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Kaiser Health News: In Swing Districts, Republicans May Pay For Having Tried To Reverse The Health Law

Not long ago many voters knew little about Tom MacArthur. A low-key moderate Republican congressman in a district that twice went for Barack Obama, he burnished his reputation as the guy who worked with Democrats to help rebuild in the years after Hurricane Sandy. Now, as he wages a bitter fight for re-election to a seat he won by 20 percentage points just two years ago, even some of his supporters have turned virulently against him. The reason? His new reputation as the turncoat whose legislation almost repealed the Affordable Care Act. (Huetteman, 10/31)

In 2014, Republican congressman Jeff Denham was all about axing the Affordable Care Act. He vowed in a campaign ad that aired before that year’s midterm election to “repeal and replace Obamacare so families aren’t forced to pay higher premiums for reduced care.” Four years later, Denham isn’t talking about the ACA. But his Democratic opponent is — quite a bit. (Ibarra, 10/31)

Now [Andy] Barr and [Amy] McGrath are running for Congress against each other in Kentucky in one of the most competitive and expensive races in the country. But their families' struggles with insurance companies has led them to different places. Whoever wins could help determine which party controls Congress for the final two years of President Donald Trump's term and shape health policy for millions of Americans. "It's the No. 1 issue," said McGrath, a Democrat and retired Marine fighter pilot. "People are worried." (Beam, 10/30)

In a race that many thought was [Gov. Rick] Scott’s to lose, polls show his opponent, [Sen. Bill] Nelson could retain his seat. The governor is being taunted as “Red Tide Rick,” and some Floridians have made him the butt of jokes on social media, contrasting the state’s beautiful beaches with the dead fish littering its shores. Scott is haunted by a perception among many voters, conservative and liberal, that his environmental policies made a natural disaster worse. In his first term, the state cut hundreds of millions of dollars from agencies that manage fresh water, laid off hundreds of workers in the environmental protection department, squashed a deal to buy land from sugar farms that pollute water and killed an attempt to increase inspections of septic tanks that soil water and contribute to the algae problem. (Fears and Rozsa, 10/30)

Sen. Joe Donnelly, Indiana’s lone statewide Democrat, was propelled into office six years ago after his opponent’s incendiary comments about abortion and rape during a disastrous debate appearance tanked his candidacy. On a similar stage Tuesday night, Donnelly’s Republican challenger Mike Braun appeared determined to avoid the same fate, despite a full-throated attack from the Democrat, who tried to force the issue. (Slodysko, 10/31)

Voters like some form of “Medicare for All” but are divided over what it should look like, according to our latest Axios/SurveyMonkey poll — which is about the same situation Democratic candidates are in. (Baker, 10/31)

Georgia’s neck-and-neck governor’s race is one of at least half a dozen where a Democratic supporter of Medicaid expansion has a fighting chance of replacing a Republican who opposes it. Competitive races in Florida, Wisconsin, Kansas, Oklahoma and South Dakota could also flip the status of those holdout states that have so far refused Obamacare's Medicaid expansion — though Republican legislatures are not likely to make it easy. (Ollstein, 10/29)

Nearly 2.5 million people could gain access to Medicaid coverage if Democrats win gubernatorial elections in six states next Tuesday and expand the program to cover more low-income adults, according to a new analysis released Tuesday. If Republicans lose competitive gubernatorial races in Florida, Georgia, Kansas, South Dakota, Maine and Wisconsin next Tuesday, it would present Democrats with the rare opportunity to expand Medicaid in those states to 2.4 million people, according to the analysis by Avalere health, a consulting firm in Washington. (Hellmann, 10/30)

Up to 2.7 million people across nine states could soon get added to Medicaid rolls depending on next week's midterm elections, according to a new analysis. Healthcare consulting firm Avalere's predictions showcase the increasingly bullish national outlook for Medicaid expansion. But those programs could look very different state by state .... "I go back to every state is different: If you've seen one Medicaid program, you've seen one Medicaid program," said Ethan James of the Georgia Hospital Association. "Same with an expansion: Every state would do it differently." (Luthi, 10/30)

The battle to expand Medicaid in Utah is being waged from a small, three-desk office in a downtown high-rise, by three women in their 20s and 50 or so volunteers. If they succeed and Utah's Proposition 3 passes, one of the reddest states will embrace the Affordable Care Act. Last week, the “Yes on 3" team was signing off on its final handouts and informational fliers, their measure cruising close to 60 percent in the polls. An electorate that's expected to elect Republican Mitt Romney to the Senate is also, increasingly, expected to approve a small tax to fund health-care coverage. (Weigel, 10/30)

Idaho’s Republican Gov. Butch Otter on Tuesday endorsed a ballot initiative that would expand Medicaid eligibility to thousands of people. “Proposition 2 is an Idaho-grown solution,” Otter said in a newly released ad by Idahoans for Healthcare, a group pushing for Medicaid expansion. "Vote yes on Proposition 2. It’s the right thing for Idaho." (Weixel, 10/30)

The Republican governor of Idaho gave advocates of expanding Medicaid a significant lift Tuesday, coming out in favor of the Obamacare policy just a week before voters in the state decide on its fate. The question of whether to grow the low-income health-care program to cover more people is on ballots in three deep-red states — Idaho, Utah and Nebraska — where conservative legislatures didn’t choose expansion. Outgoing Gov. C.L. “Butch” Otter, a conservative with an independent streak, announced his support and cut an ad for Idahoans for Healthcare, an organization advocating for expansion. (Itkowitz, 10/30)

During last week’s final Florida governor’s debate between Republican Ron DeSantis and Democrat Andrew Gillum, an ugly back-and-forth over alleged ethical lapses grabbed headlines. It also overshadowed what might have otherwise been the news of the night: DeSantis announced he had uploaded his long-awaited healthcare plan to his campaign site. (Mahoney, 10/30)

The three leading gubernatorial candidates all agree that government must protect insurance coverage for pre-existing medical conditions — a key provision of the Affordable Care Act — and that the opioid epidemic is a major public health crisis that must continue to be a top priority. They also all say that more needs to be done to bring down the costs of expensive prescription drugs and support Medicaid expansion — an issue being fought in elections outside of Connecticut — which extended coverage to low-income adults who do not have minor children and were not disabled. (Rigg, 10/30)

Locked in a tight race for governor in the perennial swing state of Ohio, Republican Mike DeWine and Democrat Richard Cordray are using the final stretch to hedge their bets on Donald Trump. ... Cordray, the Obama-era consumer protection chief, has continually hit DeWine for opposing insurance protections for those with pre-existing conditions, a top issue this year among voters. He points to DeWine's decision to join Republicans' lawsuit seeking to do away with the federal Affordable Care Act that includes such protections. (Carr Smyth, 10/30)

Massachusetts voters are souring on a ballot measure that would limit the numbers of patients assigned to nurses, according to a WBUR poll (topline results, crosstabs) out Wednesday that shows 58 percent of voters now plan to say "no" on Question 1. Earlier polls showed the "yes" camp leading or tied with the "no" side. (Borchers, 10/31)

No deeply conservative state has done more than Idaho to make Obamacare work. But no other state is doing more to untangle itself from the health care law. On the eve of the 2019 open enrollment season, at least three insurers are selling plans in every corner of the sprawling state. It’s got one of the best enrollment rates in the country. The outgoing Republican governor is supporting a ballot initiative to expand Medicaid, which could improve the health of the Obamacare market. But Idaho officials are backing a radical plan to offer skimpier coverage options, sounding the alarm over their insurance marketplace. (Demko, 10/31)

Gov. Phil Murphy on Tuesday announced a new state website to promote Affordable Care Act open enrollment, saying New Jersey will lead the way to "prove" the law -- also known as Obamacare -- works. It's the first coordinated public awareness campaign by the state since the implementation of former President Barack Obama's signature health-care law, Murphy said. The website is getcovered.nj.gov and is set to go live later Tuesday. (Arco and Johnson, 10/30)

Having lost in two federal courts and fearing more setbacks, the Trump administration is revising rules that allow employers to deny women insurance coverage for contraceptives based on religious or moral objections. Administration officials hope that the changes, the details of which remain unclear, will overcome the judges’ objections without fundamentally altering the purpose or the effects of the rules. ... It is unclear whether the administration intends to issue the final rules before the midterm elections next week. Opinion polls suggest that the birth control benefit, mandated by the Obama administration under the Affordable Care Act, is popular. (Pear, 10/30)

The Centers for Medicare & Medicaid Services is ready to charge ahead with broad audits of Medicare Advantage plans, which could result in companies paying back billions of taxpayers dollars to the federal government. (Herman, 10/31)

The Trump administration is ready to defend its sweeping new drug pricing proposals. In a new Q&A, obtained by STAT, its authors parry several key criticisms — some already aired, some expected — from drug makers and other groups. The document, which is expected to be published later Tuesday according to a senior administration official, represents a quick response from the administration, which only unveiled the policy in an address on Thursday. (Florko, 10/30)

Kaiser Health News: People With Disabilities Face Health Care Hurdles With Trump Rollback Of Accommodation Rules

Going to the doctor’s office can feel so routine. You sit in the waiting room, fill out the paperwork, get measured and hop onto the exam table. But medical appointments for patients with disabilities require navigating a tricky obstacle course, full of impediments that leave them feeling awkward and could result in substandard care. (Bluth, 10/31)

Transgender people have fought for decades for the simplest of concessions: for recognition. For the right to be seen as their true selves. To be called by their chosen name, to be addressed by the appropriate pronouns, to see a gender on their driver’s license that matched their identity. Their successes are recent. ... The news last week, that the Trump administration was considering a policy change that wouldn’t just revoke certain rights but dismiss the identities of transgender people, was appalling, say transgender men and women and their supporters. (Allday, 10/30)

The Trump administration’s actions and rhetoric on immigration are stoking fears among physician training experts that fewer foreign doctors will want to train and serve in the United States, where they make up a significant portion of a medical workforce that is already short-handed. The commission that certifies graduates of foreign medical schools who come here for their residencies says it is seeing a decrease in the number of people applying from foreign countries affected by Trump’s executive actions on immigrations. Its leaders worry that promising students or doctors from other countries will also think twice about whether to continue their medical training in the U.S. (Siddons, 10/30)

A former executive at Valeant Pharmaceuticals International Inc. was sentenced Tuesday to spend a year in prison after being found guilty of defrauding the pharmaceutical giant through a multimillion-dollar kickback scheme. Gary Tanner, and his co-defendant, Andrew Davenport, the former chief executive of specialty mail-order pharmacy Philidor Rx Services, were both sentenced to one year and a day in prison. ... The sentence from Senior U.S. District Judge Loretta Preska, who also presided over the defendants’ trial, also called for two years of supervised release and for the men to forfeit about $9.7 million each. (Thomas, 10/30)

The sentencing comes three years after the drug maker became enmeshed in scandals over its pricing and accounting practices, which led to congressional hearings, a loss of confidence among investors, and a subsequent turnover in management and the board. The Philidor episode was particularly explosive, though, because Valeant failed to properly disclose its relationship with the pharmacy. (Silverman, 10/30)

Tanner had managed Valeant’s relationship with Philidor as well as Valeant’s “alternative fulfillment” program, through which the drugmaker sought to increase prescriptions for its own drugs instead of cheaper generic substitutes. Prosecutors accused Tanner of steering Valeant business to Philidor, while concealing a $9.7 million kickback from Davenport that came from the roughly $50 million Davenport received when Valeant acquired the option to buy his company. (Stempel, 10/30)

Three former Genentech employees were arrested for allegedly stealing trade secrets and funneling the confidential information to a company in Taiwan, marking the latest episode in which a drug maker in the U.S. has purportedly encountered sensitive data being shipped overseas. In this instance, a former principal scientist named Xanthe Lam, who worked for Genentech from 1986 through 2017, helped to siphon information about four drugs — the Avastin, Rituxan, and Herceptin cancer treatments, as well as the Pulmozyme cystic fibrosis medication — to JHL Biotech, which was founded by former Genentech employees to develop biosimilars, according to court documents. (Silverman, 10/30)

In the latest response to the opioid crisis, more than half of Rite Aid (RAD) shareholders voted to require the board of the pharmacy chain to report on how the addictive painkillers are monitored, and how the company is managing related financial and reputational risks. Specifically, 57 percent of shareholders supported the resolution, which also called for the Rite Aid board to describe senior executive compensation metrics or policies. The resolution was introduced by the UAW Retiree Benefits Trust, a member of Investors for Opioid Accountability, a coalition of institutional investors that has been pushing wholesalers and pharmacies to take steps to reign in the opioid crisis. (Silverman, 10/30)

While Congress and the Trump administration were promoting greater use of the addiction medication buprenorphine to quell the opioid epidemic, a handful of states were licensing new methadone clinics in dozens of the nation’s hardest-hit communities. In fact, the methadone treatment industry, which began in the late 1960s, grew more in the past four years than it has in the past two decades, said Mark Parrino, president of the American Association for the Treatment of Opioid Dependence Inc., which represents methadone treatment providers. (Vestal, 10/31)

The Trump administration has stepped up scrutiny of asbestos trust funds, concerned that the pots of money intended to help people exposed to the hazardous substance are being depleted by fraudulent claims, harming victims, businesses and the government. The Justice Department in the last two months has demanded trust documents as part of a civil investigation, opposed the creation of another trust it said lacked sufficient safeguards, and argued against the appointment of a lawyer it said was too conflicted to represent victims. (Tucker, 10/31)

The Food and Drug Administration has agreed to consider Sanofi Pasteur’s application for Dengvaxia, the world’s first licensed vaccine that protects against dengue but one that brings with it considerable controversy and concern. The company announced Tuesday that it has received notice the regulatory agency will give the vaccine’s file a priority review, which means a decision must be rendered within six months. (Branswell, 10/30)

People can livestream their every move on Facebook and chatter endlessly in group chats. But in most parts of the U.S., they still can’t reach 911 by texting — an especially important service during mass shootings and other catastrophes when a phone call could place someone in danger. Although text-to-911 service is slowly expanding, the emphasis there is on “slow.” Limited funds, piecemeal adoption and outdated call-center technology have all helped stymie growth. (Anderson, 10/31)

Heart attacks occur more often when temperatures plummet, a large new study suggests. Based on 16 years of medical and weather data, researchers linked an increased incidence of heart attacks to lower air temperatures, lower atmospheric pressure, higher wind velocity and shorter durations of sunshine, according to the report in JAMA Cardiology. (Carroll, 10/30)

The U.S. Food and Drug Administration is revamping its definition of healthy to reflect our changing understanding of nutrition science. The push is fueling debate about eating habits and what the new standard should say. Frozen food-makers are seeking special rules for “mini meals,” citing little pizza bagels and dumplings as examples that might qualify. Chewing gum and bottled water companies say they should no longer be shut out from using the term just because their products don’t provide nutrients. Advocacy groups and health professionals are also weighing in, raising concerns about ingredients like sugar. (Choi, 10/30)

It was launched decades ago as an anesthetic for animals and people, became a potent battlefield pain reliever in Vietnam and morphed into the trippy club drug Special K. Now the chameleon drug ketamine is finding new life as an unapproved treatment for depression and suicidal behavior. Clinics have opened around the United States promising instant relief with their “unique” doses of ketamine in IVs, sprays or pills. And desperate patients are shelling out thousands of dollars for treatment often not covered by health insurance, with scant evidence on long-term benefits and risks. (Tanner, 10/31)

A century ago, the scientist Karl Pearson was studying cemetery headstones when he noticed something peculiar: Husbands and wives often died within a year of one another. Though not widely appreciated at the time, studies now show that stress and despair can significantly influence health, especially that of the heart. One of the most striking examples is a condition known as Takotsubo cardiomyopathy, or broken-heart syndrome, in which the death of a spouse, financial worries or some other emotional event severely weakens the heart, causing symptoms that mimic a heart attack. (O'Connor, 10/30)

At first, the debate over medical marijuana in Utah played out as you might expect: The Republican governor declared the issue shouldn’t be on the ballot. Once it was, the state medical association steered the opposition. By August, a senior official in the Church of Jesus Christ of Latter-day Saints was warning that residents of some states that had legalized marijuana were seeing serious “health and safety consequences.” But, then, something curious happened: Key opponents negotiated an agreement with the measure’s backers and other state leaders. Now, no matter what happens on Election Day, state lawmakers will be called into a special legislative session and plan to enact an alternate medical marijuana program. (Joseph, 10/31)

The Florida House is seeking to intervene in a potentially far-reaching legal battle about the constitutionality of a 2017 law that set regulations for the state’s medical-marijuana industry. House lawyers last week requested approval to help defend the law, which was designed to carry out a constitutional amendment that broadly legalized medical marijuana. (Saunders, 10/31)

Entrepreneurs and investors who are flocking to the industry say legalization is inevitable in the United States. But while more than 60 percent of Americans support making pot legal, the politics remain fraught. (Giammona, 10/30)

Marijuana regulators could issue another six so-called final licenses for marijuana businesses when they meet Thursday, but the retailers who have already been given final approval still have not pinned down when they will open to customers. When the Cannabis Control Commission meets Thursday afternoon, it will consider granting six final licenses, including one for a Pharmacannis Massachusetts retail store in Wareham. (Young, 10/30)

The U.S. cannabis industry is testing whether President Donald Trump's 'America First' talk extends to the pot business, now that Canada has legalized recreational marijuana use. The publicly held dispensary Terra Tech Corp. took out a full-page ad in the Wall Street Journal imploring Trump for help on the eve of Canada's decriminalization and is eyeing similar appeals on Fox & Friends — the splashiest parts of a push to galvanize support behind an industry beset by legal and regulatory uncertainty. (Owermohle, 10/30)

Marijuana, it seems, is not a performance-enhancing drug. That is, at least, not among young people, and not when the activity is learning. A study published Tuesday in the Journal of Clinical Psychiatry finds that when adolescents stop using marijuana – even for just one week – their verbal learning and memory improves. The study contributes to growing evidence that marijuana use in adolescents is associated with reduced neurocognitive functioning. (Cohen, 10/30)

Juul offered a number of schools and public school systems stipends of as much as $20,000 to adopt a vaping curriculum to be taught by Juul consultants, according to information from multiple school districts reviewed by BuzzFeed News. The ill-fated curriculum, which Juul pulled in mid-May, recently came under fire in an article published this month in the Journal of Adolescent Health that claims Juul failed to emphasize the harms caused by flavored pods and omitted information about how the e-cigarette industry markets to teens, the authors said. (Miranda, 10/30)

California spent $4 billion on Medi-Cal coverage between 2014 and 2017 for people who may not have been eligible for the government-funded health plan, according to a state audit released Tuesday. Medi-Cal provides health coverage to 13.1 million Californians, approximately one-third of the state’s population. To qualify, a single adult must make less than $16,754 annually. County workers typically determine whether someone is eligible for health coverage under Medi-Cal, then send that information to the state. But the records don’t always match up. (Karlamangla, 10/30)

Minnesota's mental health system is largely ineffective at treating depression and hasn't improved, according to a new report from Minnesota Community Measurement. ...After 6 months of treatment only 8 percent of Minnesota patients have no symptoms — or at least fewer symptoms — of depression. The remission rate has been stuck at 8 percent for years. (Catlin, 10/30)

A group of Minnesota business leaders called on fellow employers Tuesday to upgrade their benefits packages and workplace attitudes in an effort to improve the treatment of depression and reduce the state's rising suicide rate. Citing reduced productivity and increased prescription drug costs, leaders with the Minnesota Health Action Group said companies have both economic and moral reasons to take on mental health. (Olson, 10/30)

The office was initially only meant to be a temporary solution to kick off [Gov. John] Kasich’s health agenda. “We were only supposed to be an 18-month strike team, get the right people working together, and then get out,” Moody says. But eight years later, the office is still alive. To be sure, it faces an uncertain future: Kasich will step down in January, thanks to term limits, and Moody left for a job at Ohio State University in August. The office itself is down to only two employees. But as Kasich’s administration comes to a close, it’s clear that the office he created has lived up to its name as a truly transformational force in health care. “The work of department heads is incredibly complex. It’s hard to get your head above the day-to-day,” says Trish Riley, executive director of the National Academy for State Health Policy. “When you have an office like this that respects and supports them to think big, it’s incredible -- especially as health care continues to cut across so many sectors.” (Quinn, 10/30)

For nearly a year and a half, top officials in Newark denied that their water system had a widespread lead problem, despite ample evidence that the city was facing a public health crisis that had echoes of the one in Flint, Mich. ... But this month, facing results from a new study, the officials abruptly changed course, beginning an urgent giveaway of 40,000 water filters across the city of 285,000 people, targeting tens of thousands of residences. (Leyden, 10/30)

The Sutter health care team that serves the Sacramento region’s frailest senior citizens on Tuesday opened a $11.6 million center that will allow staff to care for roughly three times the patients now seen in two smaller facilities. ...The new Sutter facility, at 444 N. Third St. in Sacramento’s River District, is part of a federal health initiative known as PACE, Program of All-Inclusive Care for the Elderly, that treats the whole person rather than their set of medical conditions. (Anderson, 10/30)

Now, as part of an unusual arrangement, Ms. Chavarria may soon be welcoming some of those homeless people into her backyard. Ms. Chavarria is one of several Los Angeles residents who are building additions to their homes that would be used by people emerging from homelessness. Faced with a major housing crisis, Los Angeles is trying out an idea that some hope is so wild that it just might work: helping homeowners build small homes in their backyards and rent them to people who have spent months living in their cars, in shelters or on the streets. (Medina, 10/29)

Two years in, San Diego’s hepatitis A outbreak is finally over. Dr. Wilma Wooten, the county’s public health officer, said Monday that enough time has now passed to formally declare a curtain call for the contagion that killed 20, sickened nearly 600 and spurred a complete re-think of how the region handles homelessness.“ Last Thursday, it was officially 100 days since the most-recent case, and, for hepatitis A, that’s the threshold we use that allows us to say it no longer meets the definition of an outbreak,” Wooten said. (Sisson, 10/30)

Local health authorities detected the infectious disease in February 2017. Investigators determined the first likely case occurred during the week of Nov. 22, 2016. The outbreak led to a focus on unsanitary living conditions among San Diego’s homeless population. City and county governments promoted vaccination, washed streets, installed portable toilets and hand-washing stations, and put up temporary shelters capable of housing 700 people at a time. (10/30)

Seattle startup 98point6, whose app lets consumers consult with a primary-care doctor via text messages, has raised $50 million from investors. The company launched its virtual primary-care service to the public this spring, allowing people to schedule consultations with 98point6’s full-time staff doctors and communicate with health-care providers mostly through messaging, with video and voice calls if necessary. The service costs $20 for the first year, then increases to $120 annually, and does not require insurance. (Lerman, 10/30)

Employer-sponsored health plans in Minnesota are reporting a 5 percent increase in benefit costs for active employees, according to survey results released Tuesday, as small employers nationally say they are feeling more cost pressures. The survey from the consulting firm Mercer found that the average health benefit cost per active employee in Minnesota is now $13,228, with workers covering one-fourth of the total premium cost. (Snowbeck, 10/30)

Nancy Pelosi marched into PhRMA’s offices this July with the law on her side. Never mind that the law in question has never been put to use: Pelosi spoke in detailed terms of a federal statute that allows the U.S. government to effectively strip drug companies of exclusive licenses to some blockbuster medicines. It was a head-turning threat from the woman likely to serve as speaker of the House next year, delivered straight to the drug lobby’s board of directors — executives from many of the country’s largest and most politically powerful pharmaceutical manufacturers. (Facher, 10/30)

The American Medical Association is urging the Federal Trade Commission to take action against drug companies they say are contributing to high prices for insulin. In a letter to FTC Chairman Joseph Simons, the AMA said physicians are concerned that the rapid rise in the price of insulin for patients is unrelated to the actual costs of research, development, commercialization, or production. (Weixel, 10/29)

Novartis AG has dropped about a fifth of its research projects as the drugmaker narrows its focus on the most cutting-edge medicines. The pharmaceutical giant has reduced its drug programs to 340 from 430 after completing a review of its portfolio, Jay Bradner, president of the Novartis Institutes for Biomedical Research, said in an interview Monday. Among the research projects it’s no longer pursuing are medicines for infectious diseases. (Paton, 10/30)

After several years of legal sparring, Abbott Laboratories (ABT) and AbbVie (ABBV) will pay $25 million to settle allegations of paying kickbacks to doctors and illegally marketing the TriCor cholesterol pill. The case began with a whistleblower lawsuit filed in 2009 by a former saleswoman for Abbott, which marketed the medicine at the time and later transferred the rights after spinning off AbbVie. The sales rep, Amy Bergman, alleged she was “trained, directed, incentivized, and encouraged” to promote TriCor for so-called off-label marketing and medically unnecessary uses. (Silverman, 10/29)

In a challenge to Johnson & Johnson (JNJ), a federal court ruled that a patent on a key drug — the big-selling Zytiga prostate cancer treatment — is invalid, triggering the likely arrival of lower-cost generic competition, possibly in a matter of days. The Friday decision had largely been expected by Wall Street analysts, who noted that a U.S. Patent and Trademark Office review board earlier this year had invalidated the same patent after determining it was not sufficiently inventive. The patent, which is due to expire in 2027, covered a method for administering the drug. (Silverman, 10/29)

Pfizer (PFE) and Novartis (NVS) are pairing up on new clinical trials of combination therapies to treat the fatty liver disease known as NASH. The collaboration between the pharma giants announced Monday won’t yield significant clinical results for quite some time, but scientists working at both companies say attacking NASH with two or more drugs that act in the liver differently will ultimately bring the most benefit to patients. (Feuerstein, 10/29)

A small biotech company has a shot at shaking up a market roosted by giants, moving toward approval with a pill it believes can lower bad cholesterol at a discount to other medicines. On Sunday, Esperion Therapeutics said a combination of its once-a-day treatment and a maximum dose of statin lowered LDL cholesterol 18 percent more than statins alone after 12 weeks. The results come from the last of five successful trials on Esperion’s drug, called bempedoic acid. The company plans to submit all of its data to the Food and Drug Administration in the early months of 2019. (Garde, 10/28)

When the drug maker Novartis announced last month that it would cut 2,200 jobs, it framed the decision not as a retreat but as a restructuring. The goal, CEO Vas Narasimhan said, was to reshape the company to focus on “specialized and more personalized innovative medicines.” Out with the company’s contact lens business, in with cancer immunotherapy. Novartis became the first company to secure approval for a CAR-T therapy last year. And in a sign of its coming ambitions, last month it agreed to buy the drug maker Endocyte for $2.1 billion — to gain control of its experimental prostate cancer drug, which uses an approach called radioligand therapy. (Weintraub, 10/29)

Pfizer CEO Ian Read said the company will return to “business as normal” on its drug pricing in January, after agreeing to hold off on price increases earlier this year following pressure from President Trump. Read noted on an earnings call that the agreement to hold off on price increases would end at the end of the year, at which point the company will return to pricing based on the market. “We price to the marketplace, we price competitively,” Read said. (Sullivan, 10/30)

The company attributed the adjustments partly to lower-than-expected revenue from its “Essential Health” business selling products that have lost patent protection and sterile injectables, which are dealing with shortages. Pfizer also cited pricing pressures on the unit’s drugs, along with recent unfavorable foreign-exchange rates due to the weakening of some emerging-market currencies and the euro. (Chin and Rockoff, 10/30)

Pfizer Inc on Tuesday reported worse-than-expected third quarter revenue and lowered the top end of its full-year sales forecast as generic competition and drug pricing pressure in the United States hurt its older drugs business. Investor attention has been increasingly focused on the company post-2020, with a view toward drugs they hope will be on the market by then. The company has touted its pipeline, which it believes contains 15 drugs with annual sales potential that could exceed $1 billion launching within the next five years. (Mathias and Erman, 10/30)

Pfizer posted a 45 percent jump in third-quarter profit, as the biggest U.S.-based drugmaker benefited from sharply lower taxes due to this year’s federal tax cut. The maker of Viagra and nerve pain treatment Lyrica on Tuesday reported net income of $4.11 billion, or 69 cents per share. (Johnson, 10/30)

Buying Hospira was supposed to open a bright new pharmaceutical future for Pfizer Inc., but problems from the company’s past keep haunting the world’s largest drugmaker. When Pfizer agreed to pay $17 billion to take over Hospira in 2015, the deal was presented as a bet on biosimilars -- cheaper versions of brand-name biologic medications that could steal the thunder from some of Pfizer’s rivals’ biggest products. The move would position Pfizer as the biggest player in a burgeoning medical marketplace. (Koons, Langreth and Edney, 10/30)

French pharmaceuticals heavyweight Sanofi SA reported a rise in key third-quarter metrics Wednesday, with its bet on higher-value drugs seeming to offset declining revenue from its diabetes division, long afflicted by the loss of exclusivity for former blockbusters. Net sales at the company increased to 9.39 billion euros ($10.67 billion) from EUR9.06 billion the year prior, buoyed by sales of vaccines and by the specialty-care division Sanofi Genzyme, which grew 36% on year. (Mancini, 10/31)

Amgen Inc on Tuesday said stock buybacks lifted its third-quarter earnings per share, but operating income fell as expenses rose and sales of some key products declined. Total revenue for the quarter rose 2 percent from a year earlier to $5.9 billion. ... Amgen last week said it slashed the U.S. list price for cholesterol drug Repatha by 60 percent to $5,850 a year, mainly to reduce out-of-pocket costs for patients on Medicare, the federal government’s health plan for seniors. (Beasley, 10/30)

President Trump unloaded last week that the U.S. pays more for drugs—“same company, same box, same pill”—than, say, the United Kingdom or France. “And I’d say: ‘Why is this?’” His latest proposal reveals he still doesn’t know, so allow us to explain why the U.S. shouldn’t put the world’s most innovative drug market at the mercy of what Greece is willing to pay for a cancer treatment. ... The reason European countries pay less for drugs is because they run single-payer health systems and dictate the prices they’re willing to pay. Don’t like it? They’ll then vitiate your patents and make a copycat. This is hardly a “voluntary” discount. Other countries have the luxury of extortion because the U.S. produces more drugs than the rest of the world combined. Mr. Trump mentioned these realities in his speech but blew past them to suggest importing the same bad behavior. (10/28)

The biopharmaceutical industry saves more lives, relieves more suffering, and reinvests more profits into innovation than any other in the world. Yet the sector has become a public punching bag. Everyone from liberal Democrats to President Trump argues that drugs cost too much. The problem is that “lowering drug prices” has different meanings to different people. If the goal is to help patients afford their medicine, a set of rational policy choices could help. If the goal is to stick it to pharma and help insurance companies and the government save money, then the Trump administration is on the right track—only it will come at the expense of innovation, cures, patients and jobs. (Jim Greenwood, 10/29)

It was a big week for health care, with President Donald Trump’s ambitious new plan to lower drug costs taking center stage. But there was another big development on the drug-pricing front that may be just as significant. On Wednesday, Amgen Inc. reduced the $14,500 list price of its potential blockbuster cholesterol medicine Repatha by 60 percent. This isn’t something that happens for a novel and highly effective drug that has just been on the market for just three years. In fact, it almost never happens at all. List prices — the sticker amount on drugs — typically stay constant and serve as a starting point for negotiations. Discounting comes from behind-the-scenes rebates paid to health plans and pharmacy benefit managers, which serve as the middlemen between pharmaceutical companies and insurers. (Max Nisen, 10/26)

Bringing a new drug to market now takes, on average, $2.6 billion and more than 10 years. Those numbers could shrink, and countless patients could benefit, if Food and Drug Administration regulators were less risk-averse. I know that from firsthand experience. Oct. 30 marks the 36th anniversary of the FDA’s approval of human insulin synthesized in genetically engineered bacteria, the first product made with “gene splicing” techniques. As the head of the FDA’s evaluation team, I had a front-row seat. Although drugmakers and regulators were exploring unknown territory—the kind of situation that usually causes bureaucrats to dive for cover—the development of the drug and its regulatory review proceeded rapidly. (Henry I. Miller, 10/28)

U.S. prescription drug prices are exceedingly high and no one knows this better than seniors, who are on fixed incomes and must still choose between food and medicine. President Trump has put the blame on Big Pharma, but so far he’s only offered mild salves for the problem. However, this may change if the Democrats succeed in taking back the House this November. The 116th Congress could have an opportunity to work with the Trump administration to break the logjam on this urgent and vexing issue. House Democratic leader Nancy Pelosi (D-Calif.) indicated the party would push prescription drug legislation early next year. (Max Richtman, 10/25)

As it approaches a CEO transition, Pfizer Inc.’s management has plenty of issues on its plate. But what should really worry investors is that it can’t seem to put an old one to rest. The pharmaceutical giant announced third-quarter earnings that didn’t reassure investors. Pfizer missed analysts’ sales estimates and lowered the midpoint of its full-year revenue guidance. Foreign exchange is partly to blame, but so are drug shortages from its Hospira injectable drugs business — which suggests that drug-supply headaches that should have been resolved are lingering in a serious way. (Max Nisen, 10/30)

While the nation was focused on migrant caravans, mail bombs and President Trump’s disgusting tweets last week, his administration was making another big change to the Affordable Care Act, also known as Obamacare. The new plan would give states far more flexibility in regulating health-insurance markets within their borders. That sounds like a good thing. It is not. Obamacare reorganized the market for individual insurance plans — that is, coverage people do not get from their employers or directly from the government. The law recognized that there are only so many ways to get people with preexisting conditions onto the comprehensive plans they need. The government could insure them directly, at high taxpayer expense, or it could mandate that everyone carry decent, private health-care coverage. With many people, healthy and sick, in the system, premiums overall would be contained and everyone would have quality health insurance that would cover expected and unexpected medical costs. (10/30)

Republicans have been very busy lying about health care: lying about their policy agenda, lying about Democrats calling them liars and lying about who said who was really lying about all this. Amid those lies, however, GOP officials and candidates have occasionally lapsed and told the truth: The party, like it always has, wants to cut federal health care programs. They want to repeal the Affordable Care Act, still without having any idea how to replace it, and they’re working hard to make the law worse in the meantime. They want to slash Medicaid. They want to shrink Medicare. (Jeffrey Young, 10/30)

Despite their almost comically dishonest insistence that they have suddenly discovered a passion for protecting people with preexisting conditions, Republicans will continue their assault on the Affordable Care Act, including, yes, its protections for people with preexisting conditions. If the lawsuit filed by a group of Republican-controlled states is successful, one supported by the Trump administration and pretty much every Republican everywhere, the ACA will be nullified. Even if that doesn’t happen, the administration will continue its effort to sabotage the ACA in every way it can imagine, making health care less secure and more expensive. Republicans have already made clear that they will take another shot at repealing the ACA in Congress, and will probably attempt to cut Medicaid as well. (Paul Waldman, 10/30)

HPREP’s message was simple yet enormously powerful: You belong here and don’t let anyone sell you short.The program, which celebrates its 30th anniversary in 2019, was started by medical students at Weill Cornell Medicine with the aim of drawing more underrepresented minority students into the medical field. Now a national program under the auspices of the Student National Medical Association, more than 7,000 high school students have participated in the HPREP program. (Jessica M. Pena, 10/31)

E-cigarettes or “vapes” are known as the wildly popular “safe” alternative to cigarettes and tobacco products. Though many see them as harmless, little is known about the direct health effects of the products. This is especially concerning considering that a 2016 survey found more than 2 million U.S. middle and high school students reported using e-cigs within the last 30 days. Because e-cigs and vapes contain highly addictive nicotine and other potentially harmful agents, I believe they should be included in the, Great American Smokeout in an effort to avoid having users become the cigarette patients of tomorrow. (Peter Shields, 10/30)

We do not know whether herpes viruses, with or without host genetic susceptibility, can cause AD (Alzheimer's disease) or not. But scientists have been investigating this possibility for as long as the polio vaccine has existed. And as with the polio vaccine, the best way to find out if a virus can cause an illness, is to perform a clinical trial where half the patients receive a safe and effective agent against the implicated herpes virus(es), and half receive a placebo (sugar pill), then see if the drug-treated patients have a better outcome than the placebo-treated patients in terms of thinking ability and ability to function in daily life.Researchers believe that based on these recent studies of human herpes viruses and AD, we may be approaching a major paradigm shift in our approach to the disease, instead of continuing on our current path of spending billions on failing AD studies. (Fred G. Volinsky, Pascal J. Goldschmidt-Clermont and Steven P. Larosa, 10/30)

How about “rat explosion”? As the climate warms, rats in New York, Philadelphia and Boston are breeding faster — and experts warn of a population explosion. Like rats, humans are hardy animals, and we’ve adapted to all kinds of climates. So it can be tempting to brush off the prospect of 2 degrees of warming. Especially for Americans, who mostly use Fahrenheit. That 2 degree warming is Celsius. Think of 3.6 degrees Fahrenheit. Still not scared? Fine. (Faye Flam, 10/30)

California struck a blow for intelligent public health policy in 2015, when the state abolished all “personal belief exemptions” from child vaccine mandates. The new rules were designed to put a stop to the stupid and irresponsible behavior of parents whose casual approach to getting their children vaccinated against a host of communicable diseases — chiefly measles, mumps and rubella — places their neighbors’ children and their entire communities at risk. (Michael Hiltzik, 10/30)

(Janet) Mills has promised to move quickly to expand Medicaid, suggesting that the state use, as a down payment, $35 million from a tobacco settlement she negotiated. She would push hard for broadband for rural areas, for a transition to cleaner energy, for a better-funded school system, and for red-flag gun legislation. (10/30)