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POLITICO New York Health Care: The impact of the EpiPen price hike; Fentanyl surge

08/26/2016 10:00 AM EDT

Good morning! You are receiving the complimentary synopsis of the POLITICO New York Pro Health Care newsletter. Pro subscribers are receiving an enhanced version of this newsletter at 5:45 a.m. each weekday, which includes a look-ahead and robust analysis of health care policy news driving the day. If you would like the Pro version of this newsletter, along with customized real-time insights on New York health care, please contact us here and we will set you up with trial access. Thank you for reading!

written by Dan Goldberg

HOW THE EPIPEN PRICE HIKE IMPACTS NEW YORK FAMILIES - Louise Larsen remembers the first time her daughter, Juliet, ate from a jar of peanut butter. Anaphylactic shock, a harrowing trip to the emergency room, a life-changing event. Ever since that day in 1998, Larsen, who now runs a Facebook group with nearly 10,000 members called "Parents of Kids With a Severe Peanut Allergy," has been sure to keep EpiPens. And she's been sure to have her daughter, now 19 and in New York at Barnard College, do the same. The small injection device can reverse the effects of an allergic reaction, and for people with allergies as severe as Juliet Larsen's, it can be lifesaving. For a long time, too, the pens weren't a big cost. "There was the deductible and then it was covered ... The doctors were like, 'Here, take six,'" Larsen said. So she would. She'd get a pack of two for herself, one for her daughter's backpack, one for her husband, one to send on playdates, and more to have around just in case. "Everything seemed average until about 2013... [then] I noticed that the EpiPens were going through the roof," Larsen said. Since 2009, EpiPen maker Mylan has raised the prices of a standard pack of two EpiPens 400 percent, from close to $100 to about $600. And in the last few days, the cost concerns Larsen and parents like her have had in recent years have become national news. On Wednesday, Hillary Clinton's presidential campaign entered the ring and released a statement, saying the price hike was "outrageous." And on Thursday, New York City's first lady, Chirlane McCray, wrote in an an op-ed for the Washington Post, that she and her daughter, Chiara, both carry EpiPens.

...In the wake of the criticism, Mylan said in a statement Thursday that the company would expand its patient assistance program to 400 percent of the federal poverty level, which would make a family of four making up to $97,200 eligible to apply to get the pens for free. Mylan also said it plan to offer a $300 rebate to customers without insurance or with high-deductible plans, which would cover approximately half the cost of the EpiPens. Rebates like this also wouldn't help people like Heather Lessard, who doesn't meet Mylan's requirements and whose six-year-old son has a peanut allergy. "I'm really happy that they're going to be doing [the rebate], but it wouldn't help my family," Lessard said, who runs the No Nuts Moms Group in Albany. Like Larsen, Lessard's strategy is to make sure EpiPens are available to her child at school, on the bus, at friend's houses, at home. And while her insurance will cover the cost of two two-packs of EpiPens, the cost of any additional packs would have to come out of pocket entirely. Otherwise, Lessard said, her family simply has to hope that unused EpiPens from earlier prescriptions will do the job. "We have to play this game with going as far as we can with the expiration dates," she said. Make sure you read Addy Baird's story here:

MORE EPIPEN PROBLEMS - STAT News, which has really led the way on the Mylan stories, filed this report: "Schools across the country keep EpiPens in their nurses' offices in case a student has a severe allergic reaction. For years, Mylan Pharmaceuticals has been selling the devices to schools at a discounted price, giving them a break from rising costs. But the program also prohibited schools from buying competitors' devices - a provision that experts say may have violated antitrust law."

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AND MAKE SURE YOU FOLLOW Josefa Velasquez and me on Twitter @J__Velasquez & @DanCGoldberg. And for all New Jersey health news, check out @katiedjennings

NOW WE KNOW - A new study suggests people who post Instagram pictures using a black and white filter are more likely to be depressed, NPR reports:

WE'D LOVE TO HEAR FROM YOU: This roundup is for you, so please tell us how we can make it even better. Send tips, news, ideas, calendar items, releases, promotions, job postings, birthdays, congratulations, criticisms and corrections to

FENTANYL - New York City, still in the midst of a heroin epidemic that is plaguing much of the country, is confronting a new deadly problem - fentanyl. The powerful opiate was present in more than 30 percent of all overdose deaths during the first half of 2016, up from 16 percent in 2015, and 3 percent in years prior, according to the city's health department.

FIVE-POINT PLAN - The New York City Department of Health and Mental Hygiene, working with the United Hospital Fund and the Population Health Improvement Program, offered five strategies to expand and improve the impact of the medical home model of primary care across New York City.. See the plan here:

EXPANSION PLANS - Buffalo Business First reports: "Buffalo General Medical Center is expanding its emergency department, making use of space formerly used to treat behavioral health patients."

SETTLED - Samaritan Medical Center in Watertown and the New York State Nurses Association announced they have reached a tentative contract agreement. Negotiations had revolved around staffing issues but details of the agreement were not available as of late Thursday night.

INSURANCE REPORT: Medicare's accountable care organizations generated $466 million in savings in 2015, according to the latest data from CMS. The financial results include 392 organizations participating in the Medicare Shared Savings Program and a dozen enrolled in the more advanced Pioneer ACO program.


-MATERNAL MORTALITY RATE - Kaiser Health News reports on Georgia's very high maternal mortality rate:

...In case you are wondering, New York's maternal mortality rate between 2012-2014 was 18.3, according to the Department of Health. That's higher than the national average but a significant drop from the 23.3 that was reported five year ago.

-HOW WE PAY FOR IT - The Wall Street Journal looks at who is paying for all the health care this country is using. The answer is evolving.

TODAY'S TIP - Comes from Memorial Sloan-Kettering, which offers us "eight tips for managing weight during and after cancer treatment."


-BROAD APPROACH - Researchers at NYU Langone, writing in Stem Cell, say controlling a portion of the protein complex, known as Mediator Complex Subunit 12, or MED12, could help stop a variety of cancers because MED12 mutations have been linked to several kinds of leukemia, as well as cancers of the prostate, uterus, and connective tissue.

-WHY CANCER IS CHANGING - A new study published in the New England Journal of Medicine says gene tests may reduce the need for chemo among breast cancer patients:

-THE CONFLICT - POLITICO reports: "There is a high prevalence of large financial conflicts of interests among guideline authors for a national cancer treatment network, according to a new JAMA Oncology analysis."

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