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KHN First Edition: August 26, 2016


First Edition

Friday, August 26, 2016
Check Kaiser Health News online for the latest headlines

Today's early morning highlights from the major news organizations.

Kaiser Health News: In Boston’s ‘Safe Space,’ Surprising Insights Into Drug Highs
Martha Bebinger reports for WBUR and KHN: "Some arrive on their own, worried about what was really in that bag of heroin. Some are carried in, slumped between two friends. Others are lifted off the sidewalk or asphalt of a nearby alley and rolled in a wheelchair to what’s known as SPOT, or the Supportive Place for Observation and Treatment, at the Boston Health Care for the Homeless Program. Nine reclining chairs have been full most days, especially during peak midday hours. It may be the only room in the country where patients can ride out a heroin or other high under medical supervision." (8/26)

Kaiser Health News: Report For State Insurance Commissioners Offers Options To Improve Drug Access
Consumer columnist Michelle Andrews writes for KHN: "As prescription drug costs continue to rise, ensuring that consumers have access to the drugs they need is a growing concern. Insurers blame the drug companies for high prices while drug companies blame insurers for restrictive plans. Consumers are stuck in the middle picking up a higher tab. Now a new study highlights strategies for states to help consumers in this tug of war." (8/26)

Kaiser Health News: ‘Mental Health First Aid’ — Chirlane McCray On How N.Y.C. Is Fixing The System
Shefali Luthra reports for KHN: "For Chirlane McCray, New York City’s first lady, mental illness is not an abstract concern. It’s deeply personal. Both of her parents suffered depression, something she describes openly; and, in 2013, McCray’s daughter Chiara went public about her own battle with depression and substance abuse. It’s a pressing health problem for many of her constituents, too. In New York City, about one-in-five people are believed to have depression at any given time. Less than 40 percent get treatment." (8/26)

California Healthline: Ask Emily: Getting Doctor Lists Right
California Healthline consumer columnist Emily Bazar writes: "State Sen. Ed Hernandez and his wife, Diane, are optometrists. ... Hernandez, who chairs the Senate Health Committee, is author of a newly enacted state law that aims to improve provider directories, long riddled with out-of-date and inaccurate information. Under the law, insurance companies — and health care providers like the Hernandezes — must comply with new requirements to keep directories updated and accurate." (8/26)

The Wall Street Journal: Burden Of Health-Care Costs Moves To The Middle Class
Growth in overall health-care spending is slowing, but middle-class families’ share of the tab is getting larger, squeezing households already feeling stretched financially. Overall, health-care spending across the economy reached 18.2% of gross domestic product as of June, up from 13.3% in 2000, according to Altarum Institute, a health research group. (Sussman, 8/25)

The Wall Street Journal: 5 Things To Know About Health-Care Spending In The U.S.
Despite a slowdown in the growth rate of overall national health expenditures, Americans are seeing more of their paychecks go to health-care costs. The increase is largely thanks to cost-shifting through higher deductibles in plans offered by employers, which cover the majority of workers and their families. The trend has hit middle-income households the hardest. Here are five things to know about trends in U.S. health-care spending. (Sussman, 8/25)

Politico: Obamacare Sticker Shock Hits Key Senate Races
As insurers push large premium increases for 2017 Obamacare plans, some of the steepest hikes have been requested by insurers in crucial swing states that could determine control of the Senate. In nine of 11 states with competitive Senate races, at least one insurer seeks to hike rates for Obamacare customers by at least 30 percent next year: Highmark Blue Cross Blue Shield in Pennsylvania wants to jack up average premiums by more than 40 percent. In Wisconsin, three insurers have asked for rate hikes of more than 30 percent. In New Hampshire, two of the five carriers want to sell plans with rate increase above 30 percent. (Pradhan and Demko, 8/26)

The New York Times' The Upshot: How Expanding Medicaid Can Lower Insurance Premiums For All
The Obama administration for years has been pleading with states to expand their Medicaid programs and offer health coverage to low-income people. Now it has a further argument in its favor: Expansion of Medicaid could lower insurance prices for everyone else. A new study published by in-house researchers at the Department of Health and Human Services compared places that have expanded their Medicaid programs as part of Obamacare with neighboring places that have not. They found that, in 2015, insurance in the marketplace for middle-income people cost less in the places that had expanded Medicaid. (Sanger-Katz, 8/25)

Stateline: House Calls Might Save Medicaid Money For States
Doctors who make house calls may seem like something from America’s Norman Rockwell past. But they never disappeared entirely, and there is new evidence that home visits can play an important role in providing health care to the aged and chronically ill — while saving taxpayers millions. The federal Centers for Medicaid and Medicare Services (CMS) said this month that a demonstration project has shown that delivering comprehensive primary care services at home helped to keep Medicare recipients with multiple chronic illnesses or disabilities out of hospitals, emergency rooms and nursing homes. (Ollove, 8/25)

The Washington Post: Why Mylan’s ‘Savings Card’ Won’t Make EpiPen Cheaper For All Patients
Although the company said that the savings card would halve the cost of the drug to commercially insured patients who pay full price, outside experts said the overall impact will likely be small and that it did not amount to a solution to the broader problem. Such savings cards are a classic public relations move by the pharmaceutical industry, said Harvard Medical School professor Aaron Kesselheim, and it will only be used by a fraction of the people who need the drug. For example, such savings cards are illegal in government health programs such as Medicaid. (Johnson, 8/25)

NPR: EpiPen Manufacturer Offers A Discount, But Critics Aren't Soothed
The device's manufacturer, Mylan NV, announced Thursday that it will offer coupons worth as much as $300 off a two-pack. The move is a reaction to harsh criticism from consumers and several lawmakers over repeated price increases that have boosted the cost of the medication to more than $600 from less than $100 just a few years ago. ... But coupons may not be enough to tamp down anger over the price hikes. (Kodjak, 8/25)

The Washington Post: How Mylan, The Maker Of EpiPen, Became A Virtual Monopoly
EpiPen’s rising price is particularly notable because state and federal legislation have been key to the drug’s rapid growth. Annual prescriptions for EpiPen products have more than doubled in the past decade to 3.6 million, according to IMS Health data. Mylan benefited from factors including failed competitors, patent protections and laws requiring allergy medications in schools. Having a virtual monopoly has facilitated the rapid price hike. Mylan reached $1 billion in sales for the second time last year. (Johnson and Ho, 8/25)

The New York Times: Mylan To Offer Some Patients Aid On Cost Of EpiPens
But the moves did not mollify critics of Mylan because the company did not lower the list price of the EpiPen, which has risen to $600 for a pack of two from about $100 in 2007. So the total cost to the health system, a cost borne largely by insurers, the federal government and school districts, will remain the same. (Pollack, 8/25)

USA Today: Why Not Reuse EpiPens With New Epinephrine After They Expire?
The controversy surrounding skyrocketing prices over the EpiPen emergency allergy shots has nothing to do with what's in the devices. That's the 100-year-old chemical epinephrine, which costs just pennies. It's the device that Mylan is charging so much for. So why not replace cartridges of epinephrine that have expired with new ones? (O'Donnell, 8/25)

The New York Times: How Parents Harnessed The Power Of Social Media To Challenge EpiPen Prices
[Mellini Kantayya] went online to, a service that collects signatures and then sends them to designated lawmakers, and created the petition “Stop the EpiPen Price Gouging,” which went live on July 11. Then Ms. Kantayya shared the link with her 836 Facebook friends, with a post that began, “Stupid pharmaceutical company!” What happened next is a lesson in the power of social media to help create a groundswell, particularly among a group as committed and motivated as the parents of children with food allergies, who must often buy multiple pens for home, school and day care. In just 45 days, Ms. Kantayya’s petition grew from a few dozen signatures to more than 80,000 people who sent more than 121,000 letters to Congress. (Parker-Pope, 8/25)

The Wall Street Journal: Mylan Reacts To EpiPen Backlash
Mylan NV raced Thursday to counter a firestorm of criticism over its pricing of lifesaving EpiPens, saying it would help more patients cover their out-of-pocket costs. But the drugmaker didn’t lower the list price, and its stranglehold on the market means it is unlikely to face competitive pressure to do so. (Rockoff, 8/25)

The Wall Street Journal: Sen. Joe Manchin, Father Of Mylan’s CEO, Airs ‘Concerns’ About Drug Costs
In a statement more remarkable for who said it than for what he said, Sen. Joe Manchin (D., W. Va.) said he shares the concerns of other senators and the public about “skyrocketing prices of prescription drugs.” Sen. Manchin’s daughter is Heather Bresch, chief executive of Mylan NV and the central figure in the current national furor over the skyrocketing cost of Mylan’s auto-injector product called the EpiPen. (Burton, 8/25)

USA Today: A Timeline Of Eye-Popping Drug Prices
The firestorm over steep price increases for the EpiPen — which can rescue people having life-threatening allergic reactions  — is just the latest in a long line of controversies over high prescription drug prices. A decade ago, much of the concern over prescription drug prices involved new high-tech cancer drugs, used by only a few thousand patients a year. In recent years, the prices for decades-old generic drugs have soared, as well, as pharmaceutical companies purchase the rights for drugs with no competition. Here's a recap of some of the most eye-popping prices. (Szabo, 8/25)

NPR: Planned Parenthood Joins Campaign To Rid Miami Neighborhoods Of Zika
In Little Haiti, Liberty City, and a number of other neighborhoods in Miami, canvassers are now walking door to door to spread the word about the risks of Zika, one household at a time — hoping to reach 25, 000 people the next six weeks. In some neighborhoods, these workers aren't sponsored by federal or state health agencies, but by Planned Parenthood. (Allen, 8/26)

The Wall Street Journal: Zika Virus’s Spread Pushes Testing Labs To Expand Capacity
As summer drew near, the nation’s health officials took stock of whether they could handle a surge in demand for Zika diagnostic tests if disease-carrying mosquitoes began to proliferate. A survey of state and local laboratories found enough capacity to perform 3,500 to 5,000 tests a week for the Zika virus. But that wouldn’t be enough to meet demand under the Centers for Disease Control and Prevention’s worst-case scenario for a domestic Zika outbreak. (Evans, 8/25)

The Washington Post: After Health-Care Missteps, A Chastened Hillary Clinton Emerged
From the ashes of this defeat emerged a chastened Hillary Clinton whose caution has, over the years and as she seeks to become the nation’s first female president, become a hallmark of her identity. The 21 months from the dawn to the demise of the Clinton health plan showed the first lady as the Washington neophyte that she was, overvaluing her own ideas, misreading power relationships, crusading for a complex plan that would have disrupted many Americans’ health care. She has not attempted anything as daring again. (Goldstein, 8/25)

The Wall Street Journal: Theranos To Appeal Regulatory Sanctions
Silicon Valley startup Theranos Inc. said late Thursday it plans to appeal a decision made last month by regulators to revoke its license to operate a lab in California, among other penalties, because of unsafe practices. The Centers for Medicare and Medicaid Services, the agency that oversees U.S. labs, also banned Theranos founder Elizabeth Holmes from the blood-testing business for at least two years. (Ng, 8/25)

The Associated Press: Alabama House Narrowly Approves Governor's Proposed Lottery
The Alabama House of Representatives narrowly approved Gov. Robert Bentley's proposed state lottery Thursday night after 10 hours of contentious debate and two vote attempts. ... The Republican governor, seeking to end the Deep South state's historic opposition to gambling as a revenue source, proposed a lottery as a way to provide money to the state's perpetually cash-strapped Medicaid program. (Chandler, 8/26)

The New York Times: Seattle’s Potential Solution For Heroin Epidemic: Places For Legal Drug Use
A task force established to combat a heroin epidemic in the Seattle metropolitan area has endorsed a strategy of establishing places where addicts would be allowed to take drugs without fear of being arrested. At these sites, called safe consumption facilities, addicts would receive clean needles and syringes and would be permitted to inject heroin, smoke crack cocaine and take other addictive drugs under the supervision of trained authorities. (Bromwich, 8/25)

NPR: Illegally Made Fentanyl Seems To Be Fueling A Spike In Overdoses
Federal data suggest illegally manufactured fentanyl, a drug that is 50 to 100 times stronger than morphine, is behind an increase in synthetic opioid deaths. A report from the Centers for Disease Control and Prevention says that there was a 426 percent increase in seized drug products that tested positive for fentanyl from 2013 to 2014. And separate data show the number of deaths involving synthetic opioids, a class that includes fentanyl and tramadol but not hydrocodone, rose 79 percent during that same period. (Hobson, 8/25)

Los Angeles Times: 'The Cheapest Buzz You Can Get On Skid Row': Officials Try To Stop Homeless From Smoking Spice After Dozens Sickened
When paramedics arrived at downtown’s skid row last Friday in response to a 911 call, they found dozens of people who looked as if they’d overdosed. Many were on the ground, passed out.  ... “I’m walking down the street — it looks like a war zone,” said Georgia Berkovich, who works at the Midnight Mission, a block from the intersection. Thirty-eight people were transported to the hospital, many suspected of ingesting the synthetic drug “spice.” (Karlamangla, 8/25)

California Healthline: California Lawmakers Aim To Tackle Rural Health Challenges
Two proposals meant to ease burdens faced by California’s rural patients and their health care providers are breezing through the state legislature as lawmakers finish up for the year. One measure passed Wednesday requires Medi-Cal to cover patients’ transportation to medical appointments. Another bill would allow small rural hospitals to hire doctors directly, which supporters say could reduce health care costs and make it easier to keep physicians in areas where there are few. (Bartolone, 8/25)

NPR: Orlando Hospitals Say They Won't Bill Victims Of Pulse Nightclub Shooting
Orlando Regional Medical Center has treated 44 victims of the shooting — more than any other hospital. The center's parent company, Orlando Health, says it will not charge victims for their treatment, reports Abe Aboraya of member station WMFE. Instead, the hospital will look at federal and state funds, victims' funds like the One Orlando fund, and private funds raised for victims," Aboraya reports for our Newscast unit. "The hospital will bill insurance if a patient has it, but it will not go after a patient's copays. (Domonoske, 8/25)

The Washington Post: Teen Boys’ HPV-Vaccination Rate Hits Almost 50 Percent, CDC Says
The rate of HPV vaccination among teen boys in the United States surged in 2015, suggesting that more parents and physicians are embracing the message that it's as important for boys to be vaccinated against the human papillomavirus as it is for girls. The Centers for Disease Control and Prevention reported Thursday that 49.8 percent of boys ages 13 to 17 had gotten at least one of the recommended three doses as of 2015, up 8 percentage points from 2014. The rate for teen girls rose more slowly: Almost 63 percent had gotten at least one dose, compared to 60 percent in 2014. (McGinley, 8/25)

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