McKesson Applauds DOJ Policy Change on Opioid Quotas

McKessoc Corporation today praised the U.S. Department of Justice’s decision to exercise its authority to reduce opioid production if the agency believes a particular drug is highly diverted.

“We applaud this common-sense action by the Department of Justice. The annual opioid production quota determines the total amount of controlled substances that can be produced each year. That authority is significant as the nation struggles to address the current public health crisis around opioid addiction. This new rule calls on the Drug Enforcement Administration to carefully assess which drugs are being diverted – an important part of the effort to curb opioid misuse and abuse.”

In October 2017, McKesson called on the DEA to revise its annual production quota for opioids.

McKesson is deeply concerned by the impact the opioid epidemic is having on families and communities across the nation—and is committed to being part of the solution. The company has formed an independent foundation dedicated to addressing the crisis, to which McKesson contributed $100 million. The company is also advancing company initiatives aimed at preventing opioid abuse and has offered thoughtful public policy recommendations, including the Prescription Safety-Alert System (RxSAS) technology proposal.

To learn more about McKesson’s comprehensive efforts to address the opioid epidemic, please visit: www.McKesson.com/FightingOpioidAbuse.

https://bit.ly/2JieplX

Fortis Healthcare’s Board Approves IHH Healthcare’s Takeover Offer

Malaysian private-hospital operator IHH Healthcare Bhd. (5225.KU) received approval to buy a significant stake in Fortis Healthcare Ltd. (532843.BY), one of India’s largest hospital operators, allowing the company to gain a foothold in India’s growing health care sector.

Fortis’ board has approved IHH’s plan to invest 40 billion Indian rupees ($583.6 million) via a preferential allotment to a wholly owned unit of IHH at 170 rupees a share, subject to approval of shareholders, Fortis said in a filing to the Mumbai Stock Exchange on Friday.

In a separate stock exchange filing to Bursa Malaysia on Friday, IHH said its unit, called Northern TK Venture Pte Ltd., entered into an agreement with Fortis for the proposed subscription of 235.29 million new Fortis Shares by way of preferential allotment representing some 31.1% of the total voting equity share capital of Fortis. This means IHH must make a mandatory general offer for the shares it doesn’t own to conform with India’s takeover rules.

IHH, the world’s second-largest health-care firm by market value after U.S.-based HCA Holdings Inc., outbid the only other competing offer from TPG-backed Manipal Health Enterprises Ltd., according to Fortis.

“The IHH proposal offers a more strategically and financially compelling proposition along with simplicity and certainty,” Ravi Rajagopal, chairman of the board of Fortis, said in a statement.

IHH, which counts Malaysia’s sovereign wealth fund Khazanah Nasional Bhd. as major shareholder, has expanded in Asia, Europe and the Middle East over the past five years. IHH’s expansion is driven in part by a growing affluent class that is willing to pay for better-equipped clinics and private hospitals.

IHH said on Friday that the proposals represent an opportunity for it to further expand its footprint in India, given India’s tremendous growth potential with rising demand for quality private health care.

“The proposals are expected to propel IHH to become a leading Pan-Indian hospital operator, operating more than 5,400 beds in 37 hospitals,” IHH said.

Fortis’ hospital chain consists of 45 healthcare facilities in India, Dubai, Mauritius and Sri Lanka, with a total of about 10,000 beds and 314 diagnostic centers, according to its website.

IHH will fund the deal via a combination of external borrowings and internally funds, according to IHH’s filing.

IHH added that the deal is expected to be completed in the fourth quarter of 2018 and isn’t expected to have any material effect on its earnings for this year.

https://bit.ly/2zzYIH2

Iowa, Illinois investigating infections linked to McDonald’s salad

The Iowa and Illinois health departments said on Thursday that they were investigating cyclospora infections linked to salads at McDonald Corp’s restaurants.

McDonald’s shares fell 1.4 percent after-hours on Thursday.

The Illinois Department of Public Health said it had seen about 90 cases, and the Iowa Department of Public Health said it had recorded 15 cases.

In about one-fourth of the Illinois cases people reported eating salads from McDonald’s in the days before they became ill.

McDonald’s, the world’s largest restaurant chain, said in a statement that it had been in contact with public health authorities in both states.

It said that it had voluntarily stopped selling salads at the approximately 3,000 affected U.S. restaurants until it could switch to another lettuce blend supplier.

“We are closely monitoring this situation and cooperating with state and federal public health authorities as they further investigate,” the company said.

The parasite, cyclospora cayetanensis, infects the small intestine, typically causing watery diarrhea and frequent, sometimes explosive bowel movements. It is spread by ingesting food or water contaminated with feces and not directly from one person to another.

Several outbreaks have occurred in the United States in the past several years, especially during the summer months, that had been linked to imported fresh produce including raspberries, basil, snow peas, and lettuce.

https://bit.ly/2L88uVh

Select Medical, OhioHealth Expand JV

Select Medical announces an expansion of its joint venture agreement with OhioHealthto combine operations of 38 physical therapy centers throughout Central Ohio.

As part of the partnership, OhioHealth will be majority owner and Select Medical will serve as managing partner.

“We are honored to broaden our partnership with OhioHealth to deliver expanded outpatient rehabilitative patient care in Ohio,” says David S. Chernow, president and CEO of Mechanicsburg, Pa-headquartered Select Medical, in a media release.

Under the agreement, the combined outpatient rehabilitation services will include 22 NovaCare Rehabilitation centers, owned by Select Medical, and 16 OhioHealth centers.  All are currently operating in the region.

“This growing partnership underscores our mission to improve the health of those we serve,” comments Steve Markovich, MD, executive vice president, OhioHealth. “The addition of 22 NovaCare Rehabilitation centers to the existing OhioHealth network will allow patients to have better access to affordable, quality care in their communities.”

Select Medical and OhioHealth formed the initial joint venture in 2013 to operate OhioHealth Rehabilitation Hospital. The 44-bed hospital treats stroke, traumatic brain injury, and spinal cord injury patients, per the release.

https://bit.ly/2L3Nsan

Pfizer gets Euro OK for Xeljanz combo for psoriatic arthritis

Pfizer Inc.(NYSE:PFE) announced that the European Commission (EC) has approved XELJANZ® (tofacitinib citrate) 5 mg twice daily (BID) in combination with methotrexate (MTX) for the treatment of active psoriatic arthritis (PsA) in adult patients who have had an inadequate response or who have been intolerant to a prior disease-modifying antirheumatic drug (DMARD) therapy.1 XELJANZ is the first and only oral Janus kinase (JAK) inhibitor to be approved in the European Union (EU) for the treatment of adults with active PsA. In 2017, XELJANZ in combination with MTX was approved in the EU for the treatment of moderate to severe active rheumatoid arthritis in adult patients who have responded inadequately to, or who are intolerant to one or more DMARDs.2 “People living with psoriatic arthritis may experience a variety of symptoms, making the condition particularly difficult to diagnose and treat,” said Angela Lukin, Regional President, Inflammation and Immunology, Pfizer. “We are proud that we are now able to offer XELJANZ as an option to adult patients living with active psoriatic arthritis in the European Union.”

https://bit.ly/2Le8IHl

J&J response to St. Louis damages verdict

Johnson & Johnson (NYSE: JNJ) issued the following statement regarding today’s verdict in the St. Louis court.

“Johnson & Johnson is deeply disappointed in the verdict, which was the product of a fundamentally unfair process that allowed plaintiffs to present a group of 22 women, most of whom had no connection to Missouri, in a single case all alleging that they developed ovarian cancer. The result of the verdict, which awarded the exact same amounts to all plaintiffs irrespective of their individual facts, and differences in applicable law, reflects that the evidence in the case was simply overwhelmed by the prejudice of this type of proceeding.  Johnson & Johnson remains confident that its products do not contain asbestos and do not cause ovarian cancer and intends to pursue all available appellate remedies.  Every verdict against Johnson & Johnson in this court that has gone through the appeals process has been reversed and the multiple errors present in this trial were worse than those in the prior trials which have been reversed.”

https://bit.ly/2L9Gi15

ObamaCare plan member costs increasing, networks narrowing

• A new Physicians for Fair Coverage report conducted by Avalere showed that Affordable Care Act plan members are paying more for health insurance as payers have increased premiums, deductibles and out-of-pocket costs in recent years.
• Nearly 90% of ACA plan enrollees are in high-deductible plans, according to the report.
• Avalere found that 68% of health plans in the exchanges offered narrow networks in 2017. That percentage is compared to 48% only three years previously.

Health plans have narrowed networks as a way to cut costs and push providers to accept value-based contracts in the exchanges. There are between 34% and 66% fewer providers in ACA plans compared to other markets, Avalere said.

One downside to this cost-saving trend is that narrower networks are leading to more out-of-network care and surprise billing. An example of physician network tightening is in the most popular type of plan in the marketplace: silver. The report found that 41% of silver plan physician networks in 2015 were defined as “small” or “extra small.”

There are also issues with specialists. Avalere said nearly 15% of insurance plans in the exchanges are “specialist deficit,” meaning they lack an in-network provider for at least one specialist, such as radiologists and anesthesiologists.

Avalere said the ACA’s provision for network adequacy isn’t enough. A 2017 Commonwealth Fund study found that most states don’t have laws that protect consumers from balance billing for out-of-network care delivered in emergency departments or in-network hospitals. In fact, only six states(California, Connecticut, Florida, Illinois, Maryland and New York) provide a “comprehensive approach to protect consumers in these situations.” Even those laws have loopholes. Another 15 states offer some protection against these surprise medical bills, but there are gaps.

Narrow networks aren’t the only issue for ACA plans. Premiums are also increasing faster than in the employer-sponsored market. The average ACA exchange premium increased by 28% between 2014 and 2017. The average silver plan premium rose from $434 in 2014 to $554 in 2017. That’s minor compared to what platinum plan members are seeing. Platinum average plan premiums skyrocketed from $555 in 2014 to $892 in 2017.

Members are also faced with high deductibles. Avalere said nearly 90% of ACA plan enrollees had deductibles above $1,300, which is the IRS definition of a high-deductible plan.

All of these rising costs are resulting in an increasing number of Americans not being able to afford care. The report said nearly one-third of insured Americans say they’re having trouble paying premiums and copays. Avalere warned this could lead to patients delaying or avoiding care.

Premiums are expected to rise again in 2019. Many payers in the ACA marketplace have proposed double-digit premium increases in the exchanges for next year. There are multiple reasons for the increase that go beyond normal healthcare costs: Congress ending the individual mandate penalty that required nearly all Americans have health insurance, President Donald Trump’s proposal to expand short-term plans and association health plans along with other efforts to weaken the ACA.

These efforts will likely cause people to leave the ACA marketplace, leaving ACA plans with a sicker risk pool. Payers, in turn, will increase premiums to offset the imbalance.

https://bit.ly/2L88pxL