Top Stories

  • MD Anderson Cancer Center of Houston has moved to fire three scientists in connection with a federal investigation into China’s attempts to steal American research. After the National Institutes of Health, working in collaboration with the Federal Bureau of Investigation, informed the center that five faculty members have conflicts of interest or unreported foreign income, MD Anderson began termination proceedings against three, of whom two resigned, the third has begun the due process requirements, another was cleared and the fifth is still being investigated.  (Houston Chronicle)
  • The Food and Drug Administration approved the first medical device for the treatment of attention deficit hyperactivity disorder in children ages of 7 to 12 who are not already medicated for the condition. The device, which could cost over $1,000 for the starter kit and is not yet covered by insurance, uses mild nerve stimulation to increase activity in brain regions that regulate attention, emotion and behavior while the child is asleep. (CNN)
  • Merck & Co Inc. said it has received FDA approval to use Keytruda, its cancer therapy drug, in combination with Pfizer Inc.’s Inlyta for the treatment of advanced renal cell carcinoma, the most common form of kidney cancer. The approval of the combination therapy poses a risk for Bristol-Myers Squibb Co., whose immunotherapy combination treatment has a tight grasp on the market. (Reuters)

Chart Review

Events Calendar (All Times Local)

04/22/2019
Rx Drug Abuse and Heroin Summit
Kaiser Family Foundation forum on the Trump administration’s HIV initiative 10:00 am
World Class: A conversation with author Dr. William A. Haseltine 5:00 pm
04/23/2019
Rx Drug Abuse and Heroin Summit
04/24/2019
12th Annual FDA/AdvaMed Medical Devices and Diagnostics Statistical Issues Conference
Rx Drug Abuse and Heroin Summit
Health Affairs: Health and Housing Needs for US Seniors in the “Middle Market” 9:00 am
Association for Women in Science Innovation and Inclusion Summit 12:30 pm
04/25/2019
12th Annual FDA/AdvaMed Medical Devices and Diagnostics Statistical Issues Conference
Rx Drug Abuse and Heroin Summit
2019 Annual Congress of Enhanced Recovery and Perioperative Medicine
FDA Antimicrobial Drugs Advisory Committee Meeting 8:30 am
04/26/2019
2019 Annual Congress of Enhanced Recovery and Perioperative Medicine
FDA Antimicrobial Drugs Advisory Committee Meeting 8:30 am
Investing in Interventions that Address Non-Medical Health–Related Social Needs 8:30 am
04/27/2019
2019 Annual Congress of Enhanced Recovery and Perioperative Medicine
View full calendar

The Brands That Define American Culture and Commerce

Morning Consult analyzed over 400,000 survey interviews to determine this year’s rankings. See who made the list.

General

This Is The Part Of ‘Medicare For All’ That You Never Hear About
Jonathan Cohn, HuffPost

Sen. Bernie Sanders (I-Vt.) and his allies talk a lot about how “Medicare for All” would take back money from insurers and drug companies, and use those savings to help make sure every American has generous health insurance. That is accurate.

Republicans Offer Health Care Bills to Protect Patients (and Themselves)
Robert Pear, The New York Times

President Trump and Republicans in Congress say they are committed to protecting people with pre-existing medical conditions. But patients with cancer, diabetes and H.I.V., for example, would have significantly less protection under Republican proposals than under the Affordable Care Act.

Anti-smoking advocates question industry motives for backing higher purchasing age
Jessie Hellmann, The Hill

Public health and anti-tobacco advocates are no longer facing fierce opposition from the tobacco industry in their push to raise the legal purchasing age from 18 to 21. The reversal, prompted in large part by rising youth vaping rates, means tobacco companies such as Altria are now on the front line pushing “Tobacco 21” legislation in state legislatures and on Capitol Hill in an effort to stave off stronger regulations that could have disastrous effects on the industry, including bans on the sale of flavored tobacco products that are appealing to kids.

Texas removes thousands of children from Medicaid each month due to red tape, records show
Elizabeth Byrne, The Texas Tribune

Most states check whether children on Medicaid still qualify for the program once a year. Texas checks more often, using an automated system that critics say lead to kids losing coverage even though they’re still eligible.

Democrats Ran On Lowering Drug Prices. Now They Could Cut A Bad Deal With Donald Trump.
Zach Carter and Daniel Marans, HuffPost

For months now, House Democratic Party leaders have been feuding behind closed doors with members of the Congressional Progressive Caucus about how to lower prescription drug prices. But as details of negotiations between House Speaker Nancy Pelosi (D-Calif.) and President Donald Trump have leaked into the public, frustration among progressives is boiling over.

‘I Want What My Male Colleague Has, and That Will Cost a Few Million Dollars’
Mallory Pickett, The New York Times

Women at the Salk Institute say they faced a culture of marginalization and hostility. The numbers from other elite scientific institutions suggest they’re not alone.

Kansas to Let Farm Bureau Health Coverage Avoid ACA Rules
John Hanna, The Associated Press

Kansas will allow its state Farm Bureau to offer health care coverage that doesn’t satisfy the Affordable Care Act after Democratic Gov. Laura Kelly on Friday declined to block a Republican-backed effort to circumvent former President Barack Obama’s signature health care law.

State Republicans challenge Democrats with ‘born-alive’ bills
Renuka Rayasam and Dan Goldberg, Politico

Republican legislators across the country are rallying behind President Donald Trump’s efforts to link Democrats with “infanticide,” daring Democratic governors to veto “born alive” bills animating the party’s base before the 2020 elections.

US judge blocks part of Ohio ban on abortion procedure
Julie Carr Smyth, The Associated Press

A federal judge blocked part of an Ohio law late Thursday that bans the abortion method of dilation and evacuation in most cases, adding to a list of restrictions on the procedure that are or soon could be in legal limbo.

U.S. Stock Futures Decline in Holiday-Hit Trading: Markets Wrap
Todd White, Bloomberg

U.S. equity-index futures dropped on Monday while stocks in Asia were mixed as the Easter holiday weekend continued in many countries. Oil jumped on a report America will scrap waivers allowing the purchase of some Iranian crude.

Payers

‘Medicare for All’ Is Hammering Health Care Stocks. For Now.
Jeff Sommer, The New York Times

UnitedHealth Group has been a stock market darling for much of the past decade, dependably churning out earnings increases and rewarding shareholders with staggering returns. Its latest quarterly report, issued on Tuesday, was superb, as expected. Earnings per share jumped 24 percent.

CBO changes how it estimates insurance coverage
Robert King, Modern Healthcare

The nonpartisan Congressional Budget Office will factor new consumer and employer preferences in its estimate of how proposed legislation will impact insurance coverage and premiums.

Providers

Hospitals Stand to Lose Billions Under ‘Medicare for All’
Reed Abelson, The New York Times

For a patient’s knee replacement, Medicare will pay a hospital $17,000. The same hospital can get more than twice as much, or about $37,000, for the same surgery on a patient with private insurance.

Emergency Rooms Get a Makeover for the Elderly
Beth Howard, The Wall Street Journal

Marcus Overton isn’t a stranger to emergency rooms—and he doesn’t like them. “They’re chaotic and loud,” says the 75-year-old San Diego resident, who battles diabetes and heart-valve problems. “They usually put you in a bed, pull a curtain around you, and you wait.”

Providers jeopardize deals as they rush into M&A talks
Alex Kacik, Modern Healthcare

Healthcare executives often point to a persistent financial pressure that has accelerated strategies to cut costs, grow revenue or potentially scale up. That pressure may be causing providers to hastily enter mergers or acquisitions without the proper due diligence, some M&A experts say.

Pharma, Biotech and Devices

United Therapeutics is accused of unfairly blocking generic rival
Christopher Rowland, The Washington Post

United Therapeutics, a Maryland biotechnology company founded by a former satellite broadcasting executive to develop a treatment for her daughter’s rare disease, is the target of a lawsuit alleging that it unfairly thwarted generic competition.

Theranos founder Elizabeth Holmes in court; anatomy of a fraud
Brittany De Lea, Fox Business

Elizabeth Holmes, founder of now-defunct tech startup Theranos, is expected to appear at a federal courthouse in California on Monday, for a status hearing. It’s possible that the hearing will result in a trial start date, but other outcomes will be discussed as well.

Second death in Novartis gene therapy trials under investigation
Deena Beasley, Reuters

Novartis AG, which this week announced positive interim trial results for its experimental gene therapy for spinal muscular atrophy, on Friday said investigation is underway into whether a second trial death could be related to the treatment. Novartis has filed for U.S. Food and Drug Administration approval of the gene therapy, Zolgensma, and a decision is expected within weeks.

The Giants at the Heart of the Opioid Crisis
Danny Hakim et al., The New York Times

There are the Sacklers, the family that controls Purdue Pharma, the maker of OxyContin. There are the doctors who ran pill mills, and the rogue pharmacists who churned out opioid orders by the thousands.

The next e-cig battle: Should there be ads for vaping products?
Sarah Owermohle, Politico

E-cigarette companies that the FDA has already threatened for appealing to teens may land in more hot water with new campaigns that target older adults, say public health advocates and House Democrats. After the FDA told them to stop pitching in a way that attracted teens, Juul and other companies have begun flooding television, radio and print media with ads that tout their potential to help adults quit traditional cigarettes.

Health IT

WHO releases first digital health guidelines
Jessica Kim Cohen, Modern Healthcare

The World Health Organization has released its first-ever set of guidelines on digital health interventions. The guidelines, targeted toward government agencies and public health practitioners, outline 10 recommendations on how to use digital health tools to support patients’ health outcomes and access to care.

Health and education start-ups say recruiting has gotten easier in wake of Facebook, Google scandals
Christina Farr, CNBC

Start-up executives in health and education say they’re having success recruiting from tech giants like Facebook and Alphabet, where they previously struggled. The tech giants have suffered a variety of scandals and negative press in the last couple of years, making retention harder in the notoriously cutthroat competition for talent in Silicon Valley.

Talking to a therapist through Alexa could make mental health care more accessible
Dain Evans and Christina Farr

Starting this summer, you’ll be able to talk to a therapist through Amazon Alexa. For the many people who struggle with anxiety and depression, it’s a huge challenge to find an affordable therapist.

Can virtual reality boost positive feelings in patients with depression?
Megan Thielking, Stat News

Michelle Craske is asking patients to dive into coral reefs, ride on bullet trains rushing past pine trees, and cheer on soccer teams from the stands — at least virtually — in a bid to tackle a symptom long sidelined in depression treatment.

Opinions, Editorials and Perspectives

Let’s Make Every Day Drug Disposal Day
Mary Bono, Morning Consult

This April 27th will be the 17th National Prescription Drug Take Back Day — a day dedicated to encouraging us to bring the leftover and unused drugs in our medicine cabinet to a designated site for safe disposal. I was a House member back in 2010 when Take Back Day got started. I supported it then and still do to this day.

Research Reports

Association Between Opioid Dose Variability and Opioid Overdose Among Adults Prescribed Long-term Opioid Therapy
Jason M. Glanz et al., JAMA

In this nested case-control study that included 228 case patients who experienced an opioid overdose and 3547 control patients who did not experience an opioid overdose, high variability in opioid dose was associated with a greater than 3-fold increased risk of opioid overdose even after controlling for dose.

US Emergency Department Visits and Hospital Discharges Among Uninsured Patients Before and After Implementation of the Affordable Care Act
Adam J. Singer et al., JAMA

In this cross-sectional study of 1.4 billion US ED visits from between 2006 and 2016 and 405 million hospital discharges between 2006 and 2016, proportions of ED visits and hospital discharges by uninsured patients declined from 16% to 8% and 6% to 4%, respectively, after the 2014 ACA insurance expansions. Among patients aged 18 to 64 years, declines were from 20% to 11% and 10% to 7%, respectively.

Morning Consult