First Edition: November 2, 2018

Kaiser Health News: The Election’s Impact On Health Care: Some Bellwether Races To Watch
Voters this year have told pollsters in no uncertain terms that health care is important to them. In particular, maintaining insurance protections for preexisting conditions is the top issue to many. But the results of the midterm elections are likely to have a major impact on a broad array of other health issues that touch every single American. And how those issues are addressed will depend in large part on which party controls the U.S. House and Senate, governors’ mansions and state legislatures around the country. (Rovner, 11/2)

Kaiser Health News: New Heart Drug Spotlights Troubling Trends In Drug Marketing
At the end of September, Amarin Corp. teased some early findings for Vascepa, its preventive medicine for people at risk of heart disease. The claim was astounding: a 25 percent relative risk reduction for deaths related to heart attacks, strokes and other conditions. Headlines proclaimed a potential game changer in treating cardiovascular disease. And company shares quickly soared, from $3 a share to about $20. Vascepa is Amarin’s only product. The company wants to turn its pill made of purified fish oil into a cash cow, allowing it to staff up both in the United States and abroad so it can sell doctors and millions of consumers on its medical benefits. ... Except there is one problem. The particulars of the scientific study on which this claim was based remain a mystery. (Luthra, 11/2)

California Healthline: Ad Check: What Happens If California Limits Dialysis Center Profits?
California voters are being bombarded with ads in what is the most expensive ballot measure campaign this year. They are being asked to decide Tuesday whether the state should limit the profit of kidney dialysis centers to 15 percent over the cost of patient care, with revenue above that rebated primarily to insurers. What exactly would happen if voters approve Proposition 8 is still vague, and the $127 million raised to persuade voters hasn’t made it any clearer. (Rowan, 11/2)

Los Angeles Times: Republican Candidates Say They Would Protect Sick Americans But Fight Coverage For Poorest Patients
Even as embattled Republican candidates across the country pledge to protect Americans with preexisting medical conditions, nearly all continue to resist extending health protections to their poorest constituents. Republicans running for governor in states that have not expanded Medicaid to low-income adults through the Affordable Care Act almost universally oppose any coverage expansion through the government safety net program. (Levey, 11/1)

Stat: Voters Don’t Like ‘Big Pharma.’ But They Could Soon Elect A Senate That Includes Two Pharma Lobbyists And A CEO
In the past year alone, President Trump has bellyached about drug makers charging “rip-off” prices, numerous Democrats have accused the pharmaceutical industry of pure greed, and polls have shown that voters believe lowering the cost of prescription medicines should be among government’s top priorities. But if Republicans prevail in just two nailbiter races on Tuesday, the Senate’s ranks would suddenly include two former drug industry lobbyists and even a pharma CEO. The prospect isn’t so far-fetched. (Facher, 11/2)

The New York Times: Republicans Say They Will Protect Pre-Existing Conditions. Their Records Say Something Else.
In campaign speeches, advertisements and interviews, Republican politicians are showing a zeal for protecting Americans with pre-existing health conditions. President Trump has gone the furthest, saying not only that he will ensure protections for the previously ill, but also pledging that his party will do so more effectively than Democrats. There are many reasons to doubt these words. (Sanger-Katz, 11/2)

The New York Times: It’s Not Just Pre-Existing Conditions. Voters Weigh Many Health Issues On State Ballots
Among the most significant are referendums that would expand Medicaid in Idaho, Nebraska and Utah. If voters in all three states approve, an estimated 340,000 additional low-income adults would be eligible for free health coverage through the government program, as the health law allows, starting next year. But the ballot questions also cover a wide range of other issues: whether to ease penalties for low-level drug offenders in Ohio; consider a ban on vaping in indoor work spaces in Florida; and whether to remove abortion protections from state constitutions in Alabama and West Virginia. (Goodnough and Hoffman, 11/1)

Politico: Scott Homes In On Hispanic, Independent Voters With Health Care Ad
Florida’s U.S. Senate race could come down to what polls show is the No. 1 issue for Hispanic and independent voters: health care. Gov. Rick Scott, the GOP nominee, appears to be hyperaware of that statistic. Since early voting began, he’s run at least 1,333 ads in Orlando and Tampa media markets — crucial for reaching Hispanic and independents voters — wherein he promises to protect patients with pre-existing health conditions. The political group supporting his opponent, Democratic incumbent Bill Nelson, has run at least 541 TV hits in those same media markets, trying to convince voters of the opposite. (Glorioso, 11/1)

The Washington Post: Forget Trump, Caravans And Liberal Mobs: It’s All Health Care All The Time In This House Race
While President Trump has been talking about the Supreme Court, immigration and the “liberal mob,” Betsy Dirksen Londrigan has just kept talking about health care. Londrigan, a Democratic House candidate hoping for an upset victory over Rep. Rodney Davis, the Republican incumbent in this central Illinois district, says health care is the issue that motivated her to enter the race. (Werner and Weigel, 11/1)

USA Today: Obamacare Enrollment Under Trump: Short-Term Health Insurance Cheaper, Riskier
[Chad] Bertanzetti and other consumers will have more choices when shopping for insurance when the six-week open enrollment period for health plans under the Affordable Care Act begins Thursday. Millions of consumers buy coverage through the Obamacare marketplace. New rules created by the Trump administration allow more options, including less-expensive, bare-bones plans that lack the consumer protections found in Obamacare insurance. (Alltucker, 11/1)

The New York Times: It’s Obamacare Sign-Up Time: How To Untangle Coverage Choices
But what you pay will still vary greatly based on your income, location and plan level. Premiums for a benchmark “silver” plan are expected to dip 1.5 percent on average after rising sharply for two years. The variation is so wide, though, that people in Tennessee could see double-digit declines while those in North Dakota may see steep increases. That’s why simply renewing an existing policy could cost you plenty, and spending time comparison-shopping and digging into plan details will most likely yield more savings. (Bernard, 11/1)

The Associated Press: Federal Health Care Website Up And Running After Slow Start
The federal website where consumers can get health insurance under the Affordable Care Act was up and running Thursday after a slow start as sign-up season for 2019 opened days before the midterm elections. ... With health care a major issue in Tuesday’s elections, this sign-up season under the Trump administration is getting close scrutiny. In earlier years, technical problems with the site created major headaches for the Obama administration. (Alonso-Zaldivar, 11/1)

The Associated Press: ACLU Objects To Hawaii Retirement Home Assisted Suicide Ban
The American Civil Liberties Union demanded Thursday that a Hawaii retirement home stop discriminating against non-Catholic residents and allow them to take advantage of the state’s new medically assisted suicide law if they wish. The ACLU of Hawaii sent a letter to the executive director of the Kahala Nui home after receiving an anonymous tip that the home had notified residents they would not be permitted to exercise the provisions of the law, which takes effect in January. (McAvoy, 11/2)

The Associated Press: Cross Talk: Federal Agencies Clash On Cellphone Cancer Risk
Two U.S. government agencies are giving conflicting interpretations of a safety study on cellphone radiation: One says it causes cancer in rats. The other says there’s no reason for people to worry. No new research was issued Thursday. Instead, the National Toxicology Program dialed up its concerns about a link to heart and brain cancer from a study of male rats that was made public last winter. The Food and Drug Administration, which oversees cellphone safety, disagreed with the upgraded warning. And “these findings should not be applied to human cellphone usage,” said Dr. Jeffrey Shuren, FDA’s chief of radiological health. (Neergaard and Borenstein, 11/1)

The New York Times: Study Of Cellphone Risks Finds ‘Some Evidence’ Of Link To Cancer, At Least In Male Rats
For decades, health experts have struggled to determine whether or not cellphones can cause cancer. On Thursday, a federal agency released the final results of what experts call the world’s largest and most costly experiment to look into the question. The study originated in the Clinton administration, cost $30 million and involved some 3,000 rodents. The experiment, by the National Toxicology Program, found positive but relatively modest evidence that radio waves from some types of cellphones could raise the risk that male rats develop brain cancer. (Broad, 11/1)

The Wall Street Journal: Scientists Find ‘Clear Evidence’ Cellphone Radiation Can Cause Cancer In Rats
Their final reports, for example, concluded that there is “clear evidence” that male rats exposed to high levels of cellphone radiation developed cancerous heart tumors, after initially saying there was just “some evidence”—a less certain classification. They also said there was “some evidence” of brain and adrenal gland tumors in male rats that were exposed to cellphone radiation after characterizing that evidence as “equivocal” earlier this year. (Krouse, 11/1)

The New York Times: Changes In A V.A. Hospital’s Star Rating May Say Little About Care Quality
When the Department of Veterans Affairs released the annual ratings of its hospitals this fall, the facility in Atlanta dropped to the bottom, while the one in West Haven, Conn., shot to the top. It was something of a mystery as to why. The Atlanta hospital was downgraded to one star from three on the agency’s five-star scale, even though there had been only a “trivial change” in its quality data from the year before, according to the department. The Connecticut hospital climbed to five stars from three, even though numerous operations had to be performed elsewhere or canceled at the last minute because of problems with sterilization of surgical tools, according to an internal assessment and other accounts cited by Senator Richard Blumenthal in a letter to the agency. (Philipps, 11/1)

ProPublica: The VA Shadow Rulers’ Signature Program Is “Trending Towards Red”
When senators asked Veterans Affairs Secretary Robert Wilkie in September about the three Trump supporters who’ve been quietly shaping the agency’s agenda from the president’s Mar-a-Lago resort, he minimized his interactions with the trio, saying they’d had a single meeting on a seemingly dry subject: electronic medical records. As unexciting as that might seem, it is a subject that will shape the agency for decades to come. The VA gave a software company a $10 billion no-bid contract to replace the agency’s records system. The new system is supposed to synchronize with data from other providers, as the VA increasingly sends veterans to private doctors instead of treating them in-house. While Wilkie’s comments to the Senate made it sound like the so-called Mar-a-Lago Crowd — a doctor, a lawyer and an entertainment executive with no U.S. military or government backgrounds — opposed the records transition, they actually championed it, highlighting the issue to the incoming Trump White House and making it their top focus, four former officials said. (Arnsdorf, 11/1)

USA Today: VA Moves Ahead With Deadly Dog Experiments, Research Despite Criticism
The Department of Veterans Affairs is pushing forward with invasive and ultimately fatal experiments on dogs as part of the VA's medical research program, according to documents obtained by USA TODAY. The controversial procedures previously sparked outrage and opposition from some veterans’ advocates and prompted strict restrictions from Congress. The VA says the studies could produce discoveries that may help veterans suffering from spinal cord or breathing problems. (Slack, 11/1)

Stat: Trump Administration OKs Rule Fining Pharma For Overcharging 'Safety Net' Hospitals
After years of bickering, thousands of so-called safety-net hospitals and clinics won a significant battle over the Trump administration, which agreed to implement a rule that would penalize drug makers for overcharging for their medicines. The rule is supposed to go into effect on Jan. 1. The rule, which had been delayed several times by the Trump administration, would fine drug makers up to $5,000 for each instance in which they “knowingly and intentionally” overcharge for their medicines. The companies must also reimburse providers for medicines that were purchased. The rule would also require drug makers to post ceiling prices on a government web site. (Silverman, 11/1)

Stat: Dan Best, HHS Drug Pricing Adviser, Dies
Dan Best, the government’s top drug pricing adviser, has died, the Department of Health and Human Services announced Thursday afternoon. “It is with tremendous sadness that I learned of the passing of our friend and colleague,” HHS Secretary Alex Azar said in a statement. “I had the great privilege to know Dan Best for the past decade. He joined me here at HHS out of a desire to serve the American people by making healthcare more affordable.” (Swetlitz, 11/1)

The Hill: First FDA Approved Cannabis-Based Drug Now Available By Prescription 
The first cannabis-derived medication approved by the Food and Drug Administration is now available by prescription in every state, according to its manufacturer. Epidiolex, manufactured by GW Pharmaceuticals, is intended to treat seizures associated with two rare and severe forms of epilepsy that begin in childhood. The drug is made of cannabidiol (CBD), a component of marijuana that doesn’t give users a high. (Weixel, 11/1)

The Associated Press: Long Trip: Psychedelic Advocate Nears Goal Of Legal Ecstasy
The Food and Drug Administration has labeled the drug a potential “breakthrough” for post-traumatic stress disorder and cleared late-stage studies of up to 300 patients. The studies are to be conducted by [Rick] Doblin’s nonprofit group dedicated to promoting mind-altering drugs, the Multidisciplinary Association for Psychedelic Studies, or MAPS. Researchers will begin screening patients this month. The goal is to win FDA approval by 2021. MDMA would become the first psychedelic drug — currently in the same ultra-restrictive category as heroin and cocaine — to make the leap to prescription medicine. (Perrone, 11/1)

Reuters: From Pharma To Prisons, Election-Sensitive Stocks That Could Swing
Perhaps no sector will be in the election spotlight as much as healthcare, which has been one of the top-performing S&P 500 sectors this year. Policy efforts to lower prescription drug prices that have started under Trump could get more attention should Democrats gain control in Congress. Democratic gains in particular could lead investors to anticipate expanded coverage or other changes related to the Affordable Care Act, possibly benefiting some insurer company and hospital shares. (Krauskopf, 11/1)

Reuters: Cigna Boosts 2018 Forecast After Third Quarter Earnings Beat
U.S. health insurer Cigna Corp, which is in the process of acquiring Express Scripts Holding Co, significantly bumped up its 2018 adjusted profit forecast, and its shares rose more than 3 percent on Thursday. ... “The guidance raise in excess of the magnitude of the earnings beat this quarter signals Cigna’s confidence in its industry-leading medical cost performance,” Leerink analyst Ana Gupte said. (Mishra and Mathias, 11/1)

The Wall Street Journal: Longtime McKesson CEO To Step Down
McKesson Corp. said its longtime Chairman and Chief Executive John H. Hammergren will retire next year, capping a 17-year reign in which he helped build one of the country’s largest pharmaceutical wholesalers despite weathering shareholder criticism over his compensation and handling of the opioid crisis. (Walker, 11/1)

The Wall Street Journal: Teva Passes Its Check-Up
The turnaround at Teva Pharmaceutical Industries remains on schedule. The generic drug giant reported third-quarter sales of $4.5 billion and adjusted earnings of 68 cents a share. While both figures were down significantly from a year earlier, the earnings figure topped expectations thanks to deeper cost cuts than analysts had anticipated. Teva also increased its full-year guidance for profit and free cash flow. (Grant, 11/1)

The New York Times: How To Turbocharge Flu Protection (Llamas Required)
On Thursday, an international team of researchers offered a glimpse at something better than the seasonal flu shot. With a sophisticated combination of immunotherapy and gene therapy, they created an artificial antibody that protected mice against dozens of flu strains. It’s an important step toward a type of flu shot that scientists have long sought: a shield against whatever flu strain people happen to pick up. (Zimmer, 11/1)

Los Angeles Times: Scientists May Have Found The Key Ingredient For A Universal Flu Vaccine, And It Comes From Llamas
Along with soulful eyes, endearingly long necks and and warm fuzzy coats, llamas have a far less appreciated feature: They make an array of immune system antibodies so tiny they can fit into crevices on the surface of an invading virus. That feat could one day protect humans from entire families of flu viruses that bedevil scientists with their unpredictable and shape-shifting ways. All, potentially, with a once-a-year puff up the nose. (Healy, 11/2)

The New York Times: They Were Addicted To Opioids. Now They’re Running The New York Marathon. 
John Tavolacci, Odyssey House’s chief operating officer, said he has run 22 marathons. He started the running group in 2001 as a supplement to treatment, based on a strong belief that running can be effective in helping overcome addiction. He has watched the Odyssey House team build self-esteem among participants, create a cooperative environment, and fill time for runners that otherwise might have been spent on negative pursuits. New York City saw a nearly fivefold increase in heroin overdose deaths per 100,000 residents between 2010 and 2015. Similarly, opioids were linked to more than 42,000 deaths nationwide in 2016, five times the 1999 rate, according to the Centers for Disease Control and Prevention. (Shannon, 11/1)

The Associated Press: Family Of Singer Chris Cornell Sues Doctor Over His Death
Family members of Chris Cornell on Thursday sued a doctor they say overprescribed drugs to the rock singer, leading to his death. Cornell’s widow, Vicky Cornell, and their children, Toni and Christopher, are plaintiffs in the lawsuit filed in Los Angeles Superior Court alleging that prescription drugs, especially the anti-anxiety drug lorazepam, led to erratic behavior from the Soundgarden frontman before his death in Detroit in 2017 at age 52. (Dalton, 11/1)

The Wall Street Journal: Parents Of Children With Diabetes Sue NYC Education Department
A federal lawsuit accuses New York City of failing to ensure that students with diabetes can attend public school safely and with equal access to educational opportunities as their peers. The proposed class-action suit, filed Thursday in federal court in Brooklyn, claims that the New York City Department of Education and others violate students’ rights by denying them adequate diabetes-related care, including services for school field trips, before-and-after school activities and bus transportation. Diabetes, a lifelong condition, is considered a disability under federal and local laws. (West, 11/1)

The Washington Post: ‘They’ve Shifted The Burden To Us’: A Food Pantry Struggles To Feed An Increasingly Hungry Ohio Community
For a nonprofit in an impoverished town, the day had all the makings of a success. Every family went home with food that would help them get through the next month: tuna mac and cheese, boxes of cereal, long-grain rice, potatoes, peaches, corn on the cob, a large watermelon, chicken legs and loaves of bread. But [Margaret] Sheskey and [Larry] Lafferty were already focused on a question that has increasingly come to shape the work they do: Could they find enough food before the pantry reopened? Finding food has always been a challenge, but the task is getting even tougher — a consequence of an ongoing shift in how states distribute federal grants to help the poor. (Samuels, 11/1)