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| A Drug Company Wagers the U.S. Won’t Dare Charge It With Crimes | A Drug Company Wagers the U.S. Won’t Dare Charge It With Crimes |
| (17 days later) | |
| In the coming days, the Justice Department will make an important decision: whether to file criminal charges against one of the world’s largest pharmaceutical companies for allegedly colluding with rivals to inflate the prices of widely used drugs. | In the coming days, the Justice Department will make an important decision: whether to file criminal charges against one of the world’s largest pharmaceutical companies for allegedly colluding with rivals to inflate the prices of widely used drugs. |
| The company, Teva Pharmaceutical Industries, is betting that in the middle of a deadly pandemic, the Trump administration won’t dare to come down hard on the largest supplier of generic drugs in the United States. | The company, Teva Pharmaceutical Industries, is betting that in the middle of a deadly pandemic, the Trump administration won’t dare to come down hard on the largest supplier of generic drugs in the United States. |
| It is a high-stakes gamble that could affect millions of Americans who rely on Teva’s dozens of inexpensive generic drugs, as well as its brand-name products like Copaxone, for multiple sclerosis, and Ajovy, for migraines. Teva officials say criminal charges could cripple the Israeli company and potentially leave it unable to sell drugs to federal programs like Medicare. | It is a high-stakes gamble that could affect millions of Americans who rely on Teva’s dozens of inexpensive generic drugs, as well as its brand-name products like Copaxone, for multiple sclerosis, and Ajovy, for migraines. Teva officials say criminal charges could cripple the Israeli company and potentially leave it unable to sell drugs to federal programs like Medicare. |
| For years, the Justice Department and state prosecutors have been investigating what they describe as a conspiracy by pharmaceutical companies to increase the prices of popular drugs. The department has already extracted guilty pleas and $224 million in penalties from four other drug companies. | For years, the Justice Department and state prosecutors have been investigating what they describe as a conspiracy by pharmaceutical companies to increase the prices of popular drugs. The department has already extracted guilty pleas and $224 million in penalties from four other drug companies. |
| Lawyers for Teva, which prosecutors believe was deeply involved in the conspiracy, until recently had been holding settlement negotiations with officials in the Justice Department’s antitrust division. But in April, the company all but walked away from the talks, essentially daring the Trump administration to file charges, according to people on both sides of the discussions. | Lawyers for Teva, which prosecutors believe was deeply involved in the conspiracy, until recently had been holding settlement negotiations with officials in the Justice Department’s antitrust division. But in April, the company all but walked away from the talks, essentially daring the Trump administration to file charges, according to people on both sides of the discussions. |
| Teva officials have said that the company did nothing wrong and that they plan to vigorously defend themselves. | Teva officials have said that the company did nothing wrong and that they plan to vigorously defend themselves. |
| A Justice Department spokesman declined to comment. | A Justice Department spokesman declined to comment. |
| Teva executives and board members believe that one reason the Trump administration will back down is to avoid the impression that it is harming a company that is helping the United States fight the coronavirus. | Teva executives and board members believe that one reason the Trump administration will back down is to avoid the impression that it is harming a company that is helping the United States fight the coronavirus. |
| A week or two before Teva’s lawyers pulled out of the settlement talks, a board member, Roberto Mignone, reached out to the White House to discuss the company’s efforts to provide drugs that might help treat the coronavirus. | A week or two before Teva’s lawyers pulled out of the settlement talks, a board member, Roberto Mignone, reached out to the White House to discuss the company’s efforts to provide drugs that might help treat the coronavirus. |
| President Trump had been touting an anti-malaria drug, hydroxychloroquine, as a possible “game changer” in the fight against the coronavirus. Teva was among the companies that made hydroxychloroquine overseas and could export it to the United States. It had already donated millions of hydroxychloroquine pills to American hospitals. | President Trump had been touting an anti-malaria drug, hydroxychloroquine, as a possible “game changer” in the fight against the coronavirus. Teva was among the companies that made hydroxychloroquine overseas and could export it to the United States. It had already donated millions of hydroxychloroquine pills to American hospitals. |
| On March 24, Mr. Mignone emailed a former college roommate of Jared Kushner, Mr. Trump’s son-in-law and senior adviser. He wrote that Teva wanted the White House to help get the company’s hydroxychloroquine supplies out of India and to permit Teva to coordinate with rival drug companies to make and distribute the drugs. | On March 24, Mr. Mignone emailed a former college roommate of Jared Kushner, Mr. Trump’s son-in-law and senior adviser. He wrote that Teva wanted the White House to help get the company’s hydroxychloroquine supplies out of India and to permit Teva to coordinate with rival drug companies to make and distribute the drugs. |
| In an ensuing discussion with officials on the White House’s coronavirus task force, Teva positioned itself as a valuable partner in the manufacturing and distribution of potential medical treatments for the coronavirus, according to people familiar with the discussions, who weren’t authorized to speak publicly about them. (In the weeks since, the results of several studies have dampened enthusiasm for hydroxychloroquine, and Mr. Trump has stopped emphasizing the drug.) | In an ensuing discussion with officials on the White House’s coronavirus task force, Teva positioned itself as a valuable partner in the manufacturing and distribution of potential medical treatments for the coronavirus, according to people familiar with the discussions, who weren’t authorized to speak publicly about them. (In the weeks since, the results of several studies have dampened enthusiasm for hydroxychloroquine, and Mr. Trump has stopped emphasizing the drug.) |
| Teva officials said there was no connection between the White House conversation and the yearslong antitrust investigation. | Teva officials said there was no connection between the White House conversation and the yearslong antitrust investigation. |
| But, said Robert Field, a professor of law and health policy at Drexel University, “it’s hard to believe that Teva does not have that in mind and does not see some kind of absolution in producing a drug that might help us come out of a national nightmare while they are facing quite serious criminal charges.” | But, said Robert Field, a professor of law and health policy at Drexel University, “it’s hard to believe that Teva does not have that in mind and does not see some kind of absolution in producing a drug that might help us come out of a national nightmare while they are facing quite serious criminal charges.” |
| Ronny Gal, a research analyst who follows the generic drug industry at the brokerage Bernstein, said Teva and other generic companies had seen working with the Trump administration as an opportunity not because more sales of hydroxychloroquine would be profitable — pills cost pennies — but because “they want to be viewed as a partner.” | Ronny Gal, a research analyst who follows the generic drug industry at the brokerage Bernstein, said Teva and other generic companies had seen working with the Trump administration as an opportunity not because more sales of hydroxychloroquine would be profitable — pills cost pennies — but because “they want to be viewed as a partner.” |
| “It’s your chance, at a relatively low cost, to have a very large P.R. campaign,” he added. | “It’s your chance, at a relatively low cost, to have a very large P.R. campaign,” he added. |
| Teva had its conversation with the White House just as the company’s officials were reconsidering their settlement negotiations with the Justice Department, which along with other government bodies has for years had Teva in its cross hairs. | Teva had its conversation with the White House just as the company’s officials were reconsidering their settlement negotiations with the Justice Department, which along with other government bodies has for years had Teva in its cross hairs. |
| The investigation centers on allegations that Teva and a number of rivals illegally worked together to increase prices for widely used generic drugs like pravastatin, which is used to treat high cholesterol. | The investigation centers on allegations that Teva and a number of rivals illegally worked together to increase prices for widely used generic drugs like pravastatin, which is used to treat high cholesterol. |
| Updated June 1, 2020 | |
| Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home. | |
| States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people. | |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | |
| More than 40 million people — the equivalent of 1 in 4 U.S. workers — have filed for unemployment benefits since the pandemic took hold. One in five who were working in February reported losing a job or being furloughed in March or the beginning of April, data from a Federal Reserve survey released on May 14 showed, and that pain was highly concentrated among low earners. Fully 39 percent of former workers living in a household earning $40,000 or less lost work, compared with 13 percent in those making more than $100,000, a Fed official said. | |
| Yes, but make sure you keep six feet of distance between you and people who don’t live in your home. Even if you just hang out in a park, rather than go for a jog or a walk, getting some fresh air, and hopefully sunshine, is a good idea. | |
| Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications. | |
| The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing. | |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | |
| If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested. | |
| Charity Navigator, which evaluates charities using a numbers-based system, has a running list of nonprofits working in communities affected by the outbreak. You can give blood through the American Red Cross, and World Central Kitchen has stepped in to distribute meals in major cities. | |
| Congressional investigators have found that Teva dominated the market for some of the drugs whose prices inexplicably rose and remained high. And nearly every state attorney general and the Justice Department’s antitrust division have identified Teva as a leading player in the alleged price-fixing conspiracy. | Congressional investigators have found that Teva dominated the market for some of the drugs whose prices inexplicably rose and remained high. And nearly every state attorney general and the Justice Department’s antitrust division have identified Teva as a leading player in the alleged price-fixing conspiracy. |
| Teva executives and board members view the federal case as overly reliant on a single former Teva employee who has struck an immunity deal with the government, according to people familiar with their thinking. | Teva executives and board members view the federal case as overly reliant on a single former Teva employee who has struck an immunity deal with the government, according to people familiar with their thinking. |
| But they also feared an indictment, which would be likely to crush the company’s stock price. A criminal conviction would bar Teva from selling drugs to federal health care programs for at least five years. Avoiding such an outcome was a top priority for Teva, and a settlement seemed close at hand this spring, according to the people on both sides of the negotiations. | But they also feared an indictment, which would be likely to crush the company’s stock price. A criminal conviction would bar Teva from selling drugs to federal health care programs for at least five years. Avoiding such an outcome was a top priority for Teva, and a settlement seemed close at hand this spring, according to the people on both sides of the negotiations. |
| The Justice Department was inking settlements with other players in the alleged price-fixing conspiracy. In March, the government announced a deal with the Novartis subsidiary Sandoz, another major generic drugmaker. Sandoz admitted to criminal charges and agreed to pay a $195 million fine, the largest ever in a U.S. antitrust case. Last week, another company, Apotex, agreed to a $24 million settlement. | The Justice Department was inking settlements with other players in the alleged price-fixing conspiracy. In March, the government announced a deal with the Novartis subsidiary Sandoz, another major generic drugmaker. Sandoz admitted to criminal charges and agreed to pay a $195 million fine, the largest ever in a U.S. antitrust case. Last week, another company, Apotex, agreed to a $24 million settlement. |
| In mid-April, lawyers for Teva told officials in the antitrust division that they didn’t see a point in continuing with settlement negotiations based on their current trajectory, according to two people involved in the company’s internal discussions. | In mid-April, lawyers for Teva told officials in the antitrust division that they didn’t see a point in continuing with settlement negotiations based on their current trajectory, according to two people involved in the company’s internal discussions. |
| At a board meeting last week, Teva’s directors, lawyers and executives decided to stick with their legal strategy. With the statute of limitations on the case expiring soon, they doubted that the department would dare to charge the company. | At a board meeting last week, Teva’s directors, lawyers and executives decided to stick with their legal strategy. With the statute of limitations on the case expiring soon, they doubted that the department would dare to charge the company. |
| Because Teva makes 10 percent of oral generic drugs prescribed in the United States, Mr. Gal said, it has significant leverage in negotiating with the federal government, especially during the pandemic, when the supply of some drugs has been strained. The company has “a level of protection, where the U.S. certainly does not want the company to go bankrupt,” he said. | Because Teva makes 10 percent of oral generic drugs prescribed in the United States, Mr. Gal said, it has significant leverage in negotiating with the federal government, especially during the pandemic, when the supply of some drugs has been strained. The company has “a level of protection, where the U.S. certainly does not want the company to go bankrupt,” he said. |
| Justice Department officials haven’t given up hope that settlement talks might resume before the statute of limitation expires in the next two weeks, at which point the government needs to decide whether to charge Teva or let the company walk. | Justice Department officials haven’t given up hope that settlement talks might resume before the statute of limitation expires in the next two weeks, at which point the government needs to decide whether to charge Teva or let the company walk. |
| A Justice Department lawyer, who wasn’t authorized to speak publicly about an active investigation, said that while prosecutors were wary of seriously harming a major drug company in the heat of a pandemic, they were also worried about giving a company a pass for illegal behavior simply because of a national emergency. | A Justice Department lawyer, who wasn’t authorized to speak publicly about an active investigation, said that while prosecutors were wary of seriously harming a major drug company in the heat of a pandemic, they were also worried about giving a company a pass for illegal behavior simply because of a national emergency. |
| Jesse Drucker contributed reporting. | Jesse Drucker contributed reporting. |