Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

While governments in at least 20 other states obtained more than 30 million doses of the drug through donations from the federal reserve or private companies, Oklahoma and Utah instead bought them from private pharmaceutical companies. Top officials in both states chalked up the decisions to “the fog of war.”  Oklahoma Gov. Kevin Stitt on Tuesday defended the state’s $2 million purchase, saying the drug was showing some promise. His health secretary attributed buying the 1.2 million hydroxychloroquine pills to something that happens in the “fog of war.”  Utah Gov. Gary Herbert at first defended the state’s $800,000 purchase of 20,000 packets of hydroxychloroquine compounded with zinc, but has since ordered an investigation of a no-bid contract with a local company that had been promoting the drugs. Herbert, a Republican, also canceled an additional plan to spend $8 million more to buy 200,000 additional treatments from the same company. A left-leaning nonprofit group in Utah filed a price gouging complaint Tuesday with state regulators, arguing the $40 per pack drug was grossly overpriced. Oklahoma’s attorney general requested an investigative audit on Tuesday of its Department of Health over spending and warned the agency about retaliating against employees who report wrongful government activities under the state’s Whistleblower Act. A spokesman for Attorney General Mike Hunter declined to comment on whether the request was related to the $2 million spent on the drug. Doctors can already prescribe the malaria drug to patients with COVID-19, a practice known as off-label prescribing, and many do. But the U.S. Food and Drug Administration on Friday warned doctors against prescribing hydroxychloroquine for treating the coronavirus outside of hospitals or research settings because of reports of serious side effects, including irregular heart rhythms and death among patients. Preliminary results from a recent study done on coronavirus patients at U.S. veterans hospitals showed no benefit, casting more doubt on the drug’s efficacy during the pandemic. Those were the latest admonitions against the drug that Trump has regularly promoted in public appearances, touting its potential despite his own health advisors telling him it is unproven. Oklahoma acquired 1.2 million pills, or about 100,000 doses, on April 4 from FFF Enterprises, a California-based medical supply wholesaler, according to the Oklahoma State Department of Health. Oklahoma state Rep. Melissa Provenzano, a Democrat from Tulsa, said the state’s purchase shows that Gov. Stitt’s actions don’t follow his claim that he relies on data to drive his decisions. “Two million dollars is a lot of money to waste, especially when we have unemployment claims approved yet going unpaid, health care professionals without proper protective equipment, and diagnosed cases and deaths continuing to rise,” Provenzano said. Stitt, a first-term Republican, said hydroxychloroquine was showing some promise as a treatment in early March, and he didn’t want Oklahoma to miss out on an opportunity to acquire it. “Now there’s some evidence the chloroquine may not be as effective, but I was being proactive to try and protect Oklahomans,” Stitt said Tuesday when asked about the purchase. “That’s always going to be my first instinct, to get the equipment and things we need that I’m seeing in the future would help Oklahomans.” Oklahoma’s Secretary of Health Jerome Loughridge said several physicians, including some in Oklahoma, were previously optimistic about the drug’s promise in treating COVID-19. He added that the drug is also useful for treating lupus and some other auto-immune diseases, so the state’s supply “will not have gone to waste.” “When we were battling sort of the fog of war at that point, we certainly acquired it on the potential that it would have utility,” Loughridge said. Jeff Burton, a former adjutant general of the Utah National Guard chosen to lead the state health department’s coronavirus task force, offered a similar explanation for why the state made its purchase. He said the state never received the pills and is trying to get its money back. “I chalk it up to fog of war,” Burton told the state’s pharmacy board. “There was a lot going on. It’s easy to judge it from (an) easy chair.. . . Since then we’ve decided that was not a wise purchase.”  Doctors in Oklahoma have been using the drug to treat patients with COVID-19, often in conjunction with a second drug, azithromiocin, but the results “just are not that promising,” said Dr. Douglas Drevets, chief of infectious diseases at University of Oklahoma Medicine. FFF Enterprises said it’s the company’s policy not to comment on transactions with customers. Utah gave a local company called Meds in Motion the $800,000 contract without taking bids from other companies under emergency procurement rules, said Christopher Hughes, director of Utah’s division of purchasing. State officials haven’t explained why they didn’t seek to get the drugs for free. The Federal Emergency Management Agency said Saturday it has sent out 28.6 million tablets of hydroxychloroquine sulfate free of cost to states around the country. Several states including New York, Connecticut and Texas received donations of the medication from a private company based in New Jersey called Amneal Pharmaceutical, according to information compiled by The Associated Press. Utah taxpayers deserve to know what happened to allow a purchase that seems like a company taking advantage of the early, chaotic days of the pandemic, said Chase Thomas, executive director of the group called Alliance for a Better Utah that submitted the price gouging complaint. The complaint alleges Utah paid at least double the common price for the medication. “Whether they were buying drugs we didn’t need or paying too much for it when they could have gotten them for free, there just needed to be a lot more thought going into this,” Thomas said. Meds in Motion didn’t answer an email seeking comment about the allegations. Herbert declined to provide an update Tuesday about the investigation of the purchase. He said Friday the state’s legal counsel would aim to find out what, how and why it happened. He said he believed state officials acted in good faith as they scrambled to slow the spread of coronavirus, but acknowledged a mistake may have been made. “I have some questions about how it came about,” Herbert said Friday. “Bottom line is, we’re not purchasing any more of this drug.”  ___ McCombs and Whitehurst reported from Salt Lake City.
Oklahoma, Utah face scrutiny over malaria drug purchases.

The story did not discuss the costs of PSA tests or provide estimates of the costs for following up an increase in PSA with a biopsy. These are significant cost issues, which warranted at least a line in the story. The story didn’t quantify the potential reduction in biopsies. The competing AP story was much better on this point, reporting that using rising PSA levels, 1 in 7 men would have a prostate biopsy as compared with 1 in 20 men based solely on high PSA level. This suggests that change in PSA level results in 13/20 unnecessary prostate biopsies. The story could have provided more detail on some of the possible complications resulting from prostate biopsies. It did mention anxiety from tracking PSA levels over time.
Rapid Rise in PSA Levels a Poor Predictor of Prostate Cancer: Study

"Since the story mentioned the high cost of alternative treatment (weekly ""dialysis"" type of process costing $3,000/week and ""most health plans won't cover""), it could have at least commented on the potential cost of this new approach, even if to simply say that the cost is not yet known. The implicit suggestion is that this new drug will be cheaper than the ""dialysis"" process, which, of course, is not known. Benefits are reported in relative vs. absolute terms. See our primer on this topic. The story states that fatty liver is a potential serious harm of treatment and provides proportions of people in the very small study that experienced some form of this complication. Of course, given how small the study was, it's not possible to know what this may mean clinically. However, the story points that out, stating that more studies are needed to better understand how serious this complication may be. Plus, the story also discloses that the manufacturer shelved this particular drug because of safety concerns over this side effect. While the potential harms are not fully understood scientifically, this is discussed in the story and the potential safety issues around this are not minimized by the reporting. The type of study is not mentioned, and although some limitations in study design are pointed out, these are not discussed so that an average person would not know that these results are very preliminary and should be interpreted with great caution. No disease mongering. Familial hypercholesterolemia is described as a condition in which very few people who have it live beyond 30 years and that this condition affects very few people in the U.S. One researcher not affiliated with the research is quoted in the story. Of course, her statements are conditional on whether or not the treatment does what researchers claim it does (since she is not involved and the research is very preliminary), but given the very early nature of the research, it may not be reasonable to find an independent expert who knows any more about the findings. The article does describe the only other option for treating (or slowing progression of) this condition, which was some form of dialysis to remove fats. The story also describes the cost information for this alternate treatment. The article states the drug is ""experimental,"" which implies this is not available outside of research. The story states the drug is experimental, implying this is new. The story quotes an independent source, so it appears the story did not rely solely or largely on a press release."

Experimental drug cuts rare, lethal cholesterol levels in patients