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White House officials and several Republican lawmakers claimed Tuesday they were nearing a deal on health-care legislation with the House Freedom Caucus, with at least three leading figures in the hard-line group ready to support an overhaul after the dramatic collapse of talks last month. Reps. Mark Meadows (R-N.C.), Jim Jordan (R-Ohio), and Raúl R. Labrador (R-Idaho) — all leaders of the Freedom Caucus and central figures in the latest discussions — signaled Tuesday they are ready to support a new plan, according to two White House officials who were not authorized to speak publicly. A lawmaker close to the Freedom Caucus later confirmed that those members were close to or ready to support the tweaked bill. (Costa and Winfield Cunningham, 4/25)

[It] is far from clear that the fragile agreement will provide Speaker Paul Ryan the 216 votes needed for the House to pass the stalled legislation. Optimism is growing among Republican officials on the Hill and in the White House. Leadership will likely need at least 15 to 20 new House Freedom Caucus votes to have any shot at passing the bill. (Bade, Haberkorn and Dawsey, 4/25)

House Republicans have been under intense pressure to deliver on years of promises to repeal Obamacare, but GOP leaders weren’t making predictions of an imminent vote, despite renewed pressure from the White House as President Donald Trump approaches his 100th day in office on Saturday. The new enthusiasm stems from an amendment that would give states the authority to apply for waivers from some of Obamacare’s requirements under certain conditions. (House, Denis, Kapur, 4/25)

According to legislative text of the amendment obtained by The Hill, the measure would allow states to apply for waivers to repeal one of ObamaCare’s core protections for people with pre-existing conditions. Conservatives argue the provision drives up premiums for healthy people, but Democrats -- and many more moderate Republicans -- warn it would spark a return to the days when insurance companies could charge sick people exorbitantly high premiums. (Sullivan, 4/25)

Rep. David Brat (R-Va.), a member of the conservative House Freedom Caucus, told reporters Tuesday evening that he would likely support the American Health Care Act (AHCA) as long as discussions on what would be in the amendment appear in the legislative text. "If it shows up in the language the way we discussed it, then yes," Brat said. (Hellman, 4/25)

For most of his life, Carl Goulden had near-perfect health. He and his wife, Wanda, say that changed 10 years ago. Carl remembered feeling “a lot of pain in the back, tired, fatigue, yellow eyes — a lot of jaundice.” “Gray-like skin,” Wanda added. His liver wasn’t working, she explained. “It wasn’t filtering.” Carl was diagnosed with hepatitis B. He is now 65 and on Medicare, but back then he had a flower shop in Littlestown, Pa., so he had been buying health insurance for his family on the market for small businesses and the self-employed. (Gordon, 4/26)

Rep. Tom MacArthur has singlehandedly kept the embers of the failed repeal-and-replace effort burning, huddling with the hard-line conservative Freedom Caucus to try to forge a deal. The negotiations have allowed the White House and GOP congressional leaders to insist that despite their embarrassing failure to pass health care legislation last month, they're still making progress. But the MacArthur-as-Republican health care savior narrative has bothered some GOP moderates, who say the New Jersey lawmaker is flying solo in negotiations with the Freedom Caucus. (Cheney, Bade and Jennings, 4/26)

Leading House conservatives are saying good things about a plan to revive the GOP health care bill. But an influential GOP House moderate is opposing the proposal, leaving party leaders to assess whether the idea could help one of President Donald Trump’s premier but most problematic priorities spring back to life. Republican lawmakers were meeting Wednesday to consider how to rescue the GOP drive to repeal much of President Barack Obama’s health care law. (Fram and Taylor, 4/26)

An emerging government funding deal would see Democrats agreeing to $15 billion in additional military funding in exchange for the GOP agreeing to fund healthcare subsidies, according to two congressional officials briefed on the talks. (Bolton and Wong, 4/25)

Extending the border wall with Mexico may not force the government to shut down at midnight on Friday, but one more contentious issue still could: What to do about payments to insurance companies. The White House has wobbled on its demands to include funding for the border wall in a must-pass spending bill this week, but lawmakers still disagree about whether funding for cost-sharing reduction payments to insurance companies should be included. (McIntire and Yokley, 4/25)

Talks about averting a government shutdown progressed Tuesday after funding for building the wall between the U.S. and Mexico fell off the negotiating table, but lawmakers still had to work through a thicket of issues — including health care funding and family planning. They have until midnight Friday to reach a deal before government funding runs out. ... Republicans and Democrats were still debating how to address the need for cost-sharing subsidy payments to insurance companies to help lower-income individuals pay for the health care under the 2010 health care overhaul. The House GOP still has a lawsuit over the legality of the payments, which goes back to the administration of President Barack Obama, but some Senate Republicans were reluctant to turn off the spigot. (Lesniewski, 4/26)

The next big item for negotiators is funding for a subsidy in the Affordable Care Act that helps low-income people afford health care. The Trump administration has indicated they want to withhold funding — a move that would further destabilize the insurance market, which Trump says would help speed the collapse of Obamacare. (Caldwell, 5/25)

As President Trump and congressional leaders scramble to put together a spending bill to keep the government from shutting down at the end of this week, negotiations could turn on the fate of an arcane, but critical part of the Affordable Care Act: cost-sharing reduction payments, or CSRs. If you’ve never heard of this piece of the Obamacare puzzle, here’s a rundown of what they are and why they’re getting pulled into Trump’s first budget fight. (Levey, 4/26)

Congress must pass a bill this week to keep most of the government running beyond Friday, when a government spending bill runs out. It won’t be easy. The debate over a new spending bill focuses on an esoteric issue affecting the Affordable Care Act. The question is whether Congress will pass — and President Donald Trump will sign — a bill that also funds subsidies for lower-income people who purchase health insurance under the law. (Rovner, 4/26)

Even if the federal government shuts down, doctors will continue to get paid to see Medicare or Medicaid patients. They will however face delays as they register to provide care under the programs. (Dickson, 4/25)

In strategy and substance, the American public disagrees with the course that President Trump and congressional Republicans are pursuing to replace the Affordable Care Act with conservative policies, according to a new Washington Post-ABC News poll. Large majorities oppose the ideas at the heart of the most recent GOP negotiations to forge a plan that could pass in the House. These would allow states to choose whether to keep the ACA’s insurance protection for people with preexisting medical problems and its guarantee of specific health benefits. (Goldstein and Clement, 4/25)

Speaking over constituents’ often-hostile shouts and angry murmurs, one of Congress’ most conservative Republicans told a tense town hall meeting here Monday that less government regulation — not more — is the solution to their rising health care premiums. “What we want to do is make sure we have the best health care system in the world and bring back affordable insurance plain and simple. That’s what I’m trying to do. That’s what we continue to focus on,” said Rep. Jim Jordan, the co-founder of the House’s conservative Freedom Caucus. Its firm opposition to the GOP’s plan to replace the Affordable Care Act forced party leaders last month to yank their bill from a vote on the House floor. (Bluth, 4/25)

President Trump had promised religious groups that he would reverse the Obama administration’s requirement that employers provide birth control to their employees under the Affordable Care Act. But his Justice Department indicated Monday that it’s not yet giving up a fight with religious schools and nonprofits that are suing over the contraception mandate. The department has asked the U.S. Court of Appeals for the 5th Circuit for an additional 60 days to negotiate with East Texas Baptist University and several other religious groups objecting to a requirement to which they are morally opposed. (Winfield Cunningham, 4/25)

Is the Trump administration reneging on Donald Trump's campaign promise to exempt religious organizations from having to provide birth control to employees? (Biryukov, 4/25)

One health insurer is eager to dive back into the Affordable Care Act’s troubled insurance exchanges next year, even as competitors waver and President Donald Trump tweets doom about the law’s future. Centene Corp. said Tuesday that its exchange enrollment has swelled 74 percent since last year, up to nearly 1.2 million people. (Murphy, 4/25)

Veterans Affairs Secretary David Shulkin said there has been a sharp decline in the number of veterans who can't get through when they call the department's suicide hotline. A report from the Office of the Inspector General published in March that found nearly a third of calls to the VA crisis hotline were being forwarded to an outside service or just not being answered. (Firozi, 4/24)

The Department of Veterans Affairs prescribes Joshua Lee a lot of pills – 9,828 a year by his count ... Reached for a response, VA spokesman James Hutton, said there was no way the agency could prescribe marijuana, which remains illegal under federal law. But the VA has been quietly researching marijuana’s viability as a treatment. (Glantz, 4/25)

Last May, at the height of the Democratic presidential campaign, two weeks before the California primary, Bernie Sanders flew to San Bernardino, Calif., for a meeting with leading AIDS groups. The gathering was arranged by Peter Staley, the esteemed activist and founder of the Treatment Action Group, which in the 1990s helped speed the development of antiretroviral drugs. The meeting was called to secure the Sanders campaign’s support for a spike in federal spending to combat AIDS, but as the session began, those in attendance were puzzled to find the conversation oddly strained. Sanders’s demeanor, Staley recalled, “was very wary — he was very chilly when we shook hands.” Sanders seemed to be churning internally about something until, dispensing with ceremony, he blurted out: “Let me be blunt. Do any of you get money from the drug companies?” The question was met with an awkward silence. (Glazek, 4/26)

Pediatric researchers in Philadelphia have developed a system mimicking the environment in a mother’s womb that could provide new hope for survival and illness prevention in premature babies. The research team at the Children’s Hospital of Philadelphia call the system the “biobag.” It consists of a container made of inert plastic and electrolyte fluid that serves as substitute amniotic fluid. It also contains a device  that allows the baby’s heart to pump blood via the umbilical cord and acts in place of the placenta, continually exchanging oxygen and carbon dioxide. (Eversley, 4/25)

So far the device has only been tested on fetal lambs. A study published Tuesday involving eight animals found the device appears effective at enabling very premature fetuses to develop normally for about a month. "We've been extremely successful in replacing the conditions in the womb in our lamb model," says Alan Flake, a fetal surgeon at Children's Hospital of Philadelphia who led the study published in the journal Nature Communications. (Stein, 4/25)

The Food and Drug Administration ordered 14 companies to stop making bogus claims about cancer cures — including asparagus extract, exotic teas and topical creams for pets — or face possible product seizures and criminal prosecution. The letters covered more than five-dozen unapproved products that the companies touted as preventing, treating or curing cancer, a violation of federal law, the agency said. The items included pills, ointments, oils, drops, teas and diagnostic devices. (McGinley, 4/25)

A 'superbug' fungus is emerging as a new menace in U.S. hospitals, mostly in New York and New Jersey. First identified in Japan in 2009, the fungus has spread to more than a dozen countries around the globe. The oldest of the 66 cases reported in the U.S. dates back to 2013, but most were reported in the last year. (Stobbe, 4/25)

After its unsuccessful push to reconfigure the US health care system, the Trump administration has signaled that it will turn its attention to tax reform. While the details of the administration’s plan are still unclear, President Trump has indicated in the past a willingness to embrace measures that would greatly favor the wealthy, including tax cuts for the rich and a repeal of the estate tax. (Bor and Galea, 4/25)

Researchers in Germany have found that getting drunk is associated with abnormal heart rhythms. Their study was conducted in a place teeming with potential research subjects. "Basically we were sitting over a beer or two, ironically, and talking about how to design a study about relevance of alcohol consumption on heart rate," remembers Dr. Moritz Sinner, an assistant professor of medicine at University Hospital Munich. "This was summer [2015], and Oktoberfest happens in the fall." (Hersher, 4/26)

Noa [Shulman] is part of the first clinical trial in the world to test the benefits of medicinal marijuana for young people with autism, a potential breakthrough that would offer relief for millions of afflicted children — and their anguished parents. Calling all frequent travelers! Join our new travel insights panel, Embark There is anecdotal evidence that marijuana’s main non-psychoactive compound — cannabidiol or CBD — helps children in ways no other medication has. Now this first-of-its-kind scientific study is trying to determine if the link is real. (Schwartz, 4/25)

It was the middle of the night on a Saturday when Rob and Jessica Lott’s daughter, Shuli, awoke with deep, ragged coughs and trouble breathing. The Lotts were visiting Philadelphia for the weekend from D.C., and neither parent wanted to wait until Monday to see their pediatrician. But would this rise to the level of an emergency-room visit? And would an ER experience upset their sick toddler even more? (Gale, 4/25)

In her 30s, Sophie Marat, now 42, used to record herself reading poetry aloud, then play it back to hear if she sounded like a woman. Ms. Marat, who is transgender, had spent years trying to remake her voice in private by speaking in a higher pitch but ultimately felt that her efforts were hopeless. “I was feeling like changing my voice to match my gender identity was almost impossible,” she said. “It was terrible.” (Saint Louis, 4/25)

New York's mental health leaders are uniting to condemn psychological treatments designed to alter the sexual orientation of a minor. The New York State Psychiatric Association, the New York State Psychological Association and National Association of Social Workers' New York chapters on Tuesday urged lawmakers to outlaw conversion therapy, in which a counselor or psychologist attempts to change a minor's sexuality. (4/25)

New Hampshire lawmakers are trying to push through a last-minute effort this session to address the state’s ongoing shortage of treatment for those battling severe mental illness. The proposal has the strong support of Governor Chris Sununu. (Sutherland, 4/25)

When mentally ill inmates in New York City's Rikers Island jail become too sick, violent, delusional or suicidal for the jail to handle, they're sent to Bellevue Hospital Prison Ward for treatment. The inmates in Bellevue are awaiting trial for a variety of offenses, ranging from sleeping on the subway to murder. But for Dr. Elizabeth Ford, a psychiatrist who treats them, the charges against her patients are secondary. (Gross, 4/25)

Public health officials announced Tuesday that for the first time in New Hampshire, the synthetic opioid carfentanil was found in the blood of three residents who died from overdoses. The drug is approximately 100 times more potent than fentanyl, and is commonly used as a tranquilizer for large animals, including elephants. (Bookman, 4/25)

Timothy Pifer, director of the state forensic lab, said the state had just received confirmation that carfentanil was the cause of death. "Our biggest fear was that carfentanil would make its appearance in New Hampshire, and unfortunately we have documented its presence today," he said. When asked if other states had reported the drug, he said, “At present time I am not aware of carfentanil being confirmed in any of the other New England states.” (Solomon and Grossmith, 4/25)

Two men in Manchester died from the drug on March 11 and March 13 and another man in Meredith overdosed on the drug on March 13, according to New Hampshire Attorney General Gordon MacDonald. State officials said the New Hampshire Medical Examiner was able to confirm the link to carfentanil on Tuesday and said there have been no arrests in the deaths so far. (Nilsen, 4/25)

Massachusetts has received an $11.7 million federal grant to fight opioid addiction, as the state continues to wrestle with an overdose epidemic that has claimed thousands of lives in recent years, Governor Charlie Baker’s administration said Tuesday. The grant from the Substance Abuse and Mental Health Services Administration will support a number of treatment and recovery programs, including initiatives to help at-risk women who are pregnant and inmates scheduled to be released, the administration said in a statement. (Andersen and Geanous, 4/25)

The New York state Senate has passed a new collection of bills aimed at battling the state's increasing rates of opioid and heroin abuse. The Senate on Monday passed eight bills to staunch heroin, opioid and synthetic drug use that lawmakers and Gov. Andrew Cuomo have declared a statewide crisis. (4/25)

The State Senate on Monday (April 24) passed legislation designed to reduce the abuse and diversion of opioid pain medications like oxycodone and hydrocodone, drugs that have contributed to an unprecedented health crisis in the U.S. over the past decade. The bill now heads to a House committee for approval. (Lipinski, 4/25)

According to official records, more than 1,000 people in South Florida overdosed last year on opioids including heroin and carfentanil -- a drug so potent it’s used as an elephant tranquilizer. The growing threat of the opioids epidemic is mobilizing law enforcement and community leaders to form new partnerships and collaborate in events such as last week's discussion hosted by Florida Atlantic University (FAU). (Stein, 4/25)

The U.S. Drug Enforcement Administration has organized a  take-back day from 10 a.m. to 2 p.m. Saturday. The DEA has partnered with thousands of state, local and tribal law enforcement and community partners to provide more than 150 drop-off sites around Northern California and hundreds more throughout the nation. (Gomez, 4/25)

State health officials confirmed Monday that the number of measles cases has reached 20. The confirmed cases are in kids in Hennepin County's Somali community, which has historically been fed inaccurate information by anti-vaccination advocates. (Weber and Siple, 4/25)

Arizona firefighters gathered outside the state Capitol on Tuesday to call for an expansion of health-care coverage to treat conditions that could arise later in life. Firefighters have been working with Arizona legislators for several months to pass House Bill 2161 and House Bill 2410, both of which would expand workers' compensation insurance coverage for first responders. (Dantuono, 4/25)

The Democratic-led Illinois House defied a veto threat by the state’s Republican governor by passing legislation on Tuesday to expand state-funded coverage of abortions for low-income residents and for state employees. (4/25)

In order to keep bills alive, lawmakers have to get their bills passed through at one chamber of the General Assembly - either the House or the Senate - before midnight Thursday. That means packed committee meetings and late evenings. (Knopf and Hoban, 4/26)

Four years ago, a woman with severe mental illness poured a pot of boiling water over Michael Sorenson as he sat in his wheelchair at a Bloomington group home, leaving him with burns covering 35 percent of his body. This week the Minnesota Court of Appeals ruled that the group home operator cannot claim legal immunity under a 1967 state law and shield itself from more than $1 million in potential civil damages. (Serres, 4/25)

A healthcare consultancy and outsourcing organization plans to bring 200 new jobs to Cleveland within the next three years at its new patient coordination center east of downtown. Known as RelateCare, the organization is a joint venture established in 2013 between the Cleveland Clinic and RigneyDolphin, an Irish telecommunications service provider. (Christ, 4/25)

Jim Hinton took the helm as the new chief executive officer of Baylor Scott & White Health in January, succeeding Joel Allison, who led the organization for 23 years. (Rice, 4/25)

Students at UC Davis can now purchase emergency contraception from a campus vending machine. The machine, installed at the school’s Activities and Recreation Center over spring break, dispenses the morning-after pill as well as condoms, pregnancy tests, tampons and over-the-counter medication such as Advil. (Parvini, 4/25)

Two displaced Syrian doctors have received full-tuition scholarships worth $65,000 each to attend the Johns Hopkins Bloomberg School of Public Health. (McDaniels, 4/25)

A major supplier of home oxygen equipment has agreed to pay $11.4 million to settle accusations that it profiteered by filing false reimbursement claims with the government and arranging kickbacks with sleep-testing clinics, federal officials said Tuesday. Justice Department and health care officials announced the settlement with Pacific Pulmonary Services, which is based in Novato and has more than 100 outlets in 20 states. (Egelko, 4/25)

A mobile health company has reached a $2.5 million settlement with the Department of Health and Human Services, in the first case of its kind involving the protection of health records. CardioNet, a Malvern, Pa.-based subsidiary of BioTelemetry that operates a mobile monitoring system for patients diagnosed with cardiac arrhythmia, will pay the settlement for not properly securing sensitive patient data and for possibly violating federal privacy laws. (Reid, 4/24)

The city of Boston will deploy "trauma response and recovery teams" to several neighborhoods in the aftermath of violent incidents, as part of a new program announced Tuesday. The teams will connect residents in Roxbury, Dorchester, Jamaica Plain, East Boston and Mattapan who have been victims of or exposed to violence -- like homicides, shootings or stabbings — with mental health services and ongoing support. (Creamer, 4/25)

Medical marijuana advocates in Texas are promoting support from more conservative sources to push longshot legislation that would ease pot laws in a state that's lagging behind much of the rest of the country on medical marijuana. Conservative Christian mothers of autistic children and veterans suffering post-traumatic stress disorder rallied outside the state Capitol on Tuesday, entreating the Republican-majority Legislature to advance two bills legalizing medicinal cannabis, one by San Antonio Democratic Sen. Jose Menendez and one by Rep. Eddie Lucio III, a Brownsville Democrat. (4/25)

Cherie Rineker, a terminally ill cancer patient, tried marijuana to ease her pain and vomiting. But she had to go to Colorado to do it, she said at a press conference here to urge lawmakers to get moving on a trio of medical cannabis bills stalled in Texas House and Senate committees. (Mejia Lutz, 4/25)

Class action attorney Steve Berman is coming after a drug industry he says is “gouging” the American consumer. And his suits have the potential to crack the lid on the black box of drug pricing, shedding light on a secretive process that has sparked an escalating blame game between drug makers and the many middlemen in the US health care system. Berman sees the drug pricing system as a Rube Goldberg machine for extracting money from patients: Pharma sets a high price for a given medication, and then promises a big, undisclosed rebate to the pharmacy benefits managers who control which drugs get covered by insurers. (Garde, 4/20)

The rising pressure on drug pricing has shifted to the companies that were supposed to guard against rampant increases.A dispute between two of the most important companies in the health-care industry, Express Scripts Holding Co., the largest pharmacy benefit manager, and health insurance giant Anthem Inc., has shown in stark terms how profitable some relationships have become. That will give more ammunition to critics of the system. (Grant, 4/25)

The battle over rising drug prices has become a full-blown he-said-she-said. Drug companies have pointed the finger at middlemen in the health-care system, saying they not only benefit from rising drug prices but contribute to their increases. Those middlemen — namely, pharmacy benefits managers (or PBMs) — have said the only parties responsible for drugs' list prices are the manufacturers. So who's right? (Tirrell, 4/19)

Anthem's decision to cut ties with its long-time pharmacy benefit manager Express Scripts, saying it withheld billions in cost savings, is bound to turn up the heat on PBMs over the soaring cost of prescription drugs. (Livingston, 4/25)

A hotly anticipated hearing takes place at the US Supreme Court on Wednesday about biosimilars and the eventual decision is expected to have widespread implications for health care costs. At issue are some of the complex procedures found in the Biologics Price Competition and Innovation Act that are supposed to determine when lower-cost biosimilar medicines, which are highly identical versions of expensive biologics, can be launched. And one brand-name drug maker, Amgen, is squabbling with Sandoz, a generic company, over competing interpretations of two provisions. (Silverman, 4/25)

Pharmaceutical and biotech acquisitions totaled $44 billion last quarter, down 13 percent from a year earlier, and 35 percent below the first quarter of 2015, according to data compiled by Bloomberg. And exchange-traded funds, a good indicator of investors’ appetite in a sector because they typically track an index, are seeing about half as much trading volume in health care as three years ago, data show.Part of the reason is that President Donald Trump dashed hopes for a new biotech boom. Once thought friendlier to the industry than his Democratic campaign opponent, he’s since attacked drugmakers and vowed to force down their prices. (Hopkins, 4/21)

Before he was elected, then-candidate Donald Trump promised to take on big pharma lobbyists and the prescription drug price-fixing he claimed consumers were paying the price for. But what — if anything — can he do now that he's president? (Hanssen, 4/25)

Rising drug prices remain a top concern for health system leaders, according to a new survey.Premier, Inc.’s spring Economic Outlook Survey polled 91 people representing a variety of roles in U.S. health systems, including physicians, C-suite members and supply chain management professionals.Almost every respondent agreed that increasing pharmaceutical prices pose a significant challenge to their operations. In addition, more than 90% said they would likely experience continued drug shortages over the next three years. (Minemayer, 4/25)

South Korea’s Samsung conglomerate won approval from U.S. regulators Friday for a lower-priced copy of the blockbuster rheumatoid-arthritis drug Remicade, clearing the way for Samsung to begin selling complex pharmaceuticals in the world’s biggest drug market. (Cheng and Rockoff, 4/21)

The Western world’s first gene therapy is soon to become but a footnote in biotech history, doomed by minuscule demand and a colossal price. But its failure has hardly dampened the enthusiasm of the scientists and biotech companies betting that gene therapy’s best days are ahead. The therapy, made by the Dutch biotech UniQure, treats a one-in-a-million rare disease called familial lipoprotein lipase deficiency and has been used exactly once since winning European approval in 2012, the company said. That’s in part because it costs about $1 million for a one-time dose, a price that made it nearly impossible to get insurance coverage, as MIT Technology Review reported last year. (Garde, 4/21)

Almost a dozen top administration officials, including the vice president and two Trump family members, are scheduled to meet next month with drug companies and government scientific researchers at the White House, according to an agenda obtained by Bloomberg. Vice President Mike Pence, President Donald Trump’s daughter Ivanka Trump and his son-in-law Jared Kushner will attend the May 8 summit, along with the head of the U.S. National Institutes of Health, executives from Celgene Corp. and Regeneron Pharmaceuticals Inc., and leaders of top research universities and hospitals. (Hopkins, 4/21)

The Competition Commission of India has ordered an investigation into charges that Roche tried to block a more affordable biosimilar version of its Herceptin breast cancer drug. Although the agency did not issue a final opinion, its order suggested that Roche moved to eliminate competition after reviewing communications the drug maker sent to the Drugs Controller General of India and the National Pharmaceutical Pricing Authority, as well as doctors and hospitals. (Silverman, 4/25)

When prescribing medications, caring for children poses a particular challenge. They’re not just little adults. Their still-developing brains and bodies metabolize drugs differently, and what works for grown-ups can yield radically different — and sometimes dangerous — results in kids. (Luthra, 4/24)

Following setbacks with an important cancer drug, Bristol-Myers Squibb reorganized some key managerial slots last week and, as part of the shuffling, chief strategy officer Emmanuel Blin will leave in June, according to a memo written by chief executive officer Giovanni Caforio. The drug maker is integrating all commercial functions into one organization and Murdo Gordon, who is the chief commercial officer, will expand his responsibilities to include both worldwide oncology commercial activities and specialty drugs. (Silverman, 4/24)

If Mr. Trump wishes to show he’s serious about his populist promise, the place to start is by declaring war on the price gougers. The key power is found in the “import relief” law — an important yet unused provision of the Medicare Modernization Act of 2003 that empowers the Food and Drug Administration to allow drug imports whenever they are deemed safe and capable of saving Americans money. The savings in the price-gouging cases would be significant. Daraprim, the antiparasitic drug whose price was raised by Mr. Shkreli to nearly $750 per pill, sells for a little more than $2 overseas. The cancer drug Cosmegen is priced at $1,400 or more per injection here, as opposed to about $20 to $30 overseas. The remedy is simple: The government can create a means for pharmacies to get supplies from trusted nations overseas at much lower prices. Doing this would not only save Americans a lot of money but also deflate the incentive to engage in abusive pricing in the first place. (Tim Wu, 4/20)

The purpose of penalties such as fines and jail time is to address and correct perpetrators’ bad behaviors, whilst signaling to others that illicit behavior will not be tolerated – “crime will not pay.” However, when it comes to the business of counterfeit prescription medications, law enforcement falls far short as an effective deterrent. (Steve Pociask, 4/26)

In losing Anthem Inc. as a client, Express Scripts Holding Co. is surrendering more than just its biggest customer and 18 percent of its revenue. Its very identity is now at risk. The PBM on Monday night said it expected to lose Anthem's business at the end of 2019 after a long, bitter pricing dispute. Through Monday's trading, Express Scripts shares had fallen more than 20 percent since the Anthem squabble began in December 2015 -- so this news was somewhat priced into the stock.  (Max Nisen, 4/25)

Reducing the cost of medical care, rather than health insurance, is so often underemphasized or even absent from discussions of reforming the health care system. And yet lowering costs of medical care is essential for broadening access to care, reducing insurance premiums and ultimately ensuring better health. (Atlas, 4/20)

Cardinal Health Inc. on Tuesday announced a $6.1 billion deal for a Medtronic PLC medical supplies unit. But this deal was overshadowed by the gruesome earnings forecast Cardinal released at the same time. The company warned 2017 earnings will be at the low end of its already lowered guidance and said 2018 would miss Wall Street expectations. Cardinal shares fell 12 percent on Tuesday.That's bad news for the drug distributor and its peers McKesson Corp. and AmerisourceBergen Corp. as they enter earnings season. It also confirms a multi-year price crunch in generic and specialty drugs may not be going anywhere soon -- just as the market for such assets appears to be getting hot. Buyer beware.  (Max Nisen, 4/19)

Pharmaceutical companies need an intervention to address their addiction to prescription drug price gouging. Californians should demand that Big Pharma be more transparent about drug-pricing habits and put an end to pharmaceutical industry practices that state Sen. Ed Hernandez says “literally rape the American people at the expense of the taxpayer.” (4/24)

The rising cost of prescription drugs in Oregon should worry us all. I often hear from neighbors and constituents about the real challenges of out-of-pocket costs for prescription medicines. Given that the clock usually resets for a patient's insurance deductible responsibility in January, this time of year can be especially difficult for Oregon families who depend on expensive prescription drug treatments. (Bill Kennemer, 4/21)

Novartis AG's consideration of a spinoff or sale of its Alcon eye-care business just got serious; Bloomberg News reported Thursday the company has hired Bank of America to review its options. It's eminently reasonable for the company to consider it, as my colleague Chris Hughes and I wrote when the company aired the notion in January. The declining business has become more trouble than it's worth. And Novartis could use the money to supplement its growing generics business, or to bolster its all-important pharma division as its best-selling medicine Gleevec faces generic competition. (Max Nisen, 4/20)

Rather than renew their failed effort to repeal and replace Obamacare, President Donald Trump and congressional Republicans should move on to another aspect of health care: the need to contain costs and improve value. Such a shift would allow them to be far more productive. For many if not most Americans, cost trends and value matter more than what’s happening on the individual insurance exchanges. Progress on this front would raise people’s take-home pay and improve the nation’s long-term fiscal balance, while also constraining the growth in premiums for those who buy insurance on the exchanges. (Peter R. Orszag, 4/25)

The recent U.S. House decision to pull the first iteration of the American Health Care Act (AHCA) off the floor doesn’t necessarily mean efforts to reform health care are at an end. As members of Congress work to develop legislation that will change the current health care system, they must develop policy that ensures people with pre-existing conditions will receive coverage without additional costs in premiums, deductibles or coinsurance for their pre-existing condition. (John Meigs Jr., 4/26)

On the campaign trail, Donald Trump’s proposal on health care was nebulously perfect. Obamacare — that is, the Affordable Care Act — would be gone, he told his cheering supporters, replaced by something cheaper, better and more expansive that wouldn’t be burdened by the hated word “Obama.” When it came time to deliver on that promise, very early in his administration, the bill that was offered up was somewhat distant from that target. (Philip Bump, 4/25)

President Trump had hoped to celebrate his 100-day mark by boasting of his success in obliterating his loser predecessor’s signature domestic accomplishment — and in replacing it (naturally, since Trump is a winner) with something that delivers more and better health care for less money. Instead, one of his chief 100-day accomplishments may be that he’s in the process of making Obamacare more popular. A new Post-ABC News poll finds that 61 percent of Americans now favor keeping and improving the Affordable Care Act, while only 37 percent favor repealing and replacing it. Crucially, it also finds that huge majorities reject the ideas at the core of the latest version of the GOP replacement that Trump is championing. (Greg Sargent, 4/25)

A Tennessean article this year highlighted the efforts of a Nashville-based company to promote health care price transparency. ... Consumer empowerment in health care requires reliable price information. Online price comparison websites will be a critical building block in harnessing free market forces to control health-care spending. (Rick Abramson, 4/25)

We’ve already seen that repealing Obamacare is politically perilous. Now there’s a new complication: It may also violate international law. The United Nations has contacted the Trump administration as part of an investigation into whether repealing the Affordable Care Act without an adequate substitute for the millions who would lose health coverage would be a violation of several international conventions that bind the United States. It turns out that the notion that “health care is a right” is more than just a Democratic talking point. (Dana Milbank, 4/25)

In March, it was discovered that the Mayo Clinic's CEO, John Noseworthy, had asked staff to "prioritize . . . commercially insured patients" over those covered by Medicare or Medicaid. Observers described the message as being in poor taste but surprising only because someone publicly discussed the policy—not that hospitals were trying to bring better-paying patients through their doors, even when those hospitals are not-for-profit organizations that receive tax exemptions in return for providing community benefits. (Elizabeth Whitman, 4/24)

Gov. Scott Walker, in response to Health and Human Services Secretary Tom Price’s request for states to “innovate” their Medicaid programs, has laid out a proposal that would decrease access to health care for our most vulnerable, humiliate and marginalize those with addiction, and increase government bureaucracy. The core elements of the proposal include charging premiums, co-payments for unnecessary ER visits, work requirements for non-disabled adults, maximum enrollment periods, and, most sensationally, drug testing of Medicaid recipients. (Rebecca Bernstein, 4/25)

Here’s what Singapore’s conservative admirers get right: Singapore really is the only truly universal health insurance system in the world based on the idea that patients, not insurers, should bear the costs of routine care. But Singapore isn’t a free market utopia. Quite the opposite, really. It’s a largely state-run health care system where the government designed the insurance products with a healthy appreciation for free market principles — the kind of policy Milton Friedman might have crafted if he’d been a socialist. Unlike in America, where the government’s main role is in managing insurance programs, Singapore’s government controls and pays for much of the medical system itself — hospitals are overwhelmingly public, a large portion of doctors work directly for the state, patients can only use their Medisave accounts to purchase preapproved drugs, and the government subsidizes many medical bills directly. (Ezra Klein, 4/25)

The Democrats’ unity tour fractured into disunity almost immediately after it began. Senator Bernie Sanders of Vermont refused to say whether Jon Ossoff, the Democratic candidate trying to win a typically Republican district in Georgia while being outspoken in support of abortion rights, counts as a progressive. He then went on to stump for Heath Mello in Nebraska. Mr. Mello, who is running for mayor in Omaha, has sponsored legislation aimed at restricting women’s access to abortion, including a bill in 2009 that required women to be informed that they could look at ultrasounds of their fetuses. (Bryce Covert, 4/25)

Senator Bernie Sanders is not usually considered a moderating force within the Democratic Party, but at the moment he is playing that role on abortion policy. It’s not that he has any pro-life sympathies: He has been co-sponsoring the Freedom of Choice Act as a senator for more than two decades. But he has been willing to support Democrats who are not in lockstep with abortion-rights advocates, and some of those advocates have been fuming as a result. (Ramesh Ponnuru, 4/25)

It’s time for the Hispanics to rise up and call for an end to the scourge of abortion in our communities. Year after year, about 22 percent to 25 percent of all abortions are performed on Latino women. ... We cannot let this dark stain on the consciousness of our nation go unnoticed. (Alfonso Aguilar, 4/25)

As a family physician dedicated to helping my patients and their families live their healthiest lives, I am saddened and disheartened by our lawmakers' continued assault on the right to safe and accessible health care. Once again, our state Legislature has shown intent to criminalize and further stigmatize abortion. Instead of attacking abortion care, which most Texans believe should be accessible in their communities, I hope our tax dollars can support legislation that restores trust in doctors and allows us to practice medicine in accordance with our professional judgment and training and in the best interest of all Texans. (Robin Wallace, 4/25)

For too long, there’s been a stigma attached to mental illness in the United States and elsewhere. It’s especially bad for men, who are supposed to solve problems in this git-’er-done society of ours. Feelings? Fears? We’re supposed to swallow those, keep them bottled and buried. If they start to fight their way to the surface, you’re supposed to drown them in alcohol or play five rounds of golf every week or shut yourself away from family in your workshop or man cave. (Patrick Donnelly, 4/25)

Over his first 100 days in office, President Trump has set a new direction for the country in a variety of areas, from Defense policy to health care and federal hiring. One by one, he has been making good on his campaign promises. He is burnishing his pro-life credentials as well as proving his drive to innovate and put America back in a position of global leadership. Next on the president’s list should be a new director for the National Institutes of Health. (David A Prentice, 4/25)

As New Jersey Governor Chris Christie takes the lead in crafting the Trump administration’s response to the opioid crisis, he and his colleagues need to understand that we can’t fix the problem until we kick our long-term addiction to the war on drugs and accept overdoses for what they are: a health issue. Although the majority of Americans who consume illicit drugs do so without addiction, opioid overdose has become a deadly reality. Every day, 120 to 140 people in the US die from drug overdoses, more than from gunshot wounds or car accidents. About 90 of these are due to opioids. (Marc Krupanski, 4/25)

When a federal patent court ruled that the nonprofit Broad Institute of MIT and Harvard could legally license its version of the CRISPR-Cas9 genome-editing system, it opened the door to millions of dollars of revenue for the institute. It also contributed to the seismic shift occurring in science whereby tax-exempt research institutes established under an emerging model of “free market philanthropy” can amass money to further their research and protect their commercial interests. ... But it is the Broad’s handling of its own CRISPR business and partnerships that threaten to undermine its nonprofit mission. These relationships can challenge the concept of “public interest,” such as when the Broad sells CRISPR licenses to Monsanto for agricultural applications, since a sizable fraction of the public may not agree that genetically modified crops serve the public interest. Or it might not be in the public interest when a favored corporation reaps a financial benefit, such as when the Broad sells exclusive licenses for CRISPR to Editas Medicine, a company that was spun out of the institute. (Jim Kozubek, 4/25)

It’s a tragedy whenever a child dies needlessly of a disease that is both preventable and treatable. Sadly, that happens daily around the globe, due mainly to a raft of infectious diseases. One of these is diphtheria. It is still a killer mainly because the treatment for it is no longer made and stockpiles of it are aging and dwindling. (Mark Klepner, 4/26)

While recreational marijuana use has been legalized or decriminalized in nine states and 30 allow it for medicinal purposes, Iowa continues to limp along behind the curve. Our state has yet to get an effective, legally enforceable medical marijuana law. (Rekha Basu, 4/25)