First Edition: May 17, 2018

Kaiser Health News: Opioid Overdoses Are Rising Faster Among Latinos Than Whites Or Blacks. Why?
The tall, gangly man twists a cone of paper in his hands as stories from nearly 30 years of addiction pour out: the robbery that landed him in prison at age 17; never getting his high school equivalency diploma; going through the horrors of detox, maybe 40 times, including this latest bout, which he finished two weeks ago. He’s now in a residential treatment unit for at least 30 days. “I’m a serious addict,” said Julio Cesar Santiago, 44. “I still have dreams where I’m about to use drugs, and I have to wake up and get on my knees and pray, ‘Let God take this away from me,’ because I don’t want to go back. I know that if I go back out there, I’m done.” (Bebinger, 5/17)

California Healthline: Insurer Slashes Breast Pump Payments, Stoking Fears Fewer Moms Will Breastfeed
A sharp cut in breast pump payments by the nation’s second-largest health insurer has prompted a strong reaction from breastfeeding advocates, who warn that some new moms will not get the pumps they need and fewer babies will be breastfed. Starting last month, Anthem Inc. slashed the rate it reimburses medical suppliers for breast pumps by 44 percent — from $169.15 to $95. The move means some breast pumps that used to be free under a provision of the Affordable Care Act will now entail a cost to consumers, according to the advocacy group MomsRising. More complex pumps, which have always required an out-of-pocket payment, will now be more expensive. It’s unclear how many women will be affected. (Young, 5/17)

California Healthline: California’s Deadly STD Epidemic Sets Record
Diagnoses of sexually transmitted diseases hit a record high in California last year — with sometimes deadly consequences, according to preliminary state data released this week. More than 300,000 cases of gonorrhea, chlamydia and syphilis — the most common sexually transmitted bacterial infections — were reported in 2017. That represents a 45 percent increase since 2013 and the highest number since the state started tracking these infections, California Department of Public Health numbers show. (Rowan and Matthews, 5/16)

The Hill: Premium Hikes Reignite The ObamaCare Wars
The ObamaCare premium wars are back. The cost of health insurance plans on the ObamaCare exchanges could jump in the coming weeks, some by double digits, inflaming the issue ahead of the midterm elections. Democrats argue the price increases are the result of what they refer to as “Republican sabotage.” They contend that, since the GOP controls Congress and the White House, the price hikes are their responsibility — and that's the message they plan to take into the fall campaign.  (Roubein, 5/16)

The Hill: Court Rules Dem States Can Intervene In ObamaCare Lawsuit
A federal judge granted a request from states looking to defend ObamaCare in a lawsuit filed in Texas. California Attorney General Xavier Becerra, and 16 other state attorneys general in Democratic states, were granted the right to intervene in the lawsuit that seeks to dismantle the Affordable Care Act (ACA). (Hellmann, 5/16)

The Hill: Graham Working On New ObamaCare Repeal Bill 
Sen. Lindsey Graham (R-S.C.) said Wednesday he is working on a new version of his ObamaCare repeal-and-replace bill and has not given up on efforts to do away with the law despite Republicans’ failure last year. “I haven’t given up,” Graham said. “Will there be another effort to replace ObamaCare with a state-centric plan? I hope so.” The effort appears to have little, if any, chance of passing this year. Republican leadership has made clear that it has moved on from the ObamaCare repeal effort, and the GOP has an even slimmer margin in the Senate than they did last year when they failed to win enough votes for a bill. (Sullivan, 5/16)

The Associated Press: Vermont Positioned For Cheaper Canadian Prescription Drugs
Vermont has become the first state to create a program to import more affordable prescription drugs from Canada. But it's unclear whether it will happen because it needs federal approval and the White House hasn't endorsed it. Republican Gov. Phil Scott said Wednesday the law would likely reduce costs for Vermonters, although he's unsure whether it will get federal approval. (5/16)

The Hill: Vermont Becomes First State To Allow Imported Drugs From Canada 
Proponents of the law, which has been opposed by President Trump's health officials as well as pharmaceutical companies, believe it will help fight rising drug prices. It was widely supported in Vermont's Democratic-controlled state legislature. The law must still be certified by the Department of Health and Human Services (HHS). (Roubein and Seipel, 5/16)

Politico: Vermont Becomes First State To Permit Drug Imports From Canada
A spokeswoman for Scott said he signed the bill Wednesday morning. The measure had overwhelming support in the Democratic-controlled legislature and is one of the most aggressive attempts by a state to tackle rising drug prices that critics say are crippling state finances. Its enactment also puts the Trump administration in a bind after the rollout of a highly anticipated plan for tackling rising drug costs. HHS still has to certify Vermont’s program. (Pradhan, 5/16)

Stat: Medicare Reform May Be A Long Shot. But Drug Makers Are Already Worried
Among the litany of modest changes that the Trump administration rolled out in its plan to lower drug prices is one big idea that’s already worrying drug makers: a push to consolidate the two disparate Medicare programs that pay for prescription drugs. Health and Human Services Secretary Alex Azar has been touting the idea all week as a way to bring the negotiating power of the Part D program, which covers seniors’ prescription drugs, into the Part B program, which covers other treatments. “Let me be really clear about this: We are going to bring negotiation to Part B drugs, and we are going to give Part D plans more bargaining power. It’s going to happen,” he said. (Merhson, 5/16)

NPR: Celgene's Patent Fortress Protects Revlimid, Thalomid
When Celgene Corp. first started marketing the drug Revlimid to treat multiple myeloma in 2006, the price was $6,195 for 21 capsules, a month's supply. By the time David Mitchell started taking Revlimid in November 2010, Celgene had bumped the price up to about $8,000 a month. When he took his last month's worth of pills in April 2016, the sticker price had reached $10,691. By last March, the list price had reached $16,691. Revlimid appears to have caught the attention of Health and Human Services Secretary Alex Azar who used it as an example Wednesday — without naming it outright — of how some drug's prices rise with impunity. He said the copay for the average senior taking the drug rose from $115 to about $690 per month in the last year. (Kodjak, 5/17)

Bloomberg: How Michael Cohen Became A $1.2 Million Headache For Novartis 
When Michael Cohen showed up at Novartis AG last year proposing to help the drugmaker navigate the Donald Trump administration, it sounded like a promising opportunity. Cohen had, after all, served as an attorney for Trump and had close ties to the new president. It didn’t take long for Novartis to conclude Cohen was full of hot air. And soon -- but not soon enough -- the company realized he was also a hot potato. (Paton, 5/16)

Stat: Novartis Outlines More Steps To Contain Fallout From Payments To Trump's Lawyers
Amid the fallout over the $1.2 million payments to President Trump’s personal attorney, Novartis is trying to move quickly to contain the damage. In the past 24 hours, the drug maker’s former chief executive publicly accepted responsibility for faulty judgment in trying to gain access to the Trump administration. And the chief lawyer has resigned for being a party to the contract signed with Michael Cohen. (Silverman, 5/16)

The Associated Press: House OKs Expansion Of Private Care At VA, Budget Crisis Fix
The long-awaited bill would change how veterans receive their medical treatment by allowing them to go to a private physician when they felt government-run VA medical centers couldn't provide the care they needed, with the approval of a VA health provider. Veterans could access private care when they endured lengthy wait times, or the treatment was not what they had expected. The VA would decide in many cases when a veteran sees an outside doctor, based on conditions it sets that determine what is inadequate care. (5/16)

CQ: House Passes Veterans Health Care Overhaul
The legislation (S 2372) would extend funding for the Veterans Choice Program by $5.2 billion before combining the program with other community care programs offered by the Department of Veterans Affairs in 2019. The Choice program is expected to run out of funds by May 31. The Choice program allows veterans to seek care outside of the VA if they live more than 40 miles from a VA facility or have to wait more than 30 days for an appointment. The bill would instead allow veterans to see a private doctor if their service isn’t provided by the VA or if the doctor agrees that private care is in the patient’s best interest. (Clason, 5/16)

US News & World Report: A Battle For Community Health In Texas’ Rio Grande Valley
About three years ago, Sareth Garcia's immune system began breaking down. Rashes and infections, crippling headaches, kidney problems and what felt like a painful cramp near her heart landed her in the hospital more than once. Garcia weighed 265 pounds. Without a car, the uninsured single mother had no way to get to a doctor's office, let alone pay for medical treatment, despite working several jobs to care for her two sons. "I was so afraid to die," the 47-year-old says, clad in a floral hat and a light pink button-down bearing an insignia for La Unión Del Pueblo Entero. LUPE, a community group founded three decades ago by activist César Chávez, connected Garcia to a low-income clinic where she received a free medical assessment and insulin for her newly diagnosed diabetes. She credits the group with giving her the determination and resources to begin improving her health. (Galvin, 5/16)

The Associated Press: FDA Approves 1st Nonopioid Drug To Ease Withdrawal Symptoms
Federal regulators on Wednesday approved the first nonopioid treatment to ease withdrawal from quitting addictive opioids. The U.S. Food and Drug Administration expedited approval of Lucemyra to help combat the U.S. opioid epidemic. Two-thirds of drug overdose deaths in 2016 involved opioids, mostly fentanyl, heroin and prescription painkillers. The pill was approved to treat adults for up to two weeks for common withdrawal symptoms like vomiting, diarrhea, muscle pain and agitation. It is not an addiction medicine but can be part of a longer-term treatment plan, according to the FDA. (Johnson, 5/16)

The Wall Street Journal: FDA Approves First Nonopioid Treatment For Opioid Withdrawal Symptoms
The FDA granted the approval of Lucemyra to Louisville, Ky.-based pharmaceutical company US WorldMeds LLC, the agency said Wednesday. The company also develops products for patients with Parkinson’s disease, malignant hyperthermia and other medical conditions. “We’re developing new guidance to help accelerate the development of better treatments, including those that help manage opioid withdrawal symptoms,” FDA Commissioner Scott Gottlieb said in prepared remarks. “We know that the physical symptoms of opioid withdrawal can be one of the biggest barriers for patients seeking help and ultimately overcoming addiction.” (Al-Muslim, 5/16)

Los Angeles Times: FDA Approves Lucemyra To Treat Symptoms Of Opioid Withdrawal And Help Patients Overcome Addiction
"The physical symptoms of opioid withdrawal can be one of the biggest barriers for patients seeking help and ultimately overcoming addiction," said Dr. Scot Gottlieb, the FDA's commissioner. "The fear of experiencing withdrawal symptoms often prevents those suffering from opioid addiction from seeking help. And those who seek assistance may relapse due to continued withdrawal symptoms." (Kaplan, 5/16)

The Washington Post: San Francisco Will Bring Anti-Addiction Medication To Users On The Streets
San Francisco will begin supplying anti-addiction medication to long-term drug users and homeless people on city streets, an attempt to overcome a formidable obstacle to treatment that has complicated efforts to address the opioid crisis. The city is scheduled to announce Thursday that its medical providers will offer buprenorphine and naltrexone prescriptions at needle exchanges, in parks and in other places where people with opioid disorders congregate. Users will be able to pick up the medications, which block the craving for opioids and the painful symptoms of withdrawal, at a centrally located city-run pharmacy. (Bernstein, 5/17)

The New York Times: For Women With Early Breast Cancer, Herceptin Treatment Can Be Much Shorter
Over the past 20 years, hundreds of thousands of women with breast cancer have taken the drug Herceptin, typically for a year or more. The medicine, used to treat an aggressive form of the disease, is credited with saving many lives, but it also has some tough side effects, particularly damage to the heart. A large new study that followed thousands of women with early-stage breast cancer for a median of more than five years has found that those treated with Herceptin for only six months did just as well as those who got it for a year — and they suffered fewer side effects. (Grady, 5/16)

The Associated Press: Shorter Drug Treatment OK For Many Breast Cancer Patients
Herceptin transformed care of a dreaded disease when it was approved in 1998 for women with advanced breast cancers whose growth is aided by a faulty HER2 gene, as 15 percent to 20 percent of cases are. It was later approved for treatment of those cancers in earlier stages, too, based on studies that had tested it in patients for 12 months. That guess, that the drug should be taken for a year, became the standard of care. (Marchione, 5/16)

The Wall Street Journal: Reducing Use Of Roche Drug For Breast Cancer Didn’t Hurt Efficacy, Study Says
Still, there has been some debate among doctors over the optimal length of treatment with Herceptin. A Roche-sponsored study and one by the French National Cancer Institute, both released in 2012, suggested one year was best. But researchers have continued to study shorter durations. The U.K. researchers began their study in 2007. About half the women were assigned to receive six months of Herceptin treatment, and the other half 12 months. (Loftus, 5/16)

NPR: Breast Cancer Drug Herceptin May Work Just As Well With Much Briefer Treatment
Dr. Bruce Johnson, president of ASCO, said one benefit of this change would be to reduce the cost of treatment, both to women and to health insurers. "We think this is an important thing for the 12 percent of women who have early-stage HER2-positive breast cancer," he said. Even though the report covers the results after five years of study, there were relatively few deaths in either group, so researchers can't yet say for sure whether the long-term benefits are the same for the two treatment options. As a result, "it may be a bit early to make a definitive change in practice," Johnson said. (Harris, 5/16)

The New York Times: Fertility Rate Fell To A Record Low, For A Second Straight Year
The fertility rate in the United States fell to a record low for a second straight year, federal officials reported Thursday, extending a deep decline that began in 2008 with the Great Recession. The fertility rate fell to 60.2 births per 1,000 women of childbearing age, down 3 percent from 2016, according to the National Center for Health Statistics. It was the largest single-year decline since 2010, when families were still feeling the effects of a weak economy. (Tavernise, 5/16)

The Associated Press: US Births Hit A 30-Year Low, Despite Good Economy
Experts said several factors may be combining to drive the declines, including shifting attitudes about motherhood and changing immigration patterns. The provisional report, based on a review of more than 99 percent of the birth certificates filed nationwide, counted 3.853 million births last year. That's the lowest tally since 1987. Births have been declining since 2014, but 2017 saw the greatest year-to-year drop — about 92,000 less than the previous year. (Stobbe, 5/17)

The Wall Street Journal: U.S. Births Hit Lowest Number Since 1987
The figures suggest that a number of women who put off having babies after the 2007-09 recession are forgoing them altogether. Kenneth M. Johnson, senior demographer at the University of New Hampshire, estimates 4.8 million fewer babies were born after the recession than would have been born had fertility rates stayed at prerecession levels. “Every year I expect the number of births to go up and they don’t,” said Prof. Johnson. (Adamy, 5/17)

The Washington Post: Depression In Men May Lower Chances For Pregnancy, NIH Study Suggests
Women having trouble getting pregnant sometimes try yoga, meditation or mindfulness, and some research suggests that psychological stress may affect infertility. But what about men: Does their mental state affect a couple's ability to conceive? The latest research on this subject was published Thursday in the journal Fertility and Sterility and suggests that a link between mental health and fertility may exist for women and men. (Cha, 5/17)

The Washington Post: Surrogate Mothers Ask Supreme Court To Stop ‘Exploitation’ Of Women And Babies
Melissa Cook's story became headline news in 2015 when she was carrying triplets as a surrogate. The intended dad asked her to abort at least one of them, she says, because he couldn't afford to raise them all. She refused and has been fighting for custody of the children in court ever since. Cook and two other surrogate mothers — Gail Robinson and Toni Bare  — are in Washington this week to call on the Supreme Court to provide more clarity on the rights of women and children in the controversial industry. The women, who have separately filed lawsuits in different states, say surrogacy contracts are exploitative to the birth mothers, create a class of women as breeders and commodify children. (Cha, 5/16)

The Associated Press: A Cancer Screening Flop: Few Smokers Seek Free Lung Scans
Lung cancer screening has proved to be stunningly unpopular. New research shows that five years after government and private insurers started paying for it, less than 2 percent of eligible current and former smokers have sought the free scans. That's way below the 60 percent to 80 percent rates for breast, colon or cervical cancer screening. (Marchione, 5/16)

Bloomberg: America’s Heaviest Smokers Don’t Want To Know If They Have Cancer 
A new study found that fewer than 2 percent of heavy smokers in the U.S. get recommended lung cancer screenings, an imaging test that can catch tumors when they are small and potentially curable. The numbers fall far short of screening for other types of cancer, including mammograms and colonoscopies—both procedures that are much more uncomfortable than the CT scan used to detect tiny tumors in the lungs. Lung cancer is the leading cause of cancer death in the U.S., killing an estimated 150,000 Americans each year. For the past five years, such groups as the U.S. Preventive Services Task Force and the American Society of Clinical Oncology have urged people aged 55 or older who have smoked a pack a day (or the equivalent) for three decades or more to get checked for early stage disease. (Cortez, 5/17)

Stat: Combination Cancer Immunotherapies Take Center Stage As Investors Watch
Biotech and pharma companies are racing to develop combinations of immunotherapy drugs to treat cancer more effectively. But new data emerging Wednesday night from clinical trial research abstracts released by the American Society of Clinical Oncology (ASCO) paint a muddled picture. Even with hints of efficacy, there’s still no convincing proof cancer patients benefit more when experimental immune-boosting drugs are paired with immunotherapy blockbusters like Merck’s Keytruda and Bristol-Myers Squibb‘s Opdivo. (Feuerstein, 5/16)

Stat: After Tense Eye Surgery, World Comes Into Focus For Gene Therapy Recipient
About eight weeks earlier, in March, his eyes had been just as hollow. He’d been the first person to get an $850,000 therapy called Luxturna since it had hit the market. It was intended to replace a mutant gene in Jack’s retinal cells that impaired his vision. After the surgery, with his eyes temporarily drained of liquid and pumped full of air, he’d had to lie back for six hours, staring at the ceiling, so that the medication would pool in the right part of his retina. His mother had held an iPad above him, streaming basketball games and music until her arms got tired. Sometimes, she fed him crackers. She could only hope that the drug had worked. (Boodman, 5/17)

The New York Times: In ‘Play On,’ Exploring How Elite Athletes Improve With Age
Most people find that their athletic capabilities diminish as they get older, and accept it as an inevitable part of aging. But some elite athletes seem to just get better as they get older. Tom Brady won a Super Bowl at 39, an age when most quarterbacks are retired or in decline. The hockey star Jaromir Jagr, often referred to as the ageless wonder, led his team in scoring at the age of 44, which was double the age of some of his teammates. And Dara Torres, the elite swimmer, won three Olympic medals at the age of 41, the oldest female swimmer to compete in the games. (O'Connor, 5/17)

The Associated Press: Romaine Lettuce Outbreak Update: 172 Sick In 32 States
Health officials say nearly two dozen more cases of a food poisoning outbreak linked to romaine lettuce grown in Arizona have been reported. The Centers for Disease Control and Prevention said Wednesday that the total number of people sickened by a strain of E. coli is now 172 across 32 states. At least 75 people have been hospitalized, including 20 with kidney failure. One death was in California. (5/16)

The Washington Post: CDC Comes Close To An All-Clear On Romaine Lettuce As E. Coli Outbreak Nears Historic Level
Romaine lettuce has a shelf life of about 21 days. The current outbreak has been traced to the Yuma, Ariz., growing region, the source of virtually all lettuce sold in this country during the winter months. The CDC said Wednesday that April 16 was the last day romaine lettuce was harvested in the Yuma area. The leafy-greens industry has shifted to California over the past two months. “Romaine lettuce from the Yuma growing region is past its shelf life and is probably no longer being sold in stores or served in restaurants,” the CDC said in a news release. In the latest official update, the CDC noted that new cases of E. coli-related food poisoning came from the period when contaminated lettuce might still be in circulation or in home refrigerators. (Achenbach, 5/16)

The Associated Press: Ohio City's Last Abortion Clinic Gets License, Can Resume
The last abortion clinic in Toledo, Ohio, has been granted a license allowing it to resume performing most abortions. Capital Care of Toledo applied for the license after receiving a state-mandated patient-transfer agreement from the ProMedica hospital system in February. Restrictions passed by Ohio lawmakers in 2013 mandated the transfer agreements be with local hospitals and barred public hospitals from providing them. The University of Toledo Hospital ended its transfer arrangement with Capital Care two months before the law was enacted. (5/16)

The Associated Press: Judge To Decide Florida Ban On Smokable Medical Marijuana
A Florida judge will soon decide if patients approved to use medical marijuana will be allowed to smoke it. Leon County circuit court Judge Karen Gievers heard testimony Wednesday from two women with terminal illnesses challenging the state's ban on smoking cannabis. (5/16)

The New York Times: L.G.B.T. Students In Oregon Were Bullied And Forced To Read Bible, Report Says
In the hallways of a rural Oregon high school, gay and lesbian students were taunted with homophobic slurs. In the cafeteria, students pelted a transgender student with food. And when gay and lesbian students got into trouble, the school’s principal assigned a specific punishment just for them: readings from the Bible. Students detailed those allegations in recent state investigative reports into the North Bend School District, a coastal area about 100 miles north of California. In the reports, gay and lesbian high school students described years of harassment and bigotry from school employees and other students, and a deeply religious culture that silenced their complaints. (Haag, 5/16)

Los Angeles Times: Former Students Recount Decades Of Disturbing Behavior By USC Gynecologist
When Chelsea Wu walked into Dr. George Tyndall's exam room at USC's student health clinic, she was 19 and, in her own words, "naive." The sophomore had never seen a doctor without her parents by her side and had never been to a gynecologist. "I was blindly trusting of doctors. I pretty much followed whatever they say," Wu recalled. During the 2016 appointment, Tyndall asked prying questions about her sex life, showed prolonged interest in her Chinese heritage and made comments about the tone of her pelvic muscle as he thrust his fingers inside her, Wu said. (Ryan, Hamilton, Parvini and Pringle, 5/16)

The Associated Press: Any Doctor On Board? US Surgeon General Gives Aid On Plane
When the call went out for a doctor on board, the U.S. surgeon general says he gladly stepped in to help with a medical emergency on a commercial flight. Dr. Jerome Adams, an anesthesiologist, said he assisted someone on a Delta Air Lines jet as he prepared to fly Wednesday to Jackson, Mississippi. Adams tweeted that a call went out requesting a doctor. (5/16)