US will still pay at least twice as much after negotiating drug prices

 The US government's first-ever negotiated prices for prescription drugs are still on average more than double, and in some cases five times, what drugmakers have agreed to in four other high-income countries, a Reuters review has found.

The US Medicare health plan, which covers more than 67 million people, recently unveiled new maximum prices for the first 10 high-cost medicines negotiated under the Biden Administration's Inflation Reduction Act.

This is the first time Medicare has disclosed actual drug prices, which are largely hidden behind a complicated US system of rebates and discounts. The lower prices will result in savings of $6 billion in 2026, the first year they take effect, Medicare said.

A Reuters review of publicly available maximum prices set by other wealthy nations - Australia, Japan, Canada and Sweden - show that they have negotiated far lower prices for the same drugs.

A 30-day supply of nine of the 10 drugs will cost $17,581 for Medicare in 2026, compared with $6,725 in Sweden this year. Comparable prices were not available for the 10th drug, Novo Nordisk's (NOVO-B.CO) insulin Novolog.

"In the US we've always accepted that we are the country that overpays relative to the rest of the world," said Stacie Dusetzina, professor of health policy at Nashville's Vanderbilt University.

The US sees value in being the preferred customer, she said, pointing to early availability of COVID vaccines as an example of that advantage.

Many countries have universal prescription drug coverage that relies on centralized price negotiation with manufacturers, but US law previously prevented Medicare - the nation's single biggest government program - from doing so.

Bristol Myers (BMY) said pricing was country specific and depended on national health systems and their regulatory policies, while Merck said it was not valid to compare US prices to overseas generics. Amgen declined to comment and the others drugmakers did not respond.

A spokesperson for the US agency that oversees Medicare said the new law requires consideration of factors such as manufacturer data and availability of alternative treatments, but Congress did not include review of international prices in the negotiations.

US always pays more

A study by the non-profit RAND Corp looking at 2022 prescription prices found that US health plans paid more than three times as much for brand-name pharmaceuticals, even after estimated discounts.

Studies have shown that faster uptake of new and more expensive drugs helps drive US prices, while other high-income countries directly footing the bill for healthcare place tighter restrictions on prescriptions.

https://finance.yahoo.com/news/analysis-us-still-pay-least-100704665.html

CVS, UnitedHealth ask for FTC's Khan and 2 commissioners to be disqualified from case

 CVS Health CVS.N and UnitedHealth Group UNH.N have asked U.S. Federal Trade Commission chair Lina Khan and commissioners Rebecca Kelly Slaughter and Alvaro Bedoya to disqualify themselves from an FTC lawsuit that has accused the companies of unlawfully inflating insulin prices.

The companies provided the motions to Reuters after filing them late on Tuesday with the FTC's in-house court. They said that Khan, along with Slaughter and Bedoya, displayed bias against pharmacy benefit managers and prejudged their pricing models.

CVS pointed to the commissioners' claims that volume-based discounts, or rebates, lead to higher prices for patients, and to Khan's appearance at a National Community Pharmacist Association event in 2022. The group, made up of independent pharmacists, has criticized pharmacy benefit managers.

"Event participants wore anti-PBM paraphernalia, including pins that vilified PBMs as “bloodsuckers” and shirts depicting PBMs as vampires," the document read.

UnitedHealth said that the commissioners' appearances at anti-pharmacy benefit manager events showed their prejudice.

The FTC suit accuses CVS Health's Caremark, UnitedHealth's Optum, and Cigna's CI.N Express Scripts of unfairly limiting access to insulin drugs with lower list prices and steering patients toward more expensive drugs to increase the spread of profit generated from negotiated discounts.

Express Scripts also supported the CVS complaint.

CVS's response also pointed to statements published by the commissioners in 2022, stating PBMs exclude cheaper generics from plans and 2024 congressional testimony describing PBMs as "middlemen" between drugmakers and patients seeking access to medications.

In recent years, both Amazon AMZN.O and Meta's META.O Facebook tried and failed to have Khan removed from their antitrust cases.

https://www.xm.com/au/research/markets/allNews/reuters/cvs-unitedhealth-ask-for-ftcs-khan-and-2-commissioners-to-be-disqualified-from-case-53941847

Rented e-scooters set to vanish from Madrid streets

 Operators of rental e-scooters will have until Oct. 25 to remove all their mobility devices from the streets of Madrid, the mayor's office said on Tuesday, following an outcry against reckless driving and chaotic parking by their users.

After withdrawing their licences last month, the mayor's office said the three foreign operators - Lime, Dott and Tier Mobility - had failed to implement limits on their clients' circulation or control their parking to regain the licences.

Amsterdam-based Dott, Germany's Tier Mobility and U.S.-based Lime, whose scooters are available via the Uber app, have around 2,000 e-scooters each throughout Madrid.

Lime and Dott said they had not been officially notified by city hall of the deadline.

Lime said that if they were formally notified, they will take the appropriate measures to comply. Dott said they will assess possible legal and operating actions after receiving the official document.

Tier did not immediately respond to requests for comment.

The scooter sharing system has raised opposition in cities around the world due to reckless driving by users on streets and sidewalks and haphazard parking that often leaves public spaces cluttered.

https://uk.finance.yahoo.com/news/rented-e-scooters-set-vanish-163033208.html

Haiti gangs are recruiting more child soldiers, human rights report says

 Haiti's armed gangs are increasingly recruiting children into their ranks, a report by Human Rights Watch warned on Wednesday, as near-famine conditions push boys to pick up guns while girls are sexually abused and forced into domestic work.

The group, which advocates for human rights globally, said it had spoken to six children recently involved with gangs, all of whom said they wanted to leave and had joined because they were hungry and gangs were often the only source of food, shelter or money.

Boys are often used as informants, trained to use weapons and ammunition, and deployed in clashes against the police, HRW said. It cited the case of a boy called Michel, an orphan who was recruited six years ago when he was 8 and living on the streets and was given a loaded Kalashnikov.

Girls are raped and forced to cook and clean for gang members, the report said, and often discarded once they become pregnant.

Haiti's powerful gangs have been expanding their influence in recent years while state institutions have been paralyzed by a lack of funds and political crises. Gangs now control territory where 2.7 million people live, including half a million children.

As they have grown, the gangs have ramped up child recruitment, said HRW.

About a third of gang members are children, according to estimates by the United Nations, which has also warned of boys being used for killings and to attack institutions, and girls being forced into exploitative sexual relations and killed in broad daylight for refusing to do so.

HRW said the criminal groups are increasingly using popular social media apps to attract recruits.

The leader of the Village de Dieu gang, for instance, is a rapper and publishes well-polished music videos of his soldiers. The report said he has a specialized unit to train children how to handle weapons and set up checkpoints.

The U.N. approved Haiti's request for a security mission to help the Caribbean country's police fight the gangs a year ago, but so far the mission has only partially deployed.

HRW urged Haiti's government and other countries to provide more resources for security forces, ensure children are able to eat and go to school, and provide rehabilitation for recruits.

https://ca.news.yahoo.com/haiti-gangs-recruiting-more-child-040904873.html

Boeing halts talks, withdraws pay offer to striking union

 Boeing said on Tuesday that it had withdrawn its pay offer to around 33,000 U.S. factory workers and no further negotiations were planned with their union representatives as a financially damaging strike nears its fourth week.

Boeing and the union held their latest round of negotiations with federal mediators on Monday and Tuesday, but talks collapsed and the sides were left locked in acrimonious stalemate showing no signs of being resolved anytime soon, a person briefed on the talks said.

"Unfortunately, the union did not seriously consider our proposals," Boeing Commercial Airplanes head Stephanie Pope said in a note to the employees, calling the union's demands "non-negotiable".

"Further negotiations do not make sense at this point and our offer has been withdrawn."

She noted Boeing had been taking steps to preserve cash.

Shares of the U.S. planemaker were down 1.5% in premarket trading on Wednesday. The stock has lost 5% of its value since the strike began on Sept. 13.

Reuters reported earlier on Tuesday that the planemaker is examining options to raise billions of dollars through a sale of stock and equity-like securities while the factories producing its best-selling 737 MAX and its 767 and 777 planes are shut.

The company, which is on the brink of losing its prized investment grade credit rating, has also introduced temporary furloughs for thousands of salaried employees.

The striking union of its West Coast factory workers is seeking a 40% pay rise over four years and the restoration of a defined-benefit pension that was taken away in the contract a decade ago. More than 90% of workers voted down an offer of a 25% pay rise over four years before going on strike.

Boeing made an improved offer last month that it described as its "best and final", which would give workers a 30% raise and restore a performance bonus, but the union said a survey of its members found that was not enough.

Pope, referring to the two days of negotiations this week, said: "Our team bargained in good faith and made new and improved proposals to try to reach a compromise, including increases in take-home pay and retirement."

In contrast, the International Association of Machinists and Aerospace Workers union said in a statement that Boeing was "hell-bent on standing on the non-negotiated offer" proposed last month.

"They refused to propose any wage increases, vacation/sick leave accrual, progression, ratification bonus, or the 401k Match/SCRC Contribution. They also would not reinstate the defined benefit pension," it said.

https://uk.finance.yahoo.com/news/boeing-withdraws-pay-offer-negotiations-023407446.html

Gulf states must not allow use of airspace against Iran, Iranian official says

 Tehran has told Gulf Arab states it would be "unacceptable" if they allowed use of their airspace or military bases against Iran and warned that any such move would draw a response, a senior Iranian official said.

The official also said any action by Gulf states to balance oil markets should Iranian energy facilities be hit by Israel was not part of the discussions so far.

The comments come amid growing concern over possible Israeli retaliation for last week's Iranian missile attack, as Iran's Foreign Minister Abbas Araqchi visits Saudi Arabia and other Gulf states including Qatar for talks on Wednesday.

They followed discussions between Iran and Gulf Arab capitals last week on the sidelines of an Asia conference in Qatar, when Gulf states sought to reassure Iran of their neutrality in any conflict between Tehran and Israel.

"Iran made it clear that any action by a Persian Gulf country against Tehran, whether through the use of airspace or military bases, will be regarded by Tehran as an action taken by the entire group, and Tehran will respond accordingly," the senior Iranian official told Reuters.

"The message emphasised the need for regional unity against Israel and the importance of securing stability," he said.

"It also made clear that any assistance to Israel, such as allowing the use of a regional country’s airspace for actions against Iran, is unacceptable."

U.S. President Joe Biden is expected to hold a telephone call on Wednesday with Israeli Prime Minister Benjamin Netanyahu that will include discussion of any plans to strike Iran, according to a person familiar with the matter.

Washington hopes to weigh in on whether the response is appropriate, a separate person briefed on the discussions said. The White House did not respond to a request for comment.

Biden said last Friday he would think about alternatives to striking Iranian oil fields if he were in Israel's shoes. Last week he also said he would not support Israel striking Iranian nuclear sites.

OPEC ACTION NOT PART OF DISCUSSIONS

The Iranian official said Tehran did not discuss the issue of Gulf Arab oil producers raising output if Iranian production were disrupted during any escalation.

U.S. news website Axios, citing Israeli officials, reported last week that Israel could target oil production facilities within Iran as retaliation.

The Organization of Petroleum Exporting Countries, OPEC, which is de-facto led by Saudi Arabia, has enough spare oil capacity to make up any loss of Iranian supply if an Israeli retaliation knocks out some of the country's facilities.

Much of OPEC's spare capacity is in the Middle East Gulf region. Iran has not threatened to attack Gulf oil facilities but has previously warned that if "Israel supporters" intervene directly their interests in the region would be targeted.

Top oil exporter Saudi Arabia has had a political rapprochement with Tehran in recent years, which has helped ease regional tensions, but relations remain difficult.

Saudi Arabia has been wary of an Iranian strike on its oil facilities since a 2019 attack on its key refinery at Abqaiq briefly shut down more than 5% of global oil supply. Iran denied involvement.

A Western diplomat in the Gulf said that during Thursday's Gulf-Iran meeting in Doha, Iran made clear that Tehran had called for regional unity in the face of an Israeli attack and that it considered neutrality of Gulf states a bare minimum.

The diplomat said Iran had made clear that Tehran would keep a close eye on how each Gulf country responded in the case of an Israeli attack, and also how U.S. bases housed in their countries were used.

Bahrain, Kuwait, Qatar, Saudi Arabia and the United Arab Emirates all host U.S. military facilities or troops

https://www.yahoo.com/news/gulf-states-must-not-let-183223478.html

Florida gas stations run empty amid panic ahead of Hurricane Milton

 A growing number of gas stations were flashing empty signs on Tuesday as panic-buying gripped Florida, where residents are bracing for a monster hurricane to make landfall.

Hurricane Milton was downgraded to a Category 4 storm on Tuesday as it grinded past Mexico's Yucatan Peninsula en route to Florida's Gulf Coast where over 1 million people were ordered to evacuate. Parts of Florida are still recovering from Hurricane Helene, which battered the state at the end of September.

The storm is expected to make landfall on Wednesday.

By 6:30 p.m. ET on Tuesday, 7,912 gasoline stations in Florida, about 17.4% of the total, had run out of fuel versus almost no outages on Monday morning, according to data from fuel markets tracker GasBuddy.

As people rush to get out of harm's way, demand for gasoline has jumped, said Patrick De Haan, an analyst at GasBuddy.com.

"These numbers will continue to rise very fast," De Haan said. Milton's path over Tampa Bay is spelling trouble for major fuel distribution networks, he added.

Florida is the third-largest gasoline consumer in the United States, but there are no refineries in the state, making it dependent on waterborne imports. More than 17 million tons of petroleum- and natural gas-related products move through Tampa Bay in a typical year, according to the Energy Information Administration.

Tampa and most other Florida ports were closed on Tuesday to all vessel traffic, reports by the U.S. Coast Guard showed.

TERMINALS SHUT

Kinder Morgan has shut its Central Florida Pipeline system, which moves refined products between Tampa and Orlando, the company said in an emailed statement. It has closed all fuel delivery terminals in Tampa, but expects trucks to be able to pick up fuel from Orlando wholesale racks until winds exceed 35 miles per hour.

Fuel trucks cannot safely deliver at wind speeds exceeding that threshold, wholesale distributor Mansfield explained, and said it expects wind conditions to bring all Florida fuel deliveries to a near-halt by Wednesday.

Refiner CITGO Petroleum and infrastructure and logistics provider Buckeye Partners are also shutting down their Tampa terminals, the companies told Reuters.

Mansfield has moved all Florida markets to its "Code Red" classification, requiring a 72-hour notice to make new deliveries.

It is also requesting 48-hour notices for new deliveries in southern Georgia.

Milton could potentially be the biggest disruptor to Florida's gasoline supply since Hurricane Andrew in 1992, said Tom Kloza, head of energy analysis at Oil Price Information Service.

"I'd be hard pressed to come up with an area that could be more prone to lingering problems should a Cat3 or greater storm hit the infrastructure," Kloza said. "It's hard to anticipate any tankers or barges coming in to Tampa Bay until Sunday or Monday," he added.

https://www.yahoo.com/news/gas-stations-run-empty-panic-184120013.html