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HHS secretary: Trump wants to go ‘much, much further’ on tackling high drug prices. President Trump wants to go “much, much further” than his budget proposals to tackle high drug prices, Health and Human Services Secretary Alex Azar said Wednesday. Azar said during a speech before the American Hospital Association that his department is working to solve a “number of problems that plague drug markets.” His remarks come two days before Trump is scheduled to deliver a major address on high drug prices. Azar said the agency wants to solve problems such as the high list prices set by drug makers and “seniors and government programs overpaying for drugs due to the lack of the latest negotiating tools; rising out-of-pocket costs for consumers; and foreign governments free-riding off American investment in innovation.” Azar did not elaborate on what new negotiating tools he hopes to use. Democrats have called for Medicare to negotiate for lower drug prices, but the idea has gone nowhere in the Republican-controlled Congress. The White House has not released details about Trump’s speech on Friday. However, Azar and Food and Drug Administration Commissioner Scott Gottlieb have criticized what they call unfair rebate agreements negotiated among insurers, drug middlemen and manufacturers. They charge that consumers don’t benefit enough from the rebates.

Azar also renews call for pricing transparency. Azar, who recently spent time in an Indianapolis hospital battling a stomach infection, also touched on the need for greater transparency of prices of healthcare procedures. “I believe you ought to have the right to know what a procedure is going to cost, and what it’s going to cost you, out of pocket — before you get it,” he said. “We want your input on the best way to make this a reality, and we will applaud those who make this vision a reality on their own.”

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Democrats seize on Obamacare price increases ahead of midterms. Senate Democrats are promising to battle Republicans by being “relentless” on “who exactly is to blame” for Obamacare price increases ahead of November’s midterm elections. “Let me be clear: These increases in healthcare costs for families are a symptom of Republican sabotage,” Senate Majority Leader Chuck Schumer, D-N.Y., said in a press conference Tuesday. “They didn’t happen on their own, they wouldn’t have happened … if not for Republican sabotage.” Maryland’s Obamacare insurers are asking for a 30 percent average rate increase for 2019, with some plans seeking hikes as high as 91 percent, and most of Virginia’s Obamacare insurers are proposing double-digit rate hikes. In Virginia, Group Hospitalization and Medical Services has the biggest proposed increase with 64 percent, and Piedmont Community Healthcare came in second, with about a 46 percent increase. State officials do not have to accept the proposals, and Maryland is considering a reinsurance fund that would help lower prices, but Democrats signaled they would draw attention to headlines about the rate increases as they roll in.

Lamar Alexander gives up on working with Democrats to fix Obamacare. Sen. Lamar Alexander, R-Tenn., who played a major role pushing a bipartisan effort aimed at lowering Obamacare premiums, has formally closed the door on negotiating with Democrats on the issue. Alexander wrote in a letter to supporters Tuesday that he is instead working with the Trump administration on actions it can take to shore up Obamacare’s marketplaces. He said he regrets the effort’s collapse and that Democrats aren’t willing “even to make modest temporary changes.” Alexander also praised proposed regulations by the administration to expand access to cheaper health plans that opponents say will cause premiums to soar for customers on the exchanges and will give customers using the cheaper health plans inadequate coverage.  Alexander worked with Sen. Patty Murray, D-Wash., to write a package to shore up the law’s marketplaces. But the effort collapsed in March over a disagreement about funding for abortions.

Democrats say Medicaid cuts would undermine opioid fight. House Democrats said bipartisan efforts to combat the opioid epidemic wouldn’t do any good if Republicans cut Medicaid. The House Energy and Commerce Committee held a hearing on Wednesday to advance 26 bills to combat opioid abuse with four other bills. But Democrats criticized Republican efforts to roll back Obamacare’s Medicaid expansion as part of their moves last year to repeal the Affordable Care Act. “You cannot on one hand say we are addressing this public health crisis and the other say we are going to undermine Medicaid,” said Rep. Kathy Castor, D-Fla. Other Democrats said the legislation is not meant to take the place of Medicaid. “We have to preserve Medicaid,” said Rep. Peter Welch, D-Vt. “That is essentially the lifeline. We can’t have these bills as a substitute.” The markup is the first of two hearings that the committee has planned to move more than 50 opioid bills to the full House. Committee leaders hope to get the bills through the House by the Memorial Day recess. The second legislative hearing will be held May 17.

House panel advances major overhaul to over-the-counter drug approvals. The Energy and Commerce Committee approved a bill to completely overhaul how the FDA approves over-the-counter drugs. The Over-the-Counter Monograph Safety, Innovation and Reform Act of 2018 would modernize the monograph system the agency has used since 1972 to approve OTC drugs. The legislation would create a user fee system to fund changes to the approval system, similar to user fee programs employed for pharmaceuticals and medical devices. But Democrats and Republicans clashed over a controversial part of the bill, which would give a drug maker 18 months of market exclusivity for a new OTC drug. Rep. Frank Pallone, D-N.J., offered an amendment that would shrink the exclusivity to 12 months, with Democrats saying that the long timeframe would result in higher prices. But Republicans countered that the 18-month period is right because it would take a year for a new product to be approved. The amendment failed 30-24, but the full bill advanced via a voice vote to the full House.

CDC director agrees to take $165,000 pay cut after criticism. Centers for Disease Control and Prevention Director Robert Redfield has agreed to take a $165,000 pay cut after his $375,000 salary sparked criticism. Redfield called for a salary reduction after his initial salary created controversy. His new yearly salary of $209,700 is based on a formula used to pay the prior three CDC directors, according to HHS spokeswoman Caitlin Oakley. Redfield, a prominent AIDS researcher, didn’t want his “compensation to become a distraction” to CDC’s work, Oakley said. His decision to cut his salary came after Sen. Patty Murray, D-Wash., questioned the amount. His new salary is the same as former CDC Director Tom Frieden, who served under the Obama administration, an administration official said.

McConnell open to Trump’s $15 billion rescission bill. Senate Majority Leader Mitch McConnell said the Senate will consider voting on President Trump’s measure to cut the federal budget by $15 billion through the rarely used Impoundment Control Act, which would involve $7 billion in cuts to the Children’s Health Insurance Program. “If the House is able to pass a rescission package, we’ll take a look at it,” said McConnell, R-Ky. House Republicans are getting behind the legislation, which would eliminate budget funds that have long been dormant.  The plan gained GOP support Tuesday after it became clear that it would leave intact the recently passed $1.3 trillion fiscal 2018 budget deal and the bipartisan, two-year agreement on spending caps. Republicans argue the CHIP funding and other money has been left unused and can no longer be spent.

House panel advances bill allowing veterans to see more private health providers. A House panel has advanced legislation to allow more veterans to see doctors outside the Veterans Affairs system. The bill, the VA MISSION Act, passed the House Veterans Affairs Committee 20-2. It would allow more veterans to go outside the VA healthcare system and use private-sector doctors when VA medical centers can’t provide appointments within a month, when veterans have to drive more than 40 minutes to access care, or when care is determined inadequate by VA leaders. The bill’s lead author, Rep. Phil Roe, R-Tenn., said on Twitter that the bill offers a “once-in-a-lifetime opportunity to reform VA.” The $51 billion plan includes $5.2 billion to avoid shutdown of the Choice program, which is expected to run out of funds as early as May 31, disrupting medical care for veterans. Choice was created as a reaction to the scandals involving long wait times for care in the VA system, in which veterans died while they waited to receive medical care. Supporters hope that the legislation will gain Trump’s signature by the end of the month.

Federal appeals court paves way for release of food stamp sales figures. A federal appeals court cleared the way Thursday for the federal government to release data showing how much retailers participating in the food stamp program have received each year from the government. The ruling from the panel of three judges on the 8th U.S. Circuit Court of Appeals is a victory for the South Dakota-based Argus Leader, which asked the U.S. Department of Agriculture for more than 10 years’ worth of food stamp sales data seven years ago.

McConnell: No plans to legalize marijuana. McConnell said Tuesday he has no plans to endorse legalizing marijuana, even as Schumer is making a new push to decriminalize weed. “I do not have any plans to endorse legalization of marijuana,” McConnell said. McConnell is pushing to legalize the production of hemp, which contains small amounts of marijuana’s key ingredient, THC. “These are two entirely separate plants,” McConnell said. “I hope everybody understands that. It is a different plant. It has an illicit cousin which I choose not to embrace.”

New advice on prostate cancer screening: Leave it up to doctors and patients. An influential medical panel is recommending that the decision to screen middle-aged men for prostate cancer be left up to patients and their doctors, reversing previous advice to avoid regular screening altogether. The U.S. Preventive Services Task Force, a government-appointed panel that makes healthcare recommendations, had advised against regular screening because of the risks it carried: Treatment for prostate cancer often leaves men incontinent or with erectile dysfunction and doesn’t help them live longer. Without treatment, many men who have prostate cancer do not develop any symptoms.

Congo confirms two cases of Ebola. The Democratic Republic of Congo declared a new outbreak of Ebola on Tuesday, two years after the worst outbreak in history in West Africa ended. Over the past five weeks, the country has seen 21 suspected cases and 17 deaths. Laboratory results confirmed that two of the cases were Ebola, a disease that killed more than 11,000 people from 2014 to 2016 in West Africa. The 2014 outbreak was mainly concentrated in three West African countries: Liberia, Sierra Leone, and Guinea. One person died in the U.S. and several other people contracted the disease either by traveling to West Africa or performing their duties as a healthcare worker.

RUNDOWN

Bloomberg Mylan’s EpiPen added to FDA’s list of medications in short supply

New York Times Children of the opioid epidemic

Kaiser Health News When credit scores become casualties of healthcare

Axios Azar vs. Price: The no-drama HHS chief

Politico Trump’s ‘America First’ agenda on drug pricing could backfire around the world

Wall Street Journal California counties jump into opioid litigation fight

NPR Artificial intelligence takes scientists inside living human cells

Washington Post The creepy, dark side of DNA databases