Subject: POLITICO Pulse, presented by PhRMA: Drug price ballot fight looms in California — Sanders wonders why cigarettes are legal — Could Medicaid expansion help stop rising suicide rates?
From: POLITICO Pulse <[email-masked]>
To: <[email-masked]>
Date: Mon, 25 Apr 2016 08:01:48 -0600

By Dan Diamond | 04/25/2016 10:00 AM EDT

An FDA advisory panel holds a much-watched vote on a muscular-dystrophy drug, and one expert argues that Medicaid expansion could help slow America's rising suicide rate. But first: Concerning state reports on ACA exchange enrollment.

1M-PLUS EXCHANGE CUSTOMERS MAY HAVE QUIT SINCE FEBRUARY - That's according to Jed Graham of Investor's Business Daily, who notes evidence of significant attrition on the exchanges. Why? Blame the shuttering of co-ops, among other factors. More from Graham: http://go.politicoemail.com/?qs=7541fb2b896c7cedee9c267e27aa47982e4d4234299d36156b21a881c85e7429 

DRUGMAKERS ARE SPENDING BIG TO FIGHT CALIF. PRICE CONTROL REFERENDUM - The biggest near-term threat to the drug industry? Not Donald Trump or Hillary Clinton's pledges to introduce Medicare price negotiation - but a California ballot initiative that would test a version of that idea in the nation's most populous state.

That ballot initiative "is a grenade being rolled into the conversation, and it is being taken very seriously," a Republican drug lobbyist in Washington, D.C, tells Pro's Nancy Cook and Sarah Karlin-Smith. More for Pros: http://go.politicoemail.com/?qs=7541fb2b896c7ced009995ed12bbcde61e6e91b70e31a676829ed1bc5e736165

30 PERCENT - That's the likelihood of Congress passing a proposal in the next four years to require manufacturers to pay a rebate on drugs covered through Medicare Part D for low-income beneficiaries, according to Morningstar health care analysts. The analysts also break down how other legislative proposals could affect the health care industry: http://go.politicoemail.com/?qs=7541fb2b896c7ced0b234959545b84e5abbc3c3b735c3475d93bfd2993c6c790

GOOD MORNING, IT'S MONDAY PULSE - Where we're still wondering how Jon Snow will bounce back from ICD-10 code X99.1XXD. Tips (but no spoilers) to [email-masked] or @ddiamond on Twitter.

AN FDA PANEL TODAY WILL DECIDE THE FUTURE OF SAREPTA - An independent panel of experts will vote on whether the company's new muscular-dystrophy drug should be approved. The recommendations aren't binding - but the FDA normally goes along with its advisory panel's guidance.

Many patients with Duchenne muscular dystrophy and their families have pinned their hopes on the drug, eteplirsen, and it's seen as a make-or-break moment for Sarepta, too. However, FDA staff reviewers blasted data on the drug's effectiveness last week.

- What's Duchenne muscular dystrophy? The rare muscle-wasting condition affects about 20,000 boys in the United States every year, and it's devastating; most patients afflicted with it need a wheelchair by age 12 and die by their mid-30s.

- How patients are trying to sway regulators. Writing at Wonkblog, Carolyn Johnson examines how the fight over Sarepta is being shaped by grass-roots lobbying from families. http://go.politicoemail.com/?qs=7541fb2b896c7cede4bfb80b4acb794aaa73de36f3894f8828f69cde1137399e

- Watch the webcast. It's scheduled to run from 8 a.m. to 6:30 p.m., with the panel expected to begin hearing grueling testimony from patients and families around 2:30 p.m. and begin voting on a series of questions around 4:30 p.m. Live stream here: http://go.politicoemail.com/?qs=7541fb2b896c7ced25d3b1f46cd2b1ff18b469120ae2b0b2df0bcaee2531352c

- Expected to attend: Rick Santorum said he'll join advocates in a sign of support; Massachusetts Gov. Charlie Baker is sending his deputy chief of staff (Sarepta is located in Cambridge); and top FDA officials Janet Woodcock and Bob Temple are scheduled to present, which is an unusual move but a show of how the agency is viewing the meeting.

BERNIE SANDERS SPEAKS OUT ON CIGARETTES - Sanders last week disagreed with Hillary Clinton on soda taxes - saying they hurt the poor - but he suggested on Sunday that cigarette taxes don't go far enough.

"Cigarettes are causing cancer, obviously, and a dozen other diseases," Sanders said on "Meet the Press" yesterday. "And there is almost the question as to why it remains a legal product in this country." 

 - And if he loses the nomination to Clinton? On multiple shows, Sanders was pressed on what he would ask Clinton to focus on, if she's the Democratic nominee. "A program that makes health care for all in this country a right within the next several years," was part of his response.

- But Bernie's single-payer quest may not be over. "Sanders should be in a position to do something about this next year, even if he is not president," Jonathan Cohn writes. "He'd be occupying one of the safest seats in Congress and, for the first time in his career, he would have the visibility and support to seriously influence the congressional agenda." 

That doesn't mean Sanders would get "Medicare for all" enacted, but he could be in a position to fill in holes in the Affordable Care Act, or create building blocks for universal coverage. More from Cohn: http://go.politicoemail.com/?qs=7541fb2b896c7ced05c1c5f1a9dc10ed0c00f10a31f606c81bb51d48b46158d7 

COULD MEDICAID EXPANSION HELP STOP RISING SUICIDE RATES? - University of Chicago professor Harold Pollack thinks so, and he argues that last week's CDC report on the rising U.S. suicide rate is another reason the remaining 19 holdout states should expand.

"There is good reason to believe that these ungenerous states are harming people's mental health," Pollack writes, citing evidence from the Oregon Health Insurance Experiment on how expanding Medicaid coverage appeared to improve personal finances and lower mental distress. http://go.politicoemail.com/?qs=7541fb2b896c7ced1544aa5d33a0f7e79beea86c308f7b93889b9b6ab68520e9

** A message from PhRMA: Biopharmaceutical intellectual property (IP) protections, such as patents, provide the incentives that spur research and development and lead to lifesaving treatments and cures. Learn more here about the outcome of strong IP policies. **

PRINCE'S DEATH COULD SPARK OPIOID CONVERSATION - We won't know the results of Prince's autopsy for a few weeks, and we don't want to make too much of a TMZ report Friday that the rock star might have overdosed a few days before his death on painkillers - presumably prescribed for his chronic hip pain. 

But if opioids did play some role, expect Prince to become the high-profile face of the growing epidemic, amid the debate over how state and federal policies can curb overprescribing and a partisan fight on the Hill over resources and funding to combat and treat addiction.

- Blaming the victims? Nearly 40 percent of Americans blame opioid users for the nation's opioid crisis, according to a recent Harvard School of Public Health/Stat News poll. Almost as many blame doctors. 

'60 MINUTES' LOOKS AT OHIO's HEROIN EPIDEMIC - The state's struggling to cope with a spreading problem, and lawmakers are trying to strike a balance between prosecution and rehabilitation, according to a "60 Minutes" feature aired on Sunday night. "We're not going to arrest our way out of this problem," said Ohio attorney general Mike DeWine. More: http://go.politicoemail.com/?qs=7541fb2b896c7ced9dd64c08a5b34000eff5774604a1e160ac9a5a3ef67ea5e9 

 - Heroin kills at least 23 Ohioans per week. "60 Minutes" also cited a recent University of Cincinnati study that found one in five Ohio residents knew someone who is struggling with heroin. 

STATE WEEK: CALIFORNIA TWEAKS COVERAGE BILL - California lawmakers revised legislation to provide undocumented immigrants with coverage, and Minnesota is weighing a new exchange strategy. More in State Week: http://go.politicoemail.com/?qs=7541fb2b896c7ced0510f53f8484d170a65aa12273a2d3fd0fb34160e20729fd

CAN THERANOS SURVIVE? - The New York Times has a story this morning on whether the embattled blood-testing company has a future. Theranos has been dogged by scrutiny since the Wall Street Journal first raised questions about the tests' quality and accuracy last year.

The consensus among experts is bleak, but if the technology works, "I don't think they're beyond salvage, beyond redemption," said industry consultant Lakshman Ramamurthy. More: http://go.politicoemail.com/?qs=7541fb2b896c7ceda5fa39c8a308484b2257d15d754a90ae6b2498fb279f466b

- Unhappy with the Times story: The reporter who's led WSJ's Theranos investigation. The Times "erred calling my coverage 'scathing,'" the WSJ's John Carreyrou tweeted. "It should've said 'accurate,' 'life-saving,' or 'a public service.'"

HARVARD's $21 MILLION COMMITMENT TO HAPPINESS - China's Lee Kum Ke family officially announced a $21 million-plus gift to establish a new center for health and happiness at Harvard's School for Public Health. (Which probably boosted the happiness of a few people at Harvard.)

The center's goal: To uncover evidence on how personal behaviors, health care and a wide range of policies can influence happiness. More: http://go.politicoemail.com/?qs=7541fb2b896c7cedcb070797f16ca6ec1f1802f8847bbdf5300163196345806b 

OUT TODAY FROM CSRxP: POLICY PLAN TO CURB DRUG PRICES - The Campaign for Sustainable Rx Pricing this morning will release a new plan on using market-based policy solutions to curb rising drug prices.

What's in the roadmap: A focus on transparency, competition and value, a coalition spokesperson tells PULSE.

WHY 'FEEL THE BURN' ADS ARE NOW DOTTING D.C.'s TRANSIT SYSTEM - They're from the AIDS Healthcare Foundation and designed to raise awareness of HIV/AIDS testing, Kerry Flynn writes. The ads intentionally mimic Bernie Sanders' campaign slogan. http://go.politicoemail.com/?qs=7541fb2b896c7cede2d8785f4e7b7d5d81329e59b04ce4b4c36bc123c7f1cc0a 

SUCH GREAT HEIGHTS - Oxford economist Max Roser's latest update to his popular World in Data interactive website: an entry on human height, which has increased as nutrition has improved. See the entry and play with the data here: http://go.politicoemail.com/?qs=7541fb2b896c7ced342acd87fb9da6141063927ff175a0a7130ecc746e719b43

The average height of a U.S. man born in ... 

1900: 5 feet, 6.9 inches
1940: 5 feet, 9.3 inches
1980: 5 feet, 10.5 inches

ON TAP THIS WEEK - HHS Secretary Sylvia Mathews Burwell heads to Puerto Rico on Tuesday and Wednesday, in a high-profile effort to highlight the effects of Zika virus. The Senate Finance Committee on Thursday will hold a hearing on mental health.

IN YOUR EARBUDS THIS WEEK - Stay tuned.

PRO'S GROWING FAMILY - Friend and colleague Brett Norman, wife Kate Dailey and their son Everett welcomed Baby Boy Norman on Saturday night. "His due date was last Wednesday - Hitler's birthday - but he decided to come on Shakespeare's instead," Brett emails, "showing a very advanced aesthetic and political sense for a fetus." 

WHAT WE'RE READING 

Researchers are running a clinical trial for a "fountain of youth" drug, and would-be volunteers are begging to get in: http://go.politicoemail.com/?qs=7541fb2b896c7ced1dc31b77d124be8d74d1c6cc6daaafe9c45d2b42ca7fdfdf

The diseases we only get when we believe in them: The Atlantic's Julie Beck on maladies of the mind and culture. http://go.politicoemail.com/?qs=7541fb2b896c7ced62deb2001231c99dbcc99057e1855b1443baf5cd64f37878

Will CMS's planned star ratings actually be helpful, or will they become yet another data measure cluttering our decisions? Ashish Jha takes a look: http://go.politicoemail.com/?qs=7541fb2b896c7cedf22030e3bf710ef1e1c626687d0ab9840cb3ee31110f0a8d

Writing at Forbes, Dave Chase details the challenges facing health plans' current business model: http://go.politicoemail.com/?qs=7541fb2b896c7cedea281da864b809430787c9bedfc03655e7aa330d37564cd5

Dr. Paul Farmer on lessons learned from the Ebola outbreak - and the need to build health systems overseas. http://go.politicoemail.com/?qs=7541fb2b896c7cedaf22680f6d1958c316291693faa5a8ec67a280b4bcd61f44

Off-topic: The New York Times has an in-depth look at the rise of POLITICO Europe, which marked its one-year anniversary last week: http://go.politicoemail.com/?qs=7541fb2b896c7ced767b1076baca5ec45785d9bd765fcfa3a786bfbca22d6e50

** A message from PhRMA: Take a moment to consider the impact that strong and robust IP policies have on our daily lives and on the country. Due to the complexity of developing a medicine, strong IP protections are necessary to ensure that innovative biopharmaceutical companies are able to secure resources for future investments in research, giving hope to patients who await tomorrow's medicines. Learn more here about the outcome of strong IP policies. **

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