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.

Ex Input:
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.

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

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Although this therapy is not yet available for patient use, the story makes a point of noting that the cost may well be "stratospheric," should it make it to market. If approved, such treatments are expected to command stratospheric prices. For example, a separate Spark gene therapy for a rare type of childhood blindness, which is on track for Food and Drug Administration clearance soon, could cost $1 million per patient for infusions in both eyes, according to some Wall Street analysts. Still, the therapies can produce at least some offsetting savings. Porteus noted in his editorial that the hemophilia therapy resulted insavings of about $200,000 a year per patient because of the elimination of clotting-factor infusions. The story summarizes the outcome of the small, 10-person trial that dominates this narrative: Lindsey George, the lead investigator and a hematologist at Children's Hospital of Philadelphia, said that nine of the 10 men in the trial didn't experience any bleeding episodes after the gene therapy treatment. The one patient who needed clotting factor because of bleeding used 91 percent less than before, she said. Although the story does not address harms directlyand should haveit does note that one of the worrying side effects of gene therapyspurring the body to attack itselfwas not present in this study. It is clear from the story that the study is small and an "early-stage trial." One source also notes that the researchers tracked individuals in the study for no more than a year and a half, making longer term assessments unavailable. The story could have done more, though, to signal to the reader that, despite the encouraging outcomes of the study, the treatment is still very much under development. The next stagePhase 3 trialsrequires more participants, more careful study design, and takes, on average, three years to complete. The treatment described here, if ultimately proved worthy, could have a profound impact on a serious genetic condition. Independent sources are identified in the story, as are the funders. But missing from the text is information describing linkages between the two fundersSpark Therapeutics and Pfizerand the lead researchers. It's not clear from the story that there is a financial relationship. Individuals coping with hemophilia B have few options, and the story describes the main one: injections of blood-clotting factor to stem runaway bleeding. Since the story notes that the research is at an early stage with only 10 participants, a reader can easily infer that the treatment is not yet available. However, additional information about remaining evaluation stages for this treatment would have been a useful reinforcing addition. Hemophilia B sufferers who see this story will likely be contacting their doctors. The story establishes novelty with this: The researchers presented earlierfindingson the gene therapy a year ago at the American Society of Hematology's annual meeting, but the latest data covers a larger patient group and a longer time period. A news release issued by Children's Hospital of Philadelphia did a good job of describing this study; the Post story could have picked up more of the salient details from that text but reveals independent reporting nevertheless by including sources not connected to the study.

Ex Output:
Gene therapy makes a big advance treating hemophilia B blood disorder

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A trader watches the electronic board on the floor of the Philippine Stock Exchange, which closed up 3.08 percent in today's trading in Makati City, Metro Manila November 14, 2008. REUTERS/John Javellana Researchers said a long-term study showed that working more than 11 hours a day increased the risk of heart disease by 67 percent, compared with working a standard 7 to 8 hours a day. They said the findings suggest that information on working hours used alongside other factors like blood pressure, diabetes and smoking habits could help doctors work out a patient's risk of heart disease. However, they also said it was not yet clear whether long working hours themselves contribute to heart disease risk, or whether they act as a "marker" of other factors that can harm heart health like unhealthy eating habits, a lack of exercise or depression. "This study might make us think twice about the old adage 'hard work won't kill you'," said Stephen Holgate, chair of the population and systems medicine board at Britain's Medical Research Council, which part-funded the study. The study, published in the Annals of Internal Medicine journal, followed nearly 7,100 British workers for 11 years. "Working long days is associated with a remarkable increase in risk of heart disease," said Mika Kivimaki of Britain's University College London, who led the research. He said it may be a "wake-up call for people who overwork themselves." "Considering that including a measurement of working hours in a (doctor's) interview is so simple and useful, our research presents a strong case that it should become standard practice," he said. Cardiovascular diseases such as heart attacks and strokes are the world's largest killers, claiming around 17.1 million lives a year, according to the World Health Organization (WHO). Billions of dollars are spent every year on medical devices and drugs to treat them. The findings of this study support previous research showing a link between working hours and heart disease. But the scientists said hard workers should not necessarily be alarmed about their heart health. "Current evidence on (heart disease) prevention emphasizes the importance of focusing on the total risk, rather than single risk factors," Kivimaki told Reuters Health in an email. "People who work long hours should be particularly careful in following healthy diets, exercising sufficiently and keeping their blood pressure, cholesterol levels, and blood (sugar) within healthy limits." The research used data from a study called Whitehall II which has followed the health and wellbeing of more than 10,000 civil service workers in Britain since 1985. For this study, men and women who worked full time and had no heart disease were selected, giving 7,095 participants. The researchers collected data on heart risk factors like age, blood pressure, cholesterol, smoking and diabetes and also asked participants how many hours they worked including work during the day and work brought home on an average weekday. During the 11-year study, 192 participants had heart attacks. Those who worked 11 hours or more a day were 67 percent more likely to have a heart attack than those with fewer hours.

Ex Output:
Working long hours? Watch out for your heart.