Tagged Health Industry

Viewpoints: Doctors Facing Racism In The Exam Room; Medication’s Role In Curbing Addiction

A selection of opinions on health care from around the country.

The Washington Post: Racist Patients Often Leave Doctors At A Loss
Patients refuse care based on health-care providers’ ethnicity and religion so often that this phenomenon has been dubbed “medicine’s open secret.” A new poll shows that a majority of health-care professionals say they have faced prejudice from patients. In 2013, a nurse in Flint, Mich., sued a pediatric intensive care unit after it granted a request from a father to enter “no African American nurses” on his infant’s care plan. Damon Tweedy, an African American psychiatrist, describes similar experiences in bruising detail throughout his memoir, “Black Man in a White Coat.” And when Esther Choo, an Asian American emergency department physician, tweeted last month that white nationalists refused her care, she set off a Twitter storm of health-care providers responding with similar stories. (Dorothy R. Novick, 10/19)

The Des Moines Register: To Prevent Full-Blown Opioid Crisis, Iowa Needs Overdose Of Vigilance
Drug overdoses are now the leading cause of death for Americans under age 50, killing roughly 64,000 people in the United States last year. An increase in fatalities is largely fueled by opioids, including fentanyl, a powerful synthetic substance considered up to 50 times more potent than heroin. Although Iowa has not been hit as hard as some other states by the opioid epidemic, we have not been spared. (10/19)

Stat: Long-Acting Medications For Addiction Help Patients Maintain Recovery
Many addicted people try to bind their future selves to a commitment to stop using drugs. Some move across the country to a place where they don’t know any dealers or fellow users. Others throw away all their drugs and injection equipment. … Such tactics are often thwarted by the future self of the addicted person who adopted them. Like other drugs to which people become addicted, opioids cause enduring adaptations in the brain that weaken self-control and increase the urge to use these drugs. In addition, many people with drug addictions inhabit social networks that provide repeated stimuli and opportunities to use drugs. (Keith Humphreys, 10/19)

The New York Times: The Trump Administration’s Power Over A Pregnant Girl
In early September, a 17-year-old girl from Central America was apprehended trying cross the border between the United States and Mexico. After being taken to a shelter for unaccompanied minors in South Texas to await immigration proceedings, she learned she was pregnant. The girl, referred to as Jane Doe in court filings, was adamant that she wanted an abortion. … For almost a month, some of these Trump appointees have been waging a crusade to force the young woman, whose future in this country is extremely uncertain, to carry her pregnancy to term. Their standoff shows us the real-world consequences of this administration’s radical disregard for women’s autonomy. (Michelle Goldberg, 10/20)

Los Angeles Times: The U.S. Government Can’t Hold Undocumented Pregnant Teens Hostage When They Want An Abortion
It is unconscionable that the federal government would so flagrantly undermine the rights of a person in its custody. The girl, known in court papers simply as Jane Doe, may not be here legally, but, while she is here, she has a constitutional right — like every other pregnant girl or woman in the United States — to a legal abortion. Even U.S. District Judge Tanya Chutkan, who ruled Wednesday that Doe could get the abortion, shook her head in disbelief when a U.S. Department of Justice lawyer at the hearing would not concede that Doe has constitutional rights. (10/20)

Los Angeles Times: A Judge Calls Foul On Allergan’s Attempt To Hide Its Drug Patents Behind An Indian Tribe’s Sovereignty
In the annals of cynical corporate subterfuges, it would be hard to top the effort by the drugmaker Allergan to fend off a patent challenge by selling its drug rights to a rural New York Indian tribe. … [Judge William] Bryson didn’t invalidate the tribal deal because that wasn’t at issue in the case before him, but he expressed “serious reservations” about whether the deal should be treated as valid. That could function as a guidepost for the U.S. Patent Office, which will have to rule on the transaction’s validity. Legal authorities say Bryson’s opinion should be taken as a red light by other companies thinking about using the same maneuver. (Michael Hiltzik, 10/19)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: Minn. Gov. Blasts Medica For $120M Funds Transfer; In Mass., Closing Arguments In Murder Trial Related To Compounding Pharmacy Meningitis Outbreak

Media outlets report on news from Minnesota, Massachusetts, Texas, New Hampshire, Kansas, Arizona, Pennsylvania, Ohio, Georgia and Ohio.

The Associated Press: Closing Arguments Set In Deadly Meningitis Outbreak Trial
Attorneys are preparing to make their closing arguments in the case of a Massachusetts pharmacist charged with second-degree murder in a deadly meningitis outbreak. Closing arguments in Glenn Chin’s trial are expected Friday in Boston’s federal courthouse. Chin faces second-degree murder, mail fraud and other charges under federal racketeering law. (Richer, 10/20)

Dallas Morning News: Two Texas ERs Got Bad Reviews Online. Now They Want Google To Help Them Find Out Who Did It 
Two North Texas free-standing emergency room operators want tech giant Google to give up the identities of nearly two dozen reviewers who rated them poorly online. Highland Park Emergency Center on Lemmon Avenue and Preston Hollow Emergency Room on Walnut Hill Lane filed a joint petition Tuesday in Dallas County District Court. The 30-page pre-suit deposition lists the screen names used by 22 individuals, who the facilities claim never were treated in their emergency centers. (Rice, 10/19)

Kansas City Star: Fungus Destroyed Inmate’s Brain While Kansas Prison Contractor Did Nothing, Suit Says
Marques Davis was in the infirmary at Hutchinson Correctional Facility on Dec. 27, 2016, back with the same symptoms he’d been complaining of for months, including numbness and weakness in his legs. But on that day there was something new. “It feels like something is eating my brain,” Davis told Corizon Health employees who staff the prison infirmary. According to a lawsuit filed in federal court Monday, something was infecting his brain: a fungus that slowly killed the 27-year-old over the next four months, as he pleaded for help. (Marso, 10/17)

Arizona Republic: Arizona Heat Takes An Extra Toll On People With Mental Illness
Out of all the people who died of heat-associated causes in Maricopa County in 2016, around 15 percent had a history of mental illness, according to an Arizona Republic analysis of autopsy reports. …Some medications, including certain types of antidepressants and antipsychotics, block the body’s ability to regulate its temperature, said Dr. David Eisenman, a professor of medicine at the University of California, Los Angeles. (Altavena, 10/19)

The Philadelphia Inquirer/Philly.com: Major Sanctions At Darby Nursing Home After Neglect Found
The Pennsylvania Department of Health revoked the regular license of St. Francis Center for Rehabilitation & Healthcare last month and installed a temporary manager at the Darby nursing home after an August inspection found that a patient had developed “wounds that went down to the bone with exposed tendon.” The 273-bed facility, one of five sold in 2014 by the Archdiocese of Philadelphia to Center Management Group of New York, appealed the decision and remains open under a temporary manager installed by the health department. The revocation was the first in Pennsylvania since at least the beginning of 2014. (Brubaker, 10/20)

Des Moines Register: Quadriplegic Spent Hours In Dirty Diaper After Services Cut
Throughout last summer, 25-year-old quadriplegic Louis Facenda Jr. spent as much as half of each day in a dirty diaper after his caregiver services provided through Iowa’s Medicaid program were dramatically cut. …The cuts ended payments for at least 16 visits each week for an in-home care program that helped the family dress, feed and change the diapers of Facenda Jr. two to three times each day. (Clayworth, 10/19)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Prices For Cancer Drugs Creeping Up Much Higher Than Inflation Warrants

“Some [increases] exceeded inflation drastically and some increased at a slower rate,” said Dr. Daniel Goldstein, the author of the study. “But overall, we’re seeing a gradual creep each year.”

Stat: Cancer Drug Prices Have Been Rising Much, Much Faster Than Inflation
The prices for injectable cancer drugs — including older medicines that face competition — rose over a recent eight-year period at rates that far exceeded inflation, according to a new study. Specifically, the mean price increase for 24 branded cancer medicines that were approved in the U.S. between 1996 and 2012 was a whopping 25 percent. After adjusting for inflation, the increase was 18 percent. Moreover, gradual price increases over the years can result in substantial cumulative increases. In this instance, the mean cumulative price increase for all two dozen drugs was 36.5 percent. (Silverman, 10/19)

In other pharmaceutical news —

Stat: Allergan Faces A Cheaper, Compounded Version Of Its Restasis Eye Drops
Hoping to capitalize on consumer outrage, Imprimis Pharmaceuticals (IMMY) plans to sell a cheaper, compounded version of the Restasis dry-eye treatment that is sold by Allergan (AGN) and has been at the center of a widening controversy in recent weeks. The company plans to sell its version for a fraction of the roughly $500 monthly cost for Restasis, which generated nearly $1.5 billion in sales last year, although may now face generic competition next year after a federal court judge last week invalidated several patents for the medicine. (Silverman, 10/19)

Stat: Celgene Just Lost A Crucial Drug For Its Revenue Stream After A Clinical Trial Blowup
Celgene just lost one of the most important drugs in its research pipeline to a late-stage clinical trial blowup. The drug is mongersen, a key component in Celgene’s burgeoning immunology and inflammation franchise. On Thursday, a phase 3 study of mongersen in Crohn’s disease was halted prematurely following a finding of clinical futility by independent monitors, the company said. (Feuerstein, 10/19)

CNN: City Of Los Angeles Opens Investigation Into Drugmaker Following CNN Report
Los Angeles City Attorney Mike Feuer has launched an investigation into California-based drugmaker Avanir Pharmaceuticals, the subject of a CNN report into its aggressive targeting of nursing home residents with a drug called Nuedexta that may be unnecessary or unsafe for this population. Feuer confirmed the investigation to CNN, saying that his office is seeking information and tips from the public to help determine whether state or federal laws have been broken in the sale, marketing or prescribing of Nuedexta. (Ellis and Hicken, 10/19)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Medicare Agency May Have ‘Overcorrected’ When Canceling Cardiac Pay Models

Also in the news from the Centers for Medicare & Medicaid Services, the agency will begin evaluating some of the changes put in place by MACRA to reduce Medicare spending.

Modern Healthcare: CMS May Have Overcorrected In Cancellation Of Cardiac Models
The CMS may have overcorrected when it honored some hospitals’ request to cancel mandatory cardiac pay models. The move means hospitals that were ready to embrace the models could be out millions of dollars. Those hospitals are also missing out on millions in bonus payments they would have received had they improved care. The CMS wants to cancel models for acute myocardial infarction, coronary artery bypass and as well as the Cardiac Rehabilitation Incentive Payment Model, all of which were scheduled to begin on Jan. 1, 2018. Comments on the termination were due Oct. 16. (Dickson, 10/19)

Modern Healthcare: CMS Makes First Move To Hold Docs Accountable For Medicare Spending 
The CMS is taking its first steps to evaluate whether MACRA will lead to reduced Medicare spending with a new pilot test. The test will evaluate eight new measures to determine if physicians in the Merit-based Incentive Payment System, known as MIPS, are actually reducing the cost of care. The CMS unveiled the initiative just two weeks after the Medicare Payment Advisory Commission suggested repealing MIPS over concerns it wouldn’t lead to better quality of care for patients or lower costs. (Dickson, 10/19)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Viewpoints: Learning Cybersecurity Lessons From Medical Devices; Big Pharma Should Be Embarrassed — But Are They?

A selection of opinions on health care from around the country.

JAMA: Cybersecurity Concerns and Medical Devices: Lessons From a Pacemaker Advisory
Medical devices increasingly include capabilities for wireless communication and remote monitoring systems that relay clinical information from patients to clinicians. For example, many cardiac implantable electrical devices can transmit data regarding arrhythmia burden and heart failure metrics with minimal patient effort. This technology can improve patient care, but also introduces possible risks to data security and patient safety. (Daniel B. Kramer and Kevin Fu, 10/18)

The New York Times: ‘Drug Dealers In Lab Coats’
Big Pharma should be writhing in embarrassment this week after The Washington Post and “60 Minutes” reported that pharmaceutical lobbyists had manipulated Congress to hamstring the Drug Enforcement Administration. But the abuse goes far beyond that: The industry systematically manipulated the entire country for 25 years, and its executives are responsible for many of the 64,000 deaths of Americans last year from drugs — more than the number of Americans who died in the Vietnam and Iraq wars combined. The opioid crisis unfolded because greedy people — Latin drug lords and American pharma executives alike — lost their humanity when they saw the astounding profits that could be made. (Nicholas Kristof, 10/18)

The Washington Post: Democrats Are The Real Abortion Extremists
What would America’s abortion policy be if the number of months in the gestation of a human infant were a prime number — say, seven or eleven? This thought experiment is germane to why the abortion issue has been politically toxic, and points to a path toward a less bitter debate. The House has for a third time stepped onto this path. Senate Democrats will, for a third time, block this path when Majority Leader Mitch McConnell (R-Ky.) brings the House bill to the floor, allowing Democrats to demonstrate their extremism and aversion to bipartisan compromise. (George F. Will, 10/18)

JAMA: End-Of-Life Care Among Immigrants Disparities Or Differences In Preferences?
Although describing a “good death” is an existentially challenging exercise, most people, if asked to do so, would note the importance of the presence of friends and family, relief from distressing symptoms, time at home, completing life goals, and other values. Although these goals are likely shared quite widely, how they are prioritized, and how they relate to other goals, may vary among individuals and across cultures. (Michael O. Harhay and Scott D. Halpern, 10/17)

JAMA: Blood Transfusions From Previously Pregnant Women And Mortality: Interpreting The Evidence
The availability of large databases of blood donors and transfusion recipients has facilitated investigation of associations of donor characteristics with recipient outcomes. These databases are available in Sweden-Denmark, Canada, and the Netherlands, using government health data, and in the United States, using a donor-recipient database funded by the National Heart, Lung, and Blood Institute. (Ritchard G. Cable and Gustaf Edgren, 10/17)

JAMA: Better
I was in my first year of medicine residency, still losing my way to radiology, still forgetting the codes I needed to access one room or another, still desperately trying to learn how to keep track of my multiple patients and their multiple problems when I assumed his care. As the intern, it fell to me to examine Mr Jones and write admission orders. As the intern, I’d also been up all night. My new white coat was stained with coffee spilled while sprinting to accomplish one forgotten task or other. My pager was chirping regularly, a constant reminder of the calls I’d yet to return. Tired, anxious, and painfully aware of his nurse’s brisk competence as she quieted a beeping alarm and tugged the bed sheet, I introduced myself. (Jessica Gregg, 10/17)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Some Tips To Help Decide Whether Popular Medicare Advantage Plans Are Right For You

These private insurance plan take the place of traditional Medicare and vary in coverage and cost.

CNBC: Here’s How To Snag The Best Medicare Advantage Plan
Medicare open enrollment is underway, which means you have until Dec. 7 to sign up for an Advantage Plan or to make changes to the one you already have. If you’re uncertain whether one of these plans is right for you, it’s important to first understand your options. … In simple terms, these plans provide coverage from an insurance company and take the place of original Medicare, comprised of Part A (in-patient coverage) and Part B (outpatient care). While regulated by the government, Advantage Plans are administered by insurers and can vary in terms of coverage and cost. (O’Brien, 10/18)

Kaiser Health News: Medicare Vs. Medicare Advantage: How To Choose
As health insurers struggle with shifting government policies and considerable uncertainty, one market remains remarkably stable: Medicare Advantage plans. That’s good news for seniors as they select coverage for the year ahead during Medicare’s annual open enrollment period (this year running from Oct. 15 to Dec. 7). … Despite Medicare Advantage plans’ increasing popularity, several features — notably, the costs that older adults face in these plans and the extent to which members’ choice of doctors and hospitals is restricted — remain poorly understood. (Graham, 10/19)

And in news on Medicare payment models —

Modern Healthcare: ACOs For Specialty Providers Could Be Key To Medicare Savings
Providers saw promising savings from accountable care organization models over the last year, and recent data has shown the value-based programs could find more success in a relatively untapped area: specialty medicine. The CMS last week quietly released data showing that three ACO programs saved providers millions of dollars. Last year, the Comprehensive End-Stage Renal Disease Care Model saved $75 million, according to the agency. That’s more than the $68 million saved by Pioneer ACOs, and the $48 million saved by NextGen ACOs in the same period. Pioneer and NextGen ACOs mainly focused on better coordinating the primary care needs for Medicare patients. (Dickson, 10/18)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Parsing Health Policies And Politics: Examining The Alexander-Murray Obamacare ‘Fix’; Why Does It Have To Be So Difficult?

Opinion writers offer a variety of takes on the deal announced this week by Sen. Lamar Alexander (R-Tenn.) and Sen. Patty Murray (D-Wash.) as well as what it can and cannot accomplish. They also take a tough inventory of the politics in play and examine other health policy issues, such as Medicare Advantage networks and the status of the Children’s Health Insurance Program reauthorization.

The New York Times: Bipartisan Health Proposal Is Too Late For 2018, But A Salve For 2019
The new bipartisan health proposal is far from a cure-all for Obamacare’s problems, but if it passed it would send health insurers a message they have sought all year: that it’s safe to stay in the marketplaces. Insurers have already signed contracts and are making final arrangements to sell their products in time for next year’s enrollment period, which begins on Nov. 1. (Reed Abelson and Margot Sanger-Katz, 10/19)

Bloomberg: A Congress That Can’t Make Anything Easy
Time for another test of whether this Congress can do the easy things — on health care this time. Republican Senator Lamar Alexander of Tennessee and Democratic Senator Patty Murray of Washington have reached a deal to “fix” the Affordable Care Act — a seemingly reasonable agreement designed, in very general terms, to help the insurance markets work better while giving states more flexibility to administer things. Both parties have incentives to approve something like this. Democrats care about preserving their big policy win in the original Affordable Care Act; Republicans don’t want chaos in health insurance while they control the White House and have majorities in both chambers of Congress. Sure, Republicans in theory would rather repeal and replace Obamacare, but if they didn’t realize earlier that they don’t actually have any realistic plan for doing so, most of them surely know it now. (Jonathan Bernstein, 10/18)

Bloomberg: Bipartisan Health Care Deal Is Too Late To Fix Much 
A bipartisan proposal to shore up the Affordable Care Act and guarantee the U.S. government keeps helping insurers cover low-income patients would have been something like a best-case scenario for the companies participating in the market — if it happened several months ago. As it stands, the bill, spearheaded by Senators Patty Murray and Lamar Alexander, has only a small chance of passing. And even if it does pass, it is unlikely to entirely mitigate the Trump administration’s active sabotage of the ACA. (Max Nisen, 10/18)

The Washington Post: If Republicans Kill This Health-Care Bill, They’ll Prove Their Cowardice
Bipartisan negotiators announced Tuesday that they had struck a deal to temporarily stabilize Obamacare markets. Republican Sen. Lamar Alexander (Tenn.) agreed to continue paying “cost-sharing reduction” payments that the government promised insurance companies, and Democratic Sen. Patty Murray (Wash.) agreed to relax health-market regulations a bit. Both sides of this deal contain good policy. (10/18)

The Wall Street Journal: Republicans, Stand Up For Health Freedom
While there is plenty of blame to go around for Republicans’ inability to repeal and replace Obama Care, the effort was all but doomed as soon as the GOP chose to fight on the wrong battlefield. Trying to pass a replacement through the budget process known as reconciliation was powerfully attractive, since it would have permitted the Senate to act on ObamaCare with only 51 votes. (Phil Gramm, 10/18)

Chicago Tribune: Breaking The Gridlock On Obamacare
For seven years, congressional Republicans and Democrats battling over Obamacare have agreed on only one thing: They couldn’t agree on anything. As more Americans dropped or skipped coverage because of soaring premiums, lawmakers of the two parties couldn’t — wouldn’t — agree on how to fix the 2010 law. (10/18)

The Wall Street Journal: More Freedom For More Money
That’s the question to ask about this week’s deal between Republican Lamar Alexander and Democrat Patty Murray to appropriate two years of funding for Obama Care’s “cost-sharing” reductions that flow to insurers. The Trump Administration last week cut off these subsidies, which the Obama Administration paid without an appropriation from Congress. A federal judge ruled last year that those payments are illegal. Democrats would also get about $100 million for advertising ObamaCare. (10/18)

The New York Times: Congress, End The Health Care Chaos. You Have 9 Million Kids To Protect.
President Trump and Republicans in Congress have brought chaos to the American health care system by trying to destroy the Affordable Care Act and failing to reauthorize the Children’s Health Insurance Program, which, with bipartisan support for the past 20 years, has provided care for millions of children. Over the next few weeks they can choose to set things right or to destroy them. (10/18)

JAMA Forum: What Do Medicare Advantage Networks Look Like?
The recent, strong growth of Medicare Advantage—private plan alternatives to traditional Medicare—makes understanding the program a priority for policy makers. Of the 57 million Medicare beneficiaries, approximately 33% are now enrolled in Medicare Advantage, an increase from 13% in 2004. Although we know a great deal about Medicare Advantage, there’s one thing we know almost nothing about: the extent and value of plans’ networks of physicians and hospitals at which enrollees can obtain covered care. This is important, because establishment and oversight of networks is a principal way Medicare Advantage plans manage cost and quality, and there has been a trend toward more narrow networks in insurance markets, raising concerns about access and patient cost. (Austin Frakt, 10/18)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: Md. Website Will Help Consumers Compare Costs For Common Medical Procedures; NYC’s Public Hospital System To Get Infusion Of Funding

Media outlets report on news from Maryland, New York, Colorado, Illinois, Pennsylvania, Ohio and Minnesota.

The Washington Post: Maryland To Offer Online Shopping Tool For Common Medical Procedures
The Maryland Health Care Commission, the state’s independent regulatory agency, is unveiling a website on which people scheduling a hip replacement, knee replacement, hysterectomy or vaginal delivery can see price differences among different providers for the same procedure. The site is launching amid rising health-care costs and as some consumers turn to insurance plans with high deductibles. (Itkowitz, 10/18)

The Baltimore Sun: New Website Will Let Maryland Consumers Compare Hospital Rates For The First Time
A new website — wearthecost.org — being launched Thursday by the Maryland Health Care Commission will help consumers compare these types of costs among hospitals and bring more transparency to hospital pricing practices. While patients can request all or some of this data from other agencies and the hospitals themselves, the commission said the website compiles the information all in one place and in an easy-to-navigate, consumer-friendly way. The commission hopes the website will arm users with more information to help them make more informed decisions when choosing a hospital. (McDaniels, 10/19)

The Wall Street Journal: New York City Public Hospital System To Get Relief From State
The head of New York City’s public hospital system said New York Gov. Andrew Cuomo’s administration has agreed to disperse hundreds of millions in aid to the agency, ending a funding dispute that left the hospitals dangerously low on cash. Stanley Brezenoff, interim president and chief executive of NYC Health + Hospitals, said in a letter to agency employees Wednesday that the state had agreed to distribute some $380 million in federal and city funds under the state’s control to the system over the coming months. (Gay, 10/18)

Denver Post: Colorado Spending More On Prison Inmate Health Care, Report Finds
Colorado is spending more per inmate on health care as the state’s prison population ages, according to a national report released Wednesday. The report, from the Pew Charitable Trusts, found that Colorado spent $6,641 per inmate on health care in the 2015 fiscal year. That placed the state in the middle of the pack nationally: 21st  for the highest spending and about $900 per inmate more than the national median. (Ingold, 10/18)

Chicago Tribune: Legislators Want Answers On Illinois’ Failure To Screen Babies For Deadly Krabbe Disease 
utraged by a Chicago Tribune report, state Rep. Mary Flowers, D-Chicago, is asking officials from the Illinois Department of Public Health to explain at a legislative hearing next week why they never implemented a 2007 law that mandated screening Illinois babies for a deadly genetic condition. Flowers, chair of the Illinois House Health Care Availability and Access Committee, was a co-sponsor of the law that added Krabbe disease to the state’s newborn screening program a decade ago. (Callahan, 10/18)

The Philadelphia Inquirer/Philly.com: Einstein Healthcare Network Credit Downgraded
Moody’s Investor Service downgraded Einstein Healthcare Network’s credit rating by one notch, to just above junk bond status, citing the nonprofit system’s large and unexpected loss of $23 million on an operating basis in the year ended June 30, a decline in liquidity, and uncertain state funding. Einstein said in a statement that it “remains committed to providing high-quality care while balancing the demands of today’s challenging health-care environment. There are initiatives already underway which we believe will put the organization in a stronger financial position moving forward while increasing access to care.” (Brubaker, 10/18)

The Baltimore Sun: Maryland Health Department Gets $7.5 Million To Support Home Visits For Families
A federal grant of almost $7.5 million to the Maryland Department of Health will go to helping teach parenting skills and provide other resources to pregnant women and parents of young children, health department officials said Wednesday. The department will use the funds from the U.S. Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services, to support local agencies that make home visits to women and parents through the state’s Maternal, Infant and Early Childhood Home Visiting Program. The goal of the program is to help the families raise children who are physically, socially and emotionally healthy and ready to learn. (Cohn, 10/18)

Pioneer Press: Roseville Care Center At Fault In Resident’s Death, Health Department Says 
The resident was fine when Sunrise Assisted Living staff checked in around 9 p.m. When staff returned around 12:30 a.m., the resident’s neck was wedged between a bed and a transfer pole, and the resident was no longer breathing, according to a report by the Minnesota Health Department. The department determined earlier this month that the Roseville facility was at fault for neglect, having placed the pole too close to the bed. (Chavey, 10/18)

Chicago Sun Times: Suit: Suburban Couple Defrauded Millions From Medicare 
The federal government has filed a lawsuit accusing a south suburban couple of defrauding Medicare out of millions of dollars through false claims by their medical companies. The suit, filed Tuesday in U.S. District Court, accuses Gateway Health Systems Inc. and its owners – 58-year-old Ajibola Ayeni and his wife, Joy H. Turner-Ayeni – of violating the federal False Claims Act by seeking and accepting Medicare payments for fraudulent services, according to a statement from the U.S. attorney’s office. (10/18)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Anthem, Spurning Express Scripts, Will Join With CVS To Start A Drug Plan Business

The new business, which will start in 2020, will be a new pharmacy benefit manager (PBM) company. PBMs serve as intermediaries between drug companies and the prescription plans, but they have come under increasing pressure for not being transparent about how much money they save and how much is passed along to consumers.

Bloomberg: Anthem Breaks With Express Scripts, Will Start Own Drug Plan 
Health insurer Anthem Inc. plans to set up its own pharmacy benefits management unit, signaling a final break with Express Scripts Holding Co. after accusing it of overcharging by billions of dollars. The move means Express Scripts will not only lose its biggest client but also face a new rival. Anthem’s new unit, called IngenioRx, will grow its own business with a “full suite” of services, the insurer said in a statement on Wednesday. (Flanagan and Rausch, 10/18)

Modern Healthcare: Anthem’s New PBM To Spark Change Throughout The Industry 
There has been heightened scrutiny on the role PBMs play in the pricing of drugs in recent years. PBMs, which oversee prescription drug benefits for employers and insurers, negotiate drug discounts with pharmaceutical companies, build pharmacy networks and create their own drug benefit plans, are involved in a blame game across the secretive pharmaceutical supply chain. PBMs, drug manufacturers, insurers and wholesale distributors have pointed fingers at each other to try to explain why savings via negotiated rebates aren’t ultimately passed to the consumer. (Kacik, 10/18)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Desperate Quest For Herpes Cure Launched ‘Rogue’ Trial

As 20 Americans and Brits flew to a Caribbean island for a controversial herpes vaccine trial, many of them knew there were risks.

The lead U.S. researcher, William Halford, openly acknowledged he was flouting Food and Drug Administration regulations in the consent forms they signed. He would be injecting them with a live, though weakened, herpes virus without U.S. safety oversight.

Still, many of them felt upbeat when they arrived on St. Kitts and Nevis in the spring of 2016. They had struggled for years with debilitating, painful herpes. Halford, the creator of the vaccine, sounded confident.

Maybe they could be cured.

“It felt like paradise,” one of the participants recalled. “Or therapy combined with vacation.”

A year later, their optimism has turned to uncertainty. Memories of kicking back in a Caribbean hotel during the trial have been overshadowed by the dread of side effects and renewed outbreaks.

But they can’t turn to Halford, a Southern Illinois University professor. He died of cancer in June.

They also can’t rely on his university, which shares in the vaccine’s patent but says it was unaware of the trial until after it was over. Because the FDA didn’t monitor the research, it can’t provide guidance. Indeed, there is little independent information about what was in the vaccine or even where it was manufactured, since Halford created it himself.

At a time when the Trump administration is pushing to speed drug development, the saga of the St. Kitts trial underscores the troubling risks of ambitious researchers making their own rules without conventional oversight.

“This is exactly the problem with the way the trial was conducted,” said Jonathan Zenilman, an expert on sexually transmitted diseases at Johns Hopkins Bayview Medical Center in Baltimore. “These people are supposed to have rights as human subjects, but now there’s nowhere for them to go. We may never know if this vaccine worked, didn’t work or, even worse, harmed anyone.”

Rational Vaccines, the U.S. company co-founded by Halford, still hopes to market the vaccine. It touted success online and to other researchers, prompting millions of dollars of recent investment, including from a company run by Peter Thiel, a backer of President Donald Trump.

Thiel, a PayPal co-founder who has excoriated the FDA as too bureaucratic, declined to answer questions about his investment, which occurred after the trial had ended.

Kaiser Health News interviewed five of the 20 participants in the clinical trial and several associates of Halford.

The participants agreed to speak on condition of anonymity because they don’t want to be known as having herpes. Most also said they feared retaliation from Halford’s company but hoped by speaking out some of their concerns might be addressed.

Their accounts, along with documents, a video and emails obtained by KHN from the offshore trial, pointed to what experts said were serious irregularities:

  • Halford did not rely on an institutional review board, or an “IRB,” which monitors the safety of research trials.
  • The company has said it doesn’t know where Halford manufactured the vaccine, so it isn’t known whether he followed U.S. government guidelines when transporting it.
  • Halford offered booster shots of the unapproved vaccine inside the United States. FDA regulations prohibit such injections.
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“The FDA goes after these types of violations,” said Holly Fernandez Lynch, a lawyer and assistant professor who specializes in medical ethics at the University of Pennsylvania’s Perelman School of Medicine. “[Researchers] can be prosecuted.”

SIU, however, did little to discourage Halford. The university, which has a financial interest in the patent, said it learned of “the concerns” only after his death. In August, after KHN asked about the trial, the medical school’s IRB launched an investigation into whether Halford violated U.S. regulations or university rules.

In a statement to KHN, Rational Vaccines acknowledged that Halford “discussed a myriad of concerns … including the potential need for booster shots.”

“Unfortunately, Dr. Halford is no longer with us to address all the ways in which he may have investigated his concerns …,” stated the company. It added, “We nevertheless wholeheartedly intend to continue his line of investigation in a clinical setting to international good clinical practice standards.”

Racing Against Time

Halford first broke with scientific protocols in 2011, shortly after he was diagnosed with nasal cancer and treated with chemotherapy and radiation, according to an account he later posted on his blog.

By then, Halford was in his 40s and had worked almost a decade at SIU’s School of Medicine.

Halford, who did not have herpes, realized his cancer might not give him much time. If he submitted to the FDA’s oversight, it would take years, he reasoned in his account.

He decided to become his own research subject, injecting himself more than two dozen times with the vaccine.

“There is an ongoing herpes pandemic that demands the scientific community’s attention today, not tomorrow,” he wrote in his blog, which by his count received thousands of hits.

The experiments on himself, Halford believed, demonstrated the vaccine was safe.

In 2015, Halford set his sights on launching an offshore clinical trial.

However, his unorthodox approach made some of his peers recoil.

“He sat in my kitchen and tried to convince me to join him,” said Terri Warren, a nurse practitioner in Oregon who was approached by Halford in 2016 to help with the trial. “He believed so firmly in his vaccine. He said, ‘Think of all of the herpes patients who are suffering.’”

Warren had previously worked with Halford on a different, IRB-approved trial studying a new blood test to diagnose herpes. This time, she said, she became concerned about his methods, including how he was selecting his participants.

“I told him absolutely not,” she recalled. “I didn’t want anything to do with it. I felt bad for him because he was dying, but I thought he had lost perspective.”

But Halford did find backers, including Hollywood filmmaker Agustín Fernández III, whose credits include action films and an award-winning documentary.

Fernández recently declined to respond to questions. But in an earlier interview this year with KHN, he said he initially contacted Halford to try to help someone he knew who was battling the disease. He said he didn’t have herpes, or a background in science.

Fernández, however, became such a believer in Halford, he said, he allowed Halford to inject him with the vaccine. In 2015, he co-founded Rational Vaccines with Halford and invested his own money into the company. That same year, the company licensed two patents related to the vaccine from SIU.

“I felt like Bill had the answer, and we had to make sure he got a chance to prove it,” Fernández said.

‘Finally … Someone Who Cared’

As soon as news began spreading in the tight-knit herpes online community that Halford may have a cure, he began hearing from the most desperate who asked to be included in any future research.

For many, herpes is a mild disease that can be controlled by antiviral medicines. However, for some, it becomes a life-altering disease that destroys any hope of intimate relationships.

To several of the participants, Halford was an empathetic scientist who refused to give up on finding a cure.

“After dealing with doctors who had no answers, it felt like you were finally talking to someone who cared and could help,” said a participant in his 30s from the South who had described the trial as “paradise.”

There were other perks as well.

Rational Vaccines told some participants they would be reimbursed for their flight and hotel expenses. If they got through the entire trial, they would be given an extra $500.

As Halford organized two groups of 10 participants, he instructed them on drawing their own blood for the trial, according to a video filmed in a medical lab.

He proceeded with the trial from April to August 2016, giving participants three shots over three months.

Once in St. Kitts, many of them quickly bonded with one another and Halford. Even though they ranged in age from their 20s to 40s and came from different regions, they had the disease in common. They commiserated about how herpes had wreaked havoc on their lives.

“It was a relief to meet people who understood what we were talking about,” the Southerner said.

But other participants now say they noticed some troubling signs.

They received the injection in a house in St. Kitts, not a medical clinic.

Halford, whose gaunt frame made his cancer apparent by then, at times appeared disoriented.

Fernández, a constant presence, was introduced to them by name and made some of them uncomfortable when they socialized over drinks and dinner.

Some patients became anxious about their participation soon after receiving the vaccine.

One, a web developer in his 20s, felt ill after receiving just one dose.

“I experienced tiredness and ringing in my ears,” said the web developer, who reported the feelings along with “disequilibrium and slurred speech” continue to this day.

He said he decided not to return to St. Kitts for follow-up shots after Halford dismissed his symptoms as arising from a common cold.

Another participant, a Colorado woman in her 40s, said she told Halford she experienced flu-like aches and pains and tingling and numbness soon after the second shot. The symptoms were followed by an “excruciating” 30-day outbreak of herpes.

“I have new symptoms every day,” that woman later wrote Halford in an email exchange provided to KHN. “This is terrifying.”

Halford initially dismissed her symptoms, speculating they were caused by a mosquito-borne virus, she said.

She returned for the third shot but had her doubts. Halford and Fernández met her at a café to talk about her concerns, she recalled.

“[Fernández] kept saying, ‘You signed the consent form. You knew the risks,’” said the Colorado woman, who said Halford then removed her from the trial.

Another participant, a Californian in his 30s, said he went through with all three shots despite feeling a “terrible pain in my stomach.”

Halford then told him he had noticed in his research of mice that another version of the virus entered the gut of the mice and killed them, the participant said.

“I then thought maybe this is dangerous,” said the Californian, whose pain went away but his outbreaks did not.

Warren, the nurse practitioner in Oregon, said two participants tracked her down as a herpes expert. She said that they described possible side effects from the vaccine.

Halford had told participants he would follow up on their reactions to the vaccine for a year, according to the consent form. But he stopped sending questionnaires to the two participants who said they had been dropped from the trial.

Warren said that even when researchers stop administering a vaccine because of possible side effects, known as adverse events, they have a duty to track the subjects’ reactions.

“There is no doubt that these were adverse events that should have been reported,” Warren said.

Rational Vaccines did not respond to questions about the complaints. In previous public statements, it acknowledged that one of the 20 participants was concerned about possible side effects.

Some participants also wonder where Halford made the vaccine and how he transported it to St. Kitts.

Halford told his business partner he had made it outside of the United States, without disclosing where.

After the trial ended, some participants began complaining that the vaccine hadn’t worked. Halford and Fernández offered booster shots, according to four participants.

One participant, a man in his 40s who was also from California, declined to get the booster. He said he decided to go back to antiviral drugs when his outbreaks returned.

The Southerner said he agreed to allow Halford to give him booster shots at an office in Springfield, Ill., where Halford worked.

“It was between me and him,” said the participant. “He was doing me a favor.”

“I don’t know if it was a different strain or what, but he gave me a set of double boosters at the same time, one in each leg,” recalled the Southerner, who said he didn’t have records of the injections. He said he received them as Halford continued to collect data for the trial.

Months later, he said, he returned a second time for another set of boosters.

Courting Support Without Results

Halford, meanwhile, tried to persuade a U.S. scientific journal to publish a lengthy manuscript detailing the results of both his experiments on himself and his offshore trial. Halford put the cover letter on SIU letterhead.

In December 2016, only months after the trial had ended, Halford’s paper was rejected by the journal.

“This manuscript is partly a vision, partly science, and partly wishful thinking …,” said one reviewer for the journal. “Neither safety nor efficacy has been demonstrated by the data presented.”

Halford asked his former doctoral adviser, Daniel Carr, to attend a Rational Vaccines advisory board meeting. Carr, a University of Oklahoma Health Services Center professor, said he and other invitees heard glowing reports about the trial.

Carr agreed in May to present the trial data at a conference of herpes experts in Colorado.

A published summary of the event listed Carr as a lead author, though he said he wasn’t involved in the research.

“I just did it to help him out,” said Carr, who asked for his university’s permission to be on Rational Vaccines’ advisory board and is waiting for word on federal funding to study another version of Halford’s vaccine. “I also presented it because I thought that the scientific community would find it interesting.”

Despite its patent agreement reached in 2015, SIU said it was in the dark about Halford’s offshore activities until October 2016 — months after the trial had ended.

Halford, meanwhile, promoted his work at events attended by university officials.

In October 2016, Halford was a keynote speaker at an SIU-sponsored technology and innovation event to discuss his vaccine work.

Then, in April 2017, Halford and Rational Vaccines held a press conference to trumpet an investment pledge by Thiel’s company, according to materials handed out at the event. University officials, including SIU’s medical school dean, were invited speakers.

The university’s IRB is continuing its investigation, which includes scrutinizing whether Halford used university resources.

“If there are areas of concern, SIU will report those findings promptly to Department of Health and Human Services,” said SIU spokeswoman Karen Carlson. “We will also communicate our findings with the scientific community and the public.”

FDA spokeswoman Lauren Smith Dyer declined to comment on the trial except to say the FDA does not have jurisdiction over offshore trials that don’t seek agency approval.

Dyer, however, added that the export from the United States of an unapproved vaccine for research use and the injection of it on U.S. soil would be within the agency’s jurisdiction.

Even so, some participants don’t regret taking part in the trial.

“When you feel like a disease has ruined your life, you become desperate,” said the Southerner, who believes the boosters have lessened his outbreaks. “Some people contemplate suicide. You’re willing to do almost anything.”

Other participants still hope for some sort of accountability.

“I feel like without a doubt that my symptoms were vaccine-related,” said the Colorado woman. “I feel like it triggered something that I’ll have for the rest of my life.”

No matter what, experts said, the university has a responsibility to conduct an in-depth investigation. So far, the university has not reached out to participants who spoke to KHN.

“This researcher went rogue,” said Fernandez Lynch, the lawyer who specializes in medical ethics. “It’s true that universities can’t stand behind their researchers watching their every move. But when one of their own goes rogue, a university should launch an aggressive investigation, interview the participants and make sure it never happens again.”

KHN’s coverage of end-of-life and serious illness issues is supported by The Gordon and Betty Moore Foundation and its coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

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Viewpoints: In Defense Of Sanctuary Hospitals; Medicare, Medicaid Funding Fairness For Puerto Rico

A selection of opinions on health care from around the country.

JAMA: Making A Case For Sanctuary Hospitals
In July 2017, Jose de Jesus Martinez, an undocumented immigrant, wept at the bedside of his 16-year-old son Brandon, who was comatose in the intensive care unit of a San Antonio, Texas, hospital after being found in a parked unventilated trailer. Several agents from US Immigration and Customs Enforcement (ICE) entered Brandon’s hospital room and aggressively began questioning Jose. The incident was just one in a recent trend of disturbing actions by ICE agents at or near hospitals and other health care facilities. … everyone deserves to feel secure when in need of medical care, particularly the most vulnerable members of communities. Under previous government administrations, even ICE recognized that hospitals, like schools and places of worship, were sensitive locations where enforcement actions should not take place unless “exigent circumstances” existed. (Altaf Saadi, Sameer Ahmed and Mitchell H. Katz, 10/16)

Modern Healthcare: Puerto​ Rico​ Deserves​ Fair​ Medicaid​ And​ Medicare​ Funding
The Puerto Rican healthcare system, which serves the 3.4 million people devastated by Hurricane Maria, operates under patently unfair Medicaid and Medicare funding rules. As Americans gear up to help their fellow citizens, it’s critical that Congress and the Trump administration correct this injustice. Not only should they offer immediate aid, they should revise the inequitable formulas that systematically shortchange the 69 hospitals and approximately 20 federally qualified health centers with nearly 90 facilities that dot the Caribbean island. (Merrill Goozner, 10/14)

The Washington Post: Congress Wants To Make Americans With Disabilities Second-Class Citizens Again
Led by the hospitality and retail industries, special interests want to shift the burden of [the Americans With Disabilities Act] compliance away from business owners and onto individuals with disabilities. They’re backing a bill that has already passed the House Judiciary Committee, the so-called ADA Education and Reform Act, which would reward businesses that fail to comply with the law. The bill would allow businesses to wait until they are notified of their failure to meet legal obligations before they even have to start removing barriers that prevent Americans with disabilities from leading independent lives. (Sen. Tammy Duckworth, 10/17)

The Des Moines Register: Not Even Death Spares You From Iowa’s Budget Cuts
[G]overnment may now be too small for many Iowans, including those with complaints about a nursing home, those seeking a court date or those trying to get someone on the phone to ask questions about their now privatized Medicaid health insurance. And not even death can deliver people from the negative consequences of failing to adequately fund state government. A shortage of forensic pathologists at the Iowa Medical Examiner’s Office is delaying autopsies, which can leave families waiting weeks for their loved one’s remains. This means not only waiting for answers about a death, but also waiting to schedule funerals and burials. (10/17)

Detroit Free Press: Parents Need Honest Answers To Questions About Childhood Vaccines
My heart aches for Rebecca Bredow, the young Metro Detroit mom jailed for violating an Oakland County Circuit Court judge’s order to immunize her son against vaccine-preventable diseases. As I watched Michigan and national media coverage of Rebecca’s case, I saw a young woman who, from all indications, loves her son and is trying to do what is best for him. When Rebecca shared her story with the public, memories came flooding back of my family’s experiences with childhood immunizations. (Veronica McNally, 10/16)

Cleveland Plain Dealer: GOP’s Drastic Medicaid Cuts Would Be Devastating For HIV-Positive Ohioans Like Me
I have been living with HIV for 20 years. HIV is a very smart and dangerous virus – it can become out of control in your body quickly, and it can make the common cold a deadly illness. To manage my HIV, I take a daily medication that has the dual benefits of keeping the virus from spreading and boosting my immune system. Missing even one dose of my medication is not an option. … Medicaid expansion meant that, for the first time since I was diagnosed HIV-positive, I was able to afford all of the treatment I needed in the same month. I no longer had to choose what I would treat from month to month. (Olga Irwin, 10/18)

Stat: Canada Needs A National Registry Of Drug Company Payments To Doctors
The province of Ontario recently took a historic step for Canada by introducing legislation that would shine a light on interactions between drug companies and prescribers. The use of the term “historic” here is not hyperbole, since the extent of payments towards physicians in Canada has never been known. Other countries, such as the United States and France, have been making such information public for a few years now. But Ontario’s bill would provide a wider scope of transparency by including all sorts of prescribers — not just doctors — into the mix, and even bringing in medical device companies. (Nav Persaud, Joel Lexchin and Andrew S. Boozary, 10/17)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Viewpoints: It’s Time To Stop Drug Companies From ‘Gaming The System And Gaming The Rules’

Read recent commentaries about drug-cost issues.

USA Today: Stop Big Pharma From ‘Getting Away With Murder’
Few things are more infuriating to consumers than the constant, surging increases in drug prices. Americans under 65 are projected to pay an additional 11.6% this year, while seniors are expected to see increases of 9.9%. These increases follow similar ones in recent years. Price hikes like these, which run well above inflation and wage growth year after year, are a keen indication of how the drug industry lacks market fundamentals. Or, as President Trump put it Monday, prescription drug prices “are out of control” and the big pharmaceutical companies “are getting away with murder.” (10/16)

Bloomberg: Here’s How Drug Companies Game The Patent System
The Senate Health Committee held a hearing Tuesday morning about why prescription drugs cost so much and what might done to make them more affordable. According to the committee’s website, the witnesses include a lobbyist for the pharmaceutical industry, a lobbyist for the pharmacy industry and a lobbyist for the pharmacy benefits-management industry. (Joe Nocera, 10/17)

USA Today: PhRMA: We’re Working To Protect Patients
Ensuring patient access to medicines that are revolutionizing how we fight disease is critically important. Equally so is understanding when additional safeguards are required to ensure a medicine’s benefits outweigh its risks. In such cases, the Food and Drug Administration may require the biopharmaceutical company that manufactures the medicine to implement additional procedures, called Risk Evaluation and Mitigation Strategies (REMS), to facilitate safe use of the medicine. (James C. Stansel, 10/16)

Forbes: The Cost Of Developing Drugs Is Insane. That Paper That Says Otherwise Is Insanely Bad
You probably know this poem, or at least the story it tells. One man likens the elephant to a wall, another to a spear, a third to a snake, a fourth to a tree. The point is that each sees only part of the animal, and is thereby deceived. Well, here’s how the same thing happened when it came to a new estimate of the cost of developing a new medicine. For years, the pharmaceutical industry has relied on estimates from the Tufts Center for the Study of Drug Development, the most recent of which that puts the cost of bringing a medicine from invention to pharmacy shelves at $2.7 billion. Last month, two cancer researchers grabbed headlines by asserting that estimate is way off. Their number, published in JAMA Internal Medicine: $648 million. In an editorial that ran alongside the new study, journalist Merrill Goozner wrote: “Policymakers can safely take steps to rein in drug prices without fear of jeopardizing innovation.” There are reasons to think that (more on that later), but this paper does not add to them. (Matthew Harper, 10/16)

The Hill: The Future Of Drug Pricing: Value Over Volume
Doctors and hospitals are increasingly being paid not for the quantity of care they provide, but for the outcome or quality of care patients receive. The emerging trend in health care is about rewarding value, rather than volume. This is the future, where there is less focus on the number of tests or treatments a patient receives and more focus on whether a patient’s health is improving. (Jim Greenwood, 10/11)

Stat: Canada Needs A National Registry Of Drug Company Payments To Doctors
The province of Ontario recently took a historic step for Canada by introducing legislation that would shine a light on interactions between drug companies and prescribers. The use of the term “historic” here is not hyperbole, since the extent of payments towards physicians in Canada has never been known. Other countries, such as the United States and France, have been making such information public for a few years now. But Ontario’s bill would provide a wider scope of transparency by including all sorts of prescribers — not just doctors — into the mix, and even bringing in medical device companies. (Nav Persaud, Joel Lexchin and Andrew S. Boozary, 10/17)

The Columbus Dispatch: Ohioans Should Vote No On Issue 2
Tens of millions of dollars are being spent on advertising for and against Issue 2, the “Drug Price Relief Act.” After all this, Ohioans remain confused about this proposed voter-initiated law on the Nov. 7 ballot — a wishful scheme that aims to force the state to buy drugs at unattainable discounts. The muddle is understandable. Ohioans are being told to vote for one thing, but are being sold a bill of goods on another. Its merits shaky, Issue 2 campaigns against a straw man: Big Pharma. (10/18)

Columbus Dispatch: Should Ohioans Support The Drug Price Relief Act? Yes
As a Vietnam veteran and former head of the United States Veterans Administration, I have spent most of my life advocating for veterans. And I’m not stopping now. One of the biggest challenges now facing Ohio families and veterans is posed by the out-of-control pharmaceutical drug industry. This industry has been and continues ripping off Ohio veterans and taxpayers daily by selling our government agencies — including Medicaid — drugs at outrageous prices. (Max Cleland, 10/16)

The Courier: No On Issue 2
High drug costs are a national issue, not just an Ohio one. But voters statewide will get to weigh in on the Ohio Drug Relief Act, Issue 2, on Nov. 7. The run-up to the election, and the outcome, will be closely watched throughout the country.Issue 2, if approved, would create a new law requiring state agencies in Ohio to not pay more for prescription drugs than the federal Department of Veterans Affairs. It also would require state payment of attorney fees and expenses to specific individuals for defense of the law.The issue, which was brought about through an initiative petition signed by nearly 200,000 Ohioans, pits a California health care CEO against Big Pharma in a state which would become the first to directly take on the drug price problem if the issue is approved. (10/18)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

‘I’m Not Interested In Their Money,’ Trump Says Of Pharma. But He Took It Anyway.

News outlets report on stories related to pharmaceutical pricing.

Stat: When It Comes To Pharma Money, Trump Was With The Elephant In The Room
President Trump on Monday addressed a well-established tenet of life in Washington: The pharmaceutical industry has loads of money and doesn’t hesitate to spend it on Congress. “They contribute massive amounts of money to political people,” Trump said during an impromptu news conference, turning to Senate Majority Leader Mitch McConnell, who was standing to his side. “I don’t know, Mitch, maybe even to you.” …Trump was not wrong. In his last race in 2014, McConnell raked in $550,923 from the pharmaceutical and health products industries — more than any other individual lawmaker received that year, according to the Center for Responsive Politics, which analyzes political spending data from the Federal Election Commission. (Swetlitz and Mershon, 10/16)

Stat: What Risks? Consumers Are Tuning Out Side Effect Info In TV Drug Ads
The litany of side effects recited in TV drug ads are designed to alert you to all of the potential risks, big and small. But it turns out these well-intended laundry lists, which are required by regulators, actually have the opposite effect — consumers pay less attention to the most serious side effects and, consequently, focus on the benefits of the drug, according to a new study. In short, regulators may have created a paradox if the marketability of the drugs has increased. (Silverman, 10/12)

ProPublica: Oversized Eyedrops Waste Medicine And Money
If you’ve ever put in eyedrops, some of them have almost certainly spilled onto your eyelid or cheek. The good news is the mess doesn’t necessarily mean you missed. The bad news is that medicine you wiped off your face is wasted by design — and it’s well-known to the drug companies that make the drops. (Allen, 10/18)

USA Today: Families Allege Big Pharma Helped Finance Iraq’s Mahdi Army Through Bribes
he families of dozens of U.S. troops killed or injured during the war in Iraq filed a federal lawsuit Tuesday against several U.S. and European pharmaceutical and medical supply companies, alleging that the corporations knowingly financed the anti-American militia Mahdi Army through bribes and kickbacks to officials at a government ministry controlled by the group. (Madhani, 10/17)

Stat: Why Do We Need Drug Rebates, Anyway? A Top Lawmaker Wants To Know
Sen. Lamar Alexander has a question: why do we have drug rebates, anyway? “Why do we need rebates?” the Tennessee Republican asked a panel of pharmaceutical industry representatives at a Senate committee hearing. The Health, Education, Labor, and Pensions committee met Tuesday morning for the second of three hearings on drug pricing, and heard testimony from five interest groups representing companies that play different roles in getting medicines to patients. (Swetlitz, 10/17)

Bloomberg: Drug Supply Players Point A Finger Everywhere But Themselves
A day after President Donald Trump renewed his attack on high drug prices, officials from the drug industry’s top lobbying groups sat down at a black cloth-draped table in a Senate hearing room and told lawmakers who’s to blame: the person a few seats over. Drugmakers said in prepared remarks that insurers, pharmacy-benefit managers and hospitals, among others, keep a large chunk of the money Americans spend on medicine and don’t pass on savings to patients. (Edney, 10/17)

USA Today: Cost Of Cold And Flu Season Can Make You Sick
Cold and flu season isn’t just physically painful — it can hurt your wallet too. The average consumer shops for over-the-counter medicine 26 times each year. That’s $338 per household, according to data collected by the Consumer Healthcare Products Association, a trade organization, in 2015, the most recent available. That same year, Americans spent $328 billion on prescription retail drugs, or prescription drugs purchased in pharmacies, according to estimates from the Department of Health and Human Services. (Ell, 10/17)

The Wall Street Journal: Johnson & Johnson Outlook Buoyed By Drug Unit
Johnson & Johnson increased its 2017 sales and adjusted profit guidance for the third quarter in a row, though net income in the quarter fell due to one-time items and amortization related to the company’s Actelion acquisition.J&J, one of the largest health-products companies by revenue based in the U.S., urged lawmakers in Washington to “unite behind” a plan to overhaul the corporate tax system but said its 2017 guidance doesn’t assume there will be tax reform this year. (Rockoff and Lombardo, 10/17)

Stat: Q&A: Will We See More Drug Makers File Antitrust Lawsuits Against Rivals?
Three times in recent weeks, a big drug maker sued another for allegedly using illegal tactics to win valuable contracts with payers. In one lawsuit, Pfizer claimed that Johnson & Johnson violated antitrust law when convincing insurers not to cover its biosimilar version of the Remicade rheumatoid arthritis treatment. Then, Shire alleged Medicare Part D plans refused to cover its Xiidra dry-eye treatment, because Allergan used “bundled discounts” and “exclusive” deals to lock down the market. And Sanofi accused Mylan of thwarting its move to sell an EpiPen rival. Drug makers regularly offer discounts to payers, but the lawsuits are drawing new attention to behind-the-scenes dealings. We spoke with Michael Carrier, a Rutgers University School of Law professor who specializes in antitrust matters in the pharmaceutical industry, about the implications. (Silverman, 10/16)

Stat: Who Will Pay For A $1 Million Drug? Gene Therapies Raise Tough Questions
Gene therapy has the potential to be a one-shot treatment that could reverse blindness, restore blood clotting function to hemophiliacs, or even cure rare diseases outright. But what kind of price tag comes with that promise — and who will pay for it?  The question is no longer academic: On Thursday, Spark Therapeutics won unanimous support from a Food and Drug Administration advisory panel for its gene therapy drug, Luxturna. It seems likely to win FDA approval in the coming months. But the cost will be hefty: Analysts estimate that Luxturna, which has been shown to restore vision in children with an inherited form of blindness, could cost $1 million per patient. (Keshavan, 10/13)

Kaiser Health News: Cascade Of Costs Could Push New Gene Therapy Above $1 Million Per Patient
Outrage over the high cost of cancer care has focused on skyrocketing drug prices, including the $475,000 price tag for the country’s first gene therapy, Novartis’ Kymriah, a leukemia treatment approved in August. But the total costs of Kymriah and the 21 similar drugs in development — known as CAR T-cell therapies — will be far higher than many have imagined, reaching $1 million or more per patient, according to leading cancer experts. The next CAR T-cell drug could be approved as soon as November. (Szabo, 10/17)

Stat: Judge Invalidates Allergan Patents And Criticizes Deal With The Mohawks
In a blow to Allergan (AGN), a federal judge invalidated the patents on its Restasis eye treatment, the latest twist in a captivating controversy over the fate of the best-selling medicine. The ruling brings some of the largest generic drug makers — Mylan and Teva Pharmaceuticals (TEVA) — a big step closer to selling lower-cost versions of a product that generated nearly $1.5 billion in sales last year. For now, though, the companies must first win regulatory approval and, meanwhile, battle in court still more since Allergan plans to appeal. And this will take months to resolve, stretching well into next year. (Silverman, 10/16)

Wisconsin Public Radio: Democrat Seeks Price Transparency On Prescription Drugs
Frustration over prescription drug prices is prompting some states to force pharmaceutical makers to justify the cost of medications. California’s governor recently signed a bill doing just that. And Democratic lawmakers in Wisconsin are pushing a similar measure. A bill introduced by Debra Kolste, D-Janesville, would require advance notification to the state Office of the Commissioner of Insurance and state Department of Health Services anytime the cost of a drug increases more than 25 percent. She said consumers, insurers, the government and the public would like to better understand pharmaceutical pricing. (Mills, 10/16)

The Hill: Battle Over Drug Prices Shifts Back To The States
President Trump has derided pharmaceutical companies as “getting away with murder,” but there’s been little action in Washington to rein in the costs of prescription drugs. Some states are taking matters into their own hands. California passed a new law that requires pharmaceutical companies to explain a drug’s price tag, and other states are considering similar measures. (Roubein, 10/11)

Politifact: Ohio Issue 2 Ballot Initiative Proponents Overstate Impact On EpiPen Prices
Ohio Taxpayers for Lower Drug Prices claims its ballot initiative could lower the price tag for the EpiPen, a popular auto-injector for serious allergic reactions. “We’ve gone from paying about $100 for EpiPens to over $600. And they only hold about one dollar’s worth of medicine,” the Aug. 29, 2017, video says. “We don’t have a choice but to pay it and the drug companies know it. Vote yes on Issue 2, the Drug Price Relief Act.” (Tobias, 10/13)

Cleveland Plain Dealer: State Report: Issue 2 Savings Impossible To Predict
An analysis by the Ohio Office of Budget and Management finds the state could save some money if Issue 2 passes, but it is impossible to say with certainty or how much. Issue 2 is the ballot initiative that would require the state to pay no more for pharmaceuticals than what the U.S. Department of Veterans Administration does. (Richardson, 10/11)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Former Lilly Executive Is A Leading Candidate For HHS Secretary

Alex Azar, who served as general counsel at HHS during the George W. Bush administration, is a top contender for the job, according to reports in The Washington Post and Politico.

The Washington Post: Trump Eyeing Former Drug Firm Executive Alex Azar For Health And Human Services Secretary
Alex Azar, a former pharmaceutical executive and a top health official during the George W. Bush administration, is now the leading candidate to head the Department of Health and Human Services, two Republicans briefed on the matter said Tuesday. Azar served a decade at Lilly USA, the biggest affiliate of Eli Lilly and Co., including five years as president. He directly led a biomedicines division that covered, among other areas, neuroscience, immunology and cardiology, and was also responsible for the company’s sales and marketing operations. (Eilperin and Goldstein, 10/17)

Politico: Trump Leaning Toward Former Pharma Exec For Health Secretary
One official said Trump had signed off on Azar, but another cautioned that the pick wouldn’t be final until the White House makes a formal announcement. A third Trump administration official confirmed that Azar has been shortlisted for the job. Other contenders long seen as top candidates for the job — including Centers for Medicare and Medicaid Services Administrator Seema Verma, and Food and Drug Administration Commissioner Scott Gottlieb — are no longer under consideration, according to multiple sources. (Restuccia, Johnson, Karlin-Smith and Dawsey, 10/17)

And a look at an interesting aspect of NIH duties —

Stat: NIH Library Is A ‘Safe Harbor For Information,’ Director Vows
The National Library of Medicine, built during the height of the Cold War, was designed to protect books, documents, and public information from just about anything — even the fallout of a nuclear disaster. Today the current director thinks the library can be a beacon of transparency and openness in an era full of concerns about threats to public information. NLM Director Patricia Brennan, who heads the $1 billion agency, vows the world’s largest biomedical library will continue to take steps to make data “open and accessible” at a time when the Trump administration has clamped down on making some information available to the public. (Blau, 10/17)

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Hospitals Step In To Help House The Homeless. Will It Make A Difference?

Listen here to Pauline Bartolone’s radio version of this story, which first ran on Capital Public Radio.

Can’t see the audio player? Click here to download.

During the five years Tony Price roamed the streets and dozed in doorways, the emergency rooms of Sacramento’s hospitals were a regular place for him to sleep off a hard day’s drinking.

“A lot of times I would pass out, and then I’d wake up in the hospital,” said Price, 50.

About two or three times a month, he would show up at a local emergency department. Sometimes doctors hydrated him with intravenous fluids and sent him on his way. Other times, they kept him a night or two.

“I’m kind of ashamed to say this, but sometimes it was just cold, and I [got] drunk,” Price said. “I just want[ed] to be warm and safe.”

Hospitals in Sacramento, Calif., and around the country are taking steps to help homeless people find housing. Doing so, they say, will limit unnecessary ER visits and reduce wasteful health care spending. It also helps nonprofits such as San Francisco-based Dignity Health, Orlando-based Florida Hospital and Providence Health & Services in Portland, Ore., meet their community service obligations in exchange for tax breaks.

Dignity Health’s “Housing With Dignity” program in Sacramento got Price into an apartment, paid his rent for four months and set him up with a social worker who helped him become eligible for permanent housing.

Without that help, “I definitely would have been dead by now,” Price said.

A growing number of hospitals nationwide have invested in housing programs in recent years, from Florida to Chicago and farther west.

The Corporation for Supportive Housing (CSH), a national lender and promoter of housing development for homeless people, says hospitals put $75 million to $100 million into projects it has embraced over the past several years.

In Oregon, five hospital systems invested in a $21.5 million project last year to build nearly 400 units for homeless people.

In Northern California, Sutter Health earlier this year launched an ambitious $30 million campaign to end homelessness in Sacramento and two adjacent counties.

“There’s pretty good evidence that it’s more cost-effective to provide housing with supports than have these people live on the streets and just cycle in and out of emergency rooms and in-patient stays,” said Sarah Hunter, a researcher at the Santa Monica-based think tank Rand Corp.

A widely cited 2002 study showed that providing housing and supportive services to more than 4,600 mentally ill homeless people in New York City dramatically reduced their stays in hospitals, shelters and correctional facilities — though the cost of the housing offset the savings.

A 2009 analysis of supportive housing in Los Angeles County showed that people with stable housing cost taxpayers 79 percent less than their homeless counterparts, and most of the savings were in health care.

However, a recent Health Affairs analysis noted that it’s hard to draw definitive conclusions about the cost effectiveness of such programs because they are usually small, the study methods variable and the data not always of the highest quality.

Cost savings are not the only benefit of housing homeless people. It’s also a way for nonprofit hospitals to “check a box” that exempts them from taxes, said Anthony Galace, director of health policy at the Berkeley, Calif.-based Greenlining Institute, which advocates for racial and economic justice.

And, “from a PR standpoint, it endears them to homelessness advocates,” Galace said.

But he and other advocates say that recent efforts of health systems such as Sutter and Dignity will not make a significant dent in the homelessness problem on their own, even if they do make a difference for one person at a time. To tackle the problem systemically, “we have to have enough [investments] to meet the size of the problem,” said Joan Burke, director of advocacy for Loaves and Fishes, Sacramento’s largest homeless shelter.

California Gov. Jerry Brown recently signed a new state law expected to generate $200 million to $300 million a year for affordable housing from a real estate transaction fee. Housing advocates said it’s too soon to know if the new money can help contain homelessness.

Price keeps a small garden on his patio and shares the produce he grows. (Andrew Nixon/Capital Public Radio)

The Housing With Dignity program that got Tony Price off the streets is young and tiny. When it started in 2014, it served just five clients at a time on a budget of $150,000 a year. Now it houses 12 formerly homeless people at any given time, with financial assistance from the insurer Health Net.

That’s a drop in the bucket compared with the estimated 3,665 Sacramento residents who are homeless, according to the latest data. But Dignity says it is not aiming to end homelessness. Rather, the program is designed to help ensure that the homeless patients it does take in get follow-up care after they’re discharged, said Ashley Brand, Dignity’s director of community health and outreach.

“Our hope is [that] dependency on the hospital services will be reduced,” she said.

Sutter Health executives say that after years of investing in programs that serve smaller groups of homeless people, they wanted to be more ambitious.

Sutter committed to raising $20 million from public and private investors to help pay for its anti-homelessness project in the region. It’s also throwing in $10 million of its own money, in part to satisfy the community benefit requirement that allows it to receive tax breaks as a nonprofit.

“We can continue to put dollars in again for programs that serve 200 people,” said Keri Thomas, vice president of external affairs for Sutter Health/Sacramento Valley Area. But there would always be 200 more homeless people the next year and the year after that, unless the hospital system made a bolder push to prevent people from ending up on the streets, she said.

So far, Sutter has matched investments by local governments to buy housing, pay rents and provide social services for homeless people.

Tony’s Next Phase

It wasn’t until 2015, after Price tried to commit suicide and spent a week recovering at Dignity Hospital, that things began to turn around for him.

Because he had been in the hospital so frequently, he qualified for the services offered by Housing With Dignity. It paid for a one-bedroom apartment in Sacramento’s sprawling North Highlands neighborhood and assigned him a social worker, Chris Grabe, who drove him to medical appointments.

Grabe later moved Price to a federally funded permanent housing program, which pays his rent of $806 a month and enables Grabe to continue checking in on him.

Price has been off the streets for nearly 2½ years, and he’s been to the hospital only once since January.

But the adjustment wasn’t easy. He had lived eight months in his first apartment before he quit drinking.

“I had one scare here where I was so drunk, I was outside yelling at people that I was going to shoot somebody,” Price recalled. “I completely trashed my apartment and I got arrested in my shorts.”

Grabe has stuck with him through the rough spots. As part of its “Housing First” philosophy, Dignity Health will lodge the most frequent users of its hospitals, even if they have a substance abuse problem or a criminal record.

Tony still struggles with anxiety, but having housing has put him on the path to sobriety and stability. He now gardens, and he recently volunteered at a church and as a leader of an Alcoholics Anonymous group.

“Out there, you have to think about yourself,” he said of his life on the streets. Now, “I don’t need to be in survival mode.”

This story was produced by Kaiser Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

Categories: California Healthline, Cost and Quality, Health Industry, Mental Health, Public Health

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Chasing Millions In Medicaid Dollars, Hospitals Buy Up Nursing Homes

Westminster Village North, a nursing home and retirement community in Indianapolis, recently added 25 beds and two kitchens to speed food delivery to residents. It also redesigned patient rooms to ease wheelchair use and added Wi-Fi and flat-screen televisions. This fall, it’s opening a new assisted living unit.

“We have seen amazing changes and created a more home-like environment for our residents,” said Shelley Rauch, executive director of the home.

The nursing home can afford these multimillion-dollar improvements partly because it has, for the past five years, been collecting significantly higher reimbursement rates from Medicaid, the state-federal health insurance program for the poor. About half of its residents are covered by the program.

In 2012, the nursing facility was leased to Hancock Regional Hospital, a county-owned hospital 15 miles away. The lease lets it take advantage of a wrinkle in Medicaid’s complex funding formula that gives Indiana nursing homes owned or leased by city or county governments a funding boost. For Indiana, that translates to 30 percent more federal dollars per Medicaid resident. But that money is sent to the hospitals, which negotiate with the nursing homes on how to divide the funding.

Nearly 90 percent of the state’s 554 nursing homes have been leased or sold to county hospitals, state records show, bringing in hundreds of millions in extra federal payments to the state.

Even though Indiana’s nursing home population has remained steady at about 39,000 people over the past five years, Medicaid spending for the homes has increased by $900 million, in large part because of the extra federal dollars, according to state data. Total spending on Indiana nursing homes was $2.2 billion in 2016.

The funding enhancements were pioneered in Indiana, but hospitals in several other states, including Pennsylvania and Michigan, have also used the process. Advocates say it has been a key factor in helping to keep Indiana’s city and county hospitals economically vital at a time when many rural hospitals nationwide are facing serious financial difficulties.

Westminster Village North, a nursing home and retirement community in Indianapolis, recently redesigned patient rooms in the nursing home to ease wheelchair use. (Courtesy of Westminster Village North)

But critics argue that the money flow has not significantly improved nursing home quality and has slowed adoption of community and home health services.

More than two-thirds of Indiana’s Medicaid long-term-care dollars go to nursing homes, compared with the U.S. average of 47 percent.

Joe Moser, who until May was Indiana’s Medicaid director, said while in office that the hospital-nursing home marriages were partly responsible for keeping more people in nursing homes. “It is a factor that has contributed to our imbalance,” he said.

Daniel Hatcher, a law professor at the University of Baltimore and author of last year’s “The Poverty Industry,” said this funding arrangement is a bad deal for the poor and undercuts the purpose of the Medicaid program. “The state is using an illusory practice and taking away money from low-income elderly individuals who are living in poor performing nursing homes,” he said. He noted Indiana is ranked near the bottom of states for nursing home quality by several government and private reports.

But proponents of the practice say that even when hospitals get most of the money, it is well spent.

Marion County Hospital and Health Corp., the large safety-net hospital system in Indianapolis, owns or leases 78 nursing homes across the state, more than any other county hospital.

Sheila Guenin, vice president of long-term care there, said the hospital keeps 75 percent of the additional Medicaid dollars and the nursing homes get the rest. Still, the additional money has improved care. The transfer of the license to the hospital has kept several nursing homes from closing and increased staffing rates at many others, she said.

About 40 percent of the county hospital’s nursing homes have five-star ratings from the federal government, up substantially from 10 years ago, she said. Among the improvements at the nursing homes were the addition of electronic health records as well as high-capacity emergency generators to provide power in case of a natural disaster.

Still, some patient advocates said the extra funding is flowing to hospitals and nursing homes with little public accounting. Ron Flickinger, a regional long-term-care ombudsman in Indiana, said, “A lot of extra money is being spent here, but I’m not sure patients have seen it benefit them.”

Practice Dates To 2003

Medicaid, which typically covers about two-thirds of nursing home residents, is jointly financed by the federal and state governments. States pay no more than half of the costs, although the federal match varies based on a state’s wealth. In Indiana the federal government covers about two-thirds of Medicaid costs.

The enhanced nursing home payments began in 2003 when a financially strapped Indianapolis hospital owned by the county took advantage of the Medicaid funding provision to bolster its bottom line. In this case, the hospital purchased a nursing home, then provided the money for the state to increase what it spent on the home to the federally allowed maximum.

That increase, in turn, drew down more federal matching funds. Since the federal remittance is larger than the hospital contribution, the hospital got back its initial investment and divided the extra money with the nursing home.

Other county-owned hospitals in Indiana slowly followed suit.

Hatcher said Indiana government leaders embraced the funding arrangement because it let them avoid the politically difficult step of raising taxes to increase state funding to improve care at nursing homes. “It’s a revenue generator for the state and counties,” he said.

All the Medicaid funding for nursing homes should be going to those homes to care for the poor, not shared with hospitals to use as they choose, he added.

The strategy, promoted by consultants advising hospitals and nursing homes in Indiana, is used heavily there because of the plethora of county-owned hospitals. But the federal government is tightening the rules about such payments.

Texas has secured Medicaid approval for a similar strategy starting this month, but federal officials have made the extra funding dependent on nursing homes meeting quality measures, such as reducing falls. Oklahoma is seeking to get federal approval as well.

And in a rule released last year, the federal Centers for Medicare & Medicaid Services announced that it would gradually force states to shift to payment systems that tie such reimbursements to quality of care. Michael Grubbs, an Indiana health consultant, said that rule does not stop the Indiana hospital funding program, but it’s unclear that it will last.

Nursing home operators in Indiana say the financing arrangement has helped them keep up with rising costs and improve care for residents.

Zach Cattell, president of the Indiana Health Care Association, a nursing home trade group, noted the number of nursing homes in the state earning Medicare’s top, five-star rating has increased 9 percentage points since 2011. He said the percentage of high-risk residents with pressure ulcers and those physically restrained also dropped significantly.

The common area of the nursing home at Westminster Village North in Indianapolis, which has benefited from additional federal Medicaid funding. (Courtesy of Westminster Village North)

An Opportunity Or A Loophole?

In Indiana, the small, county-run rural hospitals generally are not facing the financial threat that has become common elsewhere, in part because of the extra Medicaid funding gained from buying nursing homes, hospital officials say.

“The money has meant a great deal to us,” said Gregg Malot, director of business development at Pulaski Memorial Hospital in northern Indiana. “I don’t see this as a loophole but see it as an opportunity for small rural community hospitals to improve our quality and access to care.”

His hospital is the only one in Pulaski County. The extra Medicaid revenue from acquiring 10 nursing homes statewide — about $2 million a year — has helped finance the hospital’s obstetrics care and the purchase of the hospital’s first MRI, so doctors don’t have to rely on a mobile unit that used to come twice a week, he said. The hospital also spent some of the funding to add a centralized telemetry unit to monitor patients.

Steve Long, CEO of Hancock Regional Hospital in Greenfield, Ind., said his hospital recently built two fitness centers in the county with help from its extra Medicaid dollars. “This would not be possible without the additional funding.”

He rejects the notion that additional Medicaid money reduces the hospital’s incentive to add home- and community-based care in the community. He said new Medicare financing arrangements, such as accountable care organizations, give the hospital motivation to find the most efficient ways to care for patients after they leave the hospital.

But he acknowledged the hospital benefits from seeing more patients go to nursing homes licensed under its name.

“Welcome to health care — it’s a complex and confusing environment where we have all different competing incentives,” Long said.

Categories: Cost and Quality, Health Industry, Medicaid, States

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Sens. Alexander, Murray Reach Bipartisan Deal To Shore Up Obamacare Marketplaces

Oct 17 2017

The agreement would provide two years of funding for subsidy payments to health insurers.

The New York Times: Senators Reach Deal To Fund Subsidies To Health Insurers
Two leading senators have reached a bipartisan deal to provide funding for critical subsidies to health insurers that President Trump said last week that he would cut off, Senator Lamar Alexander, Republican of Tennessee, said Tuesday. The plan agreed to by Mr. Alexander and Senator Patty Murray of Washington, a Democrat, is intended to stabilize health insurance markets under the Affordable Care Act. (Kaplan, 10/17)

Politico: Alexander, Murray Strike Bipartisan Obamacare Deal Providing Subsidies, State Flexibility
It would include two years of funding for Obamacare’s cost-sharing program, which President Donald Trump cut last week. It also would allow states to use existing Obamacare waivers to approve insurance plans with “comparable affordability” as Obamacare plans. The agreement also would expand availability of catastrophic health insurance plans to consumers over the age of 30. (Haberkorn, 10/17)

The Hill: GOP Senator Announces Deal On Health Insurer Payments
Trump, who was holding a press conference with Greek’s prime minister as Alexander spoke with reporters, said what ever had been negotiated represented a “short-term” deal. The president said that he could support the deal, but argued an executive order he issued last week designed to change insurance markets represented a better path forward on health care. (Sullivan, 10/17)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Sens. Alexander, Murray Strike Deal To Shore Up Obamacare Subsidies, Marketplaces

Oct 17 2017

The agreement would reportedly provide two years of funding for subsidy payments to health insurers, expand availability of catastrophic plans and restore some money for enrollment outreach. A senator’s briefing is planned for 5 p.m. ET.

The New York Times: Senators Reach Deal To Fund Subsidies To Health Insurers
Two leading senators have reached a bipartisan deal to provide funding for critical subsidies to health insurers that President Trump said last week that he would cut off, Senator Lamar Alexander, Republican of Tennessee, said Tuesday. The plan agreed to by Mr. Alexander and Senator Patty Murray of Washington, a Democrat, is intended to stabilize health insurance markets under the Affordable Care Act. (Kaplan, 10/17)

CNN: Bipartisan Senators Reach Health Care Deal
Sens. Lamar Alexander and Patty Murray have reached a deal “in principle” to restore Obamacare cost-sharing reduction payments for two years in exchange for more state flexibility in Obamacare, according to two Senate aides. One Senate aide said the plan would also restore just over $100 million in funding for Obamacare outreach. An Alexander aide told CNN that Republicans would get a major change in the affordability guardrail, that would allow states a lot more flexibility, but that final language was still being ironed out. (Fox, 10/17)

Politico: Alexander, Murray Strike Bipartisan Obamacare Deal Providing Subsidies, State Flexibility
It would include two years of funding for Obamacare’s cost-sharing program, which President Donald Trump cut last week. It also would allow states to use existing Obamacare waivers to approve insurance plans with “comparable affordability” as Obamacare plans. The agreement also would expand availability of catastrophic health insurance plans to consumers over the age of 30. (Haberkorn, 10/17)

The Hill: GOP Senator Announces Deal On Health Insurer Payments
Trump, who was holding a press conference with Greek’s prime minister as Alexander spoke with reporters, said what ever had been negotiated represented a “short-term” deal. The president said that he could support the deal, but argued an executive order he issued last week designed to change insurance markets represented a better path forward on health care. (Sullivan, 10/17)

Bloomberg: Senator Announces Bipartisan Deal On Obamacare Fixes
“This is a small step,” Alexander said on the agreement, which he worked out with Senator Patty Murray, a Washington Democrat. “President Trump has encouraged this.” The deal still has to make it through both houses of Congress and be signed by Trump. If it becomes law, it could end a chaotic week that saw the White House move to dismantle parts of the Affordable Care Act even as Trump took credit for pushing lawmakers to work out the fixes. (Edney, Wasson and Litvan, 10/17)

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Viewpoints: How Artificial Intelligence Changes Medical Practice; Birth Control Vs. Religious Liberty

A selection of opinions on health care from around the country.

Stat: The Rise Of Artificial Intelligence Means Doctors Must Redefine What They Do
This view of post-human medicine may seem repulsive to those who see medicine as uniquely human. Some of that view is grounded in arrogance — surely nothing could ever do what we do as well as us. But as medicine confronts its limitations, modern providers are faced with a paradox: We want the precision and specificity of the machine yet we want to believe that we can still do it all with our hands and eyes and ears. We probably can’t. So we need to start redefining what the human doctor of the 21st century will do. (Bryan Vartabedian, 10/16)

San Antonio Press-Express: Religious Discrimination The Sweet Spot For Undoing Birth Control
After a long history of public debate about women’s access to contraception, a University of Texas/Texas Tribune Poll conducted just last year found the right to use contraception essentially a settled issue. Now the Trump administration’s high-profile action in the name of religious liberty has introduced conflict into an area where before there had been consensus. (Jim Henson and Joshua Blank, 10/16)

Los Angeles Times: Patients Face Tough Choices When A Healthcare Provider Calls It Quits
There are nearly 30 million people with diabetes in the United States. About 90,000 of them were just thrown a curve ball. Johnson & Johnson announced that it’s closing its Animas subsidiary and getting out of the insulin-pump business, leaving the field primarily to a single large competitor, Medtronic, which will control roughly 85% of the market. (David Lazarus, 10/17)

The New York Times: How A Healthy Economy Can Shorten Life Spans
The health of a nation’s economy and the health of its people are connected, but in some surprising ways. At times like these, when the economy is strong and unemployment is low, research has found that death rates rise. At least, in the short term. In the long term, economic growth is good for health. What’s going on? (Austin Frakt, 10/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Viewpoints: How Artificial Intelligence Changes Medical Practice; Birth Control Vs. Religious Liberty

A selection of opinions on health care from around the country.

Stat: The Rise Of Artificial Intelligence Means Doctors Must Redefine What They Do
This view of post-human medicine may seem repulsive to those who see medicine as uniquely human. Some of that view is grounded in arrogance — surely nothing could ever do what we do as well as us. But as medicine confronts its limitations, modern providers are faced with a paradox: We want the precision and specificity of the machine yet we want to believe that we can still do it all with our hands and eyes and ears. We probably can’t. So we need to start redefining what the human doctor of the 21st century will do. (Bryan Vartabedian, 10/16)

San Antonio Press-Express: Religious Discrimination The Sweet Spot For Undoing Birth Control
After a long history of public debate about women’s access to contraception, a University of Texas/Texas Tribune Poll conducted just last year found the right to use contraception essentially a settled issue. Now the Trump administration’s high-profile action in the name of religious liberty has introduced conflict into an area where before there had been consensus. (Jim Henson and Joshua Blank, 10/16)

Los Angeles Times: Patients Face Tough Choices When A Healthcare Provider Calls It Quits
There are nearly 30 million people with diabetes in the United States. About 90,000 of them were just thrown a curve ball. Johnson & Johnson announced that it’s closing its Animas subsidiary and getting out of the insulin-pump business, leaving the field primarily to a single large competitor, Medtronic, which will control roughly 85% of the market. (David Lazarus, 10/17)

The New York Times: How A Healthy Economy Can Shorten Life Spans
The health of a nation’s economy and the health of its people are connected, but in some surprising ways. At times like these, when the economy is strong and unemployment is low, research has found that death rates rise. At least, in the short term. In the long term, economic growth is good for health. What’s going on? (Austin Frakt, 10/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: Calif. Gov. Signs Key Health Bills; New York Issues Updated, Emergency Guidance For Home Health Care Employers

Outlets report on news from California, New York, Oregon, Texas, Georgia, Connecticut, Puerto Rico, West Virginia, Ohio, Illinois and Florida.

California Healthline: Governor Inks Support For Some Key Health Bills, Nixes Others
Wielding his pen, Gov. Jerry Brown has reinforced the Affordable Care Act, stood up to pharmaceutical companies and boosted testing for childhood lead poisoning. Facing a Sunday deadline to approve or reject measures passed by the legislature this year, Brown weighed in on some key health care bills, including measures to protect Californians who buy insurance for themselves. (Bartolone and Ibarra, 10/16)

Modern Healthcare: New York Issues Emergency Regs On How It Pays Home Care Workers For 24-Hour Shifts
The state Department of Labor has issued an emergency update to its minimum-wage regulations that reinforces its longstanding guidance to home health care employers to pay workers for just 13 hours of a 24-hour shift. The policy, known as the ’13-hour rule,’ helps control state spending on home care, which accounts for about 11% of the Medicaid budget. But it conflicts with three New York appellate court decisions issued in April and September that threw the home care industry into a panic. The rulings said home health aides who don’t live full time with their elderly or disabled clients should be paid for every hour of a 24-hour shift. (Lewis, 10/16)

The Oregonian: Oregon Voters Will Decide Whether To Overturn $340 Million In Health Care Taxes 
An effort to overturn part of Oregon’s $550 million health care tax plan qualified for the ballot on Monday, which means voters will decide whether to keep the taxes in a Jan. 23 special election. State lawmakers passed the taxes earlier this year to raise money so they could balance the state’s Medicaid budget and stabilize the individual insurance market. Oregon’s health agency faced a budget gap due to reasons including the long-planned ramp down of federal support for states that expanded Medicaid under the Affordable Care Act. (Borrud, 10/16)

The New York Times: On Health, De Blasio Focuses On Crises And Inequality
Four years ago, Bill de Blasio, then the city’s public advocate and a mere mayoral hopeful, took part in a rally in Midtown Manhattan to protest the imminent closing of Long Island College Hospital. Surrounded by dozens of singing and cheering hospital workers, he chanted “No Hospital, No Peace,” and helped block the entrance to the offices of the chancellor of the State University of New York. The police arrested Mr. de Blasio and charged him with disorderly conduct. (Santora, 10/16)

The Washington Post: A 2-Year-Old’s Kidney Transplant Was Put On Hold — After His Donor Father’s Probation Violation
A father in Georgia who had prepared to donate a kidney to his 2-year-old son said last week that he is being forced to wait after a recent stint in county jail. Anthony Dickerson’s son, A.J., was born without kidneys, and Dickerson, who is a perfect match, was ready to donate one of his, he told NBC affiliate WXIA in Atlanta. He was arrested days before the planned transplant but released from Gwinnett County Jail this month to undergo surgery. Now, he said, the transplant center at Emory University Hospital has put it on hold — in a case that one expert called befuddling. (Bever, 10/16)

The CT Mirror: Malloy Counters With ‘Lean, No-Frills, No-Nonsense’ Budget
In a bid to end Connecticut’s budget stalemate and persuade legislators to abandon a legally questionable deferral of contributions to the state’s underfunded pension system, Gov. Dannel P. Malloy unveiled his fourth budget proposal for the new biennium Monday. It asks lawmakers to reduce tax increases by accepting deeper cuts to town aid, education and social services. (Phaneuf, Pazniokas and Rabe Thomas, 10/16)

Georgia Health News: An Alarming Trend: Premature Births Go Up In Georgia
Georgia’s preterm birth rate rose in 2016 after years of decrease, a disturbing trend that is mirrored by national data, state officials said Monday. Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. It’s also called premature birth. (Miller, 10/16)

The Washington Post: Puerto Rican Families Draw Water From Superfund Site
Every 10 minutes or so, a truck or a van pulled up to the exposed spigot of an overgrown well, known as Maguayo #4, that sits not far from a bustling expressway and around the corner from a Krispy Kreme doughnut shop. Fencing around the area had been torn open, and a red and white “Peligro” sign, warning of danger, lay hidden beneath debris and dense vegetation. One after another, people attached a hose to draw water for bathing, washing dishes and, in some cases, drinking. They filled buckets, jugs, soda bottles. (Hernandez and Dennis, 10/16)

Kaiser Health News: On Back Roads Of Appalachia’s Coal Country, Mental Health Services Are As Rare As Jobs
Every other month, Tanya Nelson travels 32 miles from the heart of Appalachia’s coal country for an appointment with the nearest psychiatrist for therapy and to renew prescriptions. But the commute, which should take less than an hour through the winding mountain roads of southern West Virginia, consumes her entire day. Nelson, 29, needs treatment for bipolar disorder, depression and anxiety. But she does not drive, so she must use a van service to keep her appointments. It makes numerous stops along the highway, picking up other travelers, and usually doesn’t return to her home in New Richmond, W.Va., until day’s end. (Connor, 10/17)

Cleveland Plain Dealer: BioEnterprise To Oversee Struggling Global Center For Health Innovation
BioEnterprise, which promotes and nutures healthcare companies and bioscience technologies, will oversee marketing, promotion and tenants at the struggling Global Center for Health Innovation. The nonprofit company was retained Monday by the Cuyahoga County Convention Facilities Development Corp., the nonprofit organization that oversees the Huntington Convention Center and Global Center. (Farkas, 10/16)

Reuters: U.S. Nursing Home Chain Faces Landlord Showdown Over Default
The fate of one of the largest U.S. nursing home operators, HCR ManorCare, will reach a critical court deadline on Thursday in a battle over months of unpaid rent, a growing problem in an industry where eviction would put thousands of elderly out on the street. Many nursing home chains spun off their properties to real estate companies over the last decade to unlock value. Now those landlords need to deal with operators behind on their rent without harming thousands of elderly residents. (Rucinski, 10/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

State Highlights: Calif. Gov. Signs Key Health Bills; New York Issues Updated, Emergency Guidance For Home Health Care Employers

Outlets report on news from California, New York, Oregon, Texas, Georgia, Connecticut, Puerto Rico, West Virginia, Ohio, Illinois and Florida.

California Healthline: Governor Inks Support For Some Key Health Bills, Nixes Others
Wielding his pen, Gov. Jerry Brown has reinforced the Affordable Care Act, stood up to pharmaceutical companies and boosted testing for childhood lead poisoning. Facing a Sunday deadline to approve or reject measures passed by the legislature this year, Brown weighed in on some key health care bills, including measures to protect Californians who buy insurance for themselves. (Bartolone and Ibarra, 10/16)

Modern Healthcare: New York Issues Emergency Regs On How It Pays Home Care Workers For 24-Hour Shifts
The state Department of Labor has issued an emergency update to its minimum-wage regulations that reinforces its longstanding guidance to home health care employers to pay workers for just 13 hours of a 24-hour shift. The policy, known as the ’13-hour rule,’ helps control state spending on home care, which accounts for about 11% of the Medicaid budget. But it conflicts with three New York appellate court decisions issued in April and September that threw the home care industry into a panic. The rulings said home health aides who don’t live full time with their elderly or disabled clients should be paid for every hour of a 24-hour shift. (Lewis, 10/16)

The Oregonian: Oregon Voters Will Decide Whether To Overturn $340 Million In Health Care Taxes 
An effort to overturn part of Oregon’s $550 million health care tax plan qualified for the ballot on Monday, which means voters will decide whether to keep the taxes in a Jan. 23 special election. State lawmakers passed the taxes earlier this year to raise money so they could balance the state’s Medicaid budget and stabilize the individual insurance market. Oregon’s health agency faced a budget gap due to reasons including the long-planned ramp down of federal support for states that expanded Medicaid under the Affordable Care Act. (Borrud, 10/16)

The New York Times: On Health, De Blasio Focuses On Crises And Inequality
Four years ago, Bill de Blasio, then the city’s public advocate and a mere mayoral hopeful, took part in a rally in Midtown Manhattan to protest the imminent closing of Long Island College Hospital. Surrounded by dozens of singing and cheering hospital workers, he chanted “No Hospital, No Peace,” and helped block the entrance to the offices of the chancellor of the State University of New York. The police arrested Mr. de Blasio and charged him with disorderly conduct. (Santora, 10/16)

The Washington Post: A 2-Year-Old’s Kidney Transplant Was Put On Hold — After His Donor Father’s Probation Violation
A father in Georgia who had prepared to donate a kidney to his 2-year-old son said last week that he is being forced to wait after a recent stint in county jail. Anthony Dickerson’s son, A.J., was born without kidneys, and Dickerson, who is a perfect match, was ready to donate one of his, he told NBC affiliate WXIA in Atlanta. He was arrested days before the planned transplant but released from Gwinnett County Jail this month to undergo surgery. Now, he said, the transplant center at Emory University Hospital has put it on hold — in a case that one expert called befuddling. (Bever, 10/16)

The CT Mirror: Malloy Counters With ‘Lean, No-Frills, No-Nonsense’ Budget
In a bid to end Connecticut’s budget stalemate and persuade legislators to abandon a legally questionable deferral of contributions to the state’s underfunded pension system, Gov. Dannel P. Malloy unveiled his fourth budget proposal for the new biennium Monday. It asks lawmakers to reduce tax increases by accepting deeper cuts to town aid, education and social services. (Phaneuf, Pazniokas and Rabe Thomas, 10/16)

Georgia Health News: An Alarming Trend: Premature Births Go Up In Georgia
Georgia’s preterm birth rate rose in 2016 after years of decrease, a disturbing trend that is mirrored by national data, state officials said Monday. Preterm birth is when a baby is born too early, before 37 weeks of pregnancy have been completed. It’s also called premature birth. (Miller, 10/16)

The Washington Post: Puerto Rican Families Draw Water From Superfund Site
Every 10 minutes or so, a truck or a van pulled up to the exposed spigot of an overgrown well, known as Maguayo #4, that sits not far from a bustling expressway and around the corner from a Krispy Kreme doughnut shop. Fencing around the area had been torn open, and a red and white “Peligro” sign, warning of danger, lay hidden beneath debris and dense vegetation. One after another, people attached a hose to draw water for bathing, washing dishes and, in some cases, drinking. They filled buckets, jugs, soda bottles. (Hernandez and Dennis, 10/16)

Kaiser Health News: On Back Roads Of Appalachia’s Coal Country, Mental Health Services Are As Rare As Jobs
Every other month, Tanya Nelson travels 32 miles from the heart of Appalachia’s coal country for an appointment with the nearest psychiatrist for therapy and to renew prescriptions. But the commute, which should take less than an hour through the winding mountain roads of southern West Virginia, consumes her entire day. Nelson, 29, needs treatment for bipolar disorder, depression and anxiety. But she does not drive, so she must use a van service to keep her appointments. It makes numerous stops along the highway, picking up other travelers, and usually doesn’t return to her home in New Richmond, W.Va., until day’s end. (Connor, 10/17)

Cleveland Plain Dealer: BioEnterprise To Oversee Struggling Global Center For Health Innovation
BioEnterprise, which promotes and nutures healthcare companies and bioscience technologies, will oversee marketing, promotion and tenants at the struggling Global Center for Health Innovation. The nonprofit company was retained Monday by the Cuyahoga County Convention Facilities Development Corp., the nonprofit organization that oversees the Huntington Convention Center and Global Center. (Farkas, 10/16)

Reuters: U.S. Nursing Home Chain Faces Landlord Showdown Over Default
The fate of one of the largest U.S. nursing home operators, HCR ManorCare, will reach a critical court deadline on Thursday in a battle over months of unpaid rent, a growing problem in an industry where eviction would put thousands of elderly out on the street. Many nursing home chains spun off their properties to real estate companies over the last decade to unlock value. Now those landlords need to deal with operators behind on their rent without harming thousands of elderly residents. (Rucinski, 10/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

After Fixing Diversity Problem, Researchers Found Normal Brain Looks Different Than They Thought

The study originally had a disproportionately high number of kids with parents who have an advanced degree. Weighting the data to make it more representative offered insights of what the brain actually looks like. In other public health news: HPV, fertility and sleep.

NPR: What Does A Normal Brain Look Like?
Brain imaging studies have a diversity problem. That’s what researchers concluded after they re-analyzed data from a large study that used MRI to measure brain development in children from 3 to 18. Like most brain imaging studies of children, this one included a disproportionate number of kids who have highly educated parents with relatively high household incomes, the team reported Thursday in the journal Nature Communications. (Hamilton, 10/16)

The New York Times: 7 Million American Men Carry Cancer-Causing HPV Virus
The incidence of mouth and throat cancers caused by the human papilloma virus in men has now surpassed the incidence of HPV-related cervical cancers in women, researchers report. The study, in the Annals of Internal Medicine, found that 11 million men and 3.2 million women in the United States had oral HPV infections. Among them, 7 million men and 1.4 million women had strains that can cause cancers of the throat, tongue and other areas of the head and neck. (Bakalar, 10/16)

The New York Times: Raising Concerns About A Widely Used Test To Measure Fertility
Michele K. Bourquin, an account executive from Atlanta, was 36 and divorced when she first looked into freezing her eggs. “I knew I wasn’t getting any younger, and my eggs were aging,” Ms. Bourquin said. So she visited a doctor who gave her a blood test that’s often used to check a woman’s egg supply. It works by looking for anti-Müllerian hormone, or AMH, which is secreted by growing follicles, the sacs that house each egg. (Caron, 10/16)

NPR: How To Fall Asleep And Why We Need More
The National Sleep Foundation recommends an average of eight hours of sleep per night for adults, but sleep scientist Matthew Walker says that too many people are falling short of the mark. “Human beings are the only species that deliberately deprive themselves of sleep for no apparent gain,” Walker says. “Many people walk through their lives in an underslept state, not realizing it.” (Gross, 10/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

After Fixing Diversity Problem, Researchers Found Normal Brain Looks Different Than They Thought

The study originally had a disproportionately high number of kids with parents who have an advanced degree. Weighting the data to make it more representative offered insights of what the brain actually looks like. In other public health news: HPV, fertility and sleep.

NPR: What Does A Normal Brain Look Like?
Brain imaging studies have a diversity problem. That’s what researchers concluded after they re-analyzed data from a large study that used MRI to measure brain development in children from 3 to 18. Like most brain imaging studies of children, this one included a disproportionate number of kids who have highly educated parents with relatively high household incomes, the team reported Thursday in the journal Nature Communications. (Hamilton, 10/16)

The New York Times: 7 Million American Men Carry Cancer-Causing HPV Virus
The incidence of mouth and throat cancers caused by the human papilloma virus in men has now surpassed the incidence of HPV-related cervical cancers in women, researchers report. The study, in the Annals of Internal Medicine, found that 11 million men and 3.2 million women in the United States had oral HPV infections. Among them, 7 million men and 1.4 million women had strains that can cause cancers of the throat, tongue and other areas of the head and neck. (Bakalar, 10/16)

The New York Times: Raising Concerns About A Widely Used Test To Measure Fertility
Michele K. Bourquin, an account executive from Atlanta, was 36 and divorced when she first looked into freezing her eggs. “I knew I wasn’t getting any younger, and my eggs were aging,” Ms. Bourquin said. So she visited a doctor who gave her a blood test that’s often used to check a woman’s egg supply. It works by looking for anti-Müllerian hormone, or AMH, which is secreted by growing follicles, the sacs that house each egg. (Caron, 10/16)

NPR: How To Fall Asleep And Why We Need More
The National Sleep Foundation recommends an average of eight hours of sleep per night for adults, but sleep scientist Matthew Walker says that too many people are falling short of the mark. “Human beings are the only species that deliberately deprive themselves of sleep for no apparent gain,” Walker says. “Many people walk through their lives in an underslept state, not realizing it.” (Gross, 10/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.

Pharma Is Still ‘Getting Away With Murder,’ Trump Says Hinting At Intent To Bring Down Costs

President Donald Trump railed against high drug prices, reiterating a talking point from the campaign, but though he promised to get prices “way down,” he offered little detail on how to accomplish that.

The Hill: Trump Promises Action On Drug Prices
President Trump on Monday attacked prescription drug companies and hinted at taking action to bring down rising drug prices. “We are going to get prescription drug prices way down because the world is taking advantage of us,” Trump said during a wide-ranging press conference. (Weixel, 10/16)

In other pharmaceutical news —

The New York Times: Patents For Restasis Are Invalidated, Opening Door To Generics
A federal judge in Texas invalidated four key patents for the dry-eye treatment Restasis on Monday, dealing a blow to its manufacturer, Allergan, which had sought to protect its patents by transferring them to a Native American tribe. The ruling, by United States Circuit Judge William C. Bryson of the Eastern District of Texas, does not mean that generic versions of the drug will be available soon, however. Allergan said that it would appeal the decision, and the Food and Drug Administration has not yet approved copycat versions of the drug. (Thomas, 10/16)

Bloomberg: Drugmakers Are Planning To Start A Phase 2 Trial To Cure Peanut Allergy
Aimmune Therapeutics Inc. is teaming with Regeneron Pharmaceuticals Inc. in hopes of developing a cure for peanut allergies. Aimmune, based in Brisbane, California, specializes in food allergy treatments and has been developing a desensitizing therapy, AR101, to protect peanut allergy sufferers against reactions from accidental exposures. By combining AR101 with Regeneron’s inflammation-inhibiting drug Dupixent, the companies are seeking to increase protection enough so patients stop reacting to peanuts even after treatment ends. (Chen, 10/16)

This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.