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Law enforcement officials have long tried to stem the opioid crisis in America with criminal charges for street dealers and cartel kingpins who traffic in drugs like fentanyl and oxycodone. Now, for the first time, federal authorities are bringing the same kind of felony drug-trafficking charges against a major pharmaceutical distributor and two of its former executives for their role in fanning the crisis. Prosecutors said the former executives at the company, Rochester Drug Cooperative, ignored red flags and shipped tens of millions of oxycodone pills and fentanyl products to pharmacies they knew were distributing drugs illegally. Their sales soared, as did the compensation of the chief executive. (Rashbaum, 4/23)

Laurence Doud III, the retired CEO of the Rochester Drug Co-Operative, operated in the fringes of the drug business, obliterating red flags to turn his small New York firm into a supplier of last resort for independent pharmacies whose dubious practices got them cut off by other distributors, an indictment unsealed Tuesday alleges. Apparently in pursuit of bigger profits for the company and fatter bonuses for himself, Doud encouraged his sales force to sign up new customers with no questions asked, picking up competitors' rejects as he boasted that his company was "the knight in shining armor" for independent pharmacies, the indictment said. (Sisak, 4/23)

The U.S. government on Tuesday filed its first criminal charges against a major drug distributor and company executives over their alleged roles in fueling the nation's opioid epidemic by putting profits ahead of patients' safety. Rochester Drug Co-operative Inc (RDC), one of the 10 largest U.S. drug distributors, agreed to pay a $20 million fine and enter a five-year deferred prosecution agreement to resolve charges it turned a blind eye to thousands of suspicious orders for opioids. (Stempel, 4/23)

From about 2012 to about March 2017, the company acknowledged in the 30-page filing, it violated federal law when it distributed addictive prescription opioids such as oxycodone and fentanyl to pharmacies it knew were dispensing for “illegitimate purposes.” These pharmacies included ones Rochester’s own compliance department flagged for being linked to diversion of prescription opioids. Some pharmacies accepted high amounts of cash payments from patients while others dispensed to out-of-area patients. (Hopkins, 4/23)

According to prosecutors, company officials failed to alert the Drug Enforcement Administration to suspicious orders, as required by law. They ignored the high percentage of cash payments for prescriptions at certain pharmacies, orders for out-of-state patients, and prescriptions issued by doctors acting outside the scope of their medical practice. Authorities said the company often did business with pharmacies that had been blacklisted by other distributors. (Berthelsen and Feeley, 4/23)

The DEA has been investigating the distributor for two years, since it violated the terms of a civil settlement after admitting it failed to report thousands of suspicious opioid orders. (Budryk, 4/23)

The charges against the country’s sixth-largest drug wholesaler are sure to send a shudder through the small group of firms that control narcotics distribution in the United States. To date, prosecutors and the Drug Enforcement Administration have used only civil penalties against these middlemen in their effort to force the companies to report and block suspicious orders of painkillers by pharmacies. “This prosecution is the first of its kind: Executives of a pharmaceutical distributor and the distributor itself have been charged with drug trafficking — trafficking the same drugs that are fueling the opioid epidemic that is ravaging this country,” said U.S. Attorney Geoffrey S. Berman. (Bernstein, 4/23)

For the last three years, a team of Quincy police and health workers has visited overdose survivors and their families, mostly within one or two days after an overdose. They offer options for counseling and treatment, and they bring naloxone, the overdose-reversing drug commonly known as Narcan. (MacQuarrie, 4/23)

The Rx Drug Abuse and Heroin Summit kicked off this week in Atlanta. It looks at ways to fight addiction, stop illegal drugs, and prevent overdose deaths. Nationwide, the economic toll of the opioid crisis is estimated at more than $1 trillion since 2001, according to the health care research firm, Altarum. (Capelouto, 4/23)

Kaiser Health News: Amid Opioid Prescriber Crackdown, Health Officials Reach Out To Pain Patients

A pharmacist in Celina, Tenn., was one of 60 people indicted on charges of opioid-related crimes last week, in a multistate sting. John Polston was charged with 21 counts of filling medically unnecessary narcotic prescriptions. He was also Gail Gray’s pharmacist and the person she relied on to regularly fill her opioid prescriptions.“I take pain medicine first thing in the morning. I’m usually up most of the night with pain,” she said. “I hurt all the time.” (Farmer, 4/24)

Substance abuse disorders impact the hospitality industry more than any other. In fact, according to a 2015 report by the Substance Abuse and Mental Health Services Administration, we rank first for illicit drug use and third for heavy alcohol use. This will surprise no one who works in restaurants. In my many years in the industry, I’ve seen colleagues tragically succumb to addiction and drug abuse, leaving behind family members, loved ones and children. (Mulvaney, 4/24)

Faced with a flood of addicted inmates and challenged by lawsuits, America's county jails are struggling to adjust to an opioid health crisis that has turned many of the jails into their area's largest drug treatment centers. In an effort to get a handle on the problem, more jails are adding some form of medication-assisted treatment to help inmates safely detox from opioids and stay clean behind bars and after release. (Westervelt, 4/24)

A federal judge in the U.S. state of Oregon will block a move by the Trump administration to cut off federal money to family planning clinics that offer abortion or refer women to abortion providers, activists and media reports said late on Tuesday. President Donald Trump's new Title X rule, set to take effect in May, would halt government funds for Planned Parenthood clinics that subsidize birth control for low-income women, and other clinics that provide abortions. (4/24)

U.S. District Judge Michael McShane made the comments after more than three hours of arguments in a lawsuit brought by 20 states and the District of Columbia, The Oregonian/OregonLive reported . The states say the rule change, due to take effect May 3, is a transparent attack on Planned Parenthood and a violation of the Affordable Care Act, which prohibits "unreasonable barriers to the ability of individuals to obtain appropriate medical care." "At the heart of these rules is an arrogant assumption that the government is better suited to direct women's health care than their providers," Oregon Public Broadcasting quoted the judge as saying. (4/23)

The changes, most of which are slated to go into effect May 3, also lift a requirement that Title X grant recipients counsel women on abortion as an option. The rules also would require that grant recipients be financially and physically separate from abortion providers, making hundreds of Planned Parenthood clinics across the country ineligible for the funding. While federal funds can't go toward abortions, the Trump administration has argued that money is fungible and any going to Planned Parenthood could indirectly support the procedure. (Hellmann, 4/23)

They sought a national injunction. But the judge said he’s reluctant to set "national health care'’ policy and would describe the scope of his injunction in a formal written opinion soon. The U.S. Justice Department urged any injunction apply only to the plaintiffs in this case, noting at least four similar suits pending in other states. (Bernstein, 4/23)

The American Medical Association, in a statement, said the rule would have created obstacles to health care for low-income patients. "We are pleased the judge shared the AMA’s concern about the physician-patient relationship that the rule would have jeopardized,” said the physician group's president Barbara McAneny. Nearly two dozen states and several medical provider and advocacy groups have filed a series of suits to block the Title X change. Similar arguments were heard last week in San Francisco, and additional hearings will be held this week in Maine and Washington state. (Colliver, 4/23)

Another legal challenge to the rules filed by the state of California is pending in San Francisco federal court. (Mehrotra, 4/23)

It's time for states with leaders who support abortion rights to go on the offensive against Trump administration attempts to restrict abortion that would reduce access to health care, the president of Planned Parenthood said Tuesday. "States are a critical backstop at a time when we have the Trump-Pence administration stripping away women's health and rights and when we cannot depend on the Supreme Court," said Dr. Leana Wen. (Witte, 4/23)

A faith-based pregnancy center in Willimantic has asked a federal judge for an injunction against a controversial Hartford ordinance that requires the religious facility and others like it to disclose whether their staff carry medical licenses. Critics of the faith-based institutions say their employees sometimes pose as medical workers to lure women and hand out misleading information about abortions. (Carlesso, 4/23)

A federal judge on Tuesday rejected Wisconsin Republican lawmakers' attempt to intervene in a Planned Parenthood lawsuit challenging the state's abortion restrictions, saying in a strongly worded order that they presented no evidence that the Democratic attorney general wouldn't adequately defend the laws. U.S. District Judge William Conley wrote in his ruling that the lawmakers failed to demonstrate a right to intervene and that allowing them to join "would likely infuse additional politics into an already politically-divisive area of the law and needlessly complicate this case." (4/23)

Democratic Wisconsin Gov. Tony Evers promised to veto a Republican-authored bill that could send doctors to prison for life if they fail to give medical care to babies born alive after a failed abortion attempt. Republicans are sending similar bills in other states to liberal-leaning governors in an attempt to energize conservative voters. North Carolina's Democratic governor vetoed a similar bill last week. Democrats in the U.S. Senate blocked a similar measure in February, leading President Donald Trump to say "they don't mind executing babies." (4/23)

Kansas' new law allowing the sale of health plans that can turn away people with pre-existing medical conditions has heightened concerns that more states may move to allow leaner, cheaper plans that don't comply with Affordable Care Act rules. So far, three states have passed laws allowing their Farm Bureaus to bypass ACA rules and sell health plans that are free from any state insurance regulation. Kansas became the latest last week. The state's Democratic governor let the bill become law without her signature in the hope of winning GOP support for a bill to expand Medicaid to low-income adults, though that remains uncertain. (Meyer, 4/23)

The House Rules Committee will hold a hearing on "Medicare for All" legislation next week, a step forward for the legislation that is gaining ground in the progressive wing of the party. The hearing on Tuesday will examine a bill from Reps. Pramila Jayapal (D-Wash.) and Debbie Dingell (D-Mich.) that has over 100 co-sponsors in the House. (Sullivan, 4/23)

Health care issues are most important to likely Democratic primary voters, according to a new poll. Twenty-five percent of the voters surveyed in the Morning Consult poll say health care issues are most important, closely followed by 22 percent who chose economic issues. Supporters of Democratic presidential candidate Pete Buttigieg, mayor of South Bend, Ind., are more likely to say health care issues are most important to them than backers of former Vice President Joe Biden and Sens. Bernie Sanders (I-Vt.) and Elizabeth Warren (D-Mass.), pollsters found. (Hellmann, 4/23)

The drugstore chain Walgreens will stop selling tobacco products to customers under 21, the company announced on Tuesday. The decision came weeks after the Food and Drug Administration accused the company of repeatedly selling tobacco products to minors — and amid similar moves by competitors and lawmakers around the country to curb teenage vaping. (Zraick and Rueb, 4/23)

The new chainwide policy for Walgreens will start Sept. 1, the company said Tuesday. Walgreens’s move is its most recent step in its effort to further prevent youth access to tobacco products, including a policy implemented last October that requires verification regardless of age, the company said. “We’ve seen positive results from other recent efforts to strengthen our policies related to tobacco sales, and believe this next step can be even more impactful to reduce its use among teens and young adults,” Richard Ashworth, Walgreens president of operations, said in a statement. (Al-Muslim, 4/23)

The moves come as more states debate raising the minimum purchasing age to 21. Senate Majority Leader Mitch McConnell (R-Ky.) said last week he would introduce legislation to raise the age nationwide. The Food and Drug Administration says the U.S. is facing a youth vaping epidemic, with 3.5 million middle and high school students smoking e-cigarettes in 2018. (Hellmann, 4/23)

The push to legalize marijuana quickly transformed the cannabis industry into a multibillion dollar legal business. And now Fortune 500 companies and elite K Street lobbying firms have joined the green gold rush. Altria, the tobacco giant better known for Marlboros, recently took a $1.8 billion stake in the cannabis company Cronos Group. Constellation Brands, which makes Corona beer, has spent money on cannabis lobbying after making a major investment in Canopy Growth, a Canadian marijuana company. (Demko, 4/23)

Hospital and health system merger and acquisition activity was strong in the first quarter of 2019 and generally consistent with levels seen in recent years, a new Kaufman Hall report found. The analysis identified 27 transactions in the quarter—about half of those in January—compared with 30 in the first quarter of 2018, which the report said was a very high activity period. But the total transacted revenue was less than half in the recently ended quarter compared with the prior-year quarter, and the average sellers in those transactions had about half the annual revenue of those in 2018, according to the report. (Bannow, 4/23)

The renegotiated trade deal with Canada and Mexico, an elusive infrastructure package and debate over prescription drug prices dominated the lobbying agendas of some of the biggest spenders on K Street early this year, setting the legislative stage for the rest of 2019. The tumult of the Trump administration and the uncertainty of divided party control on Capitol Hill have kept business interests on the defense while also looking for openings to help broker big-scope legislative deals before presidential politics takes hold by 2020. (Ackley, 4/23)

Los Angeles health officials warned this week that students and staff at UCLA and Cal State L.A. may be at risk of catching measles, an announcement that has raised questions about universities’ susceptibility to disease outbreaks. Not only can cramped dorm rooms and crowded classrooms be breeding grounds for contagion, but young adults in California are less likely to be vaccinated than other age groups, experts say. One of the people infected in L.A.’s measles outbreak is a UCLA student, university officials confirmed Tuesday. (Karlamangla, 4/23)

Public health officials in Los Angeles have declared a measles outbreak in the county, making it the latest metropolitan area to be hit by the illness and part of a national surge in cases rapidly approaching record numbers. Five cases of measles are being investigated by the Los Angeles County Department of Public Health. Though vaccination rates are typically high in California, a single case can easily spread — not only to those who are not vaccinated, but also to infants who cannot yet receive immunization and to elderly patients with suppressed immune systems. (Del Real, 4/23)

Two Sacramento County children from the same family were diagnosed with measles Tuesday – the first confirmed cases in the county in seven years, according to the Sacramento County Public Health Department. The children were not vaccinated and are at home recovering, according to county spokeswoman Brenda Bongiorno. (Yoon-Hendricks, 4/23)

Washington state lawmakers voted Tuesday to remove parents' ability to claim a personal or philosophical exemption from vaccinating their children for measles, although medical and religious exemptions will remain. The vote comes as the number of measles cases nationwide this year has passed 600. (4/23)

A year ago, in the wake of horrific tragedy, Florida lawmakers reached a compromise that had once seemed politically impossible: They passed an array of gun restrictions after a young man killed 17 people at Marjory Stoneman Douglas High School in Parkland. Part of that compromise allowed certain school employees, but not classroom teachers, to carry firearms on campus. Then, late last year, a state commission investigating the Parkland shooting came to a conclusion that made even some of its members uncomfortable: Some of the deaths at Stoneman Douglas High might have been prevented if faculty inside the building had been armed. (Mazzei, 4/23)

The measure is aimed at implementing recommendations by a state commission created in the wake of the shooting at Marjory Stoneman Douglas High School in Parkland, Fla., last year that left 17 people dead. It builds on a law passed last year that included new gun restrictions, including raising the minimum age to buy a firearm, and a guardian program that permitted the arming of certain school personnel, but not teachers. (Campo-Flores, 4/23)

Hospitals and patients have sued to block a new nationwide liver transplant policy that they say will waste viable livers, lead to fewer transplants and likely cause deaths. The U.S. Department of Health and Human Services and the United Network for Organ Sharing hastily adopted the new policy and based it on faulty assumptions, according to the suit filed Monday in Atlanta federal court. (4/23)

Two Kansas City area hospitals joined 12 other transplant centers this week in a lawsuit over a new liver allocation policy that they say will result in “hundreds of liver transplant candidates needlessly dying.” The University of Kansas Hospital and Saint Luke’s Hospital of Kansas City are plaintiffs in a federal lawsuit filed in Atlanta against the U.S. Department of Health and Human Services and the United Network for Organ Sharing, or UNOS, the private organization that contracts with the government to manage the nation’s organ transplant system. (Margolies, 4/23)

Abigail Finney was in her freshman year at Purdue University in Indiana in February 2017 when she fell asleep in her boyfriend’s dorm room. During the night he snuggled up to her in bed in the pitch black, his hand grazing her breast, and they began having sex. She soon stopped to go to the bathroom and, when she returned, discovered, to her horror, that it wasn’t her boyfriend who was in bed with her. Was it rape? (Ellin, 4/23)

In a new paper published Tuesday in the journal PLOS Biology, the researchers behind 500 Women Scientists report that their platform has been accessed more than 100,000 times. And among 1,200 participants surveyed about their experience, 11 percent said they had been contacted as a result of the database for media interviews, peer review, panels, and other opportunities. The group has ambitious plans to keep expanding its reach. They’re raising money to start a fellowship for women of color working to make science more open and accessible and they have already launched an affiliate group, 500 Women in Medicine. (Thielking, 4/23)

Americans are becoming increasingly sedentary, spending almost a third of their waking hours sitting down, and computer use is partly to blame, a new study found. Over almost a decade, average daily sitting time increased by roughly an hour, to about eight hours for U.S. teens and almost 6 1/2 hours for adults, according to the researchers. That includes school and work hours, but leisure-time computer use among all ages increased too. (4/23)

If you’re like many people, you may have decided that you want to spend less time staring at your phone. It’s a good idea: an increasing body of evidence suggests that the time we spend on our smartphones is interfering with our sleep, self-esteem, relationships, memory, attention spans, creativity, productivity and problem-solving and decision-making skills. (Price, 4/24)

Then there’s the talent that Apple is amassing. Over the past few years, the company has built out a formidable roster of physicians and medical researchers. A spokesperson for Apple wouldn’t say how many of the company’s roughly 130,000 employees are tasked with working on health — or provide much detail about the roles of the people leading its health push. But here are five of them whose work you should keep an eye on. (Robbins, 4/24)

A wearable device that uses machine learning to remotely track and analyze multiple vital signs has been cleared by the Food and Drug Administration, expanding the scope of home monitoring systems intended to keep chronically ill patients out of the hospital. Current Health, based in Edinburgh, Scotland, announced Wednesday it received clearance for an upper-arm wearable that measures a patient’s respiration, pulse, oxygen saturation, temperature and mobility. The product is capable of delivering continual updates on a patient so doctors can intervene quickly if the data signal an emerging problem. (Ross, 4/24)

On the night of Jan. 17, 2018, Lorenzo Herrera walked into the Fresno County Jail booking area and sat down for an interview. Yes, he had a gang history, an officer wrote on his intake form. But Herrera, 19, said he did not expect problems with others inside the gang pod he’d soon call home. His parents had encouraged him to barter for books and newspapers — anything he could to preoccupy himself until his trial on burglary and assault charges. His father, Carlos Herrera, offered advice: “Just be careful, and only trust yourself.” Herrera survived the violent chaos of the Fresno County Jail for 66 days, including living through a brawl that left another inmate unconscious. Then, on an afternoon in March, jail officers found him strangled. (Pohl and Gabrielson, 4/24)

A transgender inmate has filed a federal lawsuit against the Connecticut prison system for denying her transitional care and for housing her with male inmates. The Hartford Courant reports that Veronica May Clark says Department of Corrections officials have denied her medical and mental health care since she began her gender transition in prison. The suit seeks proper care and $500,000 in damages. (4/23)

Conditions at the Cuyahoga County jail continue to violate the rights of inmates, even as Cuyahoga County Executive Armond Budish and his administration say they are making changes to improve the lives of prisoners, according to a new court filing. The amended complaint filed Monday is part of a lawsuit filed in December on behalf of inmates who say conditions within the jail violate their constitutional rights. (Heisig, 4/23)

Port commissioners Tuesday night unanimously approved a proposal to lease land for a 200-bed temporary homeless shelter in the popular Embarcadero tourist area as the city struggles with a severe shortage of affordable housing. Supporters cheered as the commissioners voted unanimously to lease a port-owned parking lot to the city for two years to create the SAFE Navigation Center. There would be an option for a two-year extension under certain conditions. (4/23)

In an effort to halt an ongoing hepatitis A outbreak, health clinics in Manchester, Nashua, Somersworth, and Concord are offering free vaccines to people without health insurance. Hepatitis A is transmitted by ingesting small undetected amounts of feces from someone who is infected. Communities at high-risk for the disease include people who are homeless, people using recreational drugs, and gay men. (Moon, 4/23)

In the fiscal year ending Sept. 30, the state received about $207 million from the agency, or $17.68 per Ohioan, according to “The Impact of Chronic Underfunding on America’s Public Health System” report released Wednesday by the Trust for America’s Health. That compares with $63.28 per person in Alaska, which ranks first among the 50 states, and $17.09 per person in New Jersey, which ranks last. (Viviano, 4/24)

The Lead Safe Cleveland Coalition policy committee is close to finalizing its list of recommendations on prevention, screening, treatment and education to submit next week to Cleveland City Council. A volunteer group of about 40 representatives from the healthcare, education, legal, philanthropic and policy communities have been meeting weekly for the past two months to finalize the list to be sent to council May 1. (Zeltner and Dissell, 4/24)

The state Commerce Department said it has issued a $50,000 civil penalty plus a cease-and-desist order to a California company in connection with letters to Minnesotans about Medicare health insurance options that it said were misleading. Commerce said Tuesday that a company called eHealthInsurance Services Inc. purchased the domain name “Medicare.com” and mailed more than 600,000 letters that used the website address and offered services for picking a new insurance plan. (Snowbeck, 4/23)

The Minnesota Department of Commerce has fined a California-based health insurance agency for mailing more than 600,000 misleading letters to elderly Minnesotans, the department announced Tuesday. Gold River, Calif.-based eHealthInsurance Services purchased the web domain name “Medicare.com” and, using that name, mailed letters to Minnesotans warning that certain Medicare plans were being discontinued and offering services to obtain a new plan. The Medicare program’s correct website address is www.medicare.gov. (Salisbury, 4/23)

Faced with continuing operational losses, the board of Mendocino Coast District Hospital has asked five hospital operators, including Sutter Health and Adventist Health, to take a look at buying or partnering with a facility that serves 23,500 residents along a 70-mile stretch of California’s North Coast. (Anderson, 4/24)

A record number of homeless people — 918 last year alone — are dying across Los Angeles County, on bus benches, hillsides, railroad tracks and sidewalks. Deaths have jumped 76% in the past five years, outpacing the growth of the homeless population, according to a KHN analysis of the coroner’s data.Health officials and experts have not pinpointed a single cause for the sharp increase in deaths, but they say rising substance abuse may be a major reason. (Gorman and Rowan, 4/23)

State health inspectors found that three patients placed in non-violent restraints at Mount Carmel St. Ann’s hospital didn’t receive proper checks from a registered nurse and the hospital had conditions that violated national fire safety codes. The in-depth survey was conducted in mid-March by the Ohio Department of Health on behalf of the federal Centers for Medicare and Medicaid Services. (Wagner, 4/23)

Health care workers were attacked by two different patients in separate incidents at the same Baton Rouge mental health facility on Monday (April 22), just weeks after a nurse’s death was ruled a homicide following an attack by a mental health patient at a different Baton Rouge medical facility, WAFB reports. A total of six employees were injured in Monday’s attacks at Our Lady of the Lake Regional Medical Center’s Tau Center, which treats mental health and addiction, the TV station reports. Two patients face charges. Authorities were called to the facility at 10 a.m. in the first attack, during which two hospital workers were punched by the same patient, WAFB reports. Police responded two hours later to the same facility after a patient fought with four employees who received minor injuries. (Lane, 4/23)

Under a state law passed in 2017, anyone who believes a child or animal in a hot vehicle is in "imminent danger" of suffering injury or death can break a window to get them out without fear of a lawsuit. But that legal protection doesn't kick in automatically: You must first call law enforcement or animal control. (Polletta, 4/23)

Metro Atlanta shows mixed results on air pollution in the American Lung Association’s latest report, released Wednesday. The area had fewer days of bad ozone pollution – the main factor in smog – but still ranked 25th among cities for the worst ozone, according to the Lung Association’s 2019 State of the Air report. (Miller, 4/24)

The Missouri medical board revoked the license of pediatric surgeon Guy Rosenschein last week — more than two years after he was arrested in New Mexico on child pornography charges. Rosenschein had been licensed in Missouri since 2000 and worked in Joplin and at the University of Missouri Health Care in Columbia until 2013. (Marso, 4/24)

Fresh off filing a lawsuit alleging that a pharmacy benefit manager overcharged his state, Ohio’s attorney general is now proposing a series of legislative reforms that would toughen oversight of these controversial middlemen. The move by Attorney General Dave Yost comes amid escalating concern among Ohio officials over the prescription drug contracts administered by PBMs on behalf of the state Medicaid program and other agencies. In doing so, Yost appears to be suggesting a blueprint for other states that are grappling with rising drug costs and starting to scrutinize PBM business practices as one possible way to alleviate the financial strain. (Silverman, 4/22)

In the latest row over monopolies on medicines, Blue Cross Blue Shield of Louisiana filed a lawsuit accusing a Johnson & Johnson (JNJ) subsidiary of filing “sham” patent litigation in a bid to unfairly thwart generic competition to its best-selling Zytiga prostate cancer treatment. Having won an initial patent in 2004, Janssen Biotech three years later began pursuing additional claims with the U.S. Patent and Trademark Office, but was repeatedly rejected. By 2014, though, the subsidiary won an extension for one patent and was granted another, extending its monopoly on the drug until December 2016, according to the lawsuit filed last week in Richmond, Va. (Silverman, 4/22)

A dispute between makers of treatments for opioid use disorder is drawing attention to an obscure way that drugs can qualify for longer monopoly periods — and highlighting the lengths that some companies go to preserve those monopolies. The Food and Drug Administration’s “orphan drug” designation is supposed to be for rare diseases with a population of fewer than 200,000 patients. The companies that have won the designation can then apply for seven years of exclusive sales from the time the products are initially approved, compared to three to five years given for most other drugs. (Siddons, 4/22)

Two years after Maine adopted a law that would ban drug makers from giving gifts to doctors, state officials are now moving to clarify the limits, an effort likely to prompt another fierce battle by the pharmaceutical industry. Although the Maine law has been on the books since June 2017, the state Board of Pharmacy had not attempted to set parameters for gift giving or other forms of payment. Now, the board is proposing a $250 limit on speaking fees, an undefined “minimal value” for food and beverage at conferences, and “reasonable” travel and lodging expenses for doctors who speak on behalf of drug makers. (Silverman, 4/18)

Pharmacists and some health experts are opposing a proposal to permit the bulk importation of drugs from Canada to Maine, arguing that it could result in unsafe drugs being brought into the state and have unintended consequences, such as causing drug shortages in Canada. Proponents of Senate President Troy Jackson’s bill say those fears are unfounded, and believe it could be one of several proposals that would help to rein in prescription drug prices in Maine. (Lawlor, 4/24)

If you weren’t already aware, the era of emerging biotechs has arrived. Last year, these companies accounted for 72% of 2,853 late-stage drugs in the collective industry pipeline, up from 65% of 2,083 medicines in 2013. Meanwhile, 47% of the therapies launched in the U.S. in 2018 were attributed to emerging biotechs, which were defined as spending less than $200 million annually on R&D and having less than $500 million in revenue. (Silverman, 4/23)

Sanofi Genzyme (SNY) makes most of its money developing really complicated drugs for rare diseases. But for the next decade it will make a nice little profit in a far simpler way: by flipping its real estate. The Cambridge-based drug maker turned heads last year when it leased two whole buildings — about 900,000 square feet — at Cambridge Crossing, a huge mixed-use development that’s underway north of the MBTA’s Lechmere Station. (Logan, 4/23)

When it comes to improving its image, the best that the pharmaceutical industry can do is go sideways. Just 41% of patient groups thought the pharmaceutical industry had an “excellent” or “good” reputation last year, which is within striking distance of the 43% notched in 2017 and 38% in 2016, according to a survey by PatientView, a research firm that canvassed more than 1,500 patient groups from 78 countries between last November and this past February. And once again, pricing is a huge Achilles’ heel. (Silverman, 4/18)

The state may have to pay millions of dollars more in treatment costs for inmates infected with hepatitis C, following a federal judge’s ruling Thursday that said prison officials have been “deliberately indifferent” in caring for thousands of inmates infected with the virus. The ruling could potentially cost the Florida Department of Corrections as much $20 million more than what it is already paying to treat inmates with the virus, said Senate Criminal and Civil Justice Appropriations Chairman Jeff Brandes, who recently got a preliminary briefing from the department on the issue. (Shedden, 4/22)

Attorney General Dave Yost isn’t sure whether pharmacy benefit managers are bilking taxpayer money from the state. But he wants lawmakers to pass reforms so he and other state officials can find out. On Thursday, Yost laid out four recommendations for state lawmakers to improve transparency for “PBMs” -- middlemen who negotiate drug prices on behalf of state employees, public retirees, injured workers, and Medicaid recipients. (Pelzer, 4/22)

The last few weeks have seen a flurry of activity with several congressional committees holding hearings in an effort to address the crisis of high drug costs for patients. As the debate intensifies around drug pricing, it is easy to get lost in the rhetoric and lose sight of finding meaningful solutions that will bring down costs for patients where it hurts the most — at the pharmacy counter. Each year, patients forego needed medications due to cost. In fact, surveys have shown that nearly 50 percent of patients have abandoned a prescription at the pharmacy counter because of affordability. (Debra Barrett, 4/18)

As drug prices have soared, lawmakers and patient advocates have pushed the federal government to deploy for the first time a powerful deterrent: a legal provision that allows it to suspend a drugmaker’s patent and license someone else to produce the drug. Now, responding to industry alarm over those demands, the Trump administration is proposing to strictly limit the little-known power. (Christopher Rowland, 4/18)

With seven biosimilars currently on the market and 18 biosimilars approved by the FDA as of April 2019, one question is sparking a lot of debate: What should the scientific, or nonproprietary, names of these products be? There are two schools of thought on this. One says that a molecule that is highly similar to its reference biologic medicine should have the same nonproprietary name as the originator. The other says that for safety reasons it’s important to have distinct names for all biologics so we can more easily tell one from another. The naming decision extends far beyond marketing and directly affects how pharmacies fulfill prescriptions for these drugs and how they will be monitored once they’re on the market. (Brad Jordan, 4/23)

Americans pay a lot for pharmaceuticals, and politicians of all stripes are offering prescription drug price-relief proposals to force prices downward. Top-down approaches, though, carry a high chance of failure. We can get an inkling as to why by looking back at Roman history and surveying the contemporary landscape more closely. In 301 AD, Roman Emperor Diocletian blamed inflation on greedy merchants. His “Edict on Maximum Prices” commanded them to lower prices and imposed the death penalty for sellers — and even buyers — who violated it. Despite the brutal power of the crown, the edict was largely ignored. Inflation rolled onward. (Robert Graboyes, 4/23)

A new drug that cures, or at least delays, a deadly disease like cancer represents a huge advance — unless no one can afford it. Innovation without access is meaningless. In the past five years, we have witnessed the emergence of revolutionary scientific innovations for treating cancer such as immunotherapies, targeted oral cancer medicines, gene therapies, and more. These new approaches are turning many daunting cancers into manageable conditions. (Percival Barretto-Ko, 4/18)

Missouri’s freshman senator likely had a number of his constituents scratching their heads this month when he attacked a valued economic engine in his own state to promote his newly filed price-control legislation. Republican Sen. Josh Hawley, in his first three months on the job, took a swipe at one of the most important industries we have in Missouri — indeed, in this country — and we need to provide important context to his poor choice of words. Hawley’s characterization referred to “Big Pharma” being “not good actors.” The life sciences industry is incredibly important to our local economy, and the interwoven collaborative work of large and small pharma is vital to every person in this state who has ever needed a prescription. (Kelly Gillespie, 4/22)

Imagine if the Maine Legislature decided that large pickup trucks were becoming too expensive for the working-class people who drive them. Then imagine that legislators established a commission designed to study the costs to manufacture and sell these trucks. After careful study, the commission then concluded that large pickups produce a $3,000 profit per truck for their manufacturers. Finally, the commission then established an upper price limit on pickups sold in Maine that was $3,000 below the average price at which pickups were currently being sold. Lastly, suppose 45 other states, seeing Maine’s attempt to make pickups more affordable, also established similar price caps. What, then, would happen? (William Smith and Adam Crepeau, 4/23)

As the health care debate continues to boil, the idea of drug reimportation occasionally bubbles to the surface. That seems to be the case of late. President Donald Trump appeared to give the notion a nod in his State of the Union address. Here’s the issue in a nutshell: Research and development of a new drug costs a bundle. Drug companies price the drug in the U.S. high enough to recover those costs and make a profit. In most other developed democracies, however, government controls the price of drugs. The marginal cost of producing an additional pill is negligible. So, drug companies have little reason to refuse to sell the pills to other countries at the government-controlled price. (Robert Robb, 4/23)

My community faces a grave threat. I am not talking about the measles spreading throughout our Hasidic neighborhoods in Brooklyn. I am referring to the scientific denialism that has infected our community and has put the lives of children here and elsewhere at risk. ... According to health officials, the most recent outbreak is a direct result of disinformation efforts: Like tens of thousands of Americans, many Hasidic Jews have fallen under the sway of anti-vaccination propaganda — spread by people within our community — and have refused to inoculate their children against measles and other diseases. (Moshe Friedman, 4/23)

Eliminating measles — a victory the U.S. declared in 2000 — was an incredible accomplishment, the direct result of an effective national vaccination program. Today that work is threatened as vaccine-preventable diseases resurge across the country: The Centers for Disease Control and Prevention reports ongoing measles outbreaks in New York, Washington, California, New Jersey and Michigan. (Nicholas Cuneo, 4/24)

The concept of modifying the human genome to treat or cure disease was once the stuff of science fiction. Today there are products on the market to do just that. This amazing leap has come with a hefty price tag. Currently marketed gene therapies hover around $500,000 or more per course of therapy and future agents may top $3 million to treat a single patient. Providers and payers must ask themselves a two-pronged question about gene therapy: Who should be treated and when? (Jeremy Schafer, 4/23)

Public support for abortion rights is at its highest since the Supreme Court’s landmark Roe v. Wade ruling, with 67 percent of voters saying abortion should be legal in “all” or “most” cases.” At the same time, though, a record number of bills that would severely restrict — even ban — abortion have been filed and in some cases enacted in state legislatures across the country. The dichotomy is due to how Brett M. Kavanaugh’s appointment to the Supreme Court has so emboldened the antiabortion movement that extreme — even flagrantly unconstitutional — measures are now seen as worthy of pursuit. (4/23)

Pop culture has made some progress since 1956, when an addition to the Motion Picture Production Code that governed Hollywood movie-making declared, “The subject of abortion shall be discouraged, shall never be more than suggested, and, when referred to, shall be condemned.” But even by contemporary standards, in which characters are allowed to have abortions and movies can depict those decisions positively, Nia DaCosta’s debut feature film, “Little Woods,” is a politically urgent revelation.Rather than making the decision to have an abortion the major source of tension in the film, DaCosta starkly depicts the sacrifices that families make to afford health care, dramatizing the recent onslaught of restrictions on abortion. And her character’s choices place abortion in conversation with our national debate about opioid addiction and drug trafficking to illuminate these well-worn subjects in new ways. (Renee Bracey Sherman, 4/23)

The search for “scientific truth” is never direct. Rather, hills, curves and even the occasional U-turn describe the journey. I experienced this firsthand as an author of a report published recently in the Journal of The American Medical Association studying the diets of nearly 30,000 individuals. We found evidence of higher rates of heart disease among adults who ate more eggs. ...The vast commentary on our recent publication, has highlighted the robust and contradictory literature describing eggs as an important part of a healthy diet, the health benefits of eggs, and even six reasons why eggs are “the healthiest food on the planet.” (Mercedes Carnethon, 4/23)

Paradise, California, is being rebuilt. Crews are removing millions of tons of debris left by the devastating Camp Fire last fall. The town council is holding public meetings to plan a new community. Developers are designing new homes. And somewhere off in the future, the next voracious wildfire awaits.According to a state report, California’s fire season is now “almost year round.” More than 25 million acres of wildlands are under very high or extreme fire threat, and the high-risk area is home to 11 million people — one-quarter of the state’s population. (4/23)

One evening, here in the college town of Chico, as I was pulling weeds from the vegetable beds in my front yard, I looked up to find an elderly woman watching me, her little dog tugging at her. “I miss my garden,” she hollered from the sidewalk. I nodded, after pausing, half-expecting her say more. “I’m from Paradise,” she continued. “Oh,” I said, the only utterance of condolence I could muster before she went on her away. A shorthand that surely sounds familiar to those who’ve lived near disaster — in Tornado Alley, or along the Gulf Coast — “I’m from Paradise,” has come to mean, “I’ve lost everything.” (Sarah Pape, 4/24)

During his Senate confirmation hearing in April 2017, Dr. Scott Gottlieb committed himself to “the gold standard of safety and efficacy.” Over the past two years as head of the Food and Drug Administration (FDA), Commissioner Gottlieb has made good on that promise, and his tenure has been a model for future FDA chiefs. To his great credit and the benefit of consumers, Gottlieb, whose tenure at the agency ended recently, pursued policies that encouraged competition and choice. (Beau Brunson, 4/23)

While the outbreak may not be as immediately dangerous to humans as SARS, the official response should worry Chinese, as well as public health authorities globally. Thanks to its geographic position on migratory bird routes, its vast and largely unregulated livestock industry, and its weak public health institutions, China is a prime candidate to serve as the incubator for the next pandemic capable of killing millions of humans. Ensuring that Beijing responds to that epidemic in a responsible manner must be a global priority. (Adam Minter, 4/23)

There is no one better equipped than the faith community to alleviate the extreme pressures placed on DFCS, particularly the additional stresses from the drug crisis with the enormous caseloads of foster children. FaithBridge Foster Care partners with 46 metro Atlanta churches such as North Point in Alpharetta, First Baptist of Woodstock and Mount Bethel United Methodist in Marietta to find children homes and support while DFCS provides oversight. (Richard Jackson, 4/23)

Do you have a prescription for painkillers? If you don’t, you know someone who does. One in three Americans has a prescription for opioids, and prescriptions have almost quadrupled in the past decade.When you mention collective bargaining, I’m sure that opioid prescriptions and addiction are not what spring to mind. Throughout its history, though, the UAW has made the well-being of its members, their families and their communities as a top priority. (Gary Jones, 4/23)

Let’s be clear. Our legislature is engaged in a not-so-subtle effort to trade lives for dollars.  In the past two years, more than 128,000 children have lost TennCare coverage. Cutting health care for children won’t save Tennessee money. Studies from Georgetown University and many others make clear that providing comprehensive health care to children results in substantial cost savings in the long term and higher standards of living for those children when they become adults. (Mary Falls and Sally Smallwood, 4/23)