The New York Times: Senate Plans To End Obamacare Mandate In Revised Tax Proposal
Senate Republicans have decided to include the repeal of the Affordable Care Act’s requirement that most people have health insurance into the sprawling tax rewrite, merging the fight over health care with the high-stakes effort to cut taxes. They also have made a calculated gamble to help speed their bill to passage on a party-line vote: Republicans revealed late Tuesday they would set all of their tax cuts for individuals to expire at the end of 2025, to comply with a procedural requirement. Their deep cut in the corporate tax rate would remain permanent. (Kaplan and Tankersley, 11/14)

The Associated Press: Obama Health Mandate Now Target Of GOP In Big Tax Bill
The surprise renewal of the failed effort to eliminate the health care law's mandate came a day after President Donald Trump renewed pressure on Republican lawmakers to include the repeal in their sweeping legislation to revamp the tax system. It carries high political stakes for Trump, who lacks a major legislative achievement after nearly 10 months in office. The move by Republicans on the Senate Finance Committee upended the debate over the tax measure just as it was inching closer to passage following months of fine-tuning and compromise. (11/15)

CNN: By Combining Obamacare With Taxes, GOP Goes For It All
For Republicans, the benefits are tempting. If they can pull it off, it's a two-for-one victory. They will have overhauled the US tax code and taken a bite out of former President Barack Obama's signature legislative achievement, even if it falls short of the "root and branch" health care repeal many had vowed to see through. But if they fail, Republicans will enter the midterm election year with their message muddled, without a victory on tax reform, and having spent a year's worth of time trying and repeatedly failing to dismantle Obamacare with nothing to show for it but bad headlines. (Fox, 11/15)

The Washington Post: Senate GOP Changes Tax Bill To Add Obamacare Mandate Repeal, Make Individual Income Cuts Expire
Repealing the mandate, which compels most Americans to buy health insurance or pay a fine, would free up more than $300 billion in government funding over the next decade that Republicans could use to finance their proposed tax cuts, but it would result in 13 million fewer people having health insurance, according to projections from the nonpartisan Congressional Budget Office. (DeBonis and Paletta, 11/14)

The Wall Street Journal: Senate GOP Adds Health-Care Twist To Tax Overhaul Plan
Republicans plan to use the money freed up by repealing the mandate to direct tax cuts to middle-income households. They want to increase their proposed $1,650 child tax credit to $2,000 per child and lower the tax rates in three brackets, dropping the proposed 22.5%, 25% and 32.5% rates to 22%, 24% and 32%, respectively, according to the proposal, released Tuesday night by the Senate Finance Committee. (Armour and Rubin, 11/15)

Los Angeles Times: By Inserting Obamacare Repeal Into Tax Plan, Senate GOP May Complicate Passage
It remains to be seen whether Senate leaders can muster the 50 votes needed from their own party to pass the new version, though they expressed confidence. "We're optimistic that inserting the individual mandate repeal would be helpful," Senate Majority Leader Mitch McConnell (R-Ky.) said. (Mascaro and Puzzanghera, 11/14)

Politico: Hatch Adds Repeal Of Obamacare Mandate To Tax Bill
Sen. John Thune (R-S.D.) said he was confident that it could pass the Senate. “It’s been whipped,” said Thune, a member of the GOP leadership, adding that it’s an idea “we’ve been looking at for some time as a potential solution for some of the challenges that we’re facing in trying to make the bill do the things we’re trying to accomplish.” (Haberkorn, Kim and Becker, 11/14)

Columbus Dispatch: Portman Backs Killing Obamacare “Individual Mandate” To Finance Tax Cuts
Republican Sen. Rob Portman will support scrapping an Obamacare requirement that Americans buy health insurance, a move added to the Senate GOP tax cut that will help finance the proposal but could cause as many as 13 million people to drop their federally subsidized individual insurance policies. In a conference call with Ohio reporters Tuesday, Portman said there is “broad support” among Senate Republicans to kill the so-call “individual mandate,” which imposed fines on those who do not buy insurance policies through marketplaces established by the 2010 Affordable Care Act signed by former President Barack Obama. (Torry, 11/14)

The Wall Street Journal: Senate Republican Plan to Repeal Mandate Risks Higher Premiums
Democrats and industry groups castigated Senate Republicans on Tuesday for including the repeal in their tax package. An array of industry groups—including the American Medical Association and America’s Health Insurance Plans, a major insurers’ organization—wrote congressional leaders urging them to keep the mandate. “The tax bill is going to hit the American people with a health-care double whammy,” said Sen. Ron Wyden (D., Ore.), warning that millions would lose their health insurance or pay higher premiums. (Armour, 11/14)

Marketplace: The Senate Tax Bill Has A Health Care Throwback
Senate Republicans are working on a tax bill, and today Kentucky Sen. Rand Paul formally proposed an amendment that would get rid of the Affordable Care Act's individual health insurance mandate. Sarah Kliff is the senior policy correspondent at Vox and the host of the new podcast "The Impact." Marketplace host Kai Ryssdal called her up to do a little tax bill unpacking. (Ryssdal, 11/14)

Politico: Trump's HHS Secretary Nominee Boosted Drug Prices While At Eli Lilly
President Donald Trump tweeted Monday that his nominee for HHS secretary, Alex Azar will “be a star for … lower drug prices!” But the record of the former top executive for Eli Lilly, which tripled the price of a top-selling insulin drug while he led its U.S. operation, suggests a different story. Lilly is one of three drug companies targeted by a class-action lawsuit that accuses the company, then under Azar’s watch, of exploiting the drug pricing system to ensure higher profit for insulin and has been fined in Mexico for colluding on the pricing of the drug. (Karlin-Smith, 11/14)

Roll Call: HHS Pick At Odds With Trump’s Rhetoric On Drug Prices
President Donald Trump’s tweet Monday announcing former pharmaceutical executive Alex Azar as his choice to lead the Department of Health and Human Services boasted that Azar “will be a star for better healthcare and lower drug prices!” But Azar, who led drugmaker Eli Lilly and Co.’s United States operations from 2012 until earlier this year, has contributed significantly to the pharmaceutical industry political spending that the president has decried. (Siddons, 11/15)

Stat: On Drug Importation, Trump And His Pick To Lead HHS Are On Opposing Sides
In his quest to bring down drug prices, President Trump has advocated for policy proposals that the pharmaceutical industry opposes, including importing drugs from Canada. But his new health secretary pick — who, if confirmed, would immediately have the authority to kick-start some importation — has firmly rejected the idea. (Mershon, 11/14)

Bloomberg: Drug Costs In The Spotlight With Trump’s Pick For Health Secretary
The drug executive President Donald Trump has picked to lead the Department Health and Human Services isn’t likely to shy away from the topic of sky-high medication prices -- but it may be insurers and drug plans that feel the heat as much as his former industry. Trump’s pick, former Eli Lilly & Co. executive Alex Azar has talked about drug prices during interviews, speeches and panel appearances before leaving Lilly in January and in the months after. His remarks have paralleled a common industry argument, that it’s other parts of the pharmaceutical supply chain that bear a large share of the blame for U.S. outrage over drug costs. (Edney, Hopkins, Rausch, 11/14)

For more news on high drug costs, check out our weekly feature, Prescription Drug Watch, which includes coverage and perspectives of the issue.

The New York Times: Study Finds Competing Opioid Treatments Have Similar Outcomes
A long-awaited study has found that two of the main medications for treating opioid addiction are similarly effective, a finding likely to intensify the hard-fought competition between drugmakers seeking to dominate the rapidly expanding opioid treatment market. The study, funded by the federal government, compared Vivitrol, which comes in a monthly shot and blocks the effects of opioids, and Suboxone, which is taken daily in strips that dissolve on the tongue and contains a relatively mild opioid that helps minimize withdrawal symptoms and cravings. (Goodnough and Zernike, 11/14)

The Washington Post: Medications To Kick Opioid Addiction Are Equally Effective, Study Finds
The first major head-to-head comparison of medically assisted treatment approaches confirms that users now have two research-based options, according to the team of scientists led by Joshua D. Lee and John Rotrosen of New York University Medical School. But each method also showed a distinct disadvantage. (Bernstein, 11/14)

The Wall Street Journal: Opioid Addiction Study Finds The Drug Vivitrol, Once Begun, Is As Effective As Suboxone
“What is new, and what the study was really about from our perspective, was: What happens if you are able to get people onto one or the other medication?” said his colleague, John Rotrosen, another leader of the study and a physician and psychiatry professor at New York University School of Medicine. “What we were really hoping, and what we found was...the two medications would be sufficiently equal, so providers and patients and families really recognized they have a choice,” he said. (Whalen, 11/14)

Stat: Long-Awaited Study Finds Monthly Vivitrol As Effective As Daily Pill For Opioid Addiction
Previously, there’s been a “widespread belief” that patients “don’t do as well on naltrexone as they do on buprenorphine,” said Dr. Nora Volkow, director of NIDA. “We’re hopeful this changes the prejudice.” (Blau, 11/14)

In other news on the opioid crisis —

The Washington Post: 44 State Attorneys General Want Repeal Of Law That Curbed DEA Powers
Forty-four state attorneys general asked Congress on Tuesday to repeal a law that effectively strips the Drug Enforcement Administration of potent weapons against large drug companies that have allowed hundreds of millions of pain pills to spill onto the black market. The state law enforcement officials, many from places hit hard by the opioid epidemic, signed a letter from the National Association of Attorneys General to Republican and Democratic leaders in the House and Senate. Congress approved the law by unanimous consent, without a vote in either chamber, in 2016. (Bernstein and Higham, 11/14)

Boston Globe: Mass. Governor Aims To Expand Battle Against Opioid Addiction
Governor Charlie Baker proposed Tuesday a sweeping package intended to boost the state’s battle against opioid addiction, including an effort to ensure higher-quality addiction treatment and a new provision allowing doctors to commit unwilling patients to 72 hours in a treatment facility. Noting that the state has added 1,100 treatment beds since 2015, Baker said it is now time to address some of the gaps, particularly in the care provided after detoxification. (Freyer, 11/15)

Columbus Dispatch: DeWine Urging Congress To Restore DEA’s Power To Fight Opioid Epidemic
Ohio Attorney General Mike DeWine joined 43 other state attorneys general to ask Congress to repeal a law they argue has damaged the Drug Enforcement Agency’s ability to crack down on drug manufacturers and distributors that have contributed to the nation’s sweeping opioid epidemic. In a letter Tuesday to House and Senate leadership, the attorneys general argue that a bill passed by voice vote in 2016 made it more difficult for the DEA to take action against drug companies that were flooding communities with prescription painkillers. (Wehrman, 11/14)

The Nashville Tennessean: A Personal Quest To Give Doctors The Tools To Battle Opioid Abuse
A Memphis doctor who knows first-hand the pain of losing a child to an overdose is fighting to change medical education in Tennessee so there are more physicians throughout the state with addiction medicine expertise. (Fletcher, 11/14)

The Washington Post: FDA Warns Of ‘Deadly Risks’ Of The Herb Kratom, Citing 36 Deaths
The Food and Drug Administration issued a strong warning Tuesday to consumers to stay away from the herbal supplement kratom, saying regulators are aware of 36 deaths linked to products containing the substance. Consumers are increasingly using the supplement, which comes from a plant in Southeast Asia, for pain, anxiety and depression, as well as symptoms of opioid withdrawal. The herb also is used recreationally because it produces symptoms such as euphoria. Proponents say it is a safe way to deal with chronic pain and other ailments, and some researchers are exploring its therapeutic potential, including helping people overcome addictions. (McGinley, 11/14)

NPR: FDA Warns About Dangers Of 'Natural' Opioid Kratom
The Food and Drug Administration says there's insufficient evidence the supplement works to treat addiction or other problems and cited growing evidence it can be dangerous. Kratom may cause seizures, liver damage and withdrawal symptoms. "It's very troubling to the FDA that patients believe they can use kratom to treat opioid withdrawal symptoms," FDA Commissioner Scott Gottlieb said in a statement, adding that not only is there no reliable evidence that kratom is an effective treatment for opioid use disorder, there are FDA-approved medications that work. (Stein, 11/14)

NBC News: Kratom Products Can Kill You, FDA Says
“The FDA is aware of reports of 36 deaths associated with the use of kratom-containing products,” the agency’s commissioner, Dr. Scott Gottlieb, said in a statement. “There have been reports of kratom being laced with other opioids like hydrocodone. The use of kratom is also associated with serious side effects like seizures, liver damage and withdrawal symptoms.” (Fox, 11/14)

USA Today: FDA Chief Warns About Kratom To Treat Opioid Addiction; Will Seek More Regulatory Power
Kratom, a plant grown naturally in countries including Thailand and Malaysia, is widely sold in smoke shops and other locations as a powder that can be used in tea to slow the effects of opioid withdrawal. But it has addictive properties of its own, FDA says. public health advisory related to the FDA’s mounting concerns regarding risks associated with the use of kratom. (O'Donnell, 11/14)

The Washington Post: Damaged Bodies, Healing Hearts
Highway 52 curls around town and unspools around the rippling farmland. It is easy to miss the house tucked on a gravelly side road called Forgotten Lane, where Ty Bustamante often wakes before dawn. If it’s a bad day, he needs more time than usual to get dressed. Bending to tie his shoes, his body resists the last few inches until he wills his fingers to the laces. Ty turned 17 in October. A lineman for the Eldon High School Mustangs, he is in pain from old football injuries — a stress fracture to a lower vertebra, a bulging disk, a hard hit to his left hip. Ty recently started having seizures, as well as extreme anxiety, and the combination has kept him from playing this season. Still, he wears his No. 65 jersey at practice, trailing teammates around the field, handing them water bottles when they need a drink. (Nutt, 11/14)

The Associated Press: Scientists Try To Edit Faulty DNA Inside A Patient’s Body To Cure A Genetic Disease
Scientists for the first time have tried editing a gene inside the body in a bold attempt to permanently change a person’s DNA to try to cure a disease. The experiment was done Monday in California on 44-year-old Brian Madeux. Through an IV, he received billions of copies of a corrective gene and a genetic tool to cut his DNA in a precise spot. (11/15)

Minnesota Public Radio: What Are We Learning About How To Treat PTSD?
While the majority of men and women who were deployed to Afghanistan and Iraq returned to their lives feeling physically and emotionally fit, as many as 20 percent of all veterans who served in those war zones experience some symptoms of post-traumatic stress disorder. Why do some people experience PTSD, but not others? And what are we learning about how to treat it? MPR News host Kerri Miller spoke with Brian Engdahl, a neuroscience professor at the University of Minnesota, and the Anderson Chair in PTSD Research at the University of Minnesota Medical School. (Miller, 11/13)

CNN: Childbirth Is Killing Black Women In The US, And Here's Why
It remains complicated to answer why there has been a rise in deaths and why black women are more affected than women of other races, said Dr. Michael Lindsay, associate professor at the Emory University School of Medicine and chief of service for gynecology and obstetrics at Grady Memorial Hospital in Atlanta. (Howard, 11/15)

The New York Times: Peter Sands Named Head Of Global Disease-Fighting Agency
A former British banker was named executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria on Tuesday, taking over an international disease-fighting partnership that has struggled since its inception 15 years ago to raise enough money to fulfill its mission. (McNeil, 11/14)

NPR: Increased Hours Online Correlate With An Uptick In Teen Depression, Suicidal Thoughts
A study published Tuesday in the journal Clinical Psychological Science finds that increased time spent with popular electronic devices — whether a computer, cell phone or tablet — might have contributed to an uptick in symptoms of depression and suicidal thoughts over the last several years among teens, especially among girls. (Neighmond, 11/14)

The New York Times: Americans Are Putting Down The Soda Pop
Sugar-sweetened drinks are not as popular as they once were. According to a new study based on a continuing national health survey, 60.7 percent of children and 50 percent of adults drank a sugary beverage on any given day in 2014, down from 79.7 percent of children and 61.5 percent of adults in 2003. (Bakalar, 11/14)

Kaiser Health News: The Power Of #MeToo: Why Hashtag Sparks ‘Groundswell’ Of Sharing — And Healing
As a Ph.D. candidate in the social sciences more than 20 years ago, Duana Welch, 49, had done enough research to know the consequences she’d face by reporting sexual harassment in the workplace. “When women came forward with allegations of sexual abuse and sexual harassment, the woman was the person blamed and the woman was not believed,” she said. “I was very angry that I would pay the price for coming forward. I knew what would happen.” (Jayson, 11/15)

Stat: Electronics ‘Like A Second Skin’ Make Wearables More Practical And MRIs Safer For Kids
She’s a physicist who trained in the storied lab where Watson and Crick worked out the structure of DNA. In her years in industry, she made sharper displays for e-readers, more efficient solar panels, and sensor tape that soldiers could wear on the battlefield to measure the strength of explosions. Her manufacturing tool of choice: a simple printer. (McFarling, 11/15)

In other health technology news —

Kaiser Health News: Can Apps Slay The Medical Bill Dragon?
Rachael Norman needed to submit a pile of out-of-network medical bills to her insurance company for reimbursement. Short on time, she started searching for a company that could do that tedious work for her. She failed to find one, so she started one herself. (Wiener, 11/15)

The (Minneapolis) Star Tribune: Speak Up, And Risk Eviction
Across Minnesota, families who take maltreatment complaints to the state Department of Health encounter dead ends and delays, according to a Star Tribune review of public documents. Yet when they take their complaints directly to the management of their care homes, many find themselves facing retaliation, even the threat of eviction. Statewide, complaints about involuntary discharges and transfers from senior care facilities have surged 50 percent since 2012, according to public records. They are now the top reported grievance, with more than 600 complaints lodged in 2016. (Serres, 11/15)

Health News Florida/News Service of Florida: Nursing Homes Seek State Money For Generators
Florida's largest nursing-home association has one question as the 2018 legislative session approaches: Will the state help foot the costs of generators at nursing homes? But getting an answer is proving elusive. (11/14)

NPR: Hurricane Damage To Manufacturers In Puerto Rico Affects Mainland Hospitals, Too
At MedStar Washington Hospital Center, doctors and nurses are moving as many patients as they can from intravenous medications to the same drugs in pill form. If the patients are getting common antibiotics like ampicillin, and they can swallow, they're likely to be switched to pills, says Bonnie Levin, assistant vice president of pharmacy services for MedStar Health, which includes 10 hospitals in the Washington, D.C. area. (Kodjak, 11/15)

The CT Mirror: Senate Passes Hospital Tax Fix
The Senate voted unanimously Tuesday to fix a series of technical issues in the new state budget, including a flaw with the new hospital provider tax increase. ... “I think it’s good that the (Malloy administration) and the hospitals were able to come to terms” on the hospital tax, Senate Republican leader Len Fasano of North Haven said, adding he is confident this legislation — which the House is scheduled to consider Wednesday — would solve the disagreement between those two groups. (Phaneuf, 11/14)

Texas Tribune: Texas' Homeless Youth Slip Through Cracks Of Disjointed Support System, New Report Says
Homeless youth in Texas like [Gage] Kemp are inadequately supported due to a spotty system of programs and resources, according to a new report released Wednesday by Texas Appleseed and Texas Network of Youth Services. The report concluded that while a network of advocacy organizations serves many homeless youth across different parts of Texas, a lack of central authority or single definition of homelessness means a youth can cycle through the child welfare system, education system and juvenile justice system — jumping between being labeled a victim or an offender, eligible for resources in one system but not in another. (Arriaga, 11/15)

NPR: For Some Native Americans, Uranium Contamination Feels Like Discrimination
Helen Nez had 10 children. Now she only has three. Seven of her children died of a disorder called Navajo neuropathy, which is linked to uranium contamination. "Many people died and some have liver disease, kidney disease and some suffer from cancer as a result," Nez said through a translator. (Morales, 11/14)

Columbus Dispatch: Bill To Ban Down Syndrome Abortions In Ohio Headed To Full Senate
A bill that would further chip away at abortion in the state is now on its way to a vote by the full Senate after winning initial approval Tuesday in the Health, Human Services and Medicaid Committee in an 8-4 vote. Sen. Stephanie Kunze, R-Hilliard, strayed from her party and voted no. Senate Bill 164, sponsored by Sen. Frank LaRose, R-Hudson, would prohibit a person from performing or attempting to perform or induce an abortion on a woman whose unborn child has or might have Down syndrome. Violators would face a fourth-degree felony, and the state medical board would be required to take away a convicted physician’s license to practice medicine in Ohio. An identical bill passed in the Ohio House earlier this month, and this is Ohio’s Right to Life’s top legislative priority this year. (Henry, 11/14)

Los Angeles Times: In California, An Unexplained Increase In Valley Fever This Year
This year is shaping up to be the worst on record in California for people infected with valley fever, a lung infection caused by a fungus found in soil. State health officials announced earlier that 2016 broke the record for the most valley fever cases reported since the state started keeping count in 1995. Now, 2017 is on pace to have even more infections. (Karlamangla, 11/14)

California Healthline: Valley Fever Surging Again In California This Year
Valley Fever is shaping up to be worse this year than in 2016, when the number of cases hit a record high. Suspected cases of the fungal disease in the first 10 months of 2017 surged by more than one-third from the same period last year to 5,121, officials at the California Department of Public Health (CDPH) said Monday. That puts this year on track to surpass the number of cases recorded in 2016. (Bartolone, 11/14)

St. Louis Public Radio: Universal Design Improves Quality Of Life For People With Disabilities
Universal design involves designing buildings, products and services that meet the accessibility needs of everyone. It can help people with disabilities, but it’s intended for everyone. On Monday’s St. Louis on the Air, host Don Marsh talked about how the use of universal design can help people with disabilities and can improve the overall safety and quality of life of all people when used during disasters. (Hamdan, 11/13)

Arizona Republic: Behavioral-Health Facility Makes Third Attempt To Build In Gilbert
A behavioral-health center twice rejected in Gilbert is trying again. Kentucky-based Springstone proposes to open Copper Springs East near other medical facilities, including Mercy Gilbert Hospital. In 2013, residents twice defeated the proposed facility, saying it would be too close to neighborhoods and an elementary school. (Mo, 11/14)

Stat: Keeping The Register Ringing: Many Old Drugs Have Plenty Of New Patents
To most people, “evergreen” refers to a tree that manages to keep its leaves no matter what. But the term has another, highly contentious meaning when discussing prescription drugs — the use of additional patents to extend the monopoly on a medicine and keep cash registers ringing. Drug makers have long argued their patent modifications reflect substantive enhancements, but the practice has prompted complaints that companies often make minor changes in order to thwart generic competition. And a new study shows the approach may be more pervasive than thought — at least 74 percent of medicines associated with new patents were already on the market. (Silverman, 11/8)

FiercePharma: With Only 2 Warnings In 2017, Pharma's Ad Police Hits Historic Low
As the end of the year nears, the pharma industry can usually look back at FDA enforcement letters for insight into the agency's thinking and guidance on marketing communications. But this year, there’s not much to review. The Office of Prescription Drug Promotion (OPDP) has issued only two letters so far in 2017. Last year at this same time, OPDP had issued five letters, with six more to come in December for a total of 11 warnings or untitled letters to drugmakers. (Bulik, 11/14)

Modern Healthcare: Growth In Healthcare Prices Slows To Near-Historic Low
Healthcare prices rose just 1.1% year-over-year through September, representing the lowest price growth rate in roughly two years, according to a new report from Altarum. That growth rate was just slightly higher than the all-time low growth rate of 0.9% in December 2015. The figure has fluctuated between 1.2% and 2.3% over the past year. The small increase in healthcare prices was likely due in large part to a decline in prescription drug prices, according to the report. Price growth for prescription drugs dropped to 1.4% in September from 2.7% in August. (Castellucci, 11/9)

Stat: The FTC Takes The Long View In Effort To Foster Prescription Drug Competition
With a slew of congressional hearings that have proved to be more about posturing than policy, presidential pronouncements about murderous drug companies, and rumors of executive orders that never materialize, it’s easy to grow disillusioned by the debate over drug prices in Washington. But as the Federal Trade Commission prepares to host federal officials and other experts to discuss the issue Wednesday, there’s an unusual degree of excitement about the possibility that the agency — which can function as part law office, part think tank — could effect meaningful change to rein in prices. (Swetlitz, 11/7)

FiercePharma: With New Digital Abilify, Big Brother Isn't Watching—But Your Mother Could Be
A new digital version of Abilify is the first-ever pill to notify patients that they've swallowed it. It may be the first in a wave of dose-tracking drugs that could appeal to patients who forget to take their pills and to payers looking to get their money's worth out of their members' prescriptions. The pill and its digital companions, now FDA-approved as Abilify MyCite, aren't likely to make a big difference to Otsuka's Abilify sales—certainly not immediately, given its plans for a limited initial launch. The atypical antipsychotic drug is already available as a cheap generic, and doctors are already using an injectable, long-lasting version—Abilify Maintena—to manage patients who have problems sticking to a daily pill regimen. Payers may be wary of the costs. (Staton, 11/14)

Healthline: What Would Happen If Medicare Started Negotiating Drug Prices?
Officials in the Medicaid program do it. The people at the U.S. Department of Veterans Affairs do it as well. So why don’t the folks overseeing the Medicare program negotiate with pharmaceutical companies over the price of prescription drugs? (Mills, 11/13)

Reuters: Allergan To Sell A Quarter Of Its Teva Stake In First Quarter 2018
Allergan Plc said on Monday it will sell just under a quarter of its roughly 10 percent stake in Israel's Teva Pharmaceutical Industries during the first quarter of 2018, as it starts to unwind its position in the struggling generic drugmaker. Botox maker Allergan said in a filing with the Securities and Exchange Commission that it will sell 25 million shares to a JP Morgan Chase and Co unit - acting as a dealer for the shares - sometime next quarter. The JP Morgan unit will pay a price based on the average trading price over a yet-to-be determined period before the sale. (Erman, 11/13)

The Wall Street Journal: Pfizer Sets Up Succession Plan With Creation Of Operating Chief Role
Pfizer Inc. named executive Albert Bourla to a newly created position of chief operating officer, putting him first in line to succeed Chief Executive Ian Read at the helm of one of the world’s largest drug companies. In the new role, which takes effect Jan. 1, Dr. Bourla will oversee all sales, strategy, manufacturing and later-stage drug development at Pfizer. Drug research, financials, compliance and human resources will keep reporting to Mr. Read. (Rockoff, 11/13)

Reuters: AstraZeneca Rides China Wave As Rival GlaxoSmithKline Struggles
AstraZeneca is enjoying booming drug sales in China, helped by reforms to the country's regulatory system and an increased sales force, in sharp contrast to its British rival GlaxoSmithKline. China revenue in the third quarter increased by 12 percent at AstraZeneca and the country now accounts for 15 percent of its global product sales - a far higher proportion than at other big pharma companies. (Hirschler, 11/9)

Stat: Sarepta Gets A Belated, But Helpful, Boost From Anthem For Its Pricey Drug
In a boost for Sarepta Therapeutics (SRPT), the last remaining large health insurer has agreed to cover its pricey treatment for a rare form of muscular dystrophy. In a policy bulletin issued on Thursday, Anthem (ANTM) declared Exondys 51 to be “medically necessary,” reversing a decision made a year ago not to reimburse the drug, which had just been approved to treat Duchenne muscular dystrophy amid controversy about underlying clinical data. (Silverman, 11/10)

The Wall Street Journal: Cardinal Health Pulls Back From China
Cardinal Health Inc. has agreed to sell its Chinese pharmaceutical and medical-products distribution business to a local rival, in the latest pullback by a U.S. company in the world’s second-largest economy. In a statement, Hong Kong-listed Shanghai Pharmaceuticals Holding Co. said Wednesday it would acquire Cardinal Health China for $557 million after the exclusion of debt and other accounting adjustments. It put the “base payment” figure at $1.2 billion, the same price tag Cardinal Health attached to the deal in a separate release. (Chiu, 11/15)

Los Angeles Times: Swamp Deepens As Trump Names Former Drug Industry Exec To Be Health Secretary
Alex Azar, President Trump’s pick to serve as Health and Human Services secretary, represents everything wrong with the incestuous relationship that often exists between government officials and the industries they oversee. This is a guy who, after being active in George W. Bush’s presidential campaign, landed a plum job with the Department of Health and Human Services despite being a lawyer with no background in healthcare. (David Lazarus, 11/15)

US News & World Report: A Pick For Lower Drug Prices?
President Donald Trump announced Monday he is nominating former pharmaceutical executive Alex Azar as secretary of Health and Human Services. Azar would fill the Trump administration position vacated by Tom Price, who resigned in September amid criticism of his use of private planes as HHS secretary. Under President George W. Bush, Azar served as HHS general counsel and deputy secretary. He stepped down as president of the U.S. affiliate of pharmaceutical giant Eli Lilly in January. Trump tweeted Monday that his HHS secretary pick would "lower drug prices." (Hayley Hoefer, 11/13)

Stat: Hey, Amazon: As A Pharmacy Benefit Manager, You Could Create Real Competition For Drug Prices
Two immense problems plague the prescription drug marketplace: The costs of prescription drugs are spiraling out of control, and few people are able to access accurate information about drugs’ effectiveness, safety, or side effects, all of which are needed for wise use of these drugs. Pharmacy benefit managers (PBMs) are contributing to the cost problem and failing to address the information problem. (Linda Cahn, 11/15)

The Wall Street Journal: How Big Pharma Sandbags Generic Competition
Drug companies are always figuring out creative ways to sustain high prices on brand-name medications. In the latest twist, Allergan this fall transferred the patents covering its eyedrop Restasis to the sovereign St. Regis Mohawk Tribe, admitting outright that its goal was to prevent the patents from being overturned. (Carrier, 11/14)

Stat: The Pentagon Wants To Approve Drugs For The Battlefield. Here’s Why That’s Dangerous
Some ideas are bad. Others are simply terrible. A group of congressional lawmakers has found a way to put military personnel at risk and undermine regulatory standards for approving medicines — all at once. Under legislation that was crafted by House and Senate negotiators, a special Department of Defense panel would be authorized to approve certain drugs and devices for emergency use when members of the armed forces confront “agents of war.” (Ed Silverman, 11/14)

Stat: Medicaid ‘Best Price’ Approach To Drug Costs Needs An Upgrade
Discussions on access to prescription drugs are back in vogue in the nation’s capital, where the Senate recently convened a fiery hearing on the drug delivery system and President Trump is reiterating a commitment to addressing the cost of prescription drugs. One way to rein in drug costs would be to reduce government interference in arrangements between drug makers and insurers that reward better patient outcomes and lower costs. (Joel White, 11/10)

Des Moines Register: High Drug Costs: What Can We Do?
A Consumer Reports Best Buy Drugs national telephone poll survey recently reported three fourths of Americans 65 and older currently take an average of six prescription medications. The poll also reported one third of people over 65 experienced drug costs increases during the previous 12 months and paid an average of $53.00 more for at least one of their drugs. Other drugs have increased as well. Even though Americans over 65 have insurance coverage such as Medicare, drugs continue to increase and out-of-pocket costs for drugs increase as well. Many individuals live on a fixed income feel the price pain. (Keith Miller, 11/14)

Forbes: Laws To Control Cancer Drug Costs Don't Help Patients With Highest Expenses
When state legislators started enacting laws in 2011 to prevent insurance companies from charging patients more for oral cancer drugs than they do for cheaper, infused medicines, the idea was to shield the public from sky-high, out-of-pocket drug costs. But a new study is raising disturbing questions about the effectiveness of these “parity” laws, which have been enacted in 43 states and the District of Columbia. (Arlene Weintraub, 11/9)

Medscape: Combination Therapies: A Tipping Point For Cancer Drug Costs?
This question often comes up: At what point will we reach a critical tipping point where we can't afford to provide the therapies that we want? This is becoming a problem as we start to think about multiple combination therapies, either combinations of novel immuno-oncology agents such as checkpoint inhibitors, novel targeted agents, or a combination of targeted agents and checkpoint inhibitors. (Leonard B. Saltz, 11/9)

JAMA: High Costs Of FDA Approval For Formerly Unapproved Marketed Drugs
In May 2017, the US Food and Drug Administration (FDA) announced a Drug Competition Action Plan, designed to address competition and pricing in the generic market and improve access to prescription drugs.1 One of FDA’s stated goals is to reexamine “places where its rules—including standards and procedures related to generic drug approvals—are being used in ways that may create obstacles to generic access,” instead of ensuring the vigorous competition Congress intended. In this Viewpoint, we examine FDA’s 2006 Unapproved Drugs Initiative (UDI), designed to strengthen the agency’s regulatory oversight related to unapproved marketed drugs. Using an illustrative example, we discuss this initiative’s unintended consequences, as it appears to have created obstacles to generic drug access, likely increasing prescription drug costs. (Aaron Hakim, Ravi Gupta and Joseph S. Ross, 11/13)

JAMA: Pediatric Exclusivity And Regulatory Authority: Implications Of Amgen V. HHS
In May 2017, the US Food and Drug Administration (FDA) denied a 6-month extension of market exclusivity for Sensipar (cinacalcet), a drug manufactured by Amgen to manage hypercalcemia, common among patients with end-stage renal disease who are undergoing dialysis. The FDA determined that Amgen’s pediatric studies had been conducted inadequately and had provided inconclusive safety data. Amgen brought a lawsuit, Amgen v HHS (US Department of Health and Human Services), to challenge the denial. If Amgen prevails, it can delay generic competition for 6 months for a drug that generated $1.24 billion of revenue in 2016.2 More broadly, a decision favoring Amgen could diminish the FDA’s ability to encourage clinically meaningful pediatric studies and thus undermine the purpose of Congress in offering patent extensions to reward pediatric research. (Jeanie Kim, Joseph S. Ross and Amy Kapczynski, 11/8)

The New York Times: This Tax Bill Is Now A Health Care Bill
Republican leaders in the Senate somehow needed to find an extra few hundred billion dollars. They needed to find that money because they want to cut taxes on the wealthy — and cut them deeply. By the time the Senate leaders had finished coming up with all of their top-end tax cuts last week, their bill was projected to cost more than the House had previously committed to spending. (David Leonhardt, 11/15)

The New York Times: Obamacare’s Insurance Mandate Is Unpopular. So Why Not Just Get Rid of It?
In a bill with many unloved parts, the Affordable Care Act’s individual mandate has long been the most loathed. For years, critics of the bill have said the law’s requirement that Americans either obtain insurance or pay a fine was coercive and unfair. The mandate brought about a Supreme Court case that nearly toppled the whole Affordable Care Act. Public opinion polls consistently show that ordinary Americans dislike it. ... But there’s a reason that Obamacare’s authors kept a provision so unpleasant and unpopular. And there’s a reason the budget office said that cutting it would save so much money. (Margot Sanger-Katz, 11/14)

Stat: Dear Alex Azar: The Next HHS Secretary Must Redefine ‘Affordable’ Health Care
Affordability matters. If insurance were more affordable, much of the debate about the future of health care would be moot. Conservatives’ concerns about the increasing cost of entitlement programs, or about the onerous nature of ACA mandates, would largely disappear as more Americans would simply purchase affordable insurance on their own. This should be of great concern to former pharmaceutical executive Alex Azar, President Trump’s nominee to lead the Department of Health and Human Services. (Arthur “Tim” Garson, Jr., 11/14)

The Des Moines Register: Work For Medicaid? Health Care Ensures People Are Well Enough To Get A Job
President Lyndon B. Johnson may have rolled over in his grave when Seema Verma quoted him last week. The administrator of the Centers for Medicare and Medicaid Services was outlining her philosophy on Medicaid in a speech to state health care officials. She announced states will, for the first time, be allowed to impose work requirements on low-income Americans who rely on the government health insurance. Verma is catering to a handful of Republican governors who want to require employment or participation in job programs to qualify for coverage. (11/14)

Columbus Dispatch: Restore Federal Funding For Children’s Health Care
Nearly a quarter of a million Ohio children are at risk of losing their health-care coverage this holiday season — that is, unless Congress acts. For the past 20 years, the Children’s Health Insurance Program (CHIP) has provided health care coverage to millions of uninsured children. In Ohio, the state’s CHIP program, commonly known as Healthy Start, provides coverage to an estimated 223,583 children. Yet, in a move that has all the makings of a modern-day Ebenezer Scrooge, the Republican-controlled U.S. Congress recently failed to reauthorize funding for CHIP, allowing funding for the program to lapse at the end of September. More than a month later, Congress still has not restored funding. (Kay Wilson, 11/14)

Kansas City Star: Rep. Jenkins, Don’t Let Congress Make Kansas’ Tax Mistake
This week, Congress — including Kansas Rep. Lynn Jenkins — is considering tax legislation with far reaching consequences. According to analysis from the nonpartisan Institute for Taxation and Economic Policy, many middle-class families will see tax increases, while the wealthiest 1 percent get an average tax cut of more than $64,000 by 2027. But what’s most striking is how much this plan resembles Kansas Gov. Sam Brownback’s disastrous 2012 tax experiment. Like that plan, the current congressional proposal slashes the income tax rate for the wealthy and cuts the top rate for “pass-through” income earned by wealthy individuals, including President Donald Trump. We all know what happened here at home: We plunged into a statewide budget crisis and saw deep funding cuts for education, health care, infrastructure and environmental protection. (Sarah LaFrenz, 11/14)

Stat: I’ve Unconsciously Contributed To The Racial Gap In Infant Mortality. Not Anymore
I have spent 45 minutes during morning rounds chatting with mothers who visit their babies early every morning and stay all day. Then there are parents who miss my daily rounds because parking downtown is expensive and they must park during off hours to get a discount who I don’t take the time to call every day. Since I have recognized this unintentional but nonetheless deplorable behavior in myself, I am making an effort to adjust my actions so my biases don’t affect the babies under my care and their parents. (Nana Matoba, 11/14)