Happy Friday! I’m here to tell you that if you aren’t following the Subsys opioid trial you are missing out—salacious and horrifying details galore are emerging, including stories about executives giving doctors lap dances. (Clickbait-y as it may seem, it does paint a damning picture of the roots of this epidemic.) More on that later, but first here’s what else you may have missed this week.
“Medicare-for-all” may have once been a fringe policy proposal, but now it’s all but a litmus test for progressive Democrats who are tossing their hats in the ring for 2020 — as exemplified this week by Sen. Kamala Harris saying she’d go all-in for MFA to the point of killing off private insurers. Although she later walked it back, the idea sent a bit of a shock wave through the party and highlighted how the issue is likely to become a dividing line in the sand between moderates and progressives as the 2020 field emerges.
Republicans hit the proverbial fundraising jackpot this week, due to a few missteps by Virginia Democrats about late-term abortions.
While defending a bill on lifting restrictions for late-term abortions, a Virginia lawmaker said the measure would allow a woman to terminate a pregnancy until the moment she gives birth. (The lawmaker later said that she misspoke and wished she had been quicker on her feet when faced with the question.)
Adding fuel to that particular fire, Gov. Ralph Northam gave a radio interview about hypothetical scenarios where an infant who is severely deformed or unable to survive after birth could be left to die. The statements led to accusations from Republicans that the governor supports infanticide. And, in the background of all this, New York just passed a law that allows abortion after the 24th week of a pregnancy when there is “an absence of fetal viability, or the abortion is necessary to protect the patient’s life or health.”
The debate bubbled up to the national level when President Donald Trump and Vice President Mike Pence — with their eyes on 2020 — decided to weigh in, branding the Democrats as the “party of late-term abortion” and issuing a “call to action for all Americans,” respectively. The issue is widely seen as a unifying one for the right, and conservatives have already seized on the comments to blast out in fundraising emails.
And you know those heartbeat bills that are popular in red states? They continue to be knocked down by courts and governors’ vetoes alike, but they just keep coming. Here’s a look at their history and why they have such lasting power, despite numerous defeats.
New rules proposed by the Trump administration go after the “opaque rebate system” that flourishes between drugmakers and the middlemen known as pharmacy benefit managers. The Trump administration says the current system encourages pharma companies to set high list prices so they can pay larger rebates to insurers and those middlemen to increase the use and sales of their products.
Under the rules, rebates would be viewed as illegal kickbacks instead of standard operating procedure. Those applauding the proposal: PhRMA. Not huge fans? Insurers.
In a sign of the changing times, the pharmaceutical industry was put on notice this week when two powerful congressional committees placed high drug prices firmly at the top of their agendas. The optics of the simultaneous hearings really set the stage for pharma’s new reality on Capitol Hill — one that’s just slightly less welcoming than the industry has had in the past.
If you remember last year (I know, it feels very long ago now since January lasted for about three months), you’ll recall a fierce battle over “right-to-try” legislation. Now that the bill has been enacted, even its supporters are left wondering if they were indeed sold false hope, as critics warned.
In a move that could make nearly four times as many veterans eligible for private health care, the administration loosened drive-time regulations for the Choice program. Before, only veterans who were 40 miles from a VA clinic could seek private care under those particular restrictions. Now, veterans just have to prove that it’s more than a 30-minute drive. The change, though it may seem small, could make a big difference for those who live in rural or high-traffic areas.
On to the lap dances! But, honestly, there has been major movement in the courts this week regarding the opioid epidemic.
The previously mentioned Subsys trial is underway. (If you don’t know, Subsys is a fentanyl spray designed for cancer patients.) Insys Therapeutics founder John Kapoor and four other executives are facing racketeering and conspiracy charges on allegations that they used speaker fees to ramp up the product’s sales and lied to insurers about which patients were getting the drug. “This is a case about greed, about greed and its consequences, the consequences of putting profits over people,” Assistant U.S. Attorney David Lazarus said in his opening statement. Meanwhile, Kapoor is trying to shrug off responsibility of it all onto his underlings.
Massachusetts’ 274-page civil complaint against Purdue (the maker of OxyContin), eight members of the family that founded it, company directors and current and former executives was made public this week. There were already portions of the document that had been released, but the full thing further details the Sackler family’s involvement in the marketing of the painkiller; decisions that were made re: damage control when the opioid crisis crested; and insight into how the company considered pushing into the addiction-treatment landscape (executives said the business of selling opioids and treating addiction were “naturally linked.”)
And then over in Ohio, a massive, consolidated nationwide lawsuit against Purdue and other opioid makers and distributors is heating up. The judge overseeing the case had hoped to settle it out of court, but it’s been awhile since he asked both sides to come to an agreement, and the litigation has only become more bloated and difficult to resolve. Court watchers expect the trial, if it happens, to be reminiscent of the Big Tobacco reckoning in the ’90s.
You want to know how the health industry views the new Atul Gawande-led health initiative created by Amazon, Berkshire Hathaway and JPMorgan Chase? Just look to the trade secrets lawsuit UnitedHealth filed, and the nearly seven hours spent in court fighting over it. The case involved a former midlevel executive for Optum, who was shocked at the ferocity of the lawsuit since he’d never even met the company’s CEO. But as tech companies get more and more interested in the health care field, the established players are feeling the need to defend their turf.
In the miscellaneous file this week:
• Trump donated $100,000 from his salary to go toward alcohol-abuse research. The issue is personal to the president, who often cites his brother’s struggles with the disease.
• Check out this devastating look at a former football star who seemed to be living the perfect American dream. He suspected he had the degenerative neurological disorder CTE. His autopsy confirmed those fears.
• In a scary study, researchers find that witnessing domestic violence carries the same risk of harm to a child’s mental health and learning as if the child had been abused directly. Even scarier: exposure to domestic violence even when an infant is sleeping or in utero can reduce parts of the brain and change its overall structure.
• There’s a bit of “Schadenfreude” going on among critics of the anti-vaccination movement, because the epicenter of the recent outbreak of measles in the Northwest was a hot spot for anti-vaxxers.
• A Rawandan medical school offers lessons on providing care without all the high-tech gadgets so beloved in the U.S.
• I have to say I got a kick out of this look back at the history of wild weight loss strategies (tapeworms! ack!)
I’ll leave you with a warning from the Centers for Disease Control and Prevention: If you have a hedgehog, it’s time to stop kissing and snuggling with it. They can spread salmonella. On that note, have a great weekend!