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From Kaiser Health News:

Kaiser Health News Original Stories

2. Pharmacists Slow To Dispense Lifesaving Overdose Drug

Laws in California and most other states allow pharmacists to provide naloxone to patients or their friends without a doctor’s prescription. But many don’t do so, citing lack of demand and awareness among patients, their own fears of insufficient compensation and the challenges of treating opioid users. (Anna Gorman, 1/3)

3. Political Cartoon: 'Incurable?'

Kaiser Health News provides a fresh take on health policy developments with "Political Cartoon: 'Incurable?'" by Rick Kirkman and Jerry Scott.

Here's today's health policy haiku:


Back off of those fines
Said the industry … but what
About residents?

If you have a health policy haiku to share, please Contact Us and let us know if you want us to include your name. Keep in mind that we give extra points if you link back to a KHN original story.

Summaries Of The News:

Capitol Hill Watch

4. A Top House Republican Doesn't Concede Defeat On Health Law Repeal

Majority Whip Steve Scalise (R-La.) said that getting rid of the health law and tackling Medicaid regulations would be top priorities for the coming year. Meanwhile, Hillary Clinton has called on Congress to fully re-fund the CHIP program, saying that the lawmakers' short-term solution isn't good enough.

The Hill: House GOP Whip: Entitlement Reform, ObamaCare Repeal On 2018 Agenda
ObamaCare repeal and entitlement reform are at the top of the agenda for House Republicans in 2018, Majority Whip Steve Scalise (R-La.) said Tuesday. "The next big thing you're going to see is a need for workers, and I think the next thing we can do is to go and reform those welfare programs that are trapping people in a failed welfare state," Scalise said on "Fox & Friends" on Tuesday morning.  (Hellmann, 1/2)

The Hill: Conservative Groups Push For 2018 Repeal Of ObamaCare 
Conservative groups are pushing President Trump to make ObamaCare repeal a priority in 2018, even as some Republicans signal a desire to move on from the issue. A letter to Trump signed by 43 right-leaning groups calls for health-care reform to be the focus of the fast-track process known as reconciliation this year. Using that process would allow Republicans to repeal ObamaCare in the Senate without Democratic votes, but it would also preclude them from using the tool for other priorities like welfare reform. (Sullivan, 1/3)

The Wall Street Journal: Congress Faces Long To-Do List, Short Deadlines
At the end of 2017, Congress punted the long-term resolution of a number of thorny issues into this year. Here’s a rundown of what lawmakers will need to hammer out in early 2018. ... While lawmakers broadly support a five-year reauthorization of the Children’s Health Insurance Program, they have yet to decide how to pay for it. In its latest short-term spending bill, Congress made $2.85 billion available to shore up states’ funding for the program. The Centers for Medicare and Medicaid Services have indicated that should be enough to get states through the end of January or early February, a House GOP aide said. But states have signaled they need more certainty. (son, 1/3)

The Hill: Clinton: Short-Term CHIP Extension 'Doesn't Cut It' 
Hillary Clinton on Tuesday called on Senate Republicans to bring a full extension of the Children’s Health Insurance Program to the floor for a vote. “This alleged extension until March doesn’t cut it as states freeze enrollment & send out letters warning that coverage will end,” the 2016 Democratic presidential nominee tweeted. (Weixel, 1/2)

And in news on the tax overhaul —

Modern Healthcare: Seven Key Changes The New Tax Law Will Force Hospitals To Consider
Not-for-profit hospital systems will have to grapple with a number of changes that make their tax-exempt status less advantageous, including new provisions on unrelated business taxable income and executive compensation. In addition, borrowing rates on tax-exempt municipal bonds may rise because the new law's big corporate tax cut may make tax-exempt interest income less attractive to institutional investors, said Richard Gundling, senior vice president of the Healthcare Financial Management Association. (Meyer, 1/2)

5. With Hatch's Retirement, Pharma Will Lose A Friend In Congress

News that Senate Finance Committee Chairman Orrin Hatch (R-Utah) will retire after this year sent ripples through the health care industry.

Stat: In Orrin Hatch's Retirement, Pharma Loses Chief Congressional Ally
Drug makers are about to lose a key ally in Washington. Republican Sen. Orrin Hatch of Utah, a longtime advocate for the drug industry, announced Tuesday he will retire at the end of his term this year. Across a four-decades-long career in the Senate, Hatch used influential positions atop the Finance Committee, the Health, Education, Labor and Pensions Committee, and the Judiciary Committee to advance the industry’s major policy priorities. (Mershon, 1/2)

CQ: Hatch's Exit Will Influence Health Policy Debates
The news that Finance Committee Chairman Sen. Orrin G. Hatch of Utah would retire after this year resonated in health policy circles Tuesday. Hatch’s decades-long influence over health issues is hard to overstate. In the near term, Hatch will oversee a long-term renewal of financing for the Children’s Health Insurance Program, which he and Sen. Edward M. Kennedy, D-Mass., created in 1997. The politically popular program extended coverage to the children of poor families who didn’t qualify for Medicaid, the program for the poor. CHIP was reauthorized multiple times over the last two decades, and Hatch is currently trying to extend the program’s financing for another five years. (Siddons, 1/2)

6. Tension Heats Up On Capitol Hill Over Drug Discount Program As Cuts Go Into Effect

Hospitals and big pharma are waging a war over the 340B program, which requires pharmaceutical companies to give steep discounts to hospitals and clinics that serve high volumes of low-income patients.

Modern Healthcare: House Gears Up For 340B Oversight Push
Pressure over the status of a federal drug discount program has intensified on Capitol Hill as Medicare reimbursement cuts for 340B hospitals have officially gone into effect. On Friday, a federal court dismissed several hospital associations' suit that sought to block the cuts and lawmakers geared up for a legislative battle that has grown increasingly convoluted now that financial cuts have become conflated with a push for program transparency. (Luthi, 1/2)

The Hill: Hospital Groups Dig In After Cuts To Discount Drug Program
Hospital groups are vowing to push forward with a fight against the Trump administration over changes to a federal drug discount program following a setback last week. The American Hospital Association (AHA), America's Essential Hospitals and the Association of American Medical Colleges last year sued to block a rule from going into effect that would result in $1.6 billion in cuts to hospitals participating in the 340B Medicare drug discount program. (Hellmann, 1/2)

Administration News

7. HHS Nominee's Senate Hearing Set For Next Week

Alex Azar, who has been tapped to replace former Health and Human Services Secretary Tom Price, has been criticized for his close ties to the pharmaceutical industry.

In other news from the administration —

Stat: Scott Gottlieb Issues A Whole Lot Of Statements. We Tallied His Word Count
If it feels like you’ve been hearing from the head of the Food and Drug Administration a lot lately, you’re not imagining it. It’s a rare day here at STAT when we don’t receive in our inboxes a “Statement from FDA Commissioner Scott Gottlieb, M.D.” — or at least find him prominently quoted in another new FDA press release. Then there are all his blog posts. His speeches. His congressional testimony. And, of course, his tweets. (Robbins, 1/3)

Coverage And Access

8. U.S. Health System To Be Further Strained As Undocumented, Uninsured Immigrants Age

Few undocumented residents are able to obtain help for chronic aging issues before their problems become bad enough to send them to the ER, where they are guaranteed emergency care. The financial burden of treating an aging, uninsured population in the coming years will put stress on a system that is already struggling with high costs.

Stateline: Aging, Undocumented And Uninsured Immigrants Challenge Cities And States
For decades, the United States has struggled to deal with the health care needs of its undocumented immigrants — now an estimated 11 million — mainly through emergency room care and community health centers. But in the coming years, that struggle will evolve. As with the rest of America, the population of people living here illegally is aging and beginning to develop the same health problems that plague senior citizens generally and are a lot more expensive to treat: chronic diseases, cognitive disorders and physical injuries. Many undocumented adults lack health insurance, and even though they’re guaranteed emergency care for acute problems such as heart attacks, senior citizens without documentation don’t have access to care for chronic issues such as kidney disease and high blood pressure. (Wiltz, 1/3)

Public Health And Education

9. Profit Mining The Opioid Crisis: The Dark Underbelly Of Lucrative Addiction Treatment Industry

The opioid epidemic has sparked a huge growth in the extremely profitably addiction treatment industry -- but there is little regulation around these centers that are making a lot of money off sick and needy patients. The New York Times offers a deeper look.

The New York Times: In Pursuit Of Liquid Gold
With drug abuse rising, an array of companies have found new ways to turn the problems of addicts into billable fortunes. And few are as profitable as those focused on the lowliest byproduct of any stint in rehab: urine. Testing has long been part of recovery, a way for clinics to ensure that patients are staying clean. But starting in 2010, as opioid abuse evolved into a crisis and the Affordable Care Act offered insurance to millions more young people, the cost of urinalysis tests soared. It was soon common for clinics and labs to charge more than $4,000 per test, and to test clients two or three times a week. (Segal, 12/27)

The New York Times: The Giant, Under Attack
On the last day of his life, Gary Benefield expressed hope for the future. He was finally about to “get right,” he said. A Harley-riding tough guy and retired utility worker, Mr. Benefield had let addiction get the better of him. He was downing a dozen Budweisers a day and smoking nonstop, despite needing an oxygen tank to breathe. But that July day in 2010, he was headed to A Better Tomorrow, a California treatment center promising 24-hour care while he got sober. (Corkery and Silver-Greenberg, 12/27)

The New York Times: City Of Addict Entrepreneurs
It first dawned on Erin Burk that her town had become a haven for drug treatment soon after she noticed the fleet of white vans zooming through her neighborhood. The vans, she learned after tailing one, were ferrying addicts all over town to what amounted to halfway houses for those in recovery: sober living homes. Nobody she asked seemed to know how many sober living homes were located in Prescott, so she decided to conduct an improvised census. (Segal, 12/27)

The New York Times: A Doctor With A Phone And A Mission
More than 200,000 people seek addiction treatment on the phone or online every month. Few of them realize that their pleas for help are a valuable commodity — one that is quietly fought over by those angling to turn a distress signal into cash. Addicts represent big money to treatment centers, which are happy to pay a middleman $50 for a “lead” on a patient who might generate $40,000 or more in insurance claims in a matter of months. That is why television ads offering help to addicts air constantly nationwide. (Segal, 12/27)

10. Mobile Addiction Treatment Van Tries To Offer Help When Former Inmates Are Most At Risk

The van parks outside Baltimore Central Booking and Intake Center with a sign advertising its services to try to help people right as they're released from jail.

The Baltimore Sun: Van Parked Outside Of Baltimore Jail Offers Drug Treatment 
Homeless, occasionally incarcerated and about 24-hours after his last hit of heroin, Norman Jones walked into the big white van parked just steps from the door to Baltimore City’s jail looking for an exit from his way of life. “Enough is enough” said the 56-year-old Jones as he waited for a prescription for buprenorphine, a medication used to forestall withdrawal and long-term cravings. (Cohn and McDaniels, 1/3)

In other news on the opioid crisis —

News Service of Florida: Children Become Collateral Damage In Florida Opioid Crisis
As the numbers of addicts escalate, the numbers of children placed in out-of-home care because of parental drug abuse is increasing, according to data captured by the Department of Children and Families. ... Substance abuse played a role in two-thirds of the cases where children were removed from their homes within 30 days of birth last year. (Kam, 1/2)

Kaiser Health News: Pharmacists Slow To Dispense Lifesaving Overdose Drug
Gale Dunham, a pharmacist in Calistoga, Calif., knows the devastation the opioid epidemic has wrought, and she is glad the anti-overdose drug naloxone is becoming more accessible. But so far, Dunham said, she has not taken advantage of a California law that allows pharmacists to dispense the medication to patients without a doctor’s prescription. She said she plans to take the training required at some point but has not yet seen much demand for the drug. (Gorman, 1/3)

11. 'You Look Sick': Humans Can Tell If Someone Is Ill From Facial Clues

Paleness, sweating and drooping around the eyes can be tell-tale signs if someone is sick. A new study finds that people can pick up on those subtle clues.

The Washington Post: These Subtle Cues Are What Make Sick People Look Sick
The next time a friend tells you that you look sick, hear the person out. We are better than chance at detecting illness in others simply by looking at their faces, according to new research led by a Swedish psychologist. “We can detect subtle cues related to the skin, eyes and mouth,” said John Axelsson of the Karolinska Institute, who co-wrote the study published Tuesday in the journal Proceedings of the Royal Society B. “And we judge people as sick by those cues.” (Guarino, 1/2)

Stat: Humans May Be Able To Pick Out Sick People Just By Looking At Their Faces
But the judgements were far from perfect — 30 percent of photos of healthy people were deemed sick. The findings matter because past studies have shown that people might avoid others who appear to be sick. “How we perceive other people’s faces is really, really important,” John Axelsson, a neuroscientist at Sweden’s Karolinska Institute and the study’s lead author, told STAT. “People who are attractive always get favored. People who are sick are being stigmatized in a sense.” (Blau, 1/2)

12. Hot New Cancer Treatments Offer Tantalizing Hope To Patients But Come With Serious Side Effects

Immunotherapy -- using a patient's own immune system to fight cancer -- is sparking a revolution in cancer treatment. But with it comes a whole load of side effects and complications that even doctors can't predict until patients get them. In other public health news: Alzheimer's, hep C, obesity and diabetes, autism and more.

The Washington Post: New Cancer Treatments Have Perplexing Side Effects
When Diane Legg began seeing black specks in her right eye, she went to an ophthalmologist near her home in Amesbury, Mass. He said she had a torn retina and needed laser surgery. Legg’s oncologist was skeptical. He was worried that Legg had eye inflammation, called uveitis, that was caused by an immunotherapy drug she had been on for advanced lung cancer. If so, Legg needed to get a far different treatment — and quickly — to avoid vision problems or blindness. (McGinley, 1/2)

NPR: 'Much Better Treatment' For Alzheimer's Is 10 Years Away, Scientist Predicts
British neuroscientist Joseph Jebelli first set out to study Alzheimer's because of his grandfather, who developed the disease when Jebelli was 12. In the years that followed, Jebelli watched as his grandfather's memory started to disappear. But Jebelli points out that although a certain amount of memory loss is a natural part of aging, what happened to his grandfather and to other Alzheimer's patients is different. (Gross, 1/2)

NPR: Retired Doctor Rejoins The Fight To Cure Hepatitis C
When a hepatitis C treatment called Harvoni was released in 2014, Dr. Ronald Cirillo knew it was big. "It's the reason that dragged me out of retirement!" he says. Cirillo specialized in treating hepatitis C for more than 30 years in Stamford, Conn., before retiring to Bradenton, Fla. During his time in Connecticut, the only available treatment for hepatitis C had terrible side effects and it didn't work very well. It cured the viral infection less than half the time. But the newer drugs Harvoni and Solvaldi cure almost everybody, with few adverse reactions. (Ochoa, 1/2)

The New York Times: Obesity Is The Main Contributor To Diabetes In Blacks And Whites
Type 2 diabetes is almost twice as common in African-Americans as it is in whites. Obesity, rather than racial factors, is to blame, a new study in JAMA reports. Researchers began with 4,251 black and white men and women ages 18 to 30 who were not diabetic. They then followed up with periodic interviews and health examinations over an average of 25 years. Compared to whites, black men were 67 percent more likely, and black women almost three times as likely, to develop diabetes. (Bakalar, 1/2)

NPR: Diabetes And Baby Formula: Study Finds No Link With Cow's Milk As Ingredient
Could babies be at higher risk of developing Type 1 diabetes from drinking formula made from cow's milk? That idea has been circulating for some time but the evidence has been scant and contradictory. A study published Tuesday makes it seem less likely. There are two types of diabetes, and both are on the rise. It's clear that a major driving force behind the increase of Type 2 diabetes, which mainly affects adults, is the eating habits that are also driving the rise of obesity. (Harris, 1/2)

NPR: High-Intensity Interval Training And Group Classes Top Fitness Trends
Enough already with the activity trackers and fitness apps. They're so 2017. If you're tired of tech and of exercising solo and are ready to simplify your routine — maybe even join a group exercise class — you'll be in good company this new year. The latest annual survey of fitness professionals suggests 2018 will find more of us ditching the gadgets and getting back to basics in the way we work out: more resistance training, yoga and jump-ropes; fewer earbuds and iWatches. (Neighmond, 1/1)


13. CMS Wants To Adjust Payments For Medicare Advantage Plans

Under the proposed changes, risk scores used to set payments would take into account certain diagnoses of mental health disorders, substance abuse disorders and chronic kidney disease. Meanwhile, the Department of Health and Human Services has finalized a rule that offers providers and payers more flexibility to share substance abuse patients' data.

Modern Healthcare: HHS Relaxes Rules On Sharing Substance Abuse Patients' Information
HHS has finalized a rule that aims to make it easier for insurers and providers to share substance abuse patients' data with other parties that are involved in providing and paying for that person's care. Under the current rules, insurance companies and providers would need to obtain consent forms from patients to share their information with every company involved in their care. That red tape sometimes slowed access to care or reimbursement. But HHS is looking to change that. (Dickson, 1/2)

In other Medicare news —


14. Delaware Medicaid Program Plans To Cover Obesity Treatment Next Year

Next year, people who qualify for Medicaid and have a body mass index of 30 or higher will have access to at least 12 visits a year with a healthcare professional. News outlets also report on Medicaid developments in Colorado, California, Maryland and Illinois.

Wilmington, Del., News Journal: Delaware Medicaid Program To Cover Obesity Treatment Visits In 2019
The state's Medicaid program will cover treatment visits for people struggling with obesity in 2019 with the hopes it will improve health outcomes for Delawareans. The Delaware Division of Medicaid and Medical Assistance is one of nine founding members of My Healthy Weight, a national initiative targeted to fight obesity. This concept was developed by the Alliance for a Healthier Generation and the Bipartisan Policy Center. (Newman, 1/2)

California Healthline: State Gives Medi-Cal Enrollees Something To Smile About
Susan Inglett’s dental coverage changed just after she got a root canal on one of her top teeth. It was 2009, and California was in the midst of a budget crisis. To cut costs, Medi-Cal, the state health insurance program for low-income residents, eliminated non-emergency dental benefits for adults. Inglett, 63, of San Diego, needed a crown for that vulnerable tooth, but the state no longer paid for them. (Bazar, 1/3)

Chicago Tribune: State Charges Chicago OB-GYN In Medicaid Scam
A Northwest Side doctor has been charged with defrauding the state of $100,000 in Medicaid funds for women’s health services she didn’t provide, the Illinois attorney general’s office said. Dr. Manuela Farhi, 60, whose obstetrics and gynecology practice on West North Avenue in the Galewood neighborhood offered care for women enrolled in Medicaid, allegedly billed the state for patients who missed appointments and for services she claimed to have performed while out of the country, according to an indictment filed Friday in Cook County Circuit Court. (Channick, 1/2)

State Watch

15. State Highlights: Lawsuit Accuses Duke, UNC Of Conspiring Not To Poach Each Other's Medical Workers; Flu Nearing Epidemic Levels In San Diego

Media outlets report on news from North Carolina, California, Illinois, Florida, Missouri, Colorado, Ohio and Connecticut.

The Associated Press: Lawsuit: Duke, UNC Agreed To Not Hire Each Other's Doctors
The basketball rivalry between Duke University and the University of North Carolina battle is legendary, but a federal lawsuit says the two elite institutions have agreed not to compete in another prestigious area: the market for highly skilled medical workers. The anti-trust complaint by a former Duke radiologist accuses the schools just 10 miles (16 kilometers) apart of secretly conspiring to avoid poaching each other's professors. If her lawyers succeed in persuading a judge to make it a class action, thousands of faculty, physicians, nurses and other professionals could be affected. (Dalesio, 1/2)

San Diego Union-Times: As Hepatitis A Outbreak Wanes, San Diego County Turns Focus To The Flu
San Diego County supervisors voted Tuesday to continue the hepatitis A emergency declared in September, although there were just six new cases added to the outbreak total in the last two weeks and the death total has held at 20 for more than two months. But they were much more interested in what's going on with the flu, which is nearing epidemic levels throughout the region. (Sisson, 1/2)

Chicago Tribune: Illinois Suspends Outcome Health's Agreement For EDGE Tax Breaks
The state has suspended a tax credit agreement with Outcome Health — worth an estimated $6.1 million over a decade — in the wake of allegations that the tech company misled investors and advertisers. The agreement was part of the EDGE program, short for Economic Development for a Growing Economy, which provides tax breaks for companies that promise to create jobs in Illinois. ... Outcome Health, which has been considered a star on Chicago’s tech scene, places screens in doctor’s offices that run educational content about health topics and advertisements from drug companies. (Marotti, 1/2)

The Associated Press: Doctor Who Stole $100M From Medicare Could Get 30-Plus Years
A politically prominent Florida eye doctor could get more than 30 years in prison for stealing $100 million in one of history’s largest Medicare frauds. A sentencing hearing for Dr. Salomon Melgen resumes Wednesday after a four-week hiatus. Melgen was convicted last April of 67 crimes including health care fraud, submitting false claims and falsifying records. U.S. District Judge Kenneth Marra could give the 63-year-old Melgen a life sentence. Prosecutors are asking for 30 years. ... In a separate case, Melgen is accused of bribing New Jersey Democratic Sen. Bob Menendez. (Spencer, 1/3)

St. Louis Public Radio: SSM Health Warns 29,000 Patients About Breach Of Medical Records At Its Call Center
SSM Health is reviewing its security procedures after discovering that a former employee with its customer service call center inappropriately accessed patient medical records between Feb. 13 and Oct. 20, 2017. The health care system is notifying all patients whose records were accessed by the employee — about 29,000 people in multiple states — even if the access appears to have been legitimate, SSM officials said in a statement released last week. (Leonard, 1/2)

Denver Post: Colorado Wants Police To Try Therapeutic Approach With Mentally Ill And Drug Addicted Offenders
Colorado is pushing for new approaches to how police officers handle cases involving mental illness and drug addiction, encouraging them to steer low-level offenders toward treatment rather than jail and giving them assistance in dealing with potentially dangerous situations. In one tactic, mental health professionals ride with officers during 911 responses and some routine patrols. In another, local communities place case managers into high-crime areas to help police keep drug users, prostitutes and other offenders out of the criminal justice system. (Osher, 1/2)

St. Louis Public Radio: Dropping Temperatures Spell Trouble For The Vulnerable
After a week of below-zero temperatures, with some nights hitting lower than zero, people in the St. Louis region are struggling to keep warm. ... [ founder Gentry W.] Trotter said that senior citizens and people with disabilities are among those at greatest risk. Staying warm and dry can be crucial to their health. (Petrin and Lewis-Thompson, 1/2)

The CT Mirror: Whiting Forensic Division To Separate From Connecticut Valley Hospital
Months after a patient-abuse case that led to the arrest of ten employees and the disciplining of dozens more, Gov. Dannel P. Malloy has signed an executive order that separates the maximum security Whiting Forensic Division from Connecticut Valley Hospital. ... Under the order, beds at Whiting Maximum Security will be consolidated with those at the Dutcher Enhanced Security building, creating a 229-bed forensic hospital. (Rigg, 1/2)

Los Angeles Times: Recreational Marijuana Is Legal. But Smoking In Public And Driving Stoned Are Not, LAPD Warns
As Los Angeles moves toward allowing the sale of recreational marijuana, joining cities across the state in the newly legal enterprise, police here offered a stern word of caution. Yes, recreational pot will be legal to sell (and buy, and consume, and cultivate). But there are limits. And the Los Angeles Police Department will help enforce them. "Let me be clear," Assistant Chief Michel Moore said Tuesday. "The use of marijuana needs to be done in a responsible manner that's consistent with the law." (Mather, 1/2)

Prescription Drug Watch

16. Pharma's Strategy In Dealing With Anger Over High Prices: Point Fingers At Someone Else

News outlets report on stories related to pharmaceutical pricing.

The Washington Post: Pharma, Under Attack For Drug Prices, Started An Industry War
It’s not easy to get Americans mad at a behind-the-scenes industry they’ve barely even heard of, but pharmaceutical companies have spent most of this year trying. “Who decides what you pay for your medicines? Not who you might think,” a concerned woman’s voice says in a radio spot airing in the District last month. “More than one-third of the list price of a medicine is rebated back to middlemen, like insurers and pharmacy benefit managers.” (Johnson, 1/2)

The New York Times: Think You’re Seeing More Drug Ads On TV? You Are, And Here’s Why
Swelling of legs, hands and feet; capillary leak syndrome; fever; muscle pain; unusual bruising; dizziness, blurry vision; rash; hives; blisters; nervous system and blood disorders; lymphoma; swollen tongue; dry mouth; weight gain; inability to fight infections; nausea, diarrhea; constipation; depression; dehydration; suicidal thoughts. Oh, and death. (Kaufman, 12/24)

Modern Healthcare: Drug Prices Rise As Pharma Profit Soars
The amount of money people spend on prescription drugs has nearly doubled over the past three decades as pharmaceutical sales and profit margins have ballooned, according to a government report. Retail prescription drug expenses accounted for about 12% of total U.S. healthcare spending in 2015, up from about 7% through the 1990s. Pharmaceutical and biotechnology sales revenue increased from $534 billion to $775 billion between 2006 and 2015, according to a recent report from the U.S. Government Accountability Office. About two-thirds of drug companies saw their profit margins increase over that period, averaging 17.1%. (Kacik, 12/28)

The Wall Street Journal: Cancer Drug Price Rises 1,400% With No Generic To Challenge It
Since 2013, the price of a 40-year-old, off-patent cancer drug in the U.S. has risen 1,400%, putting the life-extending medicine out of reach for some patients. Introduced in 1976 to treat brain tumors and Hodgkin lymphoma, lomustine has no generic competition, giving seller NextSource Biotechnology LLC significant pricing power. The U.S. Food and Drug Administration is seeking to encourage more competition for drugs like lomustine, one of at least 319 drugs for which U.S. patents have expired but which have no generic copies, according to a list the agency published earlier this month. (Loftus, 12/25)

Stat: Several Drug Makers Just Raised Their Prices By Nearly 10 Percent, And Buyers Expect More Price Hikes
Several drug makers celebrated the new year with substantial single-digit price hikes, while a new survey indicated that prices for brand-name medicines are expected to rise 3 percent to 4 percent annually over the next three years. Leading the way among drug makers was Allergan (AGN), which boosted the list prices for 18 medicines by 9.5 percent, a level that allowed the company to stick to its controversial pledge to avoid double-digit price hikes. That move was made as part of a so-called social contract issued more than a year ago amid mounting anger over the cost of medicines. Only a few other drug makers formally agreed to follow suit. (Silverman, 1/2)

Stat: Price Hikes On Top-Selling Drugs Were A Lot Smaller This Year, Stat Finds
Average annual price increases have declined at least four years in a row for 20 of America’s top-selling brand-name prescription drugs, according to a STAT analysis of data from Truven Health Analytics, an IBM Watson business. The data suggest that public and political outrage over the high cost of vital medicines may be swaying corporate strategies. Price growth was especially low in 2017 — perhaps due, in part, to peer pressure, as several top pharma companies have made public pledges to limit price hikes. (Robbins, 12/27)

Stat: 3 Trends To Watch In Pharma Advertising In 2018
These are boom times for the multibillion-dollar drug advertising industry — and the parade of ads across your TV screen shows no sign of slowing down in 2018. But while the money keeps flowing, there are changes afoot: New strategies and channels are commanding more investment, raising fresh regulatory questions. (Robbins, 12/27)

Detroit Free Press: Prescription Drug Prices Kept Rising In 2017, But Scrutiny Did Help
We are still losing the battle to contain fast-rising drug prices in Michigan and across the country, but increased scrutiny of pricey pharmaceuticals led to some minor victories in 2017 for more affordable health care, according to several of Michigan's larger insurers. Prices for many popular branded drugs that made big jumps in recent years, such as insulin and rheumatoid arthritis treatments, experienced more modest increases in 2017 — although increases were still well above the general inflation rate of around 2%. (Reindl, 1/1)

The New York Times: Made In China: New And Potentially Lifesaving Drugs
One new drug promises to stop cancer from spreading to other organs. Another would treat blood cancer. A third would use the body’s immune system to kill tumors. All three show encouraging results, and need just one more step to be approved for use in the United States. The drugs have something else in common: They were created in China. (Wee, 1/3)

Medscape: Decreasing Market Competition Driving Up Generic Drug Costs
As the number of manufacturers producing a generic drug increases, the costs of these drugs fall, a recent study suggests. Chintan V. Dave, PharmD, PhD, from Brigham and Women's Hospital, Boston, Massachusetts, and colleagues reported their findings in a correspondence to the editor published online December 27 in the New England Journal of Medicine. "With 1.9 billion prescription claims, the number of manufacturers of the generic drug was strongly associated with relative price," the authors write. (Parry, 12/28)

The Star Tribune: Do State's Inmates Have A Right To Get Drug That Can Cost $100K? 
Five prison inmates infected with hepatitis C are seeking class-action status for a lawsuit that would require the Minnesota Department of Corrections to offer a class of groundbreaking, but extremely expensive, new drugs. The medications, known as “direct acting antiviral” (DAA) drugs, can have a 95 percent cure rate, but they can cost anywhere from $26,400 to well above $100,000 per patient. (Montemayor, 1/1)

The Associated Press: Kmart To Pay $32.3 Million To Settle Prescription Drugs Case
Kmart Corp. has agreed to pay $32.3 million to settle allegations its pharmacies caused federal health programs to overpay for prescription drugs by not telling the government about discounted prices.The U.S. Department of Justice announced the settlement agreement Friday.Kmart is part of Sears Holdings Corp., based in Hoffman Estates, Illinois. It was sued in 2008 by former Kmart pharmacist James Garbe, who worked in Defiance, Ohio. (12/23)

17. Perspectives: Despite Drugmakers' Blame-Game Tactics, They Really Could Control Sky-High Prices

Read recent commentaries about drug-cost issues.

The Hill: When Your Medication Costs More Than Your Mortgage
Prescription drug prices are out of control: The average annual cost for one specialty medication to treat a chronic condition is now more than what most families earn in a year. Big Pharma could solve the problem by committing to more rational and sustainable pricing models. Instead, for the last year, Big Pharma has chosen to point the finger at everyone else, and their decision to engage in a blame game is a tacit admission that drug prices are, in fact, too high. Since this is the road they’ve chosen to go down, let’s lay out some facts about the root causes of outrageous drug prices. (Rick Pollack and Marilyn Tavenner, 12/31)

Bloomberg: Trump FDA Chief Scott Gottlieb Isn't Pharma's BFF After All
Scott Gottlieb seems like the pharmaceutical industry's idea of a dream FDA Commissioner, with pharma ties and an ideological bent toward deregulation. But he has also been the only member of the Trump administration to follow through on the president's fiery rhetoric about rising drug prices. Pharma claims to like the free market. But in the year ahead, Gottlieb is set to prove how the free market can cut both ways for drugmakers. (Max Nisen, 1/2)

The Wall Street Journal: Biotech’s Breakthrough Year
Pay attention only to politics and you might think 2017 was a parade of horribles, yet most Americans saw their living standards rise and business innovations are happening apace. Consider the lifesaving medical breakthroughs greenlighted this year by the Food and Drug Administration. (12/29)

Tampa Bay Times: Let Federal Government Negotiate Prescription Drug Prices
One of the fairest and most effective ways for the nation to reduce its health care costs is for the federal government to use its massive purchasing power to negotiate more affordable prices for prescription drugs. That long-recognized reality is a key finding of a recent report by the National Academy of Sciences that makes practical recommendations for reducing drug costs while protecting the role pharmaceuticals play in the modern health care system. The report, Making Medicines Affordable, is notable for the 32 findings that address the challenge of curbing drug costs in both economic and political terms. To its credit, the academy balanced the debate by drawing attention at the outset to the contribution that the drug industry has made in delivering products that have been "very successful" in improving health and fighting disease. (12/25)

The Santa Fe New Mexican: Controlling Drug Prices — It’s Possible
A great success of modern America is the development of medicines to treat so much of what ails us. The United States knows how to develop and deliver drugs to fight disease and improve health — but success hardly comes cheap. Spending on prescription drugs is rising, with many people unable to purchase the medicines they or relatives need. The country cannot be healthy if people can’t afford prescriptions, especially ones to manage long-term conditions or ones that mean the difference between life and death. The situation has become so bad, in fact, that the prestigious National Academies of Sciences reported late last month that “consumer access to affordable medicines is a public health imperative.” (12/26)

Cleveland Plain Dealer: Congress Must Pass Bill Limiting Drug Price Hikes
Imagine this: A patient shows up in the emergency room after suffering a seizure. You discover she had stopped taking her medication because it became too expensive. You switch her to a cheaper medication, but the side effects are more severe, making it harder for her to go to work. This is the reality that doctors in Cleveland see every day. (Malavika Kesavan, 12/28)

Editorials And Opinions

18. Viewpoints: GOP Still Faces An Obamacare Conundrum; What's Up With The FDA And Food Recalls?

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

The Wall Street Journal: Republicans Can’t Avoid ObamaCare In 2018
Republicans failed to repeal and replace ObamaCare in 2017. So what should they do in 2018? Some, like Senate Majority Leader Mitch McConnell, worry that they won’t be able to do much with their 51-49 majority. Others, like Sen. Lindsey Graham, want to give health care another go. Congress has no choice but to revisit the issue. The growth in spending on health-care entitlements like Medicaid and Medicare threatens to overwhelm the Treasury, starving the federal government of the funds it needs to pay for everything else, including education, welfare and national defense. (Avik Roy, 1/2)

Los Angeles Times: A New Year's Pledge: Don't Let Politicians And Pundits Say Social Security And Medicare 'Reforms' When They Mean 'Cuts'
Just before New Year's, economist Jared Bernstein published the second in what may be an annual feature: A plea to the media to call out politicians who try to conceal their intention to gut Social Security and Medicare by talking about "reforms" instead of "cuts." Bernstein, who served as chief economist for former Vice President Joe Biden, originally raised the alarm about this sort of weaseling a year ago. I seconded the motion then, and do so again now. (Michael Hiltzik, 1/2)

USA Today: Why Is FDA So Slow On Food Recalls?
Soon after the Food and Drug Administration discovered salmonella in a plant that made nut butters in 2014, several illnesses were linked to the product. But it took more than five months before the tainted food — which caused 14 illnesses in 11 states — was recalled that August. Nor did the FDA consider using its mandatory recall authority until 161 days after the discovery. Four days later, nSpired Natural Foods voluntarily pulled the product. (1/2)

USA Today: FDA: We’re Working To Protect Consumers
Americans depend on the U.S. Food and Drug Administration to ensure their food is safe. We take their trust very seriously. When the Health and Human Services inspector general (IG) released an early alert in 2016 about our food recall process, FDA quickly acted on the concerns raised. (Scott Gottlieb, 1/2)

Chicago Tribune: One Change To Dental Care That Could Save Lives, Money
Tens of millions of Americans have decaying teeth, frequent toothaches and chronic dental pain. The result can be lost work productivity, missed school days and outright suffering. Many of those people — adults and children — lack access to the dental care that could help them. (Grover Norquist and Don Berwick, 1/2)

Boston Globe: Mass. Should Set Standards For Recovery Coaches
Even in the midst of a raging opioid epidemic, Massachusetts now lets just about anyone market themselves as a coach to help people claw back from addiction. ...But that would start to change if the Legislature passes a bill proposed by Governor Baker that would lead to professional standards for recovery coaches. (1/3)

JAMA: Improving Public Health Requires Inclusion Of Underrepresented Populations In Research
Advances in genomics have ushered in promising therapies tailored to the individual. Personalized medicine is promoted and has begun to positively influence care. For example, medications such as trastuzumab for the 30% of breast cancers that overexpress ERBB2 and vemurafenib for patients with late-stage melanoma who carry the V600E variant have been beneficial. Despite these advances, for many sectors of the population — children, older adults, pregnant and lactating women, and individuals with physical and intellectual disabilities — limited evidence-based therapies optimized to their specific medical needs exist. Combined, these groups comprise as much as 58% of the US population. Research focusing on or at the very least includes members of these groups is critically needed. (Catherine Y. Spong and Diana W. Bianchi, 12/28)

JAMA: Language, Science, And Politics: The Politicization Of Public Health
On December 16, 2017, the staff of the Centers for Disease Control and Prevention (CDC) were instructed not to use 7 words in its 2019 budget appropriation request: diversity, transgender, vulnerable, fetus, entitlement, evidence-based, and science-based. These basic phrases are intrinsic to public health. The US Department of Health and Human Services (HHS) offered alternative word choices, such as by modifying “evidence-based” with “community standards and wishes” and using “unborn child” instead of “fetus.” ... This Viewpoint explains why the budget advice of HHS undermines science and ethics—even if it is lawful. (Lawrence O. Gostin, 12/28)