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President Donald Trump signed two pieces of legislation into law on Wednesday that aim to inform consumers about drug prices.Both measures, the Know the Lowest Price Act and the Patient Right to Know Drug Prices Act, aim to end the drug industry's so-called gag orders of pharmacists, which prevent them from discussing cheaper price options with consumers. These price options include discussing whether a medication may be less expensive if using insurance or paying out-of-pocket.At Wednesday's signing, the President called the gag clauses "unjust" and said the legislation would lower drug prices that are "way out of whack" and "way too high.""It's called the law of supply and demand. They didn't want to have that. But now we have that and it's going to lower drug prices," Trump added.Both the President and Health and Human Services Secretary Alex Azar said at the signing that they expect further regulatory action on reducing drug prices in the coming months.Some states and municipalities have pharmacy gag order bans, but the Patient Right to Know Drug Prices Act, sponsored by Maine Republican Sen. Susan Collins, addresses banning the practice of gag orders on a federal level. The Know the Lowest Price Act, sponsored by Michigan Democratic Sen. Debbie Stabenow, prohibits Medicare drug plans from putting a gag clause on a pharmacy in their contracts.Collins and Stabenow were present at Wednesday's signing, as well as Tennessee Republican Sen. Lamar Alexander, Louisiana Republican Sen. Bill Cassidy, Deputy Attorney General Rod Rosenstein and National Economic Council Director Larry Kudlow.Some pharmaceutical industry experts say that although eliminating the gag clause is step toward consumer transparency, it doesn't address the issue of lowering actual drug costs, making it unclear how much of a tangible effect the legislation will have.The President has frequently expressed his frustration over rising drug prices, and in May, he laid?out his vision for increasing competition, reducing regulations and changing the incentives for all players in the pharmaceutical industry.The administration released a 44-page blueprint of the plan, entitled American Patients First, aiming to increase competition and improve the negotiation of drug prices, as well as reduce consumers' out-of-pocket spending on medicines and create incentives to lower list prices.Ending the pharmacy gag orders was included the plan, as well as speeding up the approval of over-the-counter medications and asking the Food and Drug Administration to require manufacturers to include prices in their TV ads.A gag order on a pharmacy is frequently brought on by clauses in contracts with pharmaceutical benefit managers, which manage most of our nation's prescription drug programs. The benefit managers negotiate prices with drug companies on behalf of insurance companies and other payers and then share those prices to retail pharmacies. They also negotiate rebates from manufacturers and discounts from drugstores. If pharmacists violate the gag rule, they risk losing their contract with the pharmaceutical benefit manager.Daniel Nam, executive director of federal programs at America's Health Insurance Plans, told Kaiser Health News that gag orders on pharmacies are becoming less frequent because these clauses are "not something they are incorporating into their contracts."Mark Merritt, president and CEO of a lobbying group for pharmaceutical benefit managers, the Pharmaceutical Care Management Association, told the publication that these clauses are "very much an outlier." 3635

Researchers have determined there are five kinds of cat owners, when it comes to their feelings about their felines roaming and hunting outside.Outdoor cats can be a danger to birds, rodents and small reptiles, and also create dangers for themselves from disease, larger predators and traffic.Researchers at the University of Exeter in the United Kingdom are trying to bring awareness to the downsides of cat outdoor roaming and the impact on wildlife, and published part of their ongoing study. They note that several attempts have been made to address the issues, including reducing the cat population, regulating ownership and restricting feline outdoor access.“Such proposals rarely account for cat owners’ perspectives, however, and are frequently met with strong, principled opposition,” the study’s authors wrote.They found cat owners fell into five “types”:Concerned Protectors focus on cat safety. They are most worried about their pet’s safety outside and would feel guilty if the cat died while roaming. They are likely to keep their cats inside most of the time if not permanently.Freedom Defenders prioritize cat independence and natural instincts, “like a wild animal,” and oppose restrictions on behavior. They believe keeping cats inside is cruel, and that any of the risks of being outside are outweighed by the benefits. They generally are not bothered by their cat’s hunting and some expressed pride in their pet’s hunting abilities.Tolerant Guardians believe outdoor access is important for cats but dislike their hunting and are more likely to bring their cat inside at night. Generally, this group of cat owners try to rescue prey captured by their cats, accepting that their pet is a “carnivorous wild creature” while saving all wildlife.Conscientious Caretakers feel some responsibility for managing their cats’ hunting. They are worried about their cat’s roaming, and the impact on birds and other smaller creatures. This group generally believes cats require outdoor access, but are not opposed to confinement. They are open to hunting-control measures that owners can take.Laissez‐faire Landlords were largely unaware of the issues surrounding roaming and hunting behavior. This group generally is concerned their pet may be stolen, get killed in traffic or get lost if outside roaming. They also have never thought about the effect their cat has on wildlife outside. They also believe belled collars are an effective way to manage their cat’s hunting.The large majority of study participants also felt that cats should be allowed outside at least some of the time. The study’s authors note that four of the five groups viewed hunting to be negative and may be open to more information about how to limit their pet’s predation.They recommend policymakers stay away from “blanket restrictions” and instead work with cat owners on strategies. “Identifying, refining, and promoting viable management tools and alternatives may be a more constructive approach to resolving this issue than regulation,” the study concludes. 3053

Republicans will keep control of the Senate, a result that was not unexpected but still never assured in this unpredictable political environment until voters had their say. The outcome represents a significant victory for the GOP and President Donald Trump.Despite a seemingly energized grassroots electorate, the Democratic Party has been viewed as a long shot to take back control of the Senate where Republicans currently hold a narrow majority of 51 seats to 49 seats for Democrats.PHOTOS: Election Day 2018 across the nationDemocrats face a daunting Senate map in the 2018 midterms and have been forced to defend 10 seats in states that President Donald Trump won in the 2016 presidential election, including North Dakota, Montana, West Virginia, Indiana and Missouri. 782

Regarding the incident from last night, as soon as we found out about this situation, we contacted the customer to let her know, that the behavior she experienced is unacceptable and a clear violation of our service standards. We apologized and assured her that we, as a company, do not tolerate this type of behavior, in our stores. We have since made suggestions to managers of this franchise, location, on how to deal with the employee, who caused this regrettable situation. 486

Rental car company Hertz wants to help you get to the polls on Election Day.In a press release, the company announced that it offered a free rental day for customers who reserve a car for two days and pick it up either on Nov. 2 or Nov. 3."We want to make it easier for people to exercise their right to vote – especially those who need safe and reliable transportation," said Laura Smith, Hertz Executive Vice President of Global Marketing and Customer Experience, in the news release. "We're happy to provide local and convenient mobility options to the communities we serve on Election Day."The promotion is valid at any Hertz neighborhood locations in the US.The company said customers must use the CDP code 210350 when making the reservation online. 762

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