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Alex M. Azar II, President Trump’s nominee for secretary of health and human services, said Tuesday that he was wary of proposals for the government to negotiate drug prices for Medicare beneficiaries, an idea endorsed by Mr. Trump in the 2016 campaign. But Mr. Azar said that in some situations, he was willing to look at proposals to negotiate prices for a limited number of medicines. (Pear, 1/9)

Alex Azar, a former pharmaceutical and government executive, acknowledged to the Senate Finance Committee that drug prices are too high and said he'd work to lower them if confirmed as secretary of Health and Human Services. But he said allowing Medicare to negotiate drug prices across the board would risk restricting choice for patients, since the government would have to establish an approved list of discounted medications. (Alonso-Zaldivar, 1/9)

In that first hearing, Azar stuck to traditionally conservative policy ideas like encouraging the development of more generic drugs, including “a viable and robust biosimilar market,” and limiting abuses of the patent system. This time, however, he hinted that he is open to other policies that might go further to address the list prices that drug makers charge. “There’s no silver bullet here, though, I want to be very clear. There’s not one action that all of a sudden fixes this,” he said. (Mershon, 1/9)

Azar appeared before the Senate Finance Committee on Tuesday, which will ultimately decide whether to move his nomination forward. Azar also vowed to uphold Obamacare as long as it remained the law but said that the program needed changes. "I believe I have a very important obligation to make the program work as well as possible," Azar said during the wide-ranging hearing that lasted more than two hours. "What we have now is not working for people." (Abutaleb, 1/9)

Mr. Azar said in a hearing before the Senate Finance Committee that his past position as president of an Eli Lilly & Co. affiliate gives him a unique advantage in tackling drug costs. “From having worked for the last several years in that space—this is such a complex area, the learning curve for any other individual would be so high,” Mr. Azar said. Bringing down consumer prices would be a central goal, he said, adding, “There is no silver bullet here, I want to be very clear.” Democrats said they had concerns about Mr. Azar’s views on the Affordable Care Act and Medicaid spending, as well as his tenure in the pharmaceutical industry. (Armour, 1/9)

The panel’s top Democrat, Sen. Ron Wyden (Ore.), laid out the Democratic argument against Azar during his opening remarks. Wyden pointed to four different drugs, including ones for heart disease and ADHD, saying they more than doubled during Azar’s tenure at the company. “This morning the committee will likely hear that this is just the way things work — it’s the system that’s to be blamed,” Wyden said. “My view is, there’s a lot of validity in that. The system is broken. Mr. Azar was a part of that system.” (Roubein, 1/9)

Kaiser Health News: HHS Nominee Vows To Tackle High Drug Costs, Despite His Ties To Industry

Azar countered that the nation’s pharmaceutical drug system is structured to encourage companies to raise prices, a problem he said he would work to fix as head of HHS. “I don’t know that there is any drug price of a brand-new product that has ever gone down from any company on any drug in the United States, because every incentive in this system is towards higher prices, and that is where we can do things together, working as the government to get at this,” he said. “No one company is going to fix that system.” (Huetteman, 1/9)

The minority party’s efforts during the Senate Finance Committee hearing did not appear to halt his path toward joining the president’s Cabinet. Republicans bestowed superlatives on Azar and highlighted his senior roles at the Department of Health and Human Services for a half-dozen years in the early 2000s. And during nearly 2½ hours of questioning, the nominee delivered a polished, informed performance in the witness chair, assuring senators, who have at times felt slighted by administration officials, that he is eager to work with them. (Goldstein and Eilperin, 1/9)

The expected confirmation of Alex Azar, who appeared before a Senate panel Tuesday, would put the conservative policy expert in charge of rewriting the rules of the U.S. health care system with a broad mandate to use the powers to the fullest. And following a tumultuous year marked by failed Obamacare repeal efforts and the abrupt resignation of Trump’s first HHS secretary, Republicans think Azar can ably get the Trump administration’s health agenda on track. “Mr. Azar will be the administration’s primary policy driver,” Senate Finance Committee Chairman Orrin Hatch (R-Utah) said during Azar’s confirmation hearing. “I believe his record shows that he is more than capable of leading HHS through these next few consequential years.” (Cancryn and Karlin-Smith, 1/9)

President Trump is a commander in chief who fuels himself with a steady stream of Diet Cokes, scoops of vanilla ice cream and slabs of red meat. He gets as little as five hours of sleep a night. He is not known to exercise more than the brief strolls beyond his cart on the golf course. This, he and his aides have maintained, is the very picture of presidential stamina. On Friday, Mr. Trump, 71, will undergo his first comprehensive physical examination as president, and the first formal check on his former doctor’s Trumpian 2015 campaign claim that he’d be the “healthiest individual ever elected” to the office. (Rogers and Altman, 1/9)

Trump raised concern last month when he slurred some words on national TV. When asked about it, White House press secretary Sarah Huckabee Sanders said questions about Trump's health were "frankly, pretty ridiculous" and blamed his slurred speech on a dry throat, "nothing more than that." More questions have been raised in the weeks since, given the tone of some of his tweets and the reported comments of some of the people who deal with him day to day. (Superville, 1/9)

The Centers for Disease Control and Prevention (CDC) says it “has not banned, prohibited, or forbidden” the use of certain words in official documentation, the agency director says in response to concerns from Senate Democrats. Democrats had been concerned, they said last month, “that the Trump Administration is yet again prioritizing ideology over science” after reports claimed agencies within the Department of Health and Human Services (HHS) had banned employees from using words including “fetus,” “vulnerable” and “science-based.” (Weixel 1/9)

Secretary of State Rex Tillerson will order a special panel to investigate the U.S. response to mysterious illnesses that have stricken American diplomats and their relatives in Havana. The Federal Bureau of Investigation and the State Department have been probing the incidents in recent months after the administration said they resulted from attacks. Now, Mr. Tillerson will take the further step of establishing an independent board of the same type that was set up after the 2012 attack on the U.S. consulate in Benghazi, Libya, a senior diplomat told lawmakers on Tuesday. (Schwartz, 1/9)

President Trump signed an executive order Tuesday aimed at expanding mental-health care for transitioning veterans as they leave the military, in an effort to reduce suicides in a group that is considered particularly at risk. The order will take effect March 9 and is expected to provide all new veterans with mental-health care for at least a year after they leave the military. Trump gave the Defense Department, the Department of Homeland Security and the Department of Veterans Affairs 60 days to iron out details and develop a joint plan, Veterans Affairs Secretary David Shulkin said in phone call with reporters. (Lamothe, 1/9)

Veterans who have recently left the military are between two and three times more likely to commit suicide than active duty service members, and nearly 20% of veterans returning from Iraq and Afghanistan suffer from post-traumatic stress disorder or depression. The order directs the departments of Defense, Homeland Security and Veterans Affairs to submit a plan within 60 days to provide “seamless access to mental health treatment and suicide prevention resources.” "We want them to get the highest care and the care they so richly deserve," Trump said. (Slack, 1/9)

Sen. Lamar Alexander (R-Tenn.) says he spoke to President Trump on Monday about a bipartisan bill aimed at stabilizing ObamaCare markets and that Trump again expressed his support for the measure. Alexander told reporters Tuesday that Trump asked about the bill when the two appeared together at an event in Tennessee on Monday. Alexander said he told the president he would get back to him after meeting with Sens. Patty Murray (D-Wash.) and Susan Collins (R-Maine) this week. (Sullivan, 1/9)

The chances of repealing ObamaCare this year are fading further, with top Republicans saying they hardly discussed repeal of the law during a Camp David retreat last weekend focused on their 2018 agenda. Meanwhile, Republicans say talk of welfare or entitlement reform this year is also narrowing down to an emphasis on things like job training, not the broad overhaul of Medicare, Medicaid and other entitlements that Democrats have warned against. (Sullivan, 1/10)

The Trump administration has agreed to pay $3 million to settle lawsuits filed against the Affordable Care Act's mandate for contraception coverage, BuzzFeed News reported on Tuesday. The amount went to the law firm Jones Day, which represented dozens of groups that sued the Obama administration over the mandate, according to BuzzFeed. (Delk, 1/9)

Dozens of insurers have sued the federal government to recoup hefty payments from a temporary program designed to protect them from huge losses in the early years of the Obamacare markets. But budgetary constraints Republican lawmakers imposed on the program, known as risk corridors, have led to a $12.3 billion shortfall, causing some insurers to hike premiums, abandon the marketplaces or even shut down. (Demko, 1/9)

State lawmakers in Maryland are looking to replace ObamaCare's individual mandate, which was repealed by Republicans in Congress last month. A proposal in Maryland would require people to pay a penalty for not having insurance. The money, though, could be used as a down payment for a health insurance plan. (Hellmann, 1/9)

Maryland lawmakers, worried about skyrocketing insurance premiums, have proposed creating a state-level individual mandate — and using fines levied on the uninsured to help put more people on the insurance rolls. Last month, congressional Republicans repealed the federal individual mandate at the heart of the Affordable Care Act. Now that it’s going away, a coalition of Democratic state lawmakers say the best solution is to have the uninsured pay Maryland a fine that would be used as a “down payment” on health insurance coverage on the state’s exchange. (Cox, 1/9)

While health insurance sign-ups through the Affordable Care Act dipped slightly across the nation for 2018, Floridians bought plans at nearly the same levels as last year despite a much shorter enrollment period, a smaller budget for promotion and repeated efforts to kill the program. Florida led all states with 1.75 million people signing up for Obamacare plans during the Nov. 1 to Dec. 15 open enrollment period. (Griffin, 1/10)

Colorado’s health insurance exchange, where people shop to buy health plans on their own, is on pace for record enrollment. Through Monday, more than 158,000 people have selected a plan on Connect for Health Colorado. That is 2 percent above last year’s figures at the same time, according to the exchange. And it puts the exchange in position possibly to break last year’s all-time high of nearly 176,000 plan selections. Friday is the deadline to sign up for a plan on Connect for Health Colorado or through an independent broker in order to have coverage in 2018. (Ingold, 1/9)

It was an anxious Christmas and New Year's for the Belt family. Tracy and B.J. Belt for years have lived paycheck to paycheck, as B.J.'s truck-driving job at a quarry in the hills around Morgantown hasn't left much for luxuries. But this holiday season, the Belts had a new worry. Their two boys, Bobby and Dylan, may soon be uninsured, leaving 11-year-old Bobby without the costly medicine and blood monitors he needs to control his Type 1 diabetes. (Levey, 1/9)

Lawmakers scrambling to fund the popular Children’s Health Insurance Program got an easy out after the CBO dramatically lowered its estimate of how much the program would cost. But even that may not produce a deal since the program’s fate is tangled up in the thorny politics of immigration and a government spending bill. (Pradhan, 1/9)

A federal judge on Tuesday set a goal of doing something about the nation’s opioid epidemic this year, while noting the drug crisis is “100 percent man-made.” Judge Dan Polster urged participants on all sides of lawsuits against drugmakers and distributors to work toward a common goal of reducing overdose deaths. He said the issue has come to courts because “other branches of government have punted” it. (Welsh-Huggins, 1/9)

“I don’t think anyone in the country is interested in a whole lot of finger pointing at this point, and I’m not either,” U.S. District Judge Dan Polster said Tuesday at the first gathering, in a Cleveland courtroom that was packed, of lawyers involved in the sprawling opioid litigation. Judge Polster is overseeing the consolidation of more than 200 cases filed in federal court by local governments, hospitals and other parties, all seeking to recoup the costs of opioid addiction from the manufacturers and distributors of the painkillers. (Randazzo, 1/9)

Three Native American tribes in the Dakotas are suing opioid manufacturers and distributors, alleging they concealed and minimized the addiction risk of prescription drugs. The Rosebud Sioux Tribe, Flandreau Santee Sioux Tribe and the Sisseton Wahpeton Oyate sued 24 opioid industry groups in federal court on Monday. Defendants include drug manufacturers Purdue Pharma, Teva Pharmaceutical Industries and Allergan, and distributors McKesson Corp., Cardinal Health Inc. and AmerisourceBergen Corp. (1/9)

Indian tribes in Minnesota, Wisconsin and the Dakotas are suing opioid manufacturers and distributors over the epidemic of addiction and overdoses that racks their reservations. Three North and South Dakota tribes filed suit in federal court Monday against two dozen companies. Minnesota’s Leech Lake Band of Ojibwe filed a similar suit in December, the same month the St. Croix Chippewa Indians of Wisconsin filed suit against the industries they accuse of minimizing nationwide abuse of prescription narcotics. (Brooks, 1/9)

Doctors at some of the country's largest hospital chains admit they went overboard with opioids to make people as pain-free as possible. Now the doctors shoulder part of the blame for the country's opioid crisis. In an effort to be part of the cure, they've begun to issue an uncomfortable warning to patients: You're going to feel some pain. (Farmer, 1/9)

Top Philadelphia officials are advocating that the city become the first in the U.S. to open a supervised injection site, where people suffering from heroin or opioid addiction could use the drugs under medical supervision. But the controversial proposal aimed at addressing the city's deadly drug crisis must first overcome resistance from top city police officials, community residents and the federal government. (Allyn, 1/10)

Another prominent Boston-area business leader is stepping up to address the state’s opioid crisis. The Kraft Center for Community Health at Massachusetts General Hospital — funded by New England Patriots owner Robert Kraft and his family’s charitable foundation — on Tuesday rolled out a specially equipped mobile van, dubbed CareZone, to bring health services to Boston residents who are struggling with addiction. The van will rotate between two locations in the city, one in the Dudley Square area and the other close to North Station. (Chesto, 1/9)

Last November voters in a dozen Ohio counties agreed to pay more taxes for children's services and health and human services to fight the fallout from the opioid epidemic. (Farkas, 1/9)

Public-health officials in northern Kentucky are investigating a jump in HIV cases among people who inject drugs, the region’s health department said Tuesday. The region, which includes four counties, recorded 37 new cases of HIV in 2017, up 48% from 25 cases in 2016, according to the Northern Kentucky Health Department. (Whalen and Campo-Flores, 1/9)

An "alarming" 50 percent surge in new HIV cases in Northern Kentucky in 2017 came with a huge rise in infections among injection drug users in Kenton and Campbell counties. Neither county has a needle exchange, and health officials Tuesday made a renewed call to action for those counties and the cities within them to approve exchanges to stop the spread of the virus that can cause AIDS. (DeMio, 1/9)

Senate Democrats are pushing for an extra $25 billion to be included in any final budget agreement to combat the opioid epidemic. Sens. Jeanne Shaheen and Maggie Hassan, a pair of New Hampshire Democrats who are leading the effort, said during a press conference Tuesday that the federal response to the crisis has been insufficient and negotiations over a long-term spending deal are an opportunity to change that. (Weixel, 1/9)

In its second hearing on the country’s raging drug crisis since President Trump directed the Department of Health and Human Services to declare the matter a public health emergency in October, the Senate health committee called a hearing with a single witness: a journalist. Such hearings conventionally spotlight high-profile government officials and career advocates with deep expertise in a subject. Every hearing this committee and a similarly health-focused House panel held to specifically address the opioid epidemic since 2016 has featured at least four witnesses. A committee press staffer did not answer questions about why Sam Quinones was the only witness at this full committee hearing. (Swetlitz, 1/9)

The congressman who saw his bid to become President Trump’s drug czar torpedoed by a bombshell story about the nation’s opioid epidemic is on the comeback trail. Rep. Tom Marino (R-Pa.) is facing a primary challenge against an opponent who plans to make drug legislation backed by the incumbent a key issue in the race. (Roubein, 1/10)

California health officials said Tuesday that the state's flu season could turn out to be one of the nastiest the state has seen in a long time. "This appears to be one of the worst seasons we've had in the last 10 years," state epidemiologist Dr. Gil Chavez said in a call with reporters. "We're early, and we're trending up." (Karlamangla, 1/9)

While a rise in the flu cases might not be out of the ordinary, what is different is the severity of the symptoms. ...According to DuPage County weekly influenza surveillance reports, 17 people were admitted to the intensive care units of county hospitals during the last two weeks of December, bringing the total number of admissions to 28 since Oct. 1. That's more than four times higher compared to the same period last year, when there had been only had six ICU admissions as of Dec. 31, 2016. (Baker, 1/9)

Seven more people in Dallas County have died from the flu, and North Texas may not have seen the worst of the deadly season yet, health officials said Tuesday. Dallas County Health and Human Services officials said it is too early to know if local cases have peaked or if they’re still on the rise. Flu cases typically peak between December and March. (Brumfield, Ballor and Branham, 1/9)

Where you live — in a city versus a rural area — could make a difference in how old you tend to be when you first have sex, what type of birth control you use and how many children you have. These are the findings from federal data collected using the National Survey of Family Growth, which analyzed responses from in-person interviews with more than 10,000 U.S. women, ages 18 to 44, between 2011 and 2015. (Neighmond, 1/9)

The reporting of clinical trial results to a public database — mandated by a 10-year-old federal law — has improved sharply in the last two years, with universities and other nonprofit research centers leading the way, according to a new STAT analysis of government data. Overall, trial sponsors had disclosed 72 percent of required results to the federal ClinicalTrials.gov database as of September 2017. That compares with 58 percent just two years earlier. (Bronshtein, 1/9)

For years, China’s drug industry concentrated on replicating Western medicines. ...The country is now pushing to play a bigger role in the global drug industry. Millions of people in China have cancer or diabetes, and the government has made pharmaceutical innovation a national priority. (Wee, 1/9)

The new head of a genome editing company whose main research lab is in Cambridge on Tuesday brushed aside an unpublished paper that raised concerns about preexisting immune responses to the biotech’s gene-editing technology, known as CRISPR. ...[Samarth] Kulkarni said the research paper will not delay CRISPR Therapeutics, which has almost all of its 120 employees in Cambridge, from beginning tests of a gene-editing therapy in clinical trials this year. (Saltzman, 1/9)

If HIV/AIDS patients wanted a life expectancy equal to uninfected people, all they had to do was take their medicine — on schedule, every single day, no exceptions. ...In the paper, researchers describe how they developed and tested what they call a "mini-pillbox," swallowed once a week as a capsule that remains in the stomach for seven days while it releases daily doses of medications to combat HIV. (Brink, 1/9)

Kaiser Health News: A Poor Neighborhood In Chicago Looks To Cuba To Fight Infant Mortality

Over the past few months, medical professionals on Chicago’s South Side have been trying a new tactic to bring down the area’s infant mortality rate: find women of childbearing age and ask them about everything.Really, everything. “In the last 12 months, have you had any problems with any bug infestations, rodents or mold?” Dr. Kathy Tossas-Milligan, an epidemiologist, asked Yolanda Flowers during a recent visit to her home, in Chicago’s Englewood neighborhood. “Have you ever had teeth removed or crowned because of a cavity?” (Bryan, 1/10)

Scientific research, mostly in animals, supports the idea that cannabis can effectively treat the nausea of cancer therapy, in addition to some types of cancer-related pain, according to the National Cancer Institute's cannabis information page. ...But here in Massachusetts, although medical marijuana has been legal for six years, it’s still a challenge for cancer patients to get a state-issued medical marijuana ID card, or then figure out what kind of cannabis to use. (Weintraub, 1/10)  

Facial exercises may significantly reduce some of the signs of aging, according to an interesting new study of the effects of repeating specific, expressive movements on people’s appearance. The study, published in JAMA Dermatology, found that middle-aged women looked about three years younger after a few months of exercising, perhaps providing a reasonable, new rationale for making faces behind our spouses’ backs. (Reynolds, 1/10)

Japanese astronaut Norishige Kanai told a tall tale. He said Monday on Twitter that he grew 3½ inches since arriving at the International Space Station on Dec. 19. Weightlessness has that effect ... But skepticism from a Russian colleague on board led Kanai to remeasure himself, and he found the more accurate spurt: two centimeters, or less than an inch. In his retraction later posted on Twitter, he called his inaccurate announcement “fake news,” The Japan Times reported. (Horton, 1/9)

About 700 more jobs will be cut at Dallas-based Tenet Healthcare by the second quarter as the nation’s third largest hospital operator pushes forward with a $250 million cost-cutting effort. The layoffs — expected to mainly affect staff in hospital operations and corporate positions that support those facilities — are in addition to the 1,300 jobs the for-profit hospital chain announced it would cut last year. (Rice, 1/9)

Dr. David Bailey, president and CEO of the Nemours Children's Health System, will retire this year, the Jacksonville, Fla.-based system announced Tuesday. During Bailey's 21-year tenure at Nemours, 13 of which were spent as president and CEO, the health system's revenue increased from $533 million to $1.4 billion. Nemours also grew from 15 locations to more than 80 throughout six states. Bailey will help the organization search for his successor and will lead the system until one is found. (Kacik, 1/9)

Citing financial challenges, LRGHealthcare says it’s reviewing whether it will need to cut or change some of its programs – including its maternity unit. The Laconia hospital said the future of its Family Birthplace is especially uncertain because of declining birth rates, low Medicaid reimbursement rates and difficulty retaining staff. (McDermott, 1/9)

Ochsner Health System has acquired New Orleans Urgent Care, adding two more locations to its network of non-emergency medical care sites, according to an announcement Tueday (Jan. 9). A purchase price is not being disclosed. The deal involves the New Orleans Urgent Care centers at 900 Magazine St. in the Warehouse District and 201 Decatur St. in the French Quarter. (LaRose, 1/9)

Arizona's largest health-care provider has struck a deal with a Pennsylvania company to combine operations of 38 physical-therapy clinics and four hospitals in Arizona. Banner Health will be the majority owner of a joint venture that will be managed by Select Medical Holdings Corp. of Mechanicsburg, Pennsylvania. (Alltucker, 1/9)

The flimsy hospital gown that ties in the back and leaves backs and buttocks mostly bare has long been a source of jokes, as well as of complaints by patients. Now, some say it’s time the unpopular garment that hasn’t been updated in 40 years got a modern-day makeover. MedStar Health is trying out what it hopes is a more “dignified” hospital gown: a newly designed one that doesn’t open when a patient gets out of a bed and allows for some physical modesty. (McDaniels, 1/10)

New York City will spend about $400 million to build a new, public-health laboratory, a larger facility expected to open in about seven years on the campus of Harlem Hospital Center, officials said. The move, which is to be announced in the coming weeks, is intended to give the city’s Department of Health & Mental Hygiene more flexibility for its lab equipment and help its staff work more easily in the event of a crisis such as Zika in 2016 and Ebola in 2014. (West, 1/9)

A Florida judge on Tuesday permanently blocked and declared unconstitutional a law requiring a woman to delay an abortion by at least 24 hours after making a visit to a doctor who would have to inform her of possible risks of the procedure."Florida law subjects no other medical procedure, including those that pose greater health risks than abortion, to a mandatory delay," Circuit Judge Terry Lewis wrote in his judgment. (Gonzales, 1/9)

Correctional Officer Scott Jones kissed his wife goodbye on July 8, 2011, and headed off to a maximum-security prison in the remote high desert of northeastern California. He never came home. Jones' body was found a day later, along with a note explaining why the 36-year-old took his own life: "The job made me do it." (1/9)

As state lawmakers returned to Nashville Tuesday for the start of another legislative session, more than 100 people rallied outside the House and Senate chambers demanding health care lead this year’s agenda. They cited the opioid crisis, the closure of rural hospitals and the growing number of Tennesseans uninsured. Many wore purple T-shirts or carried signs listing the number of uninsured residents in the state and questioned lawmakers entering the chambers about what each of them would do to address those issues. (Buie, 1/9)

The former administrator of an Ohio group home has pleaded guilty to charges of reckless homicide and patient abuse in connection with the death of an 85-year-old resident. Fifty-five-year-old Alice Ramsey entered the plea Monday after reaching an agreement with prosecutors to drop a charge of involuntary manslaughter. (1/9)

Fifty-one years ago in San Francisco, a small community clinic opened its doors. Its mission: to treat many of the young people who flocked to the city — who were often homeless, hungry and sick. The Haight Ashbury Free Clinic, now part of a larger network, still operates out of a second-floor office overlooking Haight Street in San Francisco, and it still helps people on the fringes of society. Carrie Feibel of San Francisco’s KQED filed this radio story for NPR and KHN on the history of the clinic. (Feibel, 1/10)

The New Hampshire House of Representatives voted Tuesday morning in favor of legislation to legalize recreational marijuana. ...The amended bill would permit adults to possess up to three-quarters of an ounce of marijuana, 5 grams of hashish, and certain marijuana-infused products. (Tuohy and Ropeik, 1/9)

A charity that helps patients pay for expensive prescription drugs is suing the federal government over what it alleges are unlawful federal restrictions that put a “stranglehold” on its ability to communicate with donors — which happen to be pharmaceutical companies that sell expensive drugs. Patient-assistance charities have become a mainstay of drug companies’ efforts to ensure patients can afford their products. It’s a circular kind of philanthropy: Drug companies give hundreds of millions of dollars a year to independent nonprofits, which in turn provide financial assistance for patients’ drug co-pays or other medical expenses. (Johnson, 1/8)

In arguing its case, Patient Services maintains an updated advisory opinion issued last March by the U.S. Department of Health and Human Services places “oppressive restrictions” on its ability to communicate with drug makers, hospitals, and other donors. Charities, which provide patients with financial assistance to obtain drugs, rely on these opinions to ensure they comply with the law. The modified opinion “ushers in a brave new world of government censorship and puts PSI in the impossible position of having to plan and set up new and modified disease funds without the benefit of the expertise of donors, prospective donors, or their purported affiliates who operate on the front lines in fighting these chronic diseases,” according to the lawsuit filed in federal court on Monday. (Silverman, 1/9)

Drugmakers can provide free medication to patients who can’t afford their prescriptions after a major industry-funded charity said it wouldn’t offer patients assistance in 2018, the federal government said. The charity, Caring Voice Coalition, had received hundreds of millions of dollars from drug companies, but said last week it won’t offer patients financial assistance in 2018 after losing a crucial stamp of approval from the U.S. government. (Langreth, 1/8)

Humira is the best-selling prescription drug in the world. You may have seen the commercials. Because of Humira, a woman with rheumatoid arthritis can wash her puppy in the bathtub, another with colitis can stroll happily through a fair packed with food vendors, while a third suffering from psoriasis can go to the gym without hiding her neck. (Hakim, 1/6)

After months of debate, New Jersey has formally adopted a tough rule that caps what doctors can earn from drug makers at $10,000 a year, and also limits meals given prescribers to just $15. The rule, which goes into effect on Jan. 16, was crafted in response to the ongoing opioid crisis and, specifically, rising concerns that some drug makers may use various forms of payments to influence prescribing of addictive prescription painkillers. (Silverman, 1/8)

Nevada officials have crafted a draft regulation that would allow companies to mark certain diabetes drugs pricing data as confidential when they begin complying with a new transparency law this coming spring. The move by the state Department of Health and Human Services appears designed to deflect a lawsuit filed recently by two pharmaceutical industry trade groups, that argued the law is unconstitutional and robs drug makers of their right to protect trade secrets. The law was adopted last summer and the draft regulations were released to provide guidance for companies, including pharmacy benefit managers. (Silverman, 1/9)

Eli Lilly & Co. Chief Executive Officer Dave Ricks said on Monday that the recent changes in U.S. tax policy will help the drugmaker lower its global tax burden as he continues to look for deals in areas like oncology. ... Lilly’s global tax rate will be lowered slightly as a result of the changes that President Donald Trump signed into law in December, Ricks said, adding that Lilly will be able to access cash regardless of where it’s stored. He said that foreign companies whose tax rates remain lower will affect dealmaking but Lilly will stand to be competitive. (Coons and Hopkins, 1/8)

The J.P. Morgan Healthcare Conference is just getting started, but one thing is already clear: Biopharma companies are positively giddy about the new tax law. The sweeping overhaul of the tax code, passed by the Republican Congress on Dec. 20, was a Christmas present with sweet implications for 2018, drug makers told investors at the industry’s annual confab here.Here’s a roundup of what some of the most closely watched companies had to say about the rewritten tax code. (Robbins, 1/8)

Last night, Celgene announced that it is buying Impact BioMedicines, a small biotech developing a drug to compete with the blockbuster blood cancer drug Jakafi, sold by Incyte and Novartis, in an announcement timed to coincide with the annual J.P. Morgan Health Care Conference, where Celgene, as it happens, always opens the show. (Herper, 1/8)

The government hasn’t even approved Alnylam Pharmaceuticals Inc.’s first drug, but officials at the Cambridge company are so optimistic the medicine will reach the market soon that they are planning a significant expansion. ... Patisiran would be Alnylam’s first approved drug since the company was founded 15 years ago. (Saltzman, 1/9)

Kmart has agreed to pay more than $1 million to settle allegations its pharmacies overbilled government health care programs for some prescription drug purchases in Illinois, the Illinois State Police said Tuesday. The deal is part of a $59 million settlement covering federal, state and insurance company claims against Kmart, part of Hoffman Estates-based Sears Holdings Corp., that the U.S. Department of Justice announced last month. (Zumbach, 1/2)

Jan. 1 isn't just a day for making New Year's resolutions and watching football. It's also become the day when the pharmaceutical industry unveils price increases, more or less en masse. The good news, as a number of pharma and biotech analysts have noted, is that the increases for 2018 are smaller than in the past. According to Deutsche Bank's Gregg Gilbert, between 2013 and 2015 — that is, before Martin Shkreli jacked up the price of an AIDS drug from $13.50 to $750 a pill and made rising drug prices a national issue — the cost of drugs was rising more than 20 percent a year. ... In recent years, however, most price hikes have been in the single digits; they averaged 7.2 percent in 2017, for instance. That's a whole lot better than a 20 percent rise. Still, even these smaller price hikes mean that many patients are being gouged. ... Which brings me to the current poster boy for patent abuse, Allergan Inc. In 2017 it made news with its outrageous attempt to protect its dry-eye medication Restasis from generic competition by transferring its patent rights to a sovereign Native American tribe. (Joe Nocera, 1/8)

Spark Therapeutics recently launched a pioneering new drug that can improve the vision of patients with a rare hereditary form of vision loss. That’s not the only thing that is pioneering about this drug, called Luxturna. Its price is, too. Spark announced this week that treatment will cost $850,000 a patient. “We believe that price reflects the type of life-altering value we’re seeing with Luxturna in clinical trials and will allow us to build on revolutionary science,” Spark Chief Executive Jeff Marrazzo told The Wall Street Journal. The company reportedly had considered setting the price even higher, at $1 million. (1/4)

Last year was solid for the biotech sector generally -- but shaky for industry bellwether Celgene Corp. The company will have a chance, as it kicks off JPMorgan Chase & Co.'s annual biopharma confab this week, to give investors reason to hope 2018 will be different. (Max Nisen, 1/8)

2017 was an extraordinary year in the history of medicine. It was the year when scientists beat cancer, and U.S. regulators approved the first therapy to fix a faulty gene. It was also a year that kept us enthralled with a quickening drumbeat of breathtaking news detailing spectacular advances – trials seemingly curing patients of hemophilia A and sickle cell anemia, and breakthroughs raising similar hopes for Huntington’s disease, Lou Gehrig’s disease, and even HIV. What is remarkable about these successes is that they are not just lucky breaks, but the products of new technologies that are ushering us into a new therapeutic space of vastly expanded possibilities. (Bernard Munos, 1/4)

Day one of the annual J.P. Morgan Healthcare Conference -- typically the biotech industry's biggest showcase of the year -- was something of a dud. The Nasdaq Biotech Index (NBI) fell as much as 2 percent on Monday. That's not a rout, but it is a disappointment.  (Max Nisen, 1/9)

As the country debates the best path forward for the nation’s healthcare system, interest groups continue to advance different ideas to address their pet causes.  One popular cause is the reduction of drug prices.  Though that debate often occurs based on narrow perceptions of the dollar figures at issue, ideas for price reduction are worthy of consideration, especially given the increasing budgetary percentage that government and personal spending healthcare now occupies.  One drug-price-reduction idea advanced toward the end of last year, however, should be vigorously opposed. (Greg Herbers, 1/4)

The opioid epidemic is now a full-blown national crisis, yet the federal government continues to dawdle. President Donald Trump declared opioid addiction a public health emergency, and he talks a tough game. But he has not taken forceful action. If he will not lead, Congress must -- and now, before the crisis grows even worse. Opioid overdose deaths rose 28 percent in 2016, to 42,000 men, women and children. Some 2.6 million more Americans are addicted to opioids, and communities in every region of the country are suffering from the resulting trauma. Largely as a result, life expectancy declined in 2016 for a second straight year -- something that has not happened since the early 1960s. (Michael R. Bloomberg, 1/10)

As devastating as the opioid epidemic is, however, its toll is modest compared to that of another substance: tobacco. Even though tobacco use has rarely made headlines in recent years, cigarette smoking is associated with an estimated 480 000 deaths in the United States annually .... Public outcry over the opioid crisis is by no means misplaced, but the contrast between the relative attention garnered by the opioid epidemic compared with tobacco use highlights the extent to which concern over tobacco has receded, despite the enormous adverse effects of tobacco on the health of society. (Ilana Richman and Harlan Krumholz, 1/8)

Despite significant policy differences, we believe that Republicans and Democrats agree more than they disagree when it comes to health care. We all want a high-performance, high-value health care system with greater access, better quality, and lower cost. In order to achieve this goal, we need a person of integrity and competence at the helm of the Department of Health and Human Services. The good news is that President Trump has nominated just such a person, Alex Azar, who we both have come to know. (Bill Frist and Tom Daschle, 1/9)

President Trump is scheduled to undergo a routine physical examination on Friday. In the run-up to the exam, the president rebutted questions about his mental health by tweeting that he “would qualify as not smart, but genius....and a very stable genius at that!” Here’s what a more presidential president would be saying this week about his health, mental and physical: “I know that, at 70, I was the oldest president ever to be sworn in for his first term. Although I believe I am in good shape, the public cannot help but wonder about my health. Media reports about my eating and sleeping habits, as well as my own admission during the campaign that I could lose a few pounds, can only contribute to the concern. The days in which a president could hide health problems, even major ones, from the public are rightly gone." (1/9)

Michael Wolff’s new semifictional book about the Trump White House has sparked a renewed wave of overwrought speculation about the president’s mental fitness. Not one to shy away from a fight, President Trump punched back that not only is he a successful chief executive, he's a “very stable genius” to boot. Dilbert creator Scott Adams took the matter a step further by arguing that proclaiming himself a “very stable genius” or “VSG” was itself a genius Trump move because that will be his “forever name.” Whether people use the expression VSG admiringly or sarcastically, the words “Trump” and “genius” are going to be kept in close proximity. (James S. Robbins, 1/9)

Aside from being a futile attempt to put the legalized-marijuana genie back in the bottle, it’s a mark of hypocrisy for Jeff Sessions, a former Alabama senator who had long championed the right of states to set their own laws without being big footed by an oppressive federal government. Missouri is among 46 states that allow at least some limited use of cannabis extracts for medical purposes. Congress could fix this easily enough by revisiting the Controlled Substances Act of 1970, where marijuana is listed as a Schedule I drug alongside heroin. Schedule I drugs must have no acceptable medical use, as marijuana surely does, and a high potential for abuse. Marijuana is sometimes abused, but far less than alcohol, which is not on the controlled substance list at all. The perfect irony would be if Sessions’ rash action wound up prompting Congress to pass rational marijuana laws. (1/10)

Foster care is intended as a temporary solution for children whose parents cannot care for them. At any one time, about half a million children in the United States are in foster homes. The foster care system has a reputation as a place for children who are victims of abuse or neglect; this reputation is only partially deserved. About half of children in foster homes have a chronic disability that can make caring for them difficult. In fact, many of these children enter foster care because they have complex medical needs that their families cannot manage, often because of limited resources. (David Mandell, 1/9)

“Always remember everything,” my mother is fond of saying. Of course, as she knows, this is impossible, even with advanced memory techniques. That’s why we take notes and use calendars. These are components of our external memory, which are parts of our extended minds. That your mind may not be entirely housed within your skull may be difficult to grasp. (Austin Frakt, 1/8)