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President Trump wants to replace his secretary of veterans affairs, David Shulkin, but for a man who practically trademarked “You’re fired,” the president is reluctant to pull the trigger, choosing instead to leave the embattled secretary twisting amid reports of his imminent ouster. Mr. Shulkin, a former hospital executive and medical doctor who remains widely popular on Capitol Hill, has so far averted his gaze from the White House and pressed on with his duties, albeit with a diminished profile. (Haberman and Fandos, 3/27)

Veterans Affairs Secretary David Shulkin appears to be on thin ice with the White House, but Shulkin has maintained a critical bloc of support in the nation's veterans groups, who have come out vocally calling on President Donald Trump to keep him at the helm of the agency. John Rowan, the head of the Vietnam Veterans of America, defended Shulkin on Tuesday, saying that Shulkin has stayed true to the agency's mission of serving America's veterans -- and that he wants to see Shulkin finish what he started. (Summers, 3/27)

Several anti-smoking groups are suing the Food and Drug Administration over a decision by Trump administration officials to delay the review of e-cigarettes. The lawsuit filed Tuesday in federal court argues that the FDA didn't follow proper requirements last year when it decided to push back the deadline for makers of e-cigarettes to submit their products for review. The groups say the delay poses a threat to children's health. (Perrone, 3/27)

The lawsuit is challenging an agency decision last summer to grant lengthy deadline extensions to manufacturers seeking FDA approval for their products. Originally, the companies were required to submit such product-review applications by this August for any item that went on the market after February 2007. The revised timeline changed that to August 2021 for cigars and August 2022 for e-cigarettes. The extensions have been embraced by the e-cigarette industry, which feared that many of its products would be banned under the original schedule. In the suit filed Tuesday, health groups argue that the delay allows flavored tobacco products that target children and teenagers to remain on the market. (McGinley, 3/27)

The Campaign for Tobacco-Free Kids and other groups behind the lawsuit argue candy flavored cigars and e-cigarettes appeal to children, who could grow addicted while the products are sold and before the reviews are completed. “As a result of the guidance, consumers will continue to be exposed for many years to thousands of tobacco products containing lethal and addictive components that have not met the statutory requirements,” the groups said in their 45-page complaint, filed in the U.S. District Court for the District of Maryland. (Wheeler, 3/27)

Medicare officials thought they had finally figured out how to do their part to fix the troubling problem of opioids being overprescribed to the old and disabled: In 2016, a staggering one in three of 43.6 million beneficiaries of the federal health insurance program had been prescribed the painkillers. Medicare, they decided, would now refuse to pay for long-term, high-dose prescriptions; a rule to that effect is expected to be approved on April 2. Some medical experts have praised the regulation as a check on addiction. (Hoffman, 3/27)

The U.S. economy has lost close to 1 million workers and $702 billion due to opioid addiction, according to a study released Tuesday. The American Action Forum (AAF), a right-leaning think tank, analyzed the impact of the opioid epidemic on U.S. labor force participation and output between 1999 and 2015. The group applied findings from previous studies on the economic impact of opioid addiction to data tracking the size of the U.S. workforce and gross domestic product (GDP). (Sylvan, 3/27)

Sheila Dhand treats a lot of people who might not step foot in a health clinic or hospital — until an emergency. "People don't want to show just anybody their wound," Dhand says. "A lot of time when talking about wounds, we're talking about drug use. And those things are so taboo." Dhand is a wound care nurse with Prevention Point, a nonprofit organization that provides addiction, health and harm reduction services in Philadelphia. Her job involves going out in a mobile-wound-care-van where she tends to skin and soft-tissue infections that often result from injecting drugs. (Gordon, 3/28)

Cigna has reduced the amount of opioids its customers use by 25 percent, the health insurer announced Wednesday. In May 2016, Cigna, one of the country’s largest health insurers, began identifying measures it could implement to try to curb the opioid epidemic. One of its efforts included decreasing opioid use 25 percent by 2019, a goal the company announced it has already met. (Roubein, 3/28)

Kaiser Health News: Difficult To Measure Rate Of Suicide Among Deaths From Opioid Overdoses

Mady Ohlman was 22 on the evening some years ago when she stood in a friend’s bathroom looking down at the sink. “I had set up a bunch of needles filled with heroin because I wanted to just do them back-to-back-to-back,” Ohlman recalled. She doesn’t remember how many she injected before collapsing, or how long she lay drugged-out on the floor. “But I remember being pissed because I could still get up, you know?” (Bebinger, 3/28)

The effort, called “Recovery Friendly Workplace,” is aimed at getting the private sector involved in combating the opioid crisis. Businesses can apply to the program to be certified as recovery friendly. That means they offer certain training to managers and support for employees struggling with substance abuse. (Greene, 3/27)

A new report by the Wyoming Survey and Analysis Center shows that opioid abuse in the state is following the same rising trends as the rest of the nation, but isn’t seeing the skyrocketing rates of Appalachia and New England. (Edwards, 3/27)

Needles will be available. Condoms won't. That's the plan for two anticipated needle exchanges in Northern Kentucky, despite the tradition of giving away condoms at needle exchanges to help fight infectious diseases. (DeMio, 3/27)

While electronic health records, clinical data-sharing tools and connected devices such as blood pressure and heart rate monitors benefit patients and make the industry more efficient, they also can leave valuable health information exposed. Every technology that connects to the internet comes with a security risk, since it is a potential doorway into a network. The tech-heavy health care industry has multiple entryways — from electronic health records to medical devices and laptops — where patient data is stored. (Rice, 3/27)

Take two tablets and a selfie? Your doctor's orders may one day include a smartphone video to make sure you took your medicine. Smartphone apps that monitor pill-taking are now available, and researchers are testing how well they work when medication matters. Experts praise the efficiency, but some say the technology raises privacy and data security concerns. (Johnson, 3/28)

The federally-funded study looked at more than 1.7 million reports of safety issues mainly in Pennsylvania, and found 1,956, or .11 percent, that mentioned a top-five health record system as a cause of patient harm. Some 557 (0.03 percent) reports had "language explicitly suggesting EHR usability contributed to possible patient harm," and among those, 80 caused temporary harm, seven may have caused permanent harm and two may have been fatal. (Goldberg, 3/27)

Morton Hospital, owned by Steward Health Care, is closing its labor and delivery services amid an extended slide in the number of women having babies at the facility. The same pattern is playing out in other Massachusetts communities and across the country. (Dayal McCluskey, 3/27)

University Hospitals was close to one day away from moving eggs and embryos to safety when a temperature fluctuation in a storage tank damaged them, rendering all 4,000 eggs and embryos in the hospital system's care nonviable. Initially, UH said 2,000 eggs and embryos were affected but late Monday revised that number to include all the specimens and upped the number of patients involved to 950 from the original 700. (Christ and Washington, 3/27)

A Pennsylvania branch of Planned Parenthood says a tweet declaring the need for a Disney princess who's had an abortion was not appropriate and the organization has taken it down. An executive for Planned Parenthood Keystone says the group believes pop culture plays a "critical role" in educating the public and sparking "meaningful conversations about sexual and reproductive health issues and policies, including abortion." (3/27)

Both sides of the abortion debate are making a final push to submit comments on a proposed rule that would allow health professionals to decline to participate in procedures they oppose on moral or religious grounds. The public comment period on the Trump administration's proposed rule ends Tuesday with more than 64,000 comments submitted from both sides of the issue. The rule also would impact policies around end of life care, contraception and other issues. (Raman, 3/27)

When journalist Maya Dusenbery was in her 20s, she started experiencing progressive pain in her joints, which she learned was caused by rheumatoid arthritis. As she began to research her own condition, Dusenbery realized how lucky she was to have been diagnosed relatively easily. Other women with similar symptoms, she says, "experienced very long diagnostic delays and felt ... that their symptoms were not taken seriously." (Gross, 3/27)

North Carolina’s prison system will no longer shackle pregnant inmates to their hospital beds while they are in labor. Prisons director Kenneth Lassiter signed a new policy on Monday to end the use of leg or wrist restraints on pregnant inmates who are giving birth, The News and Observer reported. The inmate will still be handcuffed during transportation to the hospital, as long as she could protect herself or the fetus if she were to fall. (Gstalter, 3/27)

On a recent Sunday, Emily Dial prepared to deliver a baby, just as she had done so many other times in her years as a nurse midwife. She scrubbed in, donned surgical gloves and surveyed the delivery room at Frankfort Regional Medical Center in Kentucky. There were about half a dozen members of a medical team inside, all preparing for the scheduled Caesarean section.Ready at last, Dial climbed onto the operating table and lay down as someone covered her with a see-through plastic drape. (Wang, 3/27)

Adam Fuller credits a simple, one-word command — and a black Lab mix named J.D. — with helping to save his life.“Cover,” he tells J.D., who is sitting to his left in a grassy field next to a park playground. The dog calmly walks to Fuller’s right, then sits facing backward. Were someone coming up from behind, he’d wag his tail. The signal quells the sense of threat that plagued Fuller after serving in Afghanistan, that at one point had him futilely popping medications and veering toward suicide. (Brulliard, 3/27)

Parkland Memorial Hospital in Dallas has received a perfect score for its health care options for lesbian, gay, bisexual and transgender Texans, according to an annual survey by LGBT rights organization the Human Rights Campaign. The 11th annual Healthcare Equality Index ranked 1,600 health care facilities across the nation for factors such as patient nondiscrimination and staff training. Parkland was the only Dallas-area medical center to receive a score of 100 percent. (McGaughy, 3/27)

Missouri has an unusually high number of hospitals with medical and employer practices that accommodate the needs of LGBTQ individuals, according to a new report from a national advocacy organization. The Healthcare Equality Index, released Tuesday by the Human Rights Campaign Foundation, names 14 Missouri hospitals as “LGBTQ Healthcare Equality Leaders.” That puts Missouri 8th in the nation for the number of such hospitals. Several Kansas City-area hospitals, including those in the St. Luke’s, Children’s Mercy and Truman Medical Centers systems, are listed as leaders. (Smith, 3/27)

Nine Wisconsin health care facilities earned top scores on the Human Rights Campaign Foundation's 11th Healthcare Equality Index. HRC scores health care facilities on policies and practices dedicated to the equitable treatment and inclusion of their LGBTQ patients, visitors and employees. A record 626 health care facilities participated in this year’s survey, including 10 in Wisconsin. (3/27)

The high-profile negotiations have evolved into the brinkmanship that often occurs in contract disputes between hospitals and health insurers. Piedmont Healthcare and Blue Cross and Blue Shield of Georgia face a March 31 deadline before their reimbursement contract runs out. (Miller, 3/27)

Ascension has signed a letter of intent to sell St. Vincent's Medical Center to Hartford HealthCare, the organizations announced Tuesday. Bridgeport, Conn.-based St. Vincent's includes a 473-bed community teaching hospital, a 76-bed inpatient psychiatric facility, a large multispecialty provider group and a special needs services arm. It employs more than 3,200 associates. If the transaction closes after customary regulatory reviews, St. Vincent's would continue to operate in compliance with Catholic traditions. (Kacik, 3/27)

Jefferson Health and Einstein Healthcare Network have signed a letter of intent to merge, which would create the largest residency program in the Philadelphia area. Jefferson has grown from a three-hospital academic medical center anchored in Philadelphia to a 14-hospital system with about $5 billion in annual revenue. It has been incrementally growing its network over the past several years through partnerships with Abington in the Pennsylvania suburbs, Aria Health in the Philadelphia region, Magee Rehabilitation also in Philadelphia, Kennedy in New Jersey and Philadelphia University. (Kacik, 3/27)

Nineteen years after a landmark U.S. Supreme Court ruling opened the doors to integration, thousands of Minnesotans with disabilities continue to live and work in segregated settings that keep them in poverty and limit their daily autonomy. These are among the principal findings of the state’s first comprehensive survey examining the quality of life of nearly 50,000 Minnesotans with physical, intellectual and developmental disabilities who spend most of their time in settings such as group homes, nursing facilities and cloistered workplaces known as sheltered workshops. (Serres, 3/27)

Therapy to change a child's sexual orientation or gender identity will soon be banned in the city of Milwaukee. Mayor Tom Barrett is set to sign a ban on the controversial practice, commonly known as "conversion therapy," which was overwhelmingly approved Tuesday by the Milwaukee Common Council. (Spicuzza, 3/27)

A commissioner with the Maryland Health Care Commission on Monday recommended an Anne Arundel Medical Center psychiatric hospital. The AAMC Mental Health Hospital would house 16 beds and offer in-patient and out-patient treatment for an array of mental health conditions. It would be a freestanding unit next to the Pathways alcohol and drug treatment facility on Riva Road. The project would comprise 56,236 square feet on four levels and cost about $25 million. (Ohl, 3/27)

Medivac miracles have long generated nightmare stories about patients who survived but were saddled with eye-popping bills — and, for many years now, state officials have been frustrated they can’t do anything to help, often facing court challenges when they tried. The need for air ambulance transport comes up only in dire situations, when consumers have no control over whether services are within their insurance network. (Rayasam, 3/27)

Dale Fountain is an intensely private man. He won’t say where he works. One of his oldest friends can’t say for sure where he lives. His sister knows he was once married but she isn’t in the loop these days — they haven’t spoken in two years. “He keeps to himself,” said Chris Pulliam, who went to high school with Fountain in Los Angeles and now lives in Silver Spring, Md. “I’ve just got into the habit of not asking about things.” Yet the elusive 42-year-old Silicon Valley tech worker has inserted himself into the forefront of California’s hottest health care debate: whether it should adopt a statewide single-payer health care system. (Bartolone, 3/27)

Some allergy clinics in Kansas City and elsewhere have already been offering peanut desensitization treatments, but the study that Children's Mercy is participating in is among the first worldwide to try it in a controlled, formal way. Children’s Mercy allergist Jay Portnoy said the trial, which is going on at research sites across the country, has been so successful that as soon as the U.S. Food and Drug Administration approves a product for commercial use, the hospital will start offering it to pediatric patients who aren't in the study. (Marso, 3/28)

Across America, millions of parents find themselves caught amid these opposing forces: diapers that keep getting better but not cheaper, the gap in assistance for the poor and the every-few-hours wail of a child who needs a change. (McGrory, 3/28)

Charles Ryan, director of the Arizona Department of Corrections, took the witness stand in U.S. District Court in Phoenix on Tuesday during a hearing to determine whether he and his department should be held in contempt of court over monitoring prison health care. The gist of his testimony, as one of his medical directors testified the day before, was that the health-management company retained by his department to manage inmate health care has been the root of the problem. (Kiefer, 3/27)

For the first time in a decade, Florida juvenile detention and probation officers will see a bump in their salaries — an increase in the state budget that is part of a series of juvenile justice reforms passed by the Legislature this month. (Marbin Miller, 3/27)

Chemical contamination from the North Bay Fires could now force Santa Rosa to replace the water delivery system for the severely burned Fountaingrove neighborhood, at an unbudgeted cost of $43 million. (Peterson, 3/27)

Less than three months after announcing a new initiative to combat homelessness, Mayor Martin J. Walsh said Tuesday that private businesses have already kicked in more than $3 million in donations toward the effort. That’s a third of the way toward Walsh’s goal of raising $10 million for Boston’s Way Home Fund — a city initiative he announced at his January inauguration that would subsidize rental housing to those most in need, coupled with services to help build life skills. (Valencia, 3/27)

The Louisiana Pharmacy Board postponed awarding a permit for a medical marijuana pharmacy to operate in the metro New Orleans area during its meeting Tuesday (March 27) in Baton Rouge. Instead, the board took all of the applications, including two that are seeking to open dispensaries in Metairie, under advisement until April 17. The 17-member board, which state law mandated to oversee the permit process, has said it will issue operating permits to one pharmacy in each of the state's nine designated health care regions. A 10th permit will be issued as needed. (Bacon-Blood, 3/27)

Five Iowa cities could soon have medical marijuana dispensaries after the state picked its preferred distributors Tuesday. Sioux City, Council Bluffs, Waterloo, Davenport and the Des Moines suburb of Windsor Heights are each slated to get a medical marijuana dispensary, if the companies accept the licenses by 9 a.m. on Wednesday, March 28. (Payne, 3/27)

They started as simple claims processors. Then, over three decades of mergers and shifts in business strategy, pharmacy benefit managers emerged as powerful conglomerates with the ability to extract billions of dollars in payments from the largest players in the nation’s drug supply chain. And now, as their role in prescription drug pricing comes under increasing scrutiny, the nation’s biggest PBMs are changing shape again — this time by aligning themselves with the nation’s largest insurers. (Ross, 3/22)

It’s a rite of passage for executives in the hot seat: get hauled before Congress, sit for bipartisan tirades, squirm in the face of difficult questioning. Over the past six months, lawmakers have dragged in former Equifax CEO Richard Smith, Wells Fargo’s Tim Sloan, and Amtrak’s Richard Anderson. Facebook’s Mark Zuckerberg could be the next one up. (Mershon, 3/28)

The pharmaceutical industry's top trade group on Tuesday launched a new series of advertisements as part of its drug pricing campaign aimed at blaming cost increases on insurers and pharmacy benefit managers. Pharmaceutical Research and Manufacturers of America's (PhRMA) ads in print, radio, digital and social media highlight drug companies’ use of copay coupons to help people lower their deductibles. (Weixel, 3/27)

The Securities and Exchange Commission agreed to allow shareholders in five large drug makers to vote on a proposal demanding the companies compile reports about the risks created by high prices and also examine the extent to which pricing strategies propel executive compensation. The companies involved are AbbVie (ABBV), Amgen (AMGN), Biogen (BIIB), Bristol-Myers Squibb (BMY), and Eli Lilly (LLY). (Silverman, 3/26)

The U.S. renegotiation of its free trade agreement with South Korea will include provisions to boost American pharmaceuticals as well as a pending side agreement on currency, officials said Tuesday. The White House confirmed it had renegotiated elements of the Korea-U.S. Free Trade Agreement, known as KORUS, a day after Korean Trade Minister Kim Hyun-chong announced the move. (Elis, 3/27)

The Trump administration has issued a policy change that could drive up prices of certain biologic drugs, implementing a new industry-backed measure that overturns existing regulation that promoted lower prices. The move came after months of intense lobbying last year by pharmaceutical companies to overturn an Obama administration policy, introduced in 2015, that rewarded doctors with larger profits if they used the lowest-priced biosimilars, which are generic-like copies of brand-name biologic drugs. The rationale was that steering doctors to lower-priced products would compel drugmakers to cut prices to capture market share. (Walker, 3/22)

Biotech unicorn Moderna Therapeutics baffled its peers last month when it raised $500 million in a seventh round of venture financing. How, the question went, did the company sell investors on a $7.5 billion valuation despite outstanding questions about its science? STAT obtained Moderna’s investor slide deck, one in which the company predicts billion-dollar futures for drugs only tested in mice and argues its vaccines business can bring in $15 billion in annual revenue. Those promises didn’t sit well with some investors. (Garde, 3/27)

Emma Walmsley, the rookie chief executive of GlaxoSmithKline PLC, is giving the 300-year-old British drug giant’s ailing research-and-development operations a dose of bitter medicine. In the roughly one year that the 48-year-old former cosmetics executive has been in place, Ms. Walmsley has replaced nearly half of Glaxo’s top 125 executives, according to the company. She has reassigned or let go some 400 scientists in its drug-development unit, and another 100 science jobs are still on the line, according to people familiar with the matter. She is also shutting down more than two dozen clinical drug trials, as she narrows the focus of Glaxo’s drug-discovery portfolio. (Bisserbe and Lublin, 3/25)

Gilead Sciences completely transformed its business model last year when it got into the cell-therapy field by buying CAR-T developer Kite Pharma for $11.9 billion. Its top line won't be transformed so quickly. Kite’s cancer CAR-T, approved by the FDA in October, faced early reimbursement hurdles that hampered pickup. Declining sales in the company’s hepatitis C franchise drove Gilead’s total revenues for 2017 down 14% to $26.1 billion. (Weintraub, 3/27)

When it comes to philanthropy, the Arnolds are the only major game in town on drug pricing at a time when other billionaires are flocking to fund politically charged work on hot-button issues like climate change and gun control. But no one really seems to have a good idea of what exactly has motivated the Arnolds to take on drug pricing — or specifically what their endgame is to go about addressing it. (Robbins, 3/26)

In a setback to the Federal Trade Commission, a federal judge has dismissed the first-ever lawsuit filed by the agency against a drug maker for abusing the citizen’s petition process in order to thwart generic competition to a best-selling medicine. However, the FTC appears to have won a key point that may make it more difficult for drug makers to fend off such challenges in the future. And the judge left the door open for the FTC to refile its lawsuit, although an FTC spokeswoman declined to comment when asked if the agency will do so. (Silverman, 3/23)

Cut-price copies of an expensive Roche biotech drug for blood cancer have taken 80 percent of the British market since launching last year, saving the healthcare system 80 million pounds a year, experts said on Wednesday. The rapid adoption of two so-called biosimilar forms of rituximab from Celltrion and Novartis has been accompanied by discounts of 50-60 percent as the National Health Service (NHS) has used tenders to bring down costs. (Hirschler, 3/21)

Roche is back with more survival data for its Tecentriq-Avastin cocktail—and it’s more important survival data, too. Sunday night, the Swiss drugmaker revealed that in a phase 3 trial, the two meds, combined with chemo, had beaten out an Avastin-chemo combo at prolonging lung cancer patients' lives. The trial, focused on previously untreated non-small-cell lung cancer patients, showed that the survival benefit extended across various subgroups, and it was seen in patients with tumors expressing varying levels of PD-L1. (Helfand, 3/26)

Amid ongoing scrutiny of compounding pharmacies, the Food and Drug Administration has issued new draft guidelines to address a contentious debate: When should compounders use the same raw ingredients that are found in prescription medicines? Known in industry parlance as bulk substances, these ingredients figure prominently in discussions over the safe use of compounded medicines, as well as rising tensions between drug makers and compounders that are vying for some of the same patients. (Silverman, 3/23)

Pharmacy benefit managers are receiving $1.54 per pill from Ohio’s Medicaid program for a drug commonly used to treat depression. The state pharmacy association and operators of nearly two dozen pharmacies across the state say those same pharmacy benefit managers, or PBMs, are paying them only about 18 cents for each of those pills. (Candisky, 3/25)

A hospital-backed nonprofit generic drug manufacturer has radical plans for the drug industry as it prepares to launch operations later this year. Leaders of the drugmaker said they planned to publish drug prices in an effort to force more transparency in an industry that is known for being opaque. (Liss, 3/25)

Mayor Rahm Emanuel and City Clerk Anna Valencia have been accused of “suborning voter fraud” by allowing Chicago’s CityKey municipal identification card to be used to register to vote. They’ve also been hit with a rival bidder’s politically-explosive claim that printing technology used to create the new ID compromises personal information that the city had promised to keep confidential to shield illegal immigrants from the threat of deportation. (Spielman, 3/26)

Mayor Rahm Emanuel wants Chicagoans to be able to use new municipal ID cards to get discounts on prescription drugs. Emanuel and City Clerk Anna Valencia on Monday announced a request for proposals to add the benefit to the CityKey cards. Chicagoans also will have the option of getting a separate card for prescription drug discounts, the city clerk’s office said. (Schencker, 3/26)

As the owner of the only drugstore in Trimble County, pharmacist Jennifer Grove says she provides a vital service for customers, including some who walk to the Bluegrass Drug Center in Bedford, population 600, to obtain needed medication." A lot of elderly people don't drive," she said. "A lot of poor people don't drive."But the growing power of an industry middleman in the state's Medicaid program known as a "pharmacy benefit manager," or a PBM, to determine payments to pharmacies is threatening the business of the 520 independent pharmacies around Kentucky, according to such pharmacists. (Yetter, 3/26)

They were among a dozen advocates and people living with cancer, HIV, multiple sclerosis and other chronic conditions who met Sunday with Sen. Tina Smith, D-Minn. The group spoke of the challenges of paying for prescription medications and how drug costs can be lowered.In her first piece of stand-alone legislation, Smith has introduced a bill to close a loophole that allows major drug companies to “pay to delay” bringing more affordable generic drugs to market. (Pheifer, 3/25)

It’s hard to remember now, but there once was a time when pharmaceutical companies were considered heroes, not villains. In the 1920s, Dr. Frederick Banting and Charles Best discovered insulin could be purified and administered to diabetes patients via injection. Before this groundbreaking discovery, people living with diabetes were placed on starvation diets as a form of treatment, and many patients died. (Marlene Beggelman, 3/26)

If one message is becoming clear, it’s that increased concentration is harming consumers and leading to less competition, decreased choice and higher cost. The need for corporations to compete is dampened when markets are dominated by a small number of firms. Worse, when consumers don’t have the ability to discipline markets there is a lack of transparency or accountability. Nowhere is that more true than in the market for Pharmacy Benefit Managers (PBMs) — the unregulated entities that control the reimbursement of drugs. (David Balto, 3/27)

Asset swaps have been a big thing in pharma over the past few years. Now it's time for the un-swap. Novartis AG on Tuesday said it was unwinding part of a complicated 2014 asset swap with GlaxoSmithKline PLC, trading its stake in their consumer-health joint venture for $13 billion. The decision isn't a huge surprise, though the timing is unexpected. It suggests new Novartis CEO Vas Narasimhan won't be shy about dealing with the long list of decisions his predecessor left him. It also hints at sizable, pharma-focused M&A to come. The company would be well served by ambition on both fronts. (Max Nisen, 3/27)

Of all the items on a biotech CEO’s worry list, high-level government policy has to be at or near the bottom. The demands of launching a business—every aspect of the future organization embodied in a single individual—hardly leave time for a personal life, let alone consideration of economic policy. Yet policy made in disparate parts of the world can have a profound effect on a company and an industry to innovate. (Standish Fleming, 3/27)

It's easier to promise a quick biotech buck than deliver one. Biohaven Pharmaceutical Holding Co. Ltd., which raised nearly $200 million in an IPO last year, announced Monday that its lead migraine pill had met its main goals in a late-stage trial. But the drug didn't have the impact investors had hoped, and the firm's shares retreated to their IPO price. (Max Nisen, 3/26)

Patricia Bernard of Falmouth has unwittingly become the face of American seniors facing high drug costs. Sen. Susan Collins recently invited Bernard to tell her story before the Senate Aging Committee, which Collins chairs. Diagnosed with rheumatoid arthritis 25 years ago, Bernard worked until age 79 to keep her employer-sponsored health insurance plan that allowed her to purchase the medication she needed for between $10 and $30 a month. (Terry Wilcox, 3/23)

We live in a time of extraordinary promise. Breakthroughs in artificial intelligence, 3D manufacturing, medical science and other areas have the potential to dramatically raise living standards in coming decades. But a major obstacle stands squarely in the way of this promise: high and sharply rising government debt. (Michael J. Boskin, John H. Cochrane, John F. Cogan, George P. Shultz and John B. Taylor, 3/27)

It’s understandable that Justice John Paul Stevens would call for repeal of the Second Amendment, as he did Tuesday in an op-ed article in the New York Times, in the aftermath of the U.S. Supreme Court’s misinterpretation of it to protect some gun sales. I have great respect for Justice Stevens, and what’s more I agree with him that the Heller case was wrongly decided by the court in 2008. But it would actually be a terrible idea to attempt a repeal of the Second Amendment just because the Supreme Court got it wrong. Experience shows that the Constitution is weakened if we respond to bad Supreme Court precedent by trying to amend it right away. (Noah Feldman, 3/27)

Critics often accuse the National Rifle Association of paranoia for arguing that gun controllers want to eliminate the Second Amendment. Well, being paranoid doesn’t mean the NRA is wrong. Look no further than former Supreme Court Justice John Paul Stevens, who is arguing this week that the Parkland, Florida, students and their allies shouldn’t settle for mere restrictions on guns. They should lobby Congress and the states to abolish the Second Amendment. (3/27)

Former Supreme Court Justice John Paul Stevens has just done the NRA and its allies a great favor: In an opinion piece in The New York Times, he proposed to repeal the Second Amendment.“ That simple but dramatic action would move Saturday’s marchers closer to their objective than any other possible reform,” argued Stevens, who dissented in the landmark cases recognizing an individual right to own firearms for self-defense. (Steve Chapman, 3/27)

In a last-minute move that would give Republicans an advantage in maintaining control of the House of Representatives, the Trump administration is reinstating a question about citizenship to the 2020 census. ...If the decision stands — the attorney general of California, Xavier Becerra, has filed a lawsuit seeking to block it, and other elected officials are preparing to do so, too — it would be the first time in nearly 70 years that the federal government has asked people filling out census forms to list their citizenship status. This is important because the census count determines how many House seats each state gets. The census is also used to determine how more than $600 billion in federal spending is allocated across the country, including Medicaid, food stamps and grants to schools. (3/27)

Disdain for street people is nothing new. To Marcus Tullius Cicero, homeless Romans were "the poverty-stricken scum of the city," who ought to be "drained off to the colonies." Following Huntington Beach's recent mobilization of the city's paid legal staff to oppose a county plan to house 100 homeless people near Huntington Central Park, similar coarse statements appeared in newspaper comment sections. ...When one scratches deeper into the homelessness issue, these attitudes appear not just a byproduct of the problem but also a source of it. And while the sentiment dates to Cicero — and exists in Europe, Canada, South America and elsewhere — residents in Southern California seem to shout the loudest about grime, odors and plunging housing values linked to their homeless neighbors. (Erik Skindrud, 3/27)

Pharmacists who dispense controlled substances have a responsibility not to dispense to patients who may be at risk for abuse of these drugs; however, their tools are limited. The systems that clinicians rely on to detect improper opioid prescriptions – known as Prescription Drug Monitoring Programs (PDMPs) – hold great promise, but they operate as a patchwork of separate programs in each state, creating troubling blind spots that allow episodes of abuse and unintended misuse to fester.(Joel White and Lee Ann Stemper, 3/28)

Iowa lawmakers should finally allow needle-exchange It is difficult to understand the rationale of some Iowa lawmakers. Again this year they have failed to pass simple legislation clearing the way for needle-exchange programs to legally operate in this state. Fortunately, lawmakers still have time to get this done. Three dozen other states allow needle-exchange programs, which provide intravenous drug users a way to turn in contaminated syringes and receive clean ones. Supporters say these programs can reduce transmission of diseases, and there is likely federal money available to fund them. (3/27)

Thousands of young people essentially said “enough” this past weekend in marches nationwide. The issue was guns and adult inaction on them. Our children were pointing their fingers at adults who apparently believe the Second Amendment permits the nation’s youngsters to be deemed acceptable collateral damage in the name of keeping highly lethal weapons legal. (O. Ricardo Pimentel, 3/27)

The majority of those crowded into the standing-room-only hearing on arming Kansas teachers had come to the Statehouse to plead against that folly. But it was those who’d come to argue in support of a bill that could force some teachers to take up arms who made the strongest case against pressuring educators to double as first responders. (Melinda Henneberger, 3/27)

While drug overdose deaths set records across the country, they began to recede in Rhode Island. How did the small state buck such a powerful trend? By providing to some of its most vulnerable residents the treatment proven most successful in saving lives. In 2016, the Rhode Island Department of Corrections began screening all inmates for opioid use disorder and providing those who needed it with medications for addiction treatment – methadone and Suboxone to quell cravings, and Vivitrol to prevent users from getting high. (3/27)

After a massacre at Columbine High School in Littleton, Colorado, in April 1999, journalists thought they saw a groundswell of public support for new regulations on gun ownership. Frank Bruni, then a reporter for the New York Times, marveled that “the earth has finally moved.” He explained that the National Rifle Association had lost clout. In the Washington Post, Roberto Suro reported that polling had shifted in favor of gun control. Cities were filing lawsuits to hold gun makers responsible for gun deaths. (Ramesh Ponnuru, 3/27)

My first interaction with Nikolas Cruz happened when I was in seventh grade. I was eating lunch with my friends, most likely discussing One Direction or Ed Sheeran, when I felt a sudden pain in my lower back. The force of the blow knocked the wind out of my 90-pound body; tears stung my eyes. I turned around and saw him, smirking. I had never seen this boy before, but I would never forget his face. His eyes were lit up with a sick, twisted joy as he watched me cry. (Robinson, 3/27)

A group of public health organizations and doctors filed a lawsuit against the Food and Drug Administration Tuesday for delaying its review of e-cigarettes — a growing concern amongst parents and pediatricians due to increased reports of adolescents and teenagers picking up "vaping" or "juuling" (when using a popular brand, Juul). (Eileen Drage O'Reilly, 3/28)

Clark, the most recent of these victims, was killed on March 18 by two Sacramento police officers who fired 20 times at him. The officers said that they saw a gun, but all that was found was a cellphone near Clark’s dead body. We must do a better job of understanding how this happens, of preventing it from occurring, and of holding police departments and police officers accountable when tragedies take place. (Erwin Chemerinsky, 3/27)

"You should wait until you are older to date.” Growing up in a working-class family in China, I learned this at an early age. Like many Asian parents, my mother stressed the importance of working hard and getting a good education before beginning a family. Having a child outside marriage never crossed my mind. In the small city where I grew up, it isn’t done. Even today, less than 4% of births in China are out of wedlock, and the same is true in India, Japan and South Korea. For the vast majority of young adults in Asia, the path to success clearly runs through education, work and marriage—in that order. Families, schools, media and society at large all reinforce that message. ...More important, the success sequence benefits young adults from low-income backgrounds. (Wendy Wang, 3/27)

Scientists are increasingly betting their time and effort that the way to control the world is through proteins. Proteins are what makes life animated. They take information encoded in DNA and turn it into intricate three-dimensional structures, many of which act as tiny machines. Proteins work to ferry oxygen through the bloodstream, extract energy from food, fire neurons, and attack invaders. One can think of DNA as working in the service of the proteins, carrying the information on how, when and in what quantities to make them. (Faye Flam, 3/27)