Blame Cuomo for New York’s Medicaid crisis

When it comes to New York’s latest Medicaid mess, the buck stops with Gov. Andrew Cuomo.
Or rather, the buck should stop with him, if only he would enforce his own rules.
Turns out the state’s massive government-run health plan for the poor and disabled, which covers one in three New Yorkers, has been running way over budget for months. And the Cuomo administration secretly finessed the situation by delaying $1.7 billion in payments from late March to early April, thereby shifting the red ink from the previous fiscal year into the current one — while doing nothing to slow the outflow of cash.
The result is that Albany has a $3 billion-plus hole on its balance sheet — and no known plan for closing it.
Most mystifying is that Cuomo had all the tools he needed to prevent this disaster in the first place; he invented them, in fact. But when the time came to use the tools, he left them in the toolbox.
It was Cuomo’s good idea, at the very beginning of his first term in 2011, to impose an inflation-based cap on Medicaid spending growth, bringing a modicum of fiscal discipline to the notoriously bloated program.
To enforce that discipline, Cuomo also requested — and received from the Legislature — unilateral authority to cut Medicaid payments to health care providers as soon as spending showed signs of rising too fast.
Cuomo, who styled himself a fiscally responsible Democrat in those days, presented the measures as a way to tame the program’s sky-high costs. And they seemed to work as promised — for a time.
From 2011 to 2016, the cap held spending growth to just 17%, roughly in line with medical inflation, even though Medicaid enrollment surged by 31%. Per-recipient costs dropped significantly.
After 2016, however, those welcome trends reversed — as documented in a just-published report from the Empire Center. Because it lacked an adjustment for enrollment, which flattened out, the cap allowed spending to keep chugging upward, year after year.
Plus, Cuomo and the Legislature weakened the policy with carve-outs and loopholes. The biggest exemption applied to expenses from a major minimum-wage hike, to as high as $15 an hour. That is now costing Medicaid about $2 billion a year.
Last summer and fall marked a breaking point. State Medicaid spending started overflowing its capped levels even with the extra leeway afforded by loopholes. That was when, according to statute, Cuomo and his health commissioner should have raised the alarm and invoked their authority to cut fees.

Instead, they did just the opposite — quietly ordering rate increases for hospitals and nursing homes effective last Nov. 1. That costly move came two months after the Greater New York Hospital Association secretly donated more than $1 million to the Cuomo-controlled Democratic Party, and one week before the governor easily won re-election.
Disturbingly, Cuomo kept the lid on Medicaid’s worsening financial condition for months, including during all of this year’s budget process. He failed even to disclose the $1.7 billion payment delay when it happened in the throes of final budget talks, throwing the state’s $176 billion financial plan out of balance even before lawmakers voted.
It wasn’t until weeks after passage that Team Cuomo owned up to Medicaid’s overspending problem — and warned that it might finally invoke the power to order across-the-board fee cuts that the gov ducked the year before.
Those cuts will now have to be that much deeper and more painful because of Cuomo’s year-long campaign of deception and delay. Worse, his administration has tried to portray its fiscal shell game as necessary to ensure “compliance” with the cap — an Orwellian framing that turns reality on its head. And get this: His budget aides are also holding open the option of postponing further payments, which would only dig the hole deeper.
Medicaid is state government’s costliest program and most awesome responsibility. The millions who depend on it for care, and the taxpayers who foot the bill, deserve better from their chief executive in Albany.
Bill Hammond is health policy director of the Empire Center for Public Policy. This essay is based on his just-published report: “Busting the cap: Why New York is losing control of its Medicaid spending again.”
https://nypost.com/2019/10/16/blame-cuomo-for-new-yorks-medicaid-crisis/

Roche Phase 3 Study of Tecentriq, Avastin Combination a Success

Roche Holding AG (RO.EB) said Monday that a phase 3 study combining cancer drugs Tecentriq and Avastin had met its primary targets, showing efficacy in patients with hepatocellular carcinoma.
The two drugs together increased overall as well as progression-free survival in patients with inoperable hepatocellular carcinoma who hadn’t previously received systemic therapy, the pharmaceutical company said.
Roche said that a breakdown of the data will be presented at a coming medical conference.
“We are very pleased with the results of our study testing the combination of Tecentriq and Avastin, which marks the first treatment in more than a decade to improve overall survival in people with unresectable hepatocellular carcinoma who have not received prior systemic therapy,” said Chief Medical Officer Levi Garraway.
The company said it will submit the data from the study to health regulators globally, including in the U.S., Europe and China.

https://www.marketscreener.com/ROCHE-HOLDING-AG-9364975/news/Roche-Phase-3-Study-of-Tecentriq-Avastin-Combination-a-Success-29421445/

FDA approves AstraZeneca diabetes drug for treating heart failure risk

AstraZeneca diabetes drug Farxiga has been approved for use in the United States as a treatment to reduce the chances of hospitalisation for heart failure in adults with type-2 diabetes and other cardiovascular risks, the British drugmaker said on Monday.

The approval by the U.S. Food and Drug Administration is based on results from the DECLARE-TIMI 58 clinical trial, the London-listed company said, and follows a similar approval https://www.astrazeneca.com/media-centre/press-releases/2019/forxiga-label-updated-in-the-eu-in-type-2-diabetes.html by the European authorities in August.
Farxiga is the first of its class to be approved in the United States for this indication, Ruud Dobber, executive vice president of BioPharmaceuticals at AstraZeneca said.
“This is promising news for the 30 million people living with type-2 diabetes in the United States, as heart failure is one of the earliest cardiovascular complications for them, before heart attack or stroke,” Dobber said.
Farxiga, already approved as a treatment for type-2 diabetes, is part of the SGLT2-inhibitor class of antidiabetics that cause the kidneys to expel blood sugar from the body through urine.
Diabetes is often associated with a high risk of heart failure, a condition in which the blood-pumping organ does not circulate blood as well as it should.
The treatment, one of AstraZeneca’s top 10 drugs by sales, had shown promise in reducing the risk of heart attacks or disease progression in patients with the HFrEF subtype of heart failure, accounting for about half of heart failure cases.
The FDA has already placed Farxiga under speedy reviews to treat some kinds of heart failure and kidney failure.

https://www.marketscreener.com/ASTRAZENECA-4000930/news/AstraZeneca-U-S-FDA-approves-AstraZeneca-diabetes-drug-for-treating-heart-failure-risk-29421686/

Glaxo to sell two travel vaccines to Danish biotech firm

GlaxoSmithKline Plc said on Monday it will sell two travel vaccines to Denmark-based biotechnology company Bavarian Nordic for an upfront payment of 301 million euros ($335.71 million).

The sale of anti-rabies treatment Rabipur and Encepur, used for the prevention of tick-borne encephalitis, by the British drugmaker includes milestone payments of up to 495 million euros.

https://www.marketscreener.com/BAVARIAN-NORDIC-A-S-1412846/news/GSK-to-sell-two-travel-vaccines-to-Danish-biotech-firm-29421835/

Four players in opioid epidemic face trial in Ohio Monday

Barring a last-minute settlement agreement, lawyers representing drugmaker Teva Pharmaceutical Industries, wholesalers Cardinal Health and AmerisourceBergen and retail pharmacy operator Walgreens Boots Alliance will be in a Cleveland, Ohio courtroom on Monday to face plaintiffs, two counties in the state (Cuyahoga and Summit), in a trial over the companies’ respective roles in the opioid epidemic there (mainly over-aggressive marketing while downplaying the risk of addiction).

Apparently, the companies had agreed to pay as much as $48B over time to call off the trial and settle thousands of related lawsuits but talks stalled when contingency-fee lawyers representing local governments insisted on more money.

District court Judge Dan Polster has set aside December 13 for evidence to be presented to the jury. Each side has 100 hours do state their respective cases, which some of the defendants say is woefully inadequate to argue a case of this complexity.

Private held Purdue Pharma, the poster child for the crisis, will not be present since it filed for bankruptcy last month.

https://seekingalpha.com/news/3507120-four-players-opioid-epidemic-face-trial-ohio-monday

Merck KGaA wants to get in early on Chinese innovation, sets up seed fund

Merck KGaA is carving out a small — but emblematic — portion of its venture arm to nurture new Chinese startups while it cuts the ribbon on an innovation hub in Shanghai.
The €13 million (RMB100 million) seed fund falls within the scope of M Ventures’ €300 million mandate, according to the German drugmaker, and would be jointly managed by that team and the innovation hub. Startups that fall into the healthcare, life science, performance materials and “new businesses” buckets can expect to receive investments between €500,000 and €1 million designed to bring them over to a value inflection point within two years.
“This is the first activity of our corporate strategic venture arm in China,” CEO Stefan Oschmann said in a statement. “Our seed fund initiative aims to deliver strategic returns so as to underscore our position as an innovator in China and to strengthen our ties to the dynamic Chinese innovation ecosystem.”
His comments highlight how China has become a CEO-level priority among multinational pharma giants. While the country has long been appreciated for its massive market and manufacturing scale, as McKinsey & Company Partner Franck Le Deu noted in a recent analysis, “China is an emerging source of product, portfolio, and business model innovation.”
At the newly opened innovation hub in Shanghai’s New Bund World Trade Center — and Merck KGaA is planning two others in Guangzhou and Beijing — the company will collaborate with startups, academic institutions and other industry players on various projects. There’s an accelerator component, which has already enrolled its first batch of six fledglings from China and neighboring countries.

Merck KGaA wants to get in early on Chinese innovation — so it’s setting up a seed fund there

Warren to release funding plan for universal healthcare “soon”

In the face of criticism from her Presidential rivals, Senator Elizabeth Warren (D-MA) says she will “soon release” her plan to pay for “Medicare for All,” her proposal for universal healthcare in the U.S. She commented on the issue during a campaign stop in Indianola, IA.

Voters (and Republicans) are keen to hear the details since funding for such a system will be in the trillions.

She and fellow Presidential hopeful Senator Bernie Sanders (I-VT) are the only two candidates promoting a government-backed single payer system. The other Democratic contenders are promoting public/private approaches based on the continuation of Obamacare.

https://seekingalpha.com/news/3507113-senator-warren-release-funding-plan-universal-healthcare-soon