First Edition: May 10, 2018

Kaiser Health News: Listless And Lonely In Puerto Rico, Some Older Storm Survivors Consider Suicide
A social worker, Lisel Vargas, recently visited Don Gregorio at his storm-damaged home in the steep hillsides of Humacao, a city on Puerto Rico’s eastern coast near where Category 4 Hurricane Maria first made landfall last September. Gregorio, a 62-year-old former carpenter who lives alone, looked haggard. He said he had stopped taking his medication for depression more than a week earlier and hadn’t slept in four days. He was feeling anxious and nervous, he said, rubbing his bald head and fidgeting with the silver watch on his wrist. His voice monotone and barely audible, he told Vargas he had had thoughts of suicide. (Varney, 5/10)

Kaiser Health News: For The Babies Of The Opioid Crisis, The Best Care May Be Mom’s Recovery
The halls at UNC Horizons day care are quiet at 5 p.m. Amanda Williammee pauses at the toddler classroom window to watch 2-year-old daughter Taycee. “I like to peek in on her and see what she’s doing before she sees me,” Williammee nearly whispers. “I love watching her, it’s too funny.” There’s a dance party in progress and then Taycee spots her mom, screams and comes running to the door. (Tribble, 5/10)

Kaiser Health News: Midterm Elections Are Shaping Up To Be A Referendum On Trumpism
Voters looking toward the midterm elections are more motivated by a candidate’s stance on President Donald Trump than on any specific policy question. But concerns about prescription drug prices and other health care costs still could greatly influence how people cast their ballots, according to a poll by the Kaiser Family Foundation released Thursday. (Bluth, 5/10)

California Healthline: Longtime ‘Fighter’ Lands Top Spot In Powerful Nurses Union 
Bonnie Castillo’s first experience with organized labor dates to the mid-1960s, when she was just 5. Her father was a railroad worker in Sacramento, Calif., and an active union member. More than once, she and her mom drove him to a picket line, where workers demanded better pay and benefits. “We’d pick him up within a matter of hours because they’d win,” Castillo, 57, recalled with a slight smile. “That was quite a time.” (Ibarra, 5/8)

The New York Times: To Lower Drug Costs At Home, Trump Wants Higher Prices Abroad
President Trump, poised on Friday to unveil his strategy to lower prescription drug prices, has an idea that may not be so popular abroad: Bring down costs at home by forcing higher prices in foreign countries that use their national health systems to make drugs more affordable. On Tuesday, Mr. Trump rebuffed his European allies by withdrawing from the Iran nuclear deal. Threatened tariffs on steel and aluminum have strained relations with other developed nations. And now the administration is suggesting policies that could hit the pocketbooks of some of America’s strongest allies. (Pear, 5/9)

The Wall Street Journal: Trump To Unveil Proposals To Reduce Drug Prices
The speech, which has been twice delayed, is spurring skepticism from industry experts and Democrats who say it won’t make a serious dent in costs. They say the proposals fall short of Mr. Trump’s pledge to go after pharmaceutical companies he said last year were “getting away with murder. ”Some industry officials, for their part, say they are relieved to have been spared moves on a scale that would wreck their industries and, in turn, hamper drug innovation or access. Mr. Trump’s speech on combating high drug prices will be accompanied by proposed rules and a broad request for input from manufacturers, health providers, patients and others, according to people familiar with the plan. (Armour, Radnofsky and Burton, 5/10)

The Hill: Cohen Promised Novartis Access To Trump: Report 
President Trump’s personal lawyer Michael Cohen promised the pharmaceutical company Novartis that it could have access to Trump and his inner circle if they signed a contract with Cohen, a Novartis employee told Stat on Wednesday. The employee told Stat that Cohen contacted then-CEO Joe Jimenez last year, promising that he could get Novartis access to both Trump and top administration officials. Jimenez then reportedly ordered company officials to make a deal with Cohen. (Thomsen, 5/9)

The New York Times: How Michael Cohen, Denied Job In White House, Was Seen As Its Gatekeeper
On Wednesday, additional details emerged. Novartis, the Swiss drug maker, said it had paid Mr. Cohen $1.2 million after he approached the company early last year promising insights into Mr. Trump’s views on health care. (McIntire, Vogel, Thomas and Kang, 5/9)

The Washington Post: ‘I’m Crushing It’: How Michael Cohen, Touting His Access To President Trump, Convinced Companies To Pay Millions
Novartis is one of the world’s largest drug companies, with a business deeply shaped by U.S. government actions — including drug approvals and drug reimbursements. But after an initial meeting with Cohen, Novartis determined that he “would be unable to provide the services that Novartis had anticipated related to US healthcare policy matters and the decision was taken not to engage further,” Mirza-Reid said. But she said the company could not terminate the contract “for cause,” and thus paid the agreed-upon $1.2 million. (Kranish, Helderman, Johnson and Dawsey, 5/9)

Stat: Michael Cohen Pitched Himself As A Fixer To Novartis And Got $1.2 Million
“He reached out to us,” the Novartis employee said, providing STAT with the company’s version of events as it scrambles to contain the fallout from being entangled in the investigations surrounding Trump and his inner circle, including Cohen. “With a new administration coming in, basically, all the traditional contacts disappeared and they were all new players. We were trying to find an inroad into the administration. Cohen promised access to not just Trump, but also the circle around him. It was almost as if we were hiring him as a lobbyist.” (Silverman, 5/9)

Stat: Novartis Paid Trump's Lawyer's Firm Far More Than Any Of Its Actual Lobbyists
The $100,000 monthly fee Novartis paid a company set up by President Trump’s personal attorney to help it better understand “U.S. healthcare policy matters” in the Trump era is almost four times more than it paid any actual outside lobbyist in the same time period. None of the contracts for the nearly four dozen external lobbyists Novartis employs to help explain and advocate on health care policy issues came close to the amounts paid Essential Consultants LLC, according to a STAT review of the Swiss drug maker’s 2017 and 2018 filings. (Mershon, 5/10)

The Hill: Mueller Contacted Drug Company About Cohen Payment In November
The Swiss drug company Novartis on Wednesday revealed that special counsel Robert Mueller contacted the company last year about payments it made to Michael Cohen, President Trump's longtime personal attorney. “Novartis cooperated fully with the special counsel’s office and provided all the information requested,” the company said in a statement. (Manchester, 5/9)

Politico: Mueller Team Questioned Novartis And AT&T Over Michael Cohen Payments
Novartis and AT&T revealed their contact with Mueller’s office after the companies were named in a document distributed by Michael Avenatti, a lawyer representing porn film actress Stormy Daniels. Daniels, whose legal name is Stephanie Clifford, is suing to be released from a contract, inked weeks before Election Day, that paid her $130,000 to keep quiet about an alleged sexual relationship with Trump. (Woellert, 5/9)

The Hill: White House Dodges Questions On Cohen Payments 
The White House on Wednesday largely avoided questions about reports that President Trump’s longtime lawyer, Michael Cohen, received payments from businesses seeking access to the administration. White House press secretary Sarah Huckabee Sanders skirted several questions about the revelation that Swiss drug company Novartis and AT&T each paid Cohen in exchange for insights and access to the president. (Samuels, 5/9)

Stat: Will A Former PBM Insider Shaping U.S. Drug Policy Reveal Industry Secrets?
Daniel Best is suddenly leading the government’s campaign to bring down prescription drug prices. But nobody around town seems to know the guy. While he’s a Washington outsider, he’s the very definition of a pharmaceutical industry insider, having spent the last 13 years working for pharmacy benefit managers, the middlemen who negotiate drug prices. Their secretive contracting and business practices have drawn suspicion from lawmakers and administration officials. (Swetlitz, 5/10)

Los Angeles Times: Patients Sue Gilead, Saying Drug Company Intentionally Delayed Safer HIV Medicine
Two Southern California men filed suit against Gilead Sciences on Tuesday, saying they were harmed when the drug company intentionally delayed development of a safer version of a crucial HIV medicine so that it could continue to profit from its lucrative monopoly. The lawsuit — and a similar case that seeks class-action status — says that Gilead executives knew as early as 2000 that the company's scientists had developed a less toxic form of its HIV medicine tenofovir that was less harmful to patients' kidneys and bones. (Petersen, 5/9)

Bloomberg: Mylan Faces EpiPen Shortage As Slowing Sales Trip Up Its Results
Mylan NV’s EpiPen has been hard to find in some areas because of production problems, U.S. regulators said, as the drugmaker reported that declining sales of the lifesaving allergy-shot device weighed on its results. The Food and Drug Administration posted a notification on its website on Wednesday saying that while EpiPen remains available, there are “intermittent supply constraints” due to delays at Pfizer Inc.’s Meridian Medical Technologies, which manufactures the device for Mylan. (Ockerman and Edney 5/9)

The New York Times: F.D.A. Moves To Stop Rogue Clinics From Using Unapproved Stem Cell Therapies
The Food and Drug Administration said on Wednesday that it was seeking court orders to stop two clinics from using unapproved stem cell treatments that in some cases have seriously harmed patients. The clinics remove fat from patients’ bellies by liposuction and then inject an extract of it into various parts of the body like knees or the spinal cord, on the theory that the extract contains stem cells that can provide replacement cells that will repair the damage from injury or illness. (Grady and Kaplan, 5/9)

The Associated Press: Feds Sue To Close Stem Cell Clinics In California, Florida
The Justice Department says in court filings Wednesday that the firms put consumers at risk by promising benefits from treatments never approved by the Food and Drug Administration. The complaints involve treatments derived from cells taken from patients’ own fat tissue. The lawsuits target Southern California’s Stem Cell Treatment Center and U.S. Stem Cell Clinic of Sunrise, Florida. Mark Berman, director of the California clinics, says he stands by his treatments and looks forward to fighting the lawsuit. (Weber, 5/9)

The Washington Post: FDA Seeks Injunction To Stop Two Stem Cell Companies After Patients Blinded
Hundreds of such clinics have popped up across the country in recent years, many promoting treatments for conditions including Parkinson’s disease, autism and multiple sclerosis. Federal regulators have not approved any of their procedures, and critics liken the facilities to modern-day snake-oil salesmen. Many stem cell researchers and former patients have long urged the FDA to take stronger action against the clinics. Current and former agency officials have acknowledged the need for greater regulation of the booming industry, citing limited resources for the lack of aggressive action in the past. (Wan and McGinley, 5/9)

The Associated Press: Judge To Briefly Open Court During Opioid Lawsuits Talks
A federal judge hoping to settle hundreds of lawsuits filed by government entities over the opioid crisis is planning a brief open-court session as settlement talks continue. U.S. District Judge Dan Polster in Cleveland is presiding over lawsuits filed by more than 600 local and county governments and Indian tribes regarding the crisis that killed 42,000 Americans in 2016. Polster plans to open court for an hour on Thursday before closing it again during negotiations. (5/10)

The New York Times: Schneiderman’s Downfall Puts A Spotlight On Men, Alcohol And Violence
For the past several years, a certain cultural panic around the drinking habits of affluent, educated women has taken hold, with no obvious corollary for men from a similar demographic position, even though the men seem to be causing all the trouble. Recently the magazine Mother Jones ran a piece that circulated widely online titled “Did Drinking Give Me Breast Cancer?” Generating a lot of anxiety, it argued that women ought to be gravely worried about the health effects of moderate drinking, even though the author of the article had no proof that drinking caused her illness. (Ginia Bellafante, 5/9)

Stat: Testing For Zika In Blood Donors Finds Few Infections — At $5.3 Million Each
An expensive screening program designed to keep the Zika virus out of the Red Cross’s blood supply has caught fewer than a dozen infected donations, a new study published Wednesday revealed. The program, which costs roughly $137 million a year to operate, detected only eight units that tested positive for the virus between June 2016 and September 2017. And half of those units contained Zika antibodies as well as virus, which suggests they probably would not have been able to infect a recipient, if anyone had been transfused with them, the study suggested. (Branswell, 5/9)

The Associated Press: Study Finds Little Bang For The Buck In Zika Blood Testing
The study was the first large look at the impact of guidelines set two years ago, when the Zika epidemic was an unfolding menace in the U.S. and health officials were scrambling to prevent new infections. The study, published Wednesday by the New England Journal of Medicine, found that the blood donation testing requirements offered little bang for the buck. It also raised questions about whether a cheaper testing method should be used. (Stobbe, 5/9)

The New York Times: In Ancient Skeletons, Scientists Discover A Modern Foe: Hepatitis B
Scientists reported on Wednesday that they have recovered DNA from the oldest viruses known to have infected humans — and have succeeded in resurrecting some of them in the laboratory. The viruses were all strains of hepatitis B. Two teams of researchers independently discovered its DNA in 15 ancient skeletons, the oldest a farmer who lived 7,000 years ago in what is now Germany.Until now, the oldest viral DNA ever recovered from human remains was just 450 years old. (Zimmer, 5/9)

The Washington Post: New Strains Of Hepatitis B Virus Discovered In Ancient Human Remains
The hepatitis B virus has been infecting people since at least the Bronze Age, according to a new study published in the journal Nature by geneticists who teased the virus from 4,500-year-old human remains. Hepatitis B was discovered in the 1960s, and a vaccine (and Nobel Prize) came swiftly thereafter. Despite the vaccine, the virus still kills people, and chronic infections cannot be cured. Nearly 900,000 people with the virus died in 2015, mostly from liver complications, according to the World Health Organization. An estimated 257 million people carry the virus that targets the liver and can be a risk factor for cancer. (Guarino, 5/9)

The New York Times: Breast-Feeding Has No Impact On I.Q. By Age 16
Some earlier observational studies have suggested that children who are exclusively breast-fed have higher I.Q.s through adolescence, and even higher incomes at age 30. But a randomized trial, a more rigorous type of study that better controls for socioeconomic and family variables, found that breast-feeding in infancy had no discernible effect on cognitive function by the time children reached age 16. (Bakalar, 5/9)

The Washington Post: David Goodall, 104, Traveled From Australia To Switzerland To End His Life
In his final days, David Goodall spoke about his 104 years of life and the legacy he hopes to leave behind when he dies. The Australian scientist, who has traveled from his home in Perth to Switzerland to end his life by assisted suicide, answered questions Wednesday about why he wants to die and how he plans to do it. When asked what song he wanted played at his bedside, he said he has not chosen one but if he had to, it would be Beethoven’s 9th Symphony. (Bever, 5/9)

The Washington Post: Thirdhand Smoke Is Widespread And May Be Dangerous, Mounting Evidence Shows
First came doctors’ warnings about cigarettes. Then came discoveries about the danger of secondhand smoke. Now, a growing number of scientists are raising the alarm about thirdhand smoke — residual chemicals left on indoor surfaces by tobacco smoke. Mounting research has shown such potentially hazardous residue can be absorbed through the skin, ingested and inhaled months and even years after the smoke has dissipated. (Wan, 5/9)

Los Angeles Times: This Room Was Off-Limits To Smokers, But Its Air Contained Surprising Amounts Of 'Thirdhand Smoke'
Pop quiz: If you sampled the air in an empty college classroom where smoking is not permitted, what is the last thing you'd expect to find?If you guessed "cigarette smoke," you're in good company. Peter DeCarlo, an air quality researcher at Drexel University in Philadelphia, would have agreed with you. But when he examined the air from the unoccupied room, he discovered that 29% of the tiny particles suspended within it could be traced to the residue of cigarette smoke. (Kaplan, 5/9)

NPR: You Might Be Breathing Thirdhand Smoke
"The chemistry of this is very interesting," says Neal Benowitz, professor of medicine at the University of California, San Francisco and a leader of the California Consortium on Thirdhand Smoke. He says scientists have known for some time that the nicotine levels in walls and furniture can persist for years. "What this study shows is that thirdhand smoke moves around the room," he says. (Bate, 5/9)

The Associated Press: Romaine Lettuce Outbreak Update: 149 Sick In 29 States
Four more states are reporting illnesses in a food poisoning outbreak linked to romaine lettuce. The Centers for Disease Control and Prevention updated its numbers on the outbreak Wednesday, revealing that 149 people in 29 states had gotten sick. It's unclear if new illness are still occurring. There's a lag in reporting, and the most recent illness began two weeks ago. (Stobbe, 5/9)

The Washington Post: E. Coli-Tainted Romaine Outbreak Spreads To 29 States, Sickens 149 People
This strain of E. coli produces a toxin that causes vomiting and diarrhea and potentially other severe symptoms, including  kidney failure. Information was available on 129 of the people who were sickened. Of those — ranging in age from 1 to 88 — half have been hospitalized. Seventeen have developed severe kidney failure, and one person in California has died. About 65 percent of those sickened are women. There is a time lag in reporting and confirming these cases, however. Officials may not yet be aware of people who have gotten sick in the last two or three weeks. The most recent illness reported started April 25. (Sun, 5/9)