Why is it always lettuce?

The US celebrated Thanksgiving last week, and many did so without including romaine lettuce, which is the source of yet another E. coli outbreak. That’s three in the last year for those keeping score at home. As of Friday, the FDA has identified that the tainted greens likely came from California… dang, can that state get a break? While the west half of the country has the objectively wrong choice for favorite Thanksgiving side dish, they should at least be able to enjoy it on that hallowed day. California also had the highest share of affected persons, totaling 10 of the 32 cases. FDA Commissioner Scott Gottlieb noted that they’re working to get date labels on “post-purge” (so, unaffected) produce, something that could evolve into a standard practice anyway.

Not that kind of drug registry

Have you ever looked at the online sex offender registry for your neighborhood? Not reassuring, right? Well, it looks like the state of California may soon have a similar system for drug makers. On Governor Jerry Brown’s desk is a law that would require drug manufacturers to give the state notice of price increases so that these can be posted on the internet. Even the slightest of cynics would wonder if this is being done simply to increase public (and media) pressure on a drug company that might otherwise be tempted to act like a total Shkreli. While this seems like a slam dunk for a left-leaning state like California, recall the ballot initiative that failed last November that would have capped the cost of certain drugs at the price paid by the US Department of Veterans Affairs. Strange days.

1. Forecast calls for scattered drug hoarding

Providing notice of drug price increases sounds reasonable, right? “Not so simple,” say opponents of proposed California drug pricing legislation that calls for a 60-day notice of price increases.  Opponents of the bill contend this could hang small pharmacies out to dry as larger pharmacies might be motivated to hoard drugs to avoid the higher prices to come. This could leave areas with fewer hospitals and pharmacies in danger of not being able to obtain drugs for patients with chronic illnesses. The bill could set a precedent in a movement to open up transparency across the health care system. But it could also lead to some nasty unintended consequences. Ugh.  Healthcare is hard.

3. Political push for lower drug pricing

Want votes, take aim at pharma. The most recent legislative juggernaut takes form in the California Drug Price Relief Act, a ballot initiative seeking to limit drug pricing in the state, and one that could potentially open the gates to Medicare drug-pricing negotiations. Needless to say, pharma is not down for this- they’ve set aside millions to fight it. The initiative received strong backing from Senator Bernie Sanders, a long-time proponent of pricing regulation. While some may write off Sanders support as part of a far-leftist agenda, he is one of several candidates looking for change. Leading party candidates Hillary Clinton and Donald Trump, have both condemned the existing system, making it pretty clear that both sides of the aisle are pushing for major changes in drug pricing.

5. Pharma is locked on 2016 election

Each election cycle it is common to hear people say, “Every vote matters.” This election, particularly the voting in California, matters a little bit more to Pharma. According to a Politico article, a ballot initiative in California is seeking to give the state the ability to negotiate drug prices, or at least pay no more than the U.S. Department of Veteran Affairs. Feeling pricing pressures from all sides, it seems likely that, if passed, this initiative would set a precedent for other states to follow. Pharma, currently struggling with consumer backlash, is looking to fight this initiative with the help allies such as patient advocacy groups, veterans’ organizations and the California NAACP.

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