Pharmaceutical & Life Sciences News

Capsule: Medicare Cash, a Reeling GOP, and Insulin Manufacturers

April 5, 2019, 9:14 AM

Welcome to Capsule—your weekly dose of health-care news, where we give you a recap of this week’s highs and lows for key players in the health-care industry. You can expect us every Friday morning as a bookend for your week.

In coming attractions: “Alexa, can you fill my prescription?”

Amazon could be selling generic drugs as soon as October, according to a Cleveland Research analyst. The company will be targeting Prime customers willing to pay cash for prescriptions. As for attractions happening now, let’s take a look at this week’s health news.

Here’s who ended the week on a high note:

Private Medicare Plans

  • Health insurers, who have had a bumpy ride as political rhetoric heats up ahead of the 2020 election, may feel relief this morning after Medicare rates came in better than expected, Cristin Flanagan from Bloomberg News reports.
  • The 2.53 percent bump in 2020 spells relief to insurance companies like UnitedHealth Group Inc. and Humana Inc., which have a sizable chunk of Medicare Advantage members—people who opt in to managed care benefits under Medicare.
  • Insurers were worried the annual rate adjustment wouldn’t keep pace with rising plan costs, Tony Pugh writes.
  • Plans aren’t totally satisfied though. They cheered the 2020 boost, but reiterated concerns about a wave of new regulations that include tweaks to a rating system letting customers compare coverage and pharmaceutical rebates, Pugh notes.


  • In a rare moment of bipartisanship, House lawmakers on a key committee sent a handful of bills meant to bolster drug competition to the full House floor for a vote.
  • The bill bundle includes two pieces of legislation that were extensively debated earlier—one called the CREATES Act that addresses drug sample access and another bill preventing pay-for-delay tactics. Senators said they were pleased with the bipartisan collaboration; consequently, the bills have a good chance at passing in the Senate.
  • The ability of Democrats and Republicans to work together is a good sign for drug price legislation going forward as well, with one Republican calling it a “sweet spot” for bipartisan change, Madison Alder writes.
  • Hold off on any renditions of “Kumbaya” though. There are plenty of health-care issues dividing Congress, including what to do with the Affordable Care Act, Sara Hansard reports.

Transitioning Workers

  • Transgender people increasingly are suing their employers to get back thousands of dollars they’ve been forced to spend out of pocket for gender transition-related care, Mary Anne Pazanowski reports.
  • Employer-sponsored health insurance plans are on the hook to shell out funds to cover procedures like breast augmentation and hysterectomies for transitioning workers, plaintiffs are saying in lawsuits.
  • And plaintiffs in these kinds of lawsuits are winning. It’s all part of a trend, the director of Lambda Legal’s transgender rights project in Atlanta told Pazanowski.

It was a bleak week for others. Here’s whose Thursday closed on a downswing:

Insulin Manufacturers

  • Eli Lilly, Novo Nordisk, and Sanofi are on the hot seat as lawmakers use rising insulin prices as a case study for Congress’ larger investigation into drug costs. The House Energy and Commerce Oversight Subcommittee had a hearing this week and is planning another one next week, Shira Stein and Anna Edney report.
  • Those three drugmakers will have to send representatives, as will the top three drug middlemen: CVS Health, Express Scripts, and UnitedHealth.
  • Express Scripts and health insurer Cigna tried to boost their public image this week by announcing a program that offers eligible customers a 30-day-supply of insulin for $25. But only 700,000 people would be eligible for that discount, an Express Scripts representative told me, which means the program covers about 2.3 percent of the country’s 30.3 million diabetics.

E-Cig Users

  • The Food and Drug Administration said it’s investigating a small number of reports over several years of e-cigarette users experiencing seizures, Anna Edney from Bloomberg News writes.
  • The potential link was seen mostly in young vapers, FDA Commissioner Scott Gottlieb and Principal Deputy Commissioner Amy Abernethy said in a statement this week. The FDA said it has received 35 reports of seizures possibly related to e-cigarette use between 2010 and early this year, and is concerned those numbers could indicate a wider phenomenon.
  • “We want to be clear that we don’t yet know if there’s a direct relationship between the use of e-cigs and a risk of seizure,” Gottlieb told a House appropriations subcommittee at a hearing on the agency’s budget request.


  • Republicans are between a rock and a hard place on health care thanks to the recent change in the Department of Justice’s legal stance regarding Obamacare. Now President Donald Trump says he wants the law thrown out completely, and the switch has Republicans reeling.
  • They have yet to reveal a plan that would replace the Affordable Care Act and protect pre-existing conditions, prompting a harsh warning from the president this week.
  • Trump said Republicans “blew it” on health care and will lose the 2020 election if they don’t get a plan in order, according to Bloomberg Government’s morning breakdown.
  • The GOP isn’t turning away from the president, however. Only eight Republicans voted with nearly all Democrats this week on a resolution (H. Res. 271) condemning the administration’s recent decision to ask a federal court to overturn Obamacare, Alex Ruoff reports.

Thanks for joining us this week and have a great weekend. I’m all ears when it comes to your two cents, tips, critiques, or coordinating exclusive interviews. Send them my way at jlee1@bloomberglaw.com.

To contact the reporter on this story: Jacquie Lee in Washington at jlee1@bloomberglaw.com

To contact the editors responsible for this story: Fawn Johnson at fjohnson@bloomberglaw.com; Brent Bierman at bbierman@bloomberglaw.com

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