First Edition: August 10, 2018
Today's early morning highlights from the major news organizations.
Kaiser Health News/USA Today:
Lax Oversight Leaves Surgery Center Regulators And Patients In The Dark
The first man died in April 2014. Another died later that month. Then on July 18 of that year, a woman was rushed to a hospital where she was told she was lucky to be alive. They all went to the same Little Rock, Ark., surgery center for a colonoscopy, among the safest procedures a patient can have. And each stopped breathing soon afterward, court records say, sustaining the same type of brain damage seen in a drowning victim. (Jewett and Alesia, 8/9)
Kaiser Health News:
Trump Administration Sinks Teeth Into Paring Down Drug Prices, On 5 Key Points
Three months after President Donald Trump announced his blueprint to bring down drug prices, administration officials have begun putting some teeth behind the rhetoric. Many details have yet to be announced. But experts who pay close attention to federal drug policy and Medicare rules say the administration is preparing to incrementally roll out a multipronged plan that tasks the Centers for Medicare & Medicaid Services (CMS) and the Food and Drug Administration with promoting competition, attacking the complicated drug rebate system and introducing tactics to lower what the government pays for drugs. (Tribble, 8/10)
California Healthline:
Key California Lawmaker Calls Eli Lilly’s Behavior ‘Disingenuous And Offensive’
Seven months after a controversial California law took effect requiring advance notice of planned price increases on prescription drugs, many pharmaceutical companies appear to be in compliance. But not Eli Lilly. The Indianapolis-based drugmaker — one of the largest producers of insulin — has been under fire from consumer advocates for jacking up prices on its lifesaving diabetes medication. And the company has chosen not to follow the California law, which requires it not only to disclose but justify significant price hikes to drug purchasers. (Feder Ostrov, 8/9)
Kaiser Health News:
Medicare To Overhaul ACOs But Critics Fear Less Participation
Medicare ACOs began in 2012 and today enroll more than 10 million beneficiaries. If they provide care for less than certain cost targets — while meeting quality of care standards — then they get to share in any of the savings. Commercial insurers and Medicaid have also adopted ACOs in the past decade. (Galewitz, 8/9)
Kaiser Health News:
Clinicians Who Learn Of A Patient’s Opioid Death Modestly Cut Back On Prescriptions
“You can hear a lot of statistics about the crisis,” said Jason Doctor, lead author of the study, published Thursday in the journal Science. “But it always feels like it is happening elsewhere if you are not aware of any deaths in your own practice.” (Gorman, 8/10)
Kaiser Health News:
Podcast: KHN’s ‘What The Health?’ Coming Soon: ‘Long-Term Short-Term’ Plans
The Trump administration’s new rule allowing “short-term” insurance plans to be used for up to three years has touched off a big reaction in health policy circles. Supporters of the change say those who can no longer afford comprehensive health insurance will have the ability to purchase lesser but cheaper plans. But opponents worry that consumers who fail to read the fine print will end up with plans that won’t cover care they need. (8/9)
The Washington Post:
Trump Administration Proposes Further Dismantling Of Affordable Care Act Through Medicare
The Trump administration is proposing to restrict an innovation in the Affordable Care Act, which was intended to improve Medicare and slow spending in the vast federal insurance system for older Americans. Health-care researchers hail the model’s promise to improve quality and efficiency, but government data suggest it is not saving enough money. The changes, announced Thursday by the administrator of the Department of Health and Human Services’ Centers for Medicare and Medicaid Services, would significantly curtail Accountable Care Organizations. The ACOs can be teams of doctors, hospitals or other providers who become responsible for all the health-care needs of a specific group of patients. (Goldstein, 8/9)
The Hill:
HHS Backs Off Plan To Cut Funding For Certain Teen Pregnancy Prevention Groups
The Department of Health and Human Services (HHS) on Thursday said it will resume grants for groups working to prevent teen pregnancies, a reversal from last year's announcement that it would end funding two years earlier than expected. An agency spokesperson told The Hill that HHS will continue grant funding this year for groups participating in the Teen Pregnancy Prevention Program. Several federal judges have ruled against HHS for its plan to end the five-year grants, which began in 2015, after three years. (Hellmann, 8/9)
The Wall Street Journal:
The Democratic Party’s New Litmus Test: Gun Control
During her 2010 U.S. House campaign, Democrat Ann Kirkpatrick of Arizona highlighted her “A” rating from the National Rifle Association. She opposed gun-control measures and regaled constituents in her largely rural district with stories of hunting with her father. In 2018, Ms. Kirkpatrick is running to return to the House espousing a gun-control platform that is among the country’s most aggressive. She is for universal background checks and a ban on guns described as assault weapons. She disavows her longstanding position as a “proud gun owner,” saying she gave away the hunting rifles inherited from her father. “I do not have any guns in my home,” she says. (Epstein, 8/9)
The Washington Post:
Surviving Parkland: A Teen’s Road To Recovery After A Mass School Shooting
Marie Laman carefully removes a black bow tie from its box and slips it around her son’s neck. It’s his first bow tie, for his first formal dance. A moment for a mother to savor. “I don’t want to do this,” Kyle says. He is slumped on his bed, tugging at the sleeves of his dress shirt. “This is so stupid.” Marie, still struggling with the tie’s clasp, doesn’t respond. Suddenly, Kyle shoves her away. “You’re choking me,” he says. “Stop. Stop!” (Kaplan, 8/9)
The Hill:
Ocasio-Cortez: 'Medicare For All' Is ‘Not A Pipe Dream’
New York congressional candidate Alexandria Ocasio-Cortez (D) on Wednesday said her policy proposal of "Medicare for all" is "not a pipe dream." "I think at the end of the day, we see that this is not a pipe dream," Ocasio-Cortez said on CNN's "Cuomo Prime Time." (Birnbaum, 8/9)
Stateline:
Just How Profitable Should Your Disease Be?
Dialysis, which treats patients with advanced kidney disease, is lifesaving. The question is whether California’s ballot initiative to limit the profit of dialysis clinics, Proposition 8, would be more likely to protect lives or end them. ...The number of kidney disease patients in the state rose 46 percent from 2009 to 2016, mostly because patients are living longer, according to the California Office of Statewide Health Planning and Development. In that time, 123 new dialysis centers were opened in the state, mostly by DaVita and Fresenius, the two largest dialysis companies nationwide. (Povich, 8/10)
The New York Times:
Companies Respond To An Urgent Health Care Need: Transportation
As America’s baby boomers are hitting 65 at a rate of 10,000 a day, and healthier lifestyles are keeping them in their homes longer, demand is escalating for a little talked-about — yet critical — health care-related job: Transporting people to and from nonemergency medical appointments. “It’s going to become a massive phenomena,” said Ken Dychtwald, founder and chief executive of Age Wave, a consulting firm specializing in age-related issues. “This is an unmet need that’s going to be in the tens of millions of people.” (Morrissey, 8/9)
The Associated Press:
Merger Cancellation Pushes Rite Aid Into Uncertain Future
Rite Aid shares plunged Thursday as the company headed into an uncertain future after calling off its merger with the grocer Albertsons. Analysts and retail insiders questioned the drugstore chain's prospects after it ended a planned takeover by Albertsons before Rite Aid shareholders could vote on it. That vote also faced shaky prospects due to opposition from shareholders and influential proxy advisory firms. (Murphy, 8/9)
The Wall Street Journal:
The High Cost Of Getting Your Wish At Rite Aid
Rite Aid investors might have to get used to the single life. The drugstore chain and grocer Albertsons announced Wednesday evening that they terminated their planned merger. That marks the second Rite Aid deal in about a year to fall through: Walgreens Boots Alliance had planned to buy Rite Aid last summer before regulatory concerns forced a much less ambitious asset sale. (Grant, 8/9)
The Associated Press:
Doctors Nudged By Overdose Letter Prescribe Fewer Opioids
In a novel experiment, doctors got a letter from the medical examiner's office telling them of their patient's fatal overdose. The response: They started prescribing fewer opioids. Other doctors, whose patients also overdosed, didn't get letters. Their opioid prescribing didn't change. (Johnson, 8/9)
Los Angeles Times:
Coroner Sent Letters To Doctors Whose Patients Died Of Opioid Overdoses. Doctors' Habits Quickly Changed
Addressed directly to the doctor, the letter arrived in a plain business envelope with a return address of the San Diego County medical examiner’s office. Its contents were intended, ever so carefully, to focus the physician on a national epidemic of opioid abuse — and his or her possible role in it. “This is a courtesy communication to inform you that your patient [name, date of birth inserted here] died on [date inserted here]. Prescription drug overdose was either the primary cause of death or contributed to the death,” the letter read. (Healy, 8/9)
The Washington Post:
Death Reports Make The Opioid Crisis Personal For Doctors
The letters were successful, although the effects were modest. Doctors who were informed of their patients' deaths were 7 percent less likely to start new patients on opioids and issued fewer high-dose prescriptions over the next three months, compared with those who did not receive a letter. In total, there was a 9.7 percent reduction in the total amount of opioids they prescribed, according to results published Thursday in the journal Science. (Johnson, 8/9)
NPR:
'Dear Doctor' Letters Reduce Opioid Prescribing
"What's important about what we've found is that you can do very simple things to change prescribing and make prescribing safer," says coauthor Jason Doctor, an associate professor of health policy and management at the University of Southern California. (Watson, 8/9)
The Associated Press:
Report: Jump In Deliveries Involving Moms Hooked On Opioids
U.S. health officials say they found a dramatic rise in the number of women who are hooked on opioids and delivering babies in hospitals. Opioid use during pregnancy can cause death of the mother or baby, preterm birth and infant withdrawal symptoms like seizures, excessive crying and breathing problems. (Stobbe, 8/9)
NPR:
Empathy Replaces 'Tough Love' As An Approach To Addiction
It was Bea Duncan who answered the phone at 2 a.m. on a January morning. Her son Jeff had been caught using drugs in a New Hampshire sober home and was being kicked out. Bea and her husband, Doug Duncan, drove north that night nine years ago to pick Jeff up. On the ride back home, to Natick, Mass., the parents delivered an ultimatum: Their son had to go back to rehab, or leave home. Jeff chose the latter, Bea says. She remembers a lot of yelling, cursing and tears as they stopped the car, in the dead of night, a few miles from the house. (Bebinger, 8/10)
Stat:
HHS Takes Aim At Drug Companies For 'Abusive Behavior' In Medicaid
Top federal health officials are heralding new guidance they say will keep drug makers from taking advantage of a loophole in the Medicaid program’s complex payment structure for certain medicines. The new policy, first laid out in a February law, will help states and the federal government save money when drug makers increase the price of their drugs faster than inflation. The Department of Health and Human Services detailed the complicated algebra related to the change in new letters to states and drug companies. (Swetlitz, 8/9)
Stat:
Lawmakers Urge Trump To Ensure Access To TB Drugs As UN Meeting Nears
As United Nations negotiators attempt to draft a manifesto for combating tuberculosis, more than 100 members of Congress are urging President Trump to ensure the U.S. makes a “meaningful” contribution to what they called a “crucial” effort. In a letter sent on Wednesday, the bipartisan group of lawmakers emphasized the need for the U.S. to take the lead in eradicating a public health scourge as a U.N. meeting nears to address the problem. Their missive, however, was also sent as a contentious, behind-the-scenes struggle takes place at the U.N. that pits the U.S. against dozens of other countries over issues that affect the poorest nations, in particular. (Silverman, 8/9)
Stat:
Vertex Won't Give U.K. Data Needed To Review A New Cystic Fibrosis Drug
The battle between U.K. authorities and Vertex Pharmaceuticals (VRTX) over the cost of its cystic fibrosis medicines took another twist as the drug maker declined to provide information about its newest treatment to a cost-effectiveness watchdog. In doing so, the company is delaying the approval process used to make the new treatment available to patients. The move is the latest bit of brinkmanship between the drug maker and government officials, who have been haggling for more than two years. And the impasse underscores the rising friction that can occur when cash-strapped governments confront high-priced medicines, an issue that is engulfing a growing number of countries, prompting patients to complain they have become pawns. (Silverman, 8/9)
The New York Times:
Psychologists’ Group Maintains Ban On Work At Military Detention Facilities
After an escalating debate about the role of psychologists in military prisons, the American Psychological Association voted on Wednesday to reject a proposed change in policy that would have allowed members to treat detainees held at sites that do not comply with international human rights laws. The proposed change would have reversed a 2015 determination by the association that prohibited such work, effectively blocking military psychologists from sites like the military detention facility at Guantánamo Bay, Cuba, maintained by the United States. (Carey, 8/9)
Stat:
Tumor Cells Can Unleash Tiny Weapons To Ward Off Immune System Attacks
Scientists have discovered that cancer cells can release tiny weapons called exosomes that target immune cells before they have a chance to reach a tumor. The findings, published Wednesday in Nature, point to the exosomes as a potential biomarker to predict which patients might respond to anti-PD-1 therapies. The cancer treatments target PD-1, a checkpoint protein on immune T cells. Tumor cells that express another protein, PD-L1, can bind to the PD-1 on T cells to inhibit the immune system’s ability to attack cancer cells. The University of Pennsylvania researchers are hoping that measuring exosome levels might offer insight into whether an anti-PD-1 therapy would work for a particular patient. (Thielking, 8/9)
USA Today:
Cancer-Killing Drug BXQ-350 Gets Its First Human Trials
Properly mixed, the medicine came out as a dark brown liquid. A nurse brought the intravenous bag to the side of a recliner, where a man with brain cancer sat. The nurse hung the plump bag on a stand and prepared the treatment for delivery. The moment had arrived for BXQ-350 to meet its first human patient. For the man, and for the medicine, the stakes could not have been higher. (Saker, 8/9)
The New York Times:
Can You Screen For Early Pancreatic Cancer?
Pancreatic cancer is the fourth leading cause of cancer death in the United States, claiming some 44,330 lives a year, but there is currently no standard screening test that can detect this cancer early and “has actually been proven to save lives,” said Dr. Otis Brawley, chief medical and scientific officer for the American Cancer Society. Individuals with a strong family history of pancreatic cancer, such as having a parent, sibling or child who developed the cancer before turning 50 or two such close relatives who developed it at any age, are at increased risk of developing the disease themselves. (Rabin, 8/10)
The Washington Post:
Loa Loa: His Health Had Been Failing For Years. Then He Saw Something Crawling In His Eye.
The painting was not an image of anything in particular, just an abstract confluence of psychedelic colors and wormlike patterns inside a perfectly round circle. Ben Taylor didn’t like it much, and he said he didn’t know why he painted it. But the wormlike patterns represent years of spiraling into unknown illness that had driven the 47-year-old painter and musician to depression, sometimes even thoughts of suicide. Taylor gave up on the painting and in 2014 shelved the unfinished work he had simply called “Untitled.” (Phillips, 8/9)
The Associated Press:
Court Orders Ban On Harmful Pesticide, Says EPA Violated Law
A federal appeals court ruled Thursday that the Trump administration endangered public health by keeping a widely used pesticide on the market despite extensive scientific evidence that even tiny levels of exposure can harm babies' brains. The 9th U.S. Circuit Court of Appeals in San Francisco ordered the Environmental Protection Agency to remove chlorpyrifos from sale in the United States within 60 days. (8/9)
The Washington Post:
Federal Appeals Court Orders EPA To Ban Controversial Pesticide
Judge Jed Rakoff, writing for the majority, said that over the past two decades, scientists at the agency had documented the likely adverse effects of chlorpyrifos on the mental and physical development of infants and children. But he said the EPA had “stalled” for years in banning the chemical and accused the agency of an “utter failure” in responding to objections over Pruitt’s denial last year. (Dennis, 8/9)
The Associated Press:
Puerto Rico: 1,400 Died From Hurricane But Toll Still At 64
Puerto Rico is estimating in a report to Congress that Hurricane Maria killed more than 1,400 people, though an island official said Thursday that the confirmed toll remains frozen at 64 pending a scientific review due out soon. The government, relying on updated statistics it first reported in June, said in a report to Congress detailing a $139 billion reconstruction plan that there were 1,427 more deaths from September to December 2017 than the average for the same time period over the previous four years. (8/9)
The Hill:
Puerto Rico Says Hurricane Death Toll 20 Times Higher Than First Reported
“Although the official death count from the Puerto Rico Department of Public Safety was initially 64, the toll appears to be much higher,” the report stated. “According to initial reports, 64 lives were lost. That estimate was later revised to 1,427," it added in a separate section. (Samuels, 8/9)
The Associated Press:
North Dakota Senate Hopefuls Chase The Veterans' Vote
At the American Veterans club in Bismarck where former military men and others are drawn by camaraderie, card games and affordable gravy-laden lunch specials, there's no clear favorite in North Dakota's sharply contested U.S. Senate race. But when it comes to the barrage of television ads begging for these veterans' votes, they couldn't agree more. Make them stop. (8/9)