The Wall Street Journal: Businesses Challenge IRS Bid To Start Enforcing Insurance Mandate
Businesses are pushing back on the Internal Revenue Service’s decision to begin enforcing the Affordable Care Act’s employer insurance mandate, challenging penalties that run into the millions and asserting the agency is wrong to impose the fines. The ACA imposes a penalty on employers with more than 50 workers who don’t provide qualifying coverage to employees, but the fines weren’t initially enforced. In November, the IRS said it would begin assessing penalties, starting with companies that failed to comply in 2015, when parts of the employer mandate first kicked in. (Armour, 2/13)

The Wall Street Journal: Idaho Insurer To Sell Plans At Odds With Federal Health Law
Blue Cross of Idaho said it plans to use new rules set by state regulators to sell insurance that doesn’t meet all the requirements of the Affordable Care Act, a move that could force the Trump administration to take a stance on the legality of such products. The not-for-profit company’s efforts will be closely watched by officials and insurers around the country who want to understand the limits of states’ ability to carve out their own health-insurance rules. (Wilde Mathews, 2/14)

And in health law news from Capitol Hill —

The Hill: Ryan Calls For 'Incremental' Health Reforms After Failure Of ObamaCare Repeal
Speaker Paul Ryan (R-Wis.) is calling for "incremental" health-care reform after the Senate failed to pass an ObamaCare replacement bill last year. Asked on Fox Business on Tuesday if lawmakers will try again to pass an ObamaCare repeal legislation this year, Ryan pointed to incremental changes. (Sullivan, 2/13)

CQ HealthBeat: GOP Taking Step-By-Step Approach To Health Care, Ryan Says
Republicans are taking a piecemeal approach to overhauling the health care law and health policy overall, House Speaker Paul D. Ryan said on Tuesday. “There are a lot of things we can do, kind of, incrementally,” the Wisconsin Republican said Tuesday on Fox Business, pointing to the repeal of the penalty for not having coverage in a tax overhaul (PL 115-96) and last week’s budget deal (PL 115-123). That agreement repealed the Independent Payment Advisory Board, which had cost-cutting authority; decreased certain funding under the health care law (PL 111-148, PL 111-152); and added provisions to charge higher-income people receiving Medicare higher outpatient and prescription drug premiums. (McIntire, 2/13)

The Hill: House GOP Discussing Repeal Of ObamaCare Employer Mandate
House Republicans are in discussions about repealing or delaying ObamaCare’s employer mandate to offer health insurance, House Ways and Means Committee Chairman Kevin Brady (R-Texas) said Tuesday. Brady told reporters that he has discussed the idea with Health and Human Services Secretary Alex Azar, as well as other members of the Ways and Means Committee. (Sullivan, 2/13)

Meanwhile, in Wisconsin —

Milwaukee Journal Sentinel: Walker Plan To Lower Obamacare Premiums Passes Without Funding Plan
Lawmakers Tuesday approved Gov. Scott Walker's plan to hold down Obamacare premiums but left for another day how to pay for the $200 million proposal. The Joint Finance Committee also ordered the Walker administration to study bringing back Wisconsin's high-risk insurance pool, which was phased out after the passage of the federal Affordable Care Act. (Stein, 2/13)

The Washington Post: Sanders Claims White House Budget Would Kill Thousands But Mulvaney Says That’s Not True
Sen. Bernie Sanders berated White House budget director Mick Mulvaney over President Trump’s budget proposal Tuesday, contending that thousands of people would die and others would freeze because of the administration’s proposed cuts. Sanders was referring specifically to the budget proposal’s repeal of the Affordable Care Act and cuts to the Low Income Home Energy Assistance Program. (Werner, 2/13)

NBC News: Mulvaney Tells Congress He Would Vote Against His Own Budget
Mick Mulvaney, President Donald Trump's budget director, told lawmakers at a Senate budget hearing Tuesday that if he were still in Congress, he would not vote for the $4.4 trillion proposal he was presenting. (Clark, 2/13)

The Hill: Mulvaney Remarks On Trump Budget Plan Spark Confusion
The Office of Management and Budget (OMB) said that Mick Mulvaney would vote for President Trump’s budget proposal if he were still in Congress after the OMB director suggested he would not during a Senate hearing on Tuesday. Mulvaney, who was on Capitol Hill to defend the proposal, said he “probably would have found enough shortcomings” in the document to vote against it if he were still a congressman. (Jagoda, 2/13)

In other news —

The Hill: Rubio Blasts Trump Budget For ObamaCare 'Bailout' Provision 
Sen. Marco Rubio (R-Fla.) on Tuesday criticized a provision of President Trump’s budget request that he said bails out ObamaCare insurers. The White House budget calls for more than $800 million in mandatory appropriations to fully fund ObamaCare’s risk corridor program, which was created in 2014 to help cushion insurers from major losses during the early years of the federal insurance exchanges. (Weixel, 2/13)

The Hill: Planned Parenthood Announces Nationwide Push For Abortion, Birth Control Legislation 
Planned Parenthood on Tuesday announced a nationwide initiative to expand access to abortion, birth control and reproductive health care. Planned Parenthood, its affiliates, state lawmakers and other partners will roll out legislation in more than a dozen states this week that it says will expand access to sexual and reproductive care, with a plan to advance initiatives in all 50 states by the end of the year. (Hellmann, 2/13)

Modern Healthcare: Two States Question Aetna's Prior-Authorization Practices Amid CVS Merger
Two states are scrutinizing Aetna's processes for approving or denying payment for medical care after a former Aetna medical director admitted he never reviewed patient medical records when deciding whether to authorize treatment. The states' inquiries and the medical director's admission, which drew scorn from the medical community, are a public relations nightmare for Hartford, Conn.-based Aetna, and puts a microscope on the insurance industry's pre-authorization and appeals processes. It could also hamper the national insurer's ability to merge with pharmacy giant CVS Health. (Livingston, 2/13)

California Healthline: California’s Regulators To Investigate Aetna’s Medical Coverage Decisions
Both of California’s health insurance regulators said they will investigate how Aetna Inc. makes coverage decisions, as the lawsuit of a California man who is suing the nation’s third-largest insurer for improper denial of care heads for opening arguments on Wednesday. The Department of Managed Health Care, which regulates the vast majority of health plans in California, said Monday it will investigate Hartford, Ct.-based Aetna after CNN first reported Sunday that one of the company’s medical directors had testified in a deposition related to the lawsuit that he did not examine patients’ records before deciding whether to deny or approve care. (Ostrov, 2/13)

Politico: Google Paper Stirs Interest, But Not Seen As Transformative
By throwing some of its best engineering and medical minds at vast stores of clinical data with the help of powerful computers running for hundreds of thousands of hours, Google appears to have produced a model that accurately predicts patient deaths, hospital readmissions and other health-related events. The model won't transform medicine. But academics and other technology mavens think the methods described in the paper serve as a prototype for future work in predictive models, in areas like end-of-life care. (Tahir, 2/13)

Boston Globe: Death Planning Software Faces An Obstacle: Baby Boomers Who Want To Live Forever
What happens when you develop a product for something really important that people would prefer to ignore? That’s the challenge facing Suelin Chen and other entrepreneurs like her who want to make it easier for baby boomers to deal with the prospect of death. Cake, the Boston startup Chen cofounded, has developed a website designed to help users navigate the thicket of legal documents and health care proxies associated with end-of-life planning. It also lets them assemble music playlists for their funerals and even choose whether to have a Facebook page deleted or converted to a memorial after they’ve stopped logging on. (Weisman, 2/10)

In other health and technology news —

Kaiser Health News: The Training Of Dr. Robot: Data Wave Hits Medical Care
The technology used by Facebook, Google and Amazon to turn spoken language into text, recognize faces and target advertising could help doctors combat one of the deadliest killers in American hospitals. Clostridium difficile, a deadly bacterium spread by physical contact with objects or infected people, thrives in hospitals, causing 453,000 cases a year and 29,000 deaths in the United States, according to a 2015 study in the New England Journal of Medicine. Traditional methods such as monitoring hygiene and warning signs often fail to stop the disease. (McQuaid, 2/14)

The Associated Press: Number Of Lawsuits Challenging Opioid Industry Still Growing
The number of lawsuits continues to grow in a combined federal challenge of drug companies’ role in the opioid crisis. Judge Dan Polster is overseeing the consolidated lawsuits in a case in federal court in Cleveland. The complaints allege drug manufacturers and drug distributors bear responsibility for the deadly overdose epidemic and for not doing enough to stop it. (2/14)

The Star Tribune: Standing Rock Sioux Tribe In North And South Dakota Sues Major Opioid Manufacturers And Distributors
A federal lawsuit filed Tuesday on behalf of the Standing Rock Sioux alleges that major manufacturers and distributors of opioids created a public health crisis on their reservation by fraudulently concealing the addiction risk of the drugs. The tribe, located in North and South Dakota, sued 24 defendants in the opioid industry, seeking damages for what it alleges are violations of federal racketeering laws, deceptive trade practices, and fraudulent and negligent conduct. (Brunswick, 2/13)

Modern Healthcare: Which Opioid Addiction Treatments Work? White House OKs Study To Find Answers 
The White House has approved a new, national research effort headed by the Centers for Disease Control and Prevention to determine the most effective treatments for people battling opioid addiction. The CDC, which received approval Monday from the executive branch, said it hopes that the study's results will help inform policymakers, communities and providers on when drug-assisted therapies may or may not be appropriate. "Few studies are available to help patients and providers make informed decisions about the risks and benefits associated with the different medication-assisted treatments, the agency said in a notice. There's no silver bullet for treating opioid addiction. (Dickson, 2/13)

NPR: Doctors React: OxyContin Maker Purdue Pharma Halts Opioid Marketing
The maker of OxyContin, one of the most prescribed and aggressively marketed opioid painkillers, will no longer tout the drug or any other opioids to doctors. The announcement, made Saturday, came as drugmaker Purdue Pharma faces lawsuits for deceptive marketing brought by cities and counties across the U.S., including several in Maine. The company said it's cutting its U.S. sales force by more than half. Just how important are these steps against the backdrop of a raging opioid epidemic that took the lives of more than 300 Maine residents in 2016, and accounted for more than 42,000 deaths nationwide? (Wight, 2/13)

The Hill: Sessions Makes A Remark About Opioids, Starts A Discussion About Pain 
Attorney General Jeff Sessions drew criticism last week when he suggested the opioid epidemic could be eased if people “take some aspirin sometimes and tough it out a little bit.” The attorney general’s point was that doctors are giving out too many painkillers, and that this had contributed to people becoming addicted to opioids. (Roubein, 2/14)

Cleveland Plain Dealer: Skyrocketing Cost Of Methadone Treatments Could Break The Everhart Family Budget
The clinic where Isaac [Everhart] gets his drug therapy recently lost more than $100,000 in funding for 2018. Without those funds, it can no longer underwrite the cost of methadone treatments for many patients - including those the agency describes as the "working poor." (Cain, 2/14)

The New York Times: Adam Rippon On Quiet Starvation In Men’s Figure Skating
Shortly before Adam Rippon’s breakthrough victory at the United States figure skating championships, Brian Boitano crossed paths with him and asked how he was doing. Boitano, the 1988 Olympic gold medalist, expected Rippon to rave about his jumps or his signature spins. Instead, Boitano said, Rippon pulled back his shoulders, puffed out his chest and proudly proclaimed, “I’ve never been thinner.” (Crouse, 2/13)

The Wall Street Journal: Is Chocolate A Healthy Choice For Valentine’s Day? That Depends On Which Kind
Valentine’s Day is known for two things: romantic love and chocolate. Romance is famously fickle—it comes and goes. But our love affair with chocolate never seems to wane. Americans spend more today on chocolate products than the gross national product of some of the countries where cacao is grown. The research group Euromonitor International reports that U.S. sales of chocolate went from $14.2 billion in 2007 to $18.9 billion in 2017, a period during which overall sales for candy declined, largely because of growing health concerns over sugar. (Schiffman, 2/13)

Stat: Pharma's Latest Alzheimer's Failure Comes With A Particular Sting
Ayear ago, when Merck’s (MRK) latest treatment for Alzheimer’s disease came up a dud, the company saw a silver lining. By targeting patients with early forms of the disease, yet to show major symptoms, researchers saw a winning pathway for the drug, which looked like it was hitting its molecular targets. They were wrong. (Garde, 2/13)

The Washington Post: A Potentially Powerful New Antibiotic Is Discovered In Dirt
The modern medical era began when an absent-minded British scientist named Alexander Fleming returned from vacation to find that one of the petri dishes he forgot to put away was covered in a bacteria-killing mold. He had discovered penicillin, the world's first antibiotic. Ninety years later, the world faces an antibiotic crisis. Superbugs have evolved resistance to dozens of drugs in doctors' arsenals, leading to infections that are increasingly difficult to treat. (Kaplan, 2/13)

The New York Times: Obesity Tied To Survival In Men With Melanoma
Obese men treated for metastatic melanoma may survive longer than their normal-weight peers. Researchers did a retrospective analysis of 1,918 people, 1,155 of them men, under treatment for metastatic melanoma. The study is in Lancet Oncology. (Bakalar, 2/13)

Kaiser Health News: KHN Conversation On Living Well With Dementia
Dementia is one of the most challenging chronic conditions for individuals and their caregivers. More than 15 million family members in the U.S. provide care for people with dementia. Living well with this condition is important to both groups — and extremely difficult to achieve in practice. On Feb. 13, Kaiser Health News hosted an informative and important discussion about improving care and services for people with dementia and supporting their caregivers. (2/13)

The Associated Press: Oregon House OKs Health Care As A Right, Funding Questioned
Oregon's Legislature took a step Tuesday toward enshrining the right to health care in the state Constitution, a move that would be unprecedented in the United States but raises serious funding questions. The House of Representatives' 35-25 endorsement of the bill sends it to the state Senate, whose approval would put the proposed constitutional amendment on the ballot for Oregon voters in the November election. The move comes as the Trump administration has tried to dismantle former President Barack Obama's health care law. (2/13)

The Oregonian: Oregon House Democrats Pass Universal Health Care Proposal, Amid Questions Over Cost 
Both Rep. Mitch Greenlick, a Portland Democrat and chief sponsor of the resolution, and Republican Rep. Julie Parrish of West Linn, who voted against it, asked legislative lawyers to weigh in on whether the proposed constitutional amendment would force the state to pick up the bill to ensure everyone has health care. (Borrud, 2/13)

Georgia Health News: Rural Health Care Bill Clears House Panel
A House committee Tuesday approved high-profile legislation to boost rural health care in Georgia. House Bill 769 would take several steps, including easing the creation of ‘’micro-hospitals,’’ with 24/7 care and a small number of beds, to replace full-scale hospitals that close. (Miller, 2/13)

Sacramento Bee: Dumping Patients At Homeless Shelters ‘A Systemic Issue’ In Sacramento, New Survey Says
Data released this week by a nonprofit advocacy group, the Sacramento Regional Coalition to End Homelessness, suggest that the practice of sending patients to shelters without advance notification is not uncommon. The organization recently surveyed agencies that serve the poor in the Sacramento area about whether homeless people recently had been dropped off at their organizations – by ambulance, cab or ride share – immediately following discharge from a health care provider and without prior notification. (Hubert, 2/14)

The Associated Press: Oklahoma Health Agency Head Resigns After Abuse Accusations
The interim director of Oklahoma's health department — one of Republican Gov. Mary Fallin's top aides — stepped down Tuesday following accusations of domestic violence. Preston Doerflinger stepped down after about four months on the job. Fallin appointed him in October after commissioner Terry Cline resigned amid allegations of financial mismanagement at the agency. (2/13)

Minnesota Public Radio: Facing Shortage Of IV Bags, What's A Hospital To Do?
When the storm hit Puerto Rico last summer, it devastated facilities that produce IV bags — which are critical for treating dehydration and delivering medicines. It has been a challenge for months and hospitals in Minnesota and across the country are still coping with a shortage of IV bags, forcing them to change practices and, in some cases, raise the possibility of rationing the crucial medical supplies. (Zdechlik, 2/13)

The Associated Press: Houston Surgeons Separate Toddlers Joined At Chest, Abdomen
Doctors in Houston have successfully separated twin toddlers who were born in 2016 conjoined at the chest and abdomen. A spokeswoman at Texas Children’s Hospital says 13-month-old Anna and Hope Richards were in good condition Tuesday. Lindsey Fox says separation surgery was done Jan. 13 and announced Monday. Fox says the twin sisters join two brothers and their parents, Jill and Michael Richards of North Texas. Fox declined to provide more specifics about the family as the parents focus on their daughters’ recovery. (2/13)

The Associated Press: New Hampshire Bill Targets Soda On Kids Menus
New Hampshire restaurants would no longer be allowed to offer soda as a beverage choice for children’s meals under a bill before a state House committee. The bill would apply to restaurants that serve children’s meals that include food and a beverage for one price. Such meals would only be allowed to include milk, 100 percent juice or juice combined with water, plain water or flavored water with no sweeteners. (2/14)

The Star Tribune: Blue Cross CEO Michael Guyette Leaving For New Job
Continuing a turnover trend among health plan CEOs, Michael Guyette is stepping down in March as chief executive of Eagan-based Blue Cross and Blue Shield of Minnesota to take a similar job with an insurance company in California. Kathleen Blatz, a Blue Cross board member and former chief justice of the Minnesota Supreme Court, will serve as interim chief executive at Blue Cross, the insurer announced Tuesday. The nonprofit is the largest provider of health insurance for state residents. (Snowbeck, 2/13)

Pioneer Press: Blue Cross CEO Leaving Post To Lead California Eye-Care Giant 
Blue Cross and Blue Shield of Minnesota announced Tuesday that president and CEO Michael Guyette is leaving the Eagan-based company next month to join eye-care giant VSP Global. Guyette, 53, will become president and CEO at VSP Global, a Rancho Cordova, Calif.-based company that has businesses in the retail, manufacturing, innovation and insurance sectors. (Ferraro, 2/13)

The Star Tribune: Duluth Votes To Restrict Flavored Tobacco Sales; Mankato Votes Down Proposal To Raise Minimum Age
Duluth has become the latest city to restrict the sale of menthol and other flavored tobacco products to adult-only tobacco shops. With its 7 to 2 vote, the City Council on Monday passed the ordinance that will limit sales to six adult-only tobacco stores in the city within the next 120 days. The city currently has 84 outlets that hold tobacco licenses. (Harlow, 2/13)

Denver Post: Salmonella Outbreak At Aurora Restaurant Killed 1 And Hospitalized 3
A salmonella outbreak at an Aurora restaurant killed one and hospitalized three in November. At least 33 people, including one employee, were infected at La California, a restaurant that has previously failed to meet health department standards. The outbreak affected people who ate the restaurant’s family combo menu item from Nov. 10-14, according to a report from the Tri-County Health Department. Thirteen of the cases were confirmed while 20 were probable. (Worthington, 2/13)

Milwaukee Journal Sentinel: Madison Police Investigate Injuries To Newborns At Hospital
Police in Madison are investigating what they call "several unexplained injuries" at Meriter Hospital's Newborn Intensive Care Unit, officials said Tuesday. Officials at the hospital reported the injuries last week, according to police, who added that the case is being investigated by their Special Victims Unit and that no further information would be released Tuesday. (Garza, 2/13)

The Oregonian: Two Unity Mental Health Nurses Say Violent Patients Choked Staff, Broke Bones 
Two former nurses at the new Unity Center, touted as the city's more humane alternative for people in mental health crisis, have filed a pair of $1 million lawsuits, claiming they were fired from their jobs after complaining about their safety. Registered nurses John Stough and Cindy Olivares say in the suits that the Unity Center for Behavioral Health in Northeast Portland doesn't have enough security guards to deal with patients who lash out. (Green, 2/13)

St. Louis Public Radio: Bid To Bar Enforcement Of Marijuana Laws Gets Aldermanic Committee Hearing
Legislation that would bar, in most instances, St. Louis from expending resources to enforce marijuana laws attracted mostly positive comments from city residents at an aldermanic committee hearing Tuesday night. But Alderwoman Megan Green’s legislation received a less favorable reception from some of her colleagues, including the chairman of the committee hearing the bill. (Rosenbaum, 2/14)

Stat: More State Lawmakers Are Pushing Transparency Bills For Diabetes Drugs
At least three states have recently introduced bills to require transparency surrounding the cost and pricing of diabetes medicines, posing a growing challenge to the pharmaceutical industry. Over the past few weeks, legislation was introduced in South Carolina, Hawaii, and Colorado, and the intent of each bill largely mirrors a controversial law that was adopted last fall by Nevada, which is now fending off a lawsuit filed by the industry’s largest trade group. (Silverman, 2/8)

Modern Healthcare: Walgreens, AmerisourceBergen Deal Unlikely To Cut Drug Prices
Analysts are scratching their heads over the benefits to be gained from Walgreens Boots Alliance buying a major drug distributor. One thing the unconfirmed deal wouldn't do: lower drug prices. The Deerfield, Ill.-based pharmacy giant is reportedly in talks to buy wholesale drug distributor AmerisourceBergen Corp. The pharmacy chain already owns a roughly 26% stake in AmerisourceBergen, and the two companies purchase drugs together through a joint venture. (Bannow, 2/13)

Bloomberg: Walgreens Surveys Health-Care Landscape In The Face Of Amazon Threat
The remaking of the U.S. health-care industry is gaining speed, and some of the industry’s biggest players are racing to make sure they aren’t left behind. No link in the long chain connecting drugmakers, distributors and insurers to doctors and patients has been untouched by an increasingly vigorous shakeout created by the threat of new competition from Internet giant Amazon.com Inc. and a shifting regulatory landscape. (Langreth, 2/12)

Stat: Drug Makers Loathe These Patent Challenges, And More Are Being Filed Than Ever Before
Last fall, Allergan (AGN) transferred rights for six patents to a best-selling eye drug to a Native American tribe, focusing unprecedented attention on a type of patent challenge that vexes brand-name drug makers. Called inter partes reviews, these are heard before a U.S. Patent and Trademark Office appeals board, not a court, and are generally easier and faster to pursue than more conventional patent lawsuits. Not surprisingly, there are more of these challenges being filed than ever before. (Silverman, 2/13)

Stat: Will New Migraine Drugs Be A Boon — Or Bust — For Patients And Investors?
Drug companies are racing to the market with a new class of pills meant to stop migraines in their tracks — a potential boon for both patients and investors, if the new medications prove both effective and safe. An estimated 37 million Americans suffer from acute migraines, and analysts expect the two leading drugs, from Allergan and Biohaven Pharmaceuticals, to bring in more than $1 billion apiece at their commercial peaks. (Garde, 2/14)

Stat: Bob Hugin To Run For Senate In N.J., Making Drug Prices An Issue At Ballot
Longtime Celgene executive Bob Hugin is launching a campaign to represent New Jersey in the U.S. Senate — making it likely that the high-stakes race in the pharmaceutical industry’s epicenter will become, at least in part, a referendum on drug prices. Hugin, who retired earlier this month as Celgene’s chairman, plans to announce his candidacy on Tuesday. He’ll run as a Republican seeking to unseat Democrat Robert Menendez, who’s thought to be vulnerable in his quest for a third term after facing bribery charges in a case that has since been dropped. (Robbins and Silverman, 2/12)

The Hill: McCain Urges Trump To Make Good On Promise To Address High Drug Prices 
Sens. John McCain (R-Ariz.) and Tammy Baldwin (D-Wis.) on Monday called on President Trump to make good on his promise to lower drug prices, writing that the problem "is only getting worse." The Trump administration has yet to take substantive action toward reducing the cost of prescription drugs despite promising to do so several times last year and in his State of the Union address last month.  (Hellmann, 2/12)

Kaiser Health News: KHN On NPR: The Uniquely American Problem Of High Prescription Drug Costs
Kaiser Health News Editor-in-Chief Elisabeth Rosenthal discussed drug costs with Scott Simon, the host of NPR’s Weekend Edition on Saturday, Feb. 10. This is a transcript of that conversation. (2/12)

Reuters: Drug Copies Ready To Take Next Bite Out Of Roche's Cancer Sales
European oncologists will soon get their hands on cut-price copies of breast cancer drug Herceptin, turning the screws on maker Roche and giving another boost to a new breed of companies focussed on so-called biosimilars. South Korea's Celltrion is the biggest winner in the biosimilars boom, having tripled in value to $34 billion in the past year as it gears up for more product launches in Europe and the United States. (Hirschler, 2/13)

Stat: Bristol, Needing A Cancer Immunotherapy Boost, Pays Shockingly Steep Price For Nektar Drug
Bristol-Myers Squibb, seeking a new way to make its cancer immunotherapies more effective, is paying a shockingly steep — some will say desperate — price to lock up rights to an experimental drug from Nektar Therapeutics. Under deal terms announced Wednesday, Bristol is paying $1 billion in cash and will make a $850 million equity investment in Nektar at an above-market price in exchange for non-exclusive rights to develop NKTR-214. (Feuerstein, 2/14)

Stat: Is The Novartis Breakthrough Gene Therapy Overpriced Or Not?
Late last year, Novartis (NVS) began marketing a breakthrough gene therapy for treating youngsters with advanced leukemia and slapped a $475,000 price tag on the one-time treatment. The eye-popping number sparked debate, but the drug was quickly deemed cost effective by a nonprofit watchdog.The controversy is far from over, though. (Silverman, 2/9)

Forbes: Patient Advocate Says Novartis' $475,000 Breakthrough Should Cost Just $160,000
David Mitchell, 67, says he’s sure that Novartis’ Kymriah is a breakthrough medicine, and that he will need a similar medicine to treat his own blood cancer. He’s sure of something else, too: Novartis is charging too much.Mitchell, a veteran PR man who is president of Patients for Affordable Drugs, says that Kymriah, which costs $475,000 per treatment for children with acute lymphoblastic leukemia, should cost only $160,000. That means the price is triple what it should be, by his math, and that Novartis’ breakthrough is overpriced by $315,000.  A research analysis to back up this assertion, co-authored by Mitchell, is being published in the journal Health Affairs this morning, with more detailed results published on Patients for Affordable Drugs’ web site. (Herper, 2/8)

WRIC: Lawmakers Take Aim At Scam Driving Up Drug Prices
Virginia lawmakers are taking aim at a hidden scam driving up prescription drug prices. It’s called a ‘copay clawback’ and 8News first exposed this little-known secret back in December. “The bill before you is a pro-consumer, pro-transparency bill that will help patients and our brick and mortar pharmacists back in our districts,” says Delegate Todd Pillion from Virginia’s 4th District. (O'Brien, 2/9)

Denver Post: Novartis Layoffs To Start In April At Closing Broomfield Plant 
Novartis, a Switzerland-based global health care company, will begin layoffs in April at its Sandoz division in Broomfield. The company announced the closure of its generic drug manufacturing facility late last year. The first wave of layoffs, set for April 7, will include 65 employees, according to a a notice filed by the company with the Colorado Department of Labor and Employment. (High, 2/9)

Stat: Greek Prime Minister Vows To Recover Billions 'Stolen' By Novartis In Bribery Scandal
The Greek government plans to recover billions of dollars from Novartis (NVS) for overcharging for medicines in connection with the sensational bribery scandal engulfing the country and embattling the drug maker. In comments to lawmakers on Monday, Greek Prime Minister Alexis Tsipras urged parliament to investigate allegations that Novartis bribed several former high-ranking government ministers and doctors in order to fix prices and boost sales to hospitals. (Silverman, 2/12)

Stat: Seeking Safety In Numbers, Ireland Wants To Join Multinational Coalition To Fight High Drug Prices
Underscoring a need to control the rising cost of medicines, the Irish government is holding talks with four other small European nations about joining their coalition that negotiates with drug makers. In a statement, Ireland’s health minister, Simon Harris, noted that he had sent a formal letter of intent to open negotiations with Belgium, the Netherlands, Luxembourg, and Austria to join their BeNeLuxA Initiative, which assesses the cost and benefits of medicines, and bargains over pricing. (Silverman, 2/13)

Los Angeles Times: Trump's Budget Plan Offers Little More Than A Band-Aid For Soaring Drug Prices
President Trump repeatedly has declared his unwavering commitment to improving healthcare and lowering drug prices. On Monday, he unveiled a $4.4-trillion budget plan that pointedly avoids taking meaningful steps to accomplish those goals. Instead, it offers tepid half-measures that are little more than Band-Aids for problems requiring major surgery. (David Lazarus, 2/12)

Huffington Post: Trump’s Promise On Drug Prices Looks Pretty Empty
President Donald Trump on Tuesday night pledged to bring down the price of prescription drugs. You should take this pledge as seriously as you take any other policy pledge of his ― which is to say, you shouldn’t take it seriously. Trump’s promise came about halfway into the State of the Union speech, and it was the most substantive thing he had to say on health care all night. (The Affordable Care Act, which was a primary focus of last year’s joint address to Congress, got barely any mention at all.) (Jonathan Cohn, 1/30)

JAMA: Legal Challenges To State Drug Pricing Laws
In recent years, growth in spending on prescription drugs has been fueled by high prices of new therapeutic products, increases in the prices of available brand-name drugs, and substantial price increases for a small fraction of older generic drugs. ...While the federal government has yet to enact major reforms, in 2017 some states passed laws intended to help manage and shed light on pharmaceutical prices. Most of these state legislative efforts have been challenged in court by industry associations that seek to invalidate these laws and stop them from going into effect. ...Even though these early decisions are being appealed, this review of the key issues at stake suggests that other states have a sound legal basis to take similar and even more expansive action to restrain drug prices and impose transparency requirements. (Theodore T Lee, Aaron S. Kesselheim, Amy Kapczynski, 2/12)

Bloomberg: Drug Price Growth Slows, Political Pressure Doesn't
Pharma's pricing power just isn't what it used to be, and it's probably not going to recover any time soon. Pharmacy benefit manager (PBM) Express Scripts Holding Co. last week reported a record-low 1.5 percent increase in drug spending by commercial health insurance plans in 2017. It also said per-beneficiary drug spending fell for many commercial plans and gave a discouraging forecast -- for drugmakers, anyway -- for the years ahead. (Max Nisen, 2/13)

Stat: Biosimilars: Cure For High Drug Prices Or Stake In The Heart Of Innovation?
The impact of drugs known as biologics is immense. Millions of patients are now treated with medications in this fast-growing class of therapeutic products and the market continues to grow. Biosimilars — medications designed to be similar or interchangeable with biologics — should further increase access to treatment and lower costs for patients facing serious diseases. But whether or not biosimilars will be able to make significant inroads into this market is still an open question. (Michelle Hoffmann, 2/8)

Forbes: Is Federal Policy Really To Blame For The High Cost Of Cancer Care?
U.S. healthcare costs have been high for decades, outpacing other developed countries since at least the 1980s. But costs continue to rise, and that is causing many experts to ask why. Some people blame federal policies. As an example, they point to reimbursement policies that create incentives for healthcare providers to consolidate. When hospitals merge with each other, or when hospitals buy out physician practices, healthcare providers gain negotiating leverage over insurers, which enables them to negotiate higher prices. But what evidence do we have that federal policies are to blame for such consolidation? (Peter Ubel, 2/8)

Forbes: How Much Profit Should Novartis Earn By Curing A Childhood Leukemia?
Last August, Novartis launched a new product that can cure the deadly childhood leukemia, acute lymphoblastic leukemia (ALL). The product, known as Kymriah, is the first of a class of therapies based on CAR-T technologies whereby a patient’s T-cells are removed, genetically modified, and then reintroduced to the same patient. These newly modified T-cells are then able to seek out and destroy one’s cancer cells. (John LaMattina, 2/12)

The Bulletin: Bill Would Unfairly Single Out Drug Manufacturers
State Sen. Dennis Linthicum, R-Klamath Falls, never has aimed to add a bunch more laws or regulations to the state. He wrote that Oregon needed “de-Legislators who will lessen the burdens placed on Oregon’s businesses, families and individuals. ”But he is one of the chief sponsors of a bill to add burdens on prescription drug companies. And it’s a bill that the Legislature should not support. (2/12)

The Washington Post: Trump Could Help Curb A Potential Pandemic. Instead, He Has Been Silent.
One in 10 Americans who died last week were killed by flu — more than from opioid addiction or breast cancer. The 2018 flu outbreak is on track to rival the swine flu epidemic of 2009, which made 60 million Americans sick, hospitalized more than a quarter of a million and killed more than 12,000. Of course, this epidemic is not the fault of the Trump administration, any more than 2009’s H1N1 outbreak was the fault of President Barack Obama’s White House. (Ronald A. Klain, 2/13)

The New York Times: How A Police Chief, A Governor And A Sociologist Would Spend $100 Billion To Solve The Opioid Crisis
The American opioid epidemic has defied all efforts to contain it, and the number of overdose deaths continues to grow. President Trump directed the Department of Health and Human Services to declare the opioid crisis a public health emergency in October and said “we have to do something about it” in his State of the Union address, but his administration has yet to pursue a specific strategy. (Josh Katz, 2/14)

Press Herald: Trump's Plan To Fight Opioids Has A Lot To Like
A president’s budget proposal is more a statement of his priorities than a spending plan, as Congress typically tosses it aside quickly in favor of its own work. And for most of the Trump administration’s budget, a cruel and irresponsible proposal released Monday, the bottom of a trash can would be too good of an end. But before the proposal is thrown promptly into the proverbial circular file cabinet, Congress should rip out the section on the opioid epidemic. For the first time, the Trump administration has provided a hint on how it wants to fight the deadly crisis – and there is a lot to like. As long as you ignore the bad stuff. (2/14)

The Hill: Congress Just Took Action On Technology-Enabled Medicare Reforms
Buried in the 650-page Bipartisan Budget Act passed on Friday were the most significant reforms recognizing the role of telehealth in care delivery since the Consolidated Appropriations Act of 2001, when Medicare was first required to begin reimbursement for telehealth services under a narrow set of circumstances. Among the provisions in the bill passed last week are landmark changes to facilitate telehealth in Medicare Advantage plans where 19 million seniors, or 33 percent of beneficiaries, get their care. In addition, the bill provides nationwide access to stroke telemedicine (also known as “telestroke”) and improve access to telehealth-enabled home dialysis therapy among Medicare beneficiaries, among other reforms. (Catherine Pugh, 2/13)

USA Today: Bezos, Buffett And Dimon Could Help Us Shrink Health Care Bureaucracy
The new health care company being formed by Amazon, Berkshire Hathaway and JPMorgan Chase intends to provide health care directly to their more than 1 million employees and will likely cut out parasitic middlemen like pharmacy chains and health insurers. This is a terrific idea and can only help cut down on bureaucratic red tape, while improving efficiency and saving money. (Marc Siegel, 2/13)

Seattle Times: Raise Smoking, Vaping Age To 21 And Save Lives
State lawmakers who care about the health of Washington youth need to vote to make it illegal to sell tobacco, either for smoking or vaping, to anyone under 21.Smoking is still the most common preventable cause of death, from cancer, heart disease and stroke. The saddest part of smoking-related statistics is the fact that this slow-motion death sentence usually begins in the teen years. That’s when 95 percent of adult smokers told a national survey they started, and when the brain is most susceptible to nicotine addiction. (2/13)

Kansas City Star: Vaccination Remains The Best Line Of Defense Against HPV-Related Diseases
Each year, the Centers for Disease Control and Prevention, or CDC, estimates nearly 80 million people are infected with the human papillomavirus (HPV), which has been linked to cancers of the mouth, throat, rectum, and cervix. ... Missouri ranked 46th out of 50 states with only 28.3 percent of girls completing the vaccination series, according to immunization rate data from 2014. The news is worse for boys as Missouri ranked last in the nation with only 11.3 percent receiving the vaccination doses. (Tammy Landrum, 2/13)

The New York Times: Treat Teenage Moms Like Moms, Not Children
Indianapolis — In Indiana, a 17-year-old can deliver a baby and then give a doctor permission to circumcise him. But during her delivery, she can’t give the doctors permission to give her an epidural. She needs her parents to consent to that, and they can refuse. The 17-year-old can consent to her infant’s hearing testing, vaccines and anything else the baby might need. But she cannot consent to a long-acting, reversible contraceptive — such as an IUD or an arm implant — to prevent her from getting pregnant again. Once again, she needs her parents’ permission, and if her parents aren’t around, she’s out of luck. (Tracey A. Wilkinson, Brownsyne Tucker Edmonds and Aaron E. Carroll, 2/13)

The New York Times: Last Things First For Patients With Bucket Lists
If a new study is correct, more than 91 percent of us have a bucket list — things we wish to do before we die. This revelation is interesting on several levels, including a question of what that minority of nearly 9 percent is thinking. Surely those people are aware that the chance of their kicking the bucket is 100 percent. Are we to believe that nothing in their basket of wishes is unrealized? The research, published last week in The Journal of Palliative Medicine, was based on a survey of 3,056 people across the United States. ...The study said that doctors might be better able to figure out the best courses of action for seriously ill patients. (Clyde Haberman, 2/13)