Sep 21, 2018

Axios Vitals

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1 big thing: Pharma's latest lobbying push


It’s not looking great for the pharmaceutical industry’s latest lobbying push.

The intrigue: PhRMA, the industry’s leading trade group, has been aggressively lobbying Congress to reverse a policy that put drugmakers on the hook for more of seniors’ drug costs — and it wants that to happen as part of a compromise that would be attached to opioids legislation.

  • But since news of that lobbying effort broke yesterday, the latest signs from Capitol Hill all seem to be pointing toward yet another loss for PhRMA.

Congress voted in February to make drugmakers cover more of seniors’ costs when they fall into Medicare’s “donut hole.” That would cost the industry billions, and it’s been trying ever since to get Congress to reverse itself.

“PhRMA is begging” lawmakers to attach the Medicare “fix” to its opioids bill, a GOP congressional source told Axios yesterday.

  • Industry is also pushing for a separate provision to extend an expiring Affordable Care Act policy that curbed seniors’ out-of-pocket costs, lobbyists familiar with the negotiations told Axios’ Caitlin Owens and Bob Herman.
  • As part of a compromise, PhRMA had expressed some openness to a version of the CREATES Act — a bill designed to stop brand-name drugmakers from using regulatory rules as a way to thwart generic versions of their products.

But pharma’s critics pounced at the prospect of attaching a multibillion-dollar industry priority to opioids legislation. If PhRMA gets its way, the opioids bill would likely end up with more money for pharmaceutical companies than for the opioids crisis.

  • “The industry that caused the crisis attempting to slap a rider on a bill to address the crisis, that dwarfs the opioids spending by magnitudes of 7, is a bit absurd. Even by PhRMA standards,” a former GOP leadership aide turned health industry lobbyist told Caitlin.
2. Hospital reality TV violates patients' privacy

You could probably guess, without looking it up, that if federal health privacy law does anything, it prohibits hospitals from putting trauma patients on network television without their consent. You’d be right.

And yet, four hospitals have now paid more than $3 million in settlements after allowing reality-TV crews to film trauma patients without their consent.

Driving the news: HHS yesterday announced a $999,000 agreement with three hospitals — Boston Medical Center, Brigham and Women's Hospital and Massachusetts General Hospital — that allowed crews from ABC’s “Boston Med” to film on their premises without getting patients’ consent.

  • That follows a $2.2 million settlement in 2016 with New York Presbyterian Hospital involving “NY Med,” which had aired a patient's death.
  • The man’s family didn’t even know his death had been filmed until the show aired and his widow happened to be watching, ProPublica reported.

What they're saying: “Patients in hospitals expect to encounter doctors and nurses when getting treatment, not film crews recording them at their most private and vulnerable moments,” Roger Severino, the director of HHS’ Office of Civil Rights, said in a statement yesterday about the Boston settlements.

3. New questions for Sloan-Kettering

As long we're on the subject of questionable hospital practices brought to light by ProPublica, the site also has some new reporting on turmoil within Memorial Sloan-Kettering Hospital, this time over an artificial intelligence startup in which the hospital is an investor.

The company, Paige.AI, plans to tap Sloan-Kettering's significant data troves, including some 25 million tissue samples, in an effort to develop better cancer treatments through AI.

"Hospital pathologists have strongly objected to the Paige.AI deal, saying it is unfair that the founders received equity stakes in a company that relies on the pathologists’ expertise and work amassed over 60 years," ProPublica reports.

"They also questioned the use of patients’ data — even if it is anonymous — without their knowledge in a profit-driven venture," the report says.

Why it matters: Sloan-Kettering is already attracting more scrutiny to hospitals' financial entanglements. Its chief medical officer resigned last week after failing to disclose millions of dollars in industry contributions.

4. Generic drug prices ⬇️

Data firm 46brooklyn is out with a new analysis showing prices for most generic drugs, including ones that are prescribed frequently and cost a lot, are on the decline. Bob has the details:

  • A 400-milligram tablet of the generic version of cancer drug Gleevec cost pharmacies $156 last summer, the analysis showed. It’s now $21 per pill.
  • A 50-milligram tablet of generic Viagra cost pharmacies almost $26 as recently as late August and now costs $0.67 a pill.

The big question: Whether pharmacy benefit managers are sharing those generic drug savings with health plans, employers and taxpayers.

Go deeper: The PBM drug pricing games that cost states money.

5. Congo's Ebola outbreak may be getting better
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Data: Ministry of Health DRC; Chart: Andrew Witherspoon/Axios

The Ebola outbreak in the Democratic Republic of the Congo is slowing down, Axios' Eileen Drage O'Reilly reports. But top public health officials say the good news may not last — two cities, Beni and Butembo, have become hotspots.

What they're saying: "Significant risks for further spread of the disease remain, " World Health Organization officials warned in a statement.