Tagged Pharmaceuticals

Tired Of The Financial Cost, One Politician Suggests Cutting Off Emergency Help For Those Overdosing

Dan Picard, a council member of a small town in Ohio, said that responding to an ever-increasing number of overdose calls threatens to bleed his city dry. Media outlets report on the crisis out of California, Texas, Kentucky, Pennsylvania and Maryland, as well.

The Washington Post: One Politician’s Solution To The Overdose Problem: Let Addicts Die
Under a plan by a city council member in Ohio, people who dial 911 seeking help for someone who’s overdosing on opioids may start hearing something new from dispatchers: “No.” In response to the opioid epidemic that swept the nation — including the small city of Middletown, population 50,000 — council member Dan Picard has floated an idea that has been called more of “a cry of frustration” than a legitimate solution. At a council meeting last week, Picard proposed a three-strikes-style policy for people who repeatedly overdose: Too many overdoses and authorities wouldn’t send an ambulance to resuscitate them. (Wootson, 6/28)

Stat: Setting Medicaid Aside, The House Heroin Task Force Searches For Common Ground
The House Heroin Task Force is attempting to tackle the opioid crisis with a set of bipartisan bills that would alter medical record laws, fund new grant programs for prevention and awareness efforts, and increase accountability within the Department of Veterans Affairs. In other words, the legislators are doing what they can to address the epidemic — as long as Medicaid doesn’t come up. (Facher, 6/28)

Los Angeles Times: Amid Opioid Overdoses, Santa Clarita Officials Team Up To Arrest Dealers And Offer Rehab
The dealers were smuggling in bundles of cocaine and heroin, some of it hidden in secret compartments inside their cars. They carried thousands of dollars in cash and at least one firearm, all believed to be linked to their drug peddling in Santa Clarita. Over the last month and a half, a special team of Los Angeles County sheriff’s detectives based out of the Santa Clarita Valley station arrested 39 people on suspicion of narcotics possession and sales, officials announced Wednesday. The team also seized two pounds of heroin, $13,000 in cash and a stolen firearm in the operation. (Lau, 6/28)

Stat: Kentucky Senate President Urges Release Of Secret OxyContin Records
The president of the Kentucky state Senate said Wednesday that he plans to file a motion to intervene in support of a legal effort by STAT to unseal documents filed in a case involving OxyContin maker Purdue Pharma. The secret documents were filed as part of a lawsuit by the state of Kentucky against Purdue Pharma that was settled in December 2015, with Purdue paying $24 million to the state. The documents include a deposition of Dr. Richard Sackler, a former president of Purdue and a member of the family that owns the company; internal emails about the marketing of the drug; minutes of strategy meetings; analysis by the company of clinical trials; and other documents. (Armstrong, 6/28)

The Philadelphia Inquirer/Philly.com: Methadone Is Getting An Image Rehab As Opioid Crisis Deepens
Nearly a half-century into the “war on drugs,” with a new wave of opioid addiction at crisis proportions, a handful of commercial health insurers are beginning to cover methadone maintenance, the oldest and best-researched treatment for addiction to heroin and prescription pain relievers. Independence Blue Cross, the Philadelphia region’s largest insurer, will join the emerging trend in August, offering complete coverage with no co-pays. There are spaces available at local methadone clinics and the treatment is considered highly effective. (Sapatkin, 6/29)

The Baltimore Sun: Doctor’s License Suspended After State Board Said He Over Prescribed Opioids 
As Baltimore struggles with skyrocketing overdose deaths linked largely to opioids such as heroin and prescription painkillers, state officials suspended the medical license of a local pain doctor for allegedly over-prescribing the highly addictive medications. According to an emergency order from the state Board of Physicians suspending the medical license of Dr. Kofi Shaw-Taylor, he gave “excessively high” amounts of opioid painkillers to some patients, while prescribing others both opioids and drugs to curb opioid addiction at the same time. (Cohn, 6/28)

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

Seniors Miss Out On Clinical Trials

More than 60 percent of cancer patients are older adults — and that will rise to 70 percent by 2040.  Yet seniors continue to be underrepresented in clinical trials, making it difficult to assess how treatments are likely to help or harm them.

The newest evidence of the problem comes from a Food and Drug Administration analysis, which found that only 25 percent of patients participating in cancer clinical trials were 65 and older. The analysis, which has not yet been published, was presented at the American Society of Clinical Oncology’s annual meeting in June.

Clinical trials investigate the safety and effectiveness of new drugs and therapies, as well as ways to prevent illness and detect conditions early. Their discoveries help guide medical practice.

Yet, older adults are often not included in research studies to any significant extent. This is especially true for cancer patients in their 70s and 80s, according to the FDA’s data:

  • While 19 percent of breast cancer patients are 75 or older, only 4 percent of breast cancer clinical trial participants are of this age.
  • Although 33 percent of colon cancer patients are in the 75-and-up group, a mere 8 percent of patients studied by researchers fell in that age group.
  • While 37 percent of lung cancer patients are 75 or older, only 9 percent of people of that age are represented in lung cancer clinical trials.

The sobering conclusion: “It’s difficult to practice evidence-based medicine in an older population because the data isn’t there,” said Dr. Stuart Lichtman, professor of medicine at Weill Cornell Medical College in New York City and president of the International Society of Geriatric .

And it’s not just cancer. Across medical conditions that disproportionately affect seniors, people 65 and older have a poor showing in clinical trials.

“There’s often an assumption that drugs only need to be tested in younger people and results can be extrapolated,” said Dr. Consuelo Wilkins, an associate professor of medicine at Vanderbilt University Medical Center who, with colleagues, is overseeing a major grant to help bring more seniors,  blacks, Hispanics and other groups into clinical trials. “But we know that how older adults respond to medications and interventions and their risk for adverse events is different based on their physiology.”

Difficulties enrolling older people in research studies extend to Alzheimer’s disease. With National Institutes of Health research funding now at nearly $1.4 billion a year, “we’re going to be seeing more and more clinical trials, but it’s already difficult to get enough people to participate,” said Keith Fargo, director of scientific programs at the Alzheimer’s Association.

Fewer than one-third of people diagnosed with Alzheimer’s are eligible to join clinical trials, he said.

Judith GrahamNAVIGATING AGING

Researchers often find older adults unsuitable for trials for multiple reasons:  Seniors may have multiple illnesses — diabetes and hypertension, as well as cancer or Alzheimer’s disease — that could complicate the study’s results, or they may be taking several medications already that could interact with therapies being examined.

Also, older adults may live alone, and not have someone who can accompany them to the study site for tests and procedures — a significant concern for Alzheimer’s trials, which typically require a caregiver to provide input about the patient’s condition and progress. Or, seniors can’t get around easily. Or they’re frail.

Responsibility falls to a large extent on physicians, said Dr. Richard Schilsky, chief medical officer for ASCO, noting “they don’t ask older adults whether they want to participate or not. It’s a combination of concern that older patients might be unable to comply with a trial’s requirements, which are usually quite rigorous, and concern that specified therapies might be too toxic.”

Two years ago, ASCO issued new recommendations calling for older adults to be included in more clinical trials. But progress has been slow, acknowledged Dr. Hyman Muss, director of geriatric oncology at the Lineberger Comprehensive Cancer Center at the University of North Carolina-Chapel Hill.

“My view is that every patient I see, if they’re eligible for a clinical trial I’ll tell them about it,” he said.

Don’t assume your doctor will be equally forthcoming. “Absolutely, you should take the initiative and ask,” Schilsky recommended. And don’t assume you need to have run out of options before doing so. “Clinical trials aren’t just for people who have no treatment options left — that’s a common misconception,” Schilsky said.

Debbie Earp, 67, joined a trial at the Lineberger this year, after getting a diagnosis of stage 2 breast cancer in early January. Her responsibilities over the four-month study: wearing a Fitbit, tracking how much exercise she was getting on a daily basis, and filling out a questionnaire about how she was feeling each time she got chemotherapy.

Earp said she agreed to participate because “I’ve always exercised and I felt, from a physical and psychological point of view, anything that was going to motivate me during treatment to exercise more would be a good idea.” The goal of the trial was to examine how physical activity affects older breast cancer patients’  response to chemotherapy.

Of course, clinical trials aren’t for everyone. Some older adults are reluctant to consider them because they’re skeptical of unproven therapies. Others may choose to focus on their quality of life instead of aggressive treatments.

There are good resources about clinical trials on the internet, if you know where to look. The National Institute on Aging has prepared materials for older adults, including a list of questions that seniors should ask before deciding whether to join a trial. The FDA has a patient-oriented site that delves into issues such as informed consent — making sure you’re fully informed about the potential benefits and harms of a research study, among other essential information.

For those who want to look for trials on their own, the NIH sponsors ClinicalTrials.gov, a database of studies across the world, searchable by disease and geography. Trials Today is an effort to make the NIH site more consumer-friendly, created at Vanderbilt University. ResearchMatch is another Vanderbilt effort where people who want to participate in studies can sign up and be matched with clinical trial sponsors. And TrialMatch is a one-stop-shop for clinical trials for people with Alzheimer’s disease, their caregivers, and people interested in preventing dementia, currently listing nearly more than 250 scientific studies.

Make sure you run whatever prospects you find by your doctor. “Very few patients have the expertise to understand if a clinical trial is appropriate for them,” Schilsky said. “You really need an expert opinion to help you understand what you find.”

Categories: Aging, Navigating Aging, Pharmaceuticals

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Pharmacist Sentenced To 9 Years For Role In Deadly Fungal Meningitis Outbreak

The outbreak, which was tied to the New England Compounding Center, caused at least 64 deaths.

The New York Times: Pharmacist Gets 9-Year Prison Term In Deadly Meningitis Outbreak
The tainted injection left Rachelle Shuff with pain that requires 15 medications to manage and, she said, perhaps only two years to live. Scott Shaw and Anna Shaw Allred had to bury their mother, Elwina Shaw, who at 77 was healthy, they said, until she got a tainted injection of a steroid and a debilitating illness followed. (Bidgood, 6/26)

Boston Globe: Former NECC Co-Owner Sentenced To Nine Years In Prison
Cadden was convicted in March of fraud and racketeering charges stemming from the public health crisis triggered when NECC sent tainted medicines around the country, causing a fungal meningitis outbreak that killed at least 60 and sickened hundreds. The jury did not convict him of second-degree murder charges. (Arsenault and Ellement, 6/26)

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

Take Our Quiz To Test Your Wits On Aging

As we get older, it helps to tickle the noggin’ with trivia. Here’s a pop quiz to see what you have learned as a regular reader of Kaiser Health News.

KHN’s coverage related to aging & improving care of older adults is supported by The John A. Hartford Foundation.

Categories: Aging, Health Industry, Insurance, Medicaid, Medicare, Multimedia, Pharmaceuticals

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Patients With Mental Disorders Get Half Of All Opioid Prescriptions

Adults with a mental illness receive more than 50 percent of the 115 million opioid prescriptions in the United States annually, according to a study released Monday. The results prompted researchers to suggest that improving pain management for people with mental health problems “is critical to reduce national dependency on opioids.”

People with mental health disorders represent 16 percent of the U.S. population.

The findings are worrisome, the researchers reported. They had expected that physicians were more conservative in prescribing these painkillers to people with mental illness.

“We are prescribing way too much opioids,” said Dr. Brian Sites, an anesthesiologist at Dartmouth-Hitchcock Medical Center in New Hampshire and one of the study’s researchers. “And that prescription behavior is resulting in significant morbidity in the country.”

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“Because patients with mental health disorders are a vulnerable population, [they’re] probably more likely to develop addiction and abuse,” he added. Sites suggested that physicians consider using different criteria when prescribing opioids for people with mental illness.

“The opioids are prescribed primarily for pain,” but patients with mental illness find they alleviate their mental issues too, said Dr. Edwin Salsitz, an attending physician in the Division of Chemical Dependency of Mount Sinai Beth Israel Medical Center in New York who was not involved in the study. And this, he said, is what can lead to long-term use.

The study, published in the Journal of the American Board of Family Medicine, found that nearly 19 percent of Americans with a mental health illness use prescription opioids, while the same is true for only 5 percent of those without a mental health condition.

According to the federal Centers for Disease Control and Prevention, the number of opioid sales in the U.S. quadrupled from 1999 to 2015, yet the amount of pain adults experience remained the same. In addition to that, more than 183,000 people died from overdoses related to prescription opioid use during this time.

With no objective scale for measuring pain, doctors are hampered in treating patients with chronic discomfort.

“Since [pain is] a subjective phenomenon, it’s very difficult to measure those things and to treat because some patients [report] 10-out-of-10 pain forever,” Sites said.

Dr. Andrew Saxon, director of the Addiction Psychiatry Residency Program at the University of Washington, said that “most people with chronic pain who end up on opioids do have a co-occurring psychiatric disorder.” Yet too often the drugs don’t provide lasting relief, he said.

“We have found that opioids for most of these people in the long term improve their subjective sense of pain for a little bit, but they don’t usually improve people’s level of function,” said Saxon, who was not involved in this study.

Many opioid patients, and especially those with mental health issues, should be offered an alternative treatment, Saxon said.

“It actually turns out … that the best treatment for chronic pain is going to be behavioral interventions, not medications,” he explained. That involves teaching people to understand the underlying cause of their pain and skills to better cope with it, the psychiatrist said.

Sites said alternatives to opioids could include cognitive behavioral therapy, acupuncture, meditation techniques and physical therapy.

“The idea is that we want to improve the health and well-being of the patient. And if that’s not occurring, we need alternatives to opioids,” Sites said.

Categories: Mental Health, Pharmaceuticals, Public Health

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New Shingles Vaccine May Be Approved With Preferred Rating From Influential Expert Panel

Today’s other public health news covers increased options for mammograms, the connection between the gut and brain, new science on dreams and screening kids for obesity.

Stat: U.S. Panel Considers Giving A Nod To New Vaccine, And A Competitor Objects
If you want to avoid shingles — a condition that comes with a painful rash — there is a vaccine available. But studies have shown that protection generated by the vaccine declines quickly. A new vaccine, however, is being considered for approval, and if and when the Food and Drug Administration gives it the green light, its may hit the market with a highly desirably preferential rating from an influential panel of vaccine experts. (Branswell, 6/22)

NPR: Women Have More Options In When They Have Mammograms
Women in their 40s at average risk for breast cancer should talk to their health care provider about the risks and benefits of mammography before starting regular screening at that age, according to guidelines released Thursday by the American College of Obstetricians and Gynecologists. (Hobson, 6/22)

NPR: Forget Freud: Dreams Replay Everyday Life
Thanks to Sigmund Freud, we all know what it means to dream about swords, sticks and umbrellas. Or maybe we don’t. “For 100 years, we got stuck into that Freudian perspective on dreams, which turned out to be not scientifically very accurate,” says Robert Stickgold, a sleep researcher and associate professor of psychiatry at Harvard Medical School. “So it’s only been in the last 15 to 20 years that we’ve really started making progress.” (Hamilton, 6/22)

Kaiser Health News: All Kids Should Be Screened For Obesity
Earlier this week, an influential group of experts in preventive care affirmed that children age 6 and older should be screened for obesity and referred to intensive treatment when necessary. While the Affordable Care Act requires that nearly all plans cover such treatment, most kids don’t have access to programs featuring exercise, nutrition and counseling, according to an editorial published in JAMA Internal Medicine. (Andrews, 6/23)

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Trump Executive Order Draft On Drug Prices Would Decrease Regulations, Take Steps To Increase Competition

CQ Roll Call reports that a draft document indicates that the Trump administration leaning toward a roll back of regulations to foster faster drug approvals and promoting competition and new payment models for federal insurance programs. In other pharmaceutical industry news, Mylan shareholders reject the Epi-Pen maker’s executive pay policy but re-elect its board.

Roll Call: Draft Drug Price Order Focuses On Regulations, Trade
The Trump administration might seek to roll back regulations in pursuit of faster drug approvals, promoting drug competition and new payment models for federal health insurance programs, according to a draft executive order obtained by CQ Roll Call. Some of the items listed would benefit pharmaceutical companies, despite President Donald Trump’s pledge earlier this year to take steps to rein in the industry because he said it was “getting away with murder.” But the administration is also hinting that it could address some anti-competitive behavior in that sector. There are also a number of recommended proposals that could give incentives for the development of generic drugs. (Siddons and Williams, 6/23)

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EpiPen Maker Reportedly Offered States Discounts If They Cut Down Competition

Stat reports that Mylan made the rebates conditional on states requiring that competitors’ products get special requests by clinicians to be covered by Medicaid. In other news, the Food and Drug Administration says it will hold a hearing on efforts by drugmakers to impede competition, and an Australian drug company that is linked to a U.S. congressman gets approval for U.S. trials.

Stat: Mylan Offered EpiPen Discounts To States In Exchange For Exclusive Status
The pharmaceutical company Mylan offered rebates to at least six state Medicaid programs on the condition that the states would make it harder for Medicaid patients to obtain products that compete with its EpiPen auto-injector, according to email correspondence obtained by STAT. The rebates Mylan offered to state Medicaid programs were conditional upon them making EpiPen easily available while competitor products would require special requests by clinicians in order for them to be covered. (Swetlitz, 6/22)

Morning Consult: FDA To Hold Public Hearing On ‘Gaming’ In Drug Industry
The Food and Drug Administration will hold a public meeting next month to investigate ways that federal regulations can be manipulated by brand-name drugmakers to impede generic competition from entering the market. The hearing, scheduled for July 18, is the latest step taken by newly installed FDA Commissioner Scott Gottlieb to have the agency take a more active role in policing drug prices. (Reid, 6/21)

Kaiser Health News: FDA Ruling On Aussie Biotech Could Boost Congressman’s Investment
An Australian biotech company whose largest shareholder is a U.S. congressman has the greenlight to begin human trials in the U.S. for a drug to treat advanced multiple sclerosis. The Food and Drug Administration’s decision is the first step in a long approval process demonstrating a new drug’s safety and effectiveness before regulators allow it to go on the market. In Innate Immunotherapeutics’ case, it could help the company achieve its stated goal of striking a merger or partnership deal with a larger drugmaker. (Bluth, 6/21)

Meanwhile, legislators in Pennsylvania consider giving patients more access to experimental drugs —

The Philadelphia Inquirer: Pa. ‘Right-To-Try’ Bill Moves Forward, But Would It Help Terminal Patients?
Pennsylvania is a step closer to joining 37 other states that have passed laws purporting to entitle terminally ill patients to try unapproved drugs. The Senate Health and Human Services Committee unanimously approved the “right to try” bill on Wednesday. In March, the proposal unanimously passed in a House committee, then went on to unanimous passage in the House of Representatives in April — unusually rapid legislative progress.  (Whether the full Senate and Gov. Wolf will follow suit is unclear.) (McCullough, 6/21)

And drugmakers report progress against a difficult eye disease —

San Francisco Chronicle: Drug Shows Promise Against Vision-Robbing Disease In Seniors
An experimental drug from Genentech is showing promise against an untreatable eye disease that blinds older adults — and, intriguingly, it seems to work in patients who carry a particular gene flaw that fuels the damage to their vision. Age-related macular degeneration is the leading cause of vision loss among seniors, gradually eroding crucial central vision. (Neergaard, 6/21)

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Cutting Medicaid Funding In Midst Of Opioid Crisis Would Be ‘Catastrophic,’ Advocates Warn

“It would essentially write off a generation,” said Dr. Shawn Ryan, president of BrightView Health, a network of drug treatment clinics in Cincinnati. In other news on the opioid crisis, Missouri becomes the latest state to file suit against drugmaker Purdue Pharma, one in four people on Medicaid received opioids in 2015, and a county reveals its plan to curtail the epidemic.

Los Angeles Times: Tens Of Thousands Died Due To An Opioid Addiction Last Year. With An Obamacare Repeal, Some Fear The Number Will Rise
There weren’t always strollers jamming the lobby of First Step Home, one of this city’s growing number of drug treatment centers. But as the opioid epidemic has swept through Ohio, mothers with babies and small children have flocked to an aging block of brick homes just outside downtown Cincinnati. “It’s been breathtaking,” said Margo Spence, president of First Step Home, which nearly tripled the number of mothers it treats since 2013. (Levey, 6/21)

Reuters: Missouri Sues Opioid Manufacturers, Joining Two Other U.S. States
Missouri on Wednesday became the third U.S. state to accuse major drug manufacturers of fraudulently misrepresenting the risks of opioid painkillers now at the center of a national addiction epidemic. Missouri Attorney General Josh Hawley said his office filed a lawsuit in a state court in St. Louis against Purdue Pharma LP, Johnson & Johnson and units of Endo International Plc. (Raymond, 6/21)

The Wall Street Journal: Missouri Files Its Own Suit Against Opioid-Painkiller Producers
The lawsuit, filed in state court by Attorney General Joshua Hawley, targets various parent companies and subsidiaries, including Purdue Pharma LP, Johnson & Johnson and Endo Pharmaceuticals Inc., a unit of Endo International PLC. The lawsuit alleges the companies “created a sprawling campaign of misinformation and deception to convince doctors and consumers that opioids pose little risk of addiction, and that such risks can be easily identified and mitigated.” (Whalen, 6/21)

Bloomberg: Opioids Given To Almost 1 In 4 Medicaid Patients, Study Finds 
Nearly one in four people on Medicaid, the U.S. health program for the poor, received powerful and addictive opioid pain medicines in 2015, according to research by a drug-benefits management firm. The analysis by Express Scripts Holding Co., one of the largest managers of Medicaid plans’ drug benefits for the past two decades, found that about 6 percent of all prescriptions in the program were for the pain pills. The report shows the extent to which the controversial class of narcotic pain medicines has penetrated the U.S.’s health-care safety net. (Cortez, 6/21)

Columbus Dispatch: Opioid Battle In Franklin County To Focus On Treatment, Education
The 40-page “Franklin County Opiate Action Plan,” they rolled out Wednesday afternoon is the result of three months of research. Along with treatment and education, the multi-year proposal calls for a change in community perception to stress that heroin is killing family and friends of all colors and creeds while costing millions upon millions of dollars. (Perry, 6/21)

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Viewpoints: A New Tool In The Fight Against The Opioid Epidemic; Standing Up For The Hungry

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

Cleveland Plain Dealer: Ohio Lawmakers: Stand Up For The Hungry
Helping poor Americans put food on their table ought to be nonnegotiable and nonpolitical. Alas, it isn’t and if state and the federal budget cutbacks go into effect, poor children, seniors and adults can add hunger pangs to their list of woes. (6/20)

Boston Globe: Trump Doesn’t Care About AIDS 
Not since the lethal negligence of the Reagan administration have people with HIV and AIDS and their advocates faced with such presidential indifference. In a scorching resignation letter published by Newsweek, six now-former members of President Donald Trump’s HIV/AIDS advisory council cited their inability to work for “a president who simply does not care.” (Renée Graham, 6/20)

Los Angeles Times: Don’t Let Rep. Scalise’s Injury Cow Us Into Silence About The Need For Gun Control And Universal Healthcare
As a necessary prelude to a necessary discussion, surely we all can agree that best wishes are due to the still-hospitalized House Majority Whip Steve Scalise (R-La.), who faces a difficult recovery from injuries suffered in the gun attack at a Republican baseball practice June 14. … But it’s important not to overlook how Scalise’s condition illuminates two of the most important public policy issues facing our country: There are too many guns in the hands of too many unsuitable owners; and healthcare is still treated in the United States as a privilege, not a right. (Michael Hiltzik, 6/20)

The New York Times: Stories About Disability Don’t Have To Be Sad
For the most part, despite my wheelchair and knowledge of medical terminology (you build that kind of vocabulary when it’s about your own limbs), my daily reality is mostly the same as that of my classmates. I groan over the same math and science homework, giggle with the same friends, and like every other adolescent, I probably spend too much time on my phone. As a girl with a disability, I know that my story is not a sad one. For the past four years, I’ve been trying to convince everyone else as well that my story doesn’t have to be a sad one. (Melissa Shang, 6/21)

Stat: My Decade At The WHO: Dirty Fights And Steps Toward Universal Coverage
Contentious issues were legion. Proposals that aimed to increase access to affordable medicines were nearly always sidetracked by people-versus-profits issues, with barely veiled suspicions that trade rules were rigged to favor rich and powerful nations. Equally difficult issues arose when public health interests crossed purposes with the interests of powerful economic operators, like the tobacco, alcohol, food, and beverage industries. Economic power readily translates into political power. Those industries fought nearly every move we made, from recommendations to reduce daily sugar intake and tax sugary beverages to warnings that alcohol front groups must not write national alcohol policies to our advice on how to stop the marketing of unhealthy foods and beverages to children. (Margaret Chan, 6/20)

The New York Times: Charleena Lyles Needed Health Care. Instead, She Was Killed.
On Sunday morning, two Seattle police officers shot and killed Charleena Lyles in her apartment. She was pregnant, and three of her four children were home. She had called the police to report a burglary. According to the officers’ account, shortly after they arrived, Ms. Lyles, who the police knew was mentally ill, pulled a knife. Both officers shot her. Societal failure to care for mental health, which leaves the police as mental illness first responders, may well have been one deadly ingredient in this tragic encounter. (Phillip Atiba Goff and Kim Shayo Buchanan, 6/20)

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Perspectives: The Flaws And Fluff Of Trump’s Drug Pricing Plan

Read recent commentaries about drug-cost issues.

Stat: Pharma May Be ‘Getting Away With Murder,’ But Trump May Issue A Pardon
It wasn’t too long ago that President Trump said drug makers are “getting away with murder.” But it sure sounds like he’s about to grant them a presidential pardon. For months, Trump has kept these companies off balance with remarks that suggest he’s willing to consider ideas they find abhorrent in an effort to rein in drug prices. Now, though, his team is reportedly considering moves that would do little to address the problem — and would instead please the pharmaceutical industry. (Ed Silverman, 6/19)

Bloomberg: How Trump Can Curb Runaway Drug Prices
On numerous occasions, President Donald Trump has vowed to take action to constrain drug prices. Although the specifics of Trump’s plans to lower prices are reportedly being hammered out as I write, the wrong action could have disastrous effects. Many of us remember the gas shortages of the 1970s due to price controls. Government price controls will almost certainly inadvertently produce price increases in some markets and drug shortages in others. Equally as important, misguided interference could undercut the incentives necessary to support a vibrant life-sciences industry. America’s free-market system and investments in basic research through the National Institutes of Health and universities have created the world’s most dynamic innovation engine for medical research. (Arthur Laffer, 6/17)

CNBC: Trump Can Lower Prescription Drug Prices Now
President Donald Trump is about to begin his push to lower drug prices. According to several reports, he’s likely to sign an executive order outlining a plan by early July. The good news is that the easiest and most beneficial way to cut prices comes from something Trump likes to do already: reduce regulations. Few industries are laden with more regulations and government-imposed delays than big pharma. Since we’re talking about potentially lethal drugs here, there are obviously some good reasons for a number of those rules. But critics have long complained that some of them don’t provide more safety while they add to the industry’s costs and reduce competition. (Jake Novak, 6/19)

The Wall Street Journal: Take Me Out To The Pill Game
For perspective on the national angst over drug prices, let’s pay a visit to the ballpark. The average Major League Baseball player earns an annual salary of more than $4 million (plus $100 a day in meal money)—far more than it takes to lead a comfortable, well-appointed life. Let’s say the team owners cut those salaries by half, to $2 million or so. Putting aside the union protections that the players enjoy, surely they would continue showing up to work. Almost certainly fans would continue to enjoy the same quality of play on the field. (Dana P. Goldman and Darius N. Lakdawalla, 6/19)

Morning Consult: Outcomes-Based Drug Contracts Do Not Move Us Closer To Value
Polls show that high drug prices are voters’ No. 1 concern in health care. Unsurprising, given that the U.S. ranks highest both in drug spending and in patients stopping their medications because they are unaffordable. According to many pharmaceutical corporations and academic health care economists on Big Pharma’s dole, outcomes-based contracting for drugs is the solution. Policymakers should not dive into this pool; we propose a toe in the water at most. Odds are that outcomes-based contracts will do little to ameliorate the crushing cost of drugs in the U.S., and may delay reforms that actually link a drug’s price to its benefits. (Anna Kaltenboeck and Peter B. Bach, 6/21)

Stat: Pharma Companies Fight Behind-The-Scenes Wars Over Generic Drugs
All good things must come to an end” is a proverb that brand-name drug makers have trouble taking to heart. Just look at the strategies used to prevent competitors from bringing less-expensive generics to market. Pharmaceutical research has led to tremendous advances in medicine. Because of the extraordinarily high cost of bringing new drugs to the market, our intellectual property system is designed to ensure that drug companies recoup their investment and earn a profit. After a period of time, though, generic competitors are supposed to be able to enter the market and bring down prices through competition. (Robin Feldman, 6/16)

Bloomberg: John Paulson Won’t Save Valeant
Valeant Pharmaceuticals Inc. investors have a tendency to grasp at any perceived scrap of good news, usually to their detriment. The latest ray of hope is Monday’s news that John Paulson, manager of the Paulson & Co. hedge fund, Valeant’s largest shareholder, is joining the company’s board. Shares are up 5.7 percent Monday afternoon, but this shouldn’t be cause for much celebration. (Max Nisen, 6/19)

Stat: Bedside Drug Production Will Truly Enable Personalized Medicine
Making medicines tailored to the needs and characteristics of individual patients is the dream for many scientists. This kind of personalized medicine approach would provide treatment with the highest possible effectiveness and safety, and would also save money. But it requires rethinking how we make medications. The starting point of personalized medicine can be traced to the completion of the Human Genome Project, which sequenced almost the entire human genome, in 2001. Since then, however, only a limited number of personalized pharmaceutical treatments have reached patients. (Huub Schellekens, 6/19)

Bloomberg: Get Generic Drugs To Market Faster
In late April, Patrick Leahy, a Democratic senator, and Tom Marino, a Republican member of the House of Representatives, introduced legislation to promote timely access to low-cost, high-quality generic drugs. Passing this bipartisan CREATES Act is one important way for Congress to push back against soaring prescription drug prices in the U.S. Since 2014, net retail prescription drug prices have risen 10 percent annually, primarily driven by ever higher launch prices and more frequent markups on brand-name drugs. From 2008 to 2016, the average net price for the most commonly used brand-name retail drugs rose more than 200 percent. The average list price of a new oral anti-cancer drug now exceeds $130,000 per year. (Ameet Sarpatwari and Kesselheim, 6/20)

Modern Healthcare: The Drug Industry’s Irresponsible Price Hikes
When an individual or organization is under public assault, it pays to heed the advice of the crisis consultants. Stop doing what got you in trouble, be contrite, and start acting in a socially responsible manner. No, this week’s column isn’t about President Donald Trump. (Merrill Goozner, 6/10)

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

High Drug Cost Controversy Reflected In Drop Of Expected Sales For First Time In A Decade

News outlets report on stories related to pharmaceutical pricing.

Stat: Pricing Pressure And Patent Expirations Force A Drop In Projected Drug Sales
Ongoing controversy over drug prices and a rising number of patent expirations on some big-selling medicines has prompted a downward revision in global sales over the next five years, according to EvaluatePharma, a market research firm. Last year, the firm forecast global drug sales to hit $1.12 trillion by 2022, but the pharmaceutical landscape is shifting sufficiently to now expect worldwide sales to reach $1.06 trillion. Even so, that represents a healthy 6.5 percent compounded annual growth over the upcoming five-year period. (Silverman, 6/20)

Reuters: Worldwide Drug Sale Forecasts Fall As Pricing Pressures Mount
Forecasts for global sales of pharmaceuticals have declined for the first time in a decade as continuing pressure on prices in the key U.S. market has caused analysts to moderate revenue expectations, according to a report on Tuesday. Evaluate Pharma, which compiles consensus numbers based on analysts’ forecasts, said worldwide drug sales were now expected to hit $1.06 trillion in 2022, down from $1.12 trillion predicted a year ago for the same period. (6/20)

The New York Times: Draft Order On Drug Prices Proposes Easing Regulations
In the early days of his administration, President Trump did not hesitate to bash the drug industry. But a draft of an executive order on drug prices appears to give the pharmaceutical industry much of what it has asked for — and no guarantee that costs to consumers will drop. The draft, which The New York Times obtained on Tuesday, is light on specifics but clear on philosophy: Easing regulatory hurdles for the drug industry is the best way to get prices down. (Kaplan and Thomas, 6/20)

Stat: Turning To The States To Solve The National Problem Of Drug Pricing
Drug pricing is a national problem. So a nonprofit wants to help hand off some of that burden to the states. The National Academy for State Health Policy just launched a new center, called the Center for State Rx Drug Pricing, to help state governments navigate the treacherous waters of drug pricing. It just received about a million dollars in funding from the Laura and John Arnold Foundation to help states get drug pricing initiatives underway. (Keshavan, 6/20)

Modern Healthcare: Increasing Transparency On Generic Drug Cost Data Could Save $4 Billion 
Increasing transparency on the cost of generic drugs could save about $4 billion a year in overall healthcare spending in the U.S., according to a new paper. Making actual generic drug acquisition costs available to third-party payers would empower health plans to negotiate lower rates and essentially level the playing field in a pharmaceutical supply chain that’s shrouded in secrecy. Ultimately, patients would pay less at the expense of pharmacy benefit mangers’ profits, researchers said. If the average prescription generic drug priced at $26 was reduced by $1, that would reduce health spending by $4 billion every year, data shows. The average price for branded drugs is $308. (Kacik, 6/15)

Stat: At Pharma’s Academy Awards, The Top Prize Went To … No One
There’s a reason you see so many drug ads featuring the same boilerplate images of happy embraces and beautiful landscapes: It’s hard to get too creative without running afoul of regulations. That reality was reflected this weekend at the drug industry’s Oscars, where a jury at the big annual advertising awards fete in the south of France declined to award the top prize in the pharma category to anyone. It’s the second time that’s happened since the Cannes Lions Health creative award was first introduced in 2014. (Robbins, 6/18)

Bloomberg: Billionaire John Paulson Joins Valeant’s Board Of Directors
Billionaire hedge-fund manager John Paulson bought into Valeant Pharmaceuticals International Inc. stock on its way to the top. Now, he’s trying to help push it off the bottom. Paulson will join the board after the noisy exit of another high-profile investor: onetime backer Bill Ackman. The appointment of Paulson, whose firm became Valeant’s biggest shareholder after Ackman bailed out in March, could help comfort shareholders that he’s sticking with the drugmaker while it tries to rebuild itself after high-profile scandals. (Koons and Weiss, 6/19)

Marketplace: Is Competition The Solution To High Drug Prices?
The U.S. Supreme Court this week unanimously ruled in support of a new class of generic drugs that some argue will inject more competition into the market. The decision coincides with several meetings on the subject of drug pricing — the Senate met on the topic yesterday, while the American Chamber of Commerce will discuss prices today. (Gorenstein, 6/14)

Stat: This Bill Would Reinstate A Controversial Drug Discount For Some Hospitals
A bipartisan bill was introduced in Congress this week in a bid to lower drugs costs for some hospitals, potentially reviving a contentious battle that the pharmaceutical industry appeared to win nearly two years ago. The legislation would restore a coveted discount for some 1,200 rural hospitals and a handful of cancer-care hospitals when purchasing drugs with so-called orphan designations, which are granted to medicines for treating rare diseases. A court ruling in 2015 had eliminated the price break. (Silverman, 6/16)

Stat: Cancer Patient Sues Celgene For Thwarting Generic Versions Of Pricey Meds
In what may be a first, a patient has filed a lawsuit accusing a drug maker of hiding behind a mandated safety program to thwart generic competition. The company, in this case, is Celgene. The lawsuit, which was filed by a cancer patient and consumer advocate named David Mitchell, accused the biotech of exploiting a Food and Drug Administration program that is designed to boost safety. Typically such a program, known as a Risk Evaluation and Mitigation Strategy, requires drug makers to develop a plan to educate physicians and monitor distribution. (Silverman, 6/15)

Columbus Dispatch: Which Side Should We Believe In Battle Over Ohio Drug Prices?
The Ohio Drug Price Relief Act comes in response to many of the consumer concerns. The initiated statute would require the state to pay no more than the lowest cost of drugs purchased by the U.S. Department of Veterans Affairs, a discount of at least 24 percent and potentially up to 40 percent when rebates are included. (Johnson, 6/18)

Stat: Are Drug Makers Overlooking The Next Big Category Of Sleep Drugs?
Drug makers have long flocked to sleep, trying to develop treatments to help people snooze longer and more soundly. But they’ve barely scratched the surface in exploiting the emerging connection between poor sleep and the inflammation that plays a key role in conditions like rheumatoid arthritis, lupus, and HIV/AIDS…Evidence is piling up from both animal and human studies that suggests the link between sleep and inflammation may go both ways, in something of a vicious circle. Sleep problems are hypothesized to be both the partial cause and consequence of inflammation, in a process that plays out by activating signaling pathways at the molecular and cellular levels. (Robbins, 6/16)

Bloomberg: FDA To Clear Path For Drugs Aimed At Cancer-Causing Genes 
For years, doctors have identified cancers by the affected body part: lung, breast, kidney. Now, in a long-awaited move, U.S. drug regulators will simplify the approval of treatments targeting specific gene mutations that can spur tumors in a variety of organs. The Food and Drug Administration will soon announce a plan to update agency policies and facilitate the approval of critically needed drugs, including so-called “tumor-agnostic” therapies that target cancer-linked DNA, according to FDA Commissioner Scott Gottlieb. (Edney and Cortez, 6/20)

Stat: Will Trump’s FDA Bend The Rules? Coming Portola Decision Could Be A Clue
Is the FDA under new Commissioner Scott Gottlieb willing to be flexible with the rules, and maybe even lower regulatory standards a wee bit, to approve new drugs? It’s a question that will be partially answered in the coming days when the FDA hands down a decision on betrixaban, a new anticoagulant developed by Portola Pharmaceuticals. Portola is asking the FDA to approve betrixaban to reduce the risk of dangerous blood clots in patients who are leaving the hospital after treatment for a medical (as opposed to a surgical) illness. The betrixaban clinical data, however, are messy. The drug failed to significantly reduce blood clots, when compared with placebo, in its sole phase 3 clinical trial. (Feurstein, 6/21)

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Bristol-Myers’ Supreme Court Victory Could Have Far-Reaching Ramifications In Liability Cases

The case centered around whether plaintiffs residing outside of the state who claim they were harmed by the company’s blood thinner could join in a lawsuit brought by California residents. “It will extremely limit the notion that large companies can be sued by anyone, anywhere,” said one lawyer.

The Associated Press: High Court Sides With Drugmaker In Plavix Lawsuit
The Supreme Court says hundreds of out-state-residents can’t sue drugmaker Bristol-Myers Squibb Co. in California state court over adverse reactions to the blood thinner Plavix. The justices ruled 8-1 Monday that there was not a strong enough connection between the claims against the drugmaker and the company’s ties to the state. The ruling is a win for Bristol-Myers Squibb and other companies that want to avoid lawsuits in state courts seen as more favorable to plaintiffs. (6/19)

Politico: Supreme Court Ruling In Drug Case Could Have Big Implications For Product Liability
A Supreme Court decision Monday could make it harder for large groups of plaintiffs to sue corporations in state courts for damages caused by manufacturers’ products. Bristol-Myers Squibb prevailed in its effort to get the Supreme Court to limit where patients can seek compensation for harm caused by drugs. But the ruling will echo beyond the pharmaceutical industry to potentially affect any liability case in which consumers allege harm caused by a deficient product, including automobiles, tobacco, food and other mass litigation like consumer claims of financial fraud by a company. It could also affect lawsuits against companies being accused of environmental wrongdoing. (Karlin-Smith, 6/19)

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Trump’s Working Group On Drug Prices Catering To Pharma’s Wish List

Despite promising action to reel in an industry that he said was “getting away with murder,” President Donald Trump and his administration’s working group on high prescription drug costs is leaning toward policy recommendations backed by pharmaceutical companies.

Kaiser Health News: Exclusive: White House Task Force Echoes Pharma Proposals
President Donald Trump repeatedly talks tough about reining in the pharmaceutical industry, but his administration’s efforts to lower drug prices are shrouded in secrecy. Senior administrative officials met Friday to discuss an executive order on the cost of pharmaceuticals, a roundtable informed by Trump’s “Drug Pricing and Innovation Working Group.” Kaiser Health News examined documents that shed light on the workings of this working group. The documents reveal behind-the-scenes discussions influenced by the pharmaceutical industry. (Kopp, 6/16)

Politico: Trump’s Drug Price ‘Remedy’ Expected To Be Industry Friendly
Candidate Donald Trump made rising drug costs a signature issue during his campaign and beefed up his criticisms after the election, saying in January that the drug industry was “getting away with murder.” The comments unnerved drug executives, but six months later, the industry is no longer in a state of panic. (Karlin-Smith, 6/16)

Stat: The Drug Industry Is Coasting On Capitol Hill, Despite Pressure Over Prices
If Congress has its way, the … president will soon sign into law a massive package that is at the top of the industry’s wish list: a reauthorization of drug makers’ funding agreements with the Food and Drug Administration. At least so far, the powerful pharmaceutical industry has managed to keep the package that is speeding toward Trump’s desk free of any controversial policy changes that could threaten the industry’s business model — as well as any partisan add-ons that could jeopardize its smooth, overwhelmingly bipartisan trip through the policymaking process. (Mershon, 6/19)

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Exclusive: White House Task Force Echoes Pharma Proposals

President Donald Trump repeatedly talks tough about reining in the pharmaceutical industry, but his administration’s efforts to lower drug prices are shrouded in secrecy.

Senior administrative officials met Friday to discuss an executive order on the cost of pharmaceuticals, a roundtable informed by Trump’s “Drug Pricing and Innovation Working Group.” Kaiser Health News examined documents that shed light on the workings of this working group.

The behind-the-scenes look reveals discussions influenced by the pharmaceutical industry. Joe Grogan, associate director of health programs for the Office of Management and Budget (OMB), has led the group. Until March, Grogan served as a lobbyist for Gilead Sciences, the pharmaceutical company that priced its hepatitis C drugs at $1,000 per pill. To solve the crisis of high drug prices, the group discussed strengthening the monopoly rights of pharmaceuticals overseas, ending discounts for low-income hospitals and accelerating drug approvals by the Food and Drug Administration. The White House declined to comment on the working group.

The group initially met May 4 in the Eisenhower Executive Office Building and has since met bimonthly. In addition to OMB, the working group includes officials from the White House National Economic Council, Domestic Policy Council, Health and Human Services, the FDA, the Federal Trade Commission, the Department of Commerce, the Office of the U.S. Trade Representative and the Department of Justice.

According to the documents — the latest of which is dated June 1— the working group focused on the following “principles” and “talking points”:

  1. Extending the patent life of drugs in foreign markets to “provide for protection and enforcement of intellectual property rights.” This will ensure “that American consumers do not unfairly subsidize research and development for people throughout the globe.”

Extending monopoly protections for drugs overseas has been one of the pharmaceutical industry’s top priorities since the Trans-Pacific Partnership was defeated last year.

That policy would push up global drug prices, according to Médecins Sans Frontières.

  1. Promoting competition in the U.S. drug market — both by “modernizing our regulatory and reimbursement systems” and limiting “barrier to entry, including the cost of research and development,” according to the documents.

The working group also discussed two broad policy ideas that have been championed by the pharmaceutical industry, according to sources familiar with the process:

  1. Value-based pricing, when pharmaceutical companies keep the list prices of drugs unchanged but offer rebates if patients don’t improve. It’s unclear who would audit the effectiveness of the drugs, what criteria they would use to evaluate them and who would receive the rebates. Grogan invited Robert Shapiro — an adviser for Gilead and former secretary of Commerce under President Bill Clinton — to brief the working group on value-based pricing on May 18. Shapiro is the chairman and co-founder of Sonecon LLC, a Washington, D.C., firm that consulted with Gilead, Amgen and PhRMA, according to his curriculum vitae.
  1. Grogan and Shapiro also discussed issuing 10-year U.S. Treasury bonds to drug manufacturers to pay for expensive, hepatitis C drugs like Sovaldi and Harvoni under Medicare and Medicaid, to avoid rationing drugs to the sickest patients. The 2015 Senate investigation, for example, found that though Medicaid spent more than $1 billion on Sovaldi, just 2.4 percent of Medicaid patients with hepatitis C were treated.

After the working group’s first meeting on May 4, Grogan distributed detailed policy recommendations on expediting generic drug approvals, creating a new tax credit “of up to 50 percent” for investments in generic drug manufacturing, distribution and research and development and scaling back the 340B program, which requires drug manufacturers to provide some medicines at a discount to hospitals that treat low-income patients.

Most of these policies would not ease patient costs, and at least one would increase prices, say experts who reviewed the documents at the request of Kaiser Health News.

“This six-page document contains the kind of solutions to the cost-of-drugs problem that you would get if you gathered together all the executives of pharma and asked them ‘What sort of token gestures can we do?’ ” said Vinay Prasad, a professor of medicine at Oregon Health and Sciences University who studies the costs of cancer drugs.

The pharma-friendly recommendations appear to clash with earlier press reports indicating that OMB Director Mick Mulvaney was considering requiring drugmakers to pay rebates to Medicare patients, a measure the pharmaceutical lobby fiercely opposes.

Brand-name drug prices — which account for 72 percent of drug spending — go untouched in the handouts, said Fiona Scott Morton, a Yale economics professor and former attorney with the Justice Department’s antitrust division.

“The changes to generic markets to promote competition look helpful, but there need to be some more ideas to create more competition for branded drugs or consumers aren’t really going to notice this,” Scott Morton said.

Some of the text in the handout is cribbed directly from policy papers published by the pharmaceutical industry’s powerful lobby — Pharmaceutical Research and Manufacturers Association (PhRMA).

Under the subtitle, “Encourage Use of 21st Century Tools for Drug Evaluation, Review and Approval,” one handout proposes the FDA use less rigorous clinical trial standards to speed drug approvals.

The handout cites a PhRMA paper from March 2016 that includes an identical subtitle, “Encourage Use of 21st Century Tools for Drug Evaluation, Review and Approval,” and recommends the FDA implement less rigorous clinical trial standards.

These recommendations would not lower drug prices, experts say.

Such measures “would be like a firefighter spraying gasoline on your burning garage,” Prasad said.

Another section — which recommends giving the FDA more discretion to evaluate generic copies of complex drugs — closely resembles a National Law Review article written by two lobbyists in the pharmaceutical division of Foley & Lardner, whose clients include generic drugmakers.

The handouts further recommend allowing drugmakers to supply data and off-label information to insurers and pharmacy benefit managers during the clinical trial period, before they secure FDA approval.

That’s a “terrible idea,” said Jerry Avorn, a professor at Harvard Medical School and the chief of the Division of Pharmacoepidemiology and Pharmacoeconomics at Brigham and Women’s Hospital. “That’s why we have the whole approval process, to determine what’s actually true,” he said.

KHN’s coverage of prescription drug development, costs and pricing is supported in part by the Laura and John Arnold Foundation.

Categories: Cost and Quality, Health Industry, Pharmaceuticals

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State Highlights: Minn. Nurses Union Helps Pay Patients’ Medical Debts; Head Of Colo.’s State Mental Hospital Resigns

Media outlets report on health-related news from Minnesota, Colorado, Georgia, Texas, Massachusetts, New Jersey and California.

The Star Tribune: Minnesota Nurses Raise Money To Pay Off Medical Debts Of 1,800 Patients
Roughly 1,800 patients will see $2.6 million in medical debts disappear because of charitable payments by the Minnesota Nurses Association, the union that represents hospital nurses throughout the state. The union announced on Thursday that it would pay off the patients’ debts in conjunction with the anniversary of a strike by its nurses against five Allina Health hospitals in the Twin Cities. (Olson, 6/15)

Denver Post: Head Of Colorado State Mental Hospital Resigns As Hospital Is Placed On “Termination Track” 
The head of Colorado’s state mental institution has resigned in the midst of a staffing shortage that resulted in federal regulators determining the Pueblo hospital poses an “immediate and serious threat to the health and safety” of its 449 patients. Officials at the Colorado Department of Human Services, which oversees the hospital, would not say whether the resignation of Superintendent Ron Hale is related to the hospital’s numerous deficiencies, described in two recent federal reviews. He will stay until July 9, to “ensure a smooth transition,” state officials said. (Brown, 6/15)

Georgia Health News: State Agency To Monitor Blue Cross Rule On ER Use
Blue Cross recently told policyholders that starting in July, it will stop covering ER visits it considers to have been unnecessary. The health insurer, Georgia’s largest, said it’s pursuing the move, involving its coverage of individual policies, due to the costs of routine primary care being administered in an ER setting. (Miller, 6/15)

Houston Chronicle: Six Pregnant Women In Harris County Test Positive For Zika 
Six pregnant women in Harris County have tested positive for Zika, the first cases of the mosquito-borne disease to be reported locally in 2017. All of the women have since delivered their babies, but it is not yet known if any of the children were born with the birth defects that can be caused by the virus, said a spokesman for Legacy Community Health, a southeast Texas network of clinics where the women were initially tested. (Ackerman, 6/15)

Boston Globe: These Startups Want To Save You A Trip To The Drugstore 
Since the company was founded in 2013, it has raised about $118 million in funding, built a highly automated pharmacy in Manchester, N.H., and grown to more than 500 employees. Along with another Boston startup, ZappRx, it hopes to eliminate the familiar headache of driving to the drugstore and standing in line, only to find that someone forgot to do something, and the crinkly white bag isn’t there waiting for you. (Kirsner, 6/16)

The Philadelphia Inquirer: Troubled Mount Laurel Nursing Home Closing Next Month
Mount Laurel Center for Rehabilitation & Healthcare, a South Jersey nursing home that has been on a list of the nation’s most troubled facilities for 19 months without showing improvement, said it has lost its Medicare and Medicaid certifications and will close next month…Patient transfers are expected to be completed by July 16, when Medicare and Medicaid payments will stop for patients admitted before Friday. No federal payments will be made for patients admitted after Friday. (Brubaker, 6/15)

Austin American-Statesman: Austin City Council Places Julie Oliver On Central Health Board
The council voted to approve the appointment of Julie Oliver in a 6-5 vote after a closed session discussion. Council Members Ora Houston, Jimmy Flannigan, Ann Kitchen, Delia Garza, Kathie Tovo and Ellen Troxclair voted for the appointment. Her appointment had raised some eyebrows due to her position as division controller at St. David’s HealthCare, a competitor of Seton Healthcare Family, which partners with Central Health, Travis County’s hospital district. (Goldenstein, 6/15)

San Francisco Chronicle: Most Bay Area Beaches Are Free From Harmful Bacteria, Report Says 
The bathing-suit-and-bikini set can splash around happily knowing they are unlikely to get sick frolicking in the water at Bay Area beaches, all but one of which are free of harmful bacteria and pollution, according to a statewide beach report card released Thursday. But the one that didn’t make the grade — Marina Lagoon, in the Lakeshore Park area of San Mateo County — is pretty icky, getting an F for water quality and a No. 4 spot on the environmental group Heal the Bay’s Top 10 Beach Bummer list for California. (Fimrite, 6/25)

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Viewpoints: Hearing About Hearing Aid Costs; The FDA’s Fear And Loathing Of Off-Label Communications

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

RealClear Health: Why Is The FDA So Frightened Of Off-Label Communications?
Former HHS General Counsel and Deputy FDA Commissioner Bill Schultz recently expressed his belief that FDA policies developed 50 years ago remain sufficient to govern life in the 21st century. He’s wrong. Time marches on and regulatory practices must evolve to better serve the public health. Nowhere is this more urgent than in making sure physicians and patients have unencumbered access to accurate information about FDA-approved medicines. (Peter Pitts, 6/15)

JAMA: Physician Certification And Recertification: The Role Of Empirical Evidence
Physicians are faced with the challenge of lifelong learning in a field so vast and complex that no physician can ever hope to master all medical knowledge. Nonetheless, physicians have a duty and responsibility to patients to continuously hone their knowledge, skills, and judgment while appreciating their limits. Striking this balance requires that physicians remain current with the literature, engage with colleagues, identify and address gaps in knowledge, and maintain relevant professional certifications. (Adam B. Schwartz and J. Sanford Schwartz, 6/13)

St. Louis Post-Dispatch: I Am Celebrating Life Thanks To Proton Therapy
At first glance, you would never suspect that I am a brain cancer survivor. I am young, energetic and, seemingly, the picture of health. I have competed in a total of 554 endurance sport events including marathons, Ironman events, 10Ks and 5Ks and everything in between over the last 23 years. As an endurance athlete, I spend many hours a week training, so it’s easy to see how a person might be surprised by my diagnosis. But looks can be deceiving. (Brad Eastman, 6/15)

JAMA: Gray Areas
When I was young, I had a painfully simple philosophy that could be summarized like this: there are good guys and there are bad guys. Bad guys get locked up and good guys roam free. It was straightforward and couched in the comforting illusion of a just, safe world. As a result, I believed that everyone who wound up in prison deserved to be there, and that every sentence was fair. I believed in “an eye for an eye” and enthusiastically supported capital punishment. Incidentally, I also believed that the US criminal justice system was too nice and was alarmed to learn that bad guys in prison got free food, shelter, and health care while so many good guys suffered. (Alia Moore, 6/13)

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