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Congress is poised to prohibit Medicare from spending an estimated $444 million for vacuum pumps used to treat erectile dysfunction in the next decade, a cost-saving move that may frustrate people who can’t afford drugs such as Pfizer Inc.’s Viagra. Medicare’s prescription-drug benefit, created in 2003, generally isn’t permitted to cover Viagra or other erectile-dysfunction medicines. A bill under consideration by Congress would put a similar ban on the pump devices some people use as an alternative. The spending estimate was published yesterday by the Congressional Budget Office. (Wayne, 12/4)

An analysis of payments to physicians by Insys Therapeutics, a small drug maker that markets a powerful, but highly restricted painkiller, found that five of the 20 doctors who received the most money recently faced legal or disciplinary action, The New York Times writes. And some of the physicians had allegedly prescribed painkillers inappropriately. Moreover, many of the 20 highly paid doctors, who were paid for consulting, travel or meals, were also among the top Subsys prescribers, according to the Times analysis, which relied on filings with the federal government Open Payments database, as well as internal Insys documents and prescribing information from Tricare, which is the health insurance program for military families. (Silverman, 12/2)

Americans with health coverage – including those who buy it through government insurance exchanges and Medicare beneficiaries – are likely to pay more out-of-pocket next year for so-called “specialty drugs,” which treat complex conditions, according to two studies from consulting firm Avalere Health. (Appleby, 12/2)