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Prescription drug rebates from drugmakers to commercial health plans are steadily increasing, a study published in JAMA Health Forum shows. This is all part of a system in which drugmakers negotiate to get their product on the formularies of middlemen known as pharmacy benefit managers and health plans. "While drug rebates can reduce plans' net costs, rebates do not reduce patients' cost sharing," the authors write. (Reed, 5/9)

The pandemic has spurred more Americans to do their shopping online, and shopping for medications is no exception. In addition to the mail-order business of big chains such as CVS and Walgreens and established online vendors such as Amazon and Costco, there are many online pharmacy newcomers, including GeniusRx, Honeybee Health, Ro Pharmacy, ScriptCo Pharmacy and Mark Cuban Cost Plus Drug. But shopping for meds online is not the only way to save. Here are some others. (Gill, 5/9)

Several weeks ago, Bryan Johnson laid down on a couch, and a doctor used an intramuscular injection to administer 57.75 milligrams of ketamine into his bloodstream. A helmet attached to Johnson’s head monitored what happened next as the hallucinogen triggered a profound neuronal rewiring and sent Johnson into an altered state. Johnson was, as our drug-using forebearers would say, tripping, and a very sophisticated device was taking in the show right alongside him. Researchers have observed the brain activity of people taking drugs before, although never quite like this. Test subjects on ketamine, a substance sometimes used to treat depression but also a popular recreational drug known as Special K, are traditionally placed inside of a large MRI machine at a hospital or laboratory. They hallucinate and try to open their third eyes while trapped in a confined tube and pelted by fluorescent lights. Since MRIs are expensive, a pain to conduct and not ideal for the participant, their use for this type of research has been limited. As a consequence, our knowledge of what really happens when we’re on drugs has been limited, too. (Vance, 5/9)

Paddy Doherty leaned back in the narrow hospital bed and watched a bag of clear liquid drain into a vein in his left arm, whisking billions of invisible strands of mRNA into the torrent of his bloodstream. It was only in February he’d learned the pinching pains in his toes and gasping for breath that had begun to haunt his daily dog walks through the hills of Donegal County were caused by a deformed protein piling up in his nerves and heart. Now here he was, a few months later, at a clinic in central London, so that doctors could try to fix the genetic defect he’d inherited — the same one that had already killed his father, an uncle, and a cousin. (Molteni, 5/9)

Flagship Pioneering, the venture capital firm behind Moderna, is getting into the Washington lobbying game. The firm has hired one of biopharma’s favorite lobbying shops to advocate on their behalf with Congress and the Biden administration, according to a new federal disclosure. The move comes on the heels of Flagship’s recent hiring of several Washington heavyweights. The firm brought in Stephen Hahn, the FDA commissioner under President Trump. Flagship also hired Tom DiLenge, the former top policy official at the Biotechnology Innovation Organization in January. DiLenge is overseeing policy and government affairs for the venture capital firm, though he has not formally registered to lobby on Flagship’s behalf. (Florko, 5/10)

A dangerous, new group of synthetic opioids called "nitazenes" is rapidly spreading across the U.S. In Ohio, the state's Attorney General Dave Yost issued a warning about the prevalence of nitazenes as the Buckeye state saw an increase in the illicit drug. The drug, nicknamed "Frankestein opioids," can be 1.5 to 40 times more potent than fentanyl. It is not approved for medical use anywhere in the world but is currently being made in clandestine labs, according to a bulletin from the Ohio Bureau of Criminal Investigation (BCI). (Goin, 5/10)

State lawmakers are making $2 million available to North Carolina sheriffs to start or expand opioid addiction treatment programs in their jails, but the money comes with a big caveat. The $2 million grant program included in the state budget late last year specifies that the funds can be used to provide only one of the three FDA-approved medications for opioid use disorder. Some addiction experts argue that the favored medication — naltrexone, also known by the brand name Vivitrol — is the least effective of the three. (Knopf, 5/10)

Kings County's district attorney dropped his long-running prosecution Monday of a woman who spent four years in prison for giving birth to a stillborn child after using drugs. Adora Perez had pleaded no-contest to manslaughter in 2018, to avoid a murder charge for her 2017 stillbirth and was sentenced by a judge to the maximum term of 11 years in prison. But another judge overturned her conviction — ruling that manslaughter applies only to the death of a human being, not a fetus — and freed her on bail this March. (Egelko, 5/9)

The Solomon R. Guggenheim Museum erased the Sackler family name from the institution, the latest museum to cut ties with the clan, which made billions selling opioids and contributed to a staggering public health crisis in the U.S. The Guggenheim’s Center for Arts Education dropped “Sackler” at the beginning of its name in recent weeks, according to web archives that show it listed as recently as April 28. It was removed on or before May 4, the records show. (Alexander, 5/9)