Richard Sackler, the former president of Purdue Pharma, agreed with his head of sales and marketing in 1997 not to alert doctors that OxyContin is a stronger painkiller than morphine, according to secret court documents obtained by David Armstrong of ProPublica and Stat News.
Why it matters: The deception around OxyContin, a drug that many say has fueled the country's opioid crisis, appears to have gone all the way to the top to include the billionaire family that founded Purdue.
Expect America's most prominent hate-hate relationship to get even nastier as President Trump and California clash in the lead-up to 2020.
Quick take: Hillary Clinton walloped Trump there by 30 percentage points in 2016 and the Democratic "blue wave" in 2018 swept loads of California Republicans from the House. And it's not just elections: Trump has turned the power of the federal government on California, while the Golden State has taken the lead in seeing him in court, Politico Mag's Michael Grunwald reports.
Employers often turn to brokers to help them find the right health care plan for their workers. But there's a catch: Brokers have several layers of incentives to steer companies toward plans with higher premiums.
How it works: For starters, brokers' commission is a percentage of the plan's total annual premium. Higher premium, higher commission. But there's more, as ProPublica reports.
A new Brookings Institution paper outlines ways to prevent patients from receiving surprise medical bills — particularly the patients who are unlikely to know their doctor is out-of-network.
The big picture: The paper argues that any solution must take into account that health care settings often are not normal markets.
Americans spent $3.65 trillion on health care in 2018, according to new preliminary estimates from independent federal actuaries. That total is about the same size as Spain and Canada's entire economies — combined.
Why it matters: U.S. health spending last year was 4.4% higher than in 2017, a rate that is still growing faster than the broader economy — which means more money is being taken out of people's paychecks to pay for a system that continues to worry and frustrate patients.
Federal regulators and fentanyl manufacturers didn't take action when it became clear that highly potent fentanyl products were being inappropriately prescribed to as many as half of the patients taking them, according to a new study in the Journal of the American Medical Association.
How it works: The type of fentanyl in question is approved by the Food and Drug Administration only for adult cancer patents who have already built up a tolerance to less potent opioids.
We know childbirth is wildly expensive in the U.S. The Philadelphia Inquirer has a very depressing related story: The cost of a failed pregnancy can also be unexpectedly large, leaving women or couples to sort through and challenge medical bills on top of an enormous emotional loss.
Details: One woman profiled by the Inquirer, Jodi Laughlin, had to have an emergency C-section. Her baby then lived only 32 minutes, due to a buildup of fluid in her body.
Ohio Attorney General Dave Yost has formally demanded that OptumRx, one of the country's largest pharmacy benefit managers, pay back $16 million in "overcharges" related to handling drug benefits for a state agency.
Why it matters: This isn't a lot of money in the grand scheme of things, but it's a forceful step that shows states are actively looking to claw back money from a PBM if they think the company is skimming too much profit from the drug pricing process.
