First Edition: January 18, 2019
NOTE TO READERS: KHN's First Edition will not be published Jan. 21. Look for it again in your inbox Jan. 22. Here's today's early morning highlights from the major news organizations.
Kaiser Health News:
Secretive ‘Rebate Trap’ Keeps Generic Drugs For Diabetes And Other Ills Out Of Reach
Lisa Crook was lucky. She saved $800 last year after her insurance company started covering a new, less expensive insulin called Basaglar that was virtually identical to the brand she had used for years. The list price for Lantus, a long-acting insulin made by Sanofi that she injected once a day, had nearly quadrupled over a decade.With Basaglar, “I’ve never had my insulin cost drop so significantly,” said Crook, a legal assistant in Dallas who has Type 1 diabetes. (Hancock and Lupkin, 1/18)
Kaiser Health News:
Furloughed Feds’ Health Coverage Intact, But Shutdown Still Complicates Things
Joseph Daskalakis’ son was born New Year’s Eve, a little over a week into the current government shutdown, and about 10 weeks before he was expected. Little Oliver ended up in a specialized neonatal intensive care unit, the only one that could care for him near their home in Lakeville, Minn.But air traffic controller Daskalakis, 33, has an additional worry: The hospital where the newborn is being treated is not part of his current insurer’s network and the partial government shutdown prevents him from filing the paperwork necessary to switch insurers, as he would otherwise be allowed to do. He could be on the hook for a hefty bill — while not receiving pay. Daskalakis is just one example of federal employees for whom being unable to make changes to their health plans really matters. (Appleby, 1/18)
Kaiser Health News:
Podcast: KHN’s ‘What The Health?’ Drug Prices Are Rising Again. Is Someone Going To Do Something About It?
Many drugmakers have announced price increases with the start of the new year. The new Congress wants to do something about that. And even though both Republicans and Democrats want to address the politically potent issue of drug prices, it is unclear what they might be able to agree on. Battle lines are forming between the House and Senate on the matter of abortion. The House is led by abortion-rights supporters and, since the election, the Senate has become slightly more against abortion. (1/17)
The New York Times:
Family Separation May Have Hit Thousands More Migrant Children Than Reported
The Trump administration most likely separated thousands more children from their parents at the Southern border than was previously believed, according to a report by government inspectors released on Thursday. The federal government has reported that nearly 3,000 children were forcibly separated from their parents under last year’s “zero tolerance” immigration policy, under which nearly all adults entering the country illegally were prosecuted, and any children accompanying them were put into shelters or foster care. (Jordan, 1/17)
The Associated Press:
Watchdog: Thousands More Children May Have Been Separated
Ann Maxwell, assistant inspector general for evaluations, said the number of children removed from their parents was certainly larger than the 2,737 listed by the government in court documents. Those documents chronicled separations that took place as parents were criminally prosecuted for illegally entering the country under President Donald Trump's "zero tolerance" policy. "It's certainly more," Maxwell said. "But precisely how much more is unknown." Maxwell said investigators didn't have specific numbers, but that Health and Human Services staff had estimated the tally to be in the thousands. (Long and Alonso-Zaldivar, 1/17)
Reuters:
U.S. Separated 'Thousands' More Immigrant Children Than Known: Watchdog
The administration of President Donald Trump implemented a 'zero tolerance' policy to criminally prosecute and jail all illegal border crossers even those traveling with their children, leading to a wave of separations last year. The policy sparked outrage when it became public, and the backlash led Trump to sign an executive order reversing course on June 20, 2018. But the auditor said in a report that prior to the officially announced 'zero tolerance' policy, the government began ramping up separations in 2017 for other reasons related to a child's safety and well-being, including separating parents with criminal records or lack of proper documents. (Rosenberg, 1/17)
The Washington Post:
IG: Trump Administration Took Thousands More Migrant Children From Parents
Although previous administrations also separated minors at the border in some instances — usually when they suspected the child was smuggled, or if the parent appeared unfit — the report said the practice appears far more common under Trump and began nearly a year before administration officials publicly acknowledged it. (Goldstein, 1/17)
Politico:
Trump Administration Separated Thousands More Migrants Than Previously Known, Federal Watchdog Says
The first separations began in 2017 and were seen as a trial balloon for the “zero-tolerance” policy announced by then-Attorney General Jeff Sessions in May 2018, an HHS official not involved in conducting the audit told POLITICO. A federal investigator declined to say whether senior Trump administration officials were told about those early separations, but suggested that could be addressed in the upcoming reports. "We did not, in this report, address who knew what, when," said Assistant Inspector General Ann Maxwell on the press call. The inspector general report said some family separations continued, even after President Donald Trump in June 2018 ended the policy amid uproar and a federal court ordered his administration to reunify the families. The June 2018 court order called on the administration to reunify about 2,500 separated children in government custody. Most of those families were reunited within 30 days. (Diamond, 1/17)
The Associated Press:
Trump Administration Proposes Higher 'Obamacare' Premiums
The Trump administration on Thursday announced proposed rule changes that would lead to a modest premium increase next year under the Affordable Care Act, potentially handing Democrats a new presidential-year health care issue. The roughly 1 percent increase could feed into the Democratic argument that the Trump administration is trying to "sabotage" coverage for millions. The administration said the proposal is intended to improve the accuracy of a complex formula that affects what consumers pay for their premiums. (Alonso-Zaldivar, 1/17)
The Wall Street Journal:
Trump’s Proposed ACA Rules Could Lift Costs For Millions Of People
The proposal, released by the Centers for Medicare and Medicaid Services, would raise the out-of-pocket maximum that people with employer-sponsored coverage pay in 2020. The individual maximum would increase by $200 to $8,200 annually, and the maximum for family coverage would increase by $400, analysts said. The plan would also change a calculation that determines how much people pay if they buy insurance from the ACA exchange and get credits to reduce their monthly premiums. The change could raise premiums next year for many of the roughly 9 million people who get the credit. (Armour, 1/17)
The Wall Street Journal:
Trump Administration Has Taken Many Steps To Undermine Health Law
The Trump administration has taken steps to undermine the Affordable Care Act since Republicans in Congress failed to repeal it. (Armour, 1/17)
The Washington Post:
FDA Directs Dwindling Resources Toward Reviewing New Drugs
The Food and Drug Administration plans to furlough more people and suspend lower-priority tasks to preserve money for drug reviews, including for new treatments for depression, diabetes and several types of cancer. With money for drug reviews rapidly diminishing as the government shutdown drags into its fourth week, FDA Commissioner Scott Gottlieb said in an interview Thursday that he plans to curtail “discretionary activities” and call for additional furloughs in areas in which workloads have been reduced due to the shutdown. (McGinley, 1/17)
CNN:
This Diabetic Federal Worker Rationed Her Insulin During The Shutdown Because Debt Was Scarier Than Dying
A furloughed federal worker who is diabetic said she resorted to rationing her insulin medication because "the thought of having more debt was scarier than the thought of dying" in her sleep. "I thought, no end in sight for the shutdown. I can't afford an ambulance bill. I can't afford to go to the emergency room right now, because I know there's more bills coming our way," Mallory Lorge explained on CNN's "Anderson Cooper 360." (Barrett, 1/17)
Politico:
Next Shutdown Victim: School Lunches
Servings of fresh fruits and vegetables are disappearing from school lunch trays in rural Vance County, N.C. The Prairie Hills school district in Kansas is worried about not being able to feed kids at all. On top of that, there are thousands of new kids nationwide eligible for free or low-cost school meals because their parents have been furloughed by the federal government. (Hefling and Quilantan, 1/17)
The New York Times:
F.D.A. Panel Splits On Whether To Approve New Diabetes Drug
An advisory panel for the Food and Drug Administration split evenly on Thursday over whether the agency should approve the first oral medication to treat Type 1 diabetes. The committee voted 8-8, leaving it up to the agency to decide by the end of March whether the drug, sotagliflozin, should reach the market. The drug, which is used along with insulin, is being developed by the drug makers Sanofi and Lexicon Pharmaceuticals, who plan to sell it under the brand name Zynquista. (Thomas, 1/17)
Stat:
FDA Rejects Immunomedics Breast Cancer Drug, Extending Long Drought
The 37-year drug development drought lives on. Immunomedics (IMMU), the biotech founded in 1982, was informed by the Food and Drug Administration on Thursday night that its lead drug, an antibody drug conjugate to treat women with an aggressive form of breast cancer, could not be approved at this time. The problem: unresolved manufacturing issues related to the drug, called sacituzumab govitecan. (Feuerstein, 1/17)
The Wall Street Journal:
Drugmakers Raise Prices Amid Shortages, Recalls
Drugmakers have sharply boosted prices of some older, low-cost prescription medicines amid supply shortages and recalls—in some cases, by threefold and more. At least three sellers of a widely used blood-pressure medication, valsartan, have raised prices since a series of safety-related recalls of the drug by other manufacturers began in the summer of 2018. Virtus Pharmaceuticals in May jacked up the U.S. price of a bottle of a muscle relaxant that has been in short supply, methocarbamol, by 1,137% to $105. It was the biggest percentage price increase for a prescription medicine in 2018, according to a new analysis of pricing data. (Loftus, 1/18)
The Washington Post:
VA IG Report Says Shulkin Violated Ethics Rules, Executive Protection Division Compromised Security
Members of the security detail tasked with protecting senior leaders at the Department of Veterans Affairs followed questionable procedures that put officials' safety at risk, abused rules governing overtime pay, and acted as chauffeur for former Secretary David Shulkin’s wife, according to a new investigation. The alleged failures, documented by VA Inspector General Michael Missal in a report released Thursday, detail missteps that went on for years and came to a head under Shulkin. The investigation was commissioned after “various complaints” alleged broadly that VA’s protection division was being grossly mismanaged, the report says. (Mettler and Rein, 1/17)
The Hill:
Abortion Foes March Into Divided Washington
The country's largest annual march against abortion comes to Washington on Friday, and this year there’s a new sense of urgency and frustration from a voting bloc that helped put President Trump in the White House. With virtually no chance of moving abortion restrictions through a divided Congress, anti-abortion activists are re-applying pressure on the Trump administration to take executive action ahead of the 2020 elections. (Hellmann, 1/18)
Politico:
Senate Measure Banning Abortion Funds Defeated
Senate Republicans on Thursday failed to muster the 60 votes needed to approve a permanent ban on federal funding of abortion, a largely symbolic effort timed to coincide with the country’s largest annual anti-abortion demonstration in Washington this week. The Senate vote was the first on an anti-abortion measure since Republicans narrowly expanded their majority in the chamber in the 2018 midterms, and it marked a sharp contrast with House Democrats' plans to loosen restrictions on taxpayer support for the procedure. (Ollstein, 1/17)
The Hill:
Senate Rejects Government-Wide Ban On Abortion Funding
Sens. Susan Collins (R-Maine) and Lisa Murkowski (R-Alaska) broke with their party to vote against the measure while Democratic Sens. Bob Casey (Pa.) and Joe Manchin (W.V.) voted with Republicans. Democrats criticized McConnell for holding a vote on the bill instead of voting on House-passed measures to end the government shutdown. "We know that a bill opening the government would pass the Senate, yet we're voting on a bill attacking women's health," tweeted Sen. Patty Murray (D-Wash.). (Hellmann, 1/17)
The Associated Press:
Court Rules Texas Can Bar Planned Parenthood From Medicaid
A federal appeals court panel on Thursday lifted a lower-court ban that prohibited Texas from eliminating Planned Parenthood from the state's Medicaid program. The 5th U.S. Circuit Court of Appeals in New Orleans issued the ruling that removes the preliminary injunction U.S. District Judge Sam Sparks of Austin imposed on the state of Texas in February 2017. (1/17)
The Associated Press:
Opioid Crisis Brings Unwanted Attention To Wealthy Family
The Sackler name is emblazoned on the walls at some of the world's great museums and universities, including the Smithsonian, the Guggenheim and Harvard. But now the family's ties to OxyContin and the painkiller's role in the deadly opioid crisis are bringing the Sacklers a new and unwanted kind of attention and complicating their philanthropic legacy. The Sackler family owns Purdue Pharma, the privately held drug company that has made billions from OxyContin, and Sacklers hold most of the seats on the board. (Richer, 1/17)
The Associated Press:
Researchers See Possible Link Between Opioids, Birth Defect
Health officials are looking into a possible link between prescription opioids and a horrific birth defect. When a baby is born with its intestines hanging outside the stomach, due to a hole in the abdominal wall, it's called gastroschisis. Most are repaired through surgery. Roughly 1,800 such cases are seen in the U.S. each year, but the number has been rising and officials don't know why. (Stobbe, 1/17)
The New York Times:
Does Cannabis Use Cause Schizophrenia?
Nearly a century after the film “Reefer Madness” alarmed the nation, some policymakers and doctors are again becoming concerned about the dangers of marijuana, although the reefers are long gone. Experts now distinguish between the “new cannabis” — legal, highly potent, available in tabs, edibles and vapes — and the old version, a far milder weed passed around in joints. Levels of T.H.C., the chemical that produces marijuana’s high, have been rising for at least three decades, and it’s now possible in some states to buy vape cartridges containing little but the active ingredient. (Carey, 1/17)
Los Angeles Times:
Climate Change Is Making Us Sicker And Shortening Our Lives, Doctors Say
In the welter of daily demands upon physicians, it might be easy to imagine that weaning the world off its reliance on fossil fuels is asking a bit too much. But preventing sickness and averting premature death are squarely in a physician’s wheelhouse. And dramatic increases in both are projected for the foreseeable future as the world’s continued reliance on fossil fuels results in more air pollution, infectious diseases, malnutrition, wildfires, extreme heat and increasingly powerful weather events. (Healy, 1/17)
NPR:
Neuroscientists Pinpoint Cells In The Amygdala Where Pain Hurts
Pain is a complicated experience. Our skin and muscles sense it, just like they sense softness or warmth. But unlike other sensations, the experience of pain is distinctly unpleasant. Pain has to hurt for us to pay attention to it, and avoid hurting ourselves further. But for people in chronic pain, the pain has largely lost its purpose. It just hurts. While it has long been understood how nerves signal pain to the brain, scientists haven't known how the brain adds a layer of unpleasantness. (Lambert, 1/17)
The Washington Post:
Forget To Take Your Medication? A New Digital Pill Will Alert You — And Your Doctor.
When his chemotherapy patients leave the hospital to continue treatment at home, Edward Greeno faces a new challenge. He can no longer ensure they’re taking their medicine. Greeno, the medical director of the Masonic Cancer Clinic at the University of Minnesota, has come to realize that some patients, like children hiding naughty behavior from a parent, will fudge the truth to avoid his disapproval, even when their health is at risk. (Holley, 1/17)
The Associated Press:
Patient's Widow: Hospital Safeguards 'Failed Tremendously'
The 44-year-old excavator was taken to the emergency room with shortness of breath. Breathing trouble also sent a 64-year-old woman to the same hospital. A third patient, a 79-year-old woman with health problems, was transferred from an assisted care facility. Now their relatives allege each died because employees at a hospital in Ohio either negligently or intentionally gave them inappropriately large doses of powerful pain medicine. (Franko, 1/17)
The Associated Press:
Nonprofit Reapplies To Open South Bend Abortion Clinic
A nonprofit group that had been denied a state license to open a South Bend abortion clinic reapplied for one Thursday instead of challenging the decision in court. Texas-based Whole Woman's Health Alliance reapplied for the license Thursday, avoiding what it feared would be a lengthy legal battle, the South Bend Tribune reported. (1/17)