Tagged Women’s Health

Must-Reads Of The Week From Brianna Labuskes

Happy Friday! This week was so busy that I am going to take the unprecedented step and highly recommend you check out our Morning Briefings for the past few days. So many compelling, interesting stories didn’t make the cut for the Breeze, but they’re worth reading.

On to what you may have missed!

Well, this one you probably didn’t miss unless you were in the middle of the woods sans cellphone service: Alabama Gov. Kay Ivey signed legislation that effectively bans all abortions and criminalizes the procedure. The uproar that followed was immediate and ferocious — especially from 2020 Democrats who all but tripped over each other to denounce it as “shameless” and “outrageous” — but is the bill actually the threat to Roe v. Wade that it so dearly wants to be?

The measure is destined for the courts, certainly, but that doesn’t mean it will make it to SCOTUS. One likely outcome: The justices can simply refuse to take it up, leaving in place the lower courts’ decision (which will probably be that the law is unconstitutional). Chief Justice John Roberts is known for favoring incrementalism over sweeping decisions that would overturn nearly 50 years of precedent on a hot-button social issue.

But you need only four votes to get a case on the docket, which has court-watchers eyeing newbie Justice Brett Kavanaugh. His appointment helped galvanize the anti-abortion movement in the first place, but in the past he’s talked seriously about needing a compelling reason to overturn precedent. So far, he has disagreed with the hard conservatives more than people expected. So, the future for Alabama’s law remains uncertain.

What seems more likely is that the high court will instead look to less extreme, but still restrictive state laws (such as bills dictating the disposal of fetal remains and an 18-hour waiting period after state-mandated ultrasound examinations) that are heading toward them even as we speak.

No matter how it plays out, you can pretty much guarantee this is going to be a Big Deal on the campaign trail.

The New York Times: Alabama Aims Squarely at Roe, but the Supreme Court May Prefer Glancing Blows

The Associated Press: Alabama Law Moves Abortion to the Center of 2020 Campaign

The Wall Street Journal: States’ Abortion Curbs Put Supreme Court to the Test

A smattering of the other (dozens and dozens) of thoughtful stories from the past few days:

• What is it like living in a liberal city in the Deep South during times like this?

The New York Times: Abortion and the Future of the New South

• Missouri wants in on the action this week.

KCUR: How Missouri’s Senate Passed a Restrictive Abortion Bill Overnight

• A vote in deep-blue (and very Catholic) Rhode Island was overshadowed by Alabama’s news, but it highlights how nuanced and complicated the issue can be.

Boston Globe: In Rhode Island, Vote on Abortion-Rights Bill Reveals a Complicated State

• A lot of Senate Republicans are trying their best to nope out of this conversation, like “no thank you, not touching that with a 10-foot pole.”

The Hill: Senate Republicans Running Away From Alabama Abortion Law

• And a really handy look at what’s going on at the state level.

The Washington Post: The Widening Gap in Abortion Laws in This Country


House Democrats took advantage of their newfound power by tying a vote on reining in high drug prices to legislation shoring up the health law. The bill is destined to die, of course, but the move forced their Republican colleagues to go on record voting against something that voters care very, very deeply about.

The New York Times: House Passes Legislation Aiming to Shore Up Health Law and Lower Drug Costs

They also foreshadowed a potential subpoena with letters to Attorney General William Barr. Five powerful committee chairmen said that they’ve been asking since April 8 for documents connected to the Justice Department’s decision to stop defending the health law but haven’t received a sufficient response. They’re giving DOJ two more weeks before they consider “alternative means of obtaining compliance.”

Politico: Dems Tee Up New Document Fight With DOJ Over Obamacare

Meanwhile, a new Sunlight Foundation report found that the Trump administration has been systematically altering and eliminating information on the health law that’s on government websites.

Wired: The Trump Admin Is Scrubbing Obamacare From Government Sites


Surprise medical billing is truly the darling of Capitol Hill recently with all the attention it’s getting. Multiple variations of bipartisan duos and groups are working on introducing legislation to combat the issue. The most recent bill unveiled would protect patients from the surprise costs, and let an outside arbitrator settle any disputes between hospitals and insurers. Other proposals have instead favored a rate-setting method to solve payment issues.

The Hill: Bipartisan Senators Unveil Measure to End Surprise Medical Bills

The Hill: Dem House Chairman, Top Republican Release Measure to End Surprise Medical Bills


Attorneys general from 44 states have filed suit against pharma companies over allegations that “the generic drug industry perpetrated a multibillion-dollar fraud on the American people.” The lawsuit implicates 20 pharma firms following an investigation into allegations that the companies sought not only to maintain their “fair share” of the generic drug market through agreements with one another but also to “significantly raise prices on as many drugs as possible.”

The Associated Press: States Bring Price Fixing Suit Against Generic Drug Makers


Washington state took a big step this week in approving the creation of a public option — which would essentially look like a state-sponsored health plan. But now comes the hard part: making it work.

And don’t call it a game changer quite yet, experts say. Even sponsors of the legislation acknowledge the state plans may save consumers only 5-10% on their premiums. Still, the rollout will likely be watched closely as the progressive universal health care push grows stronger.

Politico: 5 Key Questions About the Country’s First Public Option

NPR: Washington State to Create ‘Public Option’ Health Care Plans

(If you feel like you need a refresher on all these terms — join the crowd, amiright? this one from NYT’s Margot Sanger-Katz is great.)


Rural hospitals, which sometimes fight literally hour by hour to afford to stay open, are in a crisis in this country, as evidenced by two amazing pieces this week on what happens to a town when one dies.

“If we aren’t open, where do these people go?” asked one hospital worker in The Washington Post’s coverage.

“They’ll go to the cemetery,” another employee answered. “If we’re not here, these people don’t have time. They’ll die along with this hospital.”

The Washington Post: ‘Who’s Going to Take Care of These People?’

Kaiser Health News: Dealing With Hospital Closure, Pioneer Kansas Town Asks: What Comes Next?

But I found a flicker of hope in a lovely story about how a one-room clinic in North Carolina just marked its 100th year.

North Carolina Health News: One Hundred Years in a Rural Clinic


Think this measles outbreak is big? (It is, by the way!) How about the one in 1990, which had more than 27,000 cases? In the past few months, I’ve read and written about the record 963 cases from 1994 more times than you can count but had no idea that just four years earlier it was that much higher. If you’re as intrigued as I was about how that changed, dive into NPR’s historical look at what exactly was going on at the time, and how public officials made so much progress so quickly.

NPR: How a Measles Outbreak Was Halted in the 1990s


In the miscellaneous file for the week:

• There’s a pretty serious debate going on right now about fair distribution of donated livers. A new rule that went into effect this week and then was immediately blocked by a judge would give the organ to the sickest patient within 500 nautical miles. But advocates in the Midwest and South say that’s unfair.

The Washington Post: Liver Transplant Rules Spark Open Conflict Among Transplant Centers

• The U.S. birth rate has fallen again to the lowest in three decades. Some say that means the sky is falling; others are unconcerned.

The Associated Press: US Births Lowest in 3 Decades Despite Improving Economy

• Despite there being thousands of children in the country with a terminal diagnosis, only three hospice facilities in the U.S. are designed specifically for them.

The New York Times: Where Should a Child Die? Hospice Homes Help Families With the Unimaginable

• Can we learn about trauma from an island of monkeys that was devastated by Hurricane Maria?

The New York Times: Primal Fear: Can Monkeys Help Unlock the Secrets of Trauma?

• Many of our gun safety discussions focus on buying the weapons, but teaching about proper storage can make a bigger difference than you’d necessarily expect.

The New York Times: The Potentially Lifesaving Difference in How a Gun Is Stored


Whew! You made it both through this hefty Breeze and the week itself. Take it easy this weekend as a reward!

Eric Swalwell’s Tweet About Georgia’s New Abortion Restriction Only Slightly Off-Key

Georgia Gov. Brian Kemp signed into law Tuesday the state’s latest abortion restriction. Political reaction to the measure, which prohibits the procedure once a doctor can detect a fetal heartbeat — usually at about the six-week mark — was swift.

Abortion opponents applauded the measure, which puts Georgia in the company of Ohio, Kentucky, Mississippi, North Dakota and Iowa. (Courts have blocked the Iowa and North Dakota laws.) Reproductive rights activists are widely expected to challenge the Georgia law, which many legal experts say violates the abortion standard set by the Supreme Court in its landmark Roe v. Wade decision.

Rep. Eric Swalwell (D-Calif.), a 2020 Democratic presidential candidate, was among the critics who weighed in.

“The so-called ‘heartbeat’ law outlaws abortion before most women even know that they’re pregnant,” Swalwell posted on Twitter. “This is one of the most restrictive anti-abortion laws in our country.”

Swalwell’s claim is an argument we’ve heard often about the six-week abortion ban. We emailed his press team, who redirected us to an article in The Atlanta Journal-Constitution, describing the law’s passage. But we wanted to dig deeper.

‘Most Women’?

Swalwell’s claim has two components: First, he said the law bans abortion “before most women even know that they’re pregnant.”

This is a tricky one. We contacted four reproductive-law experts, along with the American College of Obstetricians and Gynecologists. We also looked at information from the Guttmacher Institute, a reproductive health research and policy organization that supports abortion rights but whose research is widely cited.

None of those sources could point us to data showing when “most women” know they’re pregnant.

Maggie McEvoy, an ACOG spokeswoman, said the organization doesn’t track that information, and it isn’t clear anyone does.

And about Swalwell’s statement:

“Is it empirically true? I don’t know that the medical literature supports that,” said Katherine Kraschel, who runs the Solomon Center for Health Law and Policy at Yale Law School.

Rep. Eric Swalwell (D-Calif.)

But even without that data, experts said, it is abundantly clear that women who are not trying to conceive are much less likely to be aware of a pregnancy until well after six weeks.

That’s because “six weeks” really means “six weeks after a woman’s last menstrual cycle.” Typically, a cycle is about 28 days, or four weeks, long. But many women are accustomed to having irregular periods, and delays can be exacerbated by everyday factors such as stress and fatigue, which could stretch a cycle to 30 or 40 days. At this point, though a woman may not yet be aware that she is pregnant or be experiencing any symptoms, a physician may be able to discern a fetal heartbeat.

Most women don’t realize they’re pregnant until missing at least one period, said Dr. Kristyn Brandi, an OB-GYN at Rutgers Medical School. Often, it takes two.

Generally, medical experts say, women who are actively trying to conceive tend to track their cycles very closely and know much sooner if they are pregnant. But for women whose pregnancies are unintended, and who may be more likely to contemplate an abortion, Swalwell’s statement is more accurate.

About two-thirds of women seeking abortions usually come in around eight weeks since their last menstrual period, per the most recent Guttmacher statistics.

In other words, the six-week restriction would cut off access to abortion at a point in the pregnancy when “there’s a high level of women who might not know,” Kraschel said.

‘One Of The Most Restrictive’

The second half of Swalwell’s claim is easier to verify.

He said this is “one of the most restrictive anti-abortion laws” in the country, a characterization experts say is certainly accurate. The phrase “one of” is a crucial distinction. The Georgia ban is no more stringent than those approved in the five other states that have passed heartbeat laws.

In Alabama, lawmakers are considering a bill that would effectively criminalize all abortions — treating physicians who perform the procedures as felons. If it were to become law, Alabama’s would be the most stringent in the nation. But voting in the state Senate on that legislation was postponed after a debate erupted over whether to include an exemption for rape or incest.

Legal experts also suspect that, as conservatives pursue new abortion legislation, heartbeat restrictions are among the likeliest to end up in front of the Supreme Court. Conservatives believe the judicial makeup favors a ruling that could overturn or scale back the abortion protections outlined in Roe v. Wade.

Our Ruling

Swalwell runs into data obstacles with the first half of his claim. He says a six-week ban prohibits abortion before “most women” know that they are pregnant, but there isn’t any research that conclusively says that’s correct.

Some clarification would help him here.

Most women who aren’t trying to conceive are less likely to know this early that they are pregnant. They probably aren’t taking pregnancy tests or closely monitoring their periods. And women seeking abortions are generally coming in after six weeks.

To be fair to Swalwell, his broader point here is true: The women more likely to seek abortions are, six weeks from their last period, less likely to realize they are pregnant.

The second half of this claim is unequivocally correct. Georgia’s law is indeed among the nation’s strictest.

This claim is correct but could use more context and clarification. We rate it Mostly True.

Must-Reads Of The Week From Brianna Labuskes

Happy Friday! As if those sky-high medical bills weren’t bad enough, apparently California teachers also must pay substitutes to cover for them — even while undergoing treatment for breast cancer.

Which is the perfect segue into what you may have missed this week (almost like I planned it).

President Donald Trump waded into the turf wars among doctors, hospitals and insurers Thursday when he called for an end to surprise medical bills. The issue has been gaining attention across the country as stories about $48,512 cat bites and $109,000 heart attacks resonate with voters who are sick of paying an arm, a leg and a mortgage for health care even when they have insurance.

It’s not exactly a controversial issue — it’s listed as a top concern among voters, and lawmakers are lining up in droves to sign their names to any potential legislation. But, as is often the case with health care costs, the devil’s in the details. The costs don’t just disappear because the president doesn’t want patients to have to pay them. Physician groups tend to favor arbitration, while insurers argue that method is flawed because it still relies on bill charges. Instead, the industry wants set prices, with rates in line with what they would consider reasonable for the procedures. Each side hates the other’s opinion. So … good luck to the lawmakers who have to balance those two big interest groups!

The New York Times: Trump Said He Wanted to Work With Democrats on Surprise Medical Bills. Then He Attacked Democrats.

(FWIW: Two stories of the patients who were featured at the White House event were previously highlighted in KHN and NPR’s “Bill of the Month” series. Check them out here.)


Kicking off a veritable blitz of bills, House Democrats voted on legislation that would ban the Trump administration from granting states waivers for health law regulations. Over the next couple of weeks, Dems are expected to go hard on their campaign promises to shore up the bruised and battered health law. Some of the topics of those bills: short-term “junk insurance” plans, outreach funding, “reinsurance” payments, drug rebates and more.

The New York Times: With Insurance Bill Passage, House Democrats Begin Health Care Blitz

Speaking of waivers, Tennessee is set to ask for one to shift its Medicaid program into a block grant model. Block grants — aka Republicans’ longtime dream system — as an idea have a long history riddled with controversy and criticism, and the request, if granted, is all but certain to draw a court challenge. Now the question is: How far is CMS ready to go in pushing the envelope on Medicaid changes? Especially when other waivers are getting knocked down left and right in court?

Modern Healthcare: Tennessee Will Test CMS’ Willingness to Block-Grant Medicaid

Meanwhile, the Trump administration is proposing a change to the formula to calculate poverty. That may seem fairly dry, but since government assistance (like Medicaid and food stamps) is tied to that line, millions could lose health care coverage and/or have to go hungry.

The New York Times: Trump Administration Seeks to Redefine Formula for Calculating Poverty


Pharma companies are going to start to have to include list prices in their TV ads under a new rule that’s central to the Trump administration’s war on high drug costs. While most people think, in general, it’s a good step, many doubt it will accomplish much. It’s not as if sick consumers can then go negotiate a different price, as they would with cars.

As Ben Wakana, the executive director of Patients for Affordable Drug Prices, told NPR: “Drug companies have been shamed about their price increases for years. They appear to be completely comfortable with the shame as long as it is bringing them in the billions of dollars a year that they make from their outrageous prices.”

NPR: New Rule for Drugmakers: Disclose Drugs’ List Prices in TV Ads

Drug prices were a hot topic this week (and most weeks, amiright?), with the Senate Finance Committee holding a hearing on the idea of setting an international price index. Other countries set lower prices and “we look like chumps,” said Sen. John Kennedy (R-La.).

Modern Healthcare: GOP Senators Warn Drug Price Controls Could Come

And, yup, there’s still more news: Despite HHS Secretary Alex Azar’s concerns about safety, Trump backed Florida’s plan to import drugs from other countries. The kicker here: Florida will surely be a battleground state in the 2020 election, and drug prices routinely top voters’ list of concerns. The potential for a winning talking point is huge.

The Associated Press: Trump Backs Fla. Plan to Import Lower-Cost Meds From Abroad


In somewhat tangential news, Gilead announced it will donate its drug that reduces the risk of HIV transmission for up to 200,000 people a year. The price of the life-changing medication has long been a barrier to the goal of ending HIV transmissions, and many advocates were thrilled with the decision. Still, others were disappointed, saying that will cover only a fifth of what the country needs.

The Associated Press: Drugmaker Will Donate Meds for US Push to End HIV Epidemic

But everyone was cheering a new study out of Europe. Out of nearly 1,000 gay male couples where one partner had HIV and was taking antiretroviral drugs, there were zero cases of HIV transmission even without the use of condoms.

Reuters: AIDS Drugs Prevent Sexual Transmission of HIV in Gay Men


Fed up with the strategy to slowly chip away at abortion rights, Alabama lawmakers are poised to go all in. The legislation (which was almost up for a vote this week, but was delayed because of a ruckus over rape and incest amendments) would effectively ban all abortions and criminalize the act of performing the procedure. The supporters of the bill aren’t being coy at all about their intention: They want to challenge Roe v. Wade with a simple, “clean bill” on the legality of abortions.

The New York Times: As States Race to Limit Abortions, Alabama Goes Further, Seeking to Outlaw Most of Them

And over in Georgia, abortion rights advocates have one message to Republican Gov. Brian Kemp, who just signed a heartbeat bill: “We will see you, sir, in court.”

The Associated Press: Opponents of Georgia Abortion Ban Promise Court Challenge


On a sad note: Legendary New York Times reporter Robert Pear passed away this week from complications of a stroke. Although I did not have the pleasure of meeting or working with him, his byline became a familiar friend of mine. He has shaped my world for the past several years with the stories he continuously broke. It is a loss for journalism, for health care and for the people he helped through the light he shined on Washington.

His last story is a perfect example of that: looking at legislation that carried promises of helping people with preexisting conditions but failed to live up to them.

The New York Times: Robert Pear, Who Covered Washington for 45 Years, Dies at 69

The New York Times: Republicans Offer Health Care Bills to Protect Patients (and Themselves)


In the miscellaneous files of the week:

• Traditionally, HHS has received, on average, one complaint related to “conscience” violations from health care workers per year. Last year, that rose to 343. What on earth happened? (Hint: It does not mean the problem actually worsened.)

NPR: Why Are Health Care Workers’ Religious and Moral Conscience Complaints Rising?

• It might seem like the anti-vaccination movement is a new phenomenon spurred on by social media, but there’s a long history of resistance in the country. And it’s not as random as it might appear at first. Usually, it’s tied to time periods that are marked by great resentment toward government.

Los Angeles Times: Why the Measles Outbreak Has Roots in Today’s Political Polarization

• Stories about student heroes stopping mass shooters and dying in the process highlight just how grim our reality has become as young people find themselves thrust into violence.

The New York Times: Colorado School Shooting Victim Died Trying to Stop the Gunman

• Not only is the United States’ maternal mortality rate abysmal, a new study finds that many of those deaths — 60%! — are preventable. What’s more, African American and American Indian/Alaska Native women are three times more likely to die from pregnancy and childbirth than white women.

USA Today: Pregnancy and Childbirth Deaths Are Largely Preventable, CDC Says

• Beneath the bright, tantalizing promises of the stem cell industry (targeted at the most desperate patients) festers a dark underbelly of greed and profit.

ProPublica: The Birth-Tissue Profiteers


Have a great weekend, and remember, as National Nurses Week wraps up, to hug (or otherwise appropriately thank) the nurses in your life. Their job can be quite tough.

Is It A Feminist Right To Want More Sex? One Company Thinks A Pill Is The Answer

Studies have never defined a “normal” level of sexual desire. Despite that, there’s a website and an online quiz to help you decide if you’ve got a problem. Called “Right to Desire,” it brands libido as a feminist “right,” and its home page offers the defiant, in-your-face prompt: “Yes, I want my desire back.”

Click a few boxes and you’re instantly directed to a remedy (and an online doctor to prescribe it): a pill called Addyi from Sprout Pharmaceuticals.

“This particular product should not have been approved by FDA, but it was, and it is not a product that adds value to women’s lives,” said Susan Wood, assistant commissioner for women’s health at the Food and Drug Administration from 2000 to 2005.

She added: “There isn’t an actual market.”

The effort, called a “disease awareness” campaign, troubles critics because it attempts to define low sexual desire as a widespread disease that is treatable with a pill. Although doctors recognize that there is (perhaps) a condition called Hypoactive Sexual Desire Disorder, many of the studies defining HSDD were sponsored by the drugmaker. Almost all doctors on the 2016 consensus panel that defined HSDD were consultants or on Sprout’s advisory board.

To further complicate matters, in the studies that led to Addyi’s approval, results were not terribly impressive. And, for those who would simply like a little more sex in their lives, is it worth a $400-a-month pill?

Enter the latest sales pitch, which encourages women to stand up for their rights. The new campaign taps into emotional issues that have long been staples of women’s equality movements, like the right to equal access to health care, the idea that women’s issues should be taken as seriously as men’s, including women in conversations about their health and valuing women as sexual beings.

“To hear our language co-opted” is upsetting, Cindy Pearson, the executive director of the National Women’s Health Network, said in an interview. “It’s really bittersweet to see it co-opted to sell, and sell a product that isn’t that good.”

Addyi — also known as flibanserin — first gained FDA approval in 2015 after a long and contentious fight. It’s often called the “female Viagra” because it’s related to sex, but Addyi and erectile dysfunction meds are quite different.

While impotence medications work by directing blood to the genitals and are taken before sex, Addyi is taken nightly and works in the brain to increase desire.

In fact, it was originally developed to be an antidepressant, but its clinical-trial performance fell short. Along the way, researchers noticed that subjects reported having some increase in sexual desire.

“Addyi is believed to work on the part of the brain involved in sexual motivation and response, though its exact mechanism of action is not fully understood,” the official website reads.

Even during drug trials, Addyi’s effectiveness was questioned. On average, women who took it reported one increased sexually gratifying experience every other month, and that was only after the subjects began recording their experiences monthly instead of daily.

There are also concerns about side effects like dangerously low blood pressure, fainting, severe drowsiness and insomnia.

The FDA rejected Addyi twice before it went before a public advisory council, where patients, doctors and women’s groups (some funded by the manufacturer, according to industry researchers) testified in favor of the drug.

In the old days, drugmakers developed drugs for known diseases. Now drugs come looking for a market.

It’s difficult to pinpoint the number of women who report a persistent lack of sexual desire. Even the findings of studies sponsored by the drugmaker vary widely. Such complaints also tend to be more common among post-menopausal women — a group for whom the drug is not approved.

Experts say it’s difficult to get an accurate picture of the problem medically known as low libido because it has so many possible causes — depression, poor body image, fatigue, stress, pregnancy and menopause. Even in the Sprout-sponsored study, many women who were distressed about their low sexual desire ascribed it to “relationship issues.”

“You take something that can occur from a wide range of reasons, some of which have nothing to do with physiological or medical problems, and you turn it into a medical problem, you give it a name and you sell a product to get rid of it,” said Diana Zuckerman, the president of the National Center for Health Research.

Rather than turn to a costly, silver-bullet medication approach, complaints like sexual dysfunction and low desire often need to be addressed by mental health professionals, sexual health professionals or people with more time and training than general practitioners, Zuckerman said.

Anyway, Addyi’s labeling expressly notes it is not approved for use by women whose low libido is caused by problems in their relationship, menopause, childbirth, medical issues, other medications they are taking or mental illness.

While Wood said she thought Sprout would like to market Addyi to “almost all women,” there’s a “tiny subset of women who suffer from HSDD.”

“And there’s not a big a market of people who actually suffer from this diagnosable condition that could benefit from a medical treatment,” Wood added.

Addyi’s labeling expressly notes it is not approved for use by women whose low libido is caused by problems in their relationship, menopause, childbirth, medical issues, other medications they are taking or mental illness.(Screenshot from addyi.com)

“Right to Desire” brands itself as a movement for women who are struggling with HSDD. The campaign is heavy on social media, with a strong Facebook presence that includes Funny or Die videos, date night “hacks” and testimonials from patients and doctors. There was a #RightToDesire “girls’ night out” Twitter party featuring several mommy bloggers and giveaways.

It’s not the first time feminism has been used to sell a product, but it’s still frustrating for women’s health activists who have been working for years to get their issues taken seriously.

At the time, a coalition of groups — some venerated women’s rights groups and some that were formed and funded by the pharmaceutical industry — known as “Even the Score” pushed for the drug’s approval and found traction. The rallying cry was the idea that 26 drugs had been approved for male sexual dysfunction and none for women.

“I believe [the FDA] found it hard to keep the product off the market when they were being accused of being sexist,” Wood said.

“They got, in my view, sort of bamboozled by that argument,” she added.

Forty-eight hours after Addyi was approved, Sprout sold it to Valeant, now under the umbrella of Bausch Health Companies, for around $1 billion.

And it flopped. According to Wood, that’s because the drug didn’t work, came with safety concerns and wasn’t covered by many insurance plans. Addyi cost around $800 a month for a daily pill, which may account for why at its peak in March 2016 only 1,600 prescriptions were written for it.

In 2017, Valeant gave up on Addyi, turning it back over to Sprout, which is now trying again to make the drug a sensation. As part of the arrangement, according to press reports, Sprout did not have to pay an upfront fee and, among other parts of the deal, agreed to pay Valeant, now Bausch, royalties on sales of the drug, though early indications say it still isn’t successful.

“We will receive royalties once they make a milestone,” Arthur Shannon, senior vice president and head of investor relations and communications for Bausch, wrote in an email. “We have not received any royalties thus far.”

The deal paved the way for a lower price tag — cut in half — and this trendy pop-feminist ad campaign.

Sprout did not make its CEO available for an interview.

Originally, the drug’s labeling included a prohibition on drinking alcohol while on the medication. This caution, though, resulted from a study whose participants were mostly men.

This spring, Sprout funded two new studies to show Addyi was safe to consume with alcohol, but the FDA kept the “black box” warning in place with one change — the alcohol prohibition is restricted to two hours before and at least eight hours after taking it.

“Now is the time to lend your voice and demand gender equality when it comes to sexual health,” the Facebook page declares as it directs visitors to a Change.org petition to get benefits managers to cover the drug. It also asserts that it’s “time to address women’s sexual health beyond reproduction alone.” It even quotes Eleanor Roosevelt.

“[Sprout is] definitely appropriating all that language, making it seem like a feminist issue,” said Dr. Steven Woloshin, a professor at the Dartmouth Institute. “This is an issue that involves women, but that doesn’t mean that taking this drug is something you should do because you’re a feminist.”

Podcast: KHN’s ‘What The Health?’ ‘Conscience’ Rules, Rx Prices and Still More Medicare


Can’t see the audio player? Click here to listen on SoundCloud.


In a new set of rules, the Trump administration wants to let not just doctors but almost any health care worker or organization decline to provide, participate in or refer patients for any health service that violates their conscience or religion.

Also this week, the Trump administration is ordering prescription drugmakers to include list prices in their television ads for nearly all products.

And there’s yet another entry in the growing group of bills aimed at overhauling the nation’s health system. This one is “Medicare for America.”

This week’s panelists are Julie Rovner of Kaiser Health News, Joanne Kenen of Politico, Jen Haberkorn of the Los Angeles Times and Alice Miranda Ollstein of Politico.

Also, Rovner interviews Joan Biskupic, author of “The Chief: The Life and Turbulent Times of Chief Justice John Roberts.” Biskupic talks about the behind-the-scenes negotiations that led to the 2012 decision upholding the constitutionality of the Affordable Care Act.

Among the takeaways from this week’s podcast:

  • Robert Pear, who died this week, was the dean of health policy reporters and will be remembered not just for the many front-page stories he produced for The New York Times, but also as a generous and kind colleague who helped mentor many reporters new to the beat.
  • The Trump administration’s announcement last week of new regulations to protect health care workers from having to do anything they believe violates their religious beliefs is a stronger policy than past Republicans have adopted. But it follows other efforts to expand past conservative policies, such as the current administration’s more stringent Title X family planning rules.
  • The administration’s new rule requiring drugmakers to add list prices to their TV ads could confuse some consumers, since few of them actually pay that price. Their insurers often negotiate better prices, and other factors, such as geography and type of pharmacy, affect the consumer’s bottom line.
  • President Donald Trump this week told Health and Human Services officials to work with Florida on its plan to import drugs from Canada to take advantage of lower prices there. HHS Secretary Alex Azar said he would see if it can be done without jeopardizing the safety of the drugs. That is the rub that his predecessors have used to stop importation efforts, dating to the 1990s.
  • The increasing interest in Democratic proposals such as “Medicare for All,” which would set up a government-run health care system, and “Medicare for America,” which would offer a government-run option for consumers and businesses, suggests that a public option is not the political hot potato it was during the debate setting up the ACA. It’s also not clear whether consumers are ready to give up their current insurance.
  • Tennessee is getting ready to ask federal officials for a major change in its Medicaid system. The state wants to switch to a block grant, in which its federal funding would be limited but would come with much more flexibility for spending. The proposal is likely to end up in court because advocates for the poor argue the change would cut off services to some people and would violate laws that have defined Medicaid.

Plus, for extra credit, the panelists recommend their favorite health policy stories of the week they think you should read too:

Julie Rovner: CNBC’s “Insiders Describe Aggressive Growth Tactics at uBiome, the Health Start-Up Raided by the FBI Last Week,” by Christina Farr, and “Health Tech Start-Up uBiome Suspends Clinical Operations Following FBI Raid,” by Christina Farr and Angelica LaVito

Joanne Kenen: ProPublica and the New Yorker’s “The Birth-Tissue Profiteers,” by Caroline Chen

Jen Haberkorn: The Los Angeles Times’ “Health Insurance Deductibles Soar, Leaving Americans With Unaffordable Bills,” by Noam N. Levey

Alice Miranda Ollstein: Bloomberg News’ “Trump May Redefine Poverty, Cutting Americans From Welfare Rolls,” by Justin Sink

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