Two weeks ago, we brought you the devastating news that Amtrak had scrapped plans to improve wifi service along the Northeast corridor.

But things are looking up. Amtrak just announced that they will begin non-stop service between DC and NYC beginning in September. The route will take 2.5 hours. That’s almost short enough that you could go without wifi.

If we’d only known that lodging our Amtrak complaints via TWTW was such an effective method…well, we’d have done so earlier. Please feel free to submit additional Amtrak feedback, and we’ll see what we can do.

Now, on to our recap of a week in which everyone – media, regulators, policymakers – seemed to show up for work.



 “Mom jeans,” “favorite jeans,” and “skinny jeans.” No, that’s not our fall shopping list. They’re the taglines on a set of plates – made by a brand named Pourtions and carried in Macy’s – that have caused some serious backlash. The brand asserts the taglines are aimed to provide “helpful — and hilarious — visual cues.” But in the same week where Forever 21 slipped Atkins bars into its clothing shipments, it seems no one is laughing.


 “Thanks, but no thanks.” That’s pretty much what Canada is saying about SB 1528, the new Florida law that establishes a program to import prescription drugs from Canada. Canada’s government recently stated their opposition to the plan, citing concerns with drug supply and potential drug shortages were Canada to export drugs to the U.S. Florida State Senator Perry Thurston echoed the impracticality of the law in an op-ed for the Palm Beach Post.


 The Federal Trade Commission leveled a $5B fine on Facebook for their data practices. If that sounds like a lot, it’s because it is. Along with the FTC-record-breaking fine, Facebook also faces some new demands from the Commission. It must make an independent privacy committee on its board and appoint a third-party data security assessor, have designated compliance officers review every product launch for data privacy and submit leadership to regular privacy audits.


 Axios’ Bob Herman had a good investigative-reporting day. Herman got his hands on an Express Scripts Medicare (ESI) contract detailing millions of dollars in annual “clawbacks.” The contract outlines a tiered pharmacy performance structure, in which pharmacies are rated based on how many patients refill and receive their medications. “Top” performers must pay back 2% of a prescription’s price to ESI, but lower performers owe 4% or 6%. We’ve got a lot of questions. Amanda Eiber wants to know if they use a law school-like curve, and I want to know how Bob Herman has not one – but two – ESI contracts in his inbox.


 Reuters scooped a potential impending executive order on drug pricing from the White House. The EO “would cut prices on virtually all branded prescription drugs sold to Medicare and other government programs.” It’s unclear what the potential timing could be for the order, but we’re staying tuned no matter what.

 The Senate Finance Committee's version of #summervibes  

If the Senate Finance Committee’s goal for Summer ‘19 was to “stay relevant,” they’re certainly making some good progress. On Tuesday, the Committee approved a broad bipartisan proposal aimed at lowering prescription drug prices.

What’s in the bill?

  • Redesign Medicare Part D to cap out of pocket costs and shift more catastrophic costs to pharma companies and health plans.
  • Cap Medicare Part B and Part D drug prices at inflation. Note: this pertains to price increases but cannot restrict prices at launch. 
  • Ban PBM “spread pricing” practices in Medicaid, where PBMs keep the difference between a pharmacy price and the wholesale price.
  • Require drugmakers to justify increases at certain price points.
  • Allow state Medicaid to use risk-sharing agreements to finance gene therapy treatments through installment payments.

What’s not in the bill?

  • International Pricing Index (IPI) language: Senators voted down an amendment to prohibit implementation of this proposed rule, but only because Committee Chairman Chuck Grassley wanted to keep the issue separate from the broader bill.
  • Allowing Medicare to negotiate directly with drug makers: Senators voted down an amendment to include this controversial language, but it could always be added later on the Senate floor.

So everyone just agreed on this?

Not really. During the bill markup, Senators debated high drug prices, which some deemed as “monopolistic.” The most debated topic – brought up by several Republicans who oppose the inflation cap – was around whether capping price increases at inflation would incentivize higher prices at launch.

Senators even discussed reviving some of the administration’s failed proposed rules, like the rebate rule that would have ended rebates pharma companies pay to PBMs under Medicare, and the rule requiring price disclosure in pharma’s direct-to-consumer advertising.

Meanwhile, PhRMA, which strongly opposes the bill, had the chance to tell President Trump as much during a private meeting on Wednesday.

What happens next:

The Trump administration supports the bill, but congressional prospects are unclear. Committee leaders intend to merge this bill with separate surprise medical billing legislation that the Senate HELP Committee cleared last month, and then will determine a potential vote by the full Senate.

P.S. Have we mentioned yet that the House is working on their own totally separate bill?

Who wrote this? The managing editors of TWTW are Dana Davis, who wishes the LIRR would take a page out of Amtrak’s book and Randi Kahn, who forgot to bring jeans to a weekend trip in the mountains (brrr).

Syneos Health Communications' Reputation & Risk Management Practice is a team of healthcare communications consultants, policy-shapers and crisis response specialists. We provide unique solutions to the evolving communications challenges in today’s healthcare industry, using evidence-based approaches to help our clients successfully navigate the most sensitive of situations.

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And now please enjoy this disclaimer that prevents our team from getting in a heap of trouble: This report may contain links to external or third party websites. These links are provided solely for your convenience. Links taken to other sites are done so at your own risk and Syneos Health accepts no liability for any linked sites or their content. Syneos Health makes no warranties or representations, express or implied about such linked websites, the third parties they are owned and operated by, the information contained on them or the suitability or quality of any of their products or services. Syneos Health does not authorize the infringement of any intellectual property rights contained in material offered through these linked sites. Please refer to the use agreement and/or copyright statements of any external site you visit, or the terms and conditions of any externally provided web site for instructions, restrictions, and guidelines. If you have a question, please contact the webmaster of the external site.

About the Author:

Dana Davis is a strategist in the Reputation & Risk Management Practice, where she helps biopharma clients communicate the value they bring to their stakeholders. Her expertise lies in issues of corporate activism; advising companies that must respond to activist tactics from patients, employees, or investors, as well as companies looking to take a proactive stance on social issues.

Syneos Health Communications' Reputation & Risk Management Practice is a team of healthcare communications consultants, policy-shapers and crisis response specialists. We provide unique solutions to the evolving communications challenges in today’s healthcare industry, using evidence-based approaches to help our clients successfully navigate the most sensitive of situations.