First Edition: April 9, 2018

Kaiser Health News: A Tale Of Two CT Scanners — One Richer, One Poorer
Benjamin Hynden, a financial adviser in Fort Myers, Fla., hadn’t been feeling well for a few weeks last fall. He’d had pain and discomfort in his abdomen. In October, he finally made an appointment to see his doctor about it. “It wasn’t severe,” he said. “It was just kind of bothersome. It just kind of annoyed me during the day.”The internist, Dr. John Ardesia, checked him out and referred him for a CT scan at a nearby imaging center. The radiologist didn’t see anything wrong on the images, and Ardesia didn’t recommend any treatment. (Kodjak, 4/9)

The New York Times: The Disappearing Doctor: How Mega-Mergers Are Changing The Business Of Medical Care
Is the doctor in? In this new medical age of urgent care centers and retail clinics, that’s not a simple question. Nor does it have a simple answer, as primary care doctors become increasingly scarce. “You call the doctor’s office to book an appointment,” said Matt Feit, a 45-year-old screenwriter in Los Angeles who visited an urgent care center eight times last year. “They’re only open Monday through Friday from these hours to those hours, and, generally, they’re not the hours I’m free or I have to take time off from my job. (Abelson and Creswell, 4/7)

The Associated Press: Where Americans Found Jobs: Manufacturing And Health Care
Manufacturers added jobs for an eighth straight month in March, driven mainly by companies that produce durable goods like cars, computers and metal products. Hiring in the sector rose by 22,000 in March and has risen 232,000 over the past year. Health care extended its strong run of gains, adding more than 22,000 jobs in March. The gain was driven by hiring by hospitals, dental clinics and physicians' offices. Professional and business services, which include accounting, advertising and administrative support, added 33,000. (4/6)

The Hill: Trump Taps New Director For Office On Medicare Reforms
The Trump administration on Friday announced a new director for the Center for Medicare and Medicaid Innovation (CMMI), an office that could be at the center of efforts to shake up and reform the health system. Centers for Medicare and Medicaid Services Administrator Seema Verma told staff in an email that Adam Boehler, the former CEO of Landmark Health, a home-based medical care company, will start as the director of the office next week. (Sullivan, 4/6)

The New York Times: Why Trump’s Tariffs Could Raise The Cost Of A Hip Replacement
Pacemakers and artificial joints. Defibrillators. Dental fillings. Birth-control pills and vaccines. All are made in China, and all could be subject to new tariffs. Dozens of drugs and medical devices are among the Chinese products and ingredients that the Trump administration targeted for a potential 25 percent tariff in a proposal this week. The list includes some products that are in dangerously short supply, like epinephrine, used to treat allergic reactions, and others, like insulin, whose rising prices have driven public outrage in the United States. (Kaplan and Thomas, 4/6)

Stateline: To Curb Rising Health Insurance Costs, Some States Try 'Reinsurance Pools'
A couple of years ago, the health insurance exchange in Minnesota – MNsure – was in deep trouble. Health insurance premiums for individual policies had shot up by as much as 67 percent, among the steepest increases in the country.  Insurers were abandoning the market, leaving 116,000 Minnesotans with scant choices. The Minnesota Legislature offered a solution: a $271 million, publicly funded reinsurance pool that would help health insurance companies pay the most expensive medical claims, thereby lowering overall insurance premiums. The hope was that backstopping the insurers would stabilize the market and halt the rocket-like rise in premiums. (Ollove, 4/9)

The Hill: Poll: Voters Say Health Care Top Issue In Midterms 
Voters rank health care as the top issue heading into this year’s midterm elections, according to a HuffPost/YouGov poll released Friday. More registered voters picked health care as the top issue than any other topic when asked to pick their top two issues, the poll found. (Sullivan, 4/6)

The New York Times: Virginia Is Close To Expanding Medicaid After Years Of Republican Opposition
Elections have consequences, goes the old saw, and in Virginia a Democratic wave in November remade the political landscape on one of the state’s longest-running and most contentious issues: whether to expand Medicaid to 400,000 low-income residents. Republicans lost 15 seats in the House of Delegates and, left clinging to a bare majority, did an about-face on Medicaid expansion — an issue that to many had smacked of “Obamacare.” But Republicans in the State Senate, who had not faced voters, blocked expansion last month, and lawmakers failed to pass a state budget because of the issue. (Gabriel, 4/6)

The Washington Post: Virginia Is On The Cusp Of Expanding Medicaid After Key Republican Lawmaker Says He Would Support It
State Sen. Frank W. Wagner (Virginia Beach) said he supports allowing more poor people to enroll in the federal-state health-care program on two conditions. He wants the plan structured so Medicaid recipients do not suddenly lose coverage if their earnings rise. And he wants a tax credit or some other help for middle-income people who already have insurance but are struggling to pay soaring premiums and co-pays. (Vozzella, 4/6)

The Hill: GOP State Senator Says He Will Support Va. Medicaid Expansion 
Even if Wagner votes with the Democrats, there are still notable barriers to Medicaid expansion being passed. Another Republican senator, Emmett W. Hanger Jr., has supported some forms of Medicaid expansion in the past, but objected to provisions in the House bill, the Post reported. Hanger wants to eliminate a hospital “bed tax” that would be used to pay for the state’s share of the expansion. Wagner supports the tax but wants the money used to cover the cost of the middle-income tax break. (Weixel, 4/6)

Los Angeles Times: An Ambitious California Bill Would Put The State In Charge Of Controlling Prices In The Commercial Healthcare Market
In one of the most aggressive efforts in the nation to curb soaring healthcare spending, a new California measure would put the state in charge of setting prices for hospital stays, doctor's visits and most other medical services covered by commercial insurers. The bill, backed by labor unions and consumer groups, is certain to rouse fierce opposition from physicians and hospitals, setting the stage for a brawl between some of the Capitol's top lobbying heavyweights. Proponents also face friction on the left from advocates of single-payer healthcare, who espouse an alternate vision of how to overhaul the state's healthcare. (Mason, 4/9)

The New York Times: Naloxone Stops Opioid Overdoses. How Do You Use It?
The United States surgeon general issued a rare national advisory on Thursday urging more Americans to carry naloxone, a drug used to revive people overdosing on opioids. The last time a surgeon general issued such an urgent warning to the country was in 2005, when Richard H. Carmona advised women not to drink alcohol when pregnant. (Dias and Correal, 4/6)

The Associated Press: Drug Overdose Deaths Decline After Years Of Steady Increases
State health officials say the number of accidental drug overdose deaths in Rhode Island declined in 2017 after years of steady increases. There were 323 deaths last year, down from 336 in 2016. That's about a 4 percent decrease.Health Department Director Nicole Alexander-Scott says it's a "small bit of momentum" that's energizing. (4/9)

NPR: Exercise And Yoga Can Ease Chronic Pain Better Than Drugs
It took several months and a team of half a dozen doctors, nurses and therapists to help Kim Brown taper off the opioid painkillers she'd been on for two years. Brown, 57, had been taking the pills since a back injury in 2010. It wasn't until she met Dr. Dennis McManus, a neurologist who specializes in managing pain without drugs, that she learned she had some control over her pain."That's when life changed," she said. (Herman, 4/6)

Bloomberg: A Rare Loss For U.S. Pharma Lobby Will Cost The Industry Billions 
Deep in a budget deal Congress passed earlier this year -- just 118 words in Section 53116, a little before passages on prison reporting data and payment yields for seed cotton -- was a hit to pharmaceutical companies that will cost them billions, and could signal more losses to come. Despite an intense lobbying push, lawmakers changed a Medicare rule, putting manufacturers on the hook for more of seniors’ prescription costs. The companies will have to offer a much more generous discount to beneficiaries who fall into the so-called donut hole coverage gap, marking down retail costs by 70 percent instead of the current 50 percent. (Edney, 4/6)

The Washington Post: Largest U.S. Drug Distributor Accused Of Illegally Handling Cancer Medication
The nation’s largest drug distributor is being accused of illegally pooling leftover cancer medication from single-dose vials and selling it to health-care providers, who treated patients with it and often billed government programs for reimbursement. A lawsuit unsealed Wednesday in New York seeks unspecified damages from McKesson Corp., the fifth-largest U.S. public corporation of any kind. (Bernstein, 4/6)

Stat: The Strange Story Of A Pharma Company's Silicon Valley Winery
The Japanese drug maker Otsuka markets chemotherapies for leukemia, antidepressants for schizophrenia, and a pill that can alert your doctor when you swallow it. It also grows grapes and sells cabernet sauvignon. ...Otsuka bought Ridge Vineyards in 1986 — the main explanation seems to be that the drug maker’s chairman at the time loved a good Bordeaux — and has held onto the investment ever since. (Robbins, 4/9)

The Wall Street Journal: Novartis Bets $8.7 Billion On Gene-Therapy Company
Novartis AG agreed to buy U.S.-based gene-therapy company AveXis Inc. for $8.7 billion, marking the first big bet by the Swiss pharmaceutical giant’s new chief as he looks to the deal table to refresh his drug-development pipeline. Novartis said Monday it will pay $218 for each share in Illinois-based AveXis, an 88% premium to its closing price on April 6. Earlier this year, Novartis Chief Executive Vasant Narasimhan agreed to cash out of its consumer health joint venture with GlaxoSmithKline PLC—a deal that gives him cash for what he describes as “bolt on” deals to replenish Novartis’ drug pipeline, his key focus since taking the reins earlier this year. (Delclaux, 4/9)

Bloomberg: Novartis Chief Spurs Rare-Disease Shift With $8.7 Billion Deal
Novartis AG agreed to acquire AveXis Inc. for $8.7 billion to gain a promising drug to treat a rare disease that afflicts infants, hastening a shift toward gene therapy and precision medicines. Shareholders of the Bannockburn, Illinois-based company will receive $218 a share in cash in a tender offer, Novartis said in a statement Monday. The price is 88 percent above where AveXis closed Friday. (Krege and Serafino, 4/9)

Stat: New York Panel To Review Vertex Pricing In First Test Of New Law 
For the first time, a New York state panel will review a prescription drug over concerns it may cause the state Medicaid program to exceed a cap on drug spending. Such reviews were greenlighted under a law passed last year in a bid to control rising prices for medicines. At issue is a cystic fibrosis drug called Orkambi, which is sold by Vertex Pharmaceuticals (VRTX). A drug utilization review board is scheduled to meet on April 26 and, depending upon the outcome, could recommend a supplemental rebate to lower the cost to the program. (Silverman, 4/6)

Stat: Should Bristol-Myers Panic Over Incyte’s Skin Cancer Failure? 
The failed skin cancer trial that crushed Incyte and Merck on Friday could be cause for alarm over at Bristol-Myers Squibb, which is running a nearly identical study with two drugs of its own that work the same way. Like Incyte (INCY) and Merck (MRK), Bristol-Myers (BMY) is testing a two-drug combination that pairs a blockbuster immunotherapy with an unapproved pill that might make the older drug more effective. For Bristol-Myers, that pill is called BMS-986205, and it works by targeting an enzyme called IDO, which plays a role in helping tumors evade the immune system’s detection. (Garde, 4/6)

The New York Times: Many People Taking Antidepressants Discover They Cannot Quit
Victoria Toline would hunch over the kitchen table, steady her hands and draw a bead of liquid from a vial with a small dropper. It was a delicate operation that had become a daily routine — extracting ever tinier doses of the antidepressant she had taken for three years, on and off, and was desperately trying to quit. “Basically that’s all I have been doing — dealing with the dizziness, the confusion, the fatigue, all the symptoms of withdrawal,” said Ms. Toline, 27, of Tacoma, Wash. It took nine months to wean herself from the drug, Zoloft, by taking increasingly smaller doses. (Carey and Gebeloff, 4/7)

The New York Times: TB Treatment May Leave Some Patients Contagious
The World Health Organization’s dosage guidelines for two leading tuberculosis medications may be far too low for patients with H.I.V., allowing them to remain contagious for longer than necessary, a new study has found. TB, now the leading infectious killer worldwide, takes over 1.5 million lives per year. Treatment lasts at least six months and can cause serious side effects, making it difficult for patients to stick to it. (Baumgaertner, 4/6)

Stat: CRISPR Might One Day Reverse Devastating Brain Diseases
It may seem unlikely, then, that such a devastating condition is near the front of the line of brain disorders that scientists believe might one day be treated with genome editing technologies such as CRISPR. By “treated,” they don’t mean just keeping a disease from getting worse. They mean reversing the damage and giving the brain a second chance: CRISPR would penetrate the brain of a patient who has lived with a disorder for years and repair the mutation that caused it, unleashing the brain’s capacity of neuroplasticity to weave new circuitry, grow new neurons, or otherwise do right what it did wrong when the mutant gene called the shots. (Begley, 4/9)

The Washington Post: How Kindness Can Help Improve Cancer Treatment
Cancer may not be life-ending, but it usually is life-changing. A cancer diagnosis instantaneously turns life upside down for patients and families. Cancer care is a “high-emotion” service, and the care team must not only effectively treat the disease but also address patients’ intense emotions. While accurate diagnosis and effective treatment are paramount, simple acts of kindness can be a potent antidote to negative emotions and may improve outcomes for those experiencing the frightening journey called cancer. A growing body of evidence reviewed at Stanford University shows that kind medical care can lead to faster wound healing, reduced pain, anxiety and blood pressure, and shorter hospital stays. (Berry, 4/8)

Los Angeles Times: Could This Drug Help The Brain Recover After A Stroke?
Despite years of effort, researchers have so far failed to find a pill you could take or a food you could eat to harden your brain against the injury that could be caused by a stroke. But new research offers the prospect of limiting a stroke's long-term damage in a different way: with a drug that enhances the brain's ability to rewire itself and promote recovery in the weeks and months after injury. In experiments, both mice and macaque monkeys that suffered strokes regained more movement and dexterity when their rehabilitative regimen included an experimental medication called edonerpic maleate. (Healy, 4/6)

The New York Times: High Blood Pressure Tied To Pregnancy Loss
Women whose blood pressure is high before they are pregnant may be at increased risk for miscarriage, a new study has found. Researchers used data from a study of 1,228 women attempting pregnancy after having previously lost a baby. Of the 797 who achieved pregnancy, 188, or almost a quarter, lost the baby again. (Bakalar, 4/6)

Reuters: More U.S. Teens Seeing E-Cigarette Ads
A large and growing proportion of U.S. teens are seeing e-cigarette ads in stores, online, on television and in newspapers and magazines, a recent study suggests. Researchers examined survey data of exposure to tobacco products collected from a nationally representative sample of thousands of middle school and high school students from 2014 to 2016. During that period, the proportion of youth who reported exposure to at least one source of e-cigarette advertising climbed from 69 percent to 78 percent, accounting for more than 20 million teens nationwide. (Rapaport, 4/6)

The Washington Post: Capgras Syndrome Causes People To Think Their Loved Ones Have Been Replaced By Imposters
On a beautiful autumn afternoon in New York’s Central Park, Carol Berman had the horrifying realization that her husband of 40 years no longer recognized her as his wife. In his eyes, she wasn’t the real Carol but rather some strange woman pretending to be Carol — effectively, an impostor. They were out for a stroll when he started yelling at a woman with a similar hairdo farther up the street: “Carol! Carol, come here!” Shocked, his wife faced him head-on, looked deep into his eyes and reassured him that she was right here. But he refused to acknowledge her as the real Carol. (Kim, 4/7)

The New York Times: Marijuana Use Tied To Fatal Car Crashes
April 20 has become known as a day to celebrate the pleasures of marijuana consumption with parties that traditionally begin at 4:20 p.m. But a study in JAMA Internal Medicine has found that the high spirits may have a price: a significant increase in fatal car wrecks after the “4/20” party ends. (Bakalar, 4/4)

The New York Times: Michigan Will No Longer Provide Free Bottled Water To Flint
Michigan will stop providing free bottled water to the city of Flint, Gov. Rick Snyder said on Friday. City officials criticized the decision, in part because Flint is still recovering from a crisis that left residents with dangerous levels of lead in their tap water beginning in 2014. But Michigan officials said lead levels in the water there have not exceeded federal limits for about two years, so the state was closing the four remaining distribution centers where residents have been picking up cases of free water since January 2016. (Fortin, 4/8)

The New York Times: Tainted Synthetic Marijuana Sickens More Than 90 In Midwest, Killing 2
The patients have arrived at emergency rooms across Illinois with mysterious, unnerving symptoms. Some were vomiting blood or bleeding from their gums and noses. Others had arms and legs that were mottled purple, splotched with unexplained bruises. Many were young and previously healthy, panicked and confused about what was happening to them. Health officials say the patients are believed to have inhaled synthetic marijuana, otherwise known as Spice or K2, laced with a pesticide called brodifacoum that is used as rat poison and causes severe bleeding. The outbreak has sickened 95 people in Illinois, Wisconsin and Indiana; two of them have died. (Bosman, 4/6)

Reuters: New Jersey Health Officials Investigating Potential E.Coli Outbreak
Health officials in New Jersey said they are investigating an E. coli outbreak in four counties that left at least eight people hospitalized. The New Jersey department of health said it was in preliminary stages of an investigation that was possibly associated with a restaurant chain without naming it.However a Business Insider report citing county officials said the chain under investigation was Panera Bread. (Balu, 4/6)

The Associated Press: Florida Eye Doctor Behind Bars Ordered To Pay Millions More
A federal judge is ordering a prominent Florida eye doctor behind bars to pay millions more in restitution. The Palm Beach Post reported that this week U.S. District Judge Kenneth Marra upped the restitution owed by Dr. Salomon Melgen by more than $10 million to a total of $52.9 million. Melgen was sentenced in February to 17 years for stealing $73 million from Medicare by persuading elderly patients to undergo excruciating tests and treatments they didn't need for diseases they didn't have. (4/8)