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Shareholders green light CVS-Aetna deal. Shareholders voted this morning to allow drugstore chain CVS Health to buy health insurer Aetna, in a deal that both parties hope will transform the way their healthcare companies deliver care. The agreement, estimated at $69 billion in cash and stock, would combine the companies’ coverage options with drugstore capabilities and pharmacy benefits platform. The announcement late last year of the intended partnership opened the door to other planned healthcare mergers and is largely in response to health providers looking for ways to reduce costs. Both sides expect that their customers will be able to benefit from the services they deliver and keep patients out of the emergency room, receiving much of their primary care from CVS MinuteClinics. Even after clearing the shareholder hurtle, the CVS-Aetna merger must be approved by the Justice Department and the Federal Trade Commission before it can proceed. "When this merger is complete, the combined company will be well-positioned to reshape the consumer health care experience, putting people at the center of healthcare delivery to ensure they have access to high-quality, more affordable care where they are, when they need it," Larry Merlo, CVS Health president and CEO, said after the vote.
Welcome to Philip Klein’s Daily on Healthcare, compiled by Washington Examiner Managing Editor Philip Klein (@philipaklein), Senior Healthcare Writer Kimberly Leonard (@LeonardKL) and Healthcare Reporter Robert King (@rking_19). Email email@example.com for tips, suggestions, calendar items and anything else. If a friend sent this to you and you’d like to sign up, click here. If signing up doesn’t work, shoot us an email and we’ll add you to our list.
House to vote on allowing terminally ill patients to try experimental drugs. The House is poised to pass legislation today that would allow people with terminal illnesses to use drugs that are still being tested by the government. The legislation has the support of President Trump, who called on Congress to pass the bill during his State of the Union address, and Vice President Mike Pence, who signed an Indiana bill into law when he was governor. The policy, referred to as "Right to Try," has been passed in at least 38 states, but the laws are not allowed to circumvent federal law that says drugs must be approved by the Food and Drug Administration before they can be given to patients. Under the bill, patients would be able to request access to medicines as long as they had passed the first phase of scientific review, which determines whether a medication is safe for people but not whether it works. Drug companies would not be required to provide the drugs to patients who request them.
Critics say right-to-try gives patients false hope. Rep. Frank Pallone Jr. of New Jersey, the top Democrat on the House Energy and Commerce Committee, opposes the bill, saying it "provides false hope to patients and their families, who will assume they will have access to investigational therapies even though the bill does nothing to require manufacturers to provide these therapies to the patient." The American Cancer Society Cancer Action Network also opposes the bill. The group's president, Chris Hansen, said he believed the FDA should stay involved when patients try experimental drugs. “The FDA would not have the opportunity, as they currently do, to provide consultation on dosing, route of administration, dosing schedule and other important safety measures which they are uniquely positioned to understand," he said. The Senate passed a version of the bill unanimously last year, but the House version would need to go back to the Senate for another vote.
Former FDA commissioner says he’s opposed to Right to Try. Dr. Robert Califf, who was FDA commissioner during the final year of former President Barack Obama’s presidency, took to Twitter this morning to say he was worried by what he saw in the bill and noted that 90 percent of drugs under trial do not make it past the first stage of experimentation. “Critically ill patients are vulnerable,” he said. “It’s critical that if this bill goes through, there is a process for consent to experimentation. Even then extra care is required to make sure desperate people and families understand.” He noted that a doctor’s job was not to harm and that evidence about medicines’ efficacy can inform future generations. He continued: “Who will pay? if this opens up a ‘cash and carry’ business for these patients it will recapitulate previous ‘snake oil’ experiences in the U.S.”
Obamacare plays a part in Pennsylvania special election today. Obamacare may play a big part in the special election in Pennsylvania on Tuesday in the race between Republican Rick Saccone and Democrat Conor Lamb. The Western Pennsylvania suburban district has become well known for the presence of University of Pittsburgh Medical Center, which is a major employer there and a dominant network of hospitals. The hospital network’s chief medical officer, Steve Shapiro, told the Washington Post in June 2017 that a Senate Obamacare repeal and replace bill would take a toll on hospitals and would increase the amount of bad debt they would take on because patients wouldn’t be able to pay their bills or would lack insurance. Lamb said on his website that he believes the Affordable Care Act “has flaws, but it has provided affordable coverage to more than a million Pennsylvanians who were previously uninsured.” Saccone, meanwhile, says he wants to repeal the law. “Under Obamacare, health insurance has become unaffordable,” his website said. “Rick Saccone will utilize free-market principles to fix our healthcare crisis.” A poll from Monmouth University on Monday showed Lamb ahead of Saccone by 6 percentage points. The district supported President Trump by 20 points. The election is to replace Rep. Tim Murphy, R-Pa., who resigned last year after a scandal in which he had an extramarital affair and wanted his mistress to get an abortion during a pregnancy scare.
Trump’s moves to lower drug prices miss the mark, critics say. Several experts and advocacy groups say policies in the administration’s latest budget proposal don’t tackle the biggest driver of high prices: Nothing prevents a drugmaker from setting a price at whatever level it wants. “I don’t see much in their budget that is really directed towards high drug costs,” said Gerard Anderson, a professor at the Johns Hopkins Bloomberg School of Public Health. The budget includes 16 policies aimed at easing drug prices, primarily through lowering costs for seniors on Medicare and boosting competition through generic drugs. Advocates, Democrats, and experts praised the cost-sharing proposals in the budget, but were dismayed that Azar and Congress aren’t doing more to lower the list price. “I think the main takeaway is you can’t really deal with this without touching the manufacturers. They don’t touch the manufacturers in any way,” said Sen. Ron Wyden, D-Ore. HHS spokeswoman Caitlin Oakley told the Washington Examiner that “all options are on the table” but declined to elaborate on new policies that the administration may propose.
Premera credits tax law for its decision to stay in Obamacare. Health insurer Premera said it remains "committed" to selling Obamacare plans in Alaska and Washington, and is crediting a cash windfall it received under the Republican-backed tax law for its decision. The company, which is a subsidiary of Blue Cross Blue Shield, announced Monday that it was investing $250 million over five years into the states to help stabilize the exchanges. It vowed as well to use its tax gains to improve access to medical care in rural areas and to fund $40 million in behavioral health services, including addiction treatment and in addressing homelessness. “This refund has given us an unexpected opportunity to reach beyond our own company to further address the critical healthcare needs of the communities where we live and work,” said Jeff Roe, president and CEO of the company.
Senators push back on attack on Obamacare bills. A supporter of two Obamacare stabilization bills cited a new analysis showing premiums will decrease due to the legislation amid attacks from outside groups that call the bills “bailouts.” Sen. Lamar Alexander, R-Tenn., pointed Monday to a new analysis from the consulting firm Oliver Wyman showing the two bills lower premiums by more than 40 percent on the individual market, which is used by people who don’t have insurance through the government or a job and includes Obamacare’s insurance exchanges. Alexander also bristled at the notion the two bills are a “bailout” for insurers, an attack leveled by outside conservative groups Monday. “I can assure you that President Trump is not about to support anything that is a bailout for insurance companies, nor will I, nor will Sen. Murray,” Alexander said, referring to Sen. Patty Murray, D-Wash., who is a co-sponsor with him on a bill that would fund cost-sharing reduction payments for two years in exchange for giving states more latitude to waive Obamacare regulations.
Federal judge dismisses Massachusetts lawsuit on birth control. U.S. District Judge Nathaniel Gorton on Monday dismissed a lawsuit by Massachusetts Attorney General Maura Healey requesting to block birth control rules set by the Trump administration. The rules give employers religious and moral exemptions to providing a full range of birth control to their workers with no co-pay. In his ruling, Gorton noted that Massachusetts passed a law closing the exemptions, and so he questioned whether female employees in the commonwealth would be affected. Similar lawsuits occurred in California and Pennsylvania, where judges issued preliminary injunctions in December.
Centene invests in pharmacy benefits manager RxAdvance. Centene announced its plans to invest in pharmacy benefits manager RxAdvance Tuesday, becoming the latest insurer to mix drug and medical plans for customers with the stated intent to reduce costs. "Centene has established a transformative partnership with RxAdvance to create its next generation pharmacy management solution," said Michael Neidorff, Centene’s chairman and CEO. "RxAdvance's transparency, disruptive technology, and unique approach to partnership will help us further improve quality health outcomes for our members and other customers, while managing healthcare costs." Ravi Ika, the founder of RxAdvance, will continue as CEO and John Sculley, former CEO of Apple, will remain as chairman and chief marketing officer.
MedPageToday Mental Health plays role in long-term teen opioid use
CNN World Health Organization gets ready for ‘disease X’
STAT News From app to drug store, digital health is redefining pharma’s pipeline
Politico Wendy Davis leaves door open for Planned Parenthood gig
Washington Post Patients mobilize to take legal action against fertility clinics with malfunctions
New York Times Congress quashed research on gun violence, since then 600,000 people have been shot
Health Affairs Tennessee insurance executive pleads guilty to fraudulent sales of association plans and limited coverage products
TUESDAY | March 13
March 13-15. Miami. Barclays Global Healthcare Conference. Details.
House vote expected on Right to Try bill.
2 p.m. 1789 Massachusetts Ave. NW. AEI event on “The Numbers Behind the Opioid Crisis”: Remarks from Sen. Mike Lee, R-Utah. Details.
2:30 p.m. Dirksen 628. Senate Indian Affairs Committee hearing on opioids. Details.
THURSDAY | March 15
10 a.m. 2362-C Rayburn. House Appropriations subcommittee hearing with Health and Human Services Secretary Alex Azar. Details.
10 a.m. 430 Dirksen. Senate Health, Education, Labor and Pensions Committee hearing on 340 B drug discount program. Details.