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Four big questions about Trump’s drug price plan. Healthcare analysts and industry groups still don’t know what to expect from the Trump administration’s plan to combat high drug prices, a week after the president announced what he deemed the “most sweeping action in history to lower the price of prescription drugs.” Trump’s blueprint laid out a series of proposals, but details for several are sparse, and no concrete regulations have been proposed yet. Here are the four biggest questions surrounding the plan:

1. Will getting rid of rebates lead to lower prices? Drugmakers and middlemen called pharmacy benefit managers currently negotiate over rebates to drugs’ list prices, but critics say that not enough of the rebates are not being passed onto customers. So HHS Secretary Alex Azar has suggested a move to fixed price discounts, which reduce the list price by a certain amount, either through a flat fee or a percentage. But competition can drive prices down and sometimes it can drive prices up “because you don’t want to make any less than what the guy across the street does,” said Kelly Brantley, vice president of health research firm Avalere.
2. Which drugs will move from Part B to Part D? This part of the blueprint drew the sharpest rebuke from the pharmaceutical industry, but there are many unanswered questions on how it would be applied. Medicare Part D is the program’s prescription drug plan. PBMs and insurers represent seniors and negotiate with drugmakers for rebates. The plan calls for moving some drugs from Part B to Part D, with the hopes that private plans could negotiate with drugmakers for lower prices. But the administration hasn’t given any details on how many or which drugs could be shifted.
3. Will Trump’s plan give lagging efforts in Congress a boost? Most of the blueprint can be handled through administrative actions, bypassing the need for congressional action. That may be for the best, as drug price bills haven’t had much success in Congress lately. But after Trump’s speech, some stalled efforts got a shot in the arm. For instance, House Speaker Paul Ryan said at an event last week that there is momentum for the Creates Act, which aims to clamp down on drug makers that block generic competition. Ryan said committees are in the work on a compromise version of the bipartisan bill, which hasn’t advanced in either chamber.
4. Coming soon to a TV ad near you: list prices? The blueprint includes a proposal to require drugmakers to include the list price for any drug in any direct-to-consumer ad. The proposal has created a host of questions for the Food and Drug Administration, including whether it legally can mandate the requirement to whether it would have any effect on prices. The U.S. is the only country in the world that allows TV advertising for drugs. The FDA currently goes after drug ads that are misleading or gloss over important details about side effects. But it does not require companies to add the list price.

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Pence calls Title X rule ‘victory for the sanctity of life.’ Vice President Mike Pence praised the proposal the Trump administration made to cut off federal family planning funds from organizations that are housed in the same buildings as those that provide abortions or whose doctors and nurses talk to patients about abortion. The rule takes direct aim at Planned Parenthood, an organization Pence is opposed to. In a statement issued Monday, Pence called the proposal a “victory for the sanctity of life and for the cause of government transparency.” “The historic proposal corrects decades of bad policy that stretched beyond the statutory intent of Title X and allowed tax dollars to subsidize institutions that perform abortions,” he said. “The forthcoming proposed rule restores policy previously upheld by the Supreme Court that would ensure that taxpayers do not indirectly fund abortions. This preserves the conscience rights of millions of Americans while maintaining Title X services for women, adolescents and men.”

Analysis: Benefits from part of Trump’s drug plan could vary widely for seniors. Some seniors may have to pay more for cancer drugs under a major part of President Trump’s plan to lower high drug prices. An analysis from the consulting firm Avalere Health released Monday finds that benefits from transitioning how certain drugs are covered under Medicare could vary widely among seniors. Trump’s drug blueprint would move some drugs covered under Medicare Part B to Part D. Part B reimburses doctors for drugs administered in the doctor’s office, such as vaccines or chemotherapy drugs. Part D is Medicare’s prescription drug plan that covers drugs that beneficiaries buy at a pharmacy. Private vendors negotiate for lower prices on Medicare Part D, and the goal is to move some drugs from Part B where there is no negotiation. However, Avalere found that out-of-pocket costs for new cancer drugs could vary widely from Part B to Part D because of supplemental health coverage and differing benefits.

Experimental Ebola vaccines arrive in Congo. Thousands of experimental vaccines have arrived in the Democratic Republic of Congo, where health workers are preparing to use them among patients who have had some contact with people infected with Ebola. More than 7,500 doses of the vaccine, called rVSV-ZEBOV, arrived Monday in an area of the Congo known as the northwestern Equator Province in Congo, where 26 people have died and least 46 more are suspected to have been infected with Ebola. The virus, which is deadly when left untreated, is spread through direct contact with an infected person. Most cases are in Bikoro, a remote rural town, though four cases have been confirmed in the city of Mbandaka, which has 1.2 million people. Last week the World Health Organization called the spread to the larger city “concerning” because traveling from Bikoro to Mbandaka is difficult, and the latest cases could indicate that the virus is spreading faster than suspected. But on Friday the WHO said the outbreak does not meet the conditions for a public health emergency declaration yet.

Oliver North says Ritalin and TV may cause shootings. Oliver North, the incoming president of the National Rifle Association, said Sunday that school shootings are “a symptom” of broader problems including violence in media and prescription drugs. “The disease in this case isn’t the Second Amendment,” North said on “Fox News Sunday.” “The disease is youngsters who are steeped in a culture of violence. They have been drugged in many cases. Nearly all of these perpetrators are male and they are young teenagers in most cases,” he said. “And they have come through a culture where violence is commonplace. All you need to do is turn on the TV, go to the movies. If you look at what has happened to the young people, many of these young boys have been on Ritalin since they were in kindergarten.” North spoke following the fatal shooting of 10 people at a Santa Fe, Texas, high school on Friday. Suspected shooter Dimitrios Pagourtzis, 17, was a student.

Melania Trump released from hospital five days after kidney procedure. First lady Melania Trump left the hospital Saturday morning, five days after being treated for a benign kidney condition. “The first lady returned home to the White House this morning. She is resting comfortably and remains in high spirits,” Stephanie Grisham, the first lady’s communications director, said in a statement. Trump underwent an embolization procedure on Monday at Walter Reed National Military Medical Center in Bethesda, Md. Patients who undergo such a procedure are typically discharged the same day. The White House released little information regarding Trump’s extended stay, but did note that “the surgery was successful and did not result in any complications.”

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