- KFF Health News Original Stories 3
- Back To The Future: Insurance Pools For High-Risk Patients Could Be Revived
- California Braces For Medi-Cal’s Future Under Trump And The GOP
- Long-Stalled FDA Reform Sits On Senate’s Lame-Duck Calendar
- Political Cartoon: 'Family History'
- Health Law 2
- Heritage Foundation Urges Congress To 'Go Further' On Repeal
- Trump Meets With Architect Of Indiana's Novel Medicaid Expansion Program
- Administration News 1
- Potential HHS Pick Tom Price Big Proponent Of Returning Health Decisions To States
- Marketplace 2
- Alaska's 500 Sickest Residents Were Driving Up Costs For Everyone. So The State Stepped In.
- Americans Are Visiting Doctor, Hospital Less, But Health Care Spending Is Still Going Up
- Public Health 4
- Babies Can Develop Microcephaly From Zika Months After Birth
- Roundup: Drug Side Effects Sending People To ER; Human Eye Transplants; Infectious Disease In U.S.
- Toys To Avoid At Christmas: Annual Report Identifies 44 Dangerous Items
- Miami Program Helps Hispanics Prevent Or Manage Diabetes
- State Watch 1
- State Highlights: Health Care Spending In Ga. Higher Than National Average; Minn. Makes Gains Against Childhood Obesity
- Prescription Drug Watch 2
- Alzheimer's Drug May Help Beleaguered Pharma Industry To Close Out Year On High Note
- Perspectives: Don't Expect New Diabetes Drugs To Ease Pricing Crunch
From KFF Health News - Latest Stories:
Trump and leading Republicans like the idea. Some policymakers and experts say it wasn’t viable in the first place. (Pauline Bartolone, )
California officials jumped at the chance to cover millions more low-income people by expanding its Medicaid program. Now, health policymakers and advocates fear the Trump administration and a Republican-ruled Congress will roll back the state’s progress. (Anna Gorman and Pauline Bartolone, )
The legislation would give federal officials more flexibility in evaluating the effectiveness and safety of drugs and devices and add billions of dollars to NIH funding. But critics say it could endanger patients’ safety and doesn’t do enough to stop spiraling drug prices. (Steven Findlay, )
KFF Health News provides a fresh take on health policy developments with "Political Cartoon: 'Family History'" by Steve Kelley and Jeff Parker, from 'Dustin'.
Here's today's health policy haiku:
A DAY FOR COMING TOGETHER
Move health care debate
To the side to celebrate.
If you have a health policy haiku to share, please Contact Us and let us know if we can include your name. Haikus follow the format of 5-7-5 syllables. We give extra brownie points if you link back to an original story.
Opinions expressed in haikus and cartoons are solely the author's and do not reflect the opinions of KFF Health News or KFF.
KHN's Morning Briefing will not be published Nov. 24-25. Look for it again in your inbox Nov 28.
Summaries Of The News:
The conservative think tank lays out a "repeal and replace" plan that would roll back the ACA's rules around plans' age rating, essential benefits and actuarial value limits. Its experts also say Republicans should institute "sensible rules" to maintain protections for patients with pre-existing conditions but prevent those patients from gaming the system.
Heritage Proposes Obamacare Replacement For 2019
Two health policy experts with the Heritage Foundation are proposing that Congress repeal Obamacare in 2017, but wait to implement a replacement until the 2019 plan cycle. In a report released Tuesday, Heritage’s Nina Owcharenko and Ed Haislmaier write that the incoming Trump administration and Congress should take steps to stabilize the marketplace in 2018 and pass a replacement plan for 2019. They also back lawmakers passing a fiscal 2017 budget early next year, creating two opportunities for lawmakers to pass reconciliation bills in 2017. (McIntire, 11/22)
Heritage Foundation Sketches Out Roadmap For Obamacare Repeal
A new Heritage Foundation report urges Congress to "initiate repeal" of the Affordable Care Act in January, but wait until 2018 to begin implementing a replacement plan. ... The Heritage authors recommend that Republicans take immediate steps to roll back Obamacare-related regulations and push states to develop alternate insurance reforms. However, they say that it's too late to push through a replacement for the 2018 plan year since insurers will be finalizing 2018 offerings by the spring. (Diamond, 11/22)
In other health law news —
The Fiscal Times:
The Health Care Industry Is In A Panic Over Obamacare Repeal
[T]he GOP’s crusade to finally destroy Obamacare has the health care industry in an uproar, with strong indications that major insurers could accelerate their departure from the ACA exchanges. At the same time, hospital administrators are in a panic, fearing that they will incur massive financial losses if millions of Americans lose their health care coverage under Obamacare or expanded Medicaid. (Pianin, 11/22)
Pressure Builds On $73M ObamaCare Funding Case As Others Wait
Anticipation is swirling around a case involving funding for an Illinois ObamaCare co-op as the Department of Justice (DOJ) seeks to delay a number of similar cases with other insurers. Land of Lincoln’s $73 million lawsuit was an early win for the administration when a federal judge dismissed it last week, and now the DOJ is pushing to hold off on other cases until Land of Lincoln’s appeal is resolved. Republican lawmakers have termed the “risk corridor” funding — designed to help soften the financial blow of insuring sicker members — a “bailout” for insurance companies, and have introduced legislation to block any potential settlements. (Clason, 11/22)
California Healthcare Advocates Rally Against Trump
The federal healthcare overhaul could be one of the first casualties of President-Elect Donald Trump, who has joined the Republicans controlling Congress in vowing to dismantle the law. ... Still, Trump’s election has California healthcare advocates on high alert, not to mention the state’s new U.S. senator. California could forfeit billions of federal dollars that support Medi-Cal, the insurance program for poor Californians, and subsidize private insurance purchases. (White, 11/22)
While Indiana was one of few red states to adopt the health law's expansion, it added a requirement that many low-income residents help contribute financially to their health coverage. Meanwhile, other Republican-led states are watching closely to see how Washington wants to change the Medicaid system.
Los Angeles Times:
One Of Donald Trump's Meetings Might Offer A Clue For How He Wants To Replace Obamacare
Donald Trump has consistently vowed to repeal and replace Obamacare. But he has yet to explain what he intends to replace it with. His meeting schedule today might offer a clue of what he is pondering. On the agenda is a chat with Seema Verma, an architect of Indiana’s unusual healthcare program for the poor. Indiana is among a handful of red states that took federal aid through the Affordable Care Act to expand Medicaid eligibility to poor, childless adults. (Levey, 11/22)
Trump's Win Puts Medicaid Expansion On Hold In Red States
Several states led by Republican governors appear to be putting Medicaid expansion under the Affordable Care Act on hold given talk by the incoming administration of Donald Trump to scrap the law or move to federal block grants to cover poor Americans. State elected officials in Idaho, Nebraska and South Dakota and political pundits in Georgia are saying talk of expanding Medicaid before the election has now subsided at least for the 2017 legislative sessions. That means more than 500,000 Americans will have to wait for health benefits. (Japsen, 11/22)
Wisconsin Public Radio:
Wisconsin Republicans Eye Possible Federal Move To Medicaid Block Grants
Wisconsin Republican leaders hope Medicaid block grants are in the state's future. A change to how the federal government disburses Medicaid funding to states would have to be made in Washington, D.C., but Gov. Scott Walker and Assembly Speaker Robin Vos, R-Rochester, have both made comments in the past week that indicate they're optimistic about the possibility of that change. House Speaker Paul Ryan has been a longtime supporter of block grants and President-elect Donald Trump has also said he supports them. (White, 11/22)
And in other Medicaid news --
TennCare Officials, Feds Near Waiver Deal
TennCare officials are nearing an agreement to extend the state’s expired Medicaid waiver as they contemplate the program's structure and operations under the incoming Donald Trump administration. The agency received a draft of waiver language from the U.S. Centers for Medicare and Medicaid Services on Nov. 19 and is in the process of reviewing the proposed changes — much of which involve the structure of funding pools that help hospitals offset uncompensated care costs. (Fletcher, 11/22)
Kansas Health Institute:
Suit Against State A Symptom Of National Failures On Medicaid Verification System
A nursing home chain’s lawsuit against the state of Kansas hinges largely on the state’s failure to implement an electronic system to verify the assets of people applying for Medicaid. But Kansas is far from the only state to fall short on that score.“ It is a nationwide issue — from Maryland to Alabama to, you know, Texas,” said Chad Bogar, a managing partner at the firm that is handling the lawsuit on behalf of the Evangelical Lutheran Good Samaritan Society. “The one state that I know which is doing a really good job with it has been Florida. Florida has a really good system set up.” (Marso, 11/22)
Georgia Rep. Tom Price was one of the first to put forward his own replacement plan in proposed legislation.
As HHS Secretary, Price Would Likely Focus On State Healthcare Reform
As President-elect Donald Trump continues to fill out his cabinet, the key position of HHS secretary is still open. Insiders expect an announcement soon, and have their eyes on Georgia Rep. Tom Price, who is expected to concentrate on state reform efforts and is known for working across the aisle. Price, an orthopedic surgeon from Georgia who is used to having considerable influence on health policy, was quick to support Trump's bid for the White House. He spoke on Trump's behalf at rallies, often focusing on complaints about the Affordable Care Act. He was seen entering Trump Tower in Manhattan last week where the presidential elect was hosting multiple potential cabinet picks. (Muchmore, 11/22)
In other administration news —
Is The EPA’s Landmark ‘Endangerment Finding’ Now Itself Imperiled?
In the crosshairs of his agenda — according to written statements the Trump campaign made shortly before the Nov. 8 election — is a 2009 determination by the U.S. Environmental Protection Agency that greenhouse gases are dangerous to human health and security, a ruling that serves as the foundation for the EPA’s efforts to curb climate-damaging emissions and that affects its governing of everything from automobile exhaust to power plants to refrigerators. ... The EPA did that — examining everything from the potential for more damaging hurricanes, to death rates due to ozone and heat exposure, to deadly exposure to pathogens — and concluded in unambiguous terms that there was “compelling” reason to believe the gases threaten the health of Americans, and that the threat would get worse. (Lustgarten, 11/22)
The state's "high-risk pool" approach could serve as a model to Republicans who want to dismantle the health law but retain the popular provision that no one can be denied coverage for pre-existing conditions.
The Wall Street Journal:
Alaska’s Novel Plan To Cut Health Premium Costs
Health-insurance premiums for individuals in Alaska have been soaring almost 40% a year. The main reason: the cost of covering fewer than 500 residents who are among the sickest in the state, according to one state analysis. That prompted the state government to come up with a novel solution. It agreed in June to kick in $55 million for at least a year to cover the health-care costs for those patients, whose outsize medical bills prompted insurers to boost premiums for all 23,000 customers in an effort to remain profitable. (Raice and Wilde Mathews, 11/22)
Back To The Future: Insurance Pools For High-Risk Patients Could Be Revived
It wasn’t so long ago that health insurance horror stories fueled discussions around the family dinner table and the national debate over health care reform. “One company said I was too heavy,” said Scott Svonkin, of Los Angeles, of the time he was denied an individual health policy in 2005. Svonkin, 50, said two other insurers seemed OK with his weight but also turned him down, citing his asthma and his wife’s pregnancy, which could put the insurers on the hook for a dependent whose health was uncertain. (Bartolone, 11/23)
Previous KHN Coverage: Sounds Like A Good Idea? High-Risk Pools
Prescription drug costs are a big part of the reason, an analysis finds.
The Fiscal Times:
Here’s Why You’re Paying More For Health Insurance
Americans are visiting their primary care physicians and hospitals less frequently, but they’re paying more for health care nevertheless. The number of visits to hospitals, emergency rooms and primary-care doctors has declined every year since 2012, according to new data from the Health Care Cost Institute, while the use of outpatient services and specialists has gone up. Regardless of how they access medical services, however, Americans are seeing higher prices, as the cost of care increased across every category of care. (Braverman, 11/22)
In other marketplace news —
The New York Times:
Where Marijuana Is The Doctor’s Orders, Will Insurers Pay?
Early this year, a disabled former automobile body worker named Greg Vialpando explained to lawmakers in New Mexico how medical marijuana helped his chronic back pain. State legislators were considering a bill backed by workers’ compensation insurers that would have exempted them from paying for medical marijuana. But Mr. Vialpando and another patient described how smoking the drug let them escape years of stupor caused by powerful prescription narcotic drugs known as opioids. (Meier, 11/22)
Zika-infected infants who are born healthy can go on to develop severe brain damage, researchers discover.
The New York Times:
Microcephaly Found In Babies Of Zika-Infected Mothers Months After Birth
It is the news that doctors and families in the heart of Zika territory had feared: Some babies not born with the unusually small heads that are the most severe hallmark of brain damage as a result of the virus have developed the condition, called microcephaly, as they have grown older. (Belluck, 11/22)
The Washington Post:
Normal Head Size At Birth Doesn’t Rule Out Microcephaly, Zika Syndrome After Birth
A study released Tuesday by the Centers for Disease Control and Prevention provides disturbing new data about a small group of Zika-infected babies in Brazil, who were born with normal-size heads but developed microcephaly five months to a year after birth. The report is the first to document infants with laboratory evidence of Zika infection in utero who experienced “poor head growth with microcephaly developing after birth.” Although other researchers have described cases of babies developing microcephaly after birth, they could only presume that those infants had been infected congenitally. (Sun, 11/22)
CDC: Zika Effects Can Appear Months After Birth
Babies born with the Zika virus may develop life-threatening brain abnormalities months after birth, according to a new study by U.S. researchers. The study, which was published Tuesday by the Centers for Disease Control and Prevention (CDC), raises a new cause alarm for the thousands of pregnant women infected with the virus worldwide. For the first time, the CDC confirms that Zika-infected infants who appear to be born healthy could go on develop severe brain damage as early as five months after birth. (Ferris, 11/22)
Also in the news: sugary drinks, anti-aging benefits of blood transfusions, sunscreen recommendations, brain injuries and non-sterile sterile products.
Drug Side Effects Have Led To Increased ER Visits In Older Americans
Side effects from medication are causing more older Americans to visit emergency rooms and leading to more hospitalizations, according to an analysis of ER data from 2005-2006 and 2013-2014. And across all age groups, the drugs most often causing side effects that sent people to an ER were the same ones identified a decade ago —anticoagulants, antibiotics, diabetes agents, and opioid analgesics. These were among the findings in a study that examined emergency department visits for adverse reactions to medicines in 2013 and 2014, compared with 2005 and 2006. (Silverman, 11/22)
Researchers Aim For First Human Eye Transplant Within The Decade
Scientists have strived for successful eye transplants for centuries. Early attempts read like the diary of Mary Shelley: implanting a dog’s eye into a rat’s groin, transplanting a rat’s eye onto the neck of another rat, plucking the eye of a sheep from one socket and placing it into the other. But never has a whole-eye transplant been successfully done in a living person. The eye’s complex web of muscles, blood vessels, and nerves — connected directly to the brain — has doomed past experiments to failure. Now a team of Pittsburgh transplant surgeons aims to turn that tide, and they’re hopeful they can do so in just the next decade, using donor eyes to restore sight in people who have suffered traumatic eye injuries. (Hare, 11/23)
100 Years Of Infectious Disease In The United States
Infectious diseases are no longer the major killers in the U.S. that they once were, but they still surprise us. According to a report published Tuesday in JAMA, the journal of the American Medical Association, deaths from infectious disease accounted for 5.4 percent of deaths from 1980 to 2014. (Hobson, 11/22)
The New York Times:
Creeping Progress In Pledge To Cut Calories In Sugary Soda
It hasn’t been a good year for the troika that dominates soft drink sales, Coca-Cola, PepsiCo and Dr Pepper Snapple. The public’s attention on the health effects of sugary sodas has continued to increase, slowing growth and increasing political pressure. This year, soft drink companies and their lobbying group, the American Beverage Association, spent $38 million to defeat election-season proposals to impose taxes on sugary drinks in four cities: San Francisco, Oakland and Albany in California, and Boulder, Colo. The companies lost all of those fights. Now, seven cities around the country have a soda tax. (Strom, 11/22)
Anti-Aging Benefits Of Blood Transfusions From Young Are Questioned
The author of a study published Tuesday cautioned against the idea that transfusions of “young” blood can reverse the aging process, a notion that has captured the public imagination and motivated startups. In the new research, published in Nature Communications, scientists replaced half of the blood in old mice with blood from young animals, and did the opposite swap in young mice, giving them old blood. They found that the younger mice experienced symptoms associated with aging — they stopped making new neurons in a part of the brain associated with memory formation. And the old mice seemed younger in some respects — their muscles recovered better after being injured. (Swetlitz, 11/22)
FDA Issues Sunscreen Guidelines
The Food and Drug Administration (FDA) is loosening its grip on sunscreen. The FDA issued a series of guidelines Tuesday aimed at speeding up the review process for sunscreen manufacturers, some of whom have waited decades for their products to be approved. In the long-awaited guidelines, the FDA requests data from maximum-use trials to determine whether the active ingredients in sunscreen are absorbed into the body. “Sunscreens are intended to be used on a regular basis in liberal amounts and over large portions of the body surface whenever consumers are exposed to the sun,” the FDA wrote in the Federal Register. (Devaney, 11/22)
Health News Florida:
Retired NFL Players File Lawsuit, Want League To Pay For Brain Injuries
Lawyers representing 142 retired NFL players filed a federal lawsuit against the NFL Monday in Fort Lauderdale. They want the league to recognize CTE, or chronic traumatic encephalopathy, as an occupational hazard that should be covered by workers compensation. (Haden, 11/22)
Two National Recalls Of Sterile Products That Might Not Be Sterile
Two national distributors of sterile medical products, one based in Palm Beach County, have issued voluntary large recalls of products after U.S. Food & Drug Administration facility inspections of each company cast doubt on the products’ sterility. Juno Beach-based Tri-Coast Pharmacy is recalling 85 sterile products produced between May 17 and Nov. 17 that haven’t expired. The list, which includes various cocktails and some types of testosterone, can be viewed here. (Neal, 11/22)
From toxic chemicals to choking hazards to overheating risks, the Florida Public Interest Group comes out with its 31st listing of toys that pose dangers to kids.
The Baltimore Sun:
Dangerous Toys Still For Sale, Annual Report Finds
The musical instrument with the cute monkey character may seem to some parents like a great toy for their kids. Except that the keyboard paint is full of lead. A brightly colored teething ring has small beads that a toddler could snap off and swallow, creating a choking hazard. The toys are among many that have been deemed unsafe by the federal Consumer Product Safety Commission but still can be found for sale, in many cases over the Internet, according to a report released Tuesday by consumer watchdog group Maryland Public Interest Research Group. (McDaniels, 11/22)
Tampa Bay Times:
Dangerous Toys Are Focus Of Safety Group's Annual Report
In 2015, more than 250,000 emergency visits nationwide for children younger than 15 were toy-related. [Wassam] Rahman, an emergency medicine physician at Johns Hopkins All Children's Hospital, alerted holiday-shopping parents at a news conference to the Florida Public Interest Group's 31st annual toy safety report. The report identifies 44 toys — ranging from M&M-branded jewelry with high levels of lead and Ikea bat capes that can cause strangulation to hoverboards/self-balancing scooters with batteries that can overheat and catch fire or explode — that have been recalled since January 2015. (Kumar, 11/22)
The CDC has found that Hispanics contract diabetes at a higher rate than non-Hispanic whites and are about 50 percent more likely to die from diabetes or liver disease. In related news, a mobile app aims to help diabetics monitor their treatment plans.
Hispanic Diet Adds To Risk For Diabetes
At the University of Miami medical school, a team of researchers is tailoring its programs to help Hispanics prevent or manage diabetes. Baptist Health South Florida has partnered with Florida International University to develop a bilingual mass open online class or (MOOC) for diabetes. The free online course provides participants with tools to help them change their eating habits and exercise patterns. (Portilla, 11/22)
Mobile Apps Help Diabetics And Doctors Monitor Health
Diabetes is the seventh-leading cause of death in the United States, according to the Centers for Disease Control and Prevention. Managing blood sugar levels is critical — that’s where the apps come in. ... Mobile apps not only allow people to monitor their glucose levels and calorie intake, but also provide data that help health providers assess their patients more accurately and efficiently than ever before. (Hsieh, 11/22)
Outlets report on health news from Georgia, Minnesota, Colorado, Ohio, Maryland, California and Florida.
Georgia Health News:
Georgia Slightly Above Average In Health Care Spending
Health care spending for the privately insured increased 4.6 percent nationally in 2015, higher than the hikes in the prior two years, according to a report released Tuesday. The report from the Health Care Cost Institute said the biggest factor in the higher spending was an increase in prices for services such as inpatient hospital care and for brand-name prescription drugs. (Miller, 11/22)
Minnesota Low-Income Children's Obesity Rate Drops
Minnesota officials are lauding gains made in reducing obesity rates among low-income children. A study released Tuesday notes that the state’s obesity rate for children ages 2 to 4 in low-income families participating in the Women, Infant and Children Program (WIC) fell from 12.7 percent in 2010 to 12.3 percent in 2014. The Centers for Disease Control and Prevention and U.S. Department of Agriculture study found Minnesota’s rate the eighth lowest in the nation. The national rate was 14.5 percent in 2014, the latest year figures are available. (11/22)
Average Life Expectancy In Denver Can Vary A Decade Depending On Neighborhood
Living in well-to-do Washington Park or in the Valverde neighborhood on Denver’s west side can mean a difference in average life expectancy of 11 years. Depression and childhood obesity rates are four times higher in some Denver neighborhoods, and tobacco use is six times higher in certain areas of the city. The health disparities are severe, and thanks to data emerging from death certificates and the electronic health records of tens of thousands of Denver residents, public health officials can map the variance down to specific pockets of town. Armed with blunt facts, the public health community has renewed its effort to intervene and help improve outcomes in the unhealthiest neighborhoods. (Brown, 11/22)
State Medical Board Of Ohio Finds No Violations In Abortion On Woman High On Drugs
The State Medical Board of Ohio has closed its investigation into physicians at Women's Med Center in suburban Dayton who performed an abortion on a woman seemingly high on drugs. Paul Coudron, executive director of Dayton Right to Life, said Tuesday he was notified by the board that there was insufficient evidence that any state laws or professional regulations had been violated. (Candisky, 11/22)
The Baltimore Sun:
New University Of Maryland Center Targeting HIV Launches With $138 Million In Federal Grants
The Institute of Human Virology at the University of Maryland School of Medicine will receive $138 million in federal funds that will support the work of the newly created Center for International Health, Education and Biosecurity to build programs in Africa to combat HIV/AIDS. The money will enable the Baltimore-based institute to continue working in countries that persistently suffer from high rates of HIV infections. The goal is to stem new infections and to find and treat more people already infected so the virus becomes more of a chronic condition, much like it is in the United States, rather than a death sentence. (Cohn, 11/22)
San Jose Mercury News:
Sexually Transmitted Diseases On The Rise In Bay Area, State
Sexually transmitted diseases — chlamydia, gonorrhea, and early (infectious) syphilis — have mostly been on the rise in the Bay Area over the past six years, according to state Department of Public Health statistics. One local health official said the trend reflects fewer people using condoms and increased reporting of the diseases by medical clinics. (Richards, 11/22)
With Small Budget, UCF Group Brings Health To Homeless
[Andrew] Aboujaoude founded Hearts for the Homeless Orlando with Alexis Ghersi, also premed, and Jennifer Carvel, who's planning to study clinical psychology. Since August, the trio and their pack of volunteers have been going to food-sharing sites in downtown Orlando one or two nights a week for a few hours to offer blood pressure screenings to homeless people who drop by for food. (Miller, 11/22)
Body Parts From Humans, Animals Aid Medical Training
[Katie] Minser, who holds a bachelor’s degree in theater design from Ohio State University, prides herself on making medical-training simulations as realistic as possible. That means using cadavers and cadaver parts, cow eyes and pig lungs, mannequins, skin-color craft supplies, items from the grocery-store baking aisle and party-store swag — all to create lifelike medical training on a minuscule budget. (Viviano, 11/23)
Columbus, Franklin County Team Up On Healthy-Food Access
Franklin County have been working for years to understand why some parts of central Ohio don’t have easy access to healthful food. Now, they say, they have a plan to address it. The city and county unveiled on Monday their Local Food Action Plan, the product of a two-year effort to address access to nutritious food, economic-development issues around food, and food waste in the region. (Rouan, 11/22)
News outlets report on stories related to pharmaceutical drug pricing.
The Wall Street Journal:
Lilly Alzheimer’s Drug Can Save Dismal Year For Pharma
After a year of drama for the health-care industry, ranging from the EpiPen pricing scandal to the collapse of Valeant Pharmaceuticals International and Theranos to the unknown future of Obamacare to a series of mergers, it is easy to forget that the business of drug companies is actually to discover new drugs. That will change in the next two weeks, when Eli Lilly unveils late-stage data for its Alzheimer’s disease drug. (Grant, 11/22)
High Prices For Some Leukemia Drugs Will Make Them Less Cost-Effective
Pills used to treat a form of leukemia may be more effective and convenient than chemotherapy, but a new study suggests pricing is projected to raise the annual cost of care by 590 percent – to more than $5 billion – over the next decade, straining payer budgets and causing financial hardship for patients. Here’s why: The number of people in the US living with chronic lymphocytic leukemia, which is a rare blood and bone marrow disease, is forecast to reach 199,000 in 2025, up from 128,000 five years ago, thanks to more effective treatment. But a higher-priced pill, which is used as a first-line therapy and taken indefinitely, will also outpace the cost of chemotherapy, which has a fixed duration for treatment. (Silverman, 11/21)
Analysts To Wall Street: Don't Celebrate Yet. The Drug-Pricing Brouhaha Is Far From Over
When presidential candidate Hillary Clinton blasted Martin Shkreli on Twitter for hiking the price of an old drug called Daraprim by 5,000% in September 2015, biotech stocks plummeted. Clinton tweeted that such price hikes in the drug market were “outrageous” and that she planned to “take it on.” So when she unexpectedly lost the election, it’s little surprise that shares of drug companies rallied, with the Nasdaq Biotech Index jumping 9% the day after the election—its biggest one-day spike in 8 years. The biopharma sector enjoyed a further boost from the failure of California’s Proposition 61, an effort to control drug prices by requiring that state agencies pay no more for medicines than the Department of Veterans Affairs does. (Weintraub, 11/17)
Rest Easy, Pharma. AstraZeneca, Ranbaxy Prevailed In Landmark Pay-For-Delay Case
In 2013, it looked as if AstraZeneca and Ranbaxy could face billions in damages in a lawsuit alleging they struck an illegal deal to block a generic of the blockbuster heartburn remedy Nexium. Now that cloud has lifted, thanks to a U.S. appeals court ruling in the companies’ favor. The legal battle over generic Nexium is a landmark case, because it was the first to go before a jury after a key U.S. Supreme Court ruling. In 2013, the high court determined that so-called pay-for-delay deals could violate antitrust laws, if only on a case-by-case basis. (Weintraub, 11/22)
NYPD Union Goes After Drug Prices Amid DOJ Pharma Probe
As the generic drug industry braces for charges from a two-year U.S. Justice Department antitrust investigation, a union representing the sergeants of the New York Police Department is attempting to hit some companies with civil penalties as well. A pair of lawsuits filed by the Sergeants Benevolent Association Health & Welfare Fund against two groups of drugmakers, which include Switzerland-based Novartis AG’s generic drug unit, along with Ireland-based Perrigo Co., India’s Wockhardt Ltd. and Taro Pharmaceutical Industries Ltd., allege the companies colluded to raise prices on two dermatological creams as much as 1,000 percent starting in 2013. (Altstedter, 11/17)
Pfizer Sues Texas Agency Over Leaked Drug Prices
Pfizer has accused the Texas Health and Human Services Commission of violating federal law by handing over the company's drug pricing information to state legislators, and is suing the agency to ensure the data aren't leaked again. So far this year, the Texas agency has allegedly handed over Pfizer's drug pricing data to two Texas Senate committee heads, stoking Pfizer's fears that the information could get leaked and jeopardize their complex and secretive pricing and discount programs. (Teichert, 11/18)
At Valeant, All Eyes On Whether Philidor Defendants Acted Alone
Gary Tanner and Andrew Davenport stand accused of trying to defraud Valeant Pharmaceuticals International Inc. But to hear their lawyers tell it, the two were just doing their jobs, in full view of sharp-minded Valeant executives. The two are the first to face charges after more than a year of rising scrutiny on Valeant and a federal investigation into the drug company’s relationship with mail-order pharmacy Philidor Rx Services LLC. The lawyers’ comments suggest this won’t be the end of troubles for Valeant or its former executives. (Berthelsen, Farrell and Hopkins, 11/22)
Launching A Drug? Be Prepared To Show It's Cost-Effective Up Front, Consultant Says
On the heels of Trinity Partners’ first medicines index, president John Corcoran said the biopharma industry can expect a continued focus on specialty drugs and drastically different drug launches in the years to come. Gone are the days of “brute force marketing” propelling new drugs to big sales, Corcoran told FiercePharma, with concepts such as “real-world evidence,” “outcomes,” “cost effectiveness,” and “health economics” expected to play a bigger role than ever moving forward. (Sagonowsky, 11/21)
Read recent commentaries about drug-cost issues.
Dueling Diabetes Duos Won't End Price Pressure
Diabetes drugmakers have suffered the most under a new drug-price paradigm, in which pharmacy benefit managers and insurers prod older medicines in competitive classes into costly price wars. Sanofi and Novo Nordisk A/S hope their new two-drug diabetes combinations Soliqua and Xultophy, both approved by the FDA Monday afternoon, will help reverse this price crunch to some extent. But while these medicines will likely help in a dismal environment, they're not going to be saviors. (Max Nisen, 11/22)
Biotech Should Cash In Its Trump Bump
Biotech's Trump-inspired rally has been a major source of relief for the industry, in more than one way. With the Nasdaq Biotech Index (NBI) up nearly 10 percent since Election Day -- including the biggest one-day jump in biotech shares in nearly a decade -- companies can now tap equity markets for funding more successfully. That's a big relief for companies depending on share sales to fund years of losses as they develop drugs. (Max Nisen, 11/22)
How High Can Drug Costs Soar Before We Reform Medicaid?
In an increasingly polarized political climate in the U.S., there is one topic that has gained support across party lines: action to keep prescription drug costs low. More people are paying attention to prescription drugs because of a large spike in costs, leading to a frenzy of media attention on the issue. (Allison Aase, 11/21)
Precision Medicine Will Increase Drug Prices And That's A Good Thing
Precision medicine provides better targeting of treatments to patients who really benefit from them. Fewer people will be treated with a given drug, compared to standard therapies, but everyone is better off – the treated have better outcomes, and everyone else can move on to another therapy that works for them. In a world where prices are increasingly based on value, this means that drug prices are likely to rise, but overall spending on pharmaceuticals may not change, or could actually fall. (Jason Shafrin, 11/21)
A selection of opinions on health care from around the country.
A Psychologist's Guide To Talking Politics — Or Not — This Thanksgiving
The task that lies before many of us at the Thanksgiving table is not unlike the task that faces us all as Americans: How do we connect across difference, especially when that difference truly hurts? Psychotherapy strategies for improving relationships, especially coping with strong feelings, might be useful. (Patricia Harney, 11/22)
Value-Based System Is Still A Worthwhile Endeavor
In this time of uncertainty, some things are still clear. Transitioning from fee-for-service medicine to a value-based system is still a worthwhile endeavor supported across the aisle. By paying for better — instead of simply more — care, the government highlights and rewards high-quality health plans, hospitals and physicians. But a glitch is causing unintended consequences for millions of seniors, leaving 2.5 million Medicare beneficiaries in 18 states without the improved benefits, reduced premiums and lower cost-sharing Congress intended to provide. (Ceci Connolly, 11/22)
Could Healthcare IT Be The Key To Better Addiction Treatment?
In a new, landmark report on addiction, the U.S. surgeon general made a solid argument for the role of health information technology in improving the treatment of patients with drug or alcohol abuse as well as behavioral health problems. Dr. Vivek Murthy's office pushed for greater health IT adoption and use by providers of alcohol, drug abuse and behavioral health treatment. But it took no position on a pending federal rule that could relax the current strict privacy protections covering the medical records of many patients receiving those treatments. (Joseph Conn, 11/22)
The New York Times:
When Doctors First Do Harm
President-elect Donald J. Trump on Tuesday expressed reservations about the use of torture. But he did not disavow the practice, or his promise to bring it back. And if he does, C.I.A. doctors may be America’s last defense against a return to savagery. But they’ll need to break sharply with what they did the last time around. (M. Gregg Bloche, 11/22)
Los Angeles Times:
The IRS Could Instantly Help 387,000 Disabled Americans. What's It Waiting For?
The Department of Education and the Social Security Administration jointly are doing yeoman’s work in identifying about 387,000 severely disabled and insolvent Americans saddled with federal student debt they can’t repay and informing them that the law allows their loans to be forgiven. But one agency still needs to act to make sure these people aren’t hit with a tax penalty when that happens: the Internal Revenue Service. (Michael Hiltzik, 11/22)
The New York Times:
My Life With Tourette’s Syndrome
I was born with a neurological disorder that causes involuntary movements, vocalizations and tics — sometimes mild, sometimes wildly disruptive: Tourette’s syndrome. Since my youth, I’ve often been stopped in public by the police and questioned because of my symptoms. Questioned: That sums it up in a single word. My whole life has been questioned. (Shane Fistell, 11/23)
More Mass. Prisoners Should Have Chance For Compassionate Release, Too
To die in prison is, in most cases, to die without autonomy. Dying behind bars will become more common as the prison population becomes older and sicker. Often, dying in prison happens even in cases like [former Massachusetts House Speaker Salvatore] DiMasi’s that were never meant to be life sentences. To pass away in prison, separated from your family, seems tragic under the best of circumstances. (Elisabeth Poorman, 11/22)
My Turn: Anti-Smoking Campaign Gives Arizonans A Shot At Better Health
There are 200,000 fewer smokers in Arizona than existed in 2011. This decrease is in part due to the contributions of the health-care community, community-based organizations and tools like the Arizona Smokers’ Helpline. But, we know it is also due to the effort of folks committed to quitting and their loved ones who encouraged and supported them. Arizona wants to have the lowest smoking rate in the U.S. by 2020. This means there is still more to do. (Jay Tibshraeny, 11/22)