Atul Gawande, surgeon and storyteller, on health care’s ‘dramatic transformation’

first_imgWhy is there this journalistic void when you’ve shown that there’s wild interest in this topic? Well, I hope STAT can answer that question. I do have a lucky vantage point being a practicing clinician, having worked in politics and policy for a while, and being a public health professor. But other writers have dug in on some of these issues in a pretty spectacular way. Ultimately, what you want to do is park yourself in a clinic or in a hospital long enough to start seeing what really happens, and then trace the threads down.Are you ever worried about being scooped on these stories? No. You know, I wrote about McAllen, Texas — the most expensive county for Medicare in the country — and it seemed like an obvious thing to go and talk to people and interview them. Then it was an obvious thing to go back six years later and say, “What happened?” I told people the idea, I told people this is what I’m doing, I wasn’t hiding it, and I never worried I was ever going to get scooped.advertisement HealthAtul Gawande, surgeon and storyteller, on health care’s ‘dramatic transformation’ Dr. Atul Gawande at Ariadne Labs in Boston. Aram Boghosian for STAT Rick Berke By Rick Berke Nov. 11, 2015 Reprints I arrived in Boston in the snow-sieged winter as employee No. 1 on a venture, as executive editor, to create STAT. After decades as a journalist in Washington and New York, I knew little of the thriving health, medicine, and life sciences ecosystem in Boston. I knew one name, though: Dr. Atul Gawande.If anyone could help me figure out how to make STAT important and urgent, it would be the famed surgeon, journalist, and public health researcher at Brigham and Women’s Hospital and Harvard Medical School. We met at Ariadne Labs, where he is executive director. The conversation that follows has been edited and condensed.What’s the biggest overlooked story today in health and medicine? There’s a lot of coverage about what goes on inside the Beltway, a lot of coverage around drug pricing, and things like that. But the biggest story that’s going on is what it’s like to actually try to get health care. The American health care system is going from being designed to deliver on pills and procedures to being designed to deliver on outcomes. That is a dramatic transformation, and we don’t know how to do it.advertisement About the Author Reprintscenter_img @rickberke Tags drug priceshealth careMartin ShkrelipharmaceuticalsPresidential campaign [email protected] You’re no stranger to politics, having worked on health care policy for Bill Clinton. How do you see health-related issues playing out in this year’s presidential campaign? In general this year, health care is not a major player in the presidential campaign. It’s not nearly as big issue as stagnating wages for the middle class and income inequality, or the dysfunction of government — and that’s not a bad thing. I’m very glad to see other issues like the delivery of health care, improving our management of end-of-life care, and things like that have been kept off the table as major partisan political issues. It made me really angry when CNN injected into the Republican debate, asking: “What do you think about vaccines?” There’s no good direction where those answers could go from a public health point of view.Has any good come from the emergence of Martin Shkreli and his tactics of raising drug prices?Yeah, I think that’s an example of digging in deeply enough to actually see how the mechanics of drug pricing really work. There’s the Martin Shkreli version of the story, which is, as far as what I can see, pure profiteering. But then there is the whole business of pricing a drug that is completely lifesaving — and this is not a competitive marketplace. So, how does it work? I’d love to know much more about it.What’s harder, being a surgeon or being a writer?By far, the least stressful day of my week is the day I’m in the operating room. There are no phone calls, no email, you’re focused in one direction, and once you start, you have to finish. But when it comes to writing, any number of things can go wrong, and it can be never-ending. With the kind of long-form journalism that I do, I’m also trying to make even the structure and form feel new every time. So, I can’t fall back into a formula — whereas in surgery, you’re always trying to fall back into a formula, it’s exactly what you want to achieve each time.You write both magazine articles and academic papers. How does the editing process compare?The editing process in journalism, I think, sometimes offers better protection for the quality of the ideas and writing than our peer review process. At The New Yorker, they will not only look to see if I have references and sources for everything I say, they will look up the references and call the sources. And they will also search themselves to make sure I haven’t cherry-picked the information. It’s a much more rigorous process than the one I go through with my scientific work.That’s fascinating, but it’s also The New Yorker.Yes, The New Yorker’s fact-checking process is legendary. They even fact-check the jokes that I write. In a piece I wrote about childbirth, I told a joke that Bill Cosby had said. They fact-checked the joke, and it turned out that Carol Burnett had told it first. And so they called up Carol Burnett, who picked up the phone and was like, “Bill Cosby has been telling that joke wrong for 20 years. This is the way I said the joke.”Did you put all that in the piece?No, it’s too complicated. I just put in Carol Burnett’s properly told joke. Co-founder & Executive Editorlast_img read more

Harvard Medical School eases up on contentious ethics rule

first_img By Melissa Bailey Nov. 30, 2015 Reprints Tags ethicsHarvard Medical Schoolresearch HealthHarvard Medical School eases up on contentious ethics rule The Harvard Medical School has changed its ethics rule governing how much of an equity stake its faculty can have in certain companies. David L Ryan/The Boston Globe Harvard Medical School has created more wiggle room in one of its conflict-of-interest rules, after complaints from professors that the policy was hampering them from turning lab discoveries into treatments that could help people.The change, announced Nov. 20, affects medical school faculty who are conducting basic science experiments — fundamental research in test tubes and animals, not in human beings. It’s the first change to emerge from a review of the school’s conflict-of-interest rules that began in January.The ethics rules, put in place in 1990, included a measure barring faculty who own equity in a private company from receiving grants, lab materials, or other contributions from that company. The same prohibition held for faculty with over $30,000 in equity in a publicly traded company. advertisement Now Harvard Medical School Dean Jeffrey Flier has agreed to offer more wiggle room by letting faculty petition the school’s ethics committee for an exception to the rule. If they can show the benefits of the research outweigh the potential risks of conflict — and put in safeguards to manage that potential conflict — they’ll be allowed to accept contributions from a company in which they have equity. The move brings Harvard Medical School “in line with what leading organizations in academic medicine have recommended,” including the Association of American Medical Colleges and the Institute of Medicine, said Campbell.“Nobody wants conflict-of-interest rules to stop basic research if the conflict can be managed,” he said.The school also lifted the $30,000 cap for publicly traded companies, saying instead that faculty who accept sponsored research from a company cannot own equity amounting to over 1 percent of that company’s value.Dr. Donald Ingber, who directs Harvard’s Wyss Institute for Biologically Inspired Engineering, called the changes “subtle” but “a move in the right direction.” “Whenever there’s greater flexibility, it increases the likelihood of greater translation” of discoveries into clinical applications, he said, which is the goal of the Wyss. “The higher the wall, the more difficult it is to jump over that wall,” he said. “This’ll make it a little bit easier to collaborate.”Dr. Robert Mayer, the Harvard Medical School professor who chairs the committee that is reexamining the conflict-of-interest rules, said his group recommended this change after reviewing 1,600 faculty surveys, conducting a literature review, comparing policies at peer institutions, and hearing testimony from faculty. The committee is still reviewing another rule related to clinical trials and expects to make final recommendations by April. Until two weeks ago, implementation of that policy was among the strictest in the nation because it did not allow faculty to routinely petition for exceptions, according to Eric Campbell, a Harvard Medical School sociologist who studies these policies. The rule affects not just professors who work directly for the school, but 12,000 faculty across Harvard’s affiliated clinical sites, including five major academic teaching hospitals. Harvard came under pressure from faculty and some hospital administrators to change that policy amid a growing national debate about whether strict conflict-of-interest policies are holding back medical progress. The debate takes place against the backdrop of a changing medical landscape, where more professors are launching startups because government funding for research is harder to get and large drug companies have moved away from investing in early-stage research.advertisementlast_img read more

Newer $285 painkiller no better than older $3 treatment, studies say

first_img About the Author Reprints By Ed Silverman Dec. 14, 2015 Reprints Ed Silverman We should note that one study, which Pacira described as independent, was conducted by a physician who has done consulting work for Pacira, according to a government database, while Outpatient Surgery magazine in a story last summer noted ties between the drug firm and physicians who conducted research supporting Exparel.Jones wrote us  that this particular study and two others sent us were initiated by the researchers and were funded by the drug maker.Meanwhile, Pacira also explained that successfully administering Exparel requires repeated use, and as physicians eventually become more comfortable with using the treatment, they will achieve better patient outcomes.This line of argument is echoed by Wall Street analysts. “The difficulty Pacira has is that they have to train physicians on how to use it properly to be able to save money,” said Shibani Malhotra, who tracks Pacira and other drug makers for Nomura Securities.Nonetheless, some physicians said they are familiar with how to administer medications during procedures. Given the difference in cost, Dr. Matthew Austin, a coauthor of one recent prospective study comparing Exparel with the older treatment, said his institution, the Rothman Specialty Orthopaedic Hospital in Philadelphia, discontinued use. We should note that Austin also does consulting work for other device makers, according to the OpenPayments federal database.  Read more: FDA yanks Pacira letterLast fall, Pacira filed a lawsuit accusing the Food and Drug Administration of overstepping its authority to thwart inappropriate marketing. The lawsuit was a response to an FDA warning letter issued last year that alleged the company promoted Exparel for use in surgeries for which the drug was not approved. The FDA also argued Exparel should only be marketed for 24-hour pain relief, not 72 hours.The drug maker countered that the FDA incorrectly interpreted the product labeling, and restricted its free speech. Negotiations have been under way for several weeks and, recently, the FDA took the unusual step of removing the warning letter from its web site, suggesting to some legal experts that the agency may eventually allow Pacira to market the drug for longer pain relief. The agency would not discuss its move, citing litigation. A resolution to the closely watched skirmish may come before the end of the month.Meanwhile, Exparel has been widely debated in the orthopedic community, where dueling papers have been released over the past year discussing its effectiveness and value. The dispute has emerged amid an escalating national controversy over the rising cost of medicines and some surgeons point to Exparel as yet another example of prescription drug pricing run amok.Pacira maintains Exparel is worth the price, because the drug is more cost-effective than such expensive options as pain pumps that some surgeons increasingly rely on. And the company cited several studies to bolster its argument, including one that found that 100 patients given the drug had significantly less pain, required fewer narcotics, and were discharged sooner than patients who received a nerve block.Dr. James Jones, senior vice president and chief medical officer at Pacira, acknowledged that Exparel is more expensive than standard bupivacaine, but he said that the older drug does not provide pain relief for as long. It also requires the use of still other treatments, sometimes narcotics, and often longer hospital stays. And these bring added costs, the company maintains. PharmalotNewer $285 painkiller no better than older $3 treatment, studies say Related: Gilead pricing for Sovaldi hepatitis C drug slammed by senators Tags ExparelFDAknee surgeryPacira Pharmaceuticalspainkiller “We’re not saying Exparel didn’t help the patient, and it appears to be a safe drug to use,” said Dr. Rajesh Jain, an orthopedic surgeon at Virtua Health System in Voorhees, N.J., who was a coauthor of one paper. “The big issue is if it’s worth the cost. We didn’t find it to be any more effective, so there’s no reason to spend more on an expensive drug.” (Here is the other paper).This is not the only controversy surrounding Exparel and its manufacturer, Pacira Pharmaceuticals.advertisement The price of a painkiller used in knee surgery is getting some doctors bent out of shape.In recent weeks, two different studies have concluded that the medicine, an analgesic called Exparel, is no more effective than an older form of the treatment. Exparel combines bupivacaine, an injectable drug that has been a standard of care, with a proprietary technique for administering pain relief.However, the wholesale price for a vial of Exparel costs about $285 versus about $3 for bupivacaine. As a result, the study authors — whose papers were released last month at the annual meeting of the American Association of Hip and Knee Surgeons — maintain the difference in price can’t be justified. Some practices have discontinued using the drug.advertisement Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. [email protected] @Pharmalot Exparel is a painkiller used for knee surgery. APStocklast_img read more

Do antioxidants promote health — or fuel cancer?

first_imgThat said, a handful of studies have found that antioxidants inhibit melanoma and other malignant cells growing in lab dishes. Maybe different antioxidants (beta-carotene; vitamins A, C, E; others) act differently and are less harmful, or even beneficial. Or maybe studies in lab dishes, when they contradict human studies, aren’t relevant.You might think that while antioxidants are a bad idea for cancer patients, they should help healthy people by preventing DNA damage that can trigger malignancies in the first place. Unfortunately, cancer turns out to be more prevalent than once thought: Many of us have undiagnosed micromalignancies that the immune system and other defenses keep in check. As a result, megadoses of antioxidants — in pills, not pomegranates — might be risky for everyone.The Takeaway: “There is no credible evidence that antioxidant supplementation positively affects health in general, or cancer risk in particular,” said epidemiologist Dr. Michael Goodman of Emory University School of Public Health. And there’s some evidence that taking antioxidant supplements can be harmful, “particularly at high doses.”This article was originally published on Nov. 5, 2015. @sxbegle By Sharon Begley Feb. 14, 2016 Reprints Tags antioxidantscancerdietary supplements In the latest experiment, scientists led by Martin Bergo of Sweden’s University of Gothenburg exposed melanoma cells growing in a lab dish to two kinds of antioxidants, including a cousin of vitamin E, at doses comparable to those in supplements. The cancer cells again became more invasive and migrated more, the scientists reported in Science Translational Medicine.Second Take: Here at STAT, we generally treat studies in lab animals as a great way to generate hypotheses about what might be true in humans — and an equally great way to be misled about that. But in this case, the mice results align with a growing body of evidence about antioxidants and cancer, including clinical trials. Way back in 1994, a large trial reported that supplement-size doses of beta carotene increased the risk of lung cancer in male smokers by 18 percent. One interpretation: Smoking triggered initially-undetectable cancer; antioxidants kept the body’s defenses from fighting it; the cancer grew enough to be detected. Two years later, another trial found that megadoses of beta-carotene increased lung cancer risk in smokers and people exposed to asbestos — populations likely to have incipient, if undiagnosed, lung tumors. And a 2011 study of 35,500 men found that large doses of vitamin E increased the risk of prostate cancer by 17 percent.advertisement Sharon Begley [email protected] center_img About the Author Reprints Senior Writer, Science and Discovery (1956-2021) Sharon covered science and discovery. Genetically engineered tomatoes, designed to contain very high levels of antioxidants called anthocyanins. John Innes Centre UK via Getty Images Gut Check is a periodic look at health claims made by studies and by newsmakers. We ask: Should we believe this?The Claim: Antioxidants make malignant melanoma cells more invasive, causing them to metastasize farther, faster.The Backstory: Antioxidants have become a multibillion-dollar business, sold as dietary supplements or added to foods such as juices and cereal. Their popularity is based on the claim that they protect cells from aging and help ward off cancer by mopping up “free radicals” — molecules that zip around harming whatever they encounter, including DNA and cell denizens called mitochondria.Naturally, things are more complicated. Free radicals attack all kinds of cells — including cancer cells, said cancer biologist Zachary Schafer of the University of Notre Dame. So if antioxidants mop up free radicals, “that might help cancer cells,” he said, allowing them to proliferate and spread more easily. His research, using mice, has shown exactly that. So did a 2014 study, which found that antioxidants accelerated the spread of human lung cancer cells implanted in mice, partly by blocking a cancer-fighting gene called p53.advertisement Gut CheckDo antioxidants promote health — or fuel cancer? last_img read more

Yet another weight loss drug fizzles

first_img STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. GET STARTED By Meghana Keshavan Jan. 4, 2017 Reprints What is it? Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Meghana Keshavan Biotech Correspondent Meghana covers biotech and contributes to The Readout newsletter. When it comes to weight loss, Arena Pharmaceuticals is throwing in the towel.The small San Diego biotech company had once expected its anti-obesity drug, Belviq, to be a blockbuster — after all, more than one-third of Americans are obese. But the market wasn’t interested, and sales never lived up to expectations — leading the company to slash its employee count by 120, nearly three-quarters of its workforce. Biotech Kristoffer Tripplaar/Sipa/AP center_img What’s included? Log In | Learn More About the Author Reprints Yet another weight loss drug fizzles Unlock this article — plus daily coverage and analysis of the biotech sector — by subscribing to STAT+. First 30 days free. GET STARTED [email protected] @megkesh Tags pharmaceuticalsSTAT+last_img read more

Novartis and a former employee are cleared of exaggerating drug claims in Japan

first_img Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. What is it? Log In | Learn More @Pharmalot About the Author Reprints Novartis and a former employee are cleared of exaggerating drug claims in Japan What’s included? In a modest victory for Novartis, a Japanese court decided the drug maker and a former employee were not guilty of violating a law that bans fraudulent and exaggerated advertising claims in connection with a research paper about the Diovan heart drug. A Novartis spokesman confirmed the ruling.The decision stems from an episode in 2014 when the company was accused of altering data in a study in order to make the drug appear better than rival medicines. The research was conducted by several Japanese universities, some of which determined results were falsified. By Ed Silverman March 17, 2017 Reprints GET STARTEDcenter_img Pharmalot Columnist, Senior Writer Ed covers the pharmaceutical industry. Ed Silverman Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Georgios Kefalas/Keystone/AP Pharmalot Tags pharmaceuticalsSTAT+ STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. [email protected]om last_img read more

Tans — even from a new drug — aren’t the way to prevent skin cancer

first_img [email protected] June K. Robinson Sherry Pagoto Morne de Klerk/Getty Images [email protected] Related: Although lead scientist Dr. David Fisher said, “This is not a toy, it’s not a cosmetic,” the market for a tanning drug is huge. Tanning beds are a $2 billion a year industry, and the market for sunless tanning creams and sprays has reached $1 billion annually. First OpinionTans — even from a new drug — aren’t the way to prevent skin cancer Scientists have created a ‘sunless tanner’ drug that boosts melanin in skin Related: The media had fun reporting on a new tanning drug that causes the skin to darken in much the same way that the sun does. Headlines told us that “Scientists have created a safe sun-free tan,” proclaimed “Suntans for all,” and predicted “Tanning drug could prevent skin cancer.” The science is interesting. But what it means for sun-loving humans remains to be seen.Last month, a team of Boston-based researchers reported that applying a compound called topical salt-inducible kinase (SIK) inhibitor to skin cells stimulated them to produce melanin, the pigment that determines skin color and provides some protection against cancer-causing ultraviolet radiation. The team had previously used this technique to give mice a tan and now has successfully used it in human skin cells.This work may prove helpful for people born with little or no natural melanin, such as redheads, since melanin has a sun protection factor (SPF) of about 3 to 4. But a boost that small may not be meaningful for the rest of us. It also pales in comparison to current recommendations to use sunscreen with an SPF of 30 or higher.advertisement The origin of our national obsession with tanned skin is lost in the mists of time. Coco Chanel is rumored to have popularized the tan in the 1920s, shifting its association from outdoor labor to a lifestyle of wealth and leisure. It’s been nearly a century, and the nation’s love for the tan persists. Just visit any beach this summer. Or take a look at the tanning salons in every other strip mall. One study found that tanning salons actually outnumber McDonald’s in major U.S. cities.America’s obsession with the tan is enormously ironic. The desire of white Americans to be darker-skinned coincides with a long history of oppressing those who are naturally dark-skinned. African-Americans never once reaped the social benefits of Coco Chanel’s campaign. Even the word “tan” as a description of melanin-enhanced white skin is puzzling. The biologically identical melanin in African-American skin is referred to as “black.” At some point, we need to do some soul searching about what this desire to be tan really means.Researchers have a long way to go before a tanning drug hits the market. In the meantime, it’s important to keep in mind the escalating skin cancer epidemic, the dangers of tanning, and the fact that all skin colors are beautiful.Sherry Pagoto, Ph.D., is a professor of medicine at the University of Massachusetts Medical School in Worcester, Mass., and president-elect of the Society of Behavioral Medicine. She reports having performed a literature review for Johnson & Johnson regarding motivation to use sunscreen. June Robinson, M.D., is a dermatologist at Northwestern University Feinberg School of Medicine in Chicago. About the Authors Reprints Skin cancer from tanning beds costs US $343 million per year Fisher suggested combining the tanning drug with sunscreen. But the devil is in the details. For example, sunscreen should be applied every two hours whereas a tanning drug applied that often could create a pretty intense tan. By combining a tanning drug with sunscreen, it might be impossible to know if your tan appeared because of shoddy sunscreen application or the drug. After all, tans from the sun and the drug look identical.Contrary to popular belief, tanning from the sun is not a good way to protect against skin cancer. That’s because DNA is damaged by ultraviolet radiation in the process.In fact, ultraviolet radiation from the sun and from tanning beds is the No. 1 preventable risk factor for skin cancer, which affects more than 1 million Americans every year. Skin cancer is more common than breast, prostate, lung, and colon cancers combined. Melanoma is the most deadly form of skin cancer, killing nearly 10,000 Americans a year. Skin cancer is one of the few cancers that have been on the increase over the last few decades. Melanoma is twice as common today as it was in 1973, which points to environmental causes.Preventing skin cancer would save both lives and dollars, but that would require people to stop wanting to be tan. @DrSherryPagoto By Sherry Pagoto and June K. Robinson July 28, 2017 Reprints If people with little to no melanin were to use a tanning drug in addition to conscientious use of sunscreen and protective clothing, that could be a public health win. But we worry that people who routinely protect themselves from the sun might also buy into the idea that a chemical will help them tan — and the tan would protect them from skin cancer. That would be a public health loss if a false sense of security caused them to ease up on using sunscreen and wearing protective clothing, resulting in an unintended increase in skin cancer risk.advertisement Tags cancerdrug developmentwellnesslast_img read more

Cigna says it won’t cover OxyContin prescriptions through employer plans

first_img About the Author Reprints STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. What is it? Toby Talbot/AP The health insurer Cigna on Wednesday announced it will no longer cover OxyContin prescriptions for customers on its employer-based health plans, the second major announcement in two weeks from an industry group billed as an effort to slow the opioid epidemic.Cigna also announced its intent to reduce opioid use among its consumers by 25 percent by 2019. Insurance consumers who have started OxyContin use for cancer or hospice care are exempt from the policy change. @levfacher Unlock this article by subscribing to STAT+ and enjoy your first 30 days free! GET STARTED Pharma Washington Correspondent Lev Facher covers the politics of health and life sciences. Lev Fachercenter_img [email protected] Cigna says it won’t cover OxyContin prescriptions through employer plans Tags insuranceopioids Log In | Learn More GET STARTED Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. By Lev Facher Oct. 4, 2017 Reprints What’s included?last_img read more

Drug makers question idea to shake up how Medicare pays for certain drugs

first_img WASHINGTON — Drug manufacturers are pushing back against one of the administration’s major proposals to bring down drug prices: a proposal to shift chemotherapy drugs and others administered in the hospital into a different part of Medicare.The idea — which Health and Human Services Secretary Alex Azar first hinted at in his confirmation hearings and then proposed in the Trump administration’s fiscal year 2019 budget — would give insurance companies and pharmacy benefit managers new power to negotiate discounts on some of Medicare’s costliest drugs. That could mean big savings for the Medicare program itself, which might be passed on to consumers. Daily reporting and analysis The most comprehensive industry coverage from a powerhouse team of reporters Subscriber-only newsletters Daily newsletters to brief you on the most important industry news of the day STAT+ Conversations Weekly opportunities to engage with our reporters and leading industry experts in live video conversations Exclusive industry events Premium access to subscriber-only networking events around the country The best reporters in the industry The most trusted and well-connected newsroom in the health care industry And much more Exclusive interviews with industry leaders, profiles, and premium tools, like our CRISPR Trackr. Health and Human Services Secretary Alex Azar Chris Kleponis/Getty Images Unlock this article — plus daily intelligence on Capitol Hill and the life sciences industry — by subscribing to STAT+. First 30 days free. GET STARTED What’s included? Politics About the Authors Reprints Erin Mershon Senior News Editor Log In | Learn More center_img Drug makers question idea to shake up how Medicare pays for certain drugs What is it? By Erin Mershon and Ike Swetlitz April 24, 2018 Reprints [email protected] @eemershon GET STARTED STAT+ is STAT’s premium subscription service for in-depth biotech, pharma, policy, and life science coverage and analysis. Our award-winning team covers news on Wall Street, policy developments in Washington, early science breakthroughs and clinical trial results, and health care disruption in Silicon Valley and beyond. Tags Donald Trumpdrug pricingMedicarepharmaceuticalspolicySTAT+last_img read more