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The heated debate over how Supreme Court nominee Brett Kavanaugh would vote on the Affordable Care Act might not matter. As long as five past defenders of the health care law remain on the nation's highest court, the odds tilt in favor of it being allowed to stand. Some Democrats are warning that President Donald Trump's designee could spell doom for the statute, even as some conservatives are portraying Kavanaugh as sympathetic to former President Barack Obama's landmark legislation. (7/17)

A workaround by states to counter Trump administration cuts to Affordable Care Act subsidies has largely succeeded in protecting consumers from higher costs, California and 17 other states said. The assessment came late Monday in a court filing asking U.S. Judge Vince Chhabria to put a lawsuit involving the cuts on hold. The filing says states have mostly protected subsidized consumers by allowing insurers to raise premiums on some plans offered on health care exchanges. (Thanawala, 7/17)

The health department has quietly dipped into tens of millions of dollars to pay for the consequences of President Donald Trump’s border policy, angering advocates who want the money spent on medical research, rural health programs and other priorities. The Department of Health and Human Services has burned through at least $40 million in the past two months for the care and reunification of migrant children separated from their families at the border — with housing costs recently estimated at about $1.5 million per day. (Diamond, 7/18)

Wet and muddy from their trek across the Mexican border, immigrant children say they sat or lay on the cold, concrete floor of the immigration holding centers where they were taken. It was hard to sleep with lights shining all night and guards kicking their feet, they say. They were hungry, after being given what they say were frozen sandwiches and smelly food. (Taxin, 7/17)

Immigrant families who were separated after they crossed the U.S.-Mexico border are slowly being reunited as the Trump administration tries to satisfy a judge’s order to restore more than 2,500 children to their parents by next week. Two mothers, each with a daughter, arrived Monday night at the Catholic Charities of San Antonio center. Three more reunited families arrived on Tuesday afternoon. As they were offered hot meals of meat, rice and beans, and outfitted with new clothing and shoes, mothers and daughters stayed close, hugging and touching. (Epstein, 7/18)

In its latest bid to address health care costs, the Food and Drug Administration issued a new guidance that offers suggestions for drug makers seeking to switch their prescription medicines to a so-called non-prescription status. The guidance, which the agency called a “first step,” is designed to encourage drug makers to think about ways to seek approval for over-the-counter approvals. A new FDA regulation that would formalize such an approach is expected next year, but the agency emphasized that approval standards for over-the-counter medicines are not being lowered. (Silverman, 7/17)

Drugmakers would have to do studies showing those strategies allow consumers to safely pick a drug and use it without medical supervision. The agency will take comments from drugmakers, medical groups and the public before issuing final rules, a process that usually takes many months. (Johnson, 7/17)

When federal regulators started giving certain drugs “breakthrough” status in 2012, pharmaceutical company interest exploded. The goal was to speed up the approval of drugs for serious diseases when there was preliminary evidence the new drugs were better than existing treatment options. Giving these drugs “breakthrough” status comes with a side benefit: an evocative name. The word “breakthrough” suggests scientific triumphs and miracle cures to many people, including physicians. Companies and media reports often tout the “breakthrough” designation for experimental drugs that have not yet been proved effective. (Johnson, 7/17)

Spero Therapeutics (SPRO), headquartered in Cambridge’s Central Square neighborhood, announced this week that two government agencies would give the company up to $54.2 million to continue developing a new antibiotic for complicated urinary tract infections. The news came just days after Novartis revealed it would shut down its antibiotics unit and and license out its drug candidates — including one for a complicated urinary tract infection. (Sheridan, 7/18)

An appeals court on Tuesday rejected an attempt by hospitals to challenge the Trump administration’s changes to the controversial federal drug discount program known as 340B, sticking them with a $1.6 billion cut in federal payments. The decision is the latest in a series of blows to hospitals trying to preserve the program, which increasingly pits them against the drug makers who must offer steep discounts on medicines under its rules. Participating hospitals get higher reimbursement for the drugs from the federal government, and use the difference to cover charity care and other costs. (Mershon, 7/17)

"When the plaintiffs filed this lawsuit, neither the hospital plaintiffs, nor any members of the hospital-association plaintiffs, had challenged the new reimbursement regulation in the context of a specific administrative claim for payment," Judge Gregory Katsas wrote. "Nor could they have done so, for the new regulation had not yet even become effective." The D.C. Circuit also rejected the hospitals' argument that they had cured the presentment problem by filing payment demands while they waited for the appeal decision, and ultimately declined to rule on the merits—a major disappointment for the hospitals. (Luthi, 7/17)

The American Hospital Association said it would refile a lawsuit against the Trump administration's cuts to a discount drug program after losing its appeal Tuesday. "We will continue our fight to reverse these unwarranted cuts and protect access for patients, and we expect to refile promptly in district court," the AHA said. Three judges from the U.S. Court of Appeals for the District of Columbia Circuit ruled Tuesday that AHA's suit against the Department of Health and Human Services (HHS) was premature. (Hellmann, 7/17)

The health insurer Anthem Inc. was sued by doctors in Georgia for declining to pay for some emergency-room care, escalating a long-running battle over how far insurance plans can go to push patients to seek lower-cost treatment. The American College of Emergency Physicians and the Medical Association of Georgia filed suit on Tuesday in U.S. District Court in Atlanta against Anthem’s Blue Cross and Blue Shield of Georgia unit over the denied payments. The doctors asked the court to require Anthem to halt its policy and cover the claims. (Tracer, 7/17)

In February, Atlanta-based Piedmont Hospital and five sister hospitals filed lawsuits claiming Anthem's policy of denying coverage for non-emergency ED visits after the fact violates Georgia law. But while Anthem tweaked the ED program in February in response to outrage from state legislators and the public, it has refused to rescind it. So ACEP—after months of back-and-forth with Anthem detailed in the lawsuit—is jumping into the mix. "This is a first step in the process and depending on how things play out, we would entertain filing in other states where Anthem is (implementing) the policy," said Laura Wooster, associate executive director for public affairs in ACEP's Washington office. (Livingston, 7/17)

Two physicians organizations filed a lawsuit Tuesday against Blue Cross and Blue Shield of Georgia and its parent company over the insurer’s emergency room payment policy, calling it “dangerous.’’ The parent company, Indianapolis-based Anthem, has pursued a new policy over the past year in Georgia and five other states, reviewing customers’ ER visits and limiting or denying payment for those it deems not to have been true emergencies. (Miller, 7/17)

Health-care providers and government agencies across the U.S. have seen an increase in cybersecurity breaches in recent months, exposing sensitive data from hundreds of thousands of people as the sector scrambles to find adequate defense mechanisms. “These threats are real,” Oscar Alleyne, senior adviser at the National Association of County and City Health Officials, said Tuesday during a panel in Washington. The breaches include malware attacks, computer thefts, unauthorized network access and other security breaches, according to a government database that tracks attacks in the health-care sector. (Kasumov, 7/17)

A new federal class-action lawsuit is claiming that shareholders of a massive Nashville-based health care company are being underpaid in the $5.6 billion sale to a private equity firm. Envision Healthcare Corporation, which runs hundreds of surgery centers in 35 states, announced last month it would be sold to KKR, an equity firm that has been on a spree of health care company acquisitions. (Kelman, 7/17)

UnitedHealth Group easily topped profit expectations during the second-quarter and hiked its outlook for the third time this year, but company shares were punished Tuesday for a performance that even company executives believe falls short of the health insurer's full potential. Enrollment jumped due partially to a surge in government-funded business, and operating earnings soared about 21 percent for the company's fast-growing Optum segment, which strays well beyond health insurance. (7/17)

The new chief executive of UnitedHealth Group’s fast-growing Optum division told investors Tuesday that digital health is a key part of the company’s future as he touted a United-backed business that soon will open a new office in Minneapolis. For several years, UnitedHealth has been developing a digital health platform called Rally, which includes online and mobile tools that subscribers use to compare insurance benefit options, search for health care providers and participate in employer wellness programs. (Snowbeck, 7/17)

Analysts said the earnings beat was fueled largely by non-operating factors, particularly a tax rate that was lower than some had estimated. The second quarter “seems mostly in-line with tax rate driving upside,” Wells Fargo analyst Peter Costa wrote in an investor note. During the earnings call, analysts zeroed in on the insurance arm’s medical loss ratio, which reflects the share of premiums that go toward health-care costs. The ratio was slightly worse than some analysts projected. (Chin and Wilde Mathews, 7/17)

UnitedHealth Group Inc. fell the most in more than five months after the health insurer’s results weren’t good enough to satisfy investors, despite beating analysts forecasts for second-quarter adjusted earnings and raising its full-year earnings projection. “We view the quarter as solid, but just meeting the bar for expectations and may underwhelm,” said Evercore ISI analyst Michael Newshel. (Tracer, 7/17)

Inviting more stopgap spending, the White House has fired off an official warning against congressional efforts to blow through budget limits. Top Trump administration officials sent a letter Monday cautioning lawmakers against raising spending caps to accommodate shifts in funding for a popular veterans health program, though they stopped short of threatening a veto. (Ferris and Scholtes, 7/16)

The Department of Veterans Affairs will replace the acting head of its health care system with a temporary appointee on Wednesday, the VA’s acting secretary said Tuesday, though the department still hasn’t settled on a permanent replacement to lead the sprawling division. Dr. Richard Stone will take over the Veterans Health Administration, the VA’s acting secretary, Peter O’Rourke, told reporters. The health administration is one of the three main branches of the VA and comprises more than 1,500 health-care facilities, thousands of physicians and nurses and a budget of about $70 billion to treat some nine million veterans. (Kesling, 7/17)

The Kansas medical board has revoked the license of an Emporia doctor for having a sexual relationship with a vulnerable patient who tried to commit suicide using pills he prescribed her. ...In a revocation order issued last week, the Kansas Board of Healing Arts wrote that Stone “was in a position of significant power” over the unnamed female patient “and he abused that power.” (Marso, 7/18)

When their marriage fell apart, the most contentious issue between Ruby Torres and John Joseph Terrell was the fate of their frozen embryos. There were seven in storage, created with her eggs and his sperm before Torres underwent chemotherapy and radiation treatment for breast cancer. Torres, 37, wanted to use the embryos to have a baby. In divorce proceedings, she told the judge that the embryos probably represented her only chance to have biological children. Terrell protested that he had no interest in having a child with Torres. (Cha, 7/17)

Planned Parenthood of the Great Northwest and the Hawaiian Islands is suing the state of Idaho in federal court over new abortion reporting requirements that critics say are unconstitutional and intended to stigmatize women seeking medical care. Planned Parenthood filed the lawsuit in Idaho's U.S. District Court on Tuesday, asking a judge to declare the reporting law void. (7/17)

Abigail Aiken, a reproductive health researcher at the University of Texas at Austin, anonymously interviewed 30 women and two men from 20 states who tried to get abortion pills online because going to a clinic posed huge financial and logistical problems. None succeeded in getting the pills. (McCullough, 7/17)

With the prospect of a more conservative Supreme Court on the horizon, some progressive women have begun to fear what will happen if Roe v. Wade, the case that legalized abortion, is overturned. Some of these prophecies have centered on a popular meme in the pro-choice community: The coat hanger. ...Women who want to have an abortion early in their pregnancies can take a combination of two drugs: misoprostol, whose brand name is Cytotec, and mifepristone, which is also called RU486. They are both on the World Health Organization’s “List of Essential Medicines,” which means they are considered safe and effective. The combination can be used until about the tenth week of pregnancy, and the medications are already used in roughly a third of all abortions. (Olga Khazan, 7/18)

The growing use of anti-anxiety pills reminds some doctors of the early days of the opioid crisis. Considered relatively safe and non-addictive by the general public and many doctors, Xanax, Valium, Ativan and Klonopin have been prescribed to millions of Americans for decades to calm jittery nerves and promote a good night’s sleep. (Vestal, 7/18)

McKesson Corp, Cardinal Health Inc. and other distributors of opioid painkillers must face claims they fueled a public health crisis by wrongfully shipping millions of opioid painkillers to retailers and pharmacies in New York. New York Judge Jerry Garguilo Tuesday rejected the drug distributors’ bids to have some counties’ and cities’ lawsuits aimed at recouping the costs of fighting the opioid epidemic thrown out. (Feeley, 7/17)

Police officers are facing a high-risk environment with opioid-fueled junkies who think they have “superhuman strength” — dramatically raising the stakes in violent encounters, law enforcement experts and forensic psychologists say. In each of three killings of New England police officers in the past three months, the suspects had significant drug histories and are alleged to have acted with extreme violence — essentially executing Weymouth police Sgt. Michael Chesna and Maine Sheriff’s Deputy Eugene Cole, while ambushing Yarmouth police Sgt. Sean Gannon and his K-9 dog. (7/17)

Emergency department physicians across the state are using more non-opioid treatments for conditions that historically have required powerful opioids for pain management, as they try to play a lead role in the overdose epidemic that kills on average 115 Americans every day. This change, coupled with other efforts, has resulted in a significant decrease in opioids ordered at emergency departments in at least two Connecticut hospitals, Norwalk and Middlesex, from 2016 to 2017. (Rigg, 7/18)

Miami-Dade’s jail system will soon begin using airport-style body scanners to search inmates for contraband — a measure precipitated by the recent deaths of three inmates who overdosed on smuggled-in drugs. Corrections officers at the county’s three jails this month began receiving training on how to scan incoming inmates for cellphones, drugs and weapons hidden on their bodies. (Ovalle, 7/17)

The more teens check social media and stream video, the more likely they might develop symptoms of attention deficit hyperactivity disorder, a new study suggests. The study, published in the medical journal JAMA on Tuesday, sheds light on how more research is needed to determine whether symptoms of the disorder, commonly called ADHD, are possibly caused by digital media use. (Howard, 7/17)

The study, published Tuesday in the Journal of the American Medical Association, tracked 2,500 teens over two years and monitored their usage and symptoms. It doesn’t prove a causal link. The study also didn’t rule out other possible causes such as lack of sleep, family stress at home or a family history of the disorder. But it was the first longitudinal study to follow so many teens over a two-year period, according to experts, going straight to an issue that pits parents and teachers against the tech industry in a battle for children’s attention. (Hernandez and Morris, 7/17)

The results do not show that prolific use of digital media causes ADHD symptoms, much less that it results in a level of impairment that would warrant an ADHD diagnosis or pharmaceutical treatment. Indeed, it’s possible the relationship is reversed — that attention problems drive an adolescent to more intensive online engagement. (Healy, 7/17)

Previous research has shown that watching television or playing video games on a console put teenagers at a slightly higher risk of developing ADHD behaviors. But less is known about the impact of computers, tablets and smartphones. (Chatterjee, 7/17)

A survey of school districts around the country finds that less than half test their water for lead, and among those that do more than a third detected elevated levels of the toxin, according to a federal report released Tuesday. Lead can cause brain damage and learning disabilities in children. (7/17)

Besides a cure, what do those afraid of Alzheimer's disease need most? According to entrepreneur and philanthropist Bill Gates, a key need is a "reliable, affordable, and accessible" diagnostic test. To jump-start that research, Gates announced today that he has joined a coalition of philanthropists who are investing $30 million to create a venture fund called Diagnostics Accelerator. "We need a better way of diagnosing Alzheimer's -- like a simple blood test or eye exam -- before we're able to slow the progression of the disease," Gates wrote in a statement announcing the investment. "Imagine a world where diagnosing Alzheimer's disease is as simple as getting your blood tested during your annual physical." (LaMotte, 7/17)

CTE has been part of the national lexicon in the U.S. since the 2015 movie Concussion dramatized the discovery of this degenerative brain disease among football players. Chronic traumatic encephalopathy is found among people who've had head injuries. Though not everyone with head trauma develops CTE, the group that's come to be most associated with it is football players, whose brains can be routinely jarred by hard hits. The disease has been linked to depression, dementia and even suicide among those who play the game. (Goldman, 7/17)

Another key patent on the CRISPR genome editing technology is facing a legal challenge. On Tuesday, St. Louis-based Benson Hill Biosystems, a privately held agriculture biotech company, filed a petition for post-grant review with the U.S. Patent and Trademark Office, arguing that a CRISPR patent granted to the Broad Institute of MIT and Harvard in 2017 and licensed by Editas Medicine (EDIT) is invalid. (Begley, 7/17)

A daily dose of baby aspirin is widely recommended for heart disease prevention, but a one-dose-fits-all approach may not work. A new analysis, in The Lancet, looked at data from 10 randomized trials and found that the size of the dose and the weight of the patient have significant effects on outcome. Researchers found that a daily dose of 75 to 100 milligrams of aspirin lowered the risk of cardiovascular events by 23 percent for people weighing less than 154 pounds, but had no effect in those weighing more. In people over 154 pounds, low-dose aspirin increased the risk for a fatal cardiovascular event. (Bakalar, 7/17)

It looks like a flash drive, can be hidden anywhere and doesn't create tell-tale smoke. Across the country, the use of these e-cigarettes are spiking among youth, but parents often aren't even sure what they are and many teens mistakenly believe there are no serious health risks. (Cardoza, 7/17)

Should we stretch before exercise? A thought-provoking new experiment with athletes suggests that the answer could depend on how we feel about stretching and what kind of exercise — and stretching — we intend to do. (Reynolds, 7/18)

A good night’s sleep may be critical for the metabolic health of teenagers. Researchers studied 829 boys and girls, average age 13, who wore electronic measuring devices that tracked sleep time, sleep quality and physical activity over seven to 10 days. They also recorded five factors associated with cardiovascular risk: waist circumference, blood pressure, HDL or “good” cholesterol, triglycerides and insulin resistance. (Bakalar, 7/17)

On her way to the orthopedic clinic, April Jorgenson steeled herself for a lecture. She was bringing in her 5-year-old son, Rusty Golaski, to see if he had broken his arm while jumping on the trampoline in the family’s Hugo backyard. “I thought I’d get some backlash from the doctor when I told him what happened, but he didn’t say a thing,” said Jorgenson, 34. “He just told me not to let Rusty jump while his cast is on.” (Burger, 7/17)

A new mapping technology is helping doctors determine where to place life-saving catheters in patients with irregular heartbeats without the use of radiation. It’s being used at Florida Hospital. One of these patients is 14-year-old Grayson Abraham who has a heart condition that can cause sudden cardiac death in young athletes. (Prieur, 7/18)

The National Institutes of Health announced Tuesday that it is launching a nationwide study on aggressive prostate cancer in African-American men. The study will be one of the first to analyze how social stressors such as discrimination, lack of health care access, and segregation interact with genetic changes in African-American men with prostate cancer. (Eppolito, 7/17)

Some patients with mental illness, particularly children, are spending days stuck in tiny windowless rooms in hospital emergency departments waiting for treatment, a persistent problem despite new statewide rules designed to resolve the backlogs. From February through May, 155 patients in mental health crisis spent at least four consecutive days in an emergency room, according to Massachusetts officials who began gathering the data six months ago. (Kowalczyk, 7/17)

Four former wrestlers say in a new lawsuit that Ohio State University officials ignored repeated complaints about "rampant sexual misconduct" by a now-dead team doctor, and a former student confirmed Tuesday that investigators have documentation about at least one decades-old incident that prompted a complaint. Former student Steve Snyder-Hill said he wrote to a student health center official in the 1990s after being examined by Dr. Richard Strauss, whose behavior is the subject of an independent investigation that began months ago. (7/17)

State auditors found sweeping contracting problems at the Texas Health and Human Services Commission, a mega-agency responsible for overseeing billions of dollars worth of health care for the state's most vulnerable residents. An audit of 28 contract awards worth roughly $4.6 billion found errors at every level, from scoring the vendor’s proposals to keeping track of all documentation. (Morris, 7/17)

The top lawyer at the Oklahoma State Department of Health already at the center of a controversy over new marijuana rules was charged Tuesday for allegedly sending threatening emails to herself. The agency's former general counsel, 37-year-old Julia Ezell of Edmond, was charged Tuesday in Oklahoma County with two felonies and one misdemeanor for allegedly sending the threats and then lying to investigators about it. (7/17)

A study released earlier this year by Doximity, the nation’s largest online network for health care providers, ranked Sacramento ninth in a list of the top 10 metropolitan areas in the nation with the highest risk of an OB-GYN shortage. The online network uses a score system to assess the severity of the lack of providers in 50 of the nation’s metropolitan areas, taking into consideration the age of practicing providers and the ratio of births to OB-GYNs. (Holzer, 7/18)

According to the latest enrollment numbers, nearly 90 percent of Texas school districts participate in the program, known as TRS-ActiveCare.But in recent years, frustration has grown with the state’s support of the program, and a few larger districts have lobbied to leave. State law currently doesn’t allow that, however, and bills designed to give the districts permission to depart have failed in the Texas Legislature. (Haigh, 7/18)

Assault weapons registered in California have increased by 43% under a new law that expanded the types of firearms gun owners must log with the state. Californians have applied to register 68,848 additional assault weapons in the last 11 months to comply with a state law enacted following the 2015 mass shooting in San Bernardino. The 2016 law bans sales of semi-automatic assault rifles equipped with “bullet buttons,” which have detachable magazines that enable quick replacement of ammunition, and requires old ones to be registered with the California Department of Justice by the end of June. The mandate should allow law enforcement to better track the weapons. (McGreevy, 7/17)

Kaiser Health News: Hurricane Maria Still Taking A Toll On Puerto Rico’s Seniors

The question of who will care for Puerto Rico’s aging population is a growing crisis, says Dr. Angel Muñoz, a clinical psychologist and researcher at the Pontifical Catholic University of Puerto Rico in Ponce. The island’s elderly population is particularly at risk amid the new Atlantic hurricane season, which runs through Nov. 30. Earlier this year, a study by Harvard researchers estimated that 4,600 Puerto Ricans died in the months after Hurricane Maria hit last September. Many were seniors who faced delays in getting medical care. (7/18)

A first-of-its kind report on racial equity in Oakland highlights some unsettling realities for African-Americans in the city, including that they are 12.95 times more likely than whites to be arrested for a felony, 8.6 times more likely than whites to be jailed and 23.68 times more likely than whites to have force used against them by a law enforcement officer. In addition to gauging public safety inequities in Oakland, the study issued last week by the City University of New York highlighted racial inequities in economy, education, public health, housing, and neighborhood and civic life categories. (Tadayon, 7/17)

The City of Milwaukee is getting another $4 million to help pay for lead pipe replacements, Gov. Scott Walker announced Wednesday. The additional money will be used to help homeowners, schools and day care centers replace their old lead service lines. (Spicuzza, 7/18)

At farmers markets around North Carolina, the tables are piled high with tomatoes, okra, cucumbers, peaches and more. But even as the growing season is peaking, some folks who might want to buy will have a harder time bringing those fresh fruits and vegetables home. That’s because the technology company that currently processes Supplemental Nutrition Assistance Program (formerly known as food stamps) benefits at 40 percent of the country’s farmers markets will stop doing so at the end of July. (Ovaska-Few, 7/18)

The industry association that represents San Francisco's landlords is backing a new Board of Supervisors proposal that would give city inspectors the power to force scofflaw property owners to install or upgrade fire alarm and sprinkler systems. Supervisor Hillary Ronen on Tuesday unveiled a set of measures that would allow the city's Fire and Building Inspection departments to order landlords who have failed to correct two or more safety violations to retrofit their buildings with sprinklers and alarms or improve existing systems. (Golderg, 7/17)

When Eddie Roth was appointed by former Mayor Francis Slay to direct Human Services — the department of St. Louis city government tasked with addressing homelessness — he sought guidance from Tina Patterson, the CEO of Dayton-based Homefull, a nonprofit providing services to the homeless there. Roth knew Patterson from his time in Dayton, and they stayed in touch when Roth returned to St. Louis. (Bott, 7/18)

An organization backing one of three competing medical marijuana initiatives in Missouri continued to pull in big-dollar contributions last quarter, though the origin of the vast majority of the haul is shrouded in secrecy. The Missourians for Patient Care campaign committee raised $530,000 in monetary contributions between April and July — and a nonprofit corporation with the same name funneled $505,000 of that total to the group. The nonprofit does not have to reveal its donors. (Suntrup, 7/17)

Amazon’s purchase of the online pharmacy PillPack answered long-lingering questions about whether and how it would enter the prescription drug business. But it also raised another big issue: What will it do about the PBMs? Pharmacy benefit managers are the companies that stand in the middle of the nation’s supply chain for prescription drugs. They administer drug benefits on behalf of employers and labor unions, and negotiate prices and reimbursements with drug makers and pharmacies that stand on either end of those transactions. In other words, they control access to the medicines and hundreds of millions of U.S. customers who take them. (Ross, 7/16)

An initiative that would have attempted to cap drug prices in South Dakota was removed from the statewide ballot by a judge on Monday, the second time that a court has prevented such a measure from going before voters in the 2018 election. The ruling came after a court determined the measure’s supporters had improperly gathered some of the signatures necessary to qualify it for the ballot, according to the initiative’s biotech-backed opposition. (Facher, 7/17)

Sen. Tammy Baldwin (D-Wis.) on Monday called on pharmaceutical giant Pfizer to “permanently roll back prices,” days after the company said it would temporarily postpone a planned price hike. In a letter to Pfizer’s CEO Ian Read, Baldwin said the company needs to stop “playing games” with the costs of prescription drugs. Pfizer instead needs to “make a firm and clear commitment” to permanent price reductions, Baldwin wrote. (Weixel, 7/16)

As a candidate and then as president, Donald Trump has had plenty to say about how drug prices are out of control and how he plans to get them down. Drug companies are “getting away with murder,” he said in January 2017, promising to save “billions” through better negotiating. On May 11, Trump called his new drug price plan “the most sweeping action in history.” And after Pfizer Inc. raised prices of many of its products this summer, he tweeted on July 9: “We will respond!” (Langreth, Koons and Gu, 7/16)

The drug manufacturing industry’s main lobbying group is backing a big change to the way prescription drugs are priced, but it’s unclear how it would impact the industry’s business model. At first glance, it looked like PhRMA is embracing one of the Trump administration’s biggest ideas for addressing prescription drug prices — eliminating rebates that drug makers pay to pharmacy benefit managers, the middlemen that negotiate drug prices on behalf of insurance companies. But in fact, PhRMA’s idea is vague enough that it’s unclear exactly what it would do and whether it will bring down the price of drugs for patients. (Swetlitz, 7/16)

Leading trade groups for brand-name and generic drugmakers endorsed overhauling the drug rebate system as a way to address the high cost of medicines, aligning themselves with HHS Secretary Alex Azar's bid to change industry practices around drug discounts. Pharmacy benefits managers, wholesalers, pharmacies and other intermediaries in the drug supply chain should not be paid based on a percentage of the list price of medicines but could instead get a flat fee, PhRMA said in comments on the Trump administration's drug pricing blueprint submitted Monday. (Karlin-Smith, 7/16)

Johnson & Johnson on Tuesday reported better-than-expected second quarter profit as sales of pharmaceuticals surged 20 percent despite a sharp decline in blockbuster arthritis drug Remicade, and its shares rose more than 4 percent. The healthcare conglomerate also expressed confidence that last week's finding by a Missouri jury that J&J's talc-based products caused cancer, and an order to pay a record $4.69 billion to defendants, would not stand. (7/17)

J&J’s pharmaceutical sales topped analysts’ expectations despite what executives said was a continued decline in average net U.S. pricing after discounts and rebates. Chief Financial Officer Joe Wolk said on a conference call with analysts that average U.S. net pricing could decline 4% to 6% this year, after a 4.6% drop last year. J&J shares surged 4% to $128.65 in midday trading after the earnings report, though the stock is still down 7.9% year to date on investors’ concerns about slower growth in other parts of J&J’s diversified business, including consumer products. (Loftus and Prang, 7/17)

Novartis says net profit rose 3 percent in the second quarter amid strong growth for some of its top products, as the Swiss pharmaceuticals giant moves to spin off its Alcon eye-care business. New CEO Vas Narasimhan touted Novartis' plans to create a "focused medicines company," including through the Alcon spinoff announced in late June. (7/18)

Novartis on Wednesday lowered its outlook for its Sandoz generics business, saying it expects a low-single digit decline in sales for the year. The company said earlier this year that the unit’s revenue would be broadly in line with the previous year or drop slightly. It raised its forecast for Alcon, saying it now expects mid-single digit growth in sales in 2018. The pharmaceutical giant earlier this year announced the purchase of rare-disease drugmaker AveXis Inc. for $8.7 billion, and Narasimhan has said he’s looking to focus Novartis’s gene-therapy program on cancer, neuroscience and ophthalmology. (Paton, 7/18)

The drug industry has officially taken center stage in an increasingly bitter Senate race in New Jersey between incumbent Bob Menendez and former Celgene CEO Bob Hugin. Last week, an ad campaign excoriated Hugin for allowing Celgene to raise prices on drugs under his leadership. Now the Republican is striking back with a pharma-focused ad of his own. (Facher, 7/16)

Martin Shkreli’s former company is losing money, watching sales of its famously costly medicine slip while considering yet another name change. Vyera Pharmaceuticals, formerly called Turing Pharmaceuticals, lost more than $1 million in the first quarter of 2018, according to financial documents obtained by STAT. Sales, driven by the $750-a-pill Daraprim, have been on the wane over the past two years, falling more than 14 percent in 2017 and on pace to drop another 7 percent in 2018. (Garde, 7/17)

Some drug companies have continued to increase prices despite growing public discontent, a move that senior equity analyst Elliot Wilbur told CNBC "makes absolutely no sense." "It’s simply bad decision-making and terrible policy on [a drug company's] part," Wilbur, who focuses on pharmaceuticals at financial firm Raymond James, said Monday on "Power Lunch." (Ell, 7/16)

Maryland government retirees will get financial assistance from the state to help pay for medications when their prescription drug coverage moves from a state plan to the federal Medicare Part D program next year. Gov. Larry Hogan and General Assembly leadership announced a one-year transition program in which the state will reimburse all out-of-pocket drug costs exceeding $1,500. That is the limit under the current state plan. The move to the federal prescription drug plan, which will take place Jan. 1, is part of state pension reform passed in 2011. (McDaniels, 7/16)

Kaiser Health News: Staggering Prices Slow Insurers’ Coverage Of CAR-T Cancer Therapy

Patients whose blood cancers have failed to respond to repeated rounds of chemotherapy may be candidates for a new type of gene therapy that could send their cancers into remission for years. But the two approved therapies, with price tags of hundreds of thousands of dollars, have roiled the insurance approval process, leading to delays and, in some cases, denials of coverage, clinicians and analysts say. (Andrews, 7/17)

It has been two months since the president released his road map for lowering drug costs that seems to lead nowhere, and about a month since he predicted the “big drug companies” would announce “voluntary massive” price cuts. Here’s where things stand: A congressional investigation has found that the drug company Novartis got more out of its $1.2 million payment to Mr. Trump’s “personal attorney” Michael Cohen than had been known. Meanwhile, several other drugmakers defied Mr. Trump’s lofty prediction by raising their prices substantially, while his administration shot down a proposal that would have helped individual states lower their drug costs. (7/17)

Hospitals could make great strides in reducing the cost of delivering health care — particularly when it comes to drug costs — through a tight focus on their processes, especially the instructions that are often detailed in electronic health record systems. At many hospitals, drug costs are an expense second only to salaries. A 2016 survey of 712 hospitals by the American Hospital Association and the Federation of American Hospitals showed that inpatient drug spending rose 23 percent a year between 2013 and 2015, and by 39 percent on a per-admission basis. (7/16)

The biggest players in pharma and biotech firms are in a rut, and even a heroic earnings season might not be enough to lift it out. The broader environment is positive: The Trump administration’s drug-pricing push is for now more sound than fury, the economy is humming, and new treatments are being approved at a rapid clip. And of course there are the benefits still accruing from the recent tax legislation. But pharmaceutical stocks from Bristol-Myers Squibb Co to Novartis AG are lagging behind the market, and a turnaround may not be forthcoming. It’s getting tougher to find blockbusters, which may make it difficult to deliver the returns investors are accustomed to, even if the latest crop of earnings come in strong. (Max Nisen, 7/16)

One of Donald Trump's more memorable promises on the campaign trail was to lower the cost of prescription drugs. Polls show this issue remains popular with Americans, especially lower-income families, who are worried about high drug prices. Of course, the entire concept of drug prices' being "too high" is subjective. Drugs are too expensive ... compared with what? Certainly not compared with not having the drugs available at all. If you suffer from the intense pain of migraine headaches or have been diagnosed with lung cancer, how much would you pay for a drug to help you? I have friends who have children who are afflicted with epilepsy or rare and fatal blood diseases, and they say they would literally give up everything they have for treatments to cure their children. (Stephen Moore, 7/16)

If you’re a powerful American drug company, then you’ve had a strange couple of months. In that time, you’ve experienced a rainbow of emotions: fear, relief and, now, confusion and anxiety. The roller-coaster ride, as you recall, began in mid-May when President Trump stood alongside HHS Secretary Alex M. Azar, in the Rose Garden of the White House, in front of a sign reading “Lower Drug Prices for Americans.” (Robert Pearl, 7/16)

Champagne corks were popping on Wall Street on May 11. President Trump had just delivered his “American Patients First” speech to address the soaring cost of prescription drugs. Investors in the pharmaceutical sector had reason to celebrate there were few teeth in the president’s new policy, and the ones that were there had unspecified timelines. At the closing bell that day, the pharmaceutical sector had surged 2.7 percent on the S&P 500. (Judith Butler, 7/17)

While we served in different administrations, we faced similar challenges in trying to improve the nation’s health-care system. The basic goal was to improve the quality of the care delivered and moderate the costs. While there are several key reforms that will help us address this challenge, one idea that nearly all health leaders in the Bush, Obama and Trump administrations agree on is that we need to move as quickly as possible from a fee-for-service, volume-based model to a health system that pays for what happens to the patients — the outcome or value of care. (Kathleen Sebelius and Tommy G. Thompson, 7/18)

You can feel the glee radiating from Gov. Larry Hogan’s re-election campaign at The Sun’s report Tuesday on a Department of Legislative Services estimate of what it would cost to implement a Maryland single-payer health care plan like the one Democrat Ben Jealous is proposing in this year’s election. The grand total — about $24 billion in new state spending, which is more than half of the entire existing state budget — sounds like an enormous amount of money, and it fits right in with the Hogan campaign’s efforts to paint Mr. Jealous as a wild-eyed tax-and-spend liberal, if not outright socialist. (7/17)

“Based on historical standards of material wellbeing and the terms of engagement, our War on Poverty is largely over and a success.” That’s from a new report by the White House Council of Economic Advisers. Naturally, the announcement triggered a certain amount of incredulity. Had the CEA visited the nation’s poorer urban, exurban and rural communities? If the War on Poverty is largely over and a success, why does poverty still seem to hold so many fortified positions? (Megan McArdle, 7/17)

The Supreme Court said in its Janus ruling last month that unions must obtain clear and affirmative consent from public employees before they collect fees. Now the Department of Health and Human Services has taken the first step toward affording home-care providers the same protection against unions that want to confiscate their money on the sly. States receive federal funds to defray the cost of in-home care for the poor and ill or disabled. These caregivers are often family members who devote their time to changing adult diapers, making sure medications get taken as prescribed, and other labors of love. But unions wanted a cut of the cash from Medicaid, the Child Care and Development Fund, and Temporary Assistance for Needy Families program. So they have argued that home-care providers should be counted as dues-paying state employees—regardless of whether caregivers want to join the union. (7/17)

It’s one thing to look at America’s health care system as a business leader, legislator, or administrator. It’s quite another to look at it as a patient or a parent. That came into sharp focus when both of my children were born more than five weeks prematurely and suffering from respiratory distress syndrome. Long days became even longer nights in the hospital neonatal intensive care unit. Fear, anxiety, and questions swirled. What are we supposed to do when we get home? What if they stop breathing? Are they going to be OK? (Matt Eyles, 7/18)

Since President Donald Trump nominated Brett Kavanaugh to replace retiring U.S. Supreme Court Justice Anthony Kennedy, the prospect that a conservative-majority court would overturn Roe v. Wade has been the subject of heated debate. A clear majority of Americans support abortion rights: Seven in 10 Americans oppose overturning Roe, according to the Pew Research Center, and 57% say abortion should be legal in most or all cases. ...If the high court overturned Roe, abortion would be illegal in Michigan. (Nancy Kaffer, 7/18)

Pediatricians work hard to keep children safe. They rely on reams of evidence to support their interventions and spend their careers striving to deliver the best care possible. One voice should not drown out thousands of others simply because that voice invokes unnecessary fears. (Emiliano Tatar, 7/18)

As Beth Israel Deaconess Medical Center and Lahey Health continue to pursue their merger dreams, those questions are front and center. The answers have huge implications for the many residents of the state — many of them working-class and people of color — who worry about becoming collateral damage. (Adrian Walker, 7/17)

Now that youth has blown away with successive winds, it feels imperative to try to preserve some sense of vitality, of stamina — some recognition in the present of what had been the enthusiasm in the past for a vibrant life, especially as talk about illness and dying is endemic among the elderly. I’m not frail; I exercise at the gym three times a week. But after 30 years of smoking from my mid-teens to early middle-age, I have lung issues. Modern medicine has kept them under control, but I’m limited in what I can do. Take, for instance, the motorcycle course I failed. The lightweight Japanese bikes proved to be too heavy for me. It’s disillusioning and disappointing when the body can’t follow through on what the mind wants it to do. (Richard C. Gross, 7/17)