Stat: PBMs Sidestep The Senate’s Tough Questions — But Lawmakers Hint At Legislation
The much-maligned pharmacy middlemen escaped largely unscathed during a high-profile congressional hearing Tuesday — but the powerful bipartisan duo behind the hearing now appears intent on legislating, and it looks like increasing transparency will be their primary goal. Executives for the country’s five largest pharmacy benefit managers, the middlemen that negotiate with drug makers over the price of their drugs, were expected to face hard questions about their role in the ever rising price of prescription drugs from members of the Senate Finance Committee. But the PBM executives largely parried the senators’ questions, none of which shone too harsh a spotlight on the industry’s practices. (Forko, 4/9)

The Associated Press: Heated Debate Over High Drug Costs Returns To Capitol Hill
Critics see PBMs as middlemen who add costs to an already expensive system for prescription drugs. Drugmakers point to the rebates as part of the problem. They say they have to offer them to land some of their products on a PBM’s list of covered drugs or a less-expensive tier, and this contributes to higher list prices. High list prices hurt patients who have to pay a big deductible when they fill a prescription. (Murphy, 4/9)

The Hill: Senators Press Drug Industry 'Middlemen' Over High Prices
During a hearing Tuesday, members of the Senate Finance Committee sought to shine a light on the work of PBMs, the drug middlemen, who handle claims for big insurers and help negotiate drug prices with manufacturers. Drug companies have long painted PBMs and insurers as the villains in the pricing debate, and the industry has few backers. “More transparency is needed,” said committee Chairman Chuck Grassley (R-Iowa), who has long criticized PBMs for what what he says are secretive industry pricing practices. "The current system is so opaque that it’s easy to see why there are many questions about PBMs’ motives and practices." (Weixel, 4/9)

CQ: Drug Middlemen Under Scrutiny As Two Panels Take On Prices
Some of the larger benefit managers recently committed to policies meant to appease customers and lawmakers. Insurer Cigna and its PBM-arm Express Scripts recently announced they would cap patient cost-sharing for insulin at $25 a month, and Optum Rx, the PBM-arm of insurance giant UnitedHealth Group, is requiring its employer plans to pass along all negotiated discounts to customers at the point of sale starting in 2020. But the systems give lawmakers and the administration the impression that the PBMs favor higher-cost drugs over cheaper ones. Oregon’s Ron Wyden, the Finance Committee ranking Democrat, described a case in which CVS’ pharmacy benefits arm makes doctors and patients get an authorization before prescribing a lower-cost, unbranded but identical version of a cholesterol drug. The same manufacturer makes both the low-cost and brand-name versions. (Siddons, 4/9)

Modern Healthcare: Senate Panel Favors Lighter Touch For PBM Regulation
Finance Committee Chair Chuck Grassley (R-Iowa) defended the PBMs' role in negotiating prices as set forward in the Medicare Part D program that he helped create. "This system of private entities negotiating is what I envisioned as an author of the Part D program," Grassley said. "I still believe this is absolutely the right approach. I oppose any effort to undo the 'non-interference clause' currently in statute." (Luthi, 4/9)

Kaiser Health News: Senate Hearing On Drug Pricing A Lesson In What PBMs Do
It was back-to-school day at the Senate Finance Committee hearing Tuesday morning. In the third of a series of hearings on rising drug prices, the senators seemed focused on getting an answer to one central question: What the heck is a pharmacy benefit manager? Pharmacy benefit managers, or PBMs, are the go-between companies that negotiate with drugmakers on which medicines will make insurance plans’ lists of covered drugs and how much insurers’ plans will pay for them. (Bluth, 4/9)

Bloomberg: Senators Call For Probe Of ‘Spread Pricing’ By Drug Middlemen 
Two U.S. senators have asked the inspector general of the Health and Human Services Department to investigate a practice by pharmacy-benefit managers known as spread pricing, as part of a wider inquiry by lawmakers into U.S. drug costs. Ron Wyden of Oregon, the ranking Democrat on the Senate Finance Committee, said that he and Chairman Chuck Grassley of Iowa have requested the inspector general, which examines the operations of government health programs, to probe the issue. (Edney and Langreth, 4/9)

In other drug pricing news —

Stat: Alex Azar On Drug Pricing, Messaging, And Trump's Expectations
Alex Azar speaks about his efforts to lower drug prices multiple times per week with President Trump, he said Tuesday. But it is his conversations with other Republicans on that issue that have often proven more difficult, the Health and Human Services secretary acknowledged Tuesday. The conservative resistance to several key Trump administration proposals to bring down the cost of medicine is substantial enough that Azar isn’t even seeking praise from members of his own party — he counts Republicans’ tempered criticisms of the administration’s signature proposal to cap some U.S. payments for drugs as a win. (Facher, 4/10)

Prescription Drug Watch: For news on rising drug costs, check out our weekly roundup of news coverage and perspectives of the issue.

Politico: Disaster Aid Talks Collapse As Congress Heads For Recess
Senate negotiations over a disaster relief package have broken down, all but ensuring that Puerto Rico and states stricken by storms, wildfires and flooding will be left waiting for emergency aid until after Congress returns from a two-week recess. Democrats have rejected the latest offer made by Republican appropriators over funding for Puerto Rico, according to three sources familiar with the talks. (Emma and Levine, 4/9)

In other news from Capitol Hill —

CQ: Panel Weighs Expanding Health Access And Religion Protections
Discussions over a bill House Democrats say would expand protections for LGBT Americans faced pushback Tuesday from Republicans, who expressed concerns that the bill would undermine religious liberty. The House Education and Labor Subcommittee on Civil Rights and Human Services is the second committee to discuss a bill (HR 5, S 788) that would add language to consider sexual orientation and gender identity as a protected class for employment, housing, public accommodations and programs that use federal funding like Medicaid, Medicare, the Children’s Health Insurance Program, Veterans Affairs clinics, and plans sold on the individual market. (Raman, 4/9)

Politico: House Democrats Demand Trump Administration Disclose Obamacare Legal Strategy
House Democrats are demanding the Trump administration turn over documents related to its refusal to defend Obamacare in court, in an escalation of the political battle over a case that has put health care at risk for millions. The chairmen of five House committees sent letters to the White House, Justice Department and top Trump health officials seeking information on the administration's recent decision to support the health care law's full elimination in court. They called it a “sudden and significant reversal” that violates the federal government’s longstanding precedent of defending its own laws. (Cancryn, 4/9)

The Hill: Dems Demand Answers On Trump Officials' Decision Not To Defend ObamaCare
Top Democrats, led by Judiciary Chairman Jerrold Nadler (N.Y.) and Oversight Chairman Elijah Cummings (Md.), sent letters Tuesday to the White House and departments of Justice as well as Health and Human Services demanding access to materials that explain the decision and identifies the officials involved in making it. (Hellmann, 4/9)

The Wall Street Journal: Attorney General Defends White House Attempt To Dismantle Affordable Care Act
Attorney General William Barr defended the Trump administration’s renewed attempt to dismantle the Affordable Care Act. He hinted, though, that he initially expressed doubts about the Justice Department’s recent shift taking a tougher stance against the Obama-era health law. Mr. Barr told lawmakers Tuesday he ultimately didn’t object to the move to oppose the law in total late last month. (Gurman and Kendall, 4/9)

The Hill: Barr Defends Administration's Efforts To Overturn ObamaCare In Court 
Asked by Rep. Matt Cartwright (D-Pa.) why the DOJ would take such “dramatic and drastic action,” Barr replied: “Do you think it’s likely we’re going to prevail?” “We are in litigation and we have to take a position. If you think it’s such an outrageous position, you have nothing to worry about. Let the courts do their job,” he said during a House Appropriations hearing Tuesday. (Hellmann, 4/9)

PBS NewsHour: WATCH: Barr Pressed About DOJ Effort To Strike Down Affordable Care Act
Rep. Matt Cartwright, D-Penn., asked Attorney General William Barr about the Justice Department’s “litigation position” to strike down the Affordable Care Act. Cartwright asked Barr whether he’s properly evaluated the consequences, including the millions of people at risk of losing health care coverage, if DOJ’s lawsuit is successful. (Barajas, 4/9)

Milwaukee Journal Sentinel: Wisconsin Is Out Of Obamacare Lawsuits After Court Rules In Last Case
A federal appeals court dropped Wisconsin Tuesday from a lawsuit over Obamacare, allowing Gov. Tony Evers and Attorney General Josh Kaul to secure one of their campaign goals. The ruling was the latest in a string of court decisions allowing Wisconsin to get out of lawsuits over Obamacare, widely known as the Affordable Care Act. (Marley, 4/9)

Meanwhile —

The Wall Street Journal: Republicans Revive Efforts To Preserve Health-Law Provisions
A group of Senate Republicans is reviving legislation aimed at guaranteeing protections for people with pre-existing conditions, as the GOP attempts to blunt the political advantage Democrats may have on health care before the 2020 election. The bill, which Sen. Thom Tillis (R., N.C.) and roughly a dozen other Senate Republicans plan to introduce Wednesday, would preserve key provisions of the Affordable Care Act, which the Trump administration has moved to strike down in court. The proposal, an expanded version of a similar Senate Republican bill introduced last year, prohibits insurers from charging higher premiums to patients with pre-existing conditions and bars them from excluding coverage of treatments for those individuals. (Duehren, 4/10)

The New York Times: Would ‘Medicare For All’ Save Billions Or Cost Billions?
How much would a “Medicare for all” plan, like the kind being introduced by Senator Bernie Sanders on Wednesday, change health spending in the United States? Some advocates have said costs would actually be lower because of gains in efficiency and scale, while critics have predicted huge increases. We asked a handful of economists and think tanks with a range of perspectives to estimate total American health care expenditures in 2019 under such a plan. (Katz, Quealy and Sanger-Katz, 4/10)

The New York Times: No Longer An Outsider, Sanders Is Using The Senate As His Launching Pad
When Bernie Sanders steps to the lectern Wednesday to reintroduce his Medicare for All Act, he will do so as a senator, just as he did when he introduced a resolution to end American military involvement in the Yemen war or when he shepherded legislation to improve veterans’ health care. But behind it are the unmistakable politics of 2020 and his campaign for president, a campaign that never really ended with the election of Donald J. Trump. And Democratic efforts to pull Mr. Sanders into the fold with a newly minted leadership post have only bolstered his platform to seek the presidency. (Stolberg, 4/10)

The Associated Press: Bernie Sanders Relaunches ‘Medicare For All’ Amid 2020 Glare
Four of Sanders’ fellow senators and rivals for the Democratic nomination are set to sign onto the updated single-payer health care proposal. The bill’s reintroduction promises to shine a bright light on Democratic presidential candidates’ disparate visions for the long-term future of American health care. Under fire from President Donald Trump and Republicans for the astronomical price tag of Medicare for All, some candidates who support the plan tout it as one of several ways to achieve more affordable coverage and lower the number of uninsured. And others who don’t back it are instead focusing on safeguarding popular provisions of the Affordable Care Act, such as the one that protects coverage of pre-existing conditions. (Schor and Alonso-Zaldivar, 4/10)

Meanwhile, Republicans go on attack against the plan —

The Hill: McConnell Fiercely Attacks 'Medicare For All' In Visit To Hospital Group
Senate Majority Leader Mitch McConnell (R-Ky.) launched a fierce attack on "Medicare for all" on Tuesday in a speech to the American Hospital Association conference, urging the hospital officials to go to Capitol Hill and oppose the idea. “This radical scheme would be serious bad news for America's hospital industry,” McConnell told the conference. “You should not be the guinea pigs in some far-left social experiment.” (Sullivan, 4/9)

Boston Globe: In Boston Visits, Trump Health Officials Ridicule ‘Medicare For All’ Plans
Two top Trump administration officials visiting Massachusetts slammed the Affordable Care Act as a failure – even though the law has broad bipartisan support in this state and key measures suggest it is working smoothly here. US Secretary of Health and Human Services Alex M. Azar II and the administrator of Medicare and Medicaid, Seema Verma, in separate appearances Monday, also ridiculed the “Medicare for All” plans that many Democrats are now promoting. (Dayal McCluskey, 4/9)

The Associated Press: Trump Suggests Family Separation Policy Deters Migrants
Facing bipartisan pushback to his immigration shake-up, President Donald Trump said he’s not looking to revive the much-criticized practice of separating migrant children from their families at the southern border. At the same time, he suggested the policy had worked to deter migrants from coming into the U.S., although he offered no evidence to support his position. Last summer the administration separated more than 2,500 children from their families before international outrage forced Trump to halt the practice and a judge ordered them reunited. (Long and Colvin, 4/10)

The Washington Post: Inside The Trump White House’s Growing Panic To Contain The Border Crisis
Trump’s increasingly erratic behavior over the past 12 days — since he first threatened to seal the border in a series of tweets on March 29 — has alarmed top Republicans, business officials and foreign leaders who fear that his emotional response might exacerbate problems at the border, harm the U.S. economy and degrade national security. The stretch also has revealed that a president who has routinely blamed spiking immigration numbers on others — past presidents, congressional Democrats, Mexican authorities, federal judges, human smugglers — is now coming to the realization that the problems are closer to home. Though his aides have taken the fall, and it is unlikely that Trump will blame himself, the president is facing an existential political crisis ahead of his 2020 reelection bid over the prospect of failure on his top domestic priority. (Nakamura, Dawsey and Kim, 4/9)

The Washington Post: Trump Administration Considers Revised Version Of Family Separation Tactic
Administration officials said Tuesday that while a return to the previous family separation tactic, known as “zero tolerance,” is not in the works, the White House is considering a “binary choice” policy, which would give parents the option of remaining in detention with their children or allowing their children to be separated and placed with another caregiver. (Miroff, Dawsey and Bade, 4/9)

The Associated Press: Inside 12 Days Of Turmoil That Shook Homeland Security
President Donald Trump had had it. The flow of migrants at the southern border was surging. Another caravan appeared to be forming. And his government had run out of holding space, forcing the release of tens of thousands of families apprehended at the border. During a meeting with senior aides on the last Thursday in March, Trump demanded drastic action to make good on the threat he’d tweeted that morning: Shut the southern border. Curbing illegal immigration was his signature issue, he railed. Why couldn’t he deliver? (Colvin and Long, 4/9)

The Associated Press Fact Check: Trump Mocks Migrants, Retreats On Health Care
Playing migrants for laughs in a speech to lobbyists and donors, President Donald Trump characterized people trying to get into the U.S. as a horde of beefy men who fake hard-luck stories so softies in the immigration system will let them in. His shtick caused plenty of amusement at the Republican Jewish Coalition event Saturday but it was a far cry from the reality of the masses at the border. (Woodward and Yen, 4/9)

The Washington Post Fact Checker: Trump Digs In On False Claim That He Stopped Obama’s Family Separation Policy
The Obama administration rejected a plan for family separations, according to Cecilia Muñoz, Obama’s top adviser for immigration. The Trump administration operated a pilot program for family separations in the El Paso area beginning in mid-2017. In April 2018, the pilot took off. Then-Attorney General Jeff Sessions rolled out a “zero tolerance” policy of prosecuting all adults caught crossing the border illegally. The next month, the Department of Homeland Security began to refer all illegal-crossing cases to federal prosecutors. (Rizzo, 4/10)

The Associated Press: Autopsy: Migrant Detainee Died From AIDS Complications
A Honduran transgender migrant, whose 2018 death while in the custody of U.S. Immigration and Customs Enforcement sparked protests and calls for an investigation, died of a rare disorder that developed quickly due to AIDS, according to an autopsy released Tuesday. The New Mexico Office of the Medical Investigator released its findings on the death of Roxsana Hernandez , 33, saying the disorder — known as multicentric Castleman disease — can progress rapidly in people with weakened immune systems and lead to death within weeks. (Contreras, 4/9)

CQ: Family Separations At Border Opposed By HHS Official
A Department of Health and Human Services official told senators Tuesday that he would not support reinstating the "zero tolerance" policy that led to thousands of children being separated from their migrant parents at the southern border in 2018. “I would never support the use of family separation and the systematic traumatization of children as a tool for immigration policy,” Commander Jonathan D. White of the U.S. Public Health Service Commissioned Corps, a branch of the Department of Health and Human Services, told senators. White is deputy director for children's programs in the Office of Emergency Management and Medical Operations under the assistant Homeland Security secretary for preparedness and response. (DeChalus, 4/9)

Reuters: U.S. Indicts Indivior Over Suboxone Opioid Treatment Marketing
The U.S. Justice Department announced on Tuesday the indictment of Indivior Plc and a subsidiary on charges they engaged in an illegal scheme to boost prescriptions of the film version of its opioid addiction treatment Suboxone. An indictment filed in federal court in Abingdon, Virginia, alleged Indivior made billions of dollars by deceiving doctors and healthcare benefit programs into believing the film version of Suboxone was safer and less susceptible to abuse than similar drugs. (Raymond, 4/10)

The Wall Street Journal: U.S. Charges Drug Maker Indivior With Organizing Multibillion-Dollar Fraud
The company said it worked with the Justice Department for years as part of its investigation and “made numerous attempts to reach a settlement that went far beyond what we believe the facts of this case support.” “Indivior’s top priority has always been the treatment of patients struggling with opioid addiction,” the company said. “Indivior does not make pain pills in the U.S. and is not a contributor to the opioid crisis.” (Armental, 4/9)

WBUR: Opioid Maker Charged With Fraud In Marketing Drug As Less Prone To Abuse
Federal prosecutors claim Indivior bilked Medicare, Medicaid and other health care providers out of billions of dollars as they paid for a more expensive version of the drug, believing it to be safer. The criminal charges, filed in the western district of Virginia, stem from a joint investigation that included the U.S. Food and Drug Administration, Virginia's state attorney general office, and other agencies. (Mann, 4/10)

Stat: After Three Years Of Controversy, CDC Clarifies Its Opioid Prescribing Guidelines
After protracted debate over federal guidelines for prescribing opioids, the Centers for Disease Control and Prevention has clarified its position, stating that its three-year-old recommendations were not intended to deny clinically appropriate treatment to patients who suffer acute or chronic pain from conditions such as cancer and sickle cell disease. Those guidelines, which focus on chronic pain except for cancer and end-of-life care, target primary care physicians because family doctors write the vast majority of prescriptions for painkillers. (Silverman, 4/9)

The Washington Post: US Warns Docs Not To Abruptly Halt Opioid Pain Treatment
U.S. health officials Tuesday warned doctors not to abruptly stop prescribing opioid painkillers to patients who are taking them for chronic pain ailments, such as backaches. The Food and Drug Administration said it will add advice to labels on how to taper opioid painkillers, such as OxyContin, Vicodin and dozens of generic pills. Federal and state officials have been fighting a nationwide opioid epidemic, which includes not only legal painkillers, but also illicit drugs like heroin and fentanyl. (Perrone, 4/9)

And in other news on the crisis —

Seattle Times: Seattle Enlisting Bartenders And Bouncers In The Fight Against Opioid Overdoses
Opioid overdoses aren’t a widespread problem in Seattle’s nightclubs, said program creator Scott Plusquellec, the city of Seattle‘s nightlife business advocate. But he wanted to take preventive action as Seattle and King County battle an opioid crisis. “This is an epidemic that will continue to grow and be problematic,” he said. The issue has been compounded recently by the emergence of fentanyl, a powerful synthetic narcotic many times more potent than heroin. The drug, used by health-care professionals to treat severe pain, is also turning up in heroin and other drugs bought on the street. (Blethen, 4/9)

Tampa Bay Times: Proposal To Allow Needle Exchanges Statewide Heads To House Floor
The Florida House is set to take up allowing needle exchanges beyond Miami-Dade, after the House Health and Human Services committee voted Tuesday to advance a bill that would let other counties create their own programs with the approval of their county commissions. CS/HB 171 would expand a state law that created a pilot needle exchange program in Miami-Dade in 2016 — since that pilot was established, injection drug users have been able to trade dirty needles for clean ones at no charge and get connected to wound care and drug treatment. (Koh, 4/9)

New Hampshire Public Radio: Housing, Transportation Emerge As Key Priorities As State's New Addiction-Treatment Program Grows
As part of broader efforts to address the opioid crisis, New Hampshire plans to invest $2.5 million in federal funds toward short-term housing vouchers for patients awaiting treatment. It’s one of several priorities outlined this month in a formal proposal by state health officials to the Substance Abuse and Mental Health Services Association (SAMHSA). (Greene, 4/9)

The New York Times: Measles Outbreak: New York Declares Health Emergency, Requiring Vaccinations In Parts Of Brooklyn
For months, New York City officials have been fighting a measles outbreak in ultra-Orthodox Jewish communities in Brooklyn, knowing that the solution — the measles vaccine — was not reaching its target audience. They tried education and outreach, working with rabbis and distributing thousands of fliers to encourage parents to vaccinate their children. They also tried harsher measures, like a ban on unvaccinated students from going to school. But with measles cases still on the rise and an anti-vaccination movement spreading, city health officials on Tuesday took a more drastic step to stem one of the largest measles outbreaks in decades. (Pager and Mays, 4/9)

The Washington Post: Measles Outbreak NY: Yeshiva Ordered To Exclude Unvaccinated Students From School
"This outbreak is being fueled by a small group of anti-vaxxers in these neighborhoods. They have been spreading dangerous misinformation based on fake science,” Health Commissioner Oxiris Barbot, a pediatrician, said in the statement. “We stand with the majority of people in this community who have worked hard to protect their children and those at risk. We’ve seen a large increase in the number of people vaccinated in these neighborhoods, but as Passover approaches, we need to do all we can to ensure more people get the vaccine.” (Bever, 4/9)

The Wall Street Journal: Measles Outbreak: New York City Orders Mandatory Vaccinations In Parts Of Brooklyn
The county said Tuesday that it had appealed the order and is working on a plan to require exposed but unvaccinated people to remain home for an incubation period, which is typically 21 days. Violators would face fines of up to $2,000, they said. “How high must our case count be before you consider it an emergency?” said Rockland County Executive Ed Day. “This outbreak is an imminent threat to our public health. Doing nothing is absolutely not an option.” (West, Abbott and McKay, 4/9)

The Washington Post: New York City Measles Public Health Emergency: Mayor Orders Vaccines In Brooklyn
New York’s action comes as health officials scramble to blunt the spread of measles, especially with the approach of Passover, a holiday associated with travel and big family gatherings. “We cannot allow this dangerous disease to make a comeback here in New York City,” Mayor Bill de Blasio (D) said Tuesday. “We have to stop it now.” (Sun, Horton and Paluch, 4/9)

The New York Times: New York City Is Requiring Vaccinations Against Measles. Can Officials Do That?
Faced with an expanding measles outbreak, Mayor Bill de Blasio of New York declared a public health emergency on Tuesday and ordered a program of mandatory vaccination in parts of Brooklyn. Such a health order is rare but not unheard-of in American history, medical experts said. It has occurred several times. The Supreme Court ruled more than a century ago that mandatory vaccination was legal, although the court drew a distinction between punishing citizens for refusing and actually vaccinating them by force. (McNeil, 4/9)

The New York Times: ‘Monkey, Rat And Pig DNA’: How Misinformation Is Driving The Measles Outbreak Among Ultra-Orthodox Jews
“The Vaccine Safety Handbook” appears innocuous, a slick magazine for parents who want to raise healthy children. But tucked inside its 40 pages are false warnings that vaccines cause autism and contain cells from aborted human fetuses. “It is our belief that there is no greater threat to public health than vaccines,” the publication concludes, contradicting the scientific consensus that vaccines are generally safe and highly effective. (Pager, 4/9)

The Hill: New York Officials Warn Parents To Stop Holding 'Measles Parties' Amid Latest Outbreak 
New York City Health Commissioner Oxiris Barbot on Tuesday warned parents in the city not to hold so-called "measles parties" as officials work to counter an outbreak of the disease. Barbot warned that some parents have had "measles parties" to have their children infected with the disease in an effort to immunize them naturally, rather than through a vaccination, according to BuzzFeed News. (Burke, 4/9)

The Washington Post: Measles Outbreak: What To Know About How It Spreads And The Vaccine
Here are some answers to commonly asked questions about measles, which can cause serious complications among all age groups, especially young children. (Sun, 4/9)

Bloomberg: Who Needs Measles Vaccine? NYC Mandates In Williamsburg Outbreak 
A measles outbreak in the Orthodox Jewish community of Williamsburg, Brooklyn, has prompted New York City to declare a public health emergency, requiring residents to be vaccinated with the measles-mumps-rubella vaccine or face a $1,000 fine. The highly contagious and potentially deadly virus has afflicted 285 New Yorkers since October, including 246 children, almost all of them in the tightly knit Orthodox Jewish community, in one of the city’s most dense neighborhoods. Twenty-one have been hospitalized, with five requiring intensive care, said city Health Commissioner Oxiris Barbot. (Goldman, 4/9)

Atlanta Journal-Constitution: Suicide In US: Children, Teens In ER With Suicidal Thoughts Doubles
The number of teens and children visiting emergency rooms for suicidal thoughts or attempts doubled between 2007 and 2015, according to new research published this week. ...Researchers looked at a large, nationwide sample of data from the Atlanta-based Centers for Disease Control’s National Hospital Ambulatory Medical Care Survey for the study. They examined the number of children between ages 5 and 18 who were diagnosed with suicidal ideation or suicide attempt. (Pirani, 4/9)

The New York Times: Most Osteoporosis Drugs Don’t Build Bone. This One Does.
The Food and Drug Administration on Tuesday approved an osteoporosis drug that represents the first new treatment approach in nearly two decades — a strategy based on a rare gene mutation in people with bones so dense that they never break. About 10 million people in the United States have osteoporosis. Worldwide, about 200 million people have brittle bones; one in three women, and one in five men, will suffer a fracture because of osteoporosis, often of the hip or spine. For many, the break leads to a downward spiral of disability. (Kolata, 4/9)

The Washington Post: The Pregnancy-Tracking App Ovia Lets Women Record Their Most Sensitive Data For Themselves — And Their Boss
Like millions of women, Diana Diller was a devoted user of the pregnancy-tracking app Ovia, logging in every night to record new details on a screen asking about her bodily functions, sex drive, medications and mood. When she gave birth last spring, she used the app to chart her baby’s first online medical data — including her name, her location and whether there had been any complications — before leaving the hospital’s recovery room. But someone else was regularly checking in, too: her employer, which paid to gain access to the intimate details of its workers’ personal lives, from their trying-to-conceive months to early motherhood. (Harwell, 4/9)

The Associated Press: Gun-Maker To Ask Supreme Court To Hear Sandy Hook Appeal
Facing a newly revived wrongful death lawsuit in Connecticut over the Sandy Hook Elementary School shooting, gun-maker Remington is going to the U.S. Supreme Court to argue it can’t be sued because of a much-debated federal law that shields firearms manufacturers from liability in most cases. The Connecticut Supreme Court issued a 4-3 ruling last month saying the Madison, North Carolina-based company can be sued under state law for how it marketed the Bushmaster AR-15-style rifle used to kill 20 first-graders and six educators at the Newtown school in 2012. (Collins, 4/9)

Kaiser Health News: Lethal Plans: When Seniors Turn To Suicide In Long-Term Care
When Larry Anders moved into the Bay at Burlington nursing home in late 2017, he wasn’t supposed to be there long. At 77, the stoic Wisconsin machinist had just endured the death of his wife of 51 years and a grim new diagnosis: throat cancer, stage 4. His son and daughter expected him to stay two weeks, tops, before going home to begin chemotherapy. From the start, they were alarmed by the lack of care at the center, where, they said, staff seemed indifferent, if not incompetent — failing to check on him promptly, handing pills to a man who couldn’t swallow. (Bailey and Aleccia, 4/9)

Modern Healthcare: PrEP Use Against HIV Linked With Increased STD Risk
Pre-exposure prophylaxis use to protect against HIV infection was associated with higher infection rates of other sexually transmitted diseases, according to a new study. An analysis in Australia found more than 2,900 sexually transmitted infections were diagnosed in nearly half of the study's participants from when they started using PrEP. Nearly 3,000 gay and bisexual men were given access to the medication. The study found infections per participant ranged from zero to 12. (Johnson, 4/9)

The New York Times: Sitting For More Than 13 Hours A Day May Sabotage The Benefits Of Exercise
Sitting for most of the day could make us resistant to the usual metabolic benefits of exercise, according to a small but worrying new study. The findings, in the Journal of Applied Physiology, suggest that inactivity may alter our bodies in ways that are not just unhealthy on their own but also blunt the healthfulness of exercise. We know, of course, that physical activity is good for us and being sedentary, for the most part, is not. (Reynolds, 4/10)

Cleveland Plain Dealer: Early Preterm Births Cause Troubling Rise In Infant Mortality: Progress Report
In the first three months of this year, Cuyahoga County’s infant mortality rate showed a troubling and dramatic rise, driven largely by a jump in the number of extremely preterm infants who died, according to statistics released at a quarterly meeting of city-county infant mortality initiative First Year Cleveland.The overall infant mortality rate, defined as the number of live-born infants who die before reaching a first birthday per 1,000 live births, was 8.43 last year and rose to 10.1 the first quarter of this year. (Zeltner, 4/10)

California Healthline: How To Fight ‘Scary’ Superbugs? Cooperation — And A Special Soap
Hospitals and nursing homes in California and Illinois are testing a surprisingly simple strategy against the dangerous, antibiotic-resistant superbugs that kill thousands of people each year: washing patients with a special soap. The efforts — funded with roughly $8 million from the federal government’s Centers for Disease Control and Prevention — are taking place at 50 facilities in those two states. (Gorman, 4/9)

NPR: Wound Healing Might Be Improved With Staples Modeled On Porcupine Quills
At first, the idea of using porcupine quills to patch up wounds sounds torturous. But, taking inspiration from the spiky rodent, researchers have begun to work on a new type of surgical staple that may be less damaging — and less painful — than current staples. Worldwide, surgeons perform more than 4 million operations annually, usually using sutures and staples to close wounds. Yet these traditional tools designed to aid healing can create their own problems. (Cassidy and Shields, 4/9)

Reuters: Special Report: As Baby Powder Concerns Mounted, J&J Focused Marketing On Minority, Overweight Women
Pressure was mounting on Johnson & Johnson and its signature Baby Powder. In 2006, an arm of the World Health Organization began classifying cosmetic talc such as Baby Powder as “possibly carcinogenic” when women used it as a genital antiperspirant and deodorant, as many had been doing for years. Talc supplier Luzenac America Inc started including that information on its shipments to J&J and other customers. J&J, meanwhile, looked for ways to sell more Baby Powder to two key groups of longtime users: African-American and overweight women. The “right place” to focus, according to a 2006 internal J&J marketing presentation, was “under developed geographical areas with hot weather, and higher AA population,” the “AA” referring to African-Americans. (4/9)

The New York Times: 24 Charged In $1.2 Billion Medicare Scheme, U.S. Says
Federal officials said Tuesday that they had dismantled a $1.2 billion Medicare scheme that spanned continents and ensnared hundreds of thousands of unsuspecting elderly and disabled patients. Under the scheme, which the authorities described as one of the largest health care frauds in United States history, doctors prescribed back, shoulder, wrist and knee braces that were not needed, prosecutors said. Twenty-four people were charged, according to the Justice Department. (Chokshi and Jacobs, 4/9)

The Hill: Feds Charge 24 People In $1.2 Billion Medicare Scam
Officials said the scheme involved offering Medicare beneficiaries orthotic braces, saying they were free to them and covered by Medicare. Patients who expressed interest were reportedly patched through to call centers in the Philippines and Latin America that were in on the scam, which would verify the beneficiaries' coverage and transfer them to telemedicine companies. The call centers collected prescriptions and sold them to medical equipment companies, officials said, which shipped the braces to beneficiaries and billed Medicare for them. The medical equipment companies received Medicare reimbursement of $500 to $900 per brace, for which they paid kickbacks of nearly $300 per brace. (Budryk, 4/9)

The New York Times: Texas Tech Medical School, Under Pressure From Education Dept., Will Stop Using Race In Admissions
A prominent Texas medical school will stop considering race or ethnicity in deciding whether to admit applicants, as part of an agreement with the Education Department’s civil rights office. The president of the Texas Tech University Health Sciences Center signed the agreement in February, 14 years after the department began investigating a complaint filed by an anti-affirmative action group. The agreement is the first of its kind for the Education Department under Secretary Betsy DeVos, and comes as the Trump administration continues its hard turn against the use of race in admissions. (Hartocollis, 4/9)

Reuters: Texas Medical School Agrees To Stop Using Race In Admissions
The U.S. Supreme Court has ruled in a series of cases that universities may use affirmative action to increase minority enrollment on their campuses. Conservatives have argued such programs can hurt whites and Asian-Americans and argue that other factors including socioeconomic status should be considered in efforts to achieve diversity. A federal judge is weighing a lawsuit accusing Harvard University of discriminating against Asian-American applicants. Legal experts believe the case could end up in U.S. Supreme Court and have wide implications regarding affirmative action. (4/9)

The Wall Street Journal: U.S. Requires Texas Tech Med School To End Use Of Race In Admissions Decisions
The Texas Tech agreement marks the first time the Trump administration has asked a school to curtail its affirmative-action practices, and signals the administration’s desire to limit the extent to which universities can factor race into admissions. In the agreement, the administration suggested the medical school consider race-neutral factors to achieve its diversity goals, such as recruiting students from low-income areas and favoring bilingual or first-generation college students. (Hackman, 4/9)

Politico: Texas Tech Medical School Will End Use Of Race In Admissions
The Trump administration is separately investigating whether Harvard and Yale are discriminating against Asian-American applicants in their use of race in admissions. The Justice Department has also backed a lawsuit targeting Harvard's use of race in admissions. And in July, the administration scrapped Obama-era guidance calling on school superintendents and colleges to consider race when trying to diversify their campuses. (Wermund, 4/9)

The Associated Press: Fetal Heartbeat Bill Stalls In Tennessee Senate Committee
Legislation banning abortion once a fetal heartbeat is detected stalled in Tennessee on Tuesday amid concerns that passing the measure would result in the state losing costly court battles. Instead, the Senate Judiciary Committee agreed to review the issue further over the summer and take it up next year after members spent nearly two hours rehashing past key abortion court battles, discussing pregnancy viability with medical officials and criticizing the history of Planned Parenthood. (Kruesi, 4/9)

Columbus Dispatch: 'Heartbeat Bill' Passes House Committee, Heads To House Floor Despite Protests
The House Health Committee’s latest version of Senate Bill 23 passed 11-7 along party lines Tuesday. While the current version does not touch the core of the bill — to ban abortions after a fetal heartbeat is detected — it does impose additional fines to physicians who perform abortions after a fetal heartbeat is detectable. (Prosser, 4/9)

WBUR: Mass. Study: Need For Judge's Consent Holds Up Minors' Abortions 6 Days On Average
A new study of abortions sought by more than 2,000 Massachusetts minors finds that needing approval from a judge causes a significant delay: an average of six extra days compared to teens who could get the required consent from their parents. For one in three minors in the study who went before a judge, that delay meant they missed the window for being able to abort using pills rather than a procedure, says Dr. Elizabeth Janiak of Harvard Medical School, lead author on the study just out in the journal Obstetrics and Gynecology. (Goldberg, 4/9)

Boston Globe: A Fix For The State’s Broken Foster Care System? Lawmakers Pledge Action
One lawmaker immediately called the state’s child advocate. Another may refile legislation requiring an independent review any time a child is bounced around in foster care. (Lazar, 4/9)

Reuters: In New York, Confusion Reigns In The Emerging CBD Edibles Business
New York state officials told food growers and processors in mid-December that they had the state's blessing to produce and sell tea and chocolates laced with CBD, the cannabis derivative reputed to ease anxiety and other ills without marijuana's high. But since then, New York City health inspectors have seized thousands of dollars worth of CBD-infused food and drinks at the Fat Cat Kitchen and other local cafes and restaurants, and warned owners to stop selling them or face penalties. The crackdown came just weeks after federal law explicitly made CBD legal across the country. (4/9)

The Washington Post: Pediatric Medical Center Supported By United Arab Emirates To Open At Former Walter Reed Site
A pediatric medical research facility funded by a financial gift from the United Arab Emirates will open next year at the former Walter Reed Army Medical Center site in the District, officials announced Tuesday. The facility, which will be affiliated with Children’s National Health System, will open in 2020 on about 12 acres in Northwest Washington. The new Children’s National Research and Innovation Campus will research rare childhood illnesses and host an outpatient clinic. (Moyer, 4/9)

KCUR: Allegations Of Fraud, Stolen Records Swirl In Legal Fight Over Hillsboro, Kansas, Hospital 
Allegations of financial fraud and stolen hospital records have surfaced in an increasingly nasty legal battle over the fate of Hillsboro Community Hospital in Hillsboro, Kansas. The critical access hospital, which is partly owned by a company controlled by Florida resident Jorge Perez, is resisting efforts by Perez to move its Chapter 11 bankruptcy case to North Carolina. (Margolies, 4/9)

Modern Healthcare: Urgent Need For New Revenue Streams Will Shape Health Systems' Strategy
Building alternative revenue sources will play a bigger role in healthcare providers' strategies, according to a new study. Ninety percent of hospital and health system executives surveyed indicated that new revenue streams were an urgent priority expected to yield a return in the next three years, a new study from Boston-based Partners HealthCare and healthcare private equity firm Fitzroy Health found. Every participant acknowledged the need to diversify revenue. (Kacik, 4/9)

Georgia Health News: Two Outbreaks: Georgia Dealing With Hepatitis A And E. Coli Infections
A large outbreak of hepatitis A infections continues to concern state public health officials. Since June of last year, 214 cases have been reported in the state, including 64 last month alone, said Cherie Drenzek, the state epidemiologist, at a Tuesday board meeting of the Georgia Department of Public Health. (Miller, 4/9)

The CT Mirror: Three Key Appointments, Including Public Health Chief, Clear Legislative Committee
Three critical gubernatorial appointments – for head of the state’s department of motor vehicles, commissioner of public health and leader of the agriculture department – easily cleared the legislature’s joint committee on executive and legislative nominations Tuesday. Lawmakers approved the nominations of Sibongile “Bongi” Magubane, Renée Coleman-Mitchell and Bryan Hurlburt, saying they were impressed with the candidates’ resumes and optimistic about the direction of each department. (Carlesso, 4/9)

Pioneer Press: Report Shines Light On Elder Neglect As MN Lawmakers Seek Reform 
Cases of elder abuse and neglect in Minnesota are disturbing, widespread and mostly preventable, according to a new report detailed Tuesday at the Capitol by advocacy groups pushing for stronger protections for older and vulnerable adults. Elder Voice Family Advocates reviewed a sample of 128 cases of neglect at assisted living and senior housing facilities substantiated over the past five years by the state Health Department’s Office of Health Facility Complaints. The report highlights 41 cases of maltreatment, including 28 deaths in which neglect was a direct or contributing factor. (Burn, 4/9)

Modern Healthcare: Suburban Chicago Hospital Suddenly Suspends Service
Pipeline Health is suspending services at Westlake Hospital, the Melrose Park, Ill., facility it planned to close later this year, primarily due to declining staff rates posing patient safety risks. The move didn't surprise Melrose Park officials, who filed an injunction yesterday to prevent such a move. The process to suspend services at 230-bed Westlake will begin immediately, Dennis Culloton, spokesman for Pipeline, said today. (Goldberg, 4/9)

Sacramento Bee: Thousands Strike At UC Hospitals, Alleging Unfair Labor Practices
Unions representing roughly 39,000 UC workers will picket the UC’s five academic hospitals from 9 a.m. to 5 p.m. Wednesday, and their marches may occasionally delay traffic near UC Davis Medical Center, 2315 Stockton Blvd., in Sacramento. UCD leaders say they expect minimal impact, so patients should keep their appointments for surgeries and other procedures. The hospital will serve bag or box lunches to patients. (Anderson, 4/10)

The Star Tribune: Hacker Breached Minnesota State Agency E-Mail, Placing Data Of 11,000 At Risk 
A data breach last year at the state agency that oversees Minnesota’s health and welfare programs may have exposed the personal information of approximately 11,000 individuals. The state Department of Human Services (DHS) notified lawmakers Tuesday that an employee’s e-mail account was compromised as a result of a cyberattack on or about March 26, 2018. A hacker unlawfully logged into a state e-mail account of a DHS employee and used it to send two e-mails to one of the employee’s co-workers, asking that co-worker to pay an “invoice” by wiring money. (Serres, 4/9)

Texas Tribune: Texas Legal Age For Tobacco Could Go From 18 To 21 Under Senate Proposal
The age of Texans who can legally buy tobacco products could soon raise from 18 to 21 years old — except for active military members. The Texas Senate on Tuesday passed Senate Bill 21 in a 20-11 vote after state Sen. Joan Huffman, R-Houston, amended her own legislation to include the military exemption. State Sen. John Whitmire of Houston was the only Democrat who voted against the bill. (Byrne, 4/9)

Boston Globe: US Reps. Katherine Clark, Ayanna Pressley Introduce Bill To Expand Protections Against Workplace #MeToo Cases
Massachusetts congresswomen on Tuesday introduced a bill that represents the first sweeping federal effort to address the systemic legal and workplace inequities exposed by the viral #MeToo movement — including an ambitious effort to phase out the tipped minimum wage, which advocates say makes women especially vulnerable to sexual harassment. (Ebbert, 4/9)

Cleveland Plain Dealer: Cuyahoga County Approves $42M Deal With MetroHealth For Jail Health Care
Cuyahoga County Council on Tuesday unanimously approved a three-year, $42 million deal with MetroHealth to oversee all health care in the county jails. Under the deal, MetroHealth must fully staff operations at the county’s three jails – the downtown Justice Center and satellite jails in Bedford Heights and Euclid -- by Oct. 31. (Astolfi, 4/9)

Kansas City Star: Missouri Medical Marijuana Licenses: No Affirmative Action
Missouri’s health department does not plan to give minority-owned businesses a boost when deciding who gets licenses to grow and sell medical marijuana — a measure some black Kansas City residents believe would help ensure equal opportunity. Officials with the Missouri Department of Health and Senior Services said this week the license applications will be stripped of all identifying information about the owners, including their race, during the selection process. (Marso, 4/9)

Texas Tribune: Texas Marijuana Decriminalization Is Up For Debate. Here's Some Context.
Lawmakers of all political stripes were chomping at the bit this session to file — or sign onto — bills that would decriminalize or lessen the criminal penalties for Texans found with small amounts of marijuana. Getting such a measure across the finish line seemed feasible with newfound support from Republican leaders that have long controlled the Texas Legislature. (Samuels, 4/10)

Boston Globe: Bill Aims To Crack Down On Black Market Marijuana
Two state lawmakers from Worcester want to create a task force of law enforcement, public health leaders, and regulators to crack down on unlicensed marijuana sellers. Senator Michael Moore, a Democrat, and state Representative Hannah Kane, a Republican, will hold a news conference Wednesday at the State House about their joint bill, filed Monday, which aims to maximize tax revenues and reduce youth pot access. (Martin, 4/9)

Bloomberg: Gene Therapy Was Hailed As A Revolution. Then Came The Bill. 
Dozens of revolutionary gene therapies that mend faulty strands of DNA are on their way, bringing the power to eliminate lethal childhood diseases, rare blood disorders and other severe illnesses. Beneath the excitement about these potential cures lies an important catch: No one knows how much to charge for them. The new therapies aim to fix the root causes of disease with a single dose, in which the correct genetic material is introduced into the patient’s cells. If the treatments can replace a lifetime of conventional costly drugs, they may slash overall spending, even at multimillion-dollar prices. Yet the prospect of high costs is already stirring pushback. (Paton, 4/7)

The Wall Street Journal: Plan To End Drug Rebates Adds Protections For Insurers
The Trump administration said the federal government would offer a risk-sharing system to reimburse health insurers for financial losses resulting from a proposed ban on certain pharmaceutical-industry rebates in Medicare. The backstop on most of insurers’ losses could help prevent premiums from rising significantly as a result of the rebate-rule changes, while making taxpayers responsible for a greater share of cost overruns in Medicare’s prescription-drug program. (Armour and Walker, 4/5)

Stat: Advocates Say A Commerce Dept. Report Would Preclude Reclaiming Patents
Nearly a dozen advocacy groups have complained to Congress that a recent Department of Commerce draft report that offered ways to modernize technology transfer and innovation would limit the ability of the federal government to curb “excessive” prescription drug prices. The 135-page report, which was issued last December by the department’s National Institute of Standards and Technology, broadly addresses innovation and proposes various suggestions for maximizing returns on taxpayer investment in R&D. (Silverman, 4/5)

The Hill: TV Biz Fights Trump Drug Pricing Rule
Broadcasting and advertising groups are adding a powerful voice to the fight against a controversial Trump administration proposal that would require drug companies to share prices in their commercials. Critics worry the new rules could discourage Big Pharma from advertising on air, costing the nation’s advertisers and television stations an important source of revenue. (Gangitano, 4/9)

Marketplace: Would Requiring Prices In Pharmaceutical Ads Make Drugs Cheaper?
The Trump administration is expected to finalize a new rule soon that would require drug makers to include list prices in their TV ads for prescription drugs. The idea is that such transparency will lead to more competition and ultimately to lower cost for consumers. (Uhler, 4/9)

Stat: A Troubled Drug Maker Attempts To Compensate For Its Problems By Taking Huge Price Hikes
Beset by a failed merger, mounting losses, and manufacturing headaches, Akorn (AKRX) last month sought to compensate for its many woes by taking a round of steep price hikes on many of its drugs. The beleaguered drug maker, which sells mostly generics, raised list prices on no fewer than a dozen medicines by 19.4 % to 285 %, with the largest increase for Lidocaine HCI gel, a product used for preventing and treating pain that now costs $56.56 for a month’s supply, according to Wells Fargo analyst David Maris. (Silverman, 4/9)

Stat: A Growing Number Of States Are Eyeing Laws To Prohibit A Controversial Cost-Sharing Tool
Over the past 10 days, Virginia and West Virginia became the first states in the U.S. to adopt laws that preclude certain health plans from using copay accumulators, a new weapon against widely used but controversial copay assistance cards that drug makers distribute to consumers. The laws, which cover individual and small market plans, come as a growing number of health plans and employers embrace accumulators to blunt rising drug costs. About 30% of employers have adopted them and another 21% are considering doing so over the next couple of years, according to the National Business Group on Health, a nonprofit. (Silverman, 4/4)

Time: Why Does Medicine Cost So Much? Here's How Drug Prices Are Set
From 2007 to 2016, Mylan raised the list price of its EpiPen about 500%, from just under $100 to more than $600. From 2002 to 2013, insulin prices more than tripled. From 2012 to 2019, the average price of AbbVie’s rheumatoid-arthritis drug Humira climbed from $19,000 a year to $60,000 a year—and that’s after rebates. These are dramatic examples of a systemwide problem: prices for brand-name drugs are rising at a rate that far outstrips inflation. (Entis, 4/9)

Milwaukee Journal Sentinel: Gov. Tony Evers Wants Prescription Drug Price Information Disclosed
Like most prices in health care, what health plans pay for prescription drugs is cloaked in secrecy. Gov. Tony Evers wants those prices to be at least a bit less secret. One of the two proposals in his budget to help control the price of prescription drugs would require manufacturers, pharmacy benefit managers who manage prescription drug benefits for health plans, health insurers and hospitals to give the state information on what they pay for prescription drugs. (Boulton, 4/9)

Stat: Audentes Therapeutics To Develop Gene Therapies For Two Types Of Muscular Dystrophy, Including Duchenne
Audentes Therapeutics, a developer of experimental gene therapies, will announce Monday that it aims to create new treatments for two forms of muscular dystrophy: Duchenne muscular dystrophy and myotonic muscular dystrophy. Duchenne, in particular, is one of the most competitive areas in the hot new field of gene therapy, which uses viruses to embed new genes in the cells of sick patients. (Herper, 4/8)

Stat: Regeneron To Invest $800 Million In Alnylam, Betting On Drug-Making Technique Enabled By A Nobel-Winning Discovery
Regeneron Pharmaceuticals said Monday it will pay $800 million to Alnylam, a biotechnology firm in Cambridge, Mass., to leverage its gene-silencing technique for the development of new therapies and to become its exclusive partner for new drugs focused on the central nervous system or the eye. “It’s about the future, and it’s about synergies,” George Yancopoulos, Regeneron’s chief scientific officer and co-founder, said in an interview. “We’re not going to be making the standard deals where companies are just hoping to acquire an asset. We’re going to do the opposite. We’re looking for people with which we can do greater things together.” (Herper, 4/8)

The Wall Street Journal: Trump’s Dubious Prescription-Price Plan
Drug manufacturers and pharmacy-benefit managers are bickering over who’s to blame for rising prescription prices at the drugstore. At a Senate hearing in February, CEOs of seven drugmakers took turns lambasting PBMs, and on Tuesday the benefits managers will get the chance to defend themselves. As usual, the biggest culprit is government, which is why the Trump administration’s plan to ameliorate the problem should be met with caution. As AstraZeneca CEO Pascal Soriot recently noted, the current system of drug pricing “is not sustainable—for patients, payers and society as a whole.” The way that system works—or rather the way it’s evolved to operate, since nobody thinks it works—drugmakers pay rebates to PBMs, which negotiate discounts for insurers in return for favorable placement on the list of covered medications. (Allysia Finley, 4/5)

The Atlantic: Do PBMs Delay Drugs And Drive Up Drug Prices? 
Lynn Lear finished her final round of chemotherapy for breast cancer in December. To help keep the cancer from coming back, Lear’s doctor told her about a new medication she could take called Nerlynx. Lear, who is 46, wanted to do everything she could to remain healthy, so she asked her doctor to order the drug for her.Unlike, say, an antibiotic or an antidepressant, a Nerlynx prescription can’t be filled at a neighborhood CVS or Walgreens. (Olga Khazan, 4/9)

San Jose Mercury News: Trump Administration Puts Cancer Patients At Risk
Right now, Medicare prescription drug plans are required to cover all drugs in six classes of medications that treat complex illnesses like cancer, epilepsy, mental illness and HIV/AIDS. These protections ensure that vulnerable patient populations have access to a wide array of medication options to treat their illnesses, with the understanding that no two patients’ needs or conditions are the same. But the administration’s proposal does not take these realities into account. Instead, the proposed changes would allow insurers to offer patients increasingly restrictive coverage, while impeding patients’ ability to access innovative, potentially more effective treatments. Clearly, this is unacceptable to the millions of patients and doctors who have come to rely on these treatment choices to fight these deadly diseases. (Bonnie J. Addario, 4/8)

The New York Times: Why I Am Stockpiling Insulin In My Fridge
My parents and I used to high-five one another when we learned that the child of someone very rich had been found to have Type 1 diabetes. We weren’t being mean, just desperate. I was given my diabetes diagnosis in 1987, when I was 9, and the years immediately following were spent fantasizing about a cure. A cure would solve all my problems, the physical, mental and financial strains of having a chronic illness. A cure would require fund-raising for charities that would then be able to sponsor life-changing research. Put more simply, a cure would require money — lots of it. So, like monsters, my family and I rooted for offspring of the wealthy to join the broken-pancreas club, so that diabetes would become their pet cause and their fancy friends would get involved. The Juvenile Diabetes Research Foundation’s charity auction would make a killing. (Kreizman, 4/9)

Columbus Dispatch: Proposal Could Lower Patients’ Out-Of-Pocket Drug Costs
Patient advocacy groups also are calling for more scrutiny of PBM practices and greater accountability for their role in drug pricing. We often hear about the “list price” of a drug. Most every patient will not pay the list price but will pay a co-insurance or other copay cost. The HHS proposal will have the greatest impact on these direct patient costs, which are determined by health plans and PBMs. (Scott Eitman, 4/9)

The Fiscal Times: Why Prescription Drug Prices Keep Rising – And 3 Ways To Get Them Under Control
Prescription drug prices have been rising at a blistering rate over the last few decades. Between 1980 and 2016, overall spending on prescription drugs rose from about $12 billion to roughly $330 billion, while its share of total health care spending doubled, from 5% to 10%. Although lawmakers have shown renewed interest in addressing the problem, with pharmaceutical CEOs testifying before the Senate Finance Committee in February and pharmacy benefit managers (PBMS) scheduled to do so this week, no comprehensive plan to halt the relentless increase in prices has been proposed, let alone agreed upon. (Michael Rainey, 4/8)

Stat: Creating New Antimicrobials Will Require Public-Private Partnerships 
As the number of infections resistant to antimicrobial drugs continues to rise around the world, and with it their huge human and financial toll, we urgently need new ways to preserve the effectiveness of existing antibiotics and to develop much-needed new ones. Creating state-run or publicly owned pharmaceutical companies, an idea recently floated by British economist Jim O’Neill, isn’t the way to proceed. (Thomas B. Cueni, 4/9)

GQ: Health-Care CEOs Made An Infuriating Amount Of Money Last Year
Last year, 62 CEOs of health-care companies made a combined total of $1.1 billion in compensation. That's according to a new report out from Axios, which coincidentally notes that CEO compensation eclipses what the Centers for Disease Control spent on chronic disease prevention by $157 million. That comparison might make the executive compensation seem galling, but a look at the bigger picture...doesn't make it better. (Luke Darby, 4/9)

The Wall Street Journal: Republicans Managed To Make ObamaCare Popular 
A Kaiser Family Foundation poll released in December 2016, just before President Obama left office, showed that the Affordable Care Act had a favorability rating of 43%, while 46% viewed it unfavorably. Last month, the same poll showed the nine-year-old health-insurance law well above water, with 50% viewing it positively to 39% negatively. Those numbers help explain why most Republicans in Congress aren’t eager to campaign on repealing ObamaCare in 2020. (Jason L. Riley, 4/9)

Stat: The Real Border Crisis Is Occurring In Medical And Emergency Clinics
A pack of border patrol agents dressed in dark green uniforms invade the trauma bay, bringing with them chaos and our newest patient. The surgeon calls for order and shouts at the agents to leave the room. It takes a while but they do, only to hover just outside the door to make sure the patient isn’t moved or discharged without their knowledge. I look at the patient lying on the gurney, his legs so badly wounded the bones are exposed. After years of living in Tucson, it doesn’t take long for me to identify the cause of such a gruesome injury: falling from the border wall. (Claire Lamneck, 4/10)

Stat: Medicare For All Should Guarantee Coverage For Oral Health
With multiple “Medicare for All” proposals now circulating in Congress, opportunities arise to fix past mistakes that have segregated care for our mouths and teeth from the rest of our bodies. Polling shows that today’s universal coverage efforts are driven largely by public outcry that people can’t afford the health care they need to be happy, healthy, and successful. As this robust discussion continues, it’s time to include comprehensive dental care as a standard part of health coverage. No plan can fully address consumers’ concerns without it. (Meg Booth, 4/10)

The Hill: There Are So Many Flaws With Medicare For All
As a physician living and working in a community with too many under and uninsured patients, I sympathize with the impulse underlying the Democratic Party’s utopian "Medicare for all" Act. Like many doctors, I also dream of a sweeping legislative fix to provide high-quality, carte blanche medicine for all Americans, especially those facing serious medical challenges. But this bill seeks utopia by giving government centralized power and control over every aspect of medicine via a single-payer model, and comes with an astronomical price tag. The cost in dollars is in the trillions, but there is also another, hidden cost: the elimination of the conscience rights of nurses and doctors. (Grazie Pozo Christie, 4/9)

The Hill: VA's Commitment To Timely Processing Of Claims And Appeals Is Merely Lip Service
There is a saying amongst veterans waiting for their disability claims and appeals to be processed that VA’s motto is “delay, deny, wait ‘til I die.” Recently, this sentiment was on full display during an oral argument before the U.S. Court of Appeals for Veterans Claims (CAVC) in Monk v. Wilkie. The Monk case centers around two important issues for veterans: the CAVC’s ability to decide class action lawsuits, and whether the U.S. Department of Veterans Affairs (VA)’s delay in adjudicating claims constituted a violation of the right to due process under the Fifth Amendment to the U.S. Constitution. (Rory E. Riley-Topping, 4/9)

Bloomberg: Lancet Study On Diet Says Lack Of Healthy Foods Is Killing People
After years of issuing dire warnings that certain foods are killing us, nutrition researchers managed to capture lots of attention last week by proclaiming that lack of certain foods was also killing us. The paper making this claim, published in the medical journal the Lancet, examined eating habits around the world, and noted a mismatch between what people actually eat and what various studies suggest we should eat. Framing things in terms of deaths, or killing, is what garnered all the attention, but this is an advance in the marketing of science more than of science itself. It’s long been known that regions where people consume lots of fruits and vegetables have good health and relatively long life expectancies. But that doesn’t get as much mileage on Twitter as a statement about lack of vegetables actually killing people. (Faye Flam, 4/9)

Roll Call: She Miscarried 8 Times. Today She’s Telling Lindsey Graham Why Abortion Should Remain Legal
Jen Jordan went to the well of the Georgia Senate two weeks ago to tell Republican lawmakers that she wasn’t looking for a fight on abortion rights, but that she and other women in the state were willing to have it as the legislature prepared to pass one of the strictest abortion laws in the country. The “heartbeat bill,” which the governor is expected to sign, bans abortions after a doctor can detect a fetal heartbeat, typically around the sixth week of pregnancy. In her dissent, the Democrat from Atlanta detailed for her fellow senators all kinds of impolite facts that most men in the chamber had probably never discussed publicly — a woman’s uterus, transvaginal ultrasounds, fertilized eggs, and why some women might not even know they are pregnant at six weeks, just one or two weeks past their menstrual period. (Patricia Murphy, 4/9)

The Washington Post: Baltimore Mayor Catherine Pugh Has Embarrassed The City. She Should Resign.
So far — and it’s fair to wonder what other squalid revelations may be forthcoming — the accounting of Baltimore Mayor Catherine E. Pugh’s take from the pay-to-play scam she ran under the guise of her self-published “Healthy Holly” children’s books amounts to roughly $800,000 since 2011. As allegations of corruption go, that puts her in the heavyweight class. Ms. Pugh, now on a leave of absence owing to what she says are health concerns, has been the subject of investigative stories in the Baltimore Sun, whose enterprising reporters have uncovered one sleazy deal after another. (4/9)