First Edition: April 25, 2018

Kaiser Health News: Peak Health Plan Premiums Give Rise To Activism In Charlottesville, Virginia
When Garnett and Dave Mellen sent their 19-year-old daughter, Gita, off to college an hour away at Virginia Commonwealth University last fall, they didn’t expect to follow her. But in November, the family received notice that its monthly health insurance premium in Charlottesville would triple for 2018, from $1,200 to an unaffordable $3,600.So, the Mellens, both longtime local business owners, packed their bags and spent time with Gita in her off-campus apartment in Richmond. (Bluth, 4/25)

California Healthline: Facebook Live: Confronting Opioid Addiction
Three medications have been approved by the Food and Drug Administration to treat opioid addiction: methadone, buprenorphine and naltrexone. But access to them depends largely on where you live. Methadone and buprenorphine are the two most popular options. But many California communities, particularly rural ones, have neither a methadone clinic nor a doctor who can prescribe buprenorphine. (4/24)

The New York Times: After Trump Hints V.A. Nominee Might Drop Out, An Aggressive Show Of Support
President Trump acknowledged Tuesday that Dr. Ronny L. Jackson, his nominee to lead the Veterans Affairs Department, is in serious trouble amid accusations that as the White House doctor he oversaw a hostile work environment, improperly dispensed prescription drugs and possibly drank on the job. Speaking at a midday news conference with the president of France, Mr. Trump strongly defended Dr. Jackson, the White House physician, as “one of the finest people that I have met,” but he hinted that Dr. Jackson might soon withdraw from consideration, blaming Democrats for mounting an unfair attack on his nominee’s record. (Fandos and Shear, 4/24)

The Wall Street Journal: Veterans Affairs Nominee Won’t Bow Out
Sen. Jon Tester of Montana, the top Democrat on the Veterans’ Affairs Committee, laid out the allegations in a CNN interview Tuesday night, saying the committee was investigating allegations from active duty and retired military officers who had worked in the White House medical office and who had come to the committee with numerous complaints, including that Dr. Jackson belittled lower-ranking employees, drank to excess on overseas trips, and handed out prescriptions “like candy,” walking down the aisle during flights doling out drugs to help people fall asleep and wake up. (Nicholas, Radnofsky and Hughes, 4/24)

The Hill: Dem Senator: Trump's VA Pick Nicknamed 'Candy Man' For Handing Out Prescriptions 
Sen. Jon Tester (D-Mont.) said Tuesday that Navy Rear Adm. Ronny Jackson, the White House physician President Trump has nominated to lead the Department of Veterans Affairs, had been nicknamed "the candy man" for handing out prescription drugs. Tester, the top Democrat on the Senate Veterans' Affairs Committee, said on CNN's "Anderson Cooper 360" that "in overseas trips, in particular, the admiral would go down the aisle way of the airplane and say, 'All right, who wants to go to sleep?' and hand out the prescription drugs like they were candy." (Sanchez, 4/24)

Reuters: White House Doctor Refuses To Pull Out As Trump's Nominee For Veterans Job
Jackson had been set to have his confirmation hearing for the job on Wednesday. But that was postponed indefinitely as senators from both parties said they wanted to look into concerns that had come to light about the Navy rear admiral, who has worked as a presidential physician since the George W. Bush administration. Trump left open the possibility during a news conference that Jackson would withdraw from a political process the president described as "too ugly and too disgusting." (Rampton and Cornwell, 4/24)

The Associated Press: Mixed Signals From Trump On VA Nominee As Allegations Build
A watchdog report requested in 2012 and reviewed by The Associated Press found that Jackson and a rival physician exhibited “unprofessional behaviors” as they engaged in a power struggle over the White House medical unit. The six-page report by the Navy’s Medical Inspector General found a lack of trust in the leadership and low morale among staff members, who described the working environment as “being caught between parents going through a bitter divorce.” “There is a severe and pervasive lack of trust in the leadership that has deteriorated to the point that staff walk on ‘eggshells,’” the assessment found. (Yen, Miller and Thomas, 4/25)

The Hill: Trump's VA Nominee Allegedly Banged On Female Employee's Hotel Door While Drunk: Report
Rear Adm. Ronny Jackson, President Trump's pick to become the next Veterans Affairs (VA) Secretary, got drunk and banged on the hotel room door of a female employee during an overseas trip in 2015, CNN reported. The Secret Service intervened after Jackson's actions became so loud that agents worried he would wake up then-President Obama, according to CNN. (Greenwood, 4/24)

The Washington Post: Trump Suggests Ronny Jackson Drop Out Of VA Nomination Because Of Ugly Process
It was another episode where a previously respected figure was lifted to prominence in Trump’s orbit — only to have their sheen and reputation tarnished. Jackson had been widely hailed by three presidents and their aides as competent, charming and fiercely protective before Trump stunned Washington last month by picking the doctor to run the country’s second-largest federal agency.  (Dawsey, Kim, Rein and Wagner, 4/24)

The Washington Post: How Ronny L. Jackson Found His VA Nomination Rapidly Imperiled
When allegations of professional misconduct by White House physician Ronny L. Jackson started trickling during the past week to the Senate committee considering his nomination to lead the Department of Veterans Affairs, its chairman, Sen. Johnny Isakson (R-Ga.), called the White House twice seeking information. The answers did not appear to satisfy him. (Gardner, Kim and Rein, 4/24)

The Washington Post: ‘What Makes It Stop?’ Veterans Lament The Ongoing Turmoil Surrounding Trump’s Pick For VA Secretary
Ronny L. Jackson’s imperiled nomination to lead the Department of Veterans Affairs underscores the agency’s deep-seated struggle to overcome years of scandal and return its focus to serving a constituency that, historically, has remained above the political fray. “This is complete and total chaos after years of complete and total chaos,” said Paul Rieckhoff, founder and chief executive of Iraq and Afghanistan Veterans of America, an advocacy group. “Our veterans deserve so much better. Our whole country does. Especially in a time of war.” (Wax-Thibodeaux, 4/24)

Politico: How Trump Botched The Ronny Jackson Nomination
President Donald Trump could have avoided the firestorm over Ronny Jackson’s nomination if he’d taken Johnny Isakson’s advice to begin with. In a private conversation with Trump last month, the Senate Veterans’ Affairs chairman mounted a strong defense of then-VA Secretary David Shulkin. But despite Isakson’s guidance, Shulkin was canned a few days later, and Jackson, the White House physician, was quickly nominated to take his place. (Everett, Johnson and Schor, 4/24)

The Associated Press: Lax Vetting On Trump Nominees Begins To Frustrate Senators
As President Donald Trump’s pick to lead Veterans Affairs skids to a halt, senators from both parties are voicing frustration that the White House is skipping crucial vetting of nominees and leaving lawmakers to clean up the mess. That sentiment was evident Tuesday on Capitol Hill after senators delayed hearings for White House physician Ronny Jackson, Trump’s surprise pick to head the VA. Jackson is facing questions about improper workplace behavior, and even Trump himself acknowledged that there were concerns about his nominee’s experience. (Mascaro, 4/25)

The Associated Press: Medicare Will Require Hospitals To Post Prices Online
Medicare will require hospitals to post their standard prices online and make electronic medical records more readily available to patients, officials said Tuesday. The program is also starting a comprehensive review of how it will pay for costly new forms of immunotherapy to battle cancer. (Alonso-Zaldivar, 4/24)

The Washington Post: HHS Proposes Medicare Payment Rules To Encourage Hospitals To Be Clearer About Prices
The Trump administration is proposing to rewrite rules on federal payments to hospitals treating older Americans on Medicare, making it easier for patients to see the prices of procedures and care. As part of annual updates to Medicare payment rules, federal health officials also want to add $1.5 billion for the coming year to the funds for so-called disproportionate share payments that help buffer hospitals from the expense of treating patients who cannot pay their bills. The increase is a sign that the government expects an influx in uninsured patients — something administration officials seldom discuss amid their policies to weaken the Affordable Care Act. (Goldstein, 4/24)

The New York Times: F.D.A. Cracks Down On ‘Juuling’ Among Teenagers
Recognizing what it called “the troubling reality” that electronic cigarettes have become “wildly popular with kids,” the Food and Drug Administration on Tuesday announced a major crackdown on the vaping industry, particularly on the trendy Juul devices, aimed at curbing sales to young people. The agency said it had started an undercover sting operation this month targeting retailers of Juuls, including gas stations, convenience stores and online retailers like eBay. So far, the F.D.A. has issued warning letters to 40 that it says violated the law preventing sales of vaping devices to anyone under 21. (Zernike, 4/24)

The Associated Press: Agency Warns Retailers Not To Sell Juul E-Cigarette To Kids
The Food and Drug Administration issued warnings to 40 retail and online stores as part of a monthlong operation against illegal sales of Juul to children. Investigators targeted 7-Eleven locations, Shell gas stations and Cumberland Farms convenience stores as well as vaping shops. FDA regulators also asked manufacturer Juul Labs to turn over documents about the design, marketing and ingredients of its product. The rare request focuses on whether certain product features are specifically appealing to young people. (Perrone, 4/24)

The Washington Post: FDA Cracks Down On Sales Of Juul, Other E-Cigarettes To Youths
“Let me be clear to retailers,” FDA Commissioner Scott Gottlieb said in a statement. “This blitz, and resulting actions, should serve as notice that we will not tolerate the sale of any tobacco products to youth.” Juul e-cigarettes resemble a USB flash drive but contain high levels of nicotine. They come in such flavors as mango, creme brulee and cool mint and their emissions can be virtually invisible, making it difficult for teachers to spot and stop use of the product. (McGinley, 4/24)

The Hill: FDA Announces Nationwide Crackdown On E-Cig Sales To Kids
Gottlieb said the FDA on Tuesday sent an official request for information to Juul Labs for documents to help the agency understand why their products appeal to kids. "We don’t yet fully understand why these products are so popular among youth. But it’s imperative that we figure it out, and fast. These documents may help us get there," Gottlieb said. (Hellmann, 4/24)

The Wall Street Journal: FDA Seeks Documents From Maker Of Juul E-Cigarettes, Popular With Teens
KandyPens Inc. is a Santa Barbara, Calif., company that sells vaporizers that resemble pens and flash drives, and highlights hip-hop videos that feature its products. KandyPens says its products aren’t intended to be used only with nicotine. “All of our products are sold empty,” said Graham Gibson, chief executive of KandyPens. “We can’t control what people put in our products.” (Chaudhuri and Chaker, 4/24)

The Hill: Senate Panel To Vote Next Month On Maternal Mortality Bill 
The Senate Health Committee will vote on a bill next month addressing increasing maternal death rates in the U.S., ranking member Patty Murray (Wash.) said Tuesday. The bill, sponsored by Sens. Shelley Moore Capito (R-W.Va.) and Heidi Heitkamp (D-N.D.), would support state-level efforts to form review committees that specifically track and investigate pregnancy-related deaths, and then look for ways to prevent future deaths from occurring. (Hellmann, 4/24)

The Hill: Senate Health Panel Approves Opioid Bill 
The Senate Health Committee unanimously voted Tuesday to send the panel’s bipartisan opioid bill to the chamber’s floor. The panel held seven hearings on the opioid crisis, including one on the discussion draft of the bill introduced by Health Committee Chairman Lamar Alexander (R-Tenn.) and ranking member Patty Murray (D-Wash.). Lawmakers touted the bipartisan process used to craft the Opioid Crisis Response Act of 2018 aimed at combating the opioid crisis, which has shown no signs of slowing down. (Roubein, 4/24)

The Washington Post: Google Is Promoting The DEA’s ‘Take Back Day’ On Its Homepage To Help Combat The Opioid Crisis
Google said that it will use its homepage and maps starting Wednesday to promote a Drug Enforcement Administration project to help combat the opioid epidemic, as regulators and lawmakers call for more direct intervention by Silicon Valley to address the drug crisis. Underneath the Google search bar, the company will promote the DEA's National Prescription Drug Take Back Day, an initiative that encourages people to anonymously take unused medications to a collection site where they can be safely discarded. The semiannual event will take place Saturday. (Shaban, 4/25)

Los Angeles Times: This Engineered Painkiller Works Like An Opioid But Isn't Addictive In Animal Tests
Sometimes forgotten in the spiraling U.S. crisis of opiate abuse is a clinical fact about narcotic pain medications: addiction is basically an unwanted side effect of drugs that are highly effective at blunting pain. Addiction, of course, is a particularly dangerous and disruptive side effect, since it hijacks a patient's brain and demands escalating doses of opioid drugs to hold withdrawal symptoms at bay. (Healy, 4/24)

Stat: Supreme Court Rules That Patent Reviews Detested By Pharma Are Constitutional
In a blow to the pharmaceutical industry, the U.S. Supreme Court ruled that a controversial procedure for reviewing patent disputes does not violate the constitutional rights of patent holders. Known as inter partes reviews, these are heard before a U.S. Patent and Trademark Office appeals board, not a court, and anger drug makers because they are easier and faster to pursue than typical patent lawsuits. Drug companies have argued patents are private property that may be revoked only by a federal court and the review process violates a constitutional right to be heard by a court and jury. (Silverman, 4/24)

The Associated Press: Drugmaker Takeda Agrees To Buy Shire For $64 Billion
Japanese drugmaker Takeda has reached a tentative agreement to buy Ireland-based Shire Plc for 46 billion pounds ($64 billion) in one of the biggest pharma deals to date. Takeda has offered the equivalent of 49 pounds in cash and stock for each share of Shire, almost 25 percent more than Tuesday’s closing price. Shire said Wednesday that it is prepared to recommend the deal to shareholders, pending agreement on other terms. (4/25)

The Wall Street Journal: Shire Opens Door To $64 Billion Sale To Japan’s Takeda
If successful, the move would cap a weekslong battle by Takeda to buy the European company and mark the largest-ever acquisition by a Japanese company of a Western rival. On Tuesday, Takeda proposed a sweetened deal to acquire Shire at £49 ($68.53) a share, its fifth attempt to buy the Dublin-based drugmaker. The new offer is marginally higher than the £47 it proposed Friday. Both companies said a revised proposal was on the table Tuesday, but didn’t disclose its financial value until Wednesday. (Rana, 4/25)

The Washington Post: For The First Time In Years, New Groups May Vie To Run Organ Transplant Network
For 32 years, the nonprofit United Network for Organ Sharing has held the federal contract to run the complex U.S. transplant system, a round-the-clock operation that matches donated organs with the sick people who need them. The Richmond-based UNOS has grown substantially and become more entrenched as transplantation has expanded. It collected nearly $58 million in revenue in 2015, according to federal tax records. But it has not faced competition from any other bidder since before 2005. (Bernstein, 4/24)

Stat: 'Regifting' Transplanted Kidneys Could Ease The Organ Shortage
There have been a handful of case reports of kidneys being reused after the first recipient dies or rejects the donor kidney, generally just days after the original surgery and often while the recipient and organ are still at a transplant center, said Tom Mone, CEO of OneLegacy, a nonprofit organ procurement organization based in southern California. “There’s no history or practice of re-transplanting,” he said. “Among transplant surgeons, there’s a mistrust it will not work out. ”Kidneys that have been transplanted once are rarely used again, [Dr. Jeffrey Veale] said, because they are seen as damaged goods after going through not one, but two “death events” and because transplant surgery can be rough on organs — they get flushed with solution, put on ice, and are sometimes injured by the reperfusion of blood, he said. Immune-suppressing drugs can also be toxic to kidneys. (McFarling, 4/25)

The Washington Post: Inside The Secret U.S. Stockpile Meant To Save Us All In A Bioterror Attack
From the outside, it looks like an ordinary commercial warehouse, only much bigger, about the size of two super Walmarts. Inside it’s dark except when motion sensors are triggered. When the lights come on, hundreds of thousands of shrink-wrapped boxes of medicines emerge from the gloom, stacked on shelves nearly five stories high. This is quite a different kind of warehouse. It and several others across the country are part of the $7 billion Strategic National Stockpile, a government repository of drugs and supplies ready for deployment in a bioterrorism or nuclear attack, or against an infectious disease outbreak — of either a known pathogen or some unknown threat with pandemic potential, which global health officials dub “Disease X” — or other major public health emergency. There are antibiotics, including the powerful medication Ciprofloxacin, vaccines for smallpox and anthrax and antivirals for a deadly influenza pandemic. (Sun, 4/24)

Stat: Early Trials Of Stem-Cell Therapies Hint At Potential To Restore Vision
In certain eye diseases, cells that are crucial for vision die off, with no innate way to rebuild their supply. But scientists around the world are increasingly deploying treatments derived from stem cells, placing them in patients’ eyes in hopes of regenerating the lost tissue. Two research groups in the past two months have reported enticing results from approaches using embryonic stem cells, finding that their therapies appear to be safe and even produced some vision gains. (Joseph, 4/25)

Stateline: What Care For The Criminally Insane Can Teach Us About Mental Health Treatment
About 14 percent of state and federal prisoners (about 200,000) and 26 percent of jailed inmates (about 190,000) have serious mental illnesses, according to a report last year by the U.S. Department of Justice. Prison and jail officials don’t have the resources to treat them, and many deteriorate behind bars. By contrast, in some states those judged to be criminally insane receive better mental health treatment than practically anybody else — including people who have never committed a crime. (Ollove, 4/25)

The Associated Press: First Drug Approved For Most Common Inherited Kidney Disease
The U.S. Food and Drug Administration has approved the first drug to slow kidney decline in patients with the most common inherited kidney disease. Jynarque (jihn-AR'-kew), from Japan's Otsuka Pharmaceutical, was approved Tuesday for autosomal dominant polycystic kidney disease.The progressive genetic disorder is the fourth-leading cause of kidney failure. It causes fluid-filled cysts to develop in and damage kidneys. (Johnson, 4/24)

The Associated Press: After A Death, How Much Can 'Broken Heart' Hurt Survivors?
You hear it whenever someone gets sick or dies soon after losing a spouse: Was it because of a broken heart? Stress might not be to blame for former President George H.W. Bush's hospitalization a day after his wife's funeral, but it does the body no favors, and one partner's health clearly affects the other's. A sudden shock can trigger a heart attack or something like it called broken heart syndrome. Some studies also have found that people are more likely to die soon after losing a longtime spouse. (Marchione, 4/24)

The Associated Press: Kids With Rare Rapid-Aging Disease Get Hope From Study Drug
Children with a rare, incurable disease that causes rapid aging and early death may live longer if treated with an experimental drug first developed for cancer patients, a study suggests. The small, preliminary study isn't proof the drug works and it found only a small benefit: Treated children with the disease progeria were more likely than others to survive during the two-year study. But some kids taking the drug in this and other studies have lived into their late teens. Researchers and others say the results suggest a potential breakthrough for a heartbreaking condition that typically kills kids before they reach adulthood. (Tanner, 4/24)

The New York Times: In Real Life, SPF 100 Sunscreens May Work Better Than SPF 50
Sunscreens with a rating of SPF 100 may be more effective than ones rated SPF 50, according to a randomized trial, even though the Food and Drug Administration says that any SPF above 50 offers no additional protection. The study, in the Journal of the American Academy of Dermatology, included 199 men and women given two tubes of sunscreen, one marked “right” and one “left.” They applied the cream to the indicated side of the face and neck, and then went about their normal activities on a sunny day at a ski resort. One of the tubes contained SPF 50 cream, the other SPF 100. (Bakalar, 4/24)

The Washington Post: She Read About A 4-Year-Old’s Mysterious Death. A Year Later, It Saved Her Own Daughter’s Life.
As 4-year-old Elianna Grace sat in the back seat of the SUV, battling her second fever in three days, her mom flashed back to the coughing and vomiting fit the preschooler had the previous weekend — and to a niggling fear about the girl's sudden illness. Elianna had spent April 14 playing in her grandparents' pool in Bradenton, Fla. She blew a geyser of water at family members with a pool noodle. One of them tried to spray her back, but Elianna was already inhaling and got a mouth full of water. (Wootson, 4/24)

The Associated Press: Study: California Gun Deaths Declined Between 2000 And 2015
Gun deaths have fallen in California over a 16-year period ending in 2015, driven largely by a decline in gang violence and falling homicide rates among black and Hispanic male victims, a recent study of firearm violence has found. Researchers at the University of California, Davis published their findings in the May issue of the journal Annals of Epidemiology after reviewing 50,921 firearm deaths recorded in California between 2000 and 2015. The University provided the study results on Monday. (4/24)

The Associated Press: Delaware ‘Red-Flag’ Gun Measure Gets Final Approval
The state Senate has given final approval to a “red flag” bill allowing authorities in Delaware to seize guns from a person deemed by a mental health provider to be a danger to themselves or others. The measure passed the Senate unanimously Tuesday after unanimous approval by the House last month. Under the bill, police who are alerted by a mental health provider could immediately ask a Justice of the Peace magistrate for a temporary order requiring the person to surrender any firearms or ammunition if there’s probable cause that he or she is dangerous. (4/24)

Los Angeles Times: HUD Secretary Ben Carson Tours Women's Homeless Center On Skid Row
Housing and Urban Development Secretary Ben Carson toured a homeless women's center on L.A.'s skid row Tuesday as part of a fact-finding trip to local public-private partnerships and faith-based programs tackling homelessness and job training. Carson, whose agency provided a record $109 million last year to L.A.'s battle with one of the nation's worst homelessness problems, also met with county and business homelessness leaders and stopped at a faith-based drug treatment residential center in Echo Park. (Holland, 4/24)

The New York Times: Tisch Fund Gives $10 Million To Initiative For Arts And Mental Health
The Laurie M. Tisch Illumination Fund has pledged $10 million to fund arts programs focused on mental health issues in New York City. The new initiative is an open-ended commitment that seeks to improve the lives of those with dementia and Alzheimer’s disease, fight stigma around mental illnesses and help people overcome trauma. The nonprofit Arts & Minds, for example, takes people with Alzheimer’s disease into museums for tours and hands-on projects in order to spur emotional connections and stimulate memories. (Chow, 4/24)

The Washington Post: Settlement Reached In Police-Custody Death Of Man With Down Syndrome
The family of Robert Ethan Saylor, a man with Down syndrome who died after three off-duty Frederick County sheriff deputies forced him from a movie theater, have reached a settlement with the state of Maryland, the deputies and the management company of the shopping center where the theater is located. The $1.9 million settlement will mark the end of a long-standing lawsuit and comes more than five years after Saylor’s death led to public outrage and a call for better training of law enforcement officials. (Vargas, 4/24)