First Edition: March 16, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News:
Bill Of The Month: For Toenail Fungus, A $1,500 Prescription
During Anne Soloviev’s semiannual visit to Braun Dermatology & Skin Cancer Center in Washington, D.C., in January, the physician assistant diagnosed fungus in two of her toenails. Soloviev is vigilant about getting skin checks, since she is at heightened risk for skin cancer, but she hadn’t complained about her toenails or even noticed a problem. The assistant noted some unusual discoloration where the nail meets the skin. “They took a toenail clipping and said, yeah, you have a fungus,” Soloviev recalled. (Luthra, 3/16)
Kaiser Health News:
FDA Moves To Cut Nicotine In Cigarettes, Helping Smokers Kick Habit
The idea of reducing nicotine to non-addictive or “minimally addictive” levels is the “cornerstone” of a comprehensive tobacco control plan announced in July by FDA Commissioner Scott Gottlieb. “We’re taking a pivotal step today that could ultimately bring us closer to our vision of a world where combustible cigarettes would no longer create or sustain addiction — making it harder for future generations to become addicted in the first place and allowing more currently addicted smokers to quit or switch to potentially less harmful products,” Gottlieb said. (Szabo, 3/15)
NPR:
FDA To Limit Nicotine In Cigarettes
The Food and Drug Administration said Thursday it wants to sharply reduce the amount of nicotine in cigarettes. The idea is to help wean millions of smokers off their deadly habit and prevent millions more from becoming regular smokers in the first place. "Despite years of aggressive efforts to tackle the leading cause of preventable disease and death in the United States, tobacco use — largely cigarette smoking — still kills more than 480,000 Americans every single year," FDA Commissioner Scott Gottlieb said in a statement. (Stein, 3/15)
The Washington Post:
FDA Moves Ahead With ‘Historic’ Plan To Reduce Nicotine In Cigarettes
Commissioner Scott Gottlieb unveiled an “advance notice of proposed rulemaking,” the earliest step in what promises to be a long, complicated regulatory effort to lower nicotine levels to be minimally addictive or nonaddictive. The notice, to be published Friday in the Federal Register, includes new data published in the New England Journal of Medicine on Thursday based on a possible policy scenario. That FDA-funded analysis found that slashing nicotine levels could push the smoking rate down to 1.4 percent from the current 15 percent of adults. That in turn would result in 8 million fewer tobacco-related deaths through the end of the century — which Gottlieb termed “an undeniable public health benefit.” (McGinley, 3/15)
The Associated Press:
FDA Begins Push To Cut Addictive Nicotine In Cigarettes
Currently, there are no limits on nicotine, which occurs naturally in tobacco plants. Under law, the FDA can regulate nicotine although it cannot remove it completely. The FDA's powers to police the tobacco industry are unique worldwide and the attempt to restrict nicotine would represent a first in global efforts to reduce smoking-related deaths. Under one scenario, the FDA estimates the U.S. smoking rate could fall as low as 1.4 percent by 2060, down from the 15 percent of adults who smoke now. (Perrone, 3/15)
The Wall Street Journal:
FDA Moves To Curb Nicotine In Cigarettes
Nicotine levels in cigarettes can be reduced in different ways. Manufacturers can adjust the blend of tobacco leaves or use different types of paper or filters. Nicotine can also be stripped from the leaf in the manufacturing process. But products with very low levels of nicotine have never garnered a significant share of the U.S. market. The FDA has said its approach will consider a continuum of risk for nicotine delivery, from combustible products such as cigarettes to replacement therapies like nicotine gums. (Chaudhuri, 3/15)
Los Angeles Times:
In A First, The FDA Announces Its Intention To Reduce The Amount Of Nicotine Allowed In Cigarettes
The FDA action won praise from public health advocates, who lament the loss of 480,000 American lives each year due to smoking. "The benefits the FDA cites for this proposal are extraordinary," said Matthew L. Myers, president of the Campaign for Tobacco-Free Kids. He added that for the proposal to have maximum impact, the FDA should reduce nicotine levels in all combustible tobacco products, not just cigarettes. (Healy, 3/15)
Politico:
Trump’s FDA Weighs Nicotine Limits In Cigarettes
The nicotine rule is one of a number of tobacco-related regulations FDA is working on. The agency will soon seek comment on the role that flavors like menthol play in tobacco use, and to get feedback and data concerning the possible regulation of premium cigars. It’s also working to modernize its approach to the development and regulation of nicotine replacement products like gum and patches. (Karlin-Smith, 3/15)
The Wall Street Journal:
Billions Of Dollars On The Line As Insurers Await Obamacare Ruling
Health insurers and the Trump administration face a court decision shortly that will determine whether the government must pay insurers billions of dollars despite Republican efforts to block payments they view as an industry bailout. Insurers have filed roughly two-dozen lawsuits claiming the federal government reneged on promises it made to pay them under the Affordable Care Act. A decision could come at any time on pivotal litigation before a three-judge panel at the U.S. Court of Appeals for the Federal Circuit. (Armour, 3/15)
The Hill:
Idaho, Trump Officials Meet On State's Controversial ObamaCare Plan
Idaho officials met with Trump administration officials and Sen. Jim Risch (R-Idaho) on Wednesday to try to find a path forward on the state’s controversial plan to skirt ObamaCare rules. Idaho insurance commissioner Dean Cameron told The Hill that he met with administration officials in Washington on Wednesday to discuss possible changes to the state’s plan. (Sullivan, 3/15)
Politico:
Exclusive: Trump Finalizing Opioid Plan That Includes Death Penalty For Dealers
The Trump administration is finalizing a long-awaited plan that it says will solve the opioid crisis, but it also calls for law enforcement measures — like the death penalty for some drug dealers — that public health advocates and congressional Republicans warn will detract from efforts to reverse the epidemic. The ambitious plan, which the White House has quietly been circulating among political appointees this month, could be announced as soon as Monday when President Donald Trump visits New Hampshire, a state hard hit by the epidemic. It includes a mix of prevention and treatment measures that advocates have long endorsed, as well as beefed-up enforcement in line with the president’s frequent calls for a harsh crackdown on drug traffickers and dealers. (Diamond, 3/15)
Stat:
Hospitals Confront A New Opioid Crisis: An Alarming Shortage Of Pain Meds
The incident command system kicked in at Brigham and Women’s Hospital about a week ago. A large team of doctors, pharmacists, and nurses began assembling every morning to confront an emerging crisis with the potential to severely undermine care for patients. The challenge was different than it was during the Boston Marathon bombing, another event that triggered the command response. This one wasn’t rushing toward caregivers as fast. But it was similarly daunting and logistically demanding: Amid a nationwide crisis caused by too-easy access to medical painkillers, hospitals are now struggling to find enough of that same class of drugs to keep their patients’ pain controlled. (Ross, 3/15)
The Associated Press:
Trump To Visit NH To Talk About Plan To Combat Opioids
President Donald Trump will be traveling to New Hampshire to unveil more of his plan to combat the nation’s opioid crisis. The White House says the president and First Lady Melania Trump will travel to the Granite State on Monday. Trump had come under fire for being slow to act on the drug crisis but has begun rolling out new plans. He had promised during the campaign to make fighting the epidemic a priority. (3/15)
The Washington Post:
Alexandria Sues Pharmaceutical Companies Over Opioid Crisis
The city of Alexandria, Va., is suing sellers of prescription painkillers, saying drug addiction has killed scores of residents and overwhelmed city services. Alexandria is asking $100 million from the companies, which include manufacturers, distributors and pharmaceutical providers. The city joins dozens of state, county and city governments across the country that have taken opioid providers to court to argue that the companies that profited so much from the drugs should help pay for their destructive effects. Montgomery and Prince George’s counties in Maryland are among those who have sued opioid manufacturers and distributors. (Weiner and Stein, 3/15)
The Associated Press:
Abortion, Free Speech Collide In Supreme Court Dispute
Informed Choices is what its president describes as a "life-affirming" pregnancy center on the edge of downtown Gilroy in northern California. Even as it advertises "free pregnancy services" and promises in signs on its door and inside to discuss all options with pregnant women, Informed Choices exists to steer women away from abortion. The state of California, prompted by abortion rights groups, worried that vulnerable, uninsured women were going to Informed Choices and other anti-abortion crisis pregnancy centers expecting they would get comprehensive care. (Sherman, 3/16)
The Associated Press:
2 Women Offer Differing Views Of Crisis Pregnancy Centers
Accounts from two women who visited crisis pregnancy centers, with differing views of the experience. (3/16)
The Hill:
Trump's Health Chief Backs HHS Official At Center Of Abortion Suit
Health and Human Services (HHS) Secretary Alex Azar indicated Thursday he would not fire Scott Lloyd, the HHS official who has tried to block unaccompanied immigrant minors in U.S. custody from getting abortions. Asked by Rep. Rosa DeLauro (D-Conn.) when Azar would fire Lloyd, Azar replied: “This is simply not an issue of Mr. Lloyd. This is the statutory obligation of the director of the Office of Refugee Resettlement (ORR) to coordinate and improve the care of placement of these minors, including providing for serious medical services to them.” (Hellmann, 3/15)
Stat:
Lawmakers Want To Remove Gag Clauses That Boost Drug Costs At The Pharmacy Counter
The next time you walk into your pharmacy, you may not get the best deal on your prescription, but don’t blame the pharmacist. Many allegedly have contracts with behind-the-scenes middlemen that contain “gag clauses” preventing them from telling you that paying cash for a prescription might cost less than your health insurance copayment. And pharmacists can face significant penalties if they disclose the difference. So now, a trio of senators has introduced a pair of bills — the Patient Right to Know Drug Prices Act and the Know the Lowest Price Act — that would prohibit pharmacy benefit managers from using these gag clauses in order to pocket the difference. (Silverman, 3/15)
The Hill:
Senators Target 'Gag Clauses' That Hide Potential Savings On Prescriptions
The clauses, which keep pharmacies from proactively telling customers they could save money on a prescription if they paid out of pocket instead of through insurance, has sometimes been included in contracts between pharmacies, insurers and companies that manage drug benefits for employers called prescription benefit managers (PBMs).
“Insurance is intended to save consumers money. Gag clauses in contracts that prohibit pharmacists from telling patients about the best prescription drug prices do the opposite,” Sen. Susan Collins (R-Maine) said in a statement Thursday. (Hellmann, 3/15)
The Washington Post:
House To Try Again On Bill Easing Use Of Unapproved Drugs
The House plans to try anew next week to approve a Republican bill making it simpler for fatally ill people to try unproven treatments. And this time, the measure seems certain to pass. Lawmakers voted for the legislation on Tuesday by a lopsided 259-140 vote. But it lost because GOP leaders had used a procedure, normally reserved for uncontroversial bills, that requires a two-thirds majority for passage. Tuesday’s vote fell just short of that. President Donald Trump backed the legislation and GOP lawmakers lined up behind it nearly unanimously, but Democrats opposed it by more than a 4-1 margin. (Fram, 3/15)
Stat:
Senate Signals Interest In Changes To Drug Discount Program
Key Senate Republicans have signaled an increasing interest in making changes to the so-called 340B drug discount program, adding to a chorus of House Republicans who are pushing to overhaul the program. The Senate Health, Education, Labor and Pensions Committee met Thursday to discuss the program with representatives of the hospitals who favor the program and the pharmaceutical companies who have long called for reining it in. The hearing was the first sign of serious Senate interest in the issue, and it follows a string of relatively heated meetings in the House Energy and Commerce Committee and a flurry of bill introductions on the topic from lawmakers in both chambers and both parties. (Mershon, 3/15)
Stat:
Drug Makers Jostle Over Potential Medicare Changes In Congressional Spending Deal
Drug company lobbyists are pushing lawmakers to include in the forthcoming appropriations package two small changes to Medicare that could help them reap bigger profits from the federal program. Johnson & Johnson, Amgen, and Genentech, the makers of several of the most popular “biologic” drugs, are lobbying Republicans to add a provision that ensures that one Medicare program doesn’t pay more for newer “biosimilar” drugs than it does for their products, according to several congressional aides and lobbyists. (Mershon, 3/16)
Bloomberg:
Pfizer Lifts CEO's Pay 61% To $27.9 Million With Retention Bonus
Pfizer Inc. boosted Chief Executive Officer Ian Read’s compensation for 2017 to $27.9 million, a 61 percent increase, to ensure he stays on the job. Read’s pay included an $8 million special equity award that will vest if the drugmaker’s average stock return tops 25 percent for 30 consecutive trading days before the end of 2022, the company said Thursday in a filing. Read, who turns 65 in May, also must remain CEO through at least next March and not work for a competitor for a minimum of two years after that to be eligible. (Melin and Hopkins, 3/15)
The Associated Press:
Republican War Over Medicaid In Virginia A Fight Over Trump
Virginia Republicans are currently at war with each other, and President Donald Trump is a big reason why. GOP lawmakers are fighting over whether to expand Medicaid to about 300,000 low-income adults, a stalemate that has blocked passage of the state budget and threatens a potential government shutdown. (3/15)
The Washington Post:
David Shulkin Says He Is Trying To Stay Focused On Veterans
Facing reports that he might soon be fired by the White House, Veterans Affairs Secretary David Shulkin told a House subcommittee Thursday that he was fighting “politics and distractions to focus on vets.” Shulkin began the session with praise of President Trump’s proposed $200 billion budget for the agency, calling it “very strong.” But he was quickly asked about his own situation. “Let’s discuss the proverbial elephant in the room — some reports even mentioned you have an armed guard stationed outside your office?” Rep. Charlie Dent (R-Pa.) asked during the hearing before the House Appropriations subcommittee. “Is all of this squabbling affecting your mission to serve veterans?” (Wax-Thibodeaux, 3/15)
The Associated Press:
Sheriff: Vet Shot Self After Killing 3 Mental Health Workers
A combat veteran killed himself after fatally shooting three mental health workers last week at a California veterans home, authorities said Thursday. The Napa County Sheriff’s Office said Albert Wong, 36, shot the three workers in the head with a rifle at the California Veterans Home in Yountville. The sheriff didn’t release the type of rifle used. The sheriff also serves as the county’s coroner. (3/15)
The Washington Post:
‘I’m Constantly Asking: Why?’ When Mass Shootings End, The Painful Wait For Answers Begins.
Long after the sirens, vigils and cable news debates, the question remains. It nags at survivors and their families. It haunts investigators as they comb through the gunman’s belongings, text messages and the scattered pieces of his life. Even as our attention as a society fades, the mystery of motive lingers like an open, forgotten wound until the next shooting, the next cycle of grief, outrage and desperate search for answers. (Wan and Berman, 3/15)
The Wall Street Journal:
The Court Case Making Gun Makers Anxious
A lawsuit in Connecticut against a leading maker of AR-15 rifles is awaiting a pivotal court ruling over whether the gun industry can be held legally responsible for mass shootings. The Connecticut Supreme Court is deciding whether to throw out a wrongful-death lawsuit brought by families of victims killed at Sandy Hook Elementary School against the manufacturer of the semiautomatic gun Adam Lanza used in the 2012 rampage. (Gershman, 3/16)
The Washington Post:
Fertility Clinic Failures Forge Lost Legacies, Heartbreak
Many of them had already endured their share of heartache. Some had been trying for years to get pregnant, suffering through multiple miscarriages. Others had undergone cancer treatments that destroyed their fertility. Now, hundreds of these women and couples have learned that the eggs and embryos they froze for eventual use in starting or expanding a family may have been destroyed by storage tank failures March 4 at two fertility clinics in suburban Cleveland and San Francisco. (Seewer, 3/15)
The New York Times:
A Quiet Drug Problem Among The Elderly
At first, the pills helped her feel so much better. Jessica Falstein, an artist living in the East Village in Manhattan, learned she had an anxiety disorder in 1992. It led to panic attacks, a racing pulse, sleeplessness. “Whenever there was too much stress, the anxiety would become almost intolerable, like acid in the veins,” she recalled. When a psychopharmacologist prescribed the drug Klonopin, everything brightened. “It just leveled me out,” Ms. Falstein said. “I had more energy. And it helped me sleep, which I was desperate for.” (Span, 3/16)
The New York Times:
What’s Behind Many Mystery Ailments? Genetic Mutations, Study Finds
Gregor Mendel discovered fundamental rules of genetics by raising pea plants. He realized that hidden factors — we now know them to be genes — were passed down from parents to offspring. It wasn’t until the early 1900s, long after Mendel’s death, that doctors discovered that humans weren’t so very different. Some diseases, it turns out, are inherited — they’re Mendelian. Today, scientists have identified over 7,000 Mendelian diseases, and many are discovered with screenings of children and adults. But a new study suggests that many disorders go undetected. (Zimmer, 3/15)
Los Angeles Times:
Move Over, Neanderthals: Our Ancestors Mated With Denisovans Not Once But Twice, Scientists Say
Humans weren't just making babies with Neanderthals back in the day. A new study that compares the genomes of different groups of modern humans has found that our ancestors interbred with another close relative, the Denisovans, more than once. The findings, published in the journal Cell, demonstrate a special method that scientists can use to find these hidden fragments of DNA from our long-gone cousins — and shed fresh light on the complexities of human evolution. (Khan, 3/15)
NPR:
Biologists Track Mutations' Effects By Spying On Single Cells
Genetic mutations are the driving force of evolution, and now scientists have managed to study the effect of mutations in exquisite detail by watching what happens as they pop up in single cells. Only about one percent of mutations were bad enough to kill off the cell, according to a report published Thursday in Science. Most of the time, these small changes in its DNA appeared to have no effect at all. (Greenfieldboyce, 3/15)
The New York Times:
A ‘Sweet Spot’ For Heart Health
When it comes to our weight, is there a “sweet spot” for heart health? A large prospective study in the European Heart Journal collected data on almost 300,000 healthy men and women ages 40 to 69 and followed them for an average of five years. Researchers measured obesity in five ways: body mass index, waist circumference, waist-to-hip ratio, waist-to-height ratio and percentage body fat mass. (Bakalar, 3/15)
NPR:
High School Football Player And CTE Brain Researcher Have Chance Encounter
As Alex Rivero biked around town raising money for the Newton North High School football team last fall, the 17-year-old started getting pretty good at guessing which houses were worth the door knock. He'd look for lights on and listen for kids' voices. When he found a house that looked promising, he would stop. At one place, Dr. Lee Goldstein opened the door. Goldstein cares a great deal about high school football. It's what he was thinking about when the doorbell rang. (Leydon, 3/15)
The New York Times:
Adding Formula To Breast-Feeding May Help Some Newborns
Supplementing breast-feeding with formula may be good for some babies in the early days of life. Exclusive breast-feeding is widely recommended by experts, and rates of breast-feeding have risen. But so have rates of readmission for dehydration and jaundice attributable to inadequate nutrition. (Bakalar, 3/15)
The Washington Post:
Measles Warning Issued After Disease Travels From Overseas
Anyone in those airport locations in that time frame who experiences high fever, red eyes, coughing, a runny nose or light sensitivity followed by a bumpy rash should contact their primary-care doctor, the agency said. Symptoms manifest 10 to 12 days after infection but could be spread to other people before that. (Horton, 3/14)
The Washington Post:
A 13-Year-Old Died After A Sinus Infection Spread To His Brain, Relatives Say
The video showed 13-year-old Marquel Brumley bundled up in a hooded coat, sluggish and slumped in his seat. He was holding somebody's hand, then loosened his grip and let go. “Get well brother,” read a caption on the video, which his sister posted on Facebook last week. (Bever, 3/15)