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Justin Gallagher, associate publisher of The American Journal of Managed Care. Welcome to This Week in Managed Care, From the Managed Markets News Network.

The Federal Trade Commission just cracked down on an unusual product that has long enjoyed exemption from regulation: homeopathic drugs. Available everywhere...homeopathic products are advertised as an effective way to treat a wide range of conditions...Americans spend over $3 billion a year on homeopathy, and the market appears to be growing steadily...companies selling these products have never been required to show they are effective at doing what they claim...the FTC announced its “enforcement policy statement” about homeopathic product labeling...the recommendations are pretty minimal...the agency produced a report that concluded customers were likely to be deceived by labels that did not carry the appropriate disclaimers, and therefore disclaimers stating that these products are untested will now be required. The requirement is not technically a law like…The rules require packaging to effectively communicate two key disclaimers:

•     “There is no scientific evidence that the product works.”
•     “The product’s claims are based only on theories of homeopathy from the 1700s that are not accepted by most modern medical experts.”

Teva has halted production at the Rimsa plant in Mexico and idled some of the workers, laying the blame for the issues at the feet of the brothers with whom they are battling in court over the $2.3 billion buyout...Teva acknowledged today that Mexican authorities suspended manufacturing at the plant in October saying the action followed...discovery of the serious violations committed under the Espinosa brothers, Rimsa's former owners....We are working closely with the Mexican authorities in order to restore production and products to the market…Mexico’s Federal Commission for Protection against Health Risks...took its action in response to a complaint by Teva. The agency is now said to be verifying that the 140 products manufactured at the plant in Guadalajara meet quality, safety and efficacy standards. COFEPRIS expects to complete its analysis by year-end...

If Novartis does snap up Amneal to beef up its own Sandoz unit, the deal will say as much about the state of the generics industry as it does about Novartis...True, Novartis is having trouble with its Alcon ophthalmology unit and it's been shopping for deals for some time. But generics companies have their own struggles, and building up by dealmaking is one way to combat them…Pricing pressures are putting a damper on sales and profits, and many analysts believe this pressure will only increase. The bigger generics makers are consolidating to become even bigger, because scale means better margins...Meanwhile, the FDA is under pressure to speed generics through the approval process, thanks to Mylan’s EpiPen pricing scandal and the attention it brought to copycat drugs with few-to-no generic competitors...the FDA is planning a renewal of the Generic Drug User Fee Act that would limit review time to 8 months...Look for the consolidation discussion to continue in generics, because the pricing problems, accelerating approvals and margin pressure aren’t going away anytime soon...

On Nov. 8 voters in California, Maine, Massachusetts and Nevada approved ballot measures to legalize recreational cannabis. It is now legal in a total of eight states. And this creates potential problems for road safety. How do we determine who’s impaired and who’s not?...The effects of alcohol vary based on a person’s size and weight, metabolism rate, related food intake and the type and amount of beverage consumed. Even so, alcohol consumption produces fairly straightforward results: The more you drink, the worse you drive. Factors like body size and drinking experience can shift the correlation slightly, but the relationship is still pretty linear, enough to be able to confidently develop a blood alcohol content scale for legally determining drunk driving. Not so with marijuana...Second to alcohol marijuana is the drug most frequently found in drivers involved in crashes...But how do you know when you’re too stoned to drive? How can police tell?...the Center for Medicinal Cannabis Research at UC San Diego...received a...$1.8 million grant from the state of California to gather data about dosages, time and what it takes to impair driving ability...then create a viable roadside sobriety test for cannabis...

The rising cost of medicines may be a growing problem for many Americans, but a new survey finds that cost is generally not a key factor when doctors decide which treatments to prescribe their patients. Among six different types of doctors queried, only primary care physicians cited cost as among their most important considerations. Forty-seven percent ranked the issue as a key concern, behind evidence that a drug is safe, effective and well-tolerated…many physicians remain more concerned with finding the best medicine for the ailment at hand, as they should. But this will also place more of the onus on patients to talk to their doctors about affordability when reviewing treatment options...

Teva is trying to clean the slate on its history of allegedly paying bribes in foreign countries to boost sales. Having revamped its governance programs and set a new tone about bad behavior, it has now put aside more than half a million dollars to cover anticipated settlements with U.S. authorities...Teva revealed it was in “advanced discussions” to settle investigations by the Justice Department and SEC into violations of the Foreign Corrupt Practices Act and set aside about $520 million to cover the expected settlements. It said those discussions concern matters that occurred in 2007-2013 in Russia, Mexico and Ukraine...Teva emphasized that none of the conduct involved its U.S. business, inferring instead that it was problems with third parties and subsidiaries. It pledged to do whatever it can to prevent a repeat...The compliance program that Teva has in place now is serious, rigorous, and comprehensive and is designed to protect the company and its subsidiaries against future violations…

The problem with pills is that you have to take them on a regular basis. An innovative new pop-up capsule solves this problem by staying in the stomach for days, where it slowly releases medication over the course of an entire treatment...This “ultra long-acting oral drug delivery” system was developed by researchers at MIT and healthcare firm Lyndra, and it’s changing the way we think about pills. After swallowing, the capsule unfurls into a star-like shape—a configuration that prevents it from entering the digestive tract, while still allowing food to pass. Then, for the next seven to ten days, it stays in the stomach, slowly releasing medication. The star eventually breaks down, allowing it to safely pass through the intestines…this pill will be particularly helpful in the developing world, and for those who have difficulty, for whatever reason, taking drugs as prescribed, including patients with hypertension, diabetes, neurological disorders, and opioid addiction.

One day before Walgreens Boots Alliance severed its relationship with the blood-testing laboratory Theranos in June 2016, Theranos acknowledged to Walgreens executives that more than 10% of the test reports —  totaling 31,000 test reports altogether —  that were provided to Walgreens customers who used Theranos' services had to be voided. "[Theranos] stated that 31,000 Walgreens customers had received voided test reports, which was 11.3% of total Walgreens customers," Walgreens alleged in court papers filed Tuesday...According to Walgreens, Theranos broke each of the promises made to the Chicago-based retail pharmacy operator, which had entered into an exclusive arrangement with Theranos in July, 2010, and which was later amended in June, 2012. The 2012 agreement provided the framework under which Theranos Wellness Centers could operate inside Walgreens' stores...

The holidays came early for the pharmaceutical industry this year...With Donald Trump elected to the White House and Republicans controlling Congress, the companies that make your medicines can expect a friendlier environment in which to operate. And investors quickly responded by boosting drug and biotech stocks…So what lies ahead? Here are a few predictions:

• FDA will stand for Faster Drug Approvals - Many Republicans would like to speed the Food and Drug Administration process for getting new medicines to patients.
• Drug makers will have more leeway on pricing - A big bet now is that the Trump administration will not be as aggressive in tackling prescription drug prices as a Clinton administration might have been.
• Friendly tax policies are on the way - Another key piece of the Trump plan is tax reform. Again, the Trump team is short on details, but one plan floating around is to allow companies to repatriate money parked overseas and pay taxes of only 10 percent or less, instead of 35 percent.