TASK DEFINITION: Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
PROBLEM: Paragraph: "Patients used to pay $10,000 a year for cancer drugs, but now they’re paying $10,000 a month, according to HBO talk show host Bill Maher. That’s a message circulating on Facebook recently, promoted by the ""Bill Maher Fanpage."" A reader asked us to check it out. The quote comes from the Oct. 2 episode of Real Time with Bill Maher, where Maher discussed Turing Pharmaceuticals, the company that jacked up the cost of a life-saving drug from $13.50 to $750 essentially overnight. ""Not that (Turing CEO Martin) Shkreli is unusual for the pharmaceutical industry,"" Maher said on his show. ""Fifteen years ago, cancer drugs cost an average of $10,000 a year. Now it’s $10,000 a month because this cartel owns the U.S. government every bit as much as Mexican drug lords own theirs."" It’s well known that the cost of health care is on the rise, but has the annual cost of cancer drugs really increased so dramatically in just a decade and a half? Maher’s team sent us links to some news articles about the rising cost of cancer drugs, and we tracked down information that speaks to his claim. The best information we could nail down is the cost of anticancer drugs at launch, the initial price when the Federal Drug Administration approves a drug. These are the sticker prices set by the pharmaceutical companies, not the prices patients actually pay out of pocket, which are reduced by insurance payments, patient assistance programs and other discounts. Costs increases, though, are often passed on to consumers. Maher has a point that cancer drug costs are on the rise. We charted the launch costs of cancer drugs the FDA approved since 1999, using a list compiled by Memorial Sloan Kettering Cancer Center. The second half of Maher’s statement -- that cancer drugs now cost about $10,000 a month -- is also on solid ground. Of drugs approved in 2015, the monthly average cost is $11,319. And experts in the field often cite that $10,000 figure themselves. Because many cancer drugs are not administered to patients for a full year, it’s difficult to determine an average annual cost, so the first half of Maher’s statement -- that they cost about $10,000 a year 15 years ago -- is hard to nail down. To his point, though, the monthly cost of a new drug was dramatically lower in 2000 than what it is now at about $4,634. One of the news articles that Maher’s team sent us is an academic article in the Journal of Oncology Practice that supports his statement. The report reads, ""The average cancer drug price for approximately one year of therapy or a total treatment duration was less than $10,000 before 2000."" Maher’s statement is ""in the ballpark,"" if not an understatement, said Rena Conti, a health economist at the University of Chicago who researches cancer drug prices. In a 2015 paper Conti authored with three other leading health economists, she examined the launch cost of anticancer drugs controlled for inflation and the benefit to the patient (how much it prolongs life expectancy). For example, in 1995, anticancer drugs cost $54,100 for an additional year of life, the study found. In 2005, drugs cost $139,100 for the same benefit, and the price grew to $207,000 in 2013. In the United States, pharmaceutical companies set their own drug prices. What’s pushing them to increase the costs? It’s not necessarily that cancer drugs are getting better and are thus worth more. Conti’s research concluded that just about one-fifth of the cancer drug cost increase can be attributed to a better product. There are two primary forces behind annual cancer drug cost increases, Conti said: First, pharmaceutical companies estimate a ""zone of indifference"" -- based on last year’s prices, how much more would buyers be willing to pay? Second, rebates and discounts for drugs have also increased over time, and this creates an incentive for drug companies to increase their costs alongside the discounts. Pharmaceutical companies defend drug price increases by emphasizing that the revenue funds innovative research and that drugs lower overall health care costs by treating illnesses. Because there’s no formal price regulation and competition in the industry is rare, ""It really is a system where there’s no downward pressure on drug prices,"" said Peter Bach, director of the Memorial Sloan Kettering Center for Health Policy and Outcomes in an interview with Fortune. Our ruling Maher said, ""15 years ago, cancer drugs cost an average of $10,000 a year. Now it’s $10,000 a month."" The average annual cost of a drug isn’t easy to calculate, given the way cancer drugs are scheduled; many drugs aren’t used every month for an entire year. So the first half of the statement is hard to verify, though we did find one academic source that cites a similar figure. However, Maher has a point that the cost of cancer drugs has increased dramatically since 2000, when the average monthly price of a cancer drug, when it first hit the market, was about $4,600. In 2015, the monthly cost is over $10,000. Maher’s numbers are a little squishy, but they’re in the ballpark." Claim: 15 years ago, cancer drugs cost an average of $10,000 a year. Now it’s $10,000 a month.

SOLUTION: "Maher said, ""15 years ago, cancer drugs cost an average of $10,000 a year. Now it’s $10,000 a month."" The average annual cost of a drug isn’t easy to calculate, given the way cancer drugs are scheduled; many drugs aren’t used every month for an entire year. So the first half of the statement is hard to verify, though we did find one academic source that cites a similar figure. However, Maher has a point that the cost of cancer drugs has increased dramatically since 2000, when the average monthly price of a cancer drug, when it first hit the market, was about $4,600. In 2015, the monthly cost is over $10,000. Maher’s numbers are a little squishy, but they’re in the ballpark."

PROBLEM: Paragraph: "The city of Fort Lauderdale’s latest attempt to regulate outdoor homeless feedings made international news when police nabbed ""Chef Arnold"" -- a 90-year-old caught in the act of such a public feeding. ""One of the police officers said, 'Drop that plate right now,' as if I were carrying a weapon,"" Arnold Abbott said, recalling his early November arrest for the Associated Press. Multiple news reports -- and Comedy Central’s The Colbert Report -- recounted the tale of Abbott’s arrest, which reignited a long-running debate about how the city should handle the homeless population downtown and at the beach. On Nov. 5, Fort Lauderdale Mayor Jack Seiler issued a statement in which he said he wanted to ""set the record straight"" about the city’s services for homeless. He said that the media had misrepresented the facts. ""Contrary to reports,"" Seiler wrote, ""the City of Fort Lauderdale is not banning groups from feeding the homeless."" Seiler said outdoor feeding is legal, but added that a new city law regulates the activity. Then Seiler addressed the situation regarding Abbott: ""At two recent outdoor food distributions, citations were rightly issued for non-compliance with the process enacted to ensure public health and safety. Contrary to what was reported in the media, no one was taken into custody. ..."" As the public-relations crisis escalated, Seiler gave multiple interviews to the media. On CNN Nov. 11, Seiler said Abbott ""was not arrested and taken into custody."" At PolitiFact Florida we agree with Seiler’s goal of setting the record straight. Was Abbott taken into custody? Fort Lauderdale’s laws about the homeless Abbott’s battle with the city has brought notoriety to Seiler, a former state representative who has been mentioned as a future statewide candidate for the Democrats. Seiler faces re-election to a third term in March. So far, no one has filed to run against him. Abbott, who founded an interfaith volunteer organization Love Thy Neighbor to help the homeless, has been battling city leaders for more than a decade. In 1999, the city tried to ban him from holding picnics for the homeless at the beach, offering him an alternative site miles away from downtown. But Abbott prevailed in court when a judge ruled that the city had violated his religious rights and that the city’s new location was too remote. Abbott resumed his feedings and resumed them in visible locations in Stranahan Park in downtown and along the beach. The battle has continued in recent years, with the commission passing a series of laws that attempted to regulate the homeless population, including a ban on soliciting for money at intersections and tougher laws against defecating in public. City officials, including Seiler, have argued that while the homeless should have access to services, including meals, they have heard complaints from some businesses and residents about the homeless population in downtown. Advocates have decried city officials for cracking down on the homeless with a series of laws. At an Oct. 21 meeting, the commission approved the ordinance about outdoor food distribution over the objection of protesters. The ordinance, approved by the Commission 4-1, codified a list of rules for outdoor food distribution, including that sites must be 500 feet away from residential areas, have bathrooms or portable toilets, equipment for hand washing and consent of the owner. The law allows indoor feedings at houses of worship. ""You have to balance the interests of everybody in the community,"" Seiler told PolitiFact Florida. ""What we always try to do is make sure everybody gets to enjoy our parks. Every single thing we have done with the ordinance is a balance."" But while the law itself doesn’t technically ban outdoor feedings, it raises the bar for groups such as Abbott’s in a way that makes it almost impossible to clear. (Abbott argues that the requirement that he get a port-a-potty should be moot since a public restroom is nearby and he says volunteers wash their hands before feedings and use gloves.) At the time of Seiler’s statement, Abbott had three run-ins with law enforcement related to the outdoor feedings: on Oct. 6, Nov. 2 and Nov. 5, police reports show. (The October arrest predated the new ordinance but the city already had a separate law banning social services in the parks.) On the first two occasions, Abbott was given a warning but then continued with the feedings. The third time, Abbott agreed to end the food distribution that day, police reports say. In none of the three instances was he handcuffed or taken to jail. Instead, he was given notices to appear in court. (In one police report, it states that Abbott shook the police officer’s hand before he left.) At least one other person helping with the feedings was also arrested in a similar manner. A city spokesman told PolitiFact Florida that the case stemming from the Nov. 2 arrest has been filed in court. The city has generally avoided referring to Abbott’s case as an ""arrest,"" but his attorney John David said that just because it’s not a ""custodial arrest"" doesn’t mean it’s not an arrest. For minor crimes, police use this type of arrest and give defendants notices to appear as long as the person has a connection to the area and is likely to show up in court. Nonetheless, ""it's an arrest, no doubt about that,"" David said. ""He is charged with a criminal offense."" Fort Lauderdale police Capt. Rick Maglione told PolitiFact Florida that ""It is similar to a misdemeanor arrest, but we do not have to take the person physically into custody and they can just show up in court and let a judge decide the case."" We interviewed a few criminal defense lawyers in South Florida not involved in the case and they agreed that the police did indeed arrest Abbott. ""With all due respect to the mayor, it is an arrest,"" said Brian Tannebaum, a Miami criminal defense lawyer. ""The fact that someone is not taken into custody does not make it something other than an arrest. Misdemeanor cases are handled with promises to appear all the time. The officer has discretion to take someone into custody, but even if they don't it is still considered an arrest."" City spokesman Chaz Adams told PolitiFact that although a notice to appear is technically an arrest, ""the mayor has been consistent in saying that Mr. Abbott was not ""arrested and taken into custody."" Abbott faces up to a $500 fine and 60 days in jail for each offense. However, lawyers say it’s unlikely that a judge will throw him behind bars. ""I can’t imagine anyone putting Arnold in jail,"" said Broward public defender Howard Finkelstein. His office is not handling the case, but he has praised Abbott. Abbott’s lawyer filed a motion in Broward court on Nov. 12 that asked a judge to enforce the injunction from the earlier case that allowed Abbott to continue the feedings. The city offered Abbott two alternative sites -- at the city’s aquatic complex near the beach, and at Church by the Sea, located near the beach -- but he rejected both. ""I plan to continue my feedings at the same site I have used for the past 23 years,"" Abbott told PolitiFact Florida in an email. Seiler says it’s not his call what penalty Abbott faces. ""We have to enforce the laws, we have to be consistent,"" Seiler told PolitiFact Florida. ""What the courts do with Mr. Abbott -- that’s up to the courts."" Seiler has defended his city’s reputation for serving the homeless, which includes working with nonprofits to provide services and allowing the county-run Homeless Assistance center to expand. The city’s police department also has a homeless outreach unit. Fort Lauderdale’s law about feeding the homeless is part of a growing national trend. Since 2007, 71 cities have attempted or enacted some type of rules related to food-sharing activities, according to the National Coalition for the Homeless. ""The best solution to the food-sharing issue is to have indoor meal programs available to the homeless three times a day, seven days a week,"" said Michael Stoops, director of community organizing National Coalition for the Homeless. ""If these locations were located conveniently in Downtown Fort Lauderdale, a good number of the homeless would opt to eat inside vs. outside. However, food-sharing with the homeless in public spaces would still be needed."" Our ruling Seiler said that ""no one was taken into custody"" for feeding the homeless. Seiler is correct that Abbott wasn’t taken into custody -- the activist was not handcuffed or taken to jail but was instead given a notice to appear in court. But his carefully worded claim glosses over the fact that Abbott was indeed arrested on more than one occasion for allegedly feeding the homeless in violation of city ordinances, something that leaves Abbott at least theoretically in peril of being sentenced to jail. Seiler’s claim is accurate but needs clarification or additional information, so" Claim: "No one was taken into custody"" for feeding the homeless."

SOLUTION: "Seiler said that ""no one was taken into custody"" for feeding the homeless. Seiler is correct that Abbott wasn’t taken into custody -- the activist was not handcuffed or taken to jail but was instead given a notice to appear in court. But his carefully worded claim glosses over the fact that Abbott was indeed arrested on more than one occasion for allegedly feeding the homeless in violation of city ordinances, something that leaves Abbott at least theoretically in peril of being sentenced to jail. Seiler’s claim is accurate but needs clarification or additional information."

PROBLEM: Paragraph: In a study in the medical journal The Lancet, they said the patients, with strains of TB known as extensively-drug resistant (XDR) and totally drug resistant (TDR) TB, have exhausted all available treatment options and are sent home. “These patients can survive for months or even years and are contributing to the community-based spread of XDR-TB,” said Keertan Dheda, who led the study at the University of Cape Town’s department of medicine. Tuberculosis infects the lungs and can spread through coughing and sneezing. In recent years, drug-resistant strains have spread around the world, batting off standard antibiotics and posing an increasingly urgent public health threat. The World Health Organization (WHO) estimates that in Eastern Europe, Asia and South Africa, 450,000 people have MDR-TB, and around half of these will fail to respond to existing treatments. Dheda’s team followed 107 patients with XDR-TB from three provinces in South Africa between March 2008 and August 2012 to establish their fate. They also took samples from 56 patients and tested them to find out which and how many of 10 first- and second-line anti-TB drugs they were susceptible to. Despite being treated intensively with an average of eight anti-tuberculosis drugs, many of the patients fared poorly, with high rates of treatment failure and death. Five years after treatment initiation, only 12 of the patients had favorable outcomes and 74 percent had died. The researchers found that almost two-thirds of the tested patients had resistance to at least eight drugs, and there was one case of totally drug-resistant TB that was not susceptible to any of the 10 drugs tested. More worrisome, Dheda said, was that of the XDR-TB patients discharged into the general community, some 42 percent had failed to get better on treatment and were testing positive for active TB, and of these almost a third were at high risk of transmitting the disease. The patients also survived in the community for an average of 20 months - plenty of time to infect others. When people with lung TB cough, sneeze or spit, they propel the TB germs into the air. Another person needs to inhale only a few of these germs to become infected. “Alarmingly, we have shown for the first time that... treatment failure and discharge of such patients into the wider community is occurring systematically on a country-wide level in South Africa,” Dheda said in a statement about the findings. In one case where the researchers followed a genetic trail of transmission, they found that a patient with XDR-TB who was discharged after failing treatment went on to infect his brother, who also eventually died. Dheda said the reason many TB patients are being sent away from hospitals appeared to be lack of bed space in designated tuberculosis hospitals. “And alternative long-term residential and palliative care facilities are scarce.”  Commenting on the findings in The Lancet, Max O’Donnell from New York’s Albert Einstein College of Medicine in the United States said they should serve as an “urgent alarm”. “MDR-TB (multi-drug-resistant TB) in all its forms is an out-of-control problem with potentially vast and devastating consequences for global public health,” he wrote. “The situation regarding MDR and XDR-TB is bleak.” Claim: South Africa risks spreading totally drug-resistant TB: study.

SOLUTION:
Patients with contagious and highly drug-resistant tuberculosis (TB) are being routinely discharged from hospitals across South Africa, exposing others in their communities to potentially deadly infections, researchers said on Friday.