AJMC Staff

BlueCross BlueShield of Tennessee is the latest insurer to announce it will no longer pay for OxyContin and will instead cover newer abuse-deterrent opioids; a new prototype may upend the way people get vaccinated during an influenza pandemic through patches with microscopic needles; as Hurricane Florence prepares to hit the Carolinas, health officials are trying to protect seniors, who tend to be the most vulnerable and bear the brunt of storms.

Not only do pharmacy benefit managers profit thousands of percent using spread pricing, but the spreads are growing; support for Medicare for all is growing among Democrats in Congress, but it's still unclear how such a drastic chage would impact the complex American healthcare system; while precision medicine has great potential, it still has far more failures than successes, but that isn't usually discussed.

The Senate appears ready to pass a package of opioid bills this week; Michigan is asking for the Trump administration’s approval for work requirements for Medicaid; the 8th US Circuit Court of Appeals overturned a 2017 ruling that blocked enforcement of a Missouri law that kept the state from enforcing new regulations on doctors providing abortions.

Memorial Sloan Kettering Cancer Center’s chief executive emailed all staff telling them they “need to do a better job” of disclosing industry relationships in the wake of a published report that the cancer center’s chief medical officer failed to disclose his extensive industry ties; the remedy to balance billing (the surprise bills patients receive after their insurance plan has paid the contracted amount with a provider) may lie at the federal or state level or possibly the courts; marijuana health research applications are stalled at the Drug Enforcement Administration, 2 years after it began taking the requests.

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Speaking at a conference organized by the Association for Accessible Medicines, an FDA official said the Trump administration’s restrictions on hiring foreign scientists are making it more difficult for the agency to attract top scientific talent; HHS Secretary Alex Azar met with Republican lawmakers on the House Ways and Means Committee to discuss ways to lower drug prices; previously secret emails from Judge Brett Kavanaugh’s time working for President George W. Bush provoked new scrutiny during his Supreme Court confirmation hearing regarding his views on abortion and other women’s health issues.

Lawmakers in at least 10 states will consider taxes on makers of opioids in the upcoming legislative session depending on the results of the November election; the numbers may be low, but overdose deaths in Alaska involving fentanyl more than quadrupled in 2017; a new company created by health systems to address drug shortages and high-cost generics is taking shape with a name and a chief executive officer.

In the second quarter of 2018, real US drug prices declined 5.8%, and it may be thanks to co-payment accumulators; more than 25 patient and consumer groups released a statement that said a new bill to protect Americans with pre-existing conditions would not be sufficient; the Department of Justice has issued a warning to cities planning to set up supervised injection sites as a tactic to curb opioid overdose deaths.

Senate Democrats plan to use the confirmation battle for Brett Kavanaugh's to the Supreme Court of the United States to mobilize their base around threats to the Affordable Care Act (ACA), the social safety net, and reproductive rights; a Texas courtroom will be the setting for another critical chapter in the fate of the ACA; consumers who buy insurance through ACA markets will find premiums have stabilized in 2019.

Here are the top 5 articles for the month of August.

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A judge tossed a lawsuit brought by pharmaceutical companies to block a California law requiring advance notice of big price increases; the FDA is testing all angiotensin II receptor blockers (ARBs) over a discovered impurity that is linked to cancer; research in monkeys has suggested that an experimental painkiller is effective at easing pain without being addictive.

Illinois has passed a law allowing doctors in the state to prescribe marijuana as pain medication in a fight against the opioid epidemic; the FDA has told California that a cancer warning label for coffee is misleading; and the FDA is continuing its push against the illegal sale of opioids.

New York and Minnesota will receive lost federal funding for programs they created under the Affordable Care Act; the government has officially increased the death toll in Puerto Rico after Hurricane Maria to 2975 people; after years of controlling the spread of sexually transmitted diseases, the United States has seen the number increase 4 years in a row to a new record high in 2017.

Nebraska voters will decide on Medicaid expansion in November; a medical watchdog has called for a stop to a clinical trial for sepsis treatment; Medicare Advantage insurer Clover Health is expanding its health plans to 6 new markets.

GOP senators have introduced legislation they say would protect provisions for preexisting conditions under the Affordable Care Act; Cigna shareholders have voted in favor of the acquisition of pharmacy benefit manager Express Scripts; and study results show that aspirin does not lower cardiovascular (CV) risk in the long-term.

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The Senate approved an $854 billion spending measure, including a 5% boost for the National Institutes of Health; Maine’s Supreme Judicial Court said 2 lower-court rulings ordering the state to implement the voter-approved Medicaid expansion stand; the chief information officer of California’s public employee benefits and retirement system (CalPERS) is trying to use data to analyze trends and recommend policies to stem rising costs.

Facing ever-increasing costs, some families are forgoing traditional medical insurance in favor of patching together an alternative using multiple sources; a new initiative led by former CMS Administrator Andy Slavitt is looking to transform Medicaid with actionable solutions to address the health and social determinants of vulnerable populations; before kids go back to school, sales of the EpiPen usually spike, but this year parents are scrambling to find the injector.

CMS today released a formal guidance that outlines the federal payer’s approach to calculating budget neutrality for Medicaid section 1115 demonstration projects, “to strengthen fiscal accountability.”

Patients living in rural areas have fewer options for a hospital as closures continue at a rate of about 30 a year; the Trump administration is sending mixed messages about how it views pharmacy benefit managers (PBMs); thousands of veterans suffering from posttraumatic stress disorder may be left without benefits after the Department of Veterans Affairs (VA) improperly handled as many as 1300 sexual trauma claims.

Senator Rand Paul, R-Kentucky, wants to attach his proposal to cut funding for Planned Parenthood to a massive defense, HHS, labor, and education funding bill that is currently being debated on the Senate floor; nearly 1 in 5 jail and prison inmates regularly used heroin or opioids before being incarcerated, making jails a place for intervention, treatment, and rehabilitation; in Maine, residents who applied for health coverage under Medicaid expansion are still waiting to hear from the governor, and in Kentucky, the governor was rebuffed in his lawsuit against 16 residents who sued the state over Mediciaid work requirements.

A Dartmouth College investigation has concluded that H. Gilbert Welch, MD, MPH, a prominent healthcare policy researcher, committed research misconduct in connection with a breast cancer paper published in The New England Journal of Medicine in 2016; a Boston University endocrinologist, Michael Holick, MD, who had a crucial role in drafting national vitamin D guidelines, has benefitted from the industry in the amount of hundreds of thousands of dollars; 24 states have passed 37 bills this year to curb rising prescription drug costs as bipartisan efforts are forcing pharmaceutical companies to disclose and justify price increases.

Every single future medical student who will study at the New York University School of Medicine, in perpetuity, will have their tuition costs fully covered; HHS has approved New Jersey’s waiver request to create a reinsurance program that would help lower insurance premiums for everyone in the state; an analysis highlights how marketing documents from the mid-1990s downplayed addiction to opioids.

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The FDA will start to review gene therapy experiments and products the same as other treatments and drugs; Alaska and Minnesota have become models for other states looking to curb health insurance premium increases with reinsurance programs; patients with limited English proficiency often have to rely on family members and friends to interpret for them, which can have serious consequences.

Advocacy groups filed a lawsuit on behalf of 3 Medicaid recipients challenging Arkansas' Medicaid work requirements; CVS Health announced that its pharmacy benefit manager will target expensive drugs to be excluded from formularies if they are not cost effective; Senate leaders have received a letter from 120 consumer and patient associations on the impact Supreme Court nominee Brett Kavanaugh could have on health policy.

Major tech companies publicly committed at a Trump administration event to improve provider–patient communications and data exchanges in health information technology in an effort to cut costs and improve outcomes; public health advocates and the FDA are at odds over how to regulate the exploding electronic cigarette industry, even as both sides agree teens and college students are using the devices at an alarming rate; billionaire investor Carl Icahn, who last week said Cigna was overpaying for Express Scripts, is no longer intending to solicit proxies to vote against the $52 billion deal.

A proposed rule from CMS would end the practice of home health aides paid directly by Medicaid having their union dues automatically deducted from their paychecks; the Trump administration says it has found a way around a federal judge’s June ruling stopping a Kentucky plan from introducing work requirements on those receiving Medicaid and will continue to allow states to put the restrictions in place; a California jury found Monsanto liable in a lawsuit filed by a school groundskeeper who said the company’s weedkillers, including Roundup, caused his non-Hodgkin lymphoma.

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