Morning Briefing
Summaries of health policy coverage from major news organizations
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鈥楤reakthrough鈥 Leukemia Drug Also Portends 鈥楺uantum Leap鈥 In Cost
A genetically altered cancer drug, based on CAR T-cell therapies, could be a big success with leukemia patients but at a staggering cost.
Summaries Of The News:
Health Law
Senate Hearings To Shore Up Marketplaces Set For When Lawmakers Return From Recess
The Senate health committee will hold two hearings early next month on how the nation's individual health insurance marketplaces can be stabilized, as party leaders grasp for a fresh path following the collapse of the Republican effort to repeal and replace much of former President Barack Obama's health care law. GOP and Democratic leaders are exploring whether they can craft a bipartisan but limited bill aimed at curbing rising premiums for people who buy their own insurance. (Fram, 8/22)
鈥淓ighteen million Americans, including 350,000 Tennesseans 鈥 songwriters, farmers, and the self-employed 鈥 do not get their health insurance from the government or on the job, which means they must buy insurance in the individual market,鈥 said Sen. Lamar Alexander, the Tennessee Republican who chairs the Senate Health, Education, Labor and Pensions Committee. 鈥淢y goal by the end of September is to give them peace of mind that they will be able to buy insurance at a reasonable price for the year 2018,鈥 Alexander said. (Collins, 8/22)
The Senate's Health Committee will聽hear from state insurance commissioners and governors about聽how to stabilize the ObamaCare exchanges during two hearings next month. State insurance commissioners will testify on聽Sept. 6, while governors will appear before the panel the following day. (Hellmann, 8/22)
The bipartisan hearings mark a stark change in direction on health care policy for the Senate. Republicans spent the first seven months of the year trying to roll back the Democrats鈥 2010 health care law by themselves, using the budget reconciliation process. (McIntire, 8/22)
With Congress on recess, U.S. Sen. Ted Cruz is taking full advantage of the time away from Washington, D.C. by crisscrossing Texas and focusing on a familiar message: it's past time to repeal Obamacare. Even though the U.S. Senate in late July rejected the latest so-called "skinny repeal," Cruz is continuing to tell Texans during stops over the last two weeks that the fight goes on. (Wallace, 8/22)
Kasich, Hickenlooper 'Getting Very Close' To Unveiling Bipartisan Health Plan
Ohio Gov. John Kasich (R) and Colorado Gov. John Hickenlooper (D) are working on a bipartisan proposal to stabilize ObamaCare that they say could be unveiled as soon as a week from now. 鈥淲e鈥檙e getting very close,鈥 Kasich said in a joint interview with Hickenlooper on Colorado Public Radio. 鈥淚 just talked to my guys today, and men and women who are working on this with John鈥檚 people, and we think we鈥檒l have some specifics here. John, I actually think we could have it within a week.鈥 (Sullivan, 8/22)
Staff for Colorado Gov. John Hickenlooper, a Democrat, and Ohio Gov. John Kasich, a Republican, are working on a joint plan to stabilize the country's health insurance markets. ... The plan will flesh out a set of principles the two men wrote about in an op-ed in The Washington Post, in which they said another one-party health care plan is "doomed to fail," just like the Republican plans considered this year. (Estabrook, 8/22)
In other news聽鈥
A bipartisan group in the House calling themselves the Problem Solvers Caucus is leading an effort to reform Obamacare. The roughly 40 members of the caucus are focused on stabilizing the system while avoiding raising the federal deficit. (Rainey, 8/22)
Thousands Likely To Drop Coverage If Feds Don't Approve Stopgap Plan, Iowa Officials Say
Iowa on Tuesday聽submitted to the federal government a final request to make changes to try to shore up its struggling ObamaCare insurance marketplace. The plan from the Iowa Insurance Division is intended to be a short-term market stabilization solution to entice more insurers into the marketplace. The state is facing what it calls a 鈥渃ollapse鈥 of its ObamaCare marketplace after all but one insurer declined to offer plans for 2018. (Weixel, 8/22)
If federal officials reject Iowa鈥檚 鈥渟topgap鈥 insurance plan, tens of thousands of consumers are likely to drop coverage because of staggering premium increases, the state insurance commissioner warned. Commissioner Doug Ommen filed a formal, 192-page proposal Monday to federal health care administrators. ... Ommen estimated that under current rules, 18,000 to 22,000 Iowans would drop their individual policies and become uninsured next year. The commissioner unveiled a draft of his proposal in June. The stopgap plan would reconfigure Obamacare subsidies to give some assistance to people above the current income threshold, which is about $48,000 for a single person. (Leys, 8/22)
Iowans facing health insurance premium increases of 57 percent or more will have a chance to air their grievances to the state鈥檚 insurance commissioner Saturday. They鈥檒l likely gain the commissioner鈥檚 sympathy, but not much relief. Commissioner Doug Ommen has said that without federal intervention, there is little he can do to rein in skyrocketing premiums for individual health insurance policies. (Leys, 8/22)
Meanwhile, in Texas聽鈥
Dave Milich, a longtime UnitedHealthcare executive, took the reins of his company's employer-sponsored health plans in Texas and Oklahoma in April. With the insurance industry at the center of the white-hot debate raging these days about the nation's health care, Milich spoke with the Houston Chronicle this week about the challenges his company faces and how it is preparing for the future amid such turbulence. (Deam, 8/22)
Trump Doesn't Name Names, But Takes Jab At McCain For Health Care Vote
President Donald Trump put the Republican Party on notice on Tuesday evening 鈥 implicitly attacking two Republican senators on their home turf, threatening a government shutdown over his border wall, and demanding that senators kill the filibuster because it's impeding his agenda. ...聽Trump did not name Sen. John McCain or Sen. Jeff Flake by name in his remarks 鈥 he joked that his aides pleaded with him not to mention the senators explicitly 鈥 but it was unmistakable who he was talking about. Over and over, Trump noted that Senate Republicans were "one vote away" from passing a bill to repeal Obamacare. The crowd at the Phoenix Convention Center immediately began jeering McCain, a longtime Trump critic who delivered the tie-breaking vote that sank the overhaul bill.聽The 80-year-old McCain is being treated for brain cancer. (Isenstadt, 8/23)
Raising the subject of the failed GOP effort to repeal and replace Obamacare, Trump repeatedly noted that the Senate fell 鈥渏ust one vote away from victory after seven years of everyone proclaiming 鈥榬epeal and replace.鈥 One vote,鈥 he said, referring to McCain. At that, a member of the audience screamed 鈥淭raitor,鈥 seemingly referring to the Navy veteran who spent years as a Vietnam War prisoner before going into politics.Trump, in a sarcastic tone, characterized Flake as an inconsequential senator.鈥淣obody wants me to talk about him,鈥 Trump said. 鈥淣obody knows who the hell he is.... See, I haven鈥檛 mentioned any names and now everyone is happy.鈥 (Decker, 8/22)
惭别补苍飞丑颈濒别听鈥
What was supposed to be a town hall meeting in Detroit on health care and the need for good jobs transformed into a campaign-like rally featuring former presidential candidate U.S. Sen. Bernie Sanders and U.S. Rep. John Conyers. Sanders, an independent from Vermont, started his remarks decrying the white supremacist rally that happened in Charlottesville, Va., that left three people dead and 19 injured,聽and President Donald Trump's reaction to it. (Gray, 8/22)
Marketplace
Chicago-Area Presence Health To Become Part Of Amita
Chicago-based Presence Health has signed a letter of intent to merge into Ascension, combining the largest Catholic-sponsored healthcare system in Illinois with the nation's largest Catholic health system, the companies announced Tuesday. If the deal is completed, 12-hospital Presence will be owned by Ascension but operate in a joint venture called Amita Health that Ascension already has with Adventist Midwest Health. (Barkholz, 8/23)
Presence Health has agreed to be acquired in a deal that will make it part of Amita Health, expanding the system to 19 hospitals in the Chicago area. No money will change hands in the deal that was announced Tuesday, though Ascension will take on Catholic hospital system Presence's liabilities, Presence President and CEO Michael Englehart said Tuesday. Presence has faced financial challenges in recent years. (Schencker, 8/22)
鈥淭he mission, values and history of Presence Health clearly align well with those of Ascension, as both systems are dedicated to caring for all, with special attention to persons living in poverty and those most vulnerable,鈥 Anthony R. Tersigni, Ascension president and chief executive, said in a news release. (8/22)
鈥淪ince we brought together Alexian Brothers Health System and Adventist Midwest Health to form AMITA Health two years ago, we鈥檝e always looked for opportunities to add like-minded partners with similar values to our system,鈥 said Mark Frey, CEO of AMITA Health. (Liss, 8/22)
Public Health
The Eclipse Was An Expensive Two Minutes For Hospitals, Even Though Nothing Really Happened
For hospitals nationwide, Monday鈥檚 solar eclipse was an expensive two minutes. St. Charles Health System in central Oregon canceled elective surgeries to get ready for a rush of patients and increased emergency and acute care staff by nearly 40 percent. In southwestern Illinois, Red Bud Regional Hospital added on-call staff and security, and held several weeks of training sessions for clinicians. (Ross and Thielking, 8/22)
For those who witnessed the Great American Eclipse on Monday and are wondering whether they could have developed vision issues, here are a few things to know about post-eclipse eye health. First, if you used proper eclipse glasses to view the sun, you should be fine, according to Dr. Avnish Deobhakta, an ophthalmologist at the New York Eye and Ear Infirmary of Mount Sinai. (Khan, 8/22)
The Next Battlefield On The War Against Opioids: Veterinarians' Offices
Some states are taking the war on opioids into veterinarians鈥 offices, aiming to prevent people who are addicted to opioids from using their pets to procure drugs for their own use. Colorado and Maine recently enacted laws that allow or require veterinarians to check the prescription histories of pet owners as well as their pets. And Alaska, Connecticut and Virginia have imposed new limits on the amount of opioids a vet can prescribe. (Mercer, 8/23)
Just before Christmas 2015, child psychiatrist Daniel Nelson noticed an unusual number of suicidal kids in the hospital emergency room. A 14-year-old girl with a parent addicted to opioids tried to choke herself with a seat belt. A 12-year-old transgender child hurt himself after being bullied. And a steady stream of kids arrived from the city鈥檚 west side, telling him they knew other kids 鈥 at school, in their neighborhoods 鈥 who had also tried to die. (Murgia, 8/22)
And in other news on the epidemic聽鈥
The private Facebook group for the Bridge 鈥 a wearable medical device claiming to help opioid users overcome the pain of withdrawal 鈥 feels like a recovery meeting. Doctors sing the device鈥檚 praises. Patients describe it as a miracle and offer to help spread the gospel. The Food and Drug Administration cleared the device, which sends small electrical pulses through four cranial nerves, for treatment of chronic and acute pain three years ago. Now, doctors from Alaska to Florida are charging $600 to $1,500 or even more to attach it to patients鈥 ears in a bid to curb the intense nausea, anxiety, and aches of opioid withdrawal. (Blau, 8/23)
ore than 4,100 people fatally overdosed in Ohio in 2016, even though state officials spent nearly $1 billion to combat the crisis. That prompted Gov. John Kasich this spring to announce that $20 million would be devoted to funding new research related to opioid abuse. ...Ohio鈥檚 Third Frontier Commission, an economic development initiative focused on tech startups, recently asked companies to submit funding requests. Over the summer 44 initial proposals flooded into the commission. These proposals have come from all kinds of applicants 鈥 doctors and device makers, biotech execs and engineers, scientists and recovery advocates 鈥 working on solutions as wide-ranging as the people touched by the opioid crisis. (Blau, 8/23)
Perhaps the one good thing about an overdose is that it might scare a drug abuser聽into going straight. But new research shows that鈥檚 usually not聽the case. The number of people filling painkiller聽prescriptions in the six months after treatment for an opioid overdose declined about 10 percent, according to a study of Pennsylvania Medicaid records published Tuesday. Meanwhile, rates of medication-assisted treatment, considered the gold standard for opioid addiction, went up 12 percent. (Sapatkin, 8/22)
Deaths in Harford County this year related to overdoses of heroin and other opioids soared past the total for all of 2016 in the past week, and the problem is expected to get even worse, the county Sheriff's Office reported. With more than four months left in 2017, the Sheriff's Office said there were 299 reported overdoses as of Tuesday, 59 of them fatal. That tally included 11 opioid related overdoses in the previous week, including one fatality. (Anderson, 8/22)
Company Claims Heating, Rather Than Burning, Cigarettes Drastically Cuts Cancer Risk
The nation鈥檚 biggest tobacco company wants to move smokers away from conventional cigarettes to a new product that鈥檚 heated rather than burned 鈥 but first it needs聽a green light聽from the government. Philip Morris聽International has聽petitioned the Food and Drug Administration (FDA) for approval to sell IQOS, which it calls a 鈥渓ess risky鈥 smoke-free tobacco product, in the United States. (Wheeler, 8/23)
If you're a woman, there's a good chance you've used Johnson's Baby Powder at some point. It smells good, and it can keep you dry. But is it dangerous? Dr. Daniel Cramer says yes. He's a professor of obstetrics and gynecology at Brigham and Women's Hospital in Boston. He says talc 鈥 the mineral in talcum powder 鈥 can cause ovarian cancer. "Overall, women may increase their risk in general by about 33 percent by using talc in their hygiene," Cramer says. (Kodjak, 8/22)
Being a world-class distance runner in your youth does not guarantee that you will be fit and healthy in retirement. But it helps, according to a new study that followed a group of elite American runners for 45 years. The study鈥檚 findings raise interesting questions about how we can and should age and the role that youthful activity might play in our health later in life. (Reynolds, 8/23)
Els van der Heijden, who has cystic fibrosis, was finding it ever harder to breathe as her lungs filled with thick, sticky mucus. Despite taking more than a dozen pills and inhalers a day, the 53-year-old had to stop working and scale back doing the thing she loved best, horseback riding. Doctors saw no sense in trying an expensive new drug because it hasn't been proven to work in people with the rare type of cystic fibrosis that van der Heijden had. (8/23)
Health IT
For $39 A Month, This 'Woebot' May Fill Gaps For Patients Who Can't See A Therapist
Fifty years ago, an MIT professor created a chatbot that simulated a psychotherapist. Named Eliza, it was able to trick some people into believing it was human. But it didn鈥檛 understand what it was told, nor did it have the capacity to learn on its own. The only test it had to pass was: Could it fool humans? (Lien, 8/23)
What if I told you there was a way to use technology to save an estimated $100 billion to $300 billion dollars a year in health care spending in the U.S.? That's the estimated cost incurred because people don't take the medications they're prescribed. A number of companies are now selling wireless "smart" pill bottles, Internet-linked devices aimed at reminding people to take their pills. But recent research suggests that actually changing that behavior may take more than an electronic nudge. (Silverman, 8/22)
In other health technology news聽鈥
Healthcare organizations praised the CMS for proposing greater flexibility in electronic health record requirements under the Merit-based Incentive Payment System track of MACRA and asked the agency to standardize EHR requirements across incentive programs. The Healthcare Information and Management Systems Society, the American Hospital Association, the American Health Information Management Association and others supported CMS' proposed 2018 performance year rule's change that would allow clinicians to continue to use 2014 edition certified EHRs for another year, potentially saving them the effort of updating and installing new software. (Arndt, 8/22)
State Watch
State Highlights: Ohio Legislature Mulls Bill Banning Down-Syndrome Related Abortions; Mental Health Experts Struggle With Chicago's Gun Violence
Senators on the Health, Human Services and Medicaid Committee are considering Senate Bill 164, sponsored by Sen. Frank LaRose, a Hudson Republican and secretary of state candidate, which would ban abortions if medical tests show a fetus may have Down syndrome. People who terminate such pregnancies would face fourth-degree felony charges. (Hancock, 8/22)
In 2016, there were more than 4,000 shootings and 762 homicides in the city, according to the Chicago Police Department 鈥 a nearly 60 percent increase from 2015. ... Between 2009 and 2012, the state cut $113.7 million in funding for mental health services, according to National Alliance on Mental Illness鈥 (NAMI) Chicago branch. (Connelly Holmes, 8/22)
Earlier this year, the legislature passed a package of reforms meant to expand access to mental health treatment. New Hampshire's Department of Health and Human Services is having mixed success soliciting vendors to oversee those changes 鈥 they鈥檝e received multiple proposals for some projects but none for others. (McDermott, 8/22)
An Orange County Superior Court jury began deliberating Tuesday whether a 79-year-old Lake Elsinore man was legally insane the day he fatally shot his former Newport Beach doctor in 2013. On Monday, the 12-member jury swiftly convicted Stanwood Elkus, a retired barber, of first-degree murder in the slaying of Dr. Ronald Gilbert, who had been Elkus鈥 urologist years earlier. Prosecutors said Elkus used a fake name to get an appointment in Gilbert鈥檚 Newport office, where he shot the 52-year-old physician 10 times after he walked into the exam room. (Fry, 8/22)
Doctors at Children鈥檚 Hospital Colorado hope to launch as many as 25 new clinical trials in the next six months after a recently signed federal law opened the floodgates to test experimental cancer drugs for children .鈥淭he pediatric oncology community is really excited,鈥 said聽Dr. Lia Gore, the director of Children鈥檚聽Center for Cancer and Blood Disorders. While there are hundreds of cancer drugs in development to treat adults, research on pediatric cancer drugs has historically lagged. Gore聽said essentially only four new drugs have been approved to treat childhood cancer since 1979. (Ingold, 8/22)
In 2016, there were 165 total infant deaths in Franklin County, 8.7 deaths per 1,000 births, according to Columbus Public Health. ... Numbers from this year are beginning to show some improvement: From Jan. 1 through the end of June, 72 babies died in Franklin County. That鈥檚 on pace for a nearly 13 percent reduction from last year鈥檚 165 total baby deaths. (Perry, 8/23)
House Bill 438 requires a half hour of instruction in organ donation as part of the regular health class curriculum in every school district. ... The bill's passage was great news for Lifebanc, a locally-based non-profit organization that educates and facilitates organ donation in 20 Ohio counties. (Morice, 8/22)
A federal appeals court has increased a judgment obtained by the former Lorain County coroner and General Health District health director, after a jury found that he was wrongly fired and endured retaliation. A jury in May 2016 originally awarded Paul Matus $1.36 million -- $1 million of which was for his retaliation claim. (Heisig, 8/22)
Hennepin county officials, with millions more in grant money, are looking for families living with lead paint in their homes. The county is getting $3.4 million from the U.S. Department of Housing and Urban Development to fund the grants. (Moylan, 8/22)
Prescription Drug Watch
Expensive Cholesterol Drugs' Value Falls Short Of Their Eye-Popping Price Tag, Doctors Say
A new analysis of the latest type of cholesterol-lowering drugs finds that prices would have to drop by more than two-thirds 鈥 to about $4,500 a year 鈥 for the medicines to be cost effective. The findings were made after assessing discounted prices and results of a recent clinical trial that studied cardiovascular outcomes for one of the two available medicines, which are known as PCSK9 inhibitors. One drug is sold by Amgen (AMGN), while the other is marketed jointly by Sanofi (SNY) and Regeneron Pharmaceuticals (REGN). The analysis was published in the Journal of the American Medical Association. (Silverman, 8/22)
When doctors talk about a new leukemia drug from Novartis, they ooze enthusiasm, using words like 鈥渂reakthrough,鈥 鈥渞evolutionary鈥 and 鈥渁 watershed moment. 鈥滲ut when they think about how much the therapy is likely to cost, their tone turns alarmist. 鈥淚t鈥檚 going to cost a fortune,鈥 said Dr. Ivan Borrello at Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore. (Szabo, 8/23)
Makers of over-the-counter drugs may soon pay for federal review of their products, just like pharmaceutical makers. And they鈥檙e fine with the change. After聽years of discussion, the Food and Drug Administration 鈥 which is holding another stakeholder meeting on the topic Wednesday afternoon 鈥 appears poised to make that change as part of a sweeping overhaul of its regulations for OTC products. (Sheridan, 8/23)
Agene therapy for a rare disease is unlikely to come cheap, so one fledgling biotech recently reached out to experts for insights into winning over cost-conscious hospitals. And to lure these experts to a so-called advisory meeting, the company used an enticing pitch 鈥 each attendee would be given a $3,000 honorarium, along with paid airfare and lodging for two-day session in November. However, AveXis (AVXS) dangled something else: The compensation would not be reported to a federal database to which industry must submit payments made to physicians. Known as OpenPayments, the database was launched three years ago in response to concerns that medical practice and research may be unduly influenced by financial relationships between doctors and drug and device makers. (Silverman, 8/22)
Michel Vounatsos, Biogen鈥檚 new chief executive, is in a tough position. A letter sent to the company by two House Democrats on Thursday as part of an investigation into high prices of multiple sclerosis drugs provides an illustration. Among other things, the congressmen are requesting information on rebates, discounts, coupons, and patient assistance charity programs that the company uses to help sell its products. (Grant, 8/18)
The Samsung conglomerate is furthering its efforts to build a full-fledged prescription-drugs business, signing its first deal to develop novel drugs for hard-to-treat diseases. Samsung, best known for its smartphones and television sets, is forming a partnership with Takeda Pharmaceutical Co. of Japan to jointly fund and develop multiple treatments in coming years, the companies said in a written statement. The companies plan to begin immediate development of a drug to treat severe acute pancreatitis. (Martin and Rockoff, 8/21)
Specialty pharmacy firm US Bioservices Corp has agreed to pay $13.4 million to settle U.S. government claims that it pushed patients to refill prescriptions of Novartis AG's iron overload drug Exjade in exchange for referrals from the Swiss drugmaker. (Pierson, 8/22)
Age isn鈥檛 just a number. For older people, it can often mean having one or several age-associated diseases. But a growing cache of research suggests that by homing in on the cellular mechanisms of aging, it is possible to ward off diseases associated with getting older. Likewise, a growing cadre of entrepreneurs and investors has emerged to support the quest for longer, healthier lives. (Mack, 8/22)
Novartis AG began testing a new anti-malaria pill in Africa, advancing development of an alternative to its most effective treatment that billionaire philanthropist Bill Gates said risked losing potency. Patients聽in Mali infected with the mosquito-borne parasite began receiving the experimental drug, known as KAF156, in combination with another medicine, the drugmaker said Monday. More than 500 children and adults across nine countries in Africa and Asia will be enrolled聽in the mid-stage study over the next few months. (Paton, 8/21)
Generic drug prices may be depressed enough to bring down the mood of many a copycat drugmaker, but that doesn鈥檛 mean prices on some unusual formulas aren鈥檛 going up. Just ask Hikma Pharmaceuticals, which posted a half-dozen big price rises just this month. (Staton, 8/21)
Over the objections of Doctors Without Borders, the Indian government has awarded a patent to Pfizer (PFE) for its best-selling Prevnar 13 pneumococcal vaccine, a move the advocacy group says will restrict access to many patients for nearly a decade. In reaching its decision, the Indian Patent Office determined the Pfizer patent was sufficiently unique to merit protection, even though Doctors Without Borders filed paperwork last year arguing otherwise. The patent 鈥渄oes not meet the inventive step requirement [and] it ought to have been rejected,鈥 the advocacy group wrote in a statement after the government decision was announced. (Silverman, 8/22)
Less rowdy than the sputtered push for single-payer healthcare and less fraught than the battle over Obamacare鈥檚 future, the concern over the cost of prescription drug prices has been overshadowed for the past year by the marquee healthcare battles gripping Sacramento and Washington. ...聽The price disclosure bill , SB 17 by state Sen.聽Ed Hernandez聽(D-Azusa), is now one of five measures that have been proposed to tackle prescription costs, forcing the drug industry to fend off multiple threats. (Mason, 8/20)
As the state legislature returned to work in Sacramento Monday, lawmakers were considering a number of bills intended to restrain the rise of health care prices, including one that would require drug makers to notify the public before raising the price of certain medications. 聽...聽If the bill passes, next year the state鈥檚 insurance regulators will keep an annual list of the 25 mostly costly drugs, the 25 most commonly prescribed drugs, and which 25 drugs鈥 prices went up the most. (Faust, 8/21)
Saying they鈥檙e tired of waiting for Congress to act, Democrats in the state House of Representatives unveiled a proposal today that they hope will stop pharmaceutical companies from boosting the prices of prescription drugs. They want to create a Prescription Drug Consumer Protection Board that would review increases in prescription drug prices and, if they find the price hikes unjustified, ask the Michigan Attorney General to investigate the matter. (Graym 8/21)
A retired Atlantic City firefighter and two pharmaceutical representatives pleaded guilty in federal court in Camden on Friday to their roles in a $28 million prescription drug benefits scheme that prosecutors say ensnared Shore firefighters, police officers, teachers, and a state trooper. Michael Pepper, 45, of Northfield, N.J., a 10-year veteran of the Atlantic City Fire Department, pleaded guilty to participating in a conspiracy to defraud public health benefits with a kickback scheme involving compounded prescription benefits. His role netted him $113,000, prosecutors said, which is now subject to forfeiture. (Rosenberg, 8/18)
They lost in California, but that hasn鈥檛 stopped activists from waging a referendum war in Ohio against the big pharmaceutical companies. If approved by voters in November, Ohio agencies and state-assisted programs would be required to buy prescription drugs at prices no higher than what the U.S. Department of Veterans Affairs pays for them 鈥 typically 20 to 24 percent less than the usual price. (Howell, 8/21)
State House and Senate Democrats on Monday called for creating a new 鈥渃onsumer protection鈥 board to discourage prescription drug price spikes and shed light on costs they claim are 鈥渙ut of control鈥 in Michigan. Legislation set for introduction next month would require pharmaceutical companies to provide the board with explanatory documentation if they want to raise wholesale prices on a drug here by 10 percent in one year or 30 percent over five years. (Oosting, 8/21)
Perspectives: Congressional Investigation Into MS Drugs Is A Pageant We've Seen Before
Things are about to get awkward for makers of drugs targeting multiple sclerosis. On Thursday afternoon, House Democrats聽sent letters聽to prominent biopharma companies that sell MS treatments including Biogen Inc., Novartis AG, Roche Holding AG, and Sanofi, demanding a variety of information about the large and, according to the letters, often seemingly concerted price hikes they have taken as part of an "in-depth investigation." As would be expected, the news sparked a decline in the drugmakers' shares. (Max Nisen, 8/18)
Their price monopolies are likely to be extended under a draft executive order promising 鈥済reater intellectual property protection鈥 in multilateral and bilateral trade agreements. The North American Free Trade Agreement, for example, has already been pegged to harmonize foreign intellectual property standards to reflect those found in the United States. Canada, it seems, will be the first target of U.S. indoctrination. (Brook K. Baker and Katrina Geddes, 8/21)
Biosimilars -- the equivalent of generic drugs for complicated and expensive medicines made by living cells -- are supposed to reduce prices and save the health care system billions of dollars聽by finally bringing competition to blockbuster drugs. But as Bloomberg News has chronicled,聽they've been slow to gain traction.聽聽Groundwork for an acceleration may come as soon as September.聽That's when the two biggest pharmacy benefit managers, CVS Health Corp. and Express Scripts Holding Co. -- middlemen that negotiate with drugmakers to lower prices for health plans -- will provide an update about which drugs that treat inflammatory conditions they'll cover and which聽they'll exclude in favor of聽competitors. Among those drugs is Remicade, Johnson & Johnson's best-selling medicine, which faces聽two biosimilar competitors. (Max Nisen, 8/17)
Congressional Democrats recently released "A Better Deal," their new economic platform. It calls for many reforms, such as expanding vocational programs and strictly enforcing anti-trust laws, that would benefit working-class Americans. But one of the proposals -- letting the government "negotiate" Medicare prescription drug prices -- would be disastrous. If it were implemented, 40 million Americans with Medicare drug coverage could lose access to vital prescriptions. That's not a better deal. (Gary A. Puckrein, 8/22)
Republican efforts to repeal and replace Obamacare may have collapsed, but as Northern Trust economists Carl R. Tannenbaum and Ankit Mital wrote in a note published Friday, there鈥檚 a broader healthcare debate that still needs to happen. 鈥淐overage and care for the roughly 20 million people covered by the ACA are very important,鈥 the economists wrote. 鈥淏ut a total of 330 million Americans are in need of better and more economical health care. Congressional debate needs to 颅颅take much wider perspective on the topic.鈥 (Yuval Rosenberg, 8/21)
The Seattle biotech Omeros (OMER) has long told investors it has a potential blockbuster on its hands in OMS721, an experimental drug aimed at treating patients with rare blood and kidney diseases. So why won鈥檛 the company answer questions about its clinical data? I鈥檝e been trying for months to get answers on key points: How many patients have been dosed with the drug in clinical trials? And is there any proof at all that the drug can be administered via subcutaneous injection, rather than intravenous drip 鈥 which is a key selling point for Omeros? (Adam Feurstein, 8/22)
Editorials And Opinions
Different Takes: Medicare's Troubles; What About Insurers And Preexisting Conditions?
Medicare鈥檚 trust fund will run out of money in just over 10 years, according to a new report from the program鈥檚 trustees. Once that happens, the federal government won鈥檛 collect enough in payroll taxes to cover beneficiaries鈥 hospital bills. Congress could hike taxes to cover the shortfall. Or it could ration care to save money. Or it could modernize and restructure Medicare 鈥 by giving beneficiaries means-tested vouchers to buy private insurance. Doing so would protect taxpayers now, preserve the program for future generations and even provide higher-quality care to seniors. (Sally Pipes, 8/22)
One of the principal achievements of the Affordable Care Act was its prohibition on denying insurance coverage to patients with pre-existing conditions. Under the ACA, insurance companies must sell polices to people with chronic diseases and charge the same premiums paid by healthy people. (Craig Blinderman, 8/22)
Blue Cross Blue Shield of North Carolina this month lowered its 2018 premium rate increase request for individual market policies. The revised request 鈥 14.1 percent, down from 22.9 percent 鈥 comes after Blue Cross鈥檚 claims data show that the market is stabilizing and costs are getting under control. (Brendan Riley and Allison Rice, 8/21)
Now that efforts to dismantle Medicaid and the ACA have hit a wall, our state has the opportunity to follow this example by working collectively to strengthen the health system for everyone by ensuring all Georgians have health care coverage. There are an estimated 300,000 to 600,000 Georgians who are stuck in the state鈥檚 coverage gap because they do not qualify for Medicaid and are too poor to buy health insurance through the ACA鈥檚 insurance exchange. Expanding our state鈥檚 Medicaid program, as 31 other states have done, would mean that these friends and neighbors would share the same ability to go to the doctor and benefit from financial protection from large medical bills as you and I. (Laura Colbert, 8/22)
Now that efforts to dismantle Medicaid and the ACA have hit a wall, our state has the opportunity to follow this example by working collectively to strengthen the health system for everyone by ensuring all Georgians have health care coverage. There are an estimated 300,000 to 600,000 Georgians who are stuck in the state鈥檚 coverage gap because they do not qualify for Medicaid and are too poor to buy health insurance through the ACA鈥檚 insurance exchange. (Laura Colbert, 8/22)
Viewpoints: Those Tired Old Politics Of Birth Control; Doctors' Responsibility To Respond To Climate Change
The Affordable Care Act requires health insurance offered by employers to cover birth control. The provision has saved women millions of dollars and is credited with helping reduce unintended pregnancies and abortions. Yet some religious groups objected to the mandate. The Obama administration responded by creating a 鈥渨orkaround,鈥 allowing women to obtain coverage for contraception if their employers refused to pay for it. Also, the U.S. Supreme Court ruled, in a case brought by Hobby Lobby, that 鈥渃losely held鈥 private companies can invoke religious objections to avoid covering contraception. The issue was settled. (8/22)
The new managers of University of Louisville Hospital are considering the politically charged question of whether to grant two local clinics an agreement the state says they need to provide abortions. Ken Marshall, hospital president and CEO, on Tuesday told members of the board who took over management July 1 that both Planned Parenthood of Indiana and Kentucky Inc. and EMW Women's Surgical Center have requested "transfer agreements" under which they could transfer patients to the hospital in an emergency. (Deborah Yetter, 8/23)
Public health research is one of the casualties of the recent partisan policy debates on climate science and the war over international agreements. Because mortality and morbidity estimates show dire connections with climate change indicators like heat waves, episodes of unexpected flash flooding, extreme storm events, and the like, this retreat from the climate reality is a critical mistake that will cost this country lives and billions of dollars. (Gary W. Yohe and Kristie L. Ebi, 8/22)
Cheyllyn Ranae Collinsworth, an 18-year-old Washington state resident, died in May following a car crash. The person responsible was driving under the influence of marijuana and has been charged with vehicular manslaughter. In states where marijuana is legal, car collisions are up 3%, according to the Highway Loss Data Institute. Although marijuana impairs driving ability, police knew the driver in Washington had been using the drug only because he confessed. (Ethan Siegel and Alex Berezow, 8/22)
President Trump announced on Aug. 8 that the federal government will adopt a law and order mindset to deal with heroin and prescription opioid abuse, calling it 鈥渁 problem the likes of which we have never seen.鈥 He said that the United States needs stricter law enforcement and a southern border wall to keep drugs out of the country. Unfortunately, harsh laws that target nonviolent drug users have never worked, and this crackdown will fail as well. (Dylan Moore, 8/23)
Preparing a child for college begins years before he or she sets foot on campus. Money is saved for tuition, hours are spent on homework and extracurricular activities, and visits are made to campuses. And while it may seem a small detail, one act of early preparation is vital, and that is being up-to-date on immunizations, and particularly for meningitis. Meningitis is a serious and sometimes deadly disease that causes inflammation of the lining of the brain and spinal cord. (Swagata Banik, 8/23)
Just as Susan Burton was getting her life back together, it fell apart again. It was 1981 when her 5-year-old son was killed in a car accident. The young mother began drinking to cope with her depression. She started taking Valium, then cocaine and crack. A year after her son's death, she was in federal prison, serving 13 months for drug possession. When Burton was released, she says, a prison guard predicted her return. As she walked out, the guard told her that the system had a "bed waiting for you, Burton," she recalled years later. "You'll be back." (Lottie Joiner, 8/22)
Move over, low-fat diets. More and more experts are recommending plant-based diets to reduce the risk of heart disease and other chronic conditions such as diabetes and cancer. But are all plant-based diets equally beneficial? And must they be all-or-none eating strategies, or is there a role for a semi-vegetarian or 鈥渇lexitarian鈥 approach? (Hena Patel and Kim Allan Williams Sr., 8/22)