First Edition: April 18, 2018

Kaiser Health News: Federal Appeals Court Puts Chill On Maryland Law To Fight Drug Price-Gouging
States continue to battle budget-busting prices of prescription drugs. But a federal court decision could limit the weapons available to them — underscoring the challenge states face as they, in the absence of federal action, go one-on-one against the powerful drug industry. The 2-to-1 ruling Friday by the U.S. 4th Circuit Court of Appeals invalidated a Maryland law meant to limit “price-gouging” by makers of generic drugs. The measure was inspired by cases such as that of former Turing Pharmaceutical CEO Martin Shkreli, who raised one generic’s price 5,000 percent after buying the company. (Luthra, 4/17)

California Healthline: California Insurer Faces Whistleblower Complaint Over Health Law Taxes
A federal whistleblower complaint alleges that a major California insurer failed to pay an estimated $89 million in taxes on premium revenue as required under the Affordable Care Act. The complaint against Blue Shield of California focuses on the taxation of certain health plans that are funded by both an employer and insurer. It could spark more scrutiny by federal officials into whether all insurers are paying their fair share of taxes on premiums. (Terhune, 4/17)

Kaiser Health News: Drug Test Spurs Frank Talk Between Hypertension Patients And Doctors
There’s an irony at the heart of the treatment of high blood pressure. The malady itself often has no symptoms, yet the medicines to treat it — and to prevent a stroke or heart attack later — can make people feel crummy. “It’s not that you don’t want to take it, because you know it’s going to help you. But it’s the getting used to it,” said Sharon Fulson, a customer service representative from Nashville, Tenn., who is trying to monitor and control her hypertension. (Farmer, 4/18)

The Washington Post: New CDC Chief Stepped Down From Four Groups To Comply With Ethics Rules
Centers for Disease Control and Prevention Director Robert Redfield has resigned his  positions at four groups, including a gene therapy biotechnology company and a conservative AIDS organization, to comply with government ethics rules, according to his financial disclosures. Redfield, a longtime HIV/AIDS researcher who started the job March 26, succeeded Brenda Fitzgerald, the former Georgia public health commissioner, who resigned Jan. 31 after serving only half a year because she was unable to divest from her financial holdings. She had also purchased tobacco stocks as CDC director. (Sun, 4/17)

The Wall Street Journal: New CDC Chief Resigned From Four Entities To Comply With Ethics Rules
In a Public Financial Disclosure Report, memorandum and letter reviewed by the Journal, Dr. Redfield, a veteran HIV/AIDS researcher, said he had resigned as a professor of medicine and from other posts at the University of Maryland. His compensation from the beginning of 2017 through March 2018 was $757,100 plus a $70,000 bonus. The CDC director’s compensation is $375,000. Dr. Redfield also resigned as consultant and chair of a clinical advisory committee for American Gene Technologies International Inc., a gene therapy biotech company; as a director of Children’s AIDS Fund International, an AIDS service organization with faith-based roots; and as a medical consultant for Guidepoint Global LLC, an advisory firm. He sold his stock in American Gene Technologies International and sold stock and forfeited options in Profectus Biosciences Inc., a vaccine development company. (McKay, 4/17)

The Hill: HHS Chief Azar Postpones Appearance At Hearing 
Health and Human Services Secretary Alex Azar is postponing a planned appearance before a Senate committee on Thursday as he recovers from an intestinal condition, an HHS official said Tuesday. The official said Azar, who was hospitalized overnight on Sunday before being released, has had his first bout of diverticulitis, an infection of pouches in the colon that can be painful. (Sullivan, 4/17)

The Associated Press: Dem Senator: Trump VA Pick Vows Not To Privatize Vets Care
President Donald Trump's pick to be Veterans Affairs secretary is promising not to privatize the agency, a key Democratic senator said Tuesday, taking a stance on a politically charged issue that his predecessor says led to his firing. The confirmation hearing of Ronny Jackson, Trump's White House doctor and a Navy rear admiral chosen to speed up improvements to the VA, is scheduled for next week. On Tuesday, he met privately with Sen. Jon Tester of Montana, the top Democrat on the Senate Veterans Affairs Committee, as a part of visits this week to assure lawmakers he could effectively lead the government's second-largest department. (Yen, 4/17)

The Hill: Trump's VA Pick Pledges Opposition To Privatization, Senator Says
Sen. Jon Tester (Mont.), the ranking Democrat on the Senate Veterans’ Affairs Committee, said Jackson pledged during a one-on-one meeting that he is against privatization. “He said all the right things, seems to have the same position on privatization that Shulkin had,” Tester told reporters. “He answered the questions right on privatization.” Political tensions about privatization could complicate the confirmation process. (Weixel, 4/17)

The New York Times: An Army Veteran Confronts His Own Trauma With A Camera
It was a cold, sunny day last spring when retired U.S. Army Specialist Michael McCoy visited the war memorial in Cumberland, Md., to look for the name of Pfc. Albert M. Nelson. Mr. McCoy, who grew up in West Baltimore, and Mr. Nelson, who was from West Philadelphia, became close friends in 2006 just before Mr. McCoy’s second of two yearlong deployments to Iraq. Mr. Nelson was a bit of a joker and, at 31, a few years older than the other soldiers. He was a big brother figure, well liked, especially by Mr. McCoy. (O'Reilly, 4/18)

The Associated Press: Citing Opioid Crisis, Feds Seek Rule Change For Drugmakers
Drugmakers would be required to identify a legitimate need for controlled substances to justify their production under a proposed rule change intended to rein in the diversion of drugs for illicit purposes, the Drug Enforcement Administration announced Tuesday. According to the DEA, current regulations were issued in 1971 but need to be updated to reflect the nation’s opioid abuse crisis and changes in the manufacture of controlled substances. (Raby, 4/17)

The Wall Street Journal: U.S. Proposes Quota Changes For Drug Enforcement Administration
Attorney General Jeff Sessions announced the publishing of the proposed rule changes in a speech in North Carolina, saying the action would help address the nation’s opioid problem, which he called “the deadliest drug crisis in American history.” Under the proposal, the Drug Enforcement Administration must consider how much drugs, particularly powerful opioid painkillers, are being misused, abused or causing overdoses when setting production quotas. The DEA will be required to assess information provided by government health agencies such as the Federal Drug Administration, as well as the states. (Wilber, 4/17)

Stat: Bernie Sanders Bill Would Impose Jail Time For Execs Behind Opioid Crisis
Sen. Bernie Sanders (I-Vt.) will introduce a bill Tuesday that would impose jail time for pharmaceutical executives whose companies engage in manipulative practices when marketing opioids. The legislation would impose a 10-year minimum prison sentence and fines equal to an executive’s compensation package if the individual’s company is found to have illegally contributed to the opioid crisis. It would also impose an additional fine on those companies of $7.8 billion — one-tenth the annual cost of the crisis, per a 2016 estimate. (Facher, 4/17)

The Hill: Sanders Unveils Bill Targeting Drug Companies Over Opioid Crisis
The bill bans companies from marketing opioids to consumers as nonaddictive, and fines them 25 percent of profits from opioid products if they are found in violation. “They knew how dangerous these products were but refused to tell doctors and patients,” he said. “Yet, while some of these companies have made billions each year in profits, not one of them has been held fully accountable for its role in an epidemic that is killing tens of thousands of Americans every year.” (Sullivan, 4/17)

The Hill: House Panel To Mark Up Opioid Bills Next Week
A House Energy and Commerce subcommittee will mark up legislation next Wednesday aimed at combatting the opioid epidemic. The April 25 markup in the panel’s health subcommittee comes as the panel's chairman pushes forward with his target of bringing a bill to the House floor by Memorial Day weekend. So far, lawmakers have reviewed more than 60 bills over three legislative hearings. (Roubein, 4/18)

Politico: Patrick Kennedy Profits From Opioid-Addiction Firms
Patrick Kennedy, the former Democratic representative and scion of the liberal political dynasty, has emerged as the unlikely go-to player for companies seeking to benefit from the Trump administration’s multibillion-dollar response to the opioid crisis, reaping well over $1 million in salaries and equity stakes in the firms. The 50-year-old son of the late Sen. Edward M. Kennedy, who stepped down from Congress in 2011 amid his own decades-long battles with addiction and mental illness, is a high-profile mental health advocate who sat on President Donald Trump’s opioid commission. (Cancryn, 4/17)

The Hill: GOP N.H. Governor Confronted White House Over Lack Of Opioid Funding: Report 
GOP New Hampshire Gov. Chris Sununu initially resisted a visit to his state from President Trump last month over the country's opioid addiction crisis, telling the White House that he didn't want his state used as a prop for the administration. CBS News reports  that Sununu battled White House aide Katy Talento, who sits on the White House Domestic Policy Council, over whether Trump could come to the state to promote his plan to battle the opioid epidemic while not providing additional funding for state initiatives. (Bowden, 4/17)

The Associated Press: Dozens Arrested In Drug Bust In Huntington, West Virginia
Dozens of people were arrested Tuesday in a major drug trafficking sweep in Huntington, West Virginia, a city hit hard by the opioid epidemic. U.S. Attorney Mike Stuart said more than 200 federal, state and local law enforcement officers targeted nearly 100 people for arrests aimed at dismantling a multi-state distribution network. He said 30 arrests were made as of midday Tuesday in the state’s second-largest city. (Raby, 4/17)

The Associated Press: Virginia House Passes Medicaid Expansion, Sends To Senate
The Virginia House of Delegates has approved a state budget that would expand Medicaid eligibility to about 400,000 low-income adults. The Republican-led House approved the state spending plan Tuesday with bipartisan support, but the measure still has to pass the state GOP-controlled Senate. Lawmakers are taking another stab at passing a budget after attempts during the regular session ended in a stalemate over disagreement about Medicaid expansion, a key part of former President Barack Obama’s health care law. (4/17)

The Associated Press: Nebraska Doesn't Extend Medicaid Benefits To Elderly Nuns
A vow of poverty by more than 20 elderly nuns isn't enough to qualify for Medicaid in Nebraska. The state cut Medicaid benefits earlier this year for the Sisters of Mercy, one of the oldest Roman Catholic religious orders in Nebraska, the Omaha World-Herald reported. (4/17)

The Hill: New Affordable Drugs Advocacy Group Pledges Six Figures In First 2018 Endorsement
A new drug-pricing advocacy group on Tuesday announced its first endorsement of the 2018 campaign, backing Rep. David McKinley (R-W.Va.) for standing up to pharmaceutical companies. The group, Patients for Affordable Drugs NOW, which was founded this year, says it will spend six figures on the race and is seeking to help counterbalance pharmaceutical companies’ spending in November's midterm elections. (Sullivan, 4/17)

Stat: FDA Takes How Long To Warn Companies About Plant Problems? 
For companies readying medicines for regulatory approval, the Food and Drug Administration can take up to half a year to issue follow-up warning letters over problematic manufacturing facilities. Last year, the median time it took the agency to issue a warning letter was 191 days, or slightly more than six months after closing an inspection and sending a so-called 483 form to a drug maker, according to a report released by the FDA. (Silverman, 4/17)

Bloomberg: Coke Versus Pepsi Of Drugmakers? Wall Street Doesn't Buy It 
Hours after markets closed on Bristol-Myers Squibb Co.’s worst day in more than a year, executives used a sugary analogy to explain to Wall Street why the drugmaker’s new cancer treatment would do just fine against its main competitor. “Point blank, these are Coke and Pepsi in lung cancer, OK?” Bristol-Myers Chief Scientific Officer Thomas Lynch told a hotel ballroom packed with analysts and investors at a major medical conference in Chicago. Merck & Co.’s drug, Keytruda, had shown impressive results at the conference -- but Bristol-Myers was right there with it, Lynch said. (Hopkins and Lipschultz, 4/17)

Stat: U.S. Catching Up To Europe On Biosimilars, FDA Official Insists
The Food and Drug Administration lags behind its European counterpart when it comes to approving biosimilars — but a top agency official insisted Tuesday that the agency is not as far behind as some critics suggest. Leah Christl, the associate director for therapeutic biologics at the FDA’s Center for Drug Evaluation and Research, pushed back on an oft-cited statistic that shows the European Medicines Agency has so far approved more than 40 biosimilars, drugs that are almost identical to biologics, compared to just nine approved in the U.S. by the FDA. (Mershon, 4/17)

The Wall Street Journal: Johnson & Johnson Raises Sales Outlook
Johnson & Johnson reported higher-than-expected sales in its latest quarter and boosted its sales outlook for the year despite ongoing pricing pressures for its prescription drugs and medical devices. J&J said it planned to cut costs in its supply chain by $600 million to $800 million a year by 2022. To carry out the changes, J&J expects it will take $1.9 billion to $2.3 billion in charges over the next several years. (Rockoff, 4/17)

Stat: Bezos Has Invested In Direct Primary Care. Could It Be In Amazon's Future?
It’s the stuff disruptors dream of. A group of Seattle doctors and investors had a plan to revolutionize primary care by freeing themselves, and their patients, from the dictates of insurance. They would charge a monthly membership fee for delivering on-demand medical services. No insurance bureaucracy. No reimbursement delays. No incomprehensible bills. In 2010, Amazon founder Jeff Bezos became one of the project’s biggest investors, providing an infusion of capital and the instant credibility his name conveys. The company, called Qliance (pronounced Key-liance), scored early successes in Seattle but faltered amid a series of financial setbacks. It closed its doors last summer. (Ross, 4/18)

The Wall Street Journal: UnitedHealth Increases Guidance For Year
UnitedHealth Group Inc. posted a 31% increase in profit for its latest quarter and raised its earnings outlook for the year. UnitedHealth, the parent of the biggest U.S. health insurer, on Tuesday reported a first-quarter profit of $2.84 billion, or $2.87 a share, up from $2.17 billion, or $2.23 a share, a year earlier. The company earned $3.04 a share on an adjusted basis, compared with $2.37 a share. (Prang, 4/17)

Reuters: Ford Expands U.S. Medical Ride Business Built Around Its Vans
Ford Motor Co said on Wednesday that it was expanding a medical transport service called GoRide in Southeast Michigan, one of several efforts by the U.S. automaker to build new ride service businesses around its Transit commercial van. Under a multi-year agreement with Michigan healthcare system Beaumont Health, Ford will use Transit vans to transport patients to medical appointments, or from hospitals to home or rehabilitation centers. (White, 4/18)

The Washington Post: Ethicist Foresees Choosing Your Baby From Dozens Of Embryos
So you want to have a baby. Would you like a dark-haired girl with a high risk of someday getting colon cancer, but a good chance of above-average music ability? Or would you prefer a girl with a good prospect for high SAT scores and a good shot at being athletic, but who also is likely to run an above-average risk of bipolar disorder and lupus as an adult? (Ritter, 4/18)

Los Angeles Times: Attention Women: Your Choice Of Blood Pressure Medicine May Affect Your Risk Of Pancreatic Cancer
In findings with potentially broad implications for the public's health, new research has found that some women who treat their high blood pressure with a class of drugs that relaxes the blood vessels were more likely to develop pancreatic cancer than those who use other hypertension medications. In a large and intensively-studied group of middle-aged and older women, the risk of developing pancreatic cancer was more than twice as high for those who took a short-acting calcium channel blocker for more than three years. (Healy, 4/17)

NPR: Exercise Is Best Bet Against Falls
Falls are a leading cause of injury and death among older adults. In 2014, about 1 in 3 adults aged 65 and older reported falling, and falls were linked to 33,000 deaths. If you want to reduce the risk of falling, regular exercise may be your best bet, according to the latest recommendations from the U.S. Preventive Services Task Force. The influential group came to that conclusion after reviewing evidence from about 20 studies that included adults 65 and older. (Aubrey, 4/17)

The New York Times: Nuts May Be Good For The Heart, But Are Hardly A Miracle Food
There is considerable research showing that nuts, with their high levels of unsaturated fatty acids, fiber and minerals, may help reduce the risk for cardiovascular disease. But a large Swedish analysis published in Heart has found that the benefits are limited and depend largely on other healthy behaviors. Researchers followed 61,364 adults for up to 17 years. They had all completed questionnaires on diet, lifestyle and other risk factors for chronic disease. (Bakalar, 4/17)

The Washington Post: Face Transplant: Frenchman Jerome Hamon Is World’s First To Have It Done Twice
Jérôme Hamon is the first person in the world to receive two face transplants. And a few months after receiving his second transplant in January, he spoke to reporters and told them that he was feeling well. “I still have moments when I’m exhausted, but overall I feel well,” he said. (Rosenberg, 4/17)

The Washington Post: 1 In 4 New York City Mice Carry Drug-Resistant Bacteria, Study Finds
Potentially harmful germs dwell inside the guts of urban mice, according to a team of scientists who trapped more than 400 of the rodents around New York City. The researchers, conducting the largest survey of microorganisms living in city mice, also identified several genes that give germs resistance to antibiotic drugs. “This doesn't tell us that these mice are directly responsible for infecting humans,” said W. Ian Lipkin, director of Columbia University's Center for Infection and Immunity. “But they have the potential to do so.” (Guarino, 4/17)

The Wall Street Journal: Mice In New York Carry Rare And Dangerous Diseases, Study Finds
In addition, the mice carried 36 types of viruses, most of which had never before been seen in mice. Mice found in the Manhattan neighborhood of Chelsea, which were fatter than other mice, harbored the greatest number of viruses. The results were published in the journal mBio. The precise level of dangerousness of New York City mice feces was, until now, not fully researched. The findings, in part, confirm common sense: Mouse droppings really are stomach-churning. For the immunosuppressed, ill or very old, mice with pathogenic microbes can be especially dangerous. (West, 4/17)

NPR: Mouse Droppings Carry Human Disease Bacteria
"You not only have mice carrying bacteria that have the potential to cause human disease, but also carrying bacteria that have components that actually would thwart our ability to treat these infections with antibiotics," (Dr. Ian) Lipkin says. Lipkin stresses that the researchers haven't actually linked mice to any large outbreaks of human disease. So people shouldn't overreact whenever they see a mouse in the house. But they should take steps to protect themselves. (Stein, 4/17)

The Associated Press: Bills To Curtail LGBT Rights Are Failing In US Legislatures
In a striking shift from recent years, major legislation curtailing LGBT rights has been completely stymied in state capitols around the country this year amid anxiety by Republican leaders over igniting economic backlash if they are depicted as discriminatory. In the thick of this year's legislative sessions, LGBT activists were tracking about 120 proposed bills that they viewed as threats to their civil rights. Not one of them has been enacted as many sessions now wind down; only two remain under serious consideration. (4/17)

The Cleveland Plain Dealer: Ohio Legislators Look To Clamp Down Harder On Communities That Try To Pass Local Gun Restrictions
Ohio lawmakers blocked cities and villages from enacting their own gun laws 12 years ago, but now they want to remove any wiggle room that could allow new restrictions and penalties in local communities. Language inserted months ago into a "stand your ground" bill is getting new attention from city leaders who want to pass gun laws in the wake of shootings in Parkland, Florida, and Las Vegas. (Borchardt, 4/17)

The Associated Press: Advocates Call For Action On State's Maternal Mortality Rate
Women's reproductive health advocates are calling on New York officials to take steps to reduce the state's maternal mortality rate among black women. Planned Parenthood of New York leaders, state Assembly members and maternity health services providers held a news conference in Albany Monday to call for action to reduce the state's national ranking of 30 out of 50 states when it comes to maternal deaths. (4/17)

The Associated Press: N.H. Child Advocate Asks For Greater Authority To Protect Kids
New Hampshire's new child advocate is pressing for changes to the law to strengthen her office's ability to protect the state's most vulnerable residents. Lawmakers created the office last year as part of larger effort to reform New Hampshire's Division of Children, Youth and Families, which has been under scrutiny since two toddlers under its supervision were killed in 2014 and 2015. (4/17)

The Associated Press: Florida Lawyer Gets Prison For Role In $23M Insurance Fraud
A Florida man has been sentenced to more than a year in prison for his role in a $23 million auto insurance fraud involving chiropractors' clinics. The SunSentinel reports 55-year-old Jason Dalley wept in court Monday as a judge sentenced him to spend a year and nine months in prison and pay more than $1.8 million in restitution. (4/17)

The Washington Post: E. Coli Romaine Lettuce Contamination: New Jersey Woman Sues Panera Bread
A 66-year-old woman who was sickened by E. coli is suing Panera Bread after apparently eating contaminated romaine lettuce at a restaurant in New Jersey. Louise Fraser first experienced abdominal pain within days of eating at a restaurant in Somerset County, according to a federal complaint. Then came bloody diarrhea and vomiting that sent her to the emergency room March 25. Doctors diagnosed hemolytic uremic syndrome, a life-threatening illness that happens to a small number of people infected with Escherichia coli and can lead to kidney failure. (Phillips, 4/17)

The Associated Press: Marijuana-Based Drug Gets Positive Review From US Agency
A closely watched medicine made from the marijuana plant reduces seizures in children with severe forms of epilepsy and warrants approval in the United States, health officials said Tuesday. British drugmaker GW Pharmaceuticals is seeking permission to sell its purified form of an ingredient found in cannabis — one that doesn't get users high — as a medication for rare, hard-to-treat seizures in children.(4/17)

The Associated Press: Medical Marijuana Push Spreads To Utah, Oklahoma
The push for legalized marijuana has moved into Utah and Oklahoma, two of the most conservative states in the country, further underscoring how quickly feelings about marijuana are changing in the United States.If the two measures pass, Utah and Oklahoma will join 30 other states that have legalized some form of medical marijuana, according to the pro-pot National Organization for the Reform of Marijuana laws. Nine of those states and Washington, D.C. also have broad legalization where adults 21 and older can use pot for any reason. Michigan could become the 10th state with its ballot initiative this year. (4/17)

Health News Florida: Judge Again Backs Allowing Man To Grow Marijuana
For the second time in less than a week, a Tallahassee judge has given Tampa strip-club owner Joe Redner the go-ahead to grow his own pot, rejecting a request from state health officials to keep in place a stay blocking the cancer survivor from cultivating medical marijuana. Leon County Circuit Judge Karen Gievers, ruling from the bench Tuesday, lifted an automatic stay that had been triggered last week when the Florida Department of Health appealed her decision allowing the 77-year-old Redner to grow his own cannabis for juicing. (4/17)

The Associated Press: Baltimore Health Official Warns Of Fake Marijuana’s Dangers
Baltimore’s health commissioner is joining the call urging people to stay away from fake marijuana as cases of severe bleeding by users tick upward. Dr. Leana Wen says synthetic cannabinoids, frequently touted as natural products, are in fact “extremely dangerous.” In a statement, she says the substance has untested chemical compounds that can have “devastating effects for users.”Fake marijuana likely contaminated with rat poison has recently killed three people in Illinois. It’s caused bleeding in more than 100 others in at least four other states, including Maryland. (4/18)