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May 2017

A Drug Quintupled in Price. Now, Drug Industry Players Are Feuding Over the Windfall.

Dr. Eric Edwards, chief medical officer and vice president of research and development for Kaléo, demonstrates how to use Evzio, the injectable overdose treatment. (Richmond Times-Dispatch, Bob Brown/AP Photo)

This article is a collaboration between ProPublica and The New York Times.

A company that manages prescription drug plans for tens of millions of Americans has sued a tiny drug maker that makes an emergency treatment for heroin and painkiller overdoses, increasing the tension between the companies that make drugs and those that decide whether they should be covered.

Express Scripts, the nation’s largest pharmacy benefits manager, is suing Kaléo, the manufacturer of Evzio, the injectable overdose treatment whose price quintupled last year, drawing widespread outrage and inquiries from members of Congress. Express Scripts claims it is owed more than $14.5 million in fees and rebates related to Evzio, and it has dropped the drug from its preferred list.

In recent months, anger over rising drug costs set off a civil war within the pharmaceutical industry, pitting drug makers against other players in the health care system, including the little-known pharmacy benefit managers who negotiate with drug makers on behalf of insurers, large employers and government health programs. Drug makers and some members of Congress have accused Express Scripts and other benefit managers of operating in the shadows, pocketing an undisclosed share of the payments they exact from drug makers even as consumers are asked to pay inflated prices for the medicines they need.

Have You Had Difficulty Paying For or Accessing Prescription Drugs?

ProPublica and The New York Times are interested in hearing from you if you had any difficulties accessing or paying for your prescription drugs. If this sounds like you, please share your story.

The lawsuit, though heavily redacted, provides some tantalizing details about Express Scripts’ business dealings. Consultants and brokers — who advise employers on their prescription drug plans — said it showed that Express Scripts is collecting fees that keep rising as drug prices go up.

For example, according to the lawsuit, which was filed in federal court in St. Louis, Express Scripts charged Kaléo “administrative fees” that climbed sharply at the same time that Evzio was rising in price. In January 2016, Evzio carried a list price of $937.50 for two injectors, and Express Scripts billed Kaléo for about $25,000 in administrative fees for its commercial clients. But three months later, Evzio’s price had climbed to $4,687.50, and these fees totaled nearly $130,000. That’s on top of charges that included “formulary rebates,” or drug discounts, and “price protection rebates,” which are triggered when a drug jumps in price. Those price-protection rebates totaled $14 million — most of the money that Express Scripts is trying to recoup.

Benefit managers like Express Scripts typically pass the rebates they collect from manufacturers along to their clients — insurers and large employers — after taking a portion of the rebates for themselves. But critics, like Linda Cahn, the chief executive of Pharmacy Benefit Consultants in Morristown, New Jersey, say that the benefit managers are not transparent about what share of fees they keep, and what share they pass along to clients.

Administrative fees are particularly murky, she and others said. Some of the fees are passed to clients, but benefit managers also collect other fees that are not returned to clients.

“The lawsuit reveals that Express Scripts is collecting immense sums of money. No one knows what they’re passing through and what they’re retaining,” said Cahn, who flagged the lawsuit in a note to clients Monday. “Every client and the federal government and taxpayers should insist that they do.”

But Brian Henry, a spokesman for Express Scripts, disagreed with her assessment and described Kaléo as a “deadbeat dad.” “They owe rebates and administrative fees that we share with our clients and we are working to get that money back,” he said in a statement.

Henry also said, “The vast majority of the administrative fees are passed back to our clients and in the Medicare space, they are all passed on. Where they are not passed back, it is with the full knowledge and agreement of our clients.”

Spencer Williamson, the chief executive of Kaléo, said in a statement that the lawsuit was “baseless” and that the company was committed to providing affordable access to its drug “without burdensome paperwork or high out-of-pocket costs.”

The lawsuit is the latest piece of bad news for Kaléo, a private Virginia company with just two products on the market. When Evzio arrived on the market in 2014, it was sold as an easy-to-use device, similar to an EpiPen, that could be stowed in a pocket or medicine cabinet and quickly used by friends or relatives to reverse the effects of a drug overdose.

But while the device was initially hailed by addiction experts who said it would make it easier to stop fatal overdoses, the company came under heavy criticism in 2016, when it quintupled the price of Evzio. The price increase — which came in the midst of a national opioid abuse epidemic — prompted letters from members of Congress, demanding to know what had prompted the change.

Kaléo has said it sharply raised the price of Evzio to cover the cost of a new patient-assistance program that lowers the out-of-pocket costs for people who cannot afford the product. Kaléo covers all of the out-of-pocket costs for patients with private insurance, and offers Evzio free of charge to uninsured people who make less than $100,000 a year.

But critics have said that such patient-assistance programs serve to drive up the cost of drugs to the health care system because while they ease the burden on patients, they leave insurers with the bulk of the bill, especially when a less expensive alternative is available. Other forms of naloxone, the active ingredient in Evzio, are available at a much lower price.

This is not the first time Express Scripts has sued a drug maker with expensive products. In 2015, Express Scripts filed suit against Horizon Pharma, also over unpaid fees. Horizon agreed to pay Express Scripts $65 million in September 2016 to settle the case. After initially dropping coverage of Horizon’s drugs, Express Scripts added them back to its preferred drug list.

Express Scripts is also being sued. Last year, the insurance giant Anthem sued Express Scripts in federal court in New York for $15 billion and claimed the company had been overcharging it for drugs. Express Scripts, which denied the claims, said recently that it would most likely lose Anthem, its largest customer, beginning in 2020, leading to speculation about how the company will replace the business it is losing. Source:

Have You Had Difficulty Paying For or Accessing Prescription Drugs? We Want to Hear From You.

by Charles Ornstein

Rob Weychert/ProPublica, source image by unizyne/Getty Images

It’s no secret that drug prices have been rising rapidly and have placed a heavy burden on American families, particularly those with health plans that force them to pay thousands of dollars before their insurance kicks in. Certainly, drug companies are partly responsible for the price hikes. But what far fewer Americans realize is that drugs travel a multi-stop route from manufacturer to user, with each player along the way taking its bite and sometimes imposing hurdles on patients’ ability to access the drugs their doctors order.

ProPublica and The New York Times are interested in hearing from patients about any difficulties they have had accessing or paying for prescription drugs, in particular if those challenges have occurred in the past year. Please share your story below. We will not share it with others or print it without your permission. Source:

Portland’s mayor took a stand against hate, but the ACLU is pushing back. Here’s why.

You can’t overcome hate with censorship, but that doesn’t mean it has to win.

On May 26, 35-year-old Jeremy Joseph Christian allegedly stabbed three men on board a Portland light-rail train after they attempted to intervene on behalf of a Muslim woman who Christian was verbally harassing.

Two of those men, Taliesin Myrddin Namkai-Meche and Ricky Best, died while a third, Micah Fletcher, survived.

Photos of Taliesin Myrddin Namkai-Meche and Ricky Best in a memorial set up in Portland. Photo by Alex Milan Tracy/AP Images.

Three days after the incident, Portland Mayor Ted Wheeler weighed in with an important message for his city.

In the message, posted to his Facebook page, Wheeler calls on the federal government to revoke the permit granted to an "alt-right" group hosting an event in Portland’s Shrunk Plaza in June.

He also appeals to the organizers of the white supremacist group to cancel the planned demonstration. "There is never a place for bigotry or hatred in our community, and especially not now," Wheeler wrote.

"I am calling on every elected leader in Oregon, every legal agency, every level of law enforcement to stand with me in preventing another tragedy."

Here’s the full text of Wheeler’s post:

"On Friday three men Rick Best, Taliesin Myrddin Namkai-Meche, and Micah Fletcher stood up against bigotry and hatred. Two paid with their lives. A third was seriously injured.

Our community remains in shock and mourning. But we are also tremendously grateful to our heroes and their families for their selflessness and heroism. They will serve to inspire us to be the loving, courageous people we are meant to be.

As Mayor, I wanted to update you on a few developments:

1) I have reached out to all of the victims and their families, including the two women who were terrorized and subjected to such hatred and bigotry. I have offered my unconditional assistance and support, day or night.

2) I have confirmed that the City of Portland has NOT and will not issue any permits for the alt right events scheduled on June 4th or June 10th. The Federal government controls permitting for Shrunk Plaza, and it is my understanding that they have issued a permit for the event on June 4th."

3) I am calling on the federal government to IMMEDIATELY REVOKE the permit(s) they have issued for the June 4th event and to not issue a permit for June 10th. Our City is in mourning, our community’s anger is real, and the timing and subject of these events can only exacerbate an already difficult situation.

4) I am appealing to the organizers of the alt-right demonstrations to CANCEL the events they have scheduled on June 4th and June 10th. I urge them to ask their supporters to stay away from Portland. There is never a place for bigotry or hatred in our community, and especially not now.

5) I am calling on every elected leader in Oregon, every legal agency, every level of law enforcement to stand with me in preventing another tragedy.

6) When and if the time is right for them, I would like to work with the families to find an appropriate way to permanently remember their sacrifice and honor their courage. Their heroism is now part of the legacy of this great city and I want future generations to remember what happened here, and why, so that it might serve to both eradicate hatred and inspire future generations to stand up for the right values like Rick, Taliesin, and Micah did last week."

The ACLU of Oregon, however, doesn’t agree with Wheeler, saying that what he suggested is a form of censorship.

In a response on their own Facebook page, the organization explained (emphasis added):

"Our hearts are broken, but government censorship is not the answer. The government cannot revoke or deny a permit based on the viewpoint of the demonstrators. Period.

It may be tempting to shut down speech we disagree with, but once we allow the government to decide what we can say, see, or hear, or who we can gather with, history shows us that the most marginalized will be disproportionately censored and punished for unpopular speech.

We are all free to reject and protest ideas we don’t agree with. That is a core, fundamental freedom of the United States. If we allow the government to shut down speech for some, we all will pay the price down the line. We must defend the Constitution, even when it is uncomfortable.

If the government has concrete evidence of an imminent threat they can and should address it without restricting First Amendment rights of others."

The thing is … both Wheeler and the ACLU of Oregon are right in different ways.

So where does that leave us?

At his arraignment, Christian shouted, "Free speech or die. Get out if you don’t like free speech … you call it terrorism, I call it patriotism … die." Photo by Beth Nakamura/The Oregonian/OregonLive.

Like a lot of things in life, it’s a bit nuanced.

Before you hop on #TeamTed or #TeamACLU, it’s important to acknowledge that pretty much everyone involved in this has good intentions, is disgusted by Christian’s actions, and doesn’t want anything like it to happen ever again.

On one hand, you can absolutely see where Wheeler is coming from. With tensions running high and the fact that Christian had just recently attended a similar rally, it makes perfect sense that his impulse would be to shut down upcoming rallies for fear of provoking or inspiring another attack. With the city still mourning this loss, it’s understandable that he’d look for ways to de-escalate the situation however he can and send a strong message against hate and bigotry.

On the other, the ACLU is totally right when it says the government can’t simply revoke permits because of someone’s political views. Responding to a comment on Facebook, the organization suggested that the mayor take a more measured approach that doesn’t violate the Constitution by talking to the groups planning to hold rallies and asking them to reschedule in light of the recent attack. The groups don’t have to, but without outlining why these rallies pose an imminent threat, that’s about all Wheeler can legally do.

Freedom of speech, however, does not mean speech without consequences.

There are times when law enforcement can and should intervene to prevent speech from becoming action. For this, let’s look at how the ACLU responded to the 2011 shooting outside the office of then-Congresswoman Gabrielle Giffords (emphasis added):

"It is important to remember that while the First Amendment carefully guards our liberty to speak freely except in the most circumscribed situations, it is not a barrier to effective law enforcement against those reasonably believed to be involved in unlawful activity. … In times like these, it is natural to look for ways to quell our horror and fear. But it is when people feel most vulnerable that our liberties are most at risk. Unraveling the principles that form the core of our democracy is not the answer."

No matter what someone’s personal politics are, no matter what group they belong to, it’s important that they’re afforded that crucial right to freedom of speech. However, in heated times with heated rhetoric, we — and law enforcement agencies — have a responsibility to prevent that speech from boiling over into physical violence.

If the groups behind those upcoming "alt-right" demonstrations want to act in good faith, then yeah, perhaps they should think about canceling their demonstration in light of recent events. Up until Jeremy Christian pulled out a knife, he sounded just like them. To show that they do not condone his behavior — and not risk being seen as "reasonably believed to be involved in unlawful activity" and held responsible should another attack happen — canceling might be in their best interest to preserve their freedom of speech.

Whether or not these demonstrations happen, it’s on the rest of us to not let an ideology of hate win out.

We can look to the brave men who lost their lives to this senseless violence as an inspiration to recommit to looking out for one another and standing up against hate. That might just be the best way to honor their memories.

A memorial set up in Portland shares a message of love and hope. Photo by Alex Milan Tracy via AP Images. Source:

This artist says girls’ sports matter, and she’s putting her money where her mouth is.

A high school volleyball team in Hawaii needs equipment. Some middle schoolers in California need new running gear.

All over the country, girls’ sports teams are relying on the website DonorsChoose to raise enough money to keep their programs going.

If they fail, these girls might lose access to the only sports available to them.

They might even fall out of athletics entirely.

But there’s good news: Thousands of young girls are about to be "Blown Away" by the generosity of one of country music’s biggest stars.

Photo by Christopher Polk/Getty Images for Stagecoach.

Carrie Underwood recently announced she would shell out over $200,000 toward these fundraising efforts.

She teamed up with Dick’s Sporting Goods to fully fund all of the girls’ sports causes posted to the site this May.

"Sports were a big part of my life growing up," the pop and country singer (and seven-time Grammy winner!) said in a press release. "So it’s important to me that girls across the country have an opportunity to play."

The money is expected to fund about 100 programs across the country and should go a long way toward buying uniforms, equipment, and transportation.

Photo by Mike Coppola/Getty Images for CMT.

The money will no doubt make a big difference. But the message behind the donation might be even more powerful.

Underwood’s donation couldn’t come at a more crucial time for women’s athletics.

Female athletes all over the world are fighting tooth and nail to be taken seriously, to be paid fairly for their performance, and to get the same kinds of resources and support as their male counterparts — not to mention the same amount of respect.

It’s imperative we send a message to young girls that sports are for them. After all, participation in sports has been shown to grow skills like teamwork, leadership, and work ethic.

It’s awesome to see Underwood using her platform to spread the message. No doubt she believes playing sports as a young girl helped turn her into the success she is today.

Disclaimer: GOOD, which is part of GOOD Worldwide along with Upworthy, has a sponsorship relationship with Dick’s Sporting Goods, but we were not paid in any way for this story. (We’ll always be up front with you when we are.) Source:

6 ways America might look different 83 years after leaving the Paris Agreement.

With the Trump administration reportedly set to leave the Paris climate agreement, it’s time to focus on what’s really important: tourism!

Since the rollout of Trump’s Muslim ban, hotels, airlines, and destinations are already losing millions as international travelers avoid the United States. But by leaving the Paris agreement, under which signatories agree to limit global temperature rise to two degrees Celsius, the administration is ensuring that the tourism industry of 2100 will boom like never before!

President Trump may be scaring away visitors now, but America will look like a completely different country by then. A mere 76-80 years after Trump is gone, America will deliver a whole new climate change-affected experience for the adventurous tourist to enjoy!

We might be too lazy to change the slogans, but nature is probably going to change the views a whole lot.

Get pumped. Here’s what the rebrand might look like:

1. Visit beautiful Miami!

Your grandma’s old condo is in there somewhere. Photo via iStock.

Without the concerted effort to curb carbon emissions and reduce temperature rise mandated by the Paris Agreement, the ensuing six- to 10-foot sea level rise by 2100 would probably sink much of the Florida city.

On the plus side, more party yachts and deep sea fishing!

2. Experience nature’s defrosted majesty at Montana’s Glacier National Park!

Photo via iStock.

The park’s signature glaciers have already shrunk 40% over the past 50 years, and the more global temperature rises, the more that trend is expected to accelerate.

Why haul your family all the way to Montana for some boring millennia-old ice sheets when you could travel thousands of miles to see … just some regular mountains!

3. Explore the magnificent, colorful coral reefs of Key West!

Photo via iStock.

Ocean warming has already bleached 91% of the Great Barrier Reef. And if it can happen in Australia, there’s no reason why it couldn’t happen here too.

Turns out, it already is — down in the Florida Keys! And more to come as the temperature rises!

We’re #1! We’re #1!

4. See the majestic swimming ponies of Assateague Island!

Photo by Alex Wong/Getty Images.

The famous Maryland/Virginia horse sanctuary is one of many eastern barrier islands that could be doomed by rising sea levels. Every year, the wild herd swims from Assateague Island to Chincoteague Island, a tourist event that draws 50,000 people to the small island community.

If sea levels continue rising, the ponies might have to adjust to longer swims — but the island’s kayaking industry will boom!

5. Roam the rolling wheat fields of Kansas!

Part of a complete breakfast. Photo via iStock.

A 2015 Kansas State University study found that wheat production will likely decline 6% for every degree Celsius of temperature rise.

With more of the state’s fertile farmland decaying into hazy, spooky wastelands, Halloween travel to the state is sure to explode!

6. Get up close and personal with history at Mar-a-Lago!

Photo via iStock.

Along with the rest of southern Florida, a double-digit sea level rise could reduce President Trump’s favorite play place to damp, moldy rubble.

If ruined monuments to civilizational hubris rake in the bucks in Greece and Rome, imagine how well they’ll do in a country that really knows how to cash in!

While the window to stop the president from withdrawing from the Paris Agreement appears to be closing (for now), it hasn’t happened yet!

Which means if you like America as is, there’s still time to try to preserve it for your kids and grandkids.

Photo by Astrid Riecken/Getty Images.

For those of us who aren’t in office, one of the most effective ways to help save the planet is to let those who are know how we feel about the choices they make.

According to an Associated Press report, 22 Republican senators are pressuring Trump to leave the accord. If you’re represented by one of them, you can give them a call to try to change their mind.

If you’re represented by Sen. Lindsay Graham, Rep. Vern Buchanan, or any of the other Republican elected officials who support staying in the agreement, call them and tell them to keep doing what they’re doing.

Even if the agreement goes down, all won’t be lost right away. Here’s some hopeful reading that describes the best-case scenario to a Paris Agreement-less U.S. — a massive grassroots backlash that leads to more renewable energy innovation and a greener future. And cities and states are stepping in to enact tougher emissions rules where the federal government is stepping back.

But in the meantime, get calling.

The stakes are too high to hope for the best. Source:

We’re studying astronaut health in deep space and the effects of space travel on the human body’s immune system:…

Bill Gates: Melinda and I are happy to welcome 14 new members to the Giving Pledge and look forward to learning from them:…

Time Is Running Out To Apply For OZO Storytellers

Nokia’s OZO range of professional virtual reality (VR) cameras are among the best-rated products for capturing high-quality 360-degree and VR footage, but that high quality comes at a significant price that makes it out of reach of most users and even some companies. However, Nokia does offer support to the aspiring VR content creator in the from of the OZO Storytellers program.

The Nokia OZO Storytellers program allows successful applicants to purchase a top-of-the-range OZO+ camera for $25,000 (USD), which is a significant price cut from the usual retail price of $40,000. In exchange for the price cut, members of the OZO Storytellers program provide VR content captured with the OZO+ and provide feedback on Nokia’s products and services.


By sharing VR and 360-degree content with Nokia, it allows aspiring content creators to share their work with a broad audience of Nokia partners as well as consumers. In a blog post about the OZO Storyteller program, Nokia said: “In order for VR to truly succeed, we want as many creative visions as possible to be realized through the power of our technology. That’s why today we’re also introducing the OZO Storytellers Program — to help more content creators make amazing VR content, and put OZO+ into more talented hands who will take it to places no one’s ever been before.”

Nokia are only accepting applications into the OZO Storyteller program up until the 18th June, 2017, so time is running out for those who wish to apply. Applications can be made through the Nokia OZO website, with terms and conditions being listed as part of the applications process.

VRFocus will continue to report on opportunities for VR content creators. Source:

The World’s Largest Floating Solar Power Plant Just Opened in a Flooded Coal Mining Area

worlds largest floating solar power plant The Worlds Largest Floating Solar Power Plant Just Opened in a Flooded Coal Mining Area

Photograph by Sungrow Power Supply


The world’s largest floating solar power plant was recently connected to the local power grid in Huainan, China. The 40-megawatt facility was installed by Sungrow Power Supply on an area that was flooded due to coal mining operations in the region.

According to Digital Trends, ‘these floating apparatuses free up land in more populated areas and also reduce water evaporation’; while the ‘cooler air at the surface also helps to minimize the risk of solar cell performance atrophy, which is often related to long-term exposure to warmer temperatures’. [source]

PV Tech also adds that the floating plant is located on flooded land with the depth of water ranging from 4 to 10 meters and that a 20MW floating system in the same region had been the largest operating since early 2016. [source]



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