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This week, the top managed care news included a report showing the US uninsured rate rose in 2018; the Trump administration indicating it will ban all flavors of e-cigarettes except for tobacco; new research showing the prevalence of hemophilia is 3 times larger than originally believed.

As orphan drugs account for an increasing share of drugs approved, they are driving up the cost of drug launches and drug prices. In a new paper, America's Health Insurance Plans analyzes these rising costs and the use of orphan drugs and asserts that policy makers need to revisit the Orphan Drug Act.

The family that owns the drug company at the center of the nation’s opioid problem reached a tentative settlement with thousands of municipal governments and nearly 2 dozen states that sued the pharma industry for its role in creating the crisis; nearly 8 in 10 Americans back legislation to protect people from surprise medical bills; the water crisis in Flint, Michigan, was not only about lead in the water—it was also about a deadly outbreak of Legionnaires’ disease.

Juul is being investigated for making unauthorized safety claims, while the governor of New York proposes to ban flavored e-cigarettes; Sutter Health is being sued for its role in rising healthcare costs; a European doctor who uses telemedicine and internet prescribing to provide American women with mifepristone and misoprostol to induce abortion in the first trimester is suing the FDA.

Human leukocyte antigen c (HLA‐C), a protein encoded by the HLA-C gene, plays an important role in protecting against both cancer and viruses. At the same time, it has been implicated in autoimmune diseases, including rheumatic diseases, though the mechanism by which it contributes to the pathogenesis of these diseases is not yet clear.

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