First Edition: November 14, 2018

Kaiser Health News: Childbirth In The Age Of Addiction: New Mom Worries About Maintaining Sobriety
When she was in her early 20s, Nicole Veum says, she made a lot of mistakes. “I was really sad and I didn’t want to feel my feelings,” she said. “I turned to the most natural way I could find to cover that all up and I started using drugs: prescription pills, heroin for a little bit of time.”Veum’s family got her into treatment. She’d been sober for nine years when she and her husband, Ben, decided to have a baby. Motherhood was something she wanted to feel. (Dembosky, 11/14)

California Healthline: ‘Grossly Unfair’? Widower Takes Ban On Military Injury Claims To Supreme Court 
More than four years after Navy Lt. Rebekah Daniel bled to death within hours of childbirth at a Washington state military hospital, her husband still doesn’t know exactly how — or why — it happened. Walter Daniel, a former Coast Guard officer, demanded explanations from officials at the Naval Hospital Bremerton, where his wife, known as “Moani,” died on March 9, 2014. (Aleccia, 11/13)

Roll Call: With Divided Congress, Health Care Action Hightails It To The States
Newly-elected leaders in the states will be in a stronger position than those in Washington to steer significant shifts in health care policy over the next couple of years as a divided Congress struggles with gridlock. State Medicaid work requirements, prescription drug prices, insurance exchanges and short-term health plans are among the areas with the potential for substantial change. Some states with new Democratic leaders may also withdraw from a multistate lawsuit aimed at killing the 2010 health care law or look for ways to curb Trump administration policies. (Williams, 11/13)

Stat: New Ads Push Lawmakers To Keep Their Drug Pricing Promises
A coalition of health industry groups on Tuesday unveiled a public-relations push that aims to ensure lawmakers keep their campaign-trail promises to lower drug costs. In doing so, lawmakers will have to “take on Big Pharma, ” according to the new digital ads from the Campaign for Sustainable Rx Pricing. For years, the group has sought to spotlight drug makers’ role in the sky-high price of prescription medicines, and a spokeswoman said the new ads represent the beginning of a “six-figure, multi-phase” campaign. (Facher, 11/13)

The Hill: Drug Pricing Group Launches Six-Figure Ad Buy Pressuring Congress To Act 
The ad shows a man writing a letter to Congress, saying, “Drug prices are going up, every single day. It's price gouging. When will you take action?” “Congress: You promised lower drug prices. Keep your commitment,” the ad ends. Advocates are hoping that the combination of the Democratic House and Trump will lead to action. But any drug pricing measures face an uphill climb, given that drug companies are still a powerful force in Washington and Republicans control the Senate. (Sullivan, 11/13)

Stat: Makers Of Top-Selling Drugs Hike Prices In Lockstep, And Patients Bear The Cost 
The drug giants moved in near-perfect synchronicity, raising prices for their top-selling arthritis treatments as though they were opposite-corner gas stations bumping up the price of unleaded. On Jan. 3, 2013, AbbVie (ABBV) hiked the price of Humira, its blockbuster biologic drug for arthritis and related conditions, by 6.9 percent. A day later, Amgen (AMGN) followed with an identical increase for Enbrel, another biologic used to treat similar patients. The pattern repeated 10 more times between 2014 and early 2018. In every instance, prices of both drugs jumped by nearly the same percentage, usually within days of each other, topping out at the exact same amount, $63,363 per year, according to a STAT analysis of pricing data. (Ross, 11/14)

The New York Times: Juul Will Suspend Selling Most E-Cigarette Flavors In Stores And Halt Social Media Promotions
Facing mounting government pressure and a public backlash over an epidemic of teenage vaping, Juul Labs announced on Tuesday that it would suspend sales of most of its flavored e-cigarette pods in retail stores and would discontinue its social media promotions. The decision by the San Francisco-based company, which has more than 70 percent of the e-cigarette market share in the United States, is the most significant sign of retrenchment by an industry that set out to offer devices to help smokers quit but now shoulders blame for a new public health problem: nicotine addiction among nonsmoking teens. (Kaplan and Hoffman, 11/13)

The Associated Press: Juul Halts Store Sales Of Some Flavored E-Cigarettes
Juul said it stopped filling store orders Tuesday for mango, fruit, creme and cucumber pods and will resume sales only to retailers that scan IDs and take other steps to verify a buyer is at least 21. It said it will continue to sell menthol and mint at stores, and sell all flavors through its website. The company also said it would close its Facebook and Instagram social media accounts, and pledged other steps to make it clear that it doesn’t want kids using its e-cigarettes. (Stobbe, 11/13)

The Wall Street Journal: Juul Says It Will Quit Social Media
Sales of Juul’s vaporizers and flavored nicotine liquids have surged over the past year, fueled in part by the product’s popularity among teenagers and children. Its rapid growth was helped by the San Francisco company’s use of social media to advertise its products as well as by user-generated posts that glamorized Juul. “There is no question that this user-generated social media content is linked to the appeal of vaping to underage users,” Juul Labs CEO Kevin Burns wrote in a blog post Tuesday. (Maloney, 11/13)

The Washington Post: FDA Signals Crackdown On Flavored Cigars To Reduce Youth Tobacco Use
Scott Gottlieb, commissioner of the Food and Drug Administration, signaled Tuesday that the agency plans action against flavored cigars — products that are especially popular among African American teens — as part of an aggressive effort to reduce underage vaping and smoking expected to be announced this week. (McGinley, 11/13)

The Associated Press: More Leeway For States To Expand Inpatient Mental Health
The Trump administration Tuesday allowed states to provide more inpatient treatment for people with serious mental illness by tapping Medicaid, a potentially far-reaching move to address issues from homelessness to violence. Health and Human Services Secretary Alex Azar made the announcement Tuesday in a speech to state Medicaid directors, a group that represents Republican and Democratic officials from around the country who are confronting common, deeply-rooted social problems. (Alonso-Zaldivar, 11/13)

The Hill: Trump Administration Loosens Restrictions On Mental Health Treatment
“Different forms of treatment work for different patients, but the decades-old restriction on Medicaid reimbursement for inpatient treatment at institutions for mental diseases, or IMDs, has been a significant barrier,” Azar said Tuesday during a speech to the National Association of Medicaid Directors. The initial exclusion was meant to phase out the use of psychiatric wards by preventing Medicaid from paying for treatment in facilities with more than 16 beds. States were responsible for the care of people with severe mental illness in those facilities. (Weixel, 11/13)

The Hill: Physicians Push Back On Trump Plans To Redefine Gender
The American Medical Association (AMA) is pushing back against a potential new policy from the Trump administration that could eliminate federal protections for transgender individuals. The country's largest physician lobbying group said Tuesday during its interim meeting that it will “oppose efforts to deny an individual’s right to determine their stated sex marker or gender identity.” (Weixel, 11/13)

Politico: HHS Talks To Anti-Abortion Groups, Scientists As It Weighs Canceling Fetal Tissue Research
The Trump administration is continuing to weigh plans to discontinue more than $100 million in research projects that use fetal tissue, alarming scientists and some HHS officials while invigorating the president’s supporters in the anti-abortion community. The White House last week convened a meeting to consider canceling the projects, according to two individuals with knowledge, and anti-abortion groups like Susan B. Anthony List have been invited to give input. Scientists who use fetal tissue in their research also have been invited to defend their work. (Diamond, 11/13)

Stat: HHS Will Bring In Fetal Tissue Experts For ‘Listening Session’ 
The meeting is the latest step in a department-wide audit of how the federal government procures fetal tissue for medical research and testing. That review was announced in September, alongside the termination of a contract between the Food and Drug Administration and a company that had provided fetal tissue for use developing testing protocols. (Facher, 11/14)

Politico: Trump's Refugee Director Planning Anti-Abortion Book
The Trump administration’s controversial refugee office director is writing a book about his anti-abortion beliefs, two individuals with knowledge confirmed to POLITICO. Scott Lloyd, who’s been under fire for his stewardship of separated migrant children in federal custody, has been working on the book while employed at HHS, the individuals say. (Diamond, 11/13)

The New York Times: When Hospitals Merge To Save Money, Patients Often Pay More
The nation’s hospitals have been merging at a rapid pace for a decade, forming powerful organizations that influence nearly every health care decision consumers make. The hospitals have argued that consolidation benefits consumers with cheaper prices from coordinated services and other savings. But an analysis conducted for The New York Times shows the opposite to be true in many cases. (Abelson, 11/14)

NPR: Installment Plans And Money-Back Guarantees Considered For Ultra-Expensive Drugs
Researchers expect that three dozen new drugs will come on the market over the next few years with astronomical prices — some likely topping a million dollars per patient. The drugmaker Novartis has told investors it might be able to charge $4 million to $5 million for one of its potential products, a treatment for a rare disease called spinal muscular atrophy. (Harris, 11/14)

The Associated Press: More US Kids Get Paralyzing Illness, Cause Is Still Unknown
More children have been diagnosed with a mysterious paralyzing illness in recent weeks, and U.S. health officials said Tuesday that they still aren't sure what's causing it. This year's count could surpass the tallies seen in similar outbreaks in 2014 and 2016, officials said. Fortunately, the disease remains rare: This year, there have been 90 cases spread among 27 states, the Centers for Disease Control and Prevention said. (11/13)

NPR: CDC: Acute Flaccid Myelitis Cases Rise To 90 In U.S.
The illness usually starts as a fever and seemingly routine respiratory symptoms. But in some cases — between three and 10 days later — children suddenly suffer paralysis. The cause of the condition remains a mystery. But officials say there is a possibility it is being caused by a virus that affects the digestive system known as an enterovirus, though that remains just a theory. (Stein, 11/13)

The Washington Post: AFM: Experts Chase The Cause Acute Flaccid Myelitis
“It’s not that often we’re faced with something we’re still learning about,” said Michelle Melicosta, a pediatrician at the Kennedy Krieger Institute in Baltimore, which specializes in disorders of the brain, spinal cord and musculoskeletal system. “We just don’t always have the answer we wish we had. It makes it a little scarier for the family.” AFM is caused by inflammation of the spinal cord that results in severe muscle weakness and paralysis. More than 400 confirmed cases, most of them in children, have been reported in the past four years, and one child with AFM died last year. Clinicians say the condition is underdiagnosed and underreported. (Sun, 11/13)

The Wall Street Journal: After NRA Rebuke, Many Doctors Speak Louder On Gun Violence
U.S. doctors and medical societies are increasingly speaking out against firearm violence, calling for gun-control measures and other solutions to what they see as a public-health crisis that shows no signs of ebbing. Their outspokenness picked up in recent days, after the National Rifle Association said in a tweet on Nov. 7: “Someone should tell self-important anti-gun doctors to stay in their lane.” The NRA, which has fought efforts to restrict access to guns, was criticizing an updated position paper that the American College of Physicians had published calling for various ways to keep guns out of the hands of people who are a threat to others or to themselves. (Loftus, 11/13)

The New York Times: Doctors Revolt After N.R.A. Tells Them To ‘Stay In Their Lane’ On Gun Policy
Over 25 years in Bronx hospitals, Dr. Marianne Haughey has lost count of how many people she has seen die from gun violence. It doesn’t stop — a child who found a gun at home, a teenager caught in the middle of a gang shooting, a store owner ambushed at work. The toughest part comes afterward, Dr. Haughey said. She sheds her blood-soaked scrubs, makes a mental note of the victim’s name and goes to tell the family. (Haag, 11/13)

The Washington Post: Shot In The Neck At 17, This Is The Trauma Surgeon Now Leading Doctors Against Gun Violence And The NRA
Joseph Sakran was standing on a playground when the bullet pierced his throat. It was a Friday night in 1994 in Fairfax, Va., and Sakran was 17. The high school senior had started the night at a school football game and ended it nearly bleeding to death in the emergency room. The errant gunshot, fired into the crowd amid a fight between other teenagers, ruptured Sakran’s trachea, severed his carotid artery and paralyzed his vocal chord. (Flynn, 11/14)

The New York Times: Return To Campus For Students Who Survived Thousand Oaks Shooting
It was college night when a gunman entered Borderline Bar & Grill late last Wednesday, the dance floor packed with students trying to let off some steam, drink a little beer and line dance to the country music blaring in the background. It was the type of night that would be familiar to college students anywhere. (Medina, 11/13)

Los Angeles Times: After A Gunman Opened Fire In Their Favorite Bar, These Survivors Have Banded Together Like Family
The first few nights after Katie Wilkie bolted out of Borderline Bar and Grill to the sounds of gunfire and shattering glass, she couldn’t bring herself to go home. She slept on her friend’s bunk bed and borrowed an old T-shirt and shorts to wear. She found herself clinging to her Borderline friends who were now fellow survivors. (Bermudez, 11/14)

NPR: Guns And Dementia: A Growing Worry For Families As Americans Age
Families of people with dementia will often take away the car keys to keep their family member safe. They might remove knobs from stove burners or lock up medicine. But what's less talked about is the risk of guns in the home for those with dementia. (Block, 11/13)

The New York Times: New Jersey Sues Pharmaceutical Company Amid Spiraling Opioid Crisis
New Jersey officials, taking on one of the state’s core industries, filed a lawsuit on Tuesday against a subsidiary of Johnson & Johnson that manufactures opioids, accusing the pharmaceutical company of misleading patients about the addictive dangers posed by its drugs. It was the first time that New Jersey has brought legal action against a company based in the state as it struggles to contain a spiraling opioid addiction crisis. And it comes at a time when state attorneys general across the country have intensified their efforts to hold pharmaceutical companies accountable for the epidemics of abuse. (Corasaniti, 11/13)

Stat: Pharmacies Fail To Offer Easy Access To Naloxone, Or To Stock It, Despite State Efforts
In communities around the country, health officials and lawmakers have expanded access to naloxone — the opioid overdose reversal medication — by making it available at pharmacies without a prescription. One problem: Not all pharmacies have gotten on board. In California, less than one-quarter of pharmacies surveyed said that customers could pick up naloxone without a prescription, even though they have been legally allowed to do so since January 2016, according to one new study. (Joseph, 11/13)

ProPublica: Oregon Board Says Those Found Criminally Insane Rarely Commit New Crimes. The Numbers Say Otherwise.
About 35 percent of people found criminally insane in Oregon and then let out of supervised psychiatric treatment were charged with new crimes within three years of being freed by state officials, according to a comprehensive new analysis by ProPublica and the Malheur Enterprise. The analysis and interviews show that Oregon releases people found not guilty by reason of insanity from supervision and treatment more quickly than nearly every other state in the nation. The speed at which the state releases the criminally insane from custody is driven by both Oregon’s unique-in-the-nation law and state officials’ expansive interpretation of applicable federal court rulings. (Fraser, 11/14)

ProPublica: What Oregon Officials Knew And When They Knew It
The top of the Oregon Psychiatric Security Review Board’s website boasts of its success in reforming people acquitted of crimes because of a mental disorder: “With public safety as its primary focus, the Board has an exceptional record of reintegrating clients into the community with a 6 year average 0.46% adult recidivism rate.” In fact, a review of public records shows that the board has known that its record with clients after they are released is far less impressive. The 0.46 percent rate of recidivism refers only to people still in the board’s custody. (Fraser, 11/14)

Sacramento Bee: Camp Fire Death Toll Now At 48, With Authorities Searching For Additional Victims
The toll from California’s deadliest wildfire continued to grow Tuesday, as authorities said six more victims of the Camp Fire had been recovered inside homes in the Butte County town of Paradise, bringing the total to 48 so far. Butte County Sheriff Kory Honea did not release additional identities of the dead or update the number of people believed to be missing. To date, the sheriff has released the names of only three victims as officials continue the laborious task of collecting remains and preparing for DNA testing to discover the identities of some victims. (Stanton, 11/13)

San Jose Mercury News: Camp Fire: 48 Funerals And Counting ... 'It’s Beyond Words, Really'
At every community meeting since the start of California’s deadliest wildfire, Butte County Sheriff Kory Honea is the last one to speak. The worst news is always saved for the end. “I’m the sheriff and I’m also your coroner,” he will say to the fire refugees filling the auditorium. “Unfortunately the news I have for you is not good.” (Sulek, 11/13)

The New York Times: A Search In Fire-Ravaged California For What No One Wants To Find
It is a measure of how frequent and deadly wildfires have become in California that identifying badly burned remains has become an area of expertise. Once again cadaver dogs have been summoned, forensic dental experts will follow and coroners and anthropologists are using their experience from previous wildfires to locate the victims. One search team on Tuesday toured the foundation of a flattened home in this singed stretch of Paradise, Calif. Carefully they circled the charred bathtub, the melted kitchen floor, the skeletal playground — poking everywhere with long metal poles. (Turkewitz and Fuller, 11/13)

The Associated Press: Identifying Wildfire Dead: DNA, And Likely Older Methods Too
Authorities doing the somber work of identifying the victims of California’s deadliest wildfire are drawing on leading-edge DNA technology, but older scientific techniques and deduction could also come into play, experts say. With the death toll from the Northern California blaze topping 40 and expected to rise, officials said they were setting up a rapid DNA-analysis system, among other steps. (Peltz, 11/13)

Los Angeles Times: Death Toll Jumps To 48 In Paradise Fire As Frantic Search For Missing Continues
The confusing search for hundreds of missing people has been complicated by many factors: bad cellphone service. A lack of access to burned-out areas. A sheer scattering of people across the region who are staying in shelters, hotels, friends’ houses and their vehicles and may have not gotten in touch with loved ones. (Serna, Smith, Branson-Potts and Santa Cruz, 11/13)

San Jose Mercury News: Schools Limit Outdoor Time, Adopt Other Changes Amid Poor Air Quality
Unhealthy conditions caused by the Camp Fire in Paradise have forced a number of local schools around the Bay Area to move students indoors or cancel outdoor activities this week. The Bay Area Air Quality Management District has extended an air quality alert for the Bay Area through Friday, advising the public to avoid outdoor activity as much as possible and to keep windows and doors closed indoors. While most schools remain open, many have made changes under the circumstances. (Sarwari, 11/13)

Arizona Republic: California Wildfires Could Cost Customers Of PG&E And Other Utilities
The costs of the damages from wildfires that ravaged parts of California last year could show up in utility bills of people throughout the state. And the burden for paying for damages caused by the current catastrophic fires could also hit millions of Californians' pocketbooks. (Randazzo, 11/13)

The New York Times: 20 Americans Die Each Day Waiting For Organs. Can Pigs Save Them?
Anchoring a row of family photos in Joseph Tector’s office is a framed, autographed picture of Baby Fae, the California newborn who made headlines in 1984 when she received a baboon’s heart to replace her own malfunctioning organ. It’s inscribed “To Joe” by Leonard L. Bailey, the surgeon who turned to the monkey heart as the only option to keep his patient alive. Bailey snapped the picture about five days after the operation, while Stephanie Fae Beauclair was sleeping. A strip of surgical tape runs down the center of her chest from neck to diaper, marking the incision line where her rib cage was pulled apart to make the swap. Baby Fae would die less than three weeks later. (Clynes, 11/14)

Stat: Sean Parker: Health Care Breakthroughs Aren't Going To Come From Google, Amazon
Sean Parker, the tech billionaire and cancer research philanthropist, may be a product of a Silicon Valley tech giant — but he’s skeptical about the impact those companies will have as they increasingly make a play in medicine. “I just don’t think the innovations that are going to drive this revolution in health care and discovery are going to come out of Amazon or Google,” Parker said Tuesday at an event put on by the Washington Post. “Google has a big group that’s focused on this — they’re really smart, they’re not unsophisticated, they’re not naive — but I don’t think that’s where you’re going to see the big breakthroughs happening.” (Robbins, 11/13)

Stat: A Biotech Analyst On Neuroscience, Placebo Effect, Not Over-Selling The Dream 
Is biotech having a renaissance in neuroscience? Can we solve the placebo effect? And what’s going to happen next year? Paul Matteis, co-head of biotech research at Stifel, sat down with STAT at the firm’s annual health care conference here to field those questions and opine on how management teams can walk the delicate balance between hype and sandbagging. This transcript has been edited for length and clarity. (Garde, 11/14)

The New York Times: Very Brief Workouts Count Toward 150-Minute Goal, New Guidelines Say
As of Monday, the United States has new federal physical-activity guidelines. The new guidelines, which represent a scientific consensus about how much and what types of physical activities we should complete for good health, bear a strong resemblance to the existing, 10-year-old governmental recommendations. But they also feature some important updates and expansions, including the first-ever federal activity parameters for 3-year-olds, as well as a few surprising omissions. And they offer a subtle, admonitory reminder that a substantial majority of us are not moving nearly as much as we should. (Reynolds, 11/14)

The Associated Press: No Accounting For These Tastes: Artificial Flavors A Mystery
Six artificial flavors are being ordered out of the food supply in a dispute over their safety, but good luck to anyone who wants to know which cookies, candies or drinks they're in. The dispute highlights the complex rules that govern what goes in our food, how much the public knows about it, and a mysterious class of ingredients that has evolved over decades largely outside of public view. (11/13)

The New York Times: Why Teenagers Mix Drinking And Sex
Adults should talk with teenagers about drinking. And we should talk with teenagers about sex. But in addition to taking up each of these topics separately, we should also address the fact that adolescents are more likely than adults to combine the two. Common sense suggests, and research confirms, that intoxicated sex can be a bad idea. Of course, underage drinking is illegal; state laws vary on the legality of having sex with an intoxicated person. Legal questions aside, results from a new survey of more than 7,000 undergraduates at Indiana University show that consensual sex is both less enjoyable and less strongly wanted when one or both of the participants has been drinking. Other research links alcohol use to higher rates of unprotected intercourse. (Damour, 11/14)

The Associated Press: Gene-Edited Food Is Coming, But Will Shoppers Buy?
The next generation of biotech food is headed for the grocery aisles, and first up may be salad dressings or granola bars made with soybean oil genetically tweaked to be good for your heart. By early next year, the first foods from plants or animals that had their DNA "edited" are expected to begin selling. It's a different technology than today's controversial "genetically modified" foods, more like faster breeding that promises to boost nutrition, spur crop growth, and make farm animals hardier and fruits and vegetables last longer. (11/14)

The Associated Press: Hawaii Retirement Home Clarifies Assisted Suicide Rules
A Hawaii retirement home said Tuesday residents in its independent living wing may take advantage of the state's new medically assisted suicide law if they wish. But Kahala Nui told residents in a memorandum this week that those in its assisted living and nursing center may not do so. (11/13)

The Associated Press: Mayo Clinic Receives Record $200M Gift From Michigan Donor
A corporate strategist from Michigan has given Mayo Clinic its largest gift ever — $200 million. The Rochester-based medical center announced Tuesday that its School of Medicine will be named for the philanthropist, Jay Alix, of Birmingham, Michigan. He also has been named to the Mayo Clinic Board of Trustees. (11/13)