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A coalition of health industry groups on Tuesday unveiled a public-relations push that aims to ensure lawmakers keep their campaign-trail promises to lower drug costs. In doing so, lawmakers will have to “take on Big Pharma, ” according to the new digital ads from the Campaign for Sustainable Rx Pricing. For years, the group has sought to spotlight drug makers’ role in the sky-high price of prescription medicines, and a spokeswoman said the new ads represent the beginning of a “six-figure, multi-phase” campaign. (Facher, 11/13)

The ad shows a man writing a letter to Congress, saying, “Drug prices are going up, every single day. It's price gouging. When will you take action?” “Congress: You promised lower drug prices. Keep your commitment,” the ad ends. Advocates are hoping that the combination of the Democratic House and Trump will lead to action. But any drug pricing measures face an uphill climb, given that drug companies are still a powerful force in Washington and Republicans control the Senate. (Sullivan, 11/13)

Express Scripts will push patients, employers and insurers in 2019 to switch to lower-cost generic drugs rather than rebated brand-name drugs as it tries to wean them off of the rebate model, the pharmacy benefit manager announced Tuesday. The company said its 2019 formulary, or its list of covered medications, will streamline the introduction of therapeutically equivalent alternatives to branded drugs. Express Scripts will add approved lower-cost generics to its National Preferred Flex Formulary and exclude the branded drug, and possibly other drugs in the therapy class, from its coverage. (Kacik, 11/13)

Health care groups are pushing for their priorities to be attached to a year-end package that would fund certain federal agencies and could spur a brawl over funding for a wall along the southern border. The lame duck session is also likely to bring a renewed fight over whether to scale back a change to financial requirements for Medicare’s prescription drug benefit. Meanwhile, industries affected by taxes levied under the 2010 health care law are pushing for those taxes to be repealed or further delayed before the end of the year.  And lawmakers hope to extend certain expiring health programs, which could stand alone or be included in a spending package before Dec. 7. (McIntire, 11/13)

Senate Judiciary Committee Chairman Charles E. Grassley has asked the U.S. Food and Drug Administration to explain how the agency is addressing cybersecurity gaps in medical devices that are already in use. Grassley’s letter was in response to a report by the FDA Inspector General from late October that found the agency’s “plans and processes were deficient for addressing medical device cybersecurity compromises,” especially in the post-market phase when equipment was already in use. (Ratnam, 11/13)

Newly-elected leaders in the states will be in a stronger position than those in Washington to steer significant shifts in health care policy over the next couple of years as a divided Congress struggles with gridlock. State Medicaid work requirements, prescription drug prices, insurance exchanges and short-term health plans are among the areas with the potential for substantial change. Some states with new Democratic leaders may also withdraw from a multistate lawsuit aimed at killing the 2010 health care law or look for ways to curb Trump administration policies. (Williams, 11/13)

If elections have consequences, the top-of-the-ticket win for Democrats in Kansas likely carries no more obvious upshot than the probable expansion of Medicaid in the state. After years of unyielding opposition from former Republican Gov. Sam Brownback and his successor — Gov. Jeff Colyer — Democratic Gov.-elect Laura Kelly looks positioned to broaden public health insurance coverage to tens of thousands more Kansans. (McLean, 11/13)

The Louisiana Department of Health may have spent anywhere from $61.6 to $85.5 million more than it should have on Medicaid recipients who are ineligible for the program, according to an audit released Tuesday (Nov. 13). Legislative Auditor Daryl Purpera’s report found that the LDH’s current process of using wage data during the application and renewal process to determine whether people are eligible for Medicaid is insufficient. (Clark, 11/13)

Facing mounting government pressure and a public backlash over an epidemic of teenage vaping, Juul Labs announced on Tuesday that it would suspend sales of most of its flavored e-cigarette pods in retail stores and would discontinue its social media promotions. The decision by the San Francisco-based company, which has more than 70 percent of the e-cigarette market share in the United States, is the most significant sign of retrenchment by an industry that set out to offer devices to help smokers quit but now shoulders blame for a new public health problem: nicotine addiction among nonsmoking teens. (Kaplan and Hoffman, 11/13)

Juul said it stopped filling store orders Tuesday for mango, fruit, creme and cucumber pods and will resume sales only to retailers that scan IDs and take other steps to verify a buyer is at least 21. It said it will continue to sell menthol and mint at stores, and sell all flavors through its website. The company also said it would close its Facebook and Instagram social media accounts, and pledged other steps to make it clear that it doesn’t want kids using its e-cigarettes. (Stobbe, 11/13)

Sales of Juul’s vaporizers and flavored nicotine liquids have surged over the past year, fueled in part by the product’s popularity among teenagers and children. Its rapid growth was helped by the San Francisco company’s use of social media to advertise its products as well as by user-generated posts that glamorized Juul. “There is no question that this user-generated social media content is linked to the appeal of vaping to underage users,” Juul Labs CEO Kevin Burns wrote in a blog post Tuesday. (Maloney, 11/13)

To prevent bulk shipments to people attempting to distribute to minors, online customers are strictly limited to two devices and 15 JUUL pod packages per month, and no more than 10 devices per year, the company announced. JUUL’s announcement comes amid increased scrutiny from federal regulators. (Weixel, 11/13)

Scott Gottlieb, commissioner of the Food and Drug Administration, signaled Tuesday that the agency plans action against flavored cigars — products that are especially popular among African American teens — as part of an aggressive effort to reduce underage vaping and smoking expected to be announced this week. (McGinley, 11/13)

The Trump administration is continuing to weigh plans to discontinue more than $100 million in research projects that use fetal tissue, alarming scientists and some HHS officials while invigorating the president’s supporters in the anti-abortion community. The White House last week convened a meeting to consider canceling the projects, according to two individuals with knowledge, and anti-abortion groups like Susan B. Anthony List have been invited to give input. Scientists who use fetal tissue in their research also have been invited to defend their work. (Diamond, 11/13)

The meeting is the latest step in a department-wide audit of how the federal government procures fetal tissue for medical research and testing. That review was announced in September, alongside the termination of a contract between the Food and Drug Administration and a company that had provided fetal tissue for use developing testing protocols. (Facher, 11/14)

The Trump administration’s controversial refugee office director is writing a book about his anti-abortion beliefs, two individuals with knowledge confirmed to POLITICO. Scott Lloyd, who’s been under fire for his stewardship of separated migrant children in federal custody, has been working on the book while employed at HHS, the individuals say. (Diamond, 11/13)

The American Medical Association (AMA) is pushing back against a potential new policy from the Trump administration that could eliminate federal protections for transgender individuals. The country's largest physician lobbying group said Tuesday during its interim meeting that it will “oppose efforts to deny an individual’s right to determine their stated sex marker or gender identity.” (Weixel, 11/13)

The nation’s hospitals have been merging at a rapid pace for a decade, forming powerful organizations that influence nearly every health care decision consumers make. The hospitals have argued that consolidation benefits consumers with cheaper prices from coordinated services and other savings. But an analysis conducted for The New York Times shows the opposite to be true in many cases. (Abelson, 11/14)

Officials at the Brockton Veterans Affairs Medical Center nursing home, rated among the worst VA facilities in the country, knew this spring they were under scrutiny and that federal investigators were coming to visit, looking for signs of patient neglect. Still, when investigators arrived, they didn’t have to look far: They found a nurse and a nurse’s aide fast asleep during their shifts. One dozed in a darkened room, the other was wrapped in a blanket in the locked cafeteria. (Estes and Slack, 11/14)

Millions of American military veterans — more than one in five, according to an American Legion survey — use marijuana to treat a medical ailment. But many of those veterans say the Department of Veterans Affairs, which provides health care to former servicemembers, isn’t responsive to their needs. Citing the federal prohibition on cannabis, the VA has long said its doctors cannot legally issue recommendations for marijuana even in states that have medical marijuana programs — an assertion disputed by some analysts. It has also largely refused to conduct studies on the potential efficacy of the drug as a treatment for PTSD and other disorders common among vets, instead focusing its research on the harms of using cannabis. Now, new legislation could change that. (Adams, 11/14)

New Jersey officials, taking on one of the state’s core industries, filed a lawsuit on Tuesday against a subsidiary of Johnson & Johnson that manufactures opioids, accusing the pharmaceutical company of misleading patients about the addictive dangers posed by its drugs. It was the first time that New Jersey has brought legal action against a company based in the state as it struggles to contain a spiraling opioid addiction crisis. And it comes at a time when state attorneys general across the country have intensified their efforts to hold pharmaceutical companies accountable for the epidemics of abuse. (Corasaniti, 11/13)

In communities around the country, health officials and lawmakers have expanded access to naloxone — the opioid overdose reversal medication — by making it available at pharmacies without a prescription. One problem: Not all pharmacies have gotten on board. In California, less than one-quarter of pharmacies surveyed said that customers could pick up naloxone without a prescription, even though they have been legally allowed to do so since January 2016, according to one new study. (Joseph, 11/13)

Now about 55 percent of patients who undergo a thyroid operation are discharged without opioids. That number jumps for similar surgeries -- nearly 80 percent for parathyroidectomies, the removal of one or more glands attached to the back of the thyroid. Oregon Health and Science University revised its pain treatment guidelines in September to reduce the number of opioids sent home with patients as the state health authority encourages alternative pain management therapies. Now, OHSU Healthcare recommends activity instead of rest for lower back pain, and acetaminophen, such as Tylenol, as a first choice of medication instead of an opioid, such as oxycodone. (Harbarger, 11/13)

For the 100,000 mostly black people in the United States who have sickle cell disease, the combination of acute crises and chronic pain can be debilitating. Treatment guidelines allow for high levels of opioids, but many sickle cell patients are now worried where recent crackdowns on opioids will leave them, particularly after a long history of misunderstanding about the disease. ...newer drugs that improve blood function have improved the quality of life for many patients, and concern about the harms of opioids have led sickle cell specialists to take different approaches to treating pain. (Smith, 11/14)

Emergency departments in Claremont and Manchester are testing out a new approach to addiction treatment for opioid users, collaborating on a federally funded study with Bellevue Hospital in New York City. In most hospitals across the country, patients presenting with complications from drug use, or having overdosed, are treated for their immediate concerns but referred elsewhere for help with their addiction. (Greene, 11/13)

Kaiser Health News: Childbirth In The Age Of Addiction: New Mom Worries About Maintaining Sobriety

When she was in her early 20s, Nicole Veum says, she made a lot of mistakes. “I was really sad and I didn’t want to feel my feelings,” she said. “I turned to the most natural way I could find to cover that all up and I started using drugs: prescription pills, heroin for a little bit of time.”Veum’s family got her into treatment. She’d been sober for nine years when she and her husband, Ben, decided to have a baby. Motherhood was something she wanted to feel. (Dembosky, 11/14)

The toll from California’s deadliest wildfire continued to grow Tuesday, as authorities said six more victims of the Camp Fire had been recovered inside homes in the Butte County town of Paradise, bringing the total to 48 so far. Butte County Sheriff Kory Honea did not release additional identities of the dead or update the number of people believed to be missing. To date, the sheriff has released the names of only three victims as officials continue the laborious task of collecting remains and preparing for DNA testing to discover the identities of some victims. (Stanton, 11/13)

At every community meeting since the start of California’s deadliest wildfire, Butte County Sheriff Kory Honea is the last one to speak. The worst news is always saved for the end. “I’m the sheriff and I’m also your coroner,” he will say to the fire refugees filling the auditorium. “Unfortunately the news I have for you is not good.” (Sulek, 11/13)

It is a measure of how frequent and deadly wildfires have become in California that identifying badly burned remains has become an area of expertise. Once again cadaver dogs have been summoned, forensic dental experts will follow and coroners and anthropologists are using their experience from previous wildfires to locate the victims. One search team on Tuesday toured the foundation of a flattened home in this singed stretch of Paradise, Calif. Carefully they circled the charred bathtub, the melted kitchen floor, the skeletal playground — poking everywhere with long metal poles. (Turkewitz and Fuller, 11/13)

Authorities doing the somber work of identifying the victims of California’s deadliest wildfire are drawing on leading-edge DNA technology, but older scientific techniques and deduction could also come into play, experts say. With the death toll from the Northern California blaze topping 40 and expected to rise, officials said they were setting up a rapid DNA-analysis system, among other steps. (Peltz, 11/13)

The confusing search for hundreds of missing people has been complicated by many factors: bad cellphone service. A lack of access to burned-out areas. A sheer scattering of people across the region who are staying in shelters, hotels, friends’ houses and their vehicles and may have not gotten in touch with loved ones. (Serna, Smith, Branson-Potts and Santa Cruz, 11/13)

Unhealthy conditions caused by the Camp Fire in Paradise have forced a number of local schools around the Bay Area to move students indoors or cancel outdoor activities this week. The Bay Area Air Quality Management District has extended an air quality alert for the Bay Area through Friday, advising the public to avoid outdoor activity as much as possible and to keep windows and doors closed indoors. While most schools remain open, many have made changes under the circumstances. (Sarwari, 11/13)

Donald Frueh and his dog, Nemesis — who live without shelter in Sacramento — spend nearly all day outside. Frueh said the smoke filling the air has made it harder to sleep and walk to get food. “The closest cheap place to here is the Dollar Store and it’s 13 blocks [away],” Frueh said. “It’s not good having dogs outside in [the smoke]. He’s not one to drink or to move around too much. It’s basically just making both of us a little lethargic.” (Beale, 11/12)

The costs of the damages from wildfires that ravaged parts of California last year could show up in utility bills of people throughout the state. And the burden for paying for damages caused by the current catastrophic fires could also hit millions of Californians' pocketbooks. (Randazzo, 11/13)

Pacific Gas and Electric Co. has agreed to pay Calaveras County $25.4 million for economic damages stemming from the 2015 Butte Fire. A Cal Fire investigation concluded the fire began in September 2015 after a PG&E power line touched brush and sparked flames that killed two people, destroyed 1,000 structures and burned 71,000 acres, mostly in Calaveras County. The county sued the utility earlier this year after months of unsuccessful negotiations, according to county spokesman Timothy Lutz. (Yoon-Hendricks, 11/13)

About 35 percent of people found criminally insane in Oregon and then let out of supervised psychiatric treatment were charged with new crimes within three years of being freed by state officials, according to a comprehensive new analysis by ProPublica and the Malheur Enterprise. The analysis and interviews show that Oregon releases people found not guilty by reason of insanity from supervision and treatment more quickly than nearly every other state in the nation. The speed at which the state releases the criminally insane from custody is driven by both Oregon’s unique-in-the-nation law and state officials’ expansive interpretation of applicable federal court rulings. (Fraser, 11/14)

The top of the Oregon Psychiatric Security Review Board’s website boasts of its success in reforming people acquitted of crimes because of a mental disorder: “With public safety as its primary focus, the Board has an exceptional record of reintegrating clients into the community with a 6 year average 0.46% adult recidivism rate.” In fact, a review of public records shows that the board has known that its record with clients after they are released is far less impressive. The 0.46 percent rate of recidivism refers only to people still in the board’s custody. (Fraser, 11/14)

U.S. doctors and medical societies are increasingly speaking out against firearm violence, calling for gun-control measures and other solutions to what they see as a public-health crisis that shows no signs of ebbing. Their outspokenness picked up in recent days, after the National Rifle Association said in a tweet on Nov. 7: “Someone should tell self-important anti-gun doctors to stay in their lane.” The NRA, which has fought efforts to restrict access to guns, was criticizing an updated position paper that the American College of Physicians had published calling for various ways to keep guns out of the hands of people who are a threat to others or to themselves. (Loftus, 11/13)

Over 25 years in Bronx hospitals, Dr. Marianne Haughey has lost count of how many people she has seen die from gun violence. It doesn’t stop — a child who found a gun at home, a teenager caught in the middle of a gang shooting, a store owner ambushed at work. The toughest part comes afterward, Dr. Haughey said. She sheds her blood-soaked scrubs, makes a mental note of the victim’s name and goes to tell the family. (Haag, 11/13)

Joseph Sakran was standing on a playground when the bullet pierced his throat. It was a Friday night in 1994 in Fairfax, Va., and Sakran was 17. The high school senior had started the night at a school football game and ended it nearly bleeding to death in the emergency room. The errant gunshot, fired into the crowd amid a fight between other teenagers, ruptured Sakran’s trachea, severed his carotid artery and paralyzed his vocal chord. (Flynn, 11/14)

It was college night when a gunman entered Borderline Bar & Grill late last Wednesday, the dance floor packed with students trying to let off some steam, drink a little beer and line dance to the country music blaring in the background. It was the type of night that would be familiar to college students anywhere. (Medina, 11/13)

The first few nights after Katie Wilkie bolted out of Borderline Bar and Grill to the sounds of gunfire and shattering glass, she couldn’t bring herself to go home. She slept on her friend’s bunk bed and borrowed an old T-shirt and shorts to wear. She found herself clinging to her Borderline friends who were now fellow survivors. (Bermudez, 11/14)

Families of people with dementia will often take away the car keys to keep their family member safe. They might remove knobs from stove burners or lock up medicine. But what's less talked about is the risk of guns in the home for those with dementia. (Block, 11/13)

More children have been diagnosed with a mysterious paralyzing illness in recent weeks, and U.S. health officials said Tuesday that they still aren't sure what's causing it. This year's count could surpass the tallies seen in similar outbreaks in 2014 and 2016, officials said. Fortunately, the disease remains rare: This year, there have been 90 cases spread among 27 states, the Centers for Disease Control and Prevention said. (11/13)

The illness usually starts as a fever and seemingly routine respiratory symptoms. But in some cases — between three and 10 days later — children suddenly suffer paralysis. The cause of the condition remains a mystery. But officials say there is a possibility it is being caused by a virus that affects the digestive system known as an enterovirus, though that remains just a theory. (Stein, 11/13)

“It’s not that often we’re faced with something we’re still learning about,” said Michelle Melicosta, a pediatrician at the Kennedy Krieger Institute in Baltimore, which specializes in disorders of the brain, spinal cord and musculoskeletal system. “We just don’t always have the answer we wish we had. It makes it a little scarier for the family.” AFM is caused by inflammation of the spinal cord that results in severe muscle weakness and paralysis. More than 400 confirmed cases, most of them in children, have been reported in the past four years, and one child with AFM died last year. Clinicians say the condition is underdiagnosed and underreported. (Sun, 11/13)

Scientists are also considering whether the cause of the illness isn’t being detected because a pathogen is hiding somewhere in the body, or because the cause of the condition had already cleared the body when limb weakness developed, she said. “We’re not sure if the reason we’re not finding pathogens in all of these patients is because it’s cleared [from their systems]. Is it because it’s hiding? Is it because it’s something we haven’t tested for?” Messonnier said. (Branswell, 11/13)

The CDC is investigating 252 cases, an increase of 33 patients since last week. The investigation includes the 90 confirmed cases. Messonnier said no deaths related to AFM have been reported to the CDC this year. (Hellmann, 11/13)

Anchoring a row of family photos in Joseph Tector’s office is a framed, autographed picture of Baby Fae, the California newborn who made headlines in 1984 when she received a baboon’s heart to replace her own malfunctioning organ. It’s inscribed “To Joe” by Leonard L. Bailey, the surgeon who turned to the monkey heart as the only option to keep his patient alive. Bailey snapped the picture about five days after the operation, while Stephanie Fae Beauclair was sleeping. A strip of surgical tape runs down the center of her chest from neck to diaper, marking the incision line where her rib cage was pulled apart to make the swap. Baby Fae would die less than three weeks later. (Clynes, 11/14)

Doctors believe they’ve found an answer for patients like [Delilah] Romero in a protein that is produced by lethal bacteria. The protein, which temporarily wipes out antibodies, was crafted into an experimental drug called imlifidase to give donated organs a fighting chance against the immune system’s defenses. Developer Hansa Medical AB says imlifidase could make transplants possible for about 35,000 U.S. patients who currently have poor odds, and increase matches for others. (Lauerman, 11/14)

Sean Parker, the tech billionaire and cancer research philanthropist, may be a product of a Silicon Valley tech giant — but he’s skeptical about the impact those companies will have as they increasingly make a play in medicine. “I just don’t think the innovations that are going to drive this revolution in health care and discovery are going to come out of Amazon or Google,” Parker said Tuesday at an event put on by the Washington Post. “Google has a big group that’s focused on this — they’re really smart, they’re not unsophisticated, they’re not naive — but I don’t think that’s where you’re going to see the big breakthroughs happening.” (Robbins, 11/13)

Is biotech having a renaissance in neuroscience? Can we solve the placebo effect? And what’s going to happen next year? Paul Matteis, co-head of biotech research at Stifel, sat down with STAT at the firm’s annual health care conference here to field those questions and opine on how management teams can walk the delicate balance between hype and sandbagging. This transcript has been edited for length and clarity. (Garde, 11/14)

As of Monday, the United States has new federal physical-activity guidelines. The new guidelines, which represent a scientific consensus about how much and what types of physical activities we should complete for good health, bear a strong resemblance to the existing, 10-year-old governmental recommendations. But they also feature some important updates and expansions, including the first-ever federal activity parameters for 3-year-olds, as well as a few surprising omissions. And they offer a subtle, admonitory reminder that a substantial majority of us are not moving nearly as much as we should. (Reynolds, 11/14)

Studies show cancer survivors are twice as likely to die by suicide than the general population. But some cancer survivors are at a greater risk than others, according to research from a St. Louis University doctor. A study appearing in this month’s journal Cancer has found patients in recovery from pancreatic, head and neck cancers die by suicide at a higher rate than other common cancers. In the case of head and neck cancer, the suicide rate is 63 for every 100,000 people — close to four times that of the general population and two times that of other cancer survivors combined. (Fentem, 11/12)

Six artificial flavors are being ordered out of the food supply in a dispute over their safety, but good luck to anyone who wants to know which cookies, candies or drinks they're in. The dispute highlights the complex rules that govern what goes in our food, how much the public knows about it, and a mysterious class of ingredients that has evolved over decades largely outside of public view. (11/13)

Adults should talk with teenagers about drinking. And we should talk with teenagers about sex. But in addition to taking up each of these topics separately, we should also address the fact that adolescents are more likely than adults to combine the two. Common sense suggests, and research confirms, that intoxicated sex can be a bad idea. Of course, underage drinking is illegal; state laws vary on the legality of having sex with an intoxicated person. Legal questions aside, results from a new survey of more than 7,000 undergraduates at Indiana University show that consensual sex is both less enjoyable and less strongly wanted when one or both of the participants has been drinking. Other research links alcohol use to higher rates of unprotected intercourse. (Damour, 11/14)

The next generation of biotech food is headed for the grocery aisles, and first up may be salad dressings or granola bars made with soybean oil genetically tweaked to be good for your heart. By early next year, the first foods from plants or animals that had their DNA "edited" are expected to begin selling. It's a different technology than today's controversial "genetically modified" foods, more like faster breeding that promises to boost nutrition, spur crop growth, and make farm animals hardier and fruits and vegetables last longer. (11/14)

Delaware once again is one of the worst states in hospital safety, according to a recent national report. Like last year, the First State tied for last, or 49th place, with the District of Columbia and North Dakota in Leapfrog's "Hospital Safety Grade." The watchdog organization, which seeks public information about patient safety and quality, assigns letter grades to 2,600 U.S. hospitals every six months. Delaware earned last place because none of its hospitals earned an A grade. The state has seen a drastic decline since Leapfrog began releasing grades in 2012. In the organization's first year, Delaware was ranked No. 8 in the country. (Newman, 11/12)

In the aftermath of a high-stakes 2018 midterm election, neither Democrats nor Republicans are victorious on the subject of hospital safety in the United States, according to The Leapfrog Group, a nonprofit that supports improvement in the quality and safety of American health care. On Thursday, the organization released data evaluating 2,600 hospitals across blue and red states its 2018 Hospital Safety Grades. Texas hospitals, at least, got a win. (de Luna, 11/13)

Regarded as one of the top hospital safety measures in the country, the Leapfrog Hospital Safety Grade, a bi-annual report, dives into hospitals and patient safety. It's an endeavor to provide people with enough information to make an informed decision on what hospital to choose. Leapfrog says "approximately 440,000" deaths happen annually from hospital injuries and that people run a 1-in-25 chance of getting a new infection from a hospital stay. (Jones, 11/13)

A handful of St. Louis area hospitals received a high rating for patient safety in a report from the medical watchdog nonprofit, the Leapfrog Group. Most of the 27 acute-care hospitals in the  region had documented problems with hospital-acquired infections, physician and nurse training and surgical complications, according to the group, which ranks 2,600 U.S. hospitals twice a year. (Fentem, 11/13)

The safety grades are out for hospitals in South Carolina. Only one Columbia or Lexington-area hospital received an A grade for safety scores in a biannual ranking by an organization that aims for transparency in the U.S. health system, and several received a C or D score. (Feit, 11/12)

A new report ranks New Jersey tops in the nation when it comes to hospital patient safety. The Leapfrog Group report gives 38 of New Jersey’s 67 hospitals an “A” rating for keeping patients safe, which is 57 percent, the highest percentage of any state in the country. (Matthau and Hochron, 11/13)

The leaders of Somerville Hospital’s parent organization met face-to-face Tuesday with the husband of a woman who died after collapsing outside their locked emergency room door in 2016, admitting to “multiple failures” during the emotional sitdown and apologizing for their role in the death. “I’m very sorry for what happened to your wife,” chief executive Patrick Wardell told Peter DeMarco, the widower of 34-year-old Laura Levis, who died after suffering a fatal asthma attack outside Somerville Hospital. “I can understand the horrible pain that this has inflicted upon you.” (Dayal McCluskey, 11/13)

Blue Cross and Blue Shield of Texas is committing $10 million to improve health care in rural communities across the state. BCBS, the state's largest health benefits provider with more than 5 million members, announced Monday that it's partnering on the project with Texas A&M University Health Science Center. It's part of Blue Cross' efforts to reduce costs and improve outcomes by addressing social disparities in health care. (O'Donnell, 11/13)

The New Hampshire ACLU has filed a federal class action lawsuit against the state of New Hampshire over a practice called emergency room boarding. The anonymous 26 year-old plaintiff in the ACLU’s suit was admitted to Southern New Hampshire Medical Center in Nashua last week following an attempted suicide. (Moon, 11/13)

St. Louis University is implementing more cost-cutting measures as fiscal problems persist, even after trimming its workforce last year. The private, Catholic university is facing a double blow of fewer students and less revenue from its doctors, resulting in a projected $30 million deficit by 2023. (Delaney, 11/13)

Bill W was looking to change careers. After decades as an executive in the tire industry, he was most of the way through a program to become a chiropractor in South Carolina. But in early 2017, he rolled his truck, leaving him with broken ribs and several fractured vertebrae. Recovering slowly, in pain while going to school and working, and a long-term heart problem had started getting worse. (Hoban, 11/14)

A health insurance provider that started selling plans on Florida’s Affordable Care Act marketplace this year is suing the state’s largest insurer. Oscar Health claims Florida Blue is creating a monopoly with a policy that restricts health insurance brokers from selling competitors’ plans. New York-based Oscar entered the Orlando market this year and made arrangements with insurance brokers to sell the Affordable Care Act plans starting on Nov. 1. (Ochoa, 11/13)

More than four years after Navy Lt. Rebekah Daniel bled to death within hours of childbirth at a Washington state military hospital, her husband still doesn’t know exactly how — or why — it happened. Walter Daniel, a former Coast Guard officer, demanded explanations from officials at the Naval Hospital Bremerton, where his wife, known as “Moani,” died on March 9, 2014. (Aleccia, 11/13)

A Hawaii retirement home said Tuesday residents in its independent living wing may take advantage of the state's new medically assisted suicide law if they wish. But Kahala Nui told residents in a memorandum this week that those in its assisted living and nursing center may not do so. (11/13)

Dartmouth-Hitchcock Medical Center is preparing to launch a new telemedicine unit focused on intensive care. Telemedicine, basically doctor’s visits by video conference, is a growing trend in healthcare -- and now Dartmouth-Hitchcock is hoping to use it to support intensive care units all over the region. (Moon, 11/13)

A corporate strategist from Michigan has given Mayo Clinic its largest gift ever — $200 million. The Rochester-based medical center announced Tuesday that its School of Medicine will be named for the philanthropist, Jay Alix, of Birmingham, Michigan. He also has been named to the Mayo Clinic Board of Trustees. (11/13)

Mayo Clinic will receive $200 million from the founder of a corporate turnaround firm to help future students pay for medical school and study fields such as genetics and artificial intelligence, which are becoming central to modern medicine. The endowment gift by Jay Alix, announced Tuesday morning, is the largest in Mayo's history. The Rochester-based health care provider is renaming its medical school as the Mayo Clinic Alix School of Medicine in recognition of the gesture. (Olson, 11/13)

A state task force on sexual assault is discussing changes to Minnesota’s laws on alcohol and consent that could have far-reaching implications for rape victims. The changes could make it easier for prosecutors to win convictions in sexual assault cases by showing that a victim was too drunk to consent to sex — now considered a significant barrier to prosecuting rapists. Many sexual assaults involve drinking, and officers and prosecutors consider them the toughest cases. (Bjorhus, 11/13)

Medina Hospital was placed on lockdown Tuesday afternoon as law enforcement officers investigate a report of a potential active shooter situation, Cleveland Clinic’s news service said. (MacDonald, 11/13)

According to the United States Department of Housing and Development, the number of people ages 62 and older who are homeless and living in shelters has increased by almost 50 percent from 2007 to 2016. In Central Florida alone seniors make up about 10 percent of the homeless population. For this reason, many are living out of their cars.Robert J. Burke knows a thing or two about cars. (Prieur, 11/13)

A week after voters approved a measure to legalize medical marijuana in Missouri, the Jackson County Prosecutor’s Office announced today that it will stop processing some marijuana possession cases. Amendment 2, which legalizes medical marijuana with a 4 percent sales tax for veterans programs and job training, passed with 66 percent approval from Missouri voters and even more support from those in Jackson County. Two other medical marijuana proposals were on the state ballot but failed. (Calacal, 11/13)

There was a time when America approximated other wealthy countries in drug spending. But in the late 1990s, U.S. spending took off. It tripled between 1997 and 2007, according to a study in Health Affairs. Then a slowdown lasted until about 2013, before spending shot up again. What explains these trends? (Frakt, 12/12)

For years, so-called influencers — celebrities, former reality television contestants and sometimes, former lawyers or other professionals — have hawked diet teas and hair products everywhere from Facebook to Snapchat. And now, pharma is catching on. An entire industry has cropped up to link drug makers with the industry’s own version of an influencer — people, usually patients, who have small but devoted followings and who might be willing to promote their products or share valuable insights about the patient community. Ciccarella, for example, is one of nearly 100,000 such influencers on the rosters of Wego Health, one of a handful of companies that essentially act a patient influencer talent agency. (Sheridan, 11/13)

How much should your medicine cost? A physician colleague recently told me the story of a patient who asked if she could put off taking her medication until the end of the month, after she received her paycheck. The price had risen and she didn’t have the money to pay for it along with her other bills. Unsure how to respond, he gave her $20 to cover part of the cost. (Khullar, 11/11)

The drug giants moved in near-perfect synchronicity, raising prices for their top-selling arthritis treatments as though they were opposite-corner gas stations bumping up the price of unleaded. On Jan. 3, 2013, AbbVie (ABBV) hiked the price of Humira, its blockbuster biologic drug for arthritis and related conditions, by 6.9 percent. A day later, Amgen (AMGN) followed with an identical increase for Enbrel, another biologic used to treat similar patients. The pattern repeated 10 more times between 2014 and early 2018. In every instance, prices of both drugs jumped by nearly the same percentage, usually within days of each other, topping out at the exact same amount, $63,363 per year, according to a STAT analysis of pricing data. (Ross, 11/14)

Researchers expect that three dozen new drugs will come on the market over the next few years with astronomical prices — some likely topping a million dollars per patient. The drugmaker Novartis has told investors it might be able to charge $4 million to $5 million for one of its potential products, a treatment for a rare disease called spinal muscular atrophy. (Harris, 11/14)

On Mother’s Day, Nicole Smith-Holt, whose son died last year after rationing his insulin, protested insulin prices at a rally at the Minnesota state capitol. That same month, she traveled to Indianapolis to meet with a representative of the insulin maker Eli Lilly. This week, she and another mother whose child died under similar circumstances plan to travel to the office of insulin maker Sanofi in Cambridge, Mass. They will also be holding their children’s ashes. (Thielking, 11/12)

The Trump administration’s plan to peg Part B drug prices to those paid in other countries may not come to fruition in its current form, but it’s meant more to signal to the healthcare industry—and voters—that it's serious on this issue, experts say. Ezekiel Emanuel, M.D., chair of the Department of Medical Ethics and Health Policy at the University of Pennsylvania and one of the key architects of the Affordable Care Act, said the policy’s release was clearly tied to the election, and means that the administration will do something, even if the final version is scaled back or revamped significantly from the current plan. (Mineymyer, 11/13)

Researchers want to save the pharmaceutical industry time and money on clinical trials. But that means teaching companies to work together and convincing them to pool patient data, benefiting not just themselves but also their competitors.It’s not an easy sell. (Wheaton, 11/9)

Rep. Chris Collins, the New York lawmaker facing insider trading charges, was once the No. 2 shareholder in an Australian firm called Innate Immunotherapeutics. According to the company’s most recent disclosure, he’s no longer even in the top 20 shareholders. What’s unclear is what happened to his shares. Under law, members of Congress are required to publicly disclose their stock trades within 30 days. Yet there is no record of Collins having sold the bulk of his shares. (Garde, 11/12)

Rep. Peter Welch, a Vermont Democrat, is one of the loudest voices in Congress on the need to lower prescription drug prices. Already, he’s met with President Trump in the White House to discuss the issue, co-sponsored one of the most aggressive drug-pricing reforms introduced in the current Congress, and taken a leadership role in a Democratic group called the Affordable Prescription Drug Task Force. With his party back in the House majority for the first time since 2010, Welch and a pair of key allies — Reps. Elijah Cummings (Md.) and Lloyd Doggett (Texas) — are positioned to push their Democratic colleagues on a number of legislative proposals, including the party’s white whale: allowing Medicare to negotiate for prescription drug prices. (Facher, 11/9)

Zhang Zhejun used a fat plastic straw to gently tap the pale yellow pharmaceutical powder onto a piece of silver foil that lay on an electronic scale. He made sure the amount was just right before he poured it into a clear capsule. When you’re making cancer drugs at home, the measurements must be precise. (Wee, 11/11)

Moderna Therapeutics, a biotech company valued at more than $7 billion, is plotting to raise $500 million in what would be the sector’s largest-ever initial public offering. The company, based in Cambridge, Mass., filed with the Securities and Exchange Commission on Friday in the first step toward listing its shares on the Nasdaq. Moderna became biotech’s most valuable private startup on the promise of crafting therapies that could transform patients’ cells into microscopic drug factories. Since its founding in 2010, Moderna has raised more than $2.5 billion through investments and partnerships, choosing to stay private while the biotech industry experienced an unprecedented boom in IPOs. (Garde, 11/9)

Merck KGaA said Wednesday that third-quarter net profit fell, but it raised its full-year organic sales growth expectations on the performance of its Healthcare and Life Science businesses in the quarter.The German chemical and pharmaceuticals company reported net profit for the quarter of $382.7 million compared with EUR644 million a year earlier. The company said the decline was due to a one-off gain of EUR321 million from its divestment of the Biosimilars business reported the previous year. (Shevlin, 11/14)

At its annual R&D investor day, Novartis updated the world on its drug pipeline and research priorities. It was an impressive session befitting a company that spends $9 billion annually on R&D (about 18% of its top line revenues). Novartis touted a pipeline that includes more than 200 programs in clinical development encompassing over 500 ongoing clinical trials with 26 potential blockbusters in late stage development. Its pipeline is truly enviable and teems with potential new treatments in a variety of therapeutic areas including various types of cancer, heart disease, metabolic disorders and rare diseases. (LaMattina, 11/13)

Over the past year, AbbVie has settled patent lawsuits with a growing number of drug makers that will delay biosimilar versions of its Humira rheumatoid arthritis medicine from becoming available in the U.S. until 2023. But one company has so far refused to settle and the litigation is yielding purported details that shed light on AbbVie’s use of a so-called patent thicket to defend its franchise product. Among the allegations is that AbbVie re-patented certain claims and processes for making the drug when, in fact, the approach was already in use, yet the company did not provide this information to the U.S. Patent and Trademark Office, according to court documents filed by Boehringer Ingelheim. (Silverman, 11/7)

President Trump announced late last month that his administration will push back on high drug costs through a number of proposals, including linking Medicare Part B prices to an international pricing index that includes 16 other countries and by requiring pharmaceutical companies to include drugs’ list prices in TV ads, the second of which later passed the Senate as an amendment to the latest appropriations package of $1 million to the Department of Health and Human Services. (Syed Kaleem, 11/9)

President Trump and House Democrats may not agree on much, but both seem eager to slash the price of prescription drugs. The most recent signal came shortly before the election when the president hailed plans to experiment with a new way of setting prices for most drugs administered through Medicare’s Part B program. A few months earlier, Rep. Nancy Pelosi (D-Calif.) reportedly delivered a blunt warning directly to the bio-pharmaceutical industry’s representatives in Washington that her party is developing an ambitious price-cutting agenda; so watch out in 2019. (Robert D. Atkinson, 11/10)

The Trump administration's new stance on drug prices goes as follows: "Socialist countries are ripping off American companies, so it's time for the U.S. to join them." It's the complete opposite of Trump's admirable defense of American interests in other areas. The Chinese government is ripping off American companies' intellectual property, so Trump is going to bat for them, using a variety of tough, aggressive approaches to force Chinese President Xi Jinping to the negotiating table. (Michael Busler, 11/11)

One thing we hope the Dispatch series “Side Effects” has made clear is just how unclear our nation’s drug-pricing system is — how many hidden manipulations affect the price we pay for medications and where that money goes. Making those machinations more visible is the key to driving change in a system that benefits invisible players at the expense of the taxpaying public and independent pharmacists. (11/07)

We never thought we would see the National Rifle Association help advance the discussion of gun violence as a public-health crisis. But that is exactly what the organization unwittingly did when it essentially told doctors they had no business talking about guns and should just shut up. What followed instead was an indignant outpouring of heart-rending stories from professionals who see close up the horror and damage caused by guns. (11/13)

To the mother whose son I couldn’t save: I wish that I possessed some combination of words that could heal the wound in your heart, some turn of phrase that could end your sorrow. But I have no such words. You will live the rest of your life with an unfillable void and the simple question “why?” forever unanswered. (Jaques Mather, 11/13)

Public heath advocates appear to be getting desperate over the state of Americans’ inactivity.The U.S. Department of Health and Human Services on Monday released a new set of physical activity guidelines and they are...ah...interesting. Instead of prescribing the standard block of sustained physical activity — previously at least 10 minutes at a time — the government is now urging Americans to, you know, move around more during the day and sit less. (Mariel Garza, 11/14)

Responses to a nationwide survey indicated that while most Americans are aware of the dangers posed by infections that have grown increasingly resistant to current antibiotic treatments, only about half know enough about the correct use of antibiotics to prevent resistance from occurring. As a physician, I have had to hope that patients’ immune systems could fill the gap left by failing treatments against antibiotic-resistant infections. As the president of the Infectious Diseases Society of America, which, with Research!America, commissioned the survey, the responses both encourage and alarm me. (Cynthia Sears, 11/13)

A critical test for the Trump administration is whether to drop support for a frivolous lawsuit to invalidate the ACA, currently being pushed by 20 Republican state attorneys general. If that lawsuit continues, expect the voters who became so active this year to keep health care on the front burner.When it comes to 2020, Republicans would prefer to make the next election a referendum on single payer health care, such as Medicare for All, than on the ACA and pre-existing conditions. That will be a tough sell, particularly if they are continuing to attack the ACA. (Andy Slavitt, 11/14)

Our new polling also revealed a more troubling trend: nearly three-quarters (72 percent) of 18-29 year olds report being concerned that women may not be able to access the full range of birth control methods in the future because of today’s political landscape. Their concerns are justified. Over the past year, the current administration has been relentless in its pursuit to limit access to no or low cost birth control. (Ginny Ehrlich, 11/13)

HHS promises to push for alternatives to the use of fetal tissue in research. But other approaches — including adult stem cells — don’t work as well. Fetal cells are less differentiated, and therefore more flexible, than adult cells. And tissue from elective abortions, unlike that from miscarriages, is easier to obtain under controlled conditions, and less likely to contain developmental abnormalities.Elective abortions, of course, are what the activists want to stop: They believe fetal-tissue research encourages them. (11/13)

As Greg Lukianoff and Jonathan Haidt chronicle in their new book, “The Coddling of the American Mind,” today’s young people tend to be obsessed with safety, troubled by a pervasive sense of threat. Consequently, understandably, they’re anxious and depressed. ...In an Atlantic article headlined “College Is Different for the School-Shooting Generation,” Ashley Fetters describes a rising generation that constantly scans rooms for exit points and games out active-shooter scenarios. (Megan McArdle, 11/13)

State measures implemented about three years ago to improve vaccine education have caused the number of non-medical vaccine waivers to drop and vaccination rates to rise in Michigan. Yet the 15 recent confirmed cases of measles prove that those who refuse vaccines — or to vaccinate their children — continue to risk both their health and the health of the state. Measles is spread by direct person-to-person contact, and through the air by a contagious person sneezing or coughing. Germs can live for up to two hours. (11/13)

Building housing is a long, slow affair. It’s even slower when developers are building housing for homeless people. Just cobbling together financing from myriad sources can take up to two years, and then there’s the permitting, the political haggling, the inevitable negotiations with neighbors. So it’s encouraging to see two different attempts to speed up this lumbering process. (11/14)