Oct 22, 2018

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning ... Today I learned there’s a sea cucumber called the headless chicken monster. It “lives a mile under the sea, has tentacles and fins and looks like a decapitated chicken ready for roasting.” Very cool.

1 big thing: Trump's next steps on opioids

President Trump declared opioids a public health emergency last year. Photo: Jabin Botsford/The Washington Post via Getty Images

The White House will be focused on opioids for at least part of this week, my colleague Jonathan Swan and I report.

  • President Trump will sign Congress' big opioids bill Wednesday at a White House event, almost a year after Trump declared the addiction crisis a public health emergency.
  • He’ll be joined in the East Room by roughly 20 other organizations announcing their own initiatives, senior White House counselor Kellyanne Conway told Swan in an interview.
  • Cigna will roll out a new initiative for veterans, and Adapt Pharma will announce it’s donating doses of Narcan, the overdose-revival drug, to every public library and YMCA in the country, Conway said.

Where it stands: Congress and the Trump administration have steered billions of dollars to help with the crisis, and most of that work has been bipartisan, highlighted by the fact the bill Trump is signing passed the Senate 98-1.

  • But overdose deaths are still climbing — as they were well before Trump took office — though Conway said the administration is encouraged by the declining rate of growth in overdose deaths.
  • "This crisis could well get worse before it gets better. We’re trying to bend the curve in the right direction," Conway said.
2. New surprise bill lobbying from ER docs

Two weeks after a handful of senators introduced legislation to curtail surprise medical bills, the American College of Emergency Physicians hired new lobbyists to handle the issue, Axios' Bob Herman notes.

Driving the news: ACEP, the trade group representing emergency room doctors, brought on 4 lobbyists with the law firm Holland & Knight on Oct. 2, according to a federal disclosure. The law firm directed questions to ACEP.

  • An ACEP spokesperson said the group “has been working on a legislative strategy on surprise bills” well before the draft law was rolled out.
  • ACEP also blamed health insurance for large bills and believes patients “should not be punished financially for having emergencies.”

Between the lines: Surprise bills are now a bona fide political issue, especially now that Sens. Maggie Hassan and Jeanne Shaheen released their own legislation. Emergency doctors obviously want their seat at the table, because they stand to lose a lot of money if their ability to do balance billing vanishes or becomes limited.

3. Ex-energy trader takes on pharma

John Arnold, a former energy trader and hedge fund manager, is putting up millions of dollars to fight the pharmaceutical industry over drug prices, the Wall Street Journal reports.

By the numbers: Arnold has given $19 million to ICER, the independent organization that studies whether drugs are worth what they cost.

  • Arnold and his wife have pledged another $5.7 million to I-MAK, an organization that challenges patents of brand name drugs.
  • Another $1 million went to Civica Rx, the drugmaker founded by a consortium of hospitals to produce generic drugs.
  • Arnold's foundation also funds the advocacy group Patients for Affordable Drugs, which has taken on industry allies from both political parties.

Why it matters: The pharmaceutical industry is so powerful and has remained free from political intervention for so long, in part because it's enormously well-funded — both in its direct lobbying and in its advocacy work.

  • No one person is likely to outmatch the entire drug industry, but Arnold's foundation controls assets of more than $2 billion, per WSJ. That's more than the Red Cross — and enough to provide a credible counterweight to pharma.
4. Fitness industry booms, but actual fitness lags
Expand chart
Data: Obesity, NCHS National Health Interview Survey. Gym memberships, IHRSA Global Report. Stress, APA Stress in America Survey; Chart: Andrew Witherspoon/Axios

Between Soul Cycle, Fitbit, Whole30 diets and social media health gurus, the health and wellness industry is booming — but Americans are more likely to be obese today than ever before.

The problem, experts told Axios’ Stef Kight, is that while exercise is obviously good for you, diet has more to do with weight loss. And Americans’ diets are still largely trash.

By the numbers: The U.S. fitness industry brought in $30 billion worth of revenue in 2017, according to the latest report by the International Health, Racquet and Sportsclub Association (IHRSA) — a global trade association for the fitness industry.

  • Since 2008, the number of gym members has increased by more than 33% in the U.S., according to the same report.
  • The commercial weight loss program market was worth $2.77 billion in 2016 and was expected to grow 9.4% to $3.03 billion in 2017, according to Marketdata.
  • Fitness apps and wearables overall are projected to be used by 16.4% of people in the market by 2023, up from 15.7% in 2016, per Statista.

Yes, but: More than a third of Americans eat fast food every day — an industry notorious for high-calorie, low nutrition meals — and only 1 in 10 eat the recommended amount of fruits and vegetables, per CDC.

Go deeper.

5. While you were weekending ...
  • Pennsylvania Gov. Tom Wolf vetoed a bill to add work requirements to the state’s Medicaid program.
  • Dialysis companies have spent more than $100 million trying to defeat a ballot initiative in California that would cut their profits, Modern Healthcare reports.
  • Business Insider notes that investors are suddenly pouring hundreds of millions of dollars into companies offering direct-to-consumer access to products like generic versions of Viagra.
  • Quartz takes an in-depth look at the unusual coalition that's helping to fight the opioid epidemic in Winchester, Va.
Caitlin Owens