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There is no official data on how many cancer patients in China turn to unregulated channels, but research indicates an increase globally in the use of gray and counterfeit markets...Medicines bought through unofficial channels are not necessarily harmful, and some of the Indian generics available online are approved for use in other markets. But they can include drugs that are ineffective or fake...The reason patients in China turn to these unregulated channels are largely financial...Low average salaries, a chasm between urban and rural wealth, and creaking state reimbursement schemes mean serious disease is among the leading causes of poverty, creating a major social burden and rising debt...Turning to unofficial channels can also carry a legal risk...It's because of problems with China's public health insurance system that so many seriously ill patients aren't able to survive…

As drug prices have spiraled upward, tens of millions of generally law-abiding Americans have committed an illegal act in response: They have bought prescriptions medicines outside the U.S. and imported them...It's no secret that some Americans regularly buy prescription drugs on the Internet or while traveling abroad. But the popularity of the approach is underscored by the results of a Kaiser Family Foundation poll conducted in November...Eight percent of respondents said they or someone in their household had imported a drug at some point...The Kaiser poll queried a nationally representative sample of 1,202 adults...The Food and Drug Administration has cautioned that many online pharmacies aren't what they seem to be. An international crackdown in 2014 found that many packages of medicines purportedly from Australia, Canada, New Zealand and the U.K. contained drugs from other countries, including India, China and Laos...imported medications could be inferior or expired. Some could be counterfeits. But many medicines purchased from another country are the same as the ones patients buy in the U.S...When purchased outside the country, many prescription medicines cost half or less than they do in the U.S...it is generally illegal for Americans to import drugs into the U.S. for personal use. The law isn't rigorously enforced, in part, because it is difficult to monitor the entry of medicine in suitcases and small packages...in 2015 the FDA implemented a rule that would give government border inspectors expanded authority to destroy drugs imported for personal use at their point of entry.

...Mylan Pharmaceuticals CEO Heather Bresch accepted "full responsibility"...for the price hikes that caused national outrage..."If EpiPen had to be the catalyst to show what hardworking families are facing, it will have been worth it," she said...referring to the upfront costs that many people encounter with high-deductible health plans. Mylan increased the price of an EpiPen two-pack nearly 550 percent to $608 over the past decade...Bresch reiterated remarks she made...at a congressional hearing...citing a lack of transparency in the pharmaceutical pricing system for the controversy surrounding the product. She justified the price increases by pointing to what she insisted were "investments" made to improve the device and patient access...the company has made plans to sell its own authorized generic version of EpiPen at roughly half the price. And...agreed to a $465 million settlement with the Department of Justice for shortchanging Medicaid over rebates...Meanwhile, the Federal Trade Commission was asked by various lawmakers to investigate whether Mylan violated antitrust laws because the contract for one option in the discounted school program, at one time, contained a clause forbidding school districts to buy rival products...

In hopes of reducing inappropriate opioid prescribing, the Chicago City Council...passed an ordinance that requires all pharmaceutical sales reps to become licensed...The ordinance, which the pharmaceutical industry opposed, will require sales reps to undergo training for ethics, marketing regulations, and applicable laws. Reps will also have to file reports with the city that disclose the names of doctors they visit as part of their work, the number of visits, and any samples, materials, or gifts provided, along with their value. Reps will also have to pay a $750 licensing fee and renew the licenses annually...The move is the latest effort by the city to combat an epidemic of deaths and overdoses attributed to opioid painkillers...The city expects to collect more than $1 million in licensing revenue and will use that to support ongoing efforts to educate doctors and the public about opioids, and cover the cost of regulation...I think will be hard to prove its an effective way to control the prescribing, so I don’t think it’s really going to solve the problem directly. It might help indirectly if the city can say that overprescribing is caused by aggressive sales tactics...I’m not sure how they can manipulate the data to prove anything. But they may be able to squeeze something out of the data. They’re asking for a lot...

About a week after the largest-ever open enrollment day for Affordable Care Act coverage, federal health officials are reporting a year-to-year enrollment increase, with states including Nevada posting an uptick...Nevadans...coverage increased about 3 percent — or by about 1,900 people — over 2015…The number of plan selections...was 60,617 in Nevada, compared with 58,752 by last year’s...deadline...In a statement Wednesday, officials argued the increase showed “clear demand for quality, affordable coverage.”

FDA admonishment of Celgene and Sanofi for DTC TV ads has industry insiders checking the tea leaves for what the letters might signal. The upshot? Possibly an end to overly happy and energetic lifestyle pharma ads...The main complaint in both untitled letters from FDA drug marketing enforcer OPDP (Office of Prescription Drug Promotion) —to Celgene for oral psoriasis treatment Otezla and Sanofi for diabetes drug Toujeo—is distracting music and visuals that interfere with consumers fully understanding the risk information. Both ads have been running since this summer...These commercials are not much different from many other upbeat DTC ads with music...If they are cracking down on these two, then they have decided to look at all of these type of ads. FDA is very subjective about these kind of violations...Sanofi told FiercePharma in an interview last week that it is working to pull the Toujeo TV ads, while Celgene said more broadly that it will work with the FDA to address its concern.

As insurance companies nationwide look for ways to cut costs, commissions for individual plans have been reduced and in some cases eliminated...That has led many of the hundreds of brokers and agents in Nevada to focus on other more-profitable sectors and made it harder for shoppers to find help navigating the complicated and confusing marketplaces for individual health insurance, either private or via the Affordable Care Act exchange...On the Silver State Health Insurance Exchange, the state’s official portal for so-called Obamacare plans, the number of brokers and agents registered to assist users declined from roughly 500 last year to about 150 this year…Nevada’s largest insurer, UnitedHealthCare, said that it will still pay commissions on renewals, though at a lower rate, but not on new policies...Our actions are consistent with our long-stated approach to continually evaluate the dynamics of the market as they evolve, and to refocus our resources as necessary so that we can provide consumers with access to quality care…

On the heels of headline-grabbing price spikes on prescription drugs, a bipartisan Senate report on Wednesday will call on Congress to take action to prevent huge, unjustified cost increases on decades-old prescription medicines that have no competition...The Senate Special Committee on Aging, reporting the results of a yearlong investigation, said that some drug companies behaved like hedge funds because of the influence of “activist investors.” These companies, the committee said, have developed a “business model that harms patients, taxpayers and the U.S. health care system.”...Our report does not recommend that the government get into the business of setting prices for prescription drugs...We think that would have a harmful impact on the pipeline of innovative drugs...I don’t think we can ignore the market failures that have occurred. The answer is to figure out how we can revitalize the market so that generic drug producers have incentives to compete with companies that are buying up drugs and jacking up prices to make quick, exorbitant profits...

The Department of Health and Human Services is giving pharmacies more flexibility to extend their reward and loyalty programs to beneficiaries in government programs such as Medicare and Medicaid…it will allow government program beneficiaries to enjoy access to programs voluntarily implemented by pharmacies, which reduce health care costs, improve quality and promote patient health...This is a very positive step forward for pharmacy patient care...and of the expanded innovative programs that pharmacies provide...Programs vary in their designs but often include cost savings or other rewards for filling prescriptions or engaging in other health-related activities, such as health screenings, medication adherence programs or healthy lifestyle behaviors…

Higher prescription drug prices, combined with changes to Medicare and Social Security, could deal a $1.6 billion blow to state budgets next year by forcing them to ratchet up spending on Medicaid…Without congressional intervention, most state Medicaid agencies will have to come up with tens of millions of dollars to cover the bill...The new costs could prompt states to tighten eligibility requirements or cut benefits...The new costs come at a time when many states already are experiencing budget strains...About $1.2 billion of the $1.6 billion projected Medicaid hike for the states is the result of higher prices for prescription drugs in Medicare, the federal health plan for the elderly and disabled people. Medicaid and therefore the states are affected by a group of “dual eligible beneficiaries,” who receive both Medicare and Medicaid benefits because of their low income...