First Edition: May 7, 2018

Kaiser Health News: Alarming Suicide Rate Jolts Texas Community Into Action
In the heart of northeast Texas, Tyler’s rolling landscape is dotted with churches and historical homes, and the city is known for its roses and flowering gardens. But the community also is shadowed by a grim statistic, one that leaders are striving to better understand and address. Smith County, which encompasses Tyler and is home to more than 225,000 residents, has the highest suicide rate among the state’s 25 most populous counties. (Huff, 5/7)

California Healthline: Number Of California Jail Inmates On Psychiatric Drugs Soars
The number of jail inmates in California taking psychotropic drugs has jumped about 25 percent in five years, and they now account for about a fifth of the county jail population across the state, according to a new analysis of state data. The increase could reflect the growing number of inmates with mental illness, though it also might stem from better identification of people in need of treatment, say researchers from California Health Policy Strategies (CHPS), a Sacramento-based consulting firm. (Gorman, 5/4)

The New York Times: As Trump Prepares Plan To Lower Drug Prices, Big Pharma Girds For A Fight
In his State of the Union address in January and again in New Hampshire in March, President Trump made a bold promise: “You’ll be seeing drug prices falling very substantially in the not-too-distant future,” he said, “and it’s going to be beautiful.” Not if the pharmaceutical companies can stop it. Big Pharma is pouring money into a lobbying campaign to thwart any serious efforts to rein in prescription drug prices ahead of a presidential speech this month where Mr. Trump plans to lay out his drug pricing proposals. (Pear, 5/6)

Stat: Trump Often Ad Libs. What Does That Mean For His Drug Pricing Speech?
President Trump is expected to deliver a major address on drug prices this week. And perhaps more than with any other president, Washington is wondering: What will he say? There’s the version of the speech that top health officials have been touting and previewing for the last several weeks — the serious, “comprehensive strategy” that will result in a “profound modernization” of how the federal government pays for at least some drugs, to hear health secretary Alex Azar or FDA Commissioner Scott Gottlieb tell it. (Mershon and Silverman, 5/7)

The Hill: Five Things To Watch As Trump Takes On Drug Prices 
President Trump is slated to give a long-awaited speech laying out proposed actions to lower drug prices. The health-care industry is on edge. It’s unclear what exactly Trump is going to propose, and the president has a well-known propensity to go off script.  (Sullivan, 5/6)

The New York Times: Trump Says He Got Rid Of Obamacare. The I.R.S. Doesn’t Agree.
At a rally in Michigan a little over a week ago, President Trump assured his supporters that he had kept his promise to abolish the Affordable Care Act — even though Congress had failed to repeal the Obama-era health law. “Essentially, we are getting rid of Obamacare,” Mr. Trump said, reminding a cheering crowd that the individual mandate that required most people to have health insurance or pay a penalty was scrapped as part of the Republican tax bill he signed into law last year. “Some people would say, essentially, we have gotten rid of it.” (Rappeport, 5/6)

The Associated Press: Idaho, Feds Wading Through Details Of Insurance Proposal
Idaho officials are hoping to allow insurers to sell plans that don't comply with former President Barack Obama's health care law. The move is needed to save Idaho's insurance exchange as premiums continue to rise and some healthy residents opt to go uninsured, Idaho Department of Insurance Director Dean Cameron says. But the federal government hasn't signed off, with agency leaders noting they are bound by law to enforce the Obama-era health insurance rules. (5/6)

The Hill: ObamaCare Insurers In Virginia Propose Major Premium Hikes For 2019 
Two of Virginia’s ObamaCare insurers are requesting significant premium hikes for 2019, according to initial filings released Friday. Both Cigna and CareFirst BlueCross BlueShield cited policies advocated by the Trump administration, including the repeal of ObamaCare's individual mandate, as part of its justifications for the increases. (Weixel, 5/4)

The New York Times: V.A. Medical System Staggers As Chaos Engulfs Its Leadership
At first, it was one doctor quitting the tiny Ukiah Veterans Affairs Outpatient Clinic in Northern California. Then another left, and another, until of the five doctors there a year ago, only one remained. The Veterans Choice Act, passed by Congress amid scandalous stories of hidden waiting lists at Veterans Affairs hospitals, allowed more veterans to get care from private providers, but it created an avalanche of paper at Veterans Affairs facilities as outside doctors sent in information on patients. Veterans Affairs doctors had to enter so many medical records manually into the aging department health records system that it crippled their ability to see patients. (Philipps and Fandos, 5/4)

Stat: Gottlieb Pushes Back Against Criticism Of 'Breakthrough' Designation 
Food and Drug Administration Commissioner Scott Gottlieb defended his agency’s “breakthrough therapy” program, which speeds review of drugs that show signs of benefit early on, amid criticism from academics that the therapies aren’t actually breakthroughs at all. A study published in late April in the Journal of Clinical Oncology showed that, on average, cancer drugs designated as “breakthrough” don’t help patients more than drugs that aren’t designated as “breakthrough.” And a study published earlier in April in the New England Journal of Medicine pointed out other examples of “breakthrough therapies” that really weren’t scientific breakthroughs. (Swetlitz, 5/4)

Stat: FDA Is Ready To Cope With Wave Of Retirements, Gottlieb Says
The Food and Drug Administration is undaunted by the fact that many of its top staff are nearing retirement age and the agency has a plan to continue to buttress its ranks, both among the leadership and rank-and-file, Commissioner Scott Gottlieb said Friday. “It is the case that about 50 percent of all the people in senior roles in [the Center for Drug Evaluation and Research] right now are nearing retirement age, where they can retire with benefits,” Gottlieb said. “We’ve been aware of that. We’ve been planning for it.” (Swetlitz, 5/4)

Stat: In A Message To Pharma, One-Fifth Of AbbVie Shareholders Support Proposal Tying Pricing Risks To Exec Pay 
In yet another rebuke to the pharmaceutical industry, nearly 22 percent of AbbVie (ABBV) shareholders voted in favor of a proposal that requires the drug maker to compile reports about the risks created by high prices and examine the extent to which pricing strategies propel executive compensation. This marks the second time this week that a notable portion of shareholders in a big drug company have signaled that rising prices for medicines are a concern. On Tuesday, 22 percent of Bristol-Myers Squibb (BMY) stockholders also voted in favor of such a proposal. (Silverman, 5/4)

The New York Times: Caught In The Theranos Wreckage: Betsy DeVos, Rupert Murdoch And Walmart’s Waltons
The company became a Silicon Valley fairy tale, with investors awarding the privately held company a valuation of around $9 billion. But the story began to unravel in October 2015 after The Wall Street Journal, owned by Mr. Murdoch’s News Corp., began questioning whether the tests worked. Theranos became the subject of federal investigations into its testing and claims of proprietary technology, which were called “nanotainers.” Much of the time the company had to resort to using conventional blood testing methods, unable to get federal approval for any test but one for Herpes. Theranos and its founder also became embroiled in a series of lawsuits, involving investors as well as one of its key partners, Walgreens, a large drugstore chain, where it offered its tests. The company reached a settlement with Walgreens last August. (Abelson and Thomas, 5/4)

The Washington Post: The Use Of Virtual Doctors Visits Are Growing But Insurance Doesn't Always Pay
Tucked into the federal budget law Congress passed in February was a provision that significantly expands the use of telemedicine — long a hyped health-care reform and now poised to go mainstream within five to 10 years. “There’s much broader recognition of the benefits,” said Mei Wa Kwong, executive director of the Center for Connected Health Policy, a research group that promotes telemedicine in Sacramento. “The law is the latest to make telemedicine more accessible. But we still have a ways to go before most consumers are aware of the option.” (Findlay, 5/6)

NPR: Transgender Health Care By Telemedicine
At an outpatient lab in Tifton, Ga., where Karen Williams gets her blood drawn, a clerk looked from her computer screen to Williams' printed lab order, then back again. "This is not right," the clerk said, squinting at the lab order. There, the birthdate and address matched the ones on the screen, but the name displayed was a male one. A transgender woman, Williams lived as a man for nearly 50 years before beginning to make physical changes several years ago. She's grown out her hair and has gotten most of an old goatee lasered off. One of the things that hasn't changed, however, is her legal name – so in most health care situations, she usually uses her old name and driver's license. (Landman, 5/5)

The Wall Street Journal: Opioid Vs. Crack: Congress Reconsiders Its Approach To Drug Epidemic
In the 1980s, Congress passed a series of laws that aimed to counter the widespread use of crack cocaine with tougher sentencing guidelines. Three decades later, lawmakers are once again considering legislation aimed at curbing a drug crisis: opioid abuse. This time, the emphasis is on funding research into a public-health crisis and enabling states to deal with its consequences. Lawmakers and experts haven’t reached a consensus on why the federal government’s response to opioids is so different from the crack epidemic that preceded it. Nor has the dynamic entirely changed on Capitol Hill. Although there is nearly universal support for a robust response to opioid abuse, a bipartisan push to revise the sentencing guidelines set during the crack era faces a more uncertain legislative future. (Peterson and Armour, 5/5)

The Associated Press: Drug Epidemic Ensnares 25-Year-Old Pill For Nerve Pain
The story line sounds familiar: a popular pain drug becomes a new way to get high as prescribing by doctors soars. But the latest drug raising red flags is not part of the opioid family at the center of the nation's drug epidemic. It's a 25-year-old generic pill long seen as a low risk way to treat seizures, nerve pain and other ailments. The drug, called gabapentin, is one of the most prescribed medications in the U.S., ranking ninth over the last year, according to prescription tracker GoodRx. Researchers attribute the recent surge to tighter restrictions on opioid painkillers, which have left doctors searching for alternatives for their patients. (5/4)

The Washington Post: DEA Issues First Immediate Suspension Of Opioid Sales To A Wholesaler Since 2012
The Drug Enforcement Administration said Friday that it had immediately suspended opioid sales by a wholesale distributor, accusing a Louisiana company of failing to report unusually large shipments of narcotics to independent drugstores “with questionable need for the drugs.” It was the first time the agency had immediately cut off narcotic sales by a distributor in six years, Justice Department officials said. (Bernstein and Horwitz, 5/4)

Stat: Drug Distributors Get Hauled To The Hill To Answer Questions About Opioids
The rhetoric has come from lawmakers and doctors, entertainers and academics, and even from President Trump: The pharmaceutical industry, all have said, is in large part to blame for the ongoing opioid crisis. But even amid an epidemic that took nearly 50,000 American lives in 2016, lawmakers have remained reluctant to bring pharmaceutical executives to Capitol Hill and question them face to face. (Facher, 5/7)

NPR: Narcan And Naloxone Can Be Hard To Get
A few months ago, Kourtnaye Sturgeon helped save someone's life. She was driving in downtown Indianapolis when she saw people gathered around a car on the side of the road. Sturgeon pulled over and a man told her there was nothing she could do: Two men had overdosed on opioids and appeared to be dead. "I kind of recall saying, 'No man, I've got Narcan,'" she says, referring to the brand-name version of the opioid overdose antidote, naloxone. "Which sounds so silly, but I'm pretty sure that's what came out." (Harper, 5/7)

The Washington Post: Iowa's 'Heartbeat' Bill Bans Abortion After Six Weeks
Iowa Gov. Kim Reynolds on Friday signed a bill that would prohibit abortions after a fetal heartbeat is detected. It is one of the most restrictive laws of its kind in the United States and one that Republicans hope will pave the way for a showdown at the U.S. Supreme Court. The “heartbeat” bill, which would ban abortions as early as six weeks — around the time women generally feel early signs of pregnancy and before many realize they are pregnant — was passed Tuesday by the Iowa House, 51-46. The state Senate passed the bill 29-17 early Wednesday, sending it to Reynolds (R), who has said abortion is “equivalent to murder.” (Phillips, 5/4)

The New York Times: Romaine Riddle: Why The E. Coli Outbreak Eludes Food Investigators
Scientists searching for a toxic strain of E. coli that has raced across 25 states, sickening 121 people and killing one, have been able to identify the general source as the Yuma, Ariz., growing region. But as the outbreak enters its second month, they still cannot find the contamination itself — it could be lurking in the area’s fields, water sources, harvesting equipment, processing plants or distribution centers. Federal officials predict that the outbreak, linked to romaine lettuce, will continue for several weeks. (Hoffman, 5/7)

Politico: Obama’s Calorie Rule Kicks In Thanks To Trump
One of Barack Obama’s top food policy rules has escaped Donald Trump’s war on regulations. Starting Monday, calorie counts will have to be posted at thousands of restaurants, grocery stores and movie theaters, representing a milestone change in how the food industry shares information with the American public. The rule, an oft-forgotten provision of Obamacare, is being pushed over the finish line by a Trump nominee, FDA Commissioner Scott Gottlieb, who says the labeling requirement is simply about transparency. (Evich, 5/7)

The Wall Street Journal: Which Anti-Depressant Is Right For You? Your DNA Can Shed Some Light
Paxil or Prozac, Zoloft or Lexapro? When treating a patient suffering from depression, Brent Forester considers which anti-depressant to prescribe—ideally, one that will ease psychic pain without side effects. It can be a tough call. (Lagnado, 5/6)

The Washington Post: Alzheimer’s Cure Is Being Pursued With The Help Of An Online Game
Want to cure Alzheimer’s? Get in line. Researchers have long been puzzled by the disease and vexed by how long it’s taking to unravel its mysteries. One group of scientists is helping speed up that process with assistance from the public. “Stall Catchers,” a game created by Cornell University’s Human Computation Institute, turns the hunt for a cure from frustrating to fun. In the game, players watch short movies — made using a multiphoton microscope — that show blood flowing through the brains of living mice. Players work on a data set of thousands of images to point out “stalls” — areas of reduced blood flow caused by white blood cells accumulating on the sides of the vessels. (Blakemore, 5/6)

The Associated Press: Schumer Wants Immediate Ban On E-Cigarette Flavors
Sen. Charles Schumer says the Food and Drug Administration should immediately ban e-cigarette flavors like candy and cookies that can appeal to young people in the wake of warnings that teens and children are increasingly using e-cigarettes. The New York Democrat on Sunday released a letter to FDA Commissioner Scott Gottlieb saying the agency had the legal authority to regulate e-cigarette flavors, and encouraging it to do so. (5/6)

The New York Times: A Simple Way To Improve A Billion Lives: Eyeglasses
Shivam Kumar’s failing eyesight was manageable at first. To better see the chalkboard, the 12-year-old moved to the front of the classroom, but in time, the indignities piled up. Increasingly blurry vision forced him to give up flying kites and then cricket, after he was repeatedly whacked by balls he could no longer see. The constant squinting gave him headaches, and he came to dread walking home from school. “Sometimes I don’t see a motorbike until it’s almost in my face,” he said. (Jacobs, 5/5)

NPR: Prevent Lyme Disease With These Steps
Lyme disease was once unheard of in western Pennsylvania, where Barbara Thorne, now an entomologist at the University of Maryland, spent time as a kid. Thorne knew that if black-legged ticks are infected with bacteria called Borrelia burgdorferi, they can transmit Lyme to people and, that if untreated, symptoms can range from fever, fatigue and a rash, to serious damage to the joints, heart and nervous system. (Aubrey, 5/7)

The New York Times: How A Low-Carb Diet Might Aid People With Type 1 Diabetes
Like many children, Andrew Hightower, 13, likes pizza, sandwiches and dessert. But Andrew has Type 1 diabetes, and six years ago, in order to control his blood sugar levels, his parents put him on a low-carbohydrate, high-protein diet. His mother makes him recipes with diabetic-friendly ingredients that won’t spike his blood sugar, like pizza with a low-carb, almond-flour crust; homemade bread with walnut flour instead of white flour; and yogurt topped with blueberries, raspberries and nuts. (O'Connor, 5/7)

The Washington Post: When Someone Is Dying, Threshold Choir Provides The Comfort Of Song
It’s a quiet afternoon at the Halquist Memorial Inpatient Center, a hospice, as four women huddle close, talking quietly in a tight circle before walking through the doors to sing to men and women on the threshold of death. These women are part of the Threshold Choir, a group that brings the comfort of song to dying people. A thin woman, who is in the last weeks of life, is the choir’s first stop. She is sitting nearly upright in a hospital bed, her daughter beside her. Leslie Kostrich, the group’s leader for this day, asks the older woman if she would like to hear a few songs. She nods; the singers set up folding stools and pull up close to her bed. (Bruno, 5/5)

The Washington Post: Ovarian Tumor: 132-Pound Mass Removed From Woman's Abdomen
The tumor had ballooned to 132 pounds and stretched the patient's abdomen into a 3-foot-wide orb. By the time  oncologist Vaagn Andikyan examined the 38-year-old woman, she could no longer walk. And because the tumor was increasing the pressure on her digestive tract, she was malnourished and growing weaker everyday. It was the largest ovarian mucinous tumor Andikyan had ever encountered, benign only in the medical sense of the word. It didn't take the gynecologic oncologist long to recognize the growth for what it really was: A death sentence. (Wootson, 5/4)

The Washington Post: ‘I Saved Them Because I’m A Superhero!’: 4-Year-Old Donates Bone Marrow To His Baby Brothers
It was barely sunrise and Michael DeMasi Jr. was romping through the corridors at a children’s hospital in Philadelphia, balancing on a red line that was etched into the floor design and telling his mother to tie a balloon to him so he could “fly.” The 4-year-old boy fancied himself a real-life superhero, wearing a blue T-shirt with photographs of his 4-month-old twin brothers, who were born with a rare immunodeficiency disease. (Bever, 5/6)

The Washington Post: A Roach Crawled Into A Florida Woman’s Ear. It Took Nine Days To Get It All Out.
Katie Holley was jolted awake by a cold thing — what she had initially thought was a small piece of ice that somehow slid down her left ear. Disoriented, she rushed to the bathroom, grabbed a cotton swab and slowly stuck it inside her ear. And then Holley felt something move. It was like a “rhythmic” movement, she recalled, as if whatever that thing was was trying to burrow deeper into her ear canal. She pulled out the cotton swab and saw small, dark brown pieces that looked like legs. (Phillips, 5/5)