First Edition: April 19, 2018

Kaiser Health News: Power Outages In Puerto Rico Make Life Worse For Chronically Ill In Remote Areas
Helicopters from the power company buzz across the skies of this picturesque valley, ferrying electrical poles on long wires to workers standing on steep hillsides. The people of Castañer, an isolated village in Puerto Rico’s central mountains, watch warily. Crews have come and gone, and people living along the mountain roads don’t expect to get power until late summer, if ever. Power finally started flowing to the center of town last month, but the electrical grid remains unstable — an island-wide blackout Wednesday disrupted progress — and the hospital continues to use its own generator. (Varney, 4/19)

Kaiser Health News: Nation’s Top Doc Wants The Overdose Antidote Widely On Hand. Is That Feasible?
When Surgeon General Jerome Adams issued an advisory calling for more people to carry naloxone — not just people at overdose risk, but also friends and family — experts and advocates were almost giddy. This is an “unequivocally positive” step forward, said Leo Beletsky, an associate professor of law and health sciences at Northeastern University.And not necessarily a surprise. Adams, who previously was Indiana’s health commissioner, was recruited to be the nation’s top doctor in part because of his work with then-Gov. Mike Pence, now the vice president. (Luthra and Bluth, 4/18)

The Wall Street Journal: Bare-Bones Health Policies Are Cheaper Than ACA Plans—And Riskier Too
Sales are growing for a type of bare-bones health policy that offers a cheaper alternative to traditional insurance but leaves buyers risking big bills if they have major medical needs. Known as fixed indemnity plans, the products offer limited help, typically paying set amounts toward the cost of doctor visits, hospital days or other services. They generally carry restrictions on people with pre-existing conditions, and they aren’t considered true health insurance under the Affordable Care Act. But insurance agents say individuals are increasingly purchasing the plans as a substitute for ACA coverage, which has become far more costly for many people who don’t get federal subsidies. (Wilde Mathews, 4/18)

The Hill: Dem Senators Unveil Expanded Public Option For Health Insurance
A group of Democratic senators on Wednesday introduced an expanded public option for health insurance as the party debates the next steps to build on ObamaCare. The new proposal, called the Choose Medicare Act, was introduced by Sens. Chris Murphy (D-Conn.) and Jeff Merkley (D-Ore.), both seen as potential presidential contenders, though Murphy has said he is not running in 2020. (Sullivan, 4/18)

The Hill: Senators Push HHS To Negotiate Lower Prices On Opioid Overdose Reversal Drug 
A group of senators is urging the Department of Health and Human Services (HHS) to take measures to reduce the price of a potentially life-saving medication reversing the effects of an opioid overdose. An estimated 115 people die per day of an overdose involving an opioid. Sens. Angus King (I-Maine) and Bernie Sanders (I-Vt.) and 13 Democratic senators signed a letter from Sen. Debbie Stabenow (D-Mich.) to call on HHS to negotiate a cheaper price for naloxone, which comes in the form of an injection or a nasal spray and is used to reverse opioid overdoses. (Roubein, 4/18)

The Hill: Republicans Refuse To Back Opioids Bill Sponsored By Vulnerable Dem 
Republicans are declining to back Democratic measures that would crack down on suspicious opioid shipments — including legislation offered by Sen. Claire McCaskill (D-Mo.), one of the most vulnerable members up for reelection this year. McCaskill said she has approached multiple Republicans about backing her bill, and all have refused.  (Sullivan, 4/18)

The Hill: Warren, Cummings Seek $100B To Fight Opioid Epidemic
Sen. Elizabeth Warren (D-Mass.) and Rep. Elijah Cummings (D-Md.) introduced a bill to provide $100 billion in funding over 10 years to address the opioid crisis. This legislation would amount to a significant infusion of new federal dollars aimed at curbing the opioid crisis, which is leading to thousands of deaths each year. (Roubein, 4/18)

Stat: NIH Shifts Course On Industry Opioids Partnership After Ethics Flags Raised
It’s been touted by health officials for almost a year: a planned opioids research partnership worth roughly $400 million. Ideally, the National Institutes of Health and the pharmaceutical industry would each pick up half the tab, NIH Director Francis Collins has said, to fund research aimed at addressing the opioid epidemic. Collins reiterated last month: Dozens of drug companies were on the verge of teaming up with the agency, which researchers hope will lead to the discovery of new medicines to treat addiction or serve as alternatives to opioids. (Facher, 4/19)

USA Today: Surgeon General, Public Health Corps Fights Opioids -- In Dress Blues
They get mistaken for military officers. But they can rightly accept the praise when strangers say, "Thank you for your service." They're the U.S. Public Health Service's Commissioned Corps, a 6,500-strong group of pharmacists, engineers, dentists and others with a broad range of health expertise and a common desire to serve their country, especially the most vulnerable. (O'Donnell, 4/17)

Reuters: Kentucky Accuses J&J Of Contributing To Opioid Epidemic
Kentucky's attorney general on Wednesday sued Johnson & Johnson, accusing the pharmaceutical manufacturer of devising a deceptive marketing scheme that mischaracterized the risk of opioid abuse and addiction. The lawsuit by Kentucky Attorney General Andy Beshear was his fifth to date seeking to hold a drug manufacturer or distributor responsible for its role in the national opioid epidemic. (Raymond, 4/18)

The Hill: Lawmakers Pressed To Act As US Struggles With Maternal Deaths 
Health experts think they know how to tackle the issue of rising pregnancy-related deaths in the U.S. The challenge is getting Congress to listen. While rates of maternal mortality have declined in other industrialized countries, they have dramatically increased in the U.S. since 2000. About 700 to 900 women die in the U.S. every year from mostly preventable complications related to pregnancy, such as blood loss and high blood pressure. (Hellmann, 4/19)

Reuters: U.S. Appeals Court Says Ohio Cannot Block Planned Parenthood Funds
A federal appeals court on Wednesday blocked an Ohio law that would cut federal taxpayer funding to 28 Planned Parenthood clinics, holding that conditions it imposed that denied funds to abortion providers were unconstitutional. The 6th U.S. Circuit Court of Appeals in Cincinnati upheld a lower-court judge's ruling enjoining a law Republican Governor John Kasich signed in 2016 that would strip funding that Planned Parenthood received for non-abortion services. (Raymond, 4/18)

The Washington Post: HHS Secretary Readmitted To Hospital For Further Treatment Of Diverticulitis
Health and Human Services Secretary Alex Azar was readmitted to an Indiana hospital Tuesday evening for further treatment and observation of a case of diverticulitis, according to department officials. The readmission came about 48 hours after Azar was admitted overnight to St. Vincent’s Hospital in Indianapolis after receiving intravenous antibiotics — and slightly more than a day after he had been discharged with plans to return to Washington. (Goldstein and Sun, 4/18)

The Wall Street Journal: HHS Secretary Azar Hospitalized Again For Diverticulitis
Mr. Azar was first hospitalized Sunday night following a “minor infection” for observation and intravenous antibiotics “out of an abundance of caution,” HHS said Sunday. He was discharged Monday from St. Vincent hospital in Indianapolis. “I’m grateful for the incredible doctors & nurses who provided me with excellent care during my one-night stay at @StVincentIN,” Mr. Azar tweeted Monday. “Also thankful for my wife, who insisted that I call my primary care doctor when I wasn’t feeling well. Glad to be back at work for the American people.” (4/18)

The Washington Post: ‘We Should See If It Works’: Lawmakers Want Veterans Affairs To Study Whether Pot Is Safer Than Painkillers
A bipartisan measure introduced this week in the House would authorize the Department of Veterans Affairs to research whether marijuana is a viable substitute for highly addictive opioids in treating former military personnel suffering from post-traumatic stress and chronic pain. The VA Medicinal Cannabis Research Act of 2018 would initiate a five-year study to examine the drug’s safety and efficacy, and require VA researchers to compile annual status reports for Congress. The bill was introduced by Rep. Phil Roe (R-Tenn.), chairman of the Veterans’ Affairs Committee, and Rep. Tim Walz (D-Minn.), the ranking minority-party member of the committee, along with 35 co-sponsors — including seven Republicans. Companion legislation is under review by leaders of the Senate Committee on Veterans’ Affairs. (Wax-Thibodeaux, 4/18)

The Associated Press: Ahead Of 420, Advocates And Critics Reflect On Pot In The US
America's marijuana supporters have a lot to celebrate on this 420 holiday: Thirty states have legalized some form of medical marijuana, according to a national advocacy group. 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. Yet cannabis remains illegal under federal law, and it still has many opponents. (4/19)

Stat: Supreme Court Weighs Reviewing A Whistleblower Case Against Gilead
In a case fraught with implications for the pharmaceutical industry, the U.S. Supreme Court has asked the solicitor general for its views on a lawsuit involving Gilead Sciences (GILD) and what constitutes a material representation by companies that bill the federal government. The request came in a long-running whistleblower suit that accused the company of misleading regulators about contaminated ingredients used in various HIV medicines and falsifying data to win marketing approval for the drugs. (Silverman, 4/18)

Stat: Which Drug Makers Are Most Vulnerable To A New Cost-Shifting Maneuver? 
Over the past year, pharmacy benefit managers have deployed a new weapon against the widely used but controversial copay assistance programs that drug makers distribute to consumers. Clumsily called copay accumulators, these are raising a controversy of their own over concerns consumers will pay more for their medicines. And drug makers, meanwhile, worry about a big financial hit. These accumulators, which target specialty medicines that are typically more expensive and are often injected or infused, do not count the value of any coupons toward out-of-pocket medicine costs that are applied toward deductibles. (Silverman, 4/18)

Bloomberg: Cigna-Express Scripts Deal To Face Justice Department Review 
Cigna Corp. confirmed that its proposed $54 billion acquisition of Express Scripts Holding Co. will be reviewed by the U.S. Department of Justice, which has raised the bar for approving deals that don’t combine direct competitors. The health insurer has been telling investors since at least early April about the review, but hadn’t made a public statement until late Wednesday. Analysts at Credit Suisse sent an alert to clients on April 5, saying Cigna Chief Executive Officer David Cordani told investors during an event in Europe that the deal would be looked at by the Justice Department. (Tracer and McLaughlin, 4/18)

Politico Pulse Check: Meet America’s Next Top Insurance Lobbyist
The incoming leader of America’s Health Insurance Plans discusses how he’ll set the agenda, whether AHIP has lost influence and what the Trump administration is doing to the nation’s insurance markets. (4/17)

The Associated Press: Spouses Can Boost Early Detection For Melanoma Patients
There's an extra bonus to marriage for melanoma patients: They tend to be diagnosed in earlier more treatable stages than patients who are unmarried, widowed or divorced, a new study says. Spouses may be apt to notice suspicious moles on their partners that could signal melanoma, the most dangerous type skin cancer. More importantly, they may also be more inclined to nag their partners to get those moles checked out, the researchers said. (4/18)

The New York Times: Married People Less Likely To Die From Melanoma
“The take-home point is not only that people should get regular skin exams, but also to bring someone with you to the visit,” said the senior author, Dr. Giorgos C. Karakousis, an associate professor of surgery at the University of Pennsylvania. “Having someone with you can help you make good decisions. And maybe dermatologists should alter their treatment strategy by suggesting more frequent visits for single people.” (Bakalar, 4/18)

Stat: A 'Breakthrough In Organ Preservation' Raises Hopes For Tranplants
For decades, transplant surgeons have treated organs as if they were beers for a camping trip: You just pack them in a cooler and hit the road. But livers, it turns out, aren’t much like lagers, and might benefit from a different sort of travel. The alternative that researchers have come up with is a machine designed to mimic the environment of the human body, keeping the organ warm and breathing as it’s being shuttled from donor to recipient. Now, after comparing the two, a team has shown that this contraption not only kept livers safer for longer than cold storage, but also allowed surgeons to transplant organs that might otherwise have been thrown out. (Boodman, 4/18)

The Associated Press: Warming, Not Cooling, Donated Livers May Improve Transplants
The transplant community isn't ditching affordable ice chests for the far pricier approach just yet. But proponents hope that storing organs in a way that mimics the body might eventually increase the number of transplants — by keeping precious donations usable for longer periods, and allowing use of some that today get thrown away. (4/18)

Los Angeles Times: Liver Transplants Are Better All Around When You Hold The Ice
For 30 years, newly harvested livers have been flushed with preservation fluid, then stored on ice until their prospective recipients were ready for surgery. The new technique, called "normothermic preservation," keeps the liver at body temperature and nourishes it with a continuous flow of oxygenated blood and other nutrients.The researchers — known as the Consortium for Organ Preservation in Europe — tested the two methods in a rigorous, first-of-its-kind clinical trial. (Healy, 4/18)

The Wall Street Journal: Gene Therapy Shows Promise In Patients With A Blood Disorder
Researchers have used an experimental gene therapy developed by biotech company bluebird bio Inc. to reduce the number of blood transfusions needed in 22 people with beta-thalassemia, an inherited blood disorder. The results are another sign of the promise of gene therapy, which aims to deliver beneficial genes to patients’ cells to replace defective ones. (Toy, 4/19)

NPR: Beta-Thalassemia Treatment With Gene Therapy Reduced Transfusions
"We're extraordinarily excited about these early results," says Alexis Thompson, a professor of pediatrics at the Northwestern University's Feinberg School of Medicine, who helped with the study released Wednesday. "For the first time ever, we have a treatment that we might offer to all our patients," says Mark Walters of the University of California, San Francisco, who also helped conduct the study. (Stein, 4/18)

Stat: Scientists Create A Biomedical Tattoo To Monitor For A Sign Of Cancer
Scientists have designed a biomedical tattoo that changes color when calcium in the blood is too high — a tool that they say could one day be used to monitor for the earliest signs of disease. Some types of cancer increase the amount of calcium in the blood before symptoms appear. So researchers engineered cells that turn dark like a tattoo when calcium is too high. They published a proof-of-concept paper on the work Wednesday in Science Translational Medicine. (Thielking, 4/18)

The New York Times: Concussions May Increase The Risk For Parkinson’s Disease
A traumatic brain injury, even a mild concussion, increases the risk for Parkinson’s disease, a new study reports. Researchers identified all patients diagnosed with T.B.I. in a Veterans Health Administration database — 162,935 men and women — and matched them with the same number of people with similar health and behavioral characteristics but who had not had a brain injury. The study is in Neurology. (Bakalar, 4/18)

NPR: Of Monkey Calls And Human Sound Processing
The words "dog" and "fog" sound pretty similar. Yet even a preschooler knows whether you're talking about a puppy or the weather. Now scientists at Georgetown University Medical Center in Washington, D.C., have identified a two-step process that helps our brains learn to first recognize, then categorize new sounds even when the differences are subtle. And it turns out the process is very similar to the way the human brain categorizes visual information, the Georgetown team reports Wednesday in the journal Neuron. (Hamilton, 4/18)

The Washington Post: Homeopath Treated 4-Year-Old's Behavior Problems With Saliva From Rabid Dog
A Canadian naturopath claims she treated a 4-year-old boy's behavioral problems with a controversial homeopathic remedy — this is, saliva from a rabid dog. The recent claims have caused concern in the medical community and prompted questions about why the saliva — known as lyssinum, lyssin or hydrophobinum — has been approved by the Canadian government as a legitimate homeopathic product. (Bever, 4/18)

The Washington Post: Nurses Will Be In D.C.’s 911 Center In Latest Attempt To Cut Emergency Call Volume
Registered nurse Ogechi Ukachu spoke into a telephone headset at the District’s 911 center, fielding an emergency call from a woman complaining about wrist pain. Ukachu asked yes or no questions to determine the caller’s pain level, any blood loss and other symptoms that could pinpoint the extent of the injury. After about a dozen answers, Ukachu determined the woman needed a trip to an urgent-care center — not a ride in a D.C. ambulance. (Williams and Lang, 4/18)

NPR: Nurses Help 911 Dispatchers Triage Calls
D.C. has the highest rate of 911 calls in the U.S., and one in four of those calls is not an actual emergency — instead, it's a twisted ankle, or a cough or a rash. The new triage program aims to improve those numbers by diverting needs that aren't urgent to medical care that doesn't involve an ambulance or an emergency room. (Simmons-Duffin, 4/19)

Reuters: Miami Among Cities At Risk From Yellow Fever Spread
Miami is at risk of a deadly yellow fever outbreak because the disease could thrive there but the city has no checks on travelers arriving from endemic zones, a study to be published by the World Health Organization showed. Yellow fever is spread by the same mosquito that causes Zika virus, which spread through the Americas after being detected in Brazil in 2015 and has been reported in southern Florida and southern Texas. (Miles, 4/18)