously unconstitutional state laws. But President Trump has been vocal about his commitment to undermining the rule of law by appointing Supreme Court justices who would ignore the settled precedent of Roe v. Wade and erase Americans’ fundamental right to access abortion. (Susan Inman, 5/9)

Giving customers more information so they can make educated choices is empowering — and might even improve their health. And, as it turns out, that’s something Republicans and Democrats can agree on, even in today’s divided political environment. This week marks the start of new labeling rules from the U.S. Food and Drug Administration, requiring thousands of restaurants, grocery stores and movie theaters to post calorie counts on their menus. The new rules, included as part of the Affordable Care Act, are now backed by FDA Commissioner Scott Gottlieb, President Donald Trump’s nominee, as well as by key lobbying groups for the restaurant industry. (5/9)

When rural hospitals close, their communities often lose their biggest employers and closest access to health care, struggling to stay afloat in the aftermath. And that's happening a lot as the health care industry keeps consolidating — 83 rural hospitals have closed since 2010, according to the North Carolina Rural Health Research ProgramThe impact: This is happening now in rural Missouri, where Community Health Systems is shuttering a 116-bed hospital. Axios spoke with some of the hospital employees who are losing their jobs. They are sad, angry and concerned about what will happen to their community. (Bob Herman, 5/10)

Jeff Bezos, the founder of Amazon, is one of the most successful businessmen of all time. He has amassed an unfathomable fortune, reportedly $131 billion. This presents a predicament. Mr. Bezos commands far more money than any one person could possibly spend, far more than any one family dynasty could possibly spend. What should he do with all this money? Unfortunately, Mr. Bezos appears to have come up with a terrible response. (Harold Pollack, 5/9)

A bit of foreboding news you might have missed this week: Insurers in Maryland's individual Obamacare market have proposed an average 32 percent increase in health insurance premiums. The rate hikes range from 18 percent to a whopping 91 percent. This follows a similar announcement in Virginia, where insurers are proposing average rate hikes from 15 to 64 percent. States across the country, including North Carolina, can expect similar proposed hikes in coming months. Obamacare sticker shock is coming, and it's going to hit rural areas especially hard. Hold on. Aren't insurers mostly profitable in the Affordable Care Act's individual markets? Yes, they are. So what's happening? Exactly what insurers and health care experts predicted when Republicans sabotaged the Affordable Care Act last year. (5/9)

The Affordable Care Act has brought health care coverage to more than 400,000 uninsured Marylanders, but this progress has been threatened as health insurance premiums in the individual market have skyrocketed under the Trump administration. Thankfully, Maryland is one of the states leading the nation in stabilizing premiums in its individual market. We commend the Maryland General Assembly and the Hogan administration for passing legislation that creates a reinsurance program to slow premium growth and that protects Marylanders from the Trump administration’s proposed rule that would further undercut insurance markets by expanding the sale of short-term plans with inadequate coverage and consumer protections. (Vincent DeMarco and Stan Dorn, 5/10)

The Trump administration on Wednesday signed off on a regulation crafted during Tom Price's days that will revert to a system in which Medicare will pay medical equipment suppliers more money, starting June 1 and going through the end of the year. The bottom line: Companies that make oxygen tanks, scooters, insulin pumps and other medical equipment will get $360 million in additional revenue this year, with taxpayers and seniors footing the bill. (Bob Herman, 5/9)

Senate Republicans driving an effort to get more Medicaid recipients working are so eager to pass the measure that they are now resorting to bullying tactics. That’s the wrong way to handle this legislation, not to mention an overstep of their authority. (5/9)

The Trump administration is all too willing to cut Medicaid benefits and the number of people receiving them. They’ve signaled this for one thing by allowing states to end retroactive eligibility and to impose work requirements. Their overall message is that states need maximum flexibility because states almost always know best. But remarkably, Kansas went too far even for this administration. This week, Kansas became the first and so far only state to be refused a Medicaid waiver under the current president. The federal government ruled that no, Kansas can’t kick people off Medicaid, the health care program for low-income Americans, just because they’ve been on it for three years. (5/9)

It's Mental Health Awareness Month, and this time Ross Trowbridge isn't running for cover, seeking anonymity or sleeping on the streets. He's organized, and advocating for people like himself. The 38-year-old who lives in Waterloo suffers from Borderline Personality Disorder, a fact he had felt the need to hide, to protect his standing and chance of finding a job. At one time, he earned close to $90,000 and had a wife and children. But as the illness took control, the lack of treatment options, the pressures of secrecy, and anger at the stigma itself became a vicious cycle. It led for three weeks in 2016 to his sleeping under Des Moines' Raccoon River Bridge. (Rekha Basu, 5/9)

In August 2016, the FDA expanded its earlier guidance to include blood-donation screening throughout the continental United States. Consequently, all donated blood in the United States is now screened for ZIKV. In this issue of the Journal, results of the screening of more than 4,000,000 U.S. blood donations for ZIKV during a 15-month period in 2016 and 2017 are reported. The current U.S. strategy for ZIKV screening comes at a cost with an unclear gain. (Evan M. Bloch, Paul M. Ness, Aaron A.R. Tobian and Jeremy Sugarman, 5/10)