Health Brief: Report Says Insys Used ‘Likely Illegal’ Tactics to Push Opioid

Government Brief

  • A report spearheaded by Sen. Claire McCaskill (D-Mo.) says that Insys Therapeutics Inc. engaged in “aggressive and likely illegal techniques” to boost prescriptions of a highly addictive opioid drug to patients. The report is the first in an investigation led by McCaskill in her role as the ranking Democrat on the Senate’s Homeland Security and Governmental Affairs Committee. (The Hill)
  • The Senate Health, Education, Labor and Pensions Committee’s bipartisan push to shore up the health insurance marketplaces has momentum but little time to succeed, even as several other GOP senators and the Trump administration try to muster support for a parallel attempt to revive Republicans’ campaign to repeal and replace the Affordable Care Act. (Politico)
  • The Senate Finance Committee is scheduled to hold a hearing on reauthorizing the Children’s Health Insurance Program, which covers millions of lower- and middle-class families and is up for renewal Sept. 30. CHIP advocates are concerned that the busy legislative agenda facing Congress could complicate the reauthorization. (Kaiser Health News)

Business Brief

  • Insurer Optima Health said it would cut back on where it expects to offer health insurance through the ACA in Virginia, leaving the commonwealth without an insurer willing to sell Obamacare coverage in 48 of its 95 counties. Optima’s decision comes approximately two weeks after Ohio officials filled what then appeared to be the last “bare” county in the United States. (The Wall Street Journal)
  • Anthem said it would only sell Obamacare plans next year in 59 of Kentucky’s 120 counties, citing uncertainty over the ACA and unstable conditions in the health insurance marketplaces. The health insurer had previously planned to sell individual market plans in all of the state’s counties. (Washington Examiner)
  • A new biotech injection by AstraZeneca and Amgen has the potential to help a much broader range of patients who suffer from severe asthma than existing medicines like GlaxoSmithKline’s Nucala, according to findings from a mid-stage clinical trial involving 584 patients. The drug tezepelumab, which heads to final-stage Phase III tests later this year or in early 2018, could shake up the competitive market for severe asthma treatments. (Reuters)

Chart Review

Coping with Medical Costs through Life
JPMorgan Chase & Co. Institute

Events Calendar (All Times Local)

Senate HELP Committee hearing with governors on ACA stabilization 9 a.m.
Senate Finance Committee hearing on reauthorizing CHIP 10 a.m.
Senate Appropriations Committee markup of HHS spending bill 10:30 a.m.
Medicare Payment Advisory Commission September meeting 9:30 a.m.
Govs. Hickenlooper, Kasich discuss bipartisan ACA plan 9 a.m.
NIHCM webinar on cancer care 1:30 p.m.
Medicare Payment Advisory Commission September meeting 10 a.m.

This Is the Future of Brand Reputation Tracking

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Bid to shore up Obamacare faces time crunch, conservative countereffort
Jennifer Haberkorn et al., Politico

A bipartisan group of senators has palpable momentum but little time to make good on a bid to shore up Obamacare insurance markets, even as conservative Republicans press a parallel attempt to make good on their promise to repeal the health care law. The stabilization effort, led by Republican Lamar Alexander (Tenn.) and Democrat Patty Murray (Wash.), could yield the first bipartisan Obamacare bill since the law was passed seven years ago.

Cassidy-Graham: the Obamacare repeal plan McCain is supporting, explained
Sarah Kliff, Vox

The senator who cast the final vote to kill Obamacare repeal is unexpectedly helping to revive that effort from the dead. Sen. John McCain told the Hill Wednesday that he would support a plan offered by Sens. Lindsey Graham (R-SC) and Bill Cassidy (R-LA) to repeal the Affordable Care Act.

Opioid Epidemic May Be Keeping Prime-Age Americans Out of the Workforce
Ben Leubsdorf, The Wall Street Journal

New research suggests a significant portion of the post-1990s decline in labor-force participation among Americans in their prime working years could be linked to the opioid epidemic. Conducted by Princeton University economist Alan Krueger, the study found that a national increase in opioid painkiller prescriptions between 1999 and 2015 may have accounted for about 20% of the decline in workforce participation among men ages 25 to 54, and roughly 25% of the drop in prime-age female workforce participation.

Stocks Gain With Euro Before ECB; Dollar Declines: Markets Wrap
Robert Brand, Bloomberg

Stocks in Europe gained and the euro strengthened as investors awaited the latest policy guidance from the region’s central bank. The dollar weakened as North Korea tensions and the increasingly cloudy Fed outlook outweighed positive sentiment from the U.S. debt ceiling extension.


Congress’ Tight Timetable Complicates Renewal Of Children’s Health Plan
Phil Galewitz, Kaiser Health News

A popular federal-state program that provides health coverage to millions of children in lower- and middle-class families is up for renewal Sept. 30. But in a deeply divided Congress facing such pressing concerns as extending the nation’s debt ceiling, finding money for the Hurricane Harvey cleanup and keeping the government open, some health advocates fear that the program for children could be in jeopardy or that conservative lawmakers will seek changes to limit the program’s reach.

Obamacare Insurer in Virginia to Scale Back Planned Expansion
Anna Wilde Mathews, The Wall Street Journal

Virginia became the latest state at risk of having regions that will lack Affordable Care Act exchange plans next year, after a small insurer announced it will scale back the area where it expects to offer marketplace insurance. The Virginia area that currently has no 2018 exchange insurer includes 48 counties and parts of six more, as well as 15 cities that are independent of counties, according to a Virginia state regulator.

Anthem scales back by half in Kentucky’s Obamacare market
Robert King, Washington Examiner

Major healthcare insurer Anthem will only offer Obamacare exchange plans in roughly half of Kentucky’s 120 counties due to mounting policy uncertainty from Washington and a deteriorating market. Anthem had earlier planned to offer individual market plans in every county in Kentucky. However, the insurer said that lingering problems with the market and massive federal uncertainty has forced its hand.


Tenet selling 8 more hospitals as investors debate company breakup
Dave Barkholz, Modern Healthcare

Tenet Healthcare Corp. expects to sell eight low-margin hospitals and its nine hospitals and clinics in the United Kingdom to reduce debt and focus on healthier operations, outgoing CEO Trevor Fetter said at an analyst conference Wednesday. The facilities, which represent about $1.8 billion in annual revenue, are expected to yield between $900 million and $1 billion in net proceeds and through lease cost reductions, Fetter told the Baird 2017 Global Healthcare Conference.

Study: Unnecessary ER visits aren’t that common
Bob Herman, Axios

A new study from researchers at the University of California at San Francisco has found that only a tiny fraction (3.3%) of emergency room visits are considered “avoidable” — meaning people went home and didn’t need any procedures, tests or medications. The results were based on seven years of federal ER visit data.

AMA: Reversing DACA puts patient care at risk, could worsen doctor shortage
Tom Sullivan, Healthcare Finance

In reaction to President Donald Trump’s decision on Tuesday to reverse the Deferred Action for Childhood Arrivals program that protects about 800,000 immigrants, the American Medical Association has called on Congress to consider alternatives that will not hinder the healthcare workforce. “President Trump’s recent announcement to end the DACA program in six months fails to recognize the enormous contributions of hundreds of thousands of individuals who are living, working and providing vital services in the United States, including healthcare,” AMA CEO James Madara, MD, wrote in a letter to lawmakers.

In preparation for Hurricane Irma, hospitals in Florida Keys evacuate patients
Max Blau, Stat News

Hospitals in the Florida Keys bracing for Hurricane Irma, a Category 5 storm with sustained winds of up to 185 miles an hour, are evacuating patients and preparing to close their doors. Three hospitals in the Florida Keys — Lower Keys Medical Center, Mariners Hospital, and Fishermen’s Community Hospital — have been discharging patients capable of going home since earlier this week and are coordinating air and ambulance transports for the 20 or so inpatients who remain inside their walls.

After Harvey Hit, a Texas Hospital Decided to Evacuate. Here’s How Patients Got Out.
Sheri Fink and Andrew Burton, The New York Times

As floodwaters from Hurricane Harvey began filling his north Beaumont, Tex., home last week, Theodore Atwood waded outside to get a utility knife, so he could pull up his carpet and protect it. Coming back to his kitchen, he slipped and fell on the wet linoleum, and ended up at a local hospital with a severely broken pelvis.

Overtreatment Is Common, Doctors Say
Nicholas Bakalar, The New York Times

Most physicians in the United States believe that overtreatment is harmful, wasteful and common. Researchers surveyed 2,106 physicians in various specialties regarding their beliefs about unnecessary medical care.

Pharma, Biotech and Devices

Report: Drugmaker used dodgy tactics to push opioids to patients
Jessie Hellmann, The Hill

A major pharmaceutical company lied and bypassed normal processes to push opioids on to patients who didn’t need them, according to a new report released Wednesday by Sen. Claire McCaskill (D-Mo.) The report is the first product of an investigation into opioid manufacturers and distributors led by McCaskill in her role as the ranking Democrat on the Senate’s Homeland Security and Governmental Affairs Committee.

New AstraZeneca, Amgen drug looks strong rival in severe asthma
Ben Hirschler, Reuters

A new kind of injectable biotech treatment for severe asthma from AstraZeneca and Amgen promises to help a much broader range of patients than existing medicines like GlaxoSmithKline’s Nucala. Findings from a mid-stage clinical trial involving 584 patients showed on Wednesday the experimental drug tezepelumab reduced the annual rate of serious asthma attacks, known as exacerbations, by between 61 and 71 percent, depending on dose.

To fight opioid epidemic, senators make the case for ‘partial fill’ prescriptions
Lev Facher, Stat News

Sens. Elizabeth Warren (D-Mass.) and Shelley Moore Capito (R-W.Va.) wrote a series of letters on Wednesday asking major figures in the battle against the nation’s opioid epidemic to consider promoting and analyzing “partial fill” policies, which allow patients to receive less than a full prescription’s worth of medication on a single pharmacy trip. A clause in the Comprehensive Addiction and Recovery Act, passed in 2016, permits pharmacies to dispense portions of prescriptions for Schedule II drugs — a classification that includes many opioid-based painkillers with high potential for abuse — and for patients to return later if they feel the remainder of prescribed medication is needed.

Health IT

The FDA is taking a page from Silicon Valley and looking for its first ‘entrepreneur in residence’
Christina Farr, CNBC

The U.S. Food and Drug Administration is so hip these days that it’s looking for its first entrepreneur-in-residence. The agency today announced that its digital health unit is recruiting fellows to help it with tasks like assessing product quality and developing new ways to collect data.

Opinions, Editorials and Perspectives

A New Approach to Combat America’s Obesity Epidemic
Rebecca Shenkman and Beth Vallen, Morning Consult 

Across the country, the obesity epidemic and related health issues affect more than 66 percent of the U.S. adult population and increase direct and indirect health care costs as much as 30 percent. To combat this epidemic, health professionals are increasingly turning to insights from behavioral science to guide clients and patients — focusing not only on what people eat, but behavioral strategies for navigating today’s food-rich environment.

Health care smackdown: Last-ditch repeal drive threatens bipartisan fixes
Andy Slavitt, USA Today

While America has been distracted by Russia, North Korea, Charlottesville and Hurricane Harvey, two opposing forces have been gathering steam and are likely to bring the health care debate to an explosive head by the end of the month. On one side, powerful Republican Senate committee chairs and their Democratic counterparts are leading an effort this week to move health care reform in a bipartisan direction by focusing on small improvements to the Affordable Care Act.

Research Reports

Fueling an Epidemic: Insys Therapeutics and the Systemic Manipulation of Prior Authorization
U.S. Senate Homeland Security & Governmental Affairs Committee, Ranking Member’s Office 

The opioid epidemic has exacted a staggering human and financial cost in the United States over the past 20 years. Approximately 183,000 Americans died from prescription opioid overdoses between 1999 and 2015, with more than 15,000 Americans dying in 2015 alone.