Lauren Clason

House drug price negotiation plan could apply beyond Medicare
Draft plan would have government set prices based on those in other wealthy countries

A comprehensive drug price bill being developed by House Democrats would give private insurers the benefit of government-negotiated prices, according to a summary of the measure obtained by CQ Roll Call.

Under the Democrats’ draft plan, the government would set prices based on what is paid in other wealthy countries, according to the summary. That is similar to how a proposal by the Trump administration would work.

Jerry Moran in line for Senate Veterans’ Affairs gavel

The news of Sen. Johnny Isakson’s pending resignation will have consequences when it comes to committee rosters, most prominently with Kansas GOP Sen. Jerry Moran the next in line to be chairman of the Senate Veterans Affairs’ Committee. 

Moran should be a familiar figure to veterans service organizations and other groups involved in policy, since he is a former chairman of the Military Construction-VA subcommittee of Appropriations. Senate Republicans tend to adhere to seniority rules, and Moran is the next lawmaker in line for the job. He also does not have any other full committee chairmanships, meaning there won’t be as much of a domino effect.

Johnson & Johnson ordered to pay $572 million in Oklahoma opioid lawsuit
The case could foreshadow outcomes in a massive consolidated case in Ohio later this fall

An Oklahoma district judge ordered Johnson & Johnson to pay more than $572 million in damages to help alleviate the state’s opioid epidemic, in a case where the state attorney general accused the company of being the “kingpin” of the crisis.

Attorney General Mike Hunter originally sought more than $17 billion for the state’s abatement plan, but District Judge Thad Balkman said he was constrained by legal limits around the “public nuisance” charge.

Planned Parenthood exits Title X program over gag rule
It left the program over a new rule prohibiting clinics receiving Title X funds from discussing abortions with patients

The nation’s largest provider of reproductive health services, including abortions, will exit the federal family planning program over the Trump administration’s “domestic gag rule,” which prohibits clinics receiving Title X funds from discussing abortions with patients.

Alexis McGill Johnson, Planned Parenthood Federation of America acting president and CEO, told reporters Monday that its clinics receiving Title X grants would begin submitting notices of withdrawal. The Department of Health and Human Services is requiring clinics to submit compliance plans by the end of the day.

Senate bill’s drug pricing provision raises industry alarms
Provision could force drugmakers to cut patient assistance for chemotherapy drugs

A little-noticed provision of the Senate Finance Committee drug price bill is alarming some doctors, with at least one group warning it could harm patients with fragile medical conditions.

The Community Oncology Alliance, an advocacy group for cancer doctors, is raising red flags about a provision it says could prompt drugmakers to cut patient assistance for pricey chemotherapy drugs, or shortchange doctors who buy them.

New Medicare initiative aims to fill holes in patient health records
The demo connects health data from multiple providers directly to a patient’s doctor

The Centers for Medicare and Medicaid Services on Tuesday unveiled a new initiative that aims to connect the dots between a patient’s health records held by different providers.

The Data at the Point of Care, or DPC, demonstration seeks to bridge the data gap by connecting Medicare’s Blue Button — a tool that allows Medicare patients to download their health records and save them in computer files or apps — directly to a patient’s doctor. A doctor could then see claims data from a patient’s other providers that might not be accessible otherwise.

Options for private health care a comfort and concern for veterans
New VA program expands private care options and boost pay for medical professionals. But some worry it could lead to wholesale privatization

Eugene Downs, a 93-year-old Navy veteran who served during World War II, the Korean War and the Vietnam War, has received nearly all of his care over the past 27 years from the Department of Veterans Affairs. He’s a regular at the Washington VA Medical Center, where he has “no gripes.”

“I get the best damn care anybody can get,” he says.

Congress is Trump’s best hope for drug pricing action
But divisions remain between Republicans and Democrats, House and Senate

An upcoming Senate bill is the Trump administration’s best hope for a significant achievement before next year’s election to lower prescription drug prices, but a lot still needs to go right for anything to become law.

Despite the overwhelming desire for action, there are still policy gulfs between Republicans and Democrats in the Senate, and another gap between the Senate and the House. And the politics of the moment might derail potential policy agreements. Some Democrats might balk at settling for a drug pricing compromise that President Donald Trump endorsed.

Trump unveils sweeping goals on kidney disease
Executive order aims to improve quality and cut costs by refocusing care on prevention

President Donald Trump outlined an agenda to improve preventive treatment of kidney disease Wednesday, zeroing in on a condition that afflicts more than 30 million Americans and costs more than $100 billion in annual Medicare spending.

The executive order Trump signed aims to improve quality and cut costs by refocusing care on prevention. The initiative’s overarching goals are to reduce the number of new patients with end-stage renal disease by 25 percent by 2030, and to have 80 percent of ESRD patients either receiving in-home dialysis or transplants by 2025.

Drug pricing legislation may not affect a new $2.1 million gene therapy drug
The blockbuster drug Zolgensma, which treats spinal muscular atrophy, is now the most expensive drug in the world

The recent approval of a treatment poised to become the world’s most expensive drug comes as Congress debates measures meant to address high prices — yet so far what lawmakers are attempting might not impact cases like this $2.1 million therapy.

The FDA announced Friday it was approving Novartis AG’s gene therapy Zolgensma, a one-time treatment designed to help young children with spinal muscular atrophy. The agency’s announcement said the safety and effectiveness of the drug was based on clinical trials that yielded positive results for patients with the rare disease.

New state laws highlight an escalating battle in the war over drug pricing
The laws restrict insurance from excluding manufacturer coupons or financial assistance from cost-sharing responsibilities

Recent laws in several states that protect drugmakers’ contributions toward patients’ prescription copays are highlighting an escalating battle in the larger war on drug pricing.

In the past month, Arizona, Virginia and West Virginia became the first states to enact laws restricting insurance companies from excluding most drug manufacturer coupons or other financial assistance from a patient’s cost-sharing responsibilities. Similar bills are pending in a host of other states, including Connecticut, Illinois, Indiana, Kentucky and North Carolina.

Single-payer health care systems are no easier in the states
Politics, costs and federal restrictions have already undercut efforts in Vermont and California

The hurdles for a government-run, single-payer health care system are amplified at the state level, where universal coverage ambitions are hampered by politics, costs and federal restrictions.

These realities ultimately undercut efforts in two of the nation’s most liberal states — Vermont, which ended its attempts to institute a single-payer system in 2014, and California, which is expected to fall short again this year.

Will FDA keep cracking down on teen vaping, other initiatives, after Gottlieb leaves?
Scott Gottlieb, fought teen vaping and approved record numbers of generic drugs will resign next month

Food and Drug Administration Commissioner Scott Gottlieb, who launched a campaign against teen vaping and approved a record number of generic drugs, is resigning next month.

The departure raises questions about whether the agency would continue to vigorously seek to curb the exploding use of e-cigarettes among young people, among other Gottlieb initiatives. But the commissioner, in a resignation letter listing accomplishments on this and other issues, said he was “confident that the FDA will continue to advance all these efforts.”

Azar touts rebate proposal as solution to 'broken' system
The proposal would create safe harbors under the anti-kickback statute for upfront discounts to patients and flat service fees to PBMs

Health and Human Services Secretary Alex Azar on Friday pitched a proposal he released the day before as a major step in reforming the complex system of the prescription drug supply chain and lowering prices.

The proposed rule released by HHS and the Office of the Inspector General Thursday would eliminate federal protections for manufacturer rebates paid to health plans and pharmacy benefit managers under federal health programs, although Azar expects the rule would also trigger changes in the commercial market. The proposal would instead create safe harbors under the anti-kickback statute for upfront discounts to patients and flat service fees to PBMs.

House, Senate panels begin hearings seeking drug cost solutions
Future hearings will likely focus more on legislative proposals, and at some point members hope that drug companies will share their ideas

Lawmakers emphasized the steep cost of the diabetes treatment insulin and ways to use Medicare and Medicaid to discourage companies from setting high prices as Congress kicked off a series of drug price hearings Tuesday.

Hearings before the Senate Finance and the House Oversight and Reform committees featured academics and patient advocates as lawmakers in both chambers investigate why drug prices are high and what Congress can do about it.

Health Industry Reports Lobbying Costs the Size of a Grapefruit — Drugmakers Lead
Expenses on track to surpass 2017 numbers

Prescription drugmakers are on track to exceed their lobbying spending from last year, according to third quarter disclosure forms that were due Monday.

In 2017, the industry spent $171.6 million. During the first half of 2018, drugmakers spent almost $95.4 million, putting them on pace to top last year’s total.

Republicans Won’t Probe Influence of Trump Friends at Veterans Department
Dems have questions about trio named in lawsuit

Updated 3:31 p.m. | Top Republican lawmakers have no plans to examine the alleged influence that a trio of President Donald Trump’s friends have at the Department of Veterans Affairs, even as Democrats call for an investigation.

The controversy peaked in recent weeks after reports that Marvel Entertainment Chairman Ike Perlmutter, Palm Beach doctor Bruce Moskowitz and D.C. lawyer Marc Sherman hold undue sway with VA leadership, including senior adviser Peter O’Rourke, who formerly served as acting secretary. Liberal veterans group VoteVets filed a lawsuit against the administration last week, claiming the VA is violating federal protocol related to private influence in matters of federal policy.

Veterans Affairs Watchdog Finds Significant Problems in VA Caregiver Program
Report comes as caregiver program is set to expand

Family caregivers seeking help from the Department of Veterans Affairs encountered extended wait times and spotty aid from the agency, according to a new report from the VA’s Office of Inspector General.

The OIG investigation found that 65 percent of the more than 1,800 applicants between January and September 2017 were forced to wait longer than the required 45-day timeframe to be approved for the program. Fifty-five percent of the applicants waited between three and six months for approval, while 14 percent waited even longer, according to thereport released Thursday.

House Committee Pledges to Roll Back More Medicare Regulations
Regulatory burdens now come at expense of patient care, Roskam says

The House Ways and Means Committee said it would continue exploring ways to reduce regulations in Medicare, after issuing a report last week on its conversations with health care providers.

While light on specifics, the committee said it is engaging in “ongoing dialogue” with the Trump administration over where legislative solutions are needed to reduce what it deems unnecessary regulations.

Number of Pregnant Women Abusing Opioids Skyrockets
Vermont and West Virginia most affected

The number of women giving birth with opioid use disorder quadrupled between 1999 and 2014, a new report from the Centers for Disease Control and Prevention shows.

The increase underscores the severity of the country’s opioid epidemic as a legislative package aimed at helping states curb addiction rates idles in the Senate. Newborns exposed to drugs while in the womb can suffer severe complications, including withdrawal, preterm birth and death.