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POLITICO New York Health Care, presented by Professional Women in Advocacy Conference: A new villain; HHS reexamining cuts

Dear readers: POLITICO New York Pro subscribers receive this email at 5:30 a.m. each weekday. If you'd like to receive it at that time, along with a customized real-time news feed of New York health care policy news throughout the day, please contact us at and we'll set you up for trial access.

written by Dan Goldberg and Josefa Velasquez

IS PHARMA THE NEW INSURANCE? — For years, insurance companies have been the favorite scapegoat of politicians and the “bad guy” to the public. They were a popular target because they were the ones raising premiums every year. Of course, health care costs rise for lots of reasons but insurers always struggled to get that point across. Now, pharmacy companies, by bringing a spate of expensive new drugs to market, have handed insurers an opportunity to blame something else, something concrete, for the rise in health costs. And polls show Americans number one concern is rising drug prices.

TO THAT END — Upstate insurer CDPHP has launched a campaign to look into pharmaceutical costs and what it sees as a lack of transparency among drug companies. Coming on the heels of Turing Pharmaceuticals decision to raise the price of a 62-year-old drug from $13.50 to $750 per tablet overnight, CDPHP, an Albany-based insurer, created a website where consumers can receive information regarding drug price trends and legislative effort to control costs. New York and five other states have introduced legislation to support drug price transparency, but efforts have stalled. POLITICO New York’s Josefa Velasquez has more: [PRO]

..."The persistence and dedication of researchers and scientists across the biopharmaceutical industry has resulted in significant breakthroughs against some of our most challenging diseases, including cancer, hepatitis c, heart disease and other devastating conditions,” Priscilla VanderVeer, a spokeswoman for PhRMA, said in response to the CDPHP story. "Ideally, patients would have no challenges accessing needed medicines. However, when patients do face barriers to access, our industry works to provide important back stops, such as prescription assistance programs for people who are uninsured or underinsured."

CLINTON’S PROPOSAL — Democratic presidential candidate Hillary Clinton unveiled her plan to tackle drug prices. She wants to cap at $250 per month what consumers pay for drugs, and empower Medicare to negotiate drug prices. President Obama wanted Medicare to negotiate drug prices as well but traded the idea for the promise of support from the industry for what became Obamacare.

...That was swiftly condemned by PhRMA, which doesn’t want to negotiate with Medicare, the nation’s largest insurer, and America’s Health Insurance Plans, which doesn’t want “an arbitrary cap.”

...Meanwhile a new study found pharmaceutical companies are charging up to 600 times what the medicines cost to make, according to Reuters. “The United States also pays more than double the price charged in Europe for these drugs - so-called tyrosine kinase inhibitors (TKIs), a potent class of cancer pills with fewer side effects than chemotherapy.”

... Health economists and other health policy experts aren’t on board with Clinton’s plan. Experts, according to a report by the New York Times, said Clinton’s plan would create perverse incentives that could raise the cost of developing new drugs rather than lowering them. “This is an astonishingly naïve approach,” Amitabh Chandra, a professor of public policy at Harvard University, told the Times.

WHAT’S CHANGED — Drug costs have been increasing for decades but the Affordable Care Act and other recent changes have changed how Americans feel that increase. The Kaiser Family Foundation points out that the share of Americans with deductibles of more than $2,000 has doubled in recent years. That means consumers are more aware than ever of what they are paying. That’s why policy wonks love high deductible plans. The idea is that when consumers get fed up, something changes and health care costs overall begin to slow.

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NOW WE KNOW Mice sing for sex. Scientists have long known that males, looking for love, sing to female mice, but new research shows the females are singing back. And when these female mice sing, they slow down, making it easier for the males to catch them.

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RE-EXAMINING CUTS— A federal judge has ruled that the secretary of health and human services does have the authority to cut Medicare payments for all hospitals, but that she failed to follow the proper procedures for doing so. The ruling is a mixed bag for hospital trade groups and their members, who have vigorously fought the agency’s so-called two-midnight rule in Congress and in court.That rule stipulates that Medicare would only pay inpatient rates — typically higher than outpatient rates — if a patient stayed in the hospital for two midnights. HHS determined the rule would mean more inpatients and would thus cost the federal government $220 million, and it decided to offset that increase with an across-the-board, reduction in compensation for inpatient services.

GOING AFTER K2 — The New York Police Department is creating a new unit to tackle drugs and homelessness on East 125th Street in East Harlem, commissioner Bill Bratton announced Tuesday. The plans come after The New York Times ran a front-page story earlier this month about the problems plaguing the area. That section of East Harlem is home to two methadone clinics, several homeless encampments and a plethora of bodegas selling K2, the cheap, powerful synthetic marijuana that Bratton has said can cause psychotic behavior. On Tuesday, Bratton — speaking at a breakfast hosted by the Association for a Better New York in Midtown — said officers in the new unit would get specialized training in dealing with drug and homeless issues.

FARLEY IS IN TENNESSEE — Former New York City health commissioner Thomas Farley was in Tennessee Tuesday morning taking on a familiar foe: sugar-sweetened beverages. Farley, who led New York City's failed attempt to cap the size of certain sugary drinks, is working with public health leaders from northeast Tennessee and southwest Virginia to encourage people to drink water instead of sugar. [PRO]

NEW HOSPITAL— The Board of Directors of the Mohawk Valley Health System announced that a new hospital will be built in downtown Utica. The hospital, according to Time Warner Cable News, will replace the the St. Luke's Campus of Faxton St. Luke's Healthcare and at St. Elizabeth Medical Center. The hospital will cost between $500 million and $600 million and take four to six years to complete.

COMING UP— Upstate Medical University will be hosting a conference Thursday with researchers from around the globe to discuss the latest treatment for kidney cancer.

SANDRA LEE QUESTIONS TREATMENT— Celebrity chef Sandra Lee, Gov. Andrew Cuomo’s long time girlfriend said she is cancer-free, but questioned a study released earlier this summer. She questioned doctors who say pre-emptive surgeries aren't the best way to deal with pre-cancerous conditions. Lee opted to have a double mastectomy after she was diagnosed with ductal carcinoma in situ — or DCIS — in May. A study published in JAMA Oncology in August found that early surgery in response to DCIS may not affect survival rates. Lee called a New York Times article about those findings “absolutely ridiculous." She said cancer should be treated aggressively and immediately. “Why we would consider negotiation with cancer is beyond me. Let's just see what it does?” Lee said. “It's like a terrorist that lives inside your body, and we're going to wait and see what it does? We know what it's going to do.” POLITICO New York’s Jimmy Vielkind has more:

IN CASE YOU MISSED — Rochester General Hospital might be expanding soon.

GRANT LAND — Dr. David Lohman, assistant professor of biology at The City College of New York, and his colleagues received $2.5 million in grants from the National Science Foundation for a collaborative study to resolve the evolutionary history of all butterfly species.

PHARMA REPORT — Martin Shkreli, the CEO to Turing Pharmaceuticals announced Tuesday night that the company will roll back the price of Daraprim after facing public backlash. It is unclear how much the reduction will be.


-WHAT’S THE HOLD UP? — POLITICO’s David Pittman explains how a gun control rule got hung up on health privacy. “The Obama administration since January has been sitting on a regulation that would allow health care providers to share mental health information with the FBI's firearms background check system. The pending final rule was part of the administration's gun control plan in the weeks after the December 2012 mass shooting at a Newtown, Conn., elementary school. It requires rule changes in the Health Insurance Portability and Accountability Act, but HHS' Office of Civil Rights was slow to draft them.” [PRO]

DISCLOSURE— Coca-Cola published a list of grants given to physician groups, university researchers, cancer and diabetes organizations and public parks, and even a foundation for the National Institutes of Health, the Times reports. The list came weeks after chief executive Muhtar Kent published an opinion piece promising to be transparent about its partnerships after news broke that Coca-Cola used its resources to downplay criticism that its products aided in the spread of obesity. Among those issued grants by Coca-Cola were American College of Cardiology, the American Academy of Family Physicians, the American Academy of Pediatrics, the American Cancer Society and the Academy of Nutrition and Dietetics.

TODAY'S TIP — Comes from the state’s Health Department. Have any tattoos or piercings? Make sure to get tested for hepatitis C.


-GOOD NEWS — Sex is very rarely the cause of a heart attack, according to a research letter published in the Journal of the American College of Cardiology. That means heart disease patients need not fear jumping back into the sack. The letter explains that sex is really no different than climbing two staircases or taking a brisk walk.

-SUPPLY AND DEMAND—Demand for newly-trained primary care physicians is surpassing the demand for specialists, a study by the University at Albany’s Center for Health and Workforce found. The report, Trends in Demand for New Physicians, 2010-2014, found that newly-trained physicians in most specialities have improved or remained stable over the last several years.

-REACHING ACROSS THE AISLE— Support for federal health care spending due to the Obamacare is eroding from Republicans, but also Democrats and independents, a study by John Hopkins University found. Prior to the passage of the Affordable Care Act, 86 percent of Democrats thought too little was being spent on health, but after wards support for health care spending dropped 12 percent. Roughly two-thirds of Republicans supported spending and that dropped 25 percent after Obamacare.

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MISSED A ROUNDUP? Get caught up here: 9/22, 9/21, 9/20, 918, 9/17,

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