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Health insurers pressed Trump administration officials on Tuesday to continue billions of dollars in subsidies for low-income people buying plans under the federal health care law, but left with nothing that would dissipate the fog of uncertainty hanging over the industry. (Abelson, 4/18)

The executives had hoped that Tuesday’s meeting at the Department of Health and Human Services would provide a clearer signal on whether they will continue getting “cost-sharing” payments, which help insurers bring down costs for about six million low-income customers enrolled through ACA insurance exchanges. President Donald Trump has unnerved insurance companies recently by sending mixed signals on the payments, just as the companies are making decisions on whether or not to take part on the ACA exchanges in 2018. (Hackman, Radnofsky and Wilde Mathews, 4/18)

"We welcomed the chance to share perspectives on the value of coverage delivered to more than 70 million Americans through Medicare Advantage and Medicaid health plans, but reiterated our most pressing concern: the instability in the individual market created by the uncertainty of funding for the cost sharing reduction (CSR) program," said Kristine Grow, an AHIP spokeswoman, in a statement. (Young, 4/18)

A CMS official confirmed that Verma “did not comment” on the payments, called cost-sharing reductions, at the meeting and told those gathered that it was a decision to be made by Congress. (Johnson, 4/18)

Democrats’ demand that ObamaCare subsidies be wrapped into a must-pass spending package is complicating GOP efforts to prevent a government shutdown at the end of next week. Speaker Paul Ryan (R-Wis.) has signaled no plans to include the subsidies in a bill to keep the government open, but President Trump’s recent threat to withhold the subsidies to insurers has led several top Republicans to intervene. (Lillis and Marcos, 4/19)

President Donald Trump on Tuesday promised big wins in the next stretch of his administration, glossing past the reality that the political newcomer will celebrate his first 100 days without a major legislative victory. In a speech that could be seen as a messaging test for that milestone, Trump hailed the opening days of his administration as a wild success and pledged to quickly deliver on health care, tax reform and infrastructure. (McCaskill, 4/18)

Health care dominated U.S. Sen. Chuck Grassley’s town meeting on Tuesday, as southeast Iowa constituents pressed him on insurance affordability and challenged him to embrace a single-payer solution. Congress is currently considering several proposals with the potential to lower insurance premiums, Grassley said, while a single-payer system in which government supplants private insurers is a nonstarter.  One woman described to Grassley how the insurance plan her family bought on the state’s Affordable Care Act exchange rose from $1,400 to $2,200 per month – and will go away altogether in 2018. (Noble, 4/18)

Allies of President Donald Trump this week are targeting Congressman Scott Tipton of Colorado with a new TV ad that uses an unusual tactic — reverse psychology — to get him to support a second effort to repeal and replace the Affordable Care Act. The 30-second spot, paid for by the Trump-aligned group America First Policies, urges viewers to call Tipton and thank him for “his courage and for standing with President Trump to repeal Obamacare now.” The oddity comes from the fact that Tipton, R-Cortez, was the only House Republican from Colorado to publicly declare that he would have voted against the GOP health-care plan that collapsed last month — telling The Daily Sentinel in Grand Junction afterward that he was opposed to the legislation. (Mattews, 4/18)

Since the Affordable Care Act was formally launched in 2014, taxpayers have had to check a box on line 61 of their 1040 federal tax returns declaring whether they or members of their family have qualified health insurance -- and provide documentation to prove it. This was required as part of Obamacare’s “individual mandate” to make nearly everyone without insurance eventually sign up. (Pianin, 4/18)

HHS Secretary Tom Price is facing a stark test of whether to keep Obamacare insurance markets afloat until Republicans come up with a potential alternative — a dilemma triggered by health plans fleeing 16 counties around Knoxville, Tenn. (Haberkorn and Pradhan, 4/18)

Insurers lost hundreds of millions of dollars figuring out how to cover Texans under Obamacare. The industry's painful lesson could be for naught if Republicans make good on their promise to scrap the law and upend the plans' carefully calibrated remedies. (Rayasam and Demko, 4/18)

UnitedHealth's first-quarter profit soared 35 percent as the nation's biggest health insurer slashed participation in Affordable Care Act exchanges but grew just about every other part of its business. The insurer also hiked its 2017 earnings forecast on Tuesday, and company shares started climbing shortly after it detailed results. (4/18)

As the largest U.S. health insurer and the first to report quarterly results, UnitedHealth is typically viewed as a bellwether for the industry’s earnings season, and analysts said its better-than-expected results would likely lift expectations for its managed-care peers. (Wilde Mathews and Hufford, 4/18)

The Trump administration is struggling to fill a top mental-health post, a job created last year to coordinate the efforts of far-flung federal agencies. The assistant secretary position in the Department of Health and Human Services was first offered to a Florida judge, but the offer was withdrawn due to his lack of a medical background, according to people familiar with the matter. A second candidate had broad support but pulled out. Now a leading contender is Michael Welner, a forensic psychiatrist who has testified for the prosecution in numerous high-profile criminal cases, according to a half-dozen people familiar with the process including Dr. Welner himself. He faces opposition for some controversial positions. (Hackman, 4/18)

Donald Trump railed against President Barack Obama’s decision to bring patients with Ebola to the United States for treatment in 2014. Now that Trump is president, his administration is preparing for similar, and possibly larger-scale, evacuations. The State Department and Department of Health and Human Services said Tuesday they led an unprecedented inter-agency drill last week to test their preparedness to deal with a new outbreak of Ebola or another deadly, highly infectious disease. (Lee, 4/18)

It was a “fix” that didn’t fix much — but Veterans Choice is expected to be extended anyway, with a stroke of President Donald Trump’s pen that could come as early as Wednesday. Veterans Choice is a $10 billion response to the 2014 scandal in which Veterans Affairs health facilities altered records to hide months-long waits for care in Phoenix and elsewhere. The troubled Choice program pays for private-sector health care for veterans and was set to expire in August, but the VA and some of the program’s harshest critics in Congress have agreed to extend it, with a few changes, until January. They said that will give the VA time to propose a more comprehensive package of reforms — fixes for the fix. (Whitney, 4/19)

Embattled blood testing company Theranos, Inc. has agreed to pay $4.65 million to cover full refunds for every Arizona customer who used the company's testing services, Arizona Attorney General Mark Brnovich announced Tuesday. The settlement with the Palo Alto, California-based company covers more than 175,000 Arizonans who paid for blood tests between 2013 and the suspension of Theranos services last year, Brnovich said. (4/18)

The pact is the second legal settlement in two days involving claims that Theranos had faulty blood-testing technology or lab practices. On Monday, Theranos resolved regulatory and legal matters with federal health regulators after the company and its founder Elizabeth Holmes agreed to stay out of the medical-lab business for two years. Theranos has said it has shifted its focus to developing lab equipment to sell to other companies rather than doing tests itself. (Weaver, 4/18)

Embattled diagnostics startup Theranos said it will return $4.65 million to Arizona residents for the blood testing services they received between 2013 and 2016. ... Some 1.5 million blood tests were performed on 175,000 customers — and more than 10 percent were ultimately voided. The deal, made with the Arizona attorney general’s office, is Theranos’s second for the week: The Silicon Valley company also told the Centers for Medicare and Medicaid Services that it wouldn’t conduct any blood testing for at least two years, in exchange for pared-down penalties from federal health authorities. (Keshavan, 4/18)

Neither settlement affects the numerous civil lawsuits filed by consumers, investors and Theranos' former retail partner, Walgreens, in Arizona and other states. (Alltucker, 4/18)

The drug and medical products distributor Cardinal Health plans to acquire Medtronic's medical supplies business for $6.1 billion, the company announced on Tuesday. The cash deal would give the Dublin, Ohio-based company access to Medtronic's 23 product categories in its patient care, deep vein thrombosis and nutritional insufficiency business, which "are used in nearly every U.S. hospital," Cardinal said. (Kacik, 4/18)

Cardinal Health Inc. struck a deal to buy part of Medtronic PLC's patient monitoring and recovery unit for $6.1 billion, bringing businesses under Cardinal’s roof that it has sought for years but also boosting its debt load. Cardinal said it would fund the acquisition with $4.5 billion in new debt plus existing cash. (Steele and Walker, 4/18)

Cardinal Health has made an anticipated deal to buy three medical-supply units from Medtronic for $6.1 billion. It is one of Cardinal’s biggest medical-products acquisitions. (Rose, 4/18)

The public could soon get a look at confidential reports about errors, mishaps and mix-ups in the nation's hospitals that put patients' health and safety at risk, under a groundbreaking proposal from federal health officials. The Centers for Medicare and Medicaid Services wants to require that private health care accreditors publicly detail problems they find during inspections of hospitals and other medical facilities, as well as the steps being taken to fix them. Nearly nine in 10 hospitals are directly overseen by those accreditors, not the government. (Ornstein, 4/18)

Surgery checklists save lives, a study released Monday found. Hospitals in South Carolina that completed a voluntary, statewide program to implement the World Health Organization's Surgical Safety Checklist had a 22 percent reduction in post-surgical deaths. The study, set to publish in the August 2017 issue of Annals of Surgery, is one of the first to show a large-scale impact of the checklist on the general population. (Naqvi, 4/18)

Nearly half of California hospitals received a grade of C or lower for patient safety on a national report card aimed at prodding medical centers to do more to prevent injuries and deaths. The Leapfrog Group, an employer-backed nonprofit group focused on health care quality, issued its latest scores last week. The report card is part of an effort to make consumers and employers aware of how their hospitals perform on key quality measures, so they can make better-informed health care decisions. The scores are updated twice a year, in spring and fall. (Terhune, 4/18)

A bacteria that can cause pneumonia, bloodstream infections or meningitis has been identified in six patients at Bon Secours St. Mary’s Hospital. The cases involving the bacteria ESBL klebsiella were identified between March 26 and April 16, according to a news release from St. Mary’s. (Demeria, 4/18)

The opioid epidemic ravaging the United States has brought new impetus to understanding how addiction hijacks the brain. More and more, scientists are shifting their focus to what’s going on in the brain after people like Mooney go off drugs. Their quest has unveiled a troubling picture: Repeated drug use leads to long-term changes to the brain. Some of those changes, new research suggests, might be hard to reverse and might even intensify right after withdrawal, explaining why it is so hard to stay off drugs. (Wesphal, 4/19)

In a summit full of addiction experts, each looking for the next big solution to curb opioid abuse, everything from treatment policies to the containers holding prescription pills are being considered. Owners of several drug supply companies say prescription vials holding drugs have done little to slow the nation’s epidemic. With seven out of 10 people who abuse prescription opioids getting drugs from a friend or family member’s medicine cabinet, some medical entrepreneurs are pushing security measures from locks to iPhone alerts as a way to deter drug abuse. (Blau, 4/19)

As an outgrowth of the parish's Greater Than Heroin outreach effort - which includes the www.greaterthanheroin.com website - a clearinghouse of community resources, advocacy and news related to heroin addiction - [Bob] Stec has asked more than 300 religious leaders [to] speak about the issue to their congregations on April 23. The Easter season, with its message of renewal, provides a perfect opportunity to speak on the growing epidemic of opioid addiction, Stec said. (Lisik, 4/18)

Adams, Brown, Lawrence and Scioto counties are to receive money to bring the pilot program — called Ohio START (Sobriety, Treatment and Reducing Trauma) — to their communities, Ohio Attorney General Mike DeWine said Tuesday. That makes 18 counties, all of them hard-hit by the state’s heroin and opioid-medication crisis, participating in the program. (Price, 4/18)

In a year in which Milwaukee County is preparing for an unprecedented number of fatal drug overdoses, add a new and particularly pernicious killer, carfentanil, which the county's medical examiner's office on Tuesday linked to two more deaths. And it's just beginning. (Stephenson, 4/18)

Cluster headaches, as the rare condition is known, are characterized by bursts of severe pain in cyclical patterns. They’re often misdiagnosed and undertreated. But on Tuesday, the Food and Drug Administration cleared a new, first-of-its kind option for such patients: a handheld device, designed to be used by patients to zap their own necks with a mild electrical signal to relieve symptoms. The hitch: It’s not clear how much difference the “gammaCore” device will make for the several hundred thousand people in the United States with the condition. (Robbins, 4/18)

Most people recognize Parkinson's patients through tremors, slow body movements and other motor problems. Yet up to half of patients develop psychosis at some time during the disease's course, often in the later stages and sometimes as a side effect from drugs prescribed to help motor skills. Tackling the psychosis has proved difficult, in part because doctors struggled for decades to address the motor problems, [Dr. Rajesh] Pahwa said. As gains happened there, the nonmotor problems became a bigger and bigger challenge to manage, he said. (McGuire, 4/18)

Routes are planned. Speakers are announced. But there’s still one question about this weekend’s March for Science that is begging to be answered: Who exactly is going to show up? The march has carved a wide mandate for itself as a non-partisan “celebration of science,” leaving the door open for many different groups to gather under its umbrella. Now, in recent weeks, the organizers of the Washington march and the hundreds of satellite marches across the US and overseas have been trying to anticipate who is going to turn up on April 22, including surveying social media and asking marchers to RSVP. (Sheridan, 4/19)

Dr. Jon Hallberg is having fewer conversations with vaccine skeptics at his Minneapolis practice now. He credits that to the spread of information that vaccines are safe and the debunking of any false claims otherwise. Still, as of Tuesday, there have been nine recent cases of measles in Minnesota kids — all of them unvaccinated. (Crann and Nelson, 4/18)

A compound found in marijuana halves the risk of certain seizures in people who have a severe form of epilepsy, a new study shows. Researchers at Nationwide Children’s Hospital gave a liquid form of a compound called cannabidiol to young people with Lennox-Gastaut syndrome. (Viviano, 4/18)

Iowa legislators sent Gov. Terry Branstad a measure Tuesday that would ban most abortions at 20 weeks of pregnancy and impose a 72-hour waiting period on women seeking the procedure, a move highlighting the state's conservative shift since the November election. The Republican-majority state Senate voted 30-20 along party lines for the legislation, after the GOP-led House approved it earlier this month. Branstad, a Republican, is expected to sign it. (4/18)

Texas hospitals and abortion clinics would have to bury or cremate fetal remains under a measure that passed out of a House committee on Tuesday. It's a rule that has its roots in Texas' fiery reproductive rights debate: While supporters argue the bill has nothing to do with abortion and is about "ensuring the dignity of the deceased," opponents say it's yet another way for the state to punish women who choose to legally terminate a pregnancy. (Samuels, 4/18)

A new research program at Penn State aims to improve the health of neglected and abused children and test an innovative approach to screen kids for head injuries. Penn State said Tuesday it will establish the Center for Healthy Children at its main campus, supported by nearly $8 million from the National Institutes for Health. The university is putting in more than $3 million. The program will supplement the university’s Child Maltreatment Solutions Network , established in response to the Jerry Sandusky child molestation scandal. (Scolforo, 4/18)

In St. Charles County, 181 children ... were abused and neglected last year. Those were the reported cases. ... And now, St. Charles County law enforcement officials say they need the public's help in reporting the crime. (Rack and Schwarz, 4/18)

In a much anticipated City Council meeting, Edina residents waited till almost midnight Tuesday to voice their opinions on an ordinance that would change the minimum age of tobacco sales in the city. Not until 11:50 p.m., after lengthy discussion of a project at 50th and France, did Mayor Jim Hovland and Edina City Council members hear the public’s views on raising the age from 18 to 21 — an effort to curb teen tobacco use. (Zamora, 4/19)

San Francisco has unveiled a tough anti-tobacco ordinance that would ban the retail sale of menthol cigarettes and other flavored tobacco or tobacco-related products that are often the first choice of minority group members and teenagers who smoke. Supervisor Malia Cohen, the proposal’s sponsor, joined Tuesday with public health experts and community advocates to announce the measure, which she said goes beyond more narrow laws on flavored tobacco in cities such as Chicago, Berkeley and New York. (Korry, 4/19)

A campaign that has successfully changed laws to limit the sale and purchase of nicotine products in 10 Johnson County cities will be considered on Thursday for unincorporated parts of the county. If it is approved, it will raise the legal age to buy nicotine products to 21. (Hammill, 4/18)

Electronic cigarettes and other so-called vaping products sold to Iowans on the internet would be regulated for the first time under a last-minute spending bill as the GOP majority strives toward adjournment of this year’s legislative session. Under the bill, sellers would be required to obtain a permit to sell the alternative nicotine products online. (Russell, 4/18)

The complaints offer a narrow glimpse into what can happen long after a patient leaves a doctor’s office or hospital and disputes or refuses payment of a bill. Hospitals and doctors often deal with unpaid bills. Some turn to debt collectors to get what the insurance company, the consumer or both refused to pay. (Alltucker, 4/18)

For four decades, hospitals wanting to expand or open new facilities have had to get the state to agree there’s a need for more healthcare in their community. It’s a rule that Republicans in the Florida House say creates unnecessary burdens on the free market. This week, they’ll be passing a bill to repeal it. (Auslen, 4/18)

Veterans in the Phoenix VA Health Care System can now get immediate medical treatment for minor illnesses and injuries from CVS MinuteClinics under a pilot project announced Tuesday. The program will be open to about 120,000 veterans, enabling them to call VA triage nurses and, if their symptoms qualify, receive an appointment within two hours at one of the drugstore chain's 24 clinic outlets in central Arizona. (Wagner, 4/18)

Flint’s mayor reversed course Tuesday and recommended that the Michigan city beset by a man-made crisis that left the water supply contaminated with lead continue getting its drinking water from a Detroit-area system long term, saying a third switch would be too risky and expensive. (Eggert, 4/18)

A Portsmouth company that fills a unique niche in the insurance market is confident its services will be in demand for years to come. Long Term Care Partners on Arboretum Drive is a third-party administrator of insurance services for federal employees. Under a seven-year contract regulated by the U.S. Office of Personnel Management, LTC is responsible for the Federal Long Term Care Insurance Program, which has about 275,000 enrollees and an eligible population of 4.4 million-plus federal employees, annuitants and qualified family members. LTC is also contracted to administer BENEFEDS, an exchange and service platform through which more than 2.5 million federal employees can manage their dental and vision coverage, with the choice of coverage from more than a dozen major national carriers. (Haas, 4/18)

New Orleans has a plan in place to help evacuate around 40,000 people who might not be able to get out on their own ahead of a hurricane. But during an evacuation, how does the city know where to find of the most vulnerable people, the elderly and disabled? Enter the Special Needs Registry, created to provide transportation and shelter for New Orleanians with special medical needs during emergencies such as a power outage, evacuation or hurricane. The registry keeps a database of information on around 4,400 people who will need extra help during an evacuation, and comes equipped with a small outreach team to update the records and annually. (Evans, 4/18)

A new study of the soda tax in Berkeley, Calif., shows that residents are doing what public health experts had hoped — they’re ditching sugary drinks and opting for healthier beverages. The study, the largest to date of Berkeley’s soda tax, comes as California lawmakers this week again consider legislation to put a warning label on sweetened beverages — a bill that died in committee three times in three years. (Ibarra, 4/18)

From the perspective of public health experts, Berkeley’s tax on sugar-sweetened beverages — the first of its kind in the country — has worked. The city has seen a significant drop in soda sales since the tax was implemented in March 2015. (Cheng, 4/18)

California’s Department of Motor Vehicles needs to significantly beef up efforts to prevent fraud and abuse in the state’s disabled person placard program, a new state audit recommends, noting that officials accept applications lacking required medical documentation, issue too many duplicates, and fail to cancel the placards of people who have died. Almost 3 million people had disabled placards or special license plates as of June 2016, according to Tuesday’s Bureau of State Audits report. (Miller, 4/18)

Companies in the industry provide a range of products and services, from electronic health records, medical billing and revenue management to diagnostics, preserving the security of information exchanges, and consumer health information... The revolution in patients’ medical records has accelerated the IT spurt, with physicians’ offices across the U.S. giving up folders full of written notes and turning to digital data. (Miller, 4/18)

A plan to move toward requiring a judge's review before the state removes children from their homes has died. Lawmakers in the Arizona House of Representatives this week nixed what Rep. John Allen had called a "half step" toward a warrant program for child removals in cases of child abuse and neglect. (Pitzl, 4/18)

Disability-rights advocates deemed Tuesday a "sad day" after Gov. Doug Ducey signed into law new limits on accessibility protections, contending he and state legislators chose business interests over civil rights despite having a practical alternative.​ (Polletta, 4/18)

A La Vergne woman who stole $1.5 million from state programs that feed children in need was sentenced last week to three months in prison, records show. Federal sentencing guidelines recommended more than five years prison time, according to court records. The reason U.S. District Judge Aleta Trauger handed LaShane Hayes the shorter term is unclear because several court documents are sealed, however other filings indicate Hayes wanted a probation sentence because of a medical condition. (Barchenger, 4/18)

Marijuana farmers – clad in plaid shirts and jeans, and looking like, well, farmers – openly assembled for a meeting of the California Growers Association. But the trade group’s agenda topic – about banks refusing cannabis business – still spoke of doors closed and cash transactions made in the shadows. (Hecht, 4/18)

Florida lawmakers are moving full steam ahead to implement the voter-approved constitutional amendment to legalize medical marijuana, but there is still no sign of a compromise between competing House and Senate plans. (Auslen, 4/19)

Congressional hearings. Federal investigations. Consumer outrage. In the wake of developments like these, many drug company executives are laying low. Their favored business models, based on raising drug prices indiscriminately, are now seen as a liability; many pharmaceutical companies are curbing increases on their products and accepting that this once-lucrative jig may be up. (Morgenson, 4/14)

All the recent rancor over drug pricing has led biotech to change its ways. Not by making new drugs cheaper, of course, but by holding off on naming a price — and thus inviting controversy — until the last possible minute. Nowadays, as soon as a drug wins Food and Drug Administration approval, so begins a debate about whether it’s worth the thousands of dollars a year new therapies generally cost. And so companies, perhaps mindful of how a few scolding tweets can snowball into a market-moving event, are starting to keep that information under wraps for as long as possible. (Garde, 4/12)

Making money when drug prices were rising was easy. Now comes the hard part.The latest signal: Distribution giant Cardinal Health lowered earnings expectations Tuesday morning and told investors that business wouldn’t pick up until the middle of 2018. The company is being hit by falling prices of generic drugs, which are expected to decline by a percentage in the low double digits for the fiscal year ending in June. (Grant, 4/18)

In a bid to loosen off-label communications, a congressman quietly introduced a bill late last month that would expand the ability of drug makers to discuss unapproved uses of their medicines with doctors. The legislation, which was proposed by Representative Morgan Griffith (R-Va.), addresses a controversial, if technical term called “intended use.” The Food and Drug Administration maintains that discussion of an unapproved, or off-label use, creates a new intended use for which a drug maker must have regulatory approval. (Silverman, 4/18)

U.S. regulators have approved the first drug for treating a neurological syndrome that causes uncontrollable body movements that can also interfere with speech, swallowing and breathing. The sometimes-disabling disorder, tardive dyskinesia, is caused by some widely used prescription medicines for psychiatric and gastrointestinal disorders. It can surface while patients are on those medicines or years after they stop. It affects about 500,000 U.S. patients. (Johnson, 4/11)

A nonprofit organization that has orchestrated a wide-reaching campaign against foreign drug imports has deep ties to the Pharmaceutical Research and Manufacturers of America, or PhRMA, the powerhouse lobbying group that includes Eli Lilly, Pfizer and Bayer. A PhRMA senior vice president, Scott LaGanga, for 10 years led the Partnership for Safe Medicines, a nonprofit that has recently emerged as a leading voice against Senate bills that would allow drug importation from Canada. (Kopp and Bluth, 4/19)

Abill that was recently introduced in Nevada to fight the cost of diabetes medicines is quickly generating vociferous opposition from several patient organizations, some of which receive financial support from the pharmaceutical industry. The groups include the National Organization for Rare Disorders, Caregiver Voices United, the Myositis Association, the International Pain Foundation, RetireSafe, and the Epilepsy Foundation. And most of their letters, which were sent to Nevada state senators, use nearly identical language in citing concerns. (Silverman, 4/17)

The long and contentious purchase of Alere Inc. of Waltham by Abbott Laboratories appears at hand, after the two health care companies said Friday they have a new deal that lowers the takeover price by $500 million. The amended takeover, under which Abbott will pay $51 for each share of Alere, is valued at $5.3 billion, down from the $5.8 billion the parties had initially agreed to in February 2016. (Weisman, 4/14)

Eli Lilly’s path to what looked like a surefire blockbuster got derailed by an unforeseen FDA rejection, clouding the future of a drug the company viewed as a pipeline in a pill. The Food and Drug Administration declined to approve Lilly’s baricitinib, an oral treatment for rheumatoid arthritis. According to Lilly, the agency wants to see more clinical data to determine the safety and ideal doses for the drug. Lilly didn’t disclose whether that means it will have to recruit and run new studies of the treatment, but if so, a resubmission could be delayed by months. (Garde, 4/14)

In September 2015, Satish Mehta, the billionaire chief executive of the Indian drug company Emcure Pharmaceuticals, wrote an effusive email congratulating Jeffrey Glazer, the CEO of his U.S. crown jewel, Heritage Pharmaceuticals, on a job well done. "In a short span of 4.5 years, you have taken Heritage to another level," Mehta wrote, adding that he considered Glazer to be "an integral part of our family." (Vardi and Karmali, 4/18)

The Senate unanimously approved a measure Monday to create a prescription drug-share program that would allow donations of packaged cancer drugs, but not opioids. The bill would allow nonprofit organizations to donate and redistribute prescription drugs still in their manufacturer packaging to people who don't have health insurance and meet other criteria. Multiple senators said the medication will largely come from long-term care facilities, which throw away a large amount of unused medication. (Lowary, 4/17)

The legislation, which was introduced by Pennsylvania Representative Patrick Meehan, a Republican, was co-sponsored by two North Carolina congressmen, Republican George Holding and Democrat G.K. Butterfield. In their home state, CROs employ some 24,000 people. Today, North Carolina is home to 152 CROs, which include powerhouses like PPD, PRA Health Sciences, and INC Research, as well as smaller outfits like Rho and Cato Services. CROs — which are also often referred to as contract research organizations — are a boon to North Carolina’s life science industry, which raked in nearly $2.2 billion in state and local government tax revenues in 2016, according to an economic impact report from the North Carolina Biotechnology Center. (Broadfoot, 4/18)

Americans have clear reason to think they’re paying too much for prescription drugs. The cost of medicines is rising faster than any other category of health-care spending, standing at almost 17 percent of total health costs. What’s harder to discern is what to do about it, in part because so little is known about how drug prices are set, what discounts and rebates drugmakers negotiate with wholesale buyers, and to what extent savings are passed along to customers at the pharmacy counter. Addressing this lack of transparency would be a good first step. (4/18)

Americans are rightfully concerned with rising medical costs, but some of the ways by which costs rise can be tedious and difficult to understand for those not already familiar with broader regulatory issues. What’s going on, though, is actually pretty straightforward: Brand-name producers regularly take advantage of systems designed to protect consumers to instead protect their bottom lines and crush out competition from their generic competitors. One common way by which anti-competitive behavior occurs is by preventing access to the materials needed to test generic or biosimilar alternatives. In other words, pharmaceutical companies refuse to let competitors prove their safety, and then enjoy the monopoly that results when theirs are the only drugs proven to be safe. (Jonathan Bydlak, 4/18)

The drug importation debate, sparked by Sen. Bernie Sanders’ introduction of legislation that would allow Americans and pharmacies to import medicines not approved by the FDA from foreign countries through and including Canada, is largely focused on one key question: A­re medications imported from outside the FDA’s jurisdiction safe for consumers? (Marvin D. Sheperd, 4/19)

When President Donald Trump and Sen. Bernie Sanders, (I-Vt.) see eye to eye on an issue, you know that it is politically volatile. That is the state of the current debate around prescription drug pricing, which has become a cause célèbre for lawmakers across the political spectrum. The frustration is justified. For too long, patients have endured repeated price hikes for the medicines they need to go about their daily lives. An opaque pricing system and supply chain that effectively operates as a “black box” of rebates, clawbacks and middlemen only serves to exacerbate patient anger. (Larry Smith and Larry Ellingson, 4/18)

In recent months, we have seen encouraging signs of a new commitment to the social contract drug makers have with patients. Novo Nordisk and Allergan have made pledges to hold the line on drug prices. Mylan has taken responsibility for the price increases for EpiPen, and is promising to do more to advance affordability. More recently, Regeneron engaged early on in a meaningful and responsible way to discuss pricing of a new therapy. (Steve Miller, 4/14)

Among the drugs that helped bring Valeant Pharmaceuticals International low, none did more damage to its reputation and stock price than Syprine. Syprine is a drug that treats a rare illness called Wilson disease, which prevents the body from metabolizing copper and can lead to liver failure and death if left untreated. For decades, the price of Syprine was $1 per 250-milligram tablet, according to a recent article in the medical journal Hepatology. For most people, a maintenance dose requires four pills a day, bringing the price during that era to $1,460 a year. (Joe Nocera, 4/18)

If you’re like most Californians who have health insurance, you know two things about how prescription drugs fit into your health plan. You know that you receive some level of coverage for medications, and you know that soaring prices for prescription drugs are a major cost-driver that have caused insurance premiums to soar. What you don’t know is how your coverage for prescription drugs works, who determines which drugs are covered, or who gets how much from the money you pay for your prescription drugs. The fact is, almost no one knows those things. (Jim Wood, 4/17)

Big Pharma wants us to believe that such costs reflect the expensive nature of research and development. But what the pharmaceutical companies spend on research, clinical trials and their 24/7 advertising campaigns is kept hush-hush. One study found that for every $1 drug companies spend on R&D, they spend $19 on advertising. (Ed Hernandez and Tom Steyer, 4/18)

In a now-leaked email, a senior executive at a large  pharmaceutical company discussed destroying supplies of generic cancer drugs as part of a pricing battle with health authorities in Spain, according to a report in the British newspaper The Times. The idea was floated in 2014 in an exchange with another staff member at Aspen Pharmacare, which has a market valuation of $10 billion and sells products globally, including in the United States, according to the company website. (Nick Mulcahy, 4/17)

It's much easier to tell a story of unlimited promise and sales growth than to deliver on it. Eli Lilly & Co. has been aggressively talking up its revamped drug pipeline. Investors who bought into this got a rude awakening Friday, when the company disclosed that the FDA had declined to approve baricitinib, an expected blockbuster arthritis treatment. Many investors assumed baricitinib would hit the market this year. But the FDA has asked for data on the drug's safety and optimal dose, meaning it may not be approved for years. (Max Nisen, 4/17)

Republicans in Congress say they’ll keep working on health-care reform. It never made sense to give up after only a few months of trying, but their plan would have better prospects if they modified it to address the criticism that it would leave too many people without insurance. The solution is to enroll uninsured Americans automatically in no-premium health coverage. (James C. Capretta and Lanhee J. Chen, 4/18)

The Obamacare marketplaces can be thought of as a government-run store. The government gives many customers subsidies, like gift cards, that they can use to buy insurance. But what happens if no companies want to sell their products in the store? (Margot Sanger-Katz, 4/18)

When our hard-working members of Congress return to work next week refreshed from their 18-day Easter recess, they’re planning to take up healthcare reform again. This time, their Affordable Care Act repeal effort has been dressed up with a new provision known as “invisible risk sharing,” based on what they assert was a successful program in Maine. They’re blowing smoke. (Michael Hiltzik, 4/18)

It is time for Sensenbrenner to face the facts. Obamacare is popular. It is not failing. He can continue to work against it or he can help his constituents afford quality health care. (Mike Cummens, 4/18)

Perhaps it sounds a little odd, but people both in Louisiana and elsewhere are sometimes fuzzy about the differences between the Affordable Care and Patient Protection Act, expanded Medicaid, and “Obamacare” — the politically charged term that involves the whole of the parts. ... The survey, conducted by the LSU Public Policy Lab, found that Louisiana residents approve of the state’s decision to expand its Medicaid program last year under the auspices of the Affordable Care Act, or ACA — but respondents to the survey remain deeply divided over the ACA itself. ... Many GOP members of [the] House and Senate balked at Medicaid expansion when it was a party litmus test during the terms of former Gov. Bobby Jindal; now, though, [Gov. John Bel Edwards] actions have provided a significant financial lifeline for working people in low-wage jobs who had no meaningful access to health care before. (4/19)

Let’s be clear: Expanding Medicaid might not have been enough to save St. Francis Health, the Topeka hospital that stands on the brink of closure. But few doubt that the millions of dollars that expansion would have brought to the nonprofit Catholic health center would have made a substantial difference. Most likely, the doors would have remained open for months longer. In the words of House Minority Leader Jim Ward, a “lifeline” would have been extended. (4/18)

One of the most threatening of those policies is in President Trump’s budget blueprint: a cut of nearly $6 billion to the National Institutes of Health (NIH). As The Post reported last month, the proposal would slash roughly a fifth of NIH’s funding in fiscal year 2018, “a seismic disruption in government-funded medical and scientific research.” The administration has also proposed a separate $1.2 billion reduction in the remainder of this year’s NIH funding, along with severe cuts to the National Science Foundation, the Environmental Protection Agency .... the debate over NIH funding is further evidence of what has been clear for quite some time: Science is now political. In response, scientists are becoming more political, too. (Katrina vanden Heuvel, 4/18)

In 1988, my family traveled from America to India to visit the homeland of my birth. At age 11, I vividly remember seeing beggars crippled by polio, crawling on the ground. I remember them staring at me. I, too, have polio, but I am able to walk with leg braces and crutches. I contracted polio as a baby in India. I was adopted from an orphanage at age 3 and moved to America. (Minda Dentler, 4/18)

Attendings have more experience than residents — sometimes decades more — but that doesn’t mean residents can’t occasionally be right when there’s a disagreement. A resident might be familiar with new research or guidelines because he or she has had more recent education on a topic. Attendings who are specialists in a field like cardiology or oncology may be less comfortable with conditions outside their expertise. Perhaps the most common reason that residents can be right is because they typically spend much more time with patients and their families than attendings. That means they may have a stronger understanding of important psychosocial factors that affect patients’ clinical care. (Alex Harding, 4/19)

Just about every week now, we see a new round of headlines about the crisis in overdose deaths from opioids. This is the class of drugs that includes prescription medications such as hydrocodone and street drugs such as heroin and fentanyl. There’s no question that the United States has seen a surge in addiction and deaths from overdose, although there are a couple of important things to keep in mind when reading such reports. (Radley Balko, 4/18)

The U.S. Preventive Services Task Force is changing their guidelines about prostate cancer screening. In 2012, the Task Force gave it a D grade – meaning they recommended against prostate specific antigen (PSA) screening because its harms exceeded its benefits. Earlier this week, in their draft recommendation, the Task Force upped it to a C grade for men ages 55 to 69 – meaning the decision to screen should be based on professional judgment and patient preference. (H. Gilbert Welch, 4/19)

As a professor of ophthalmology and a teacher of eye surgeons, I implore North Carolina not to make the mistake my Kentucky made six years ago, blindly rushing into law a bill that let non-surgeons operate on people’s eyes – a move legislators later regretted, and which Kentucky’s citizens opposed four-to-one. (Woodford S. Van Meter, 4/17)

As we recognize Parkinson’s Awareness Month in April, one of our most pressing priorities at the Parkinson’s Foundation is to improve the standard of care for this disease. It affects a growing number of people of all genders, ages, races and ethnicities. Every nine minutes, someone in the United States is diagnosed with this neurodegenerative disease that often progresses slowly over decades. People with Parkinson’s disease struggle to find a way to live with their symptoms — such as tremors that make even the smallest tasks like a buttoning a shirt or tying a shoe seem impossible. (John L. Lehr, 4/17)

Kansas lawmakers are still discussing ways to close a two-year, $1 billion budget gap. They need to come up with a plan quickly: They reconvene May 1 for what’s expected to be a long and difficult veto session. Before adjourning their regular meeting, legislators correctly rejected Gov. Sam Brownback’s half-baked budget ideas. They crushed a flat income tax, which would have disproportionately hurt the poor. (4/18)

As smokers turned to electronic cigarettes to reduce the health risks of smoking, big tobacco companies started buying e-cigarette makers and producing and selling their own. Now those companies are lobbying Congress to prevent the Food and Drug Administration from regulating electronic cigarettes and cigars, as it does conventional cigarettes. If they succeed, they will be able to sell and market addictive nicotine products to young people with few restrictions. (4/19)

The devastation of the opiate epidemic cannot be understated, nor can the urgency of doing something — anything — to alleviate its effects. Gov. Scott and Attorney General Pam Bondi understand the gravity of this crisis, working with law enforcement, the Legislature and other stakeholders to attack the insidious threat to public health and safety from multiple fronts. (Ben Pollara, 4/18)