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.
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Question: Teva Pharmaceutical Industries Ltd’s rival migraine headache preventer is excluded on one list and patients can pay more for it in some cases on a second list, the note said. As with rival PBMs Express Scripts and CVS Health Corp, OptumRx’s lists of covered drugs, or formularies, cover tens of millions of consumers who receive their healthcare from employers and health insurers. About 39 million Americans suffer from migraine headaches, according to the Migraine Research Foundation, and global migraine drug sales could reach $8.7 billion by 2026, according to analytics firm GlobalData. OptumRx’s decision secures easier access to customers for Lilly’s Emgality at all three of the biggest PBMs - including CVS and Express Scripts - and gives Amgen’s Aimovig a leg up after CVS decided not to include it on its preferred drug list. Teva’s Ajovy only has preferred status at CVS, while Amgen also has it at Express Scripts, part of Cigna Corp.  “We are pleased that all three companies have chosen Emgality to be one of the preferred medications, making it accessible to even more patients suffering from migraine,” Lilly said in an emailed statement. Inclusion on a preferred drugs list by the largest PBMs and health insurers is critically important for sales of new medicines. Increasingly, PBMs are choosing a subset of treatments for their coverage list when there are multiple treatments that are considered equivalent. The three treatments, approved by the U.S. Food and Drug Administration last year, belong to a class of drugs called CGRP inhibitors that have proven effective in helping to prevent migraines. A Teva spokeswoman said the company is committed to increasing access to Ajovy regardless of formulary decisions and is still offering discounts that allow patients to pay nothing in some cases, regardless of insurance. “Since Ajovy injection launched in September, we have experienced strong demand and steady growth, and we continue discussions with payers,” the spokeswoman said. An Amgen spokeswoman said that the company was pleased with the decision and is committed to ensuring affordable access to its drug. Amgen, which shares Aimovig U.S. revenue with Novartis AG, earlier this week reported fourth-quarter sales of $95 million, nearly doubling Wall Street estimates. The OptumRx decision becomes effective Feb. 1. The OptumRx select formulary relegates Teva’s drug to a lower access level that would typically require a higher out-of-pocket cost, it said. PBMs typically extract discounts from drugmakers in return for favorable placement on their preferred list of covered drugs, such as through a low co-payment, or coinsurance payment, for their members. All three migraine drugs have a list price of $575 a month, or $6,900 a year. Those prices do not reflect the rebates and discounts to PBMs, who design and negotiate benefits for employers and insurers. All three drugmakers are providing a limited duration supply of the new drugs at no cost directly to patients in addition to other assistance programs. Amgen’s Aimovig was first-to-market from the new class. But the rivals from Teva and Lilly followed soon after. The three large PBMs together cover the majority of the more than 150 million Americans who receive benefits through their employers. Their clients, including insurers and corporations, may choose not to follow a PBM’s recommendations on coverage, but that typically would cost more. Amgen shares were off 28 cents at $186.63, Lilly was up nearly 1 percent at $120.90 and Teva shares traded in New York  were down nearly 1 percent at $19.69.

Answer: Exclusive: Top U.S. insurer to cover Amgen, Eli Lilly migraine drugs, exclude Teva.


Question: This release doesn’t discuss costs in its comparison of influenza shots versus nasal sprays, although both modes of immunization have been around for a long while and the costs for both are easily known. While flu immunizations are often free through public health clinics and such, some people receive their immunizations from their family physicians and carry a specific cost. Knowing the difference in costs between the two types is useful information both for people and public health officials. The release reports similar rates of vaccine uptake for intranasal vaccine and standard flu shots. But it does not quantify benefits for the main outcome of the study, that is, rates of influenza in communities vaccinated with nasal vs injected vaccine over the course of the study. These rates were statistically no different: 5.2% for the standard vs 5.3% for the nasal vaccine. This release makes no mention of possible harms that my follow the use of either the influenza vaccine injections or nasal spray, even though there are well-known restrictions on whom should and should not receive the nasal spray, and potential negative reactions to the injections among some people. The release points out that the study was the “first blinded randomized controlled trial” done in children within largely closed communities and it found similar efficacy in using the two modes of immunization. However, we do wish the release had addressed limitations, as well as some of the complexity of making these results generalizable to a larger population, as we saw with NPR’s take on the news. While media attention is routinely heightened leading up to and during flu season, this release does not appear to reach the level of disease mongering. The release does identify the chief funder of the study, the Canadian Institutes for Health Research, although it offers no information on possible conflicts of interest among any of the researchers. The abstract of the study does state that two of the researchers do have links to pharmaceutical firms, but not in relation this study. Since the study looked a two forms of influenza vaccine administration, it obviously addresses the question of comparing alternatives. Both forms of immunization — shots and nasal spray — have been around for some time, their availability is widely known, earning the release a Satisfactory in this category. The release makes clear that the novelty of this study is its ability to examine both indirect effects of vaccination on the community as well as direct effects for persons receiving the vaccine. The release does not use any unjustifiable language.

Answer: Flu nasal spray provides similar protection against influenza as flu shot: Study


Question: In November 2018, a Grand Rapids, Michigan woman who needed a heart transplant due to complications from chemotherapy was turned down by a Spectrum Health medical committee due to lack of funds:Martin’s son, Alex Britt, said she was diagnosed with breast cancer in 2005 and the chemotherapy treatment, while curing her cancer, damaged her heart to the extent that she requires a transplant and had to leave her job on disability. Britt said she walked dogs and would pet-sit to raise funds.Martin said she was supposed to have a procedure Monday for an assistive device to help sustain her while waiting for a new heart. At the time, Martin had already raised $4,600 on GoFundMe for her prior medical bills.Britt set up a new GoFundMe page to raise the additional $10,000 needed to cover the cost of the immunosuppressive drugs. The medical center reportedly would not consider Martin for a heart transplant without her being able to pay for the drugs.The letter to Hedda Martin reportedly said, in part:Your medical situation was presented to our multidisciplinary heart transplant committee on Tuesday, October 20, 2018. The decision made by the committee is that you are not a candidate at this time for a heart transplant due to needing a more secure financial plan for immunosuppressive medication coverage. The Committee is recommending a fundraising effort of $10,000.The story went viral when it was shared by Rep-Elect Alexandria Ocasio-Cortez (D-New York):Insurance groups are recommending GoFundMe as official policy – where customers can die if they can’t raise the goal in time – but sure, single payer healthcare is unreasonable.h/t @DanRiffle pic.twitter.com/zetPW0MgDd— Alexandria Ocasio-Cortez (@Ocasio2018) November 24, 2018The story is true. Spectrum Health acknowledged the letter in a lengthy statement on their official website, although the organization stopped short of discussing Martin’s specific circumstances:It is important for patients to understand the long-term commitment they are making when accepting an organ donation. For this reason, we strive to ensure each patient is the best match so the donation contributes to a renewed life.Each transplant candidate is evaluated by our highly-skilled multidisciplinary team of physicians, nurses, social workers, clinical ethicists, dieticians and other experts. Transplant eligibility is a complex process. It requires consideration of a multitude of factors based on established best practice standards used by transplant centers across the country. Physical health, psychological and social well-being, and financial resources are among the factors considered for each patient. The ability to pay for post-transplant care and life-long immunosuppression medications is essential to increase the likelihood of a successful transplant and longevity of the transplant recipient. We help patients understand the long-term health implications of a transplant along with their total financial commitment, such as post-transplant medication expenses paid to pharmacies of their choice.Martin’s GoFundMe has raised more than enough to cover the costs of the immunosuppressant medication she needs, but her story is far from unusual. At least a third of the money raised on GoFundMe in 2017 was to help with medical issues, because health care costs in the United States are so high:It’s become a go-to way for people in need to help pay their doctors. Medical fundraisers now account for 1 in 3 of the website’s campaigns, and they bring in more money than any other GoFundMe category, said GoFundMe CEO Rob Solomon.“In the old paradigm you would give $20 to somebody who needed help,” Solomon said. “In the new paradigm, you’ll give $20, you’ll share that and that could turn into 10, 20, 50 or 100 people doing that. So, the $20 could turn in hundreds, if not thousands, of dollars.”Since at least 2017, a majority of Americans have listed access to affordable healthcare as one of their most pressing concerns.

Answer:
"A medical committee withheld a heart transplant from a woman saying that she needed to have at least $10,000 for immunosuppressant medication and suggested ""a fundraising effort."