TASK DEFINITION: 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.
PROBLEM: Developed by Eli Lilly and Co's (LLY.N) Loxo Oncology and marketed by German drugmaker Bayer (BAYGn.DE), it fights a rare genetic mutation that appears in less than 1% of solid tumors, regardless of where they appear in the body. Finding those patients will require widespread adoption of sophisticated tests that look for multiple genetic alterations that could be driving the cancer. So far, progress has been slow. Adoption of so-called next-generation sequencing (NGS) tests has been stalled by lack of reimbursement from insurers over concerns that the evidence is not there yet to support widescale use, according to more than a dozen interviews with oncologists and pharmaceutical and diagnostic industry executives. As a result, pharma companies from small biotech Blueprint Medicines Corp (BPMC.O) to larger rivals Lilly and Roche Holding AG (ROG.S) are taking matters into their own hands, bulking up staff to increase patient and physician awareness about testing and building up a gene testing infrastructure that for many community hospitals still does not exist. Bayer executives told Reuters it plans to spend $70 million to increase patient and physician awareness of testing for rare mutations and to encourage regulatory approval of more tests. They expect that budget to expand as Vitrakvi continues to win approval in other countries. Lilly told Reuters the company has signed an agreement with Thermo Fisher Scientific (TMO.N) to develop a companion diagnostic test for its experimental drug, LOXO-292. The deal adds RET mutations - the target of both Lilly's and Blueprint's drugs - to Thermo's Oncomine Dx Target Test, which local pathology labs can use to identify multiple genes linked with non-small cell lung cancer. The agreement is aimed to help identify more lung and thyroid cancer patients who may benefit from the Lilly or Blueprint therapies. The Thermo test is already approved by the U.S. Food and Drug Administration - a key standard for Medicare coverage, the companies said. According to Dr. Brian Alexander, chief medical officer of Roche's gene testing company Foundation Medicine, only about 15% of U.S. patients with advanced cancers get comprehensive genomic profiling. Another 25% get single-gene testing, he said, and a large proportion "are not getting any testing at all." At MD Anderson, which sees 100,000 new cancer patients a year, only around 10,000 eventually have their tumors sequenced. For a rare few, the tests are lifesaving. Xin Zheng, 47, a mother of three in Michigan who was referred to Reuters by Blueprint, was diagnosed with stage 4 lung cancer in 2016. After failing several treatments, she was out of options. Her husband, Zhigang Wei, asked for genetic sequencing, and the test turned up a RET mutation. After contacting multiple lung cancer experts, Zhigang found an early-stage clinical trial treating patients with Blueprint's experimental drug, BLU-677. Now, Xin is nearly back to normal. "My wife is lucky,"he said, adding her quality of life is much better and she has hope for the future. Finding patients with such rare mutations is like "looking for the needle in the haystack," said Stefan Oelrich, head of pharmaceuticals at Bayer. Dr. David Hyman of Memorial Sloan Kettering Cancer Center, who tested Vitrakvi in clinical trials, said making these tests the norm for advanced cancer patients will require a huge shift in the way oncology is practiced. "It's painful to know there are patients out there with these alterations who are dying without knowing about it and without getting any treatments," he said. For Bayer's Vitrakvi and Roche's Rozlytrek, along with similar drugs in development, genomic testing is critical to finding patients who can benefit from them. Cancer patients and drug companies alike got a boost last year when the federal Medicare health program for the elderly and disabled said it would cover FDA-approved tests for advanced cancer patients that can identify hundreds of genetic mutations at once. A Medicare endorsement is generally followed by widespread coverage decisions by private insurers. But the final regulations dropped a requirement that testmakers prove the tests are cost-effective and improve patient care. That created an "evidence gap" that has allowed some insurers, also known as third-party payers, to withhold coverage or demand more proof that they benefit patients, said Jeff Schreier of Diaceutics PLC (DXRX.L), a data analytics company that works with drugmakers to improve diagnostic testing. "More payers are coming around, but it's slow," he said. The most recent coverage policy from CVS Health Corp's (CVS.N) Aetna approves many single-gene tests for specific cancers, but still largely considers multi-gene tests experimental. Anthem Inc's (ANTM.N) policy limits testing to "medically necessary" use and states there's "insufficient published evidence" to support widespread testing. And while Foundation Medicine's and Thermo Fisher's tests are getting reimbursed from Medicare, many hospitals such as MD Anderson, which have developed their own tests, are not guaranteed payment. "Reimbursement is still a driving force," MD Anderson's Kenna Shaw said of genomic testing, which costs an average of $5,000 per patient globally. Lilly bought Loxo in January for $8 billion to profit from its targeted drugs in early-stage development. Bayer secured the rights to Loxo's two leading compounds in a 2017 alliance. Dr. Anthony Sireci, Loxo's senior medical director, said the company has been working to "democratize" testing in the United States by increasing its use in local pathology labs, where most cancer testing has traditionally been done. The Thermo Fisher agreement will support those goals and expand patients' access to "high-quality genomic testing," he said. Bayer has hired diagnostic experts to help its medical and sales staff assess the barriers to genomic testing and ensure that local pathology labs are including the genetic alterations targeted by its drugs when they profile tumors, the company's oncology strategic business chief Robert LaCaze said in an interview. Bayer also launched a public awareness campaign called "Test Your Cancer" that urges patients to ask their doctors about genomic cancer testing. The company is working with testing providers to ensure test reports are easy to understand. Blueprint, which has six genomically-targeted drugs in development, told Reuters it plans to hire six diagnostics experts to increase awareness of the mutations their drugs target, especially in community medical practices, where 70% of cancers are treated. Bayer sees signs of progress. Based on internal data, the company estimates average sequencing rates across tumors neared 30% last year, and the company saw a two-fold increase in the number of labs offering tests that carry the mutation targeted by Vitrakvi. Bayer has not released sales figures for Vitrakvi. Asked for an update in the most recent earnings call in July, Bayer's Oelrich said uptake is going "according to plan," but declined to say how many patients are using the drug. LaCaze said with very rare cancers like the ones Vitrakvi targets, sales growth is "something that will build over time."

SOLUTION: Inside drugmakers' strategy to boost cancer medicines with 'Lazarus effect'.

PROBLEM: """We're No. 23"" may not sound like a stirring claim, but Gov. John Kasich has been using one version of it to lead cheers for Ohio. ""We jumped 11 spaces since beginning this year in terms of being job-friendly,"" he said in an interview July 12, 2011, with former Fox News colleague Sean Hannity, crediting the improvement to ""probably the most massive comprehensive piece of legislation passed in modern times in Ohio."" He was referring to the recently passed state budget, which he signed into law June 30. He cited more accomplishments and some sources of information when he repeated the claim the next day with former House colleague Joe Scarborough and Mika Brzezinski on MSNBC: ""My state was dying. It is my job to get us out of this. We jumped, according to CNBC, 11 places since I've become governor as business friendly in America."" And Kasich got a third chance to tout Ohio July 17, 2001, on NBC's ""Meet the Press,"" telling host David Gregory: ""Ohio was dying, and we are beginning to really become business-friendly. ... In Ohio, because we faced our $8 billion budget deficit and provide tax relief, what's happened? CNBC says we've jumped 11 points, 11 places in terms of business-friendly."" PolitiFact Ohio decided to take a look at the claim. The governor's office confirmed he was talking about CNBC's annual rating of ""America's top states for business,"" which the business channel released in June. Ohio ranked 23rd. That is, in fact, an advance of 11 spots from last year's list, which made Ohio the most improved state (followed by Florida and Pennsylvania). CNBC said its study used input from business groups including the National Association of Manufacturers and the Council on Competitiveness to rank states in 10 categories: cost of doing business; workforce; quality of life; economy; transportation and infrastructure; technology and innovation; education; business friendliness; access to capital, and cost of living. Ohio's biggest improvement came in the ""cost of doing business"" category, based on tax burden, including individual income and property taxes, and business taxes, particularly as they apply to new investments. Utilities, wages and rental space were also figured. That specific improvement was hailed by the Ohio Business Development Coalition, which said, ""Ohio improved to 5th place from 29th place last year due to a multi-year effort to reform the state's tax structure, which took full effect in 2010."" In April, the coalition noted, a report from Ernst & Young with the Council On State Taxation ranked Ohio as having the third friendliest tax environment in the nation. Those tax reforms came before Kasich's watch, however; they started two administrations ago, under Republican Gov. Bob Taft and a GOP-controlled legislature in 2005. Kasich can claim some credit in the category of economy, where the study measured each state's fiscal health by looking at projected budget gaps or surpluses for the coming fiscal year. Ohio moved up 10 spots to 24th. We think it's fair to allow the governor some license for salesmanship, but we don't think it's splitting hairs to note that the CNBC study did not give Ohio high marks for being ""job friendly"" or ""business friendly"" as he stated. His underlying meaning is that Ohio's business climate has improved, and his wording is similar to the name of the study, ""America's top states for business."" But Ohio did not fare as well in some of the study's 10 categories as it did overall. One category specifically graded states ""on the perceived 'friendliness' of their legal and regulatory frameworks to business."" Ohio ranked 42nd in it. The state was dead last in the ""workforce"" category. CNBC says states were rated ""on the education level of their workforce, as well as the numbers of available workers. We also considered union membership. While organized labor contends that a union workforce is a quality workforce, that argument, more often than not, doesn't resonate with business. We also looked at the relative success of each state's worker training programs in placing their participants in jobs."" CNBC's list is one of many. Chief Executive magazine annually rates the ""best/worst states for business,"" using input on ""overall business-friendliness"" from 550 CEOs. Ohio this year ranked 41st -- improved two places from last year but down 19 places from 2006, making the state one of the biggest losers over five years (with Illinois, Washington, Maryland and Pennsylvania). The conservative-leaning Tax Foundation ranked Ohio 46th in its state business tax rankings for 2011. But the Small Business and Entrepreneurship Council, a trade group that represents small businesses and advocates for less government regulation, annually issues a rigorous ""Business Tax Index"" that pulls together 18 different tax measures to rank the states from best to worst in terms of the costs of their tax systems on entrepreneurship and small business. The index for 2011, published in April, ranked Ohio 9th. The SBE Council also has a ""Small Business Survival Index"" that evaluates states in 36 categories including corporate and income taxes, gas and diesel taxes, government spending, health care and energy costs, inheritance taxes, and workers compensation costs. The latest, released in December, rated Ohio 9th in the nation, up from 11th a year earlier. So where does that leave the governor's claim? He was correct that Ohio jumped 11 places in a study from CNBC, although he misstated the name of the study. The state didn't fare as well in some catagories of that study, including one that specifically looked at perceived friendliness to business. There also are several other rankings for business climate and tax burdens out there. In some of those, Ohio has shown improvement. Others, however, still have the state low in their rankings. And some of the tax changes that boosted the state were put in place by previous administrations. Kasich was trying to show progress in Ohio, selling both the state and his stewardship. In his claim, he was citing only one study. On that study his statement was accurate, but these other points help clarify the picture. On the Truth-O-Meter, that gets a rating of ."

SOLUTION: We jumped 11 places since beginning this year in terms of being job-friendly.

PROBLEM: "In the wake of mass shootings in Wisconsin and around the country, it may have been alarming to hear Gov. Scott Walker explain why he proposed more spending for mental health care in his 2013-2015 budget. ""Nationally, serious mental illness costs at least $193 billion a year in lost earnings,"" Walker said during his Feb. 20, 2013, budget presentation. ""In Wisconsin, only half of all the adults with serious psychological distress received mental health treatment or medication."" In the course of his remarks, Walker used two different terms -- ""serious mental illness"" and ""serious psychological distress."" He used the second to illustrate lack of care. Is he correct that only half of Wisconsin adults with ""serious psychological distress"" receive care? Backdrop: mass shootings Walker didn't mention mass shootings in his budget address, but he alluded to them two weeks earlier when he revealed his plan to boost mental health spending by $29 million over two years. The National Alliance on Mental Illness Wisconsin praised the spending boost, which would be done from several different pots of money.But the advocacy group said Walker's rejection of a federal proposal to expand Medicaid ""reflects a shallow understanding"" of ""crucial means to affordable mental health care for Wisconsin residents."" In revealing his plans, the governor stopped short of drawing a clear link between treating mental illness and preventing mass shootings, but indicated his plan took on greater urgency after mass killings in 2012. Those incidents included the shooting deaths of six worshippers at a Sikh temple outside of Milwaukee and of 26 children and adults at an elementary school in Newtown, Conn. To be clear, only about 1 percent of people with mental illness considered to be severe are regarded as dangerous. But a 2011 Milwaukee Journal Sentinelreport found that this group can pose a dilemma for policy-makers, who lack the data to develop a sound system for dealing with it. Walker's budget, which could be modified by the Legislature, includes $12.6 million to treat more patients who have been committed to mental hospitals, $10.2 million to expand community-based care programs for people with severe mental illness and $3.8 million for more coordination of care for children with behavioral issues. Walker's evidence When we asked Walker's office for evidence to back his claim, we were initially referred to a January 2013 report by his Department of Health Services. The report estimated, based on a federal survey of American adults, that in 2011, 49 percent of the 1 million adults in Wisconsin who had ""any mental illness"" did not get treatment. Any mental illness refers to people who have a ""diagnosable mental, behavioral, or emotional disorder."" The disorder causes impairment -- ranging from mild to moderate to substantial -- in carrying out major life activities. The 49 percent figure cited in the health department's report might appear to support Walker's claim. But his claim about Wisconsin didn't use the term mental illness. It used the phrase ""serious psychological distress."" We pointed out the difference to Stephanie Smiley, spokeswoman for the department. She then cited federal survey data showing that over a two-year period -- 2010 to 2011 -- an estimated 51 percent of Wisconsin adults with ""serious psychological distress"" did not get treatment in the previous year. (She also said that in 2008-2009, 31 percent of state adults with serious mental illness got treatment.) So, the 51 percent figure about serious psychological distress appears to back Walker's claim. But let's understand serious psychological distress as compared to serious mental illness, given that mental illness was the focus of Walker's comments and his proposed spending increase. Other evidence Based on definitions pertaining to adults from the U.S. Substance Abuse and Mental Health Services Administration, which oversees the surveys Walker cited: there are differences between serious mental illness -- the first term Walker used in his budget speech -- and serious psychological distress, which he mentioned second. Serious mental illness refers to a ""diagnosable mental, behavioral, or emotional disorder"" that involves substantial impairment in carrying out major life activities. Serious psychological distress refers to how a person responds to six questions in a federal survey about whether they feel nervous, hopeless, restless or fidgety, sad or depressed, ""that everything was an effort"" and ""no good or worthless."" Experts we consulted said that serious mental illness was a more precise term used to identify a person after thorough diagnosis and that serious psychological distress was an intentionally vague term used by researchers doing surveys. ""It kind of casts a wider net,"" Annabelle Potvin of the National Alliance on Mental Illness Wisconsin said of the serious psychological distress term, which she said indicates a need for a person to get a mental health assessment. Serious psychological distress can encompass people anywhere on a scale from mild to serious mental illness, but tends to be lower on the scale. That's according to the University of Wisconsin-Madison's Tim Connor, who evaluates mental health programs across the state; and Walter Laux, behavioral health division director of Community Advocates, a Milwaukee-based nonprofit agency. Indeed, the state Department of Health Services, in a 2010 report, also made a distinction. Serious psychological distress is a ""non-specific category of distress"" characterized by a ""mood or anxiety disorder and a lesser degree of functional impairment than serious mental illness."" It is considered to be ""an indicator of possible serious mental illness, with similar but less strict inclusion criteria."" In other words, people with serious psychological distress might have mental illness, but that distress is generally regarded as lower on a scale than serious mental illness. Our rating After making a reference to serious mental illness, Walker said: ""In Wisconsin, only half of all the adults with serious psychological distress received mental health treatment or medication."" Strictly speaking, Walker's statistical claim is accurate, at least based on estimates derived from a federal survey. But his statement needs clarification, given that people with serious psychological distress may have mental illness, but have not been diagnosed as being mentally ill."

SOLUTION:
In Wisconsin, only half of all the adults with serious psychological distress received mental health treatment or medication.