In so-called pay-for-delay deals or reverse settlements, a patent holder pays a would-be competitor not to sell a generic version of a drug for a specified period of time. The brand-name manufacturer can continue to charge monopoly prices, and the generic company is compensated for inaction.

In Federal Trade Commission v. Actavis, the government sued drug companies over one such deal. The Justice Department asked the court to rule that all pay-for-delay deals are illegal, but Justice Stephen Breyer, who wrote the opinion for the court’s 5-3 majority, said that was going too far. (Read the full decision here.) The deals’ “complexities lead us to conclude that the FTC must prove its case” one at a time, Breyer wrote.

Related: Does a Top Drugmaker’s Playbook Stifle Competition?

Fallout from such arrangements “reverberates throughout the health care system — including Medicare and Medicaid — and is especially burdensome for consumers,” AARP said in a statement applauding the court’s decision. AARP, which filed a friend-of-the-court brief in the case, said it hopes the ruling “will lead to an end to such agreements and that ultimately courts will find them anticompetitive and illegal.”

In a statement FTC Chairwoman Edith Ramirez called the decision “a significant victory for American consumers, American taxpayers and free markets.”

The FTC estimates that pay-for-delay agreements cost American consumers $3.5 billion per year.

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• Join AARP: Savings, resources and news for your well-being

See the AARP home page for deals, savings tips, trivia and more

You might look at what Pfizer did when time was running out on its patent for the cholesterol-lowering drug Lipitor, which by 2011 had become the all-time bestselling prescription drug of any kind. And you could save yourself some time by reviewing a new AARP Public Policy Institute case study of Pfizer’s approach.

The AARP study lays out six steps that the drugmaker reportedly employed to protect and extend their revenue from Lipitor. Some of them are routine business practices. Others are under scrutiny by the Federal Trade Commission, Congress and federal courts.

Here they are:

1. Pay another drugmaker to delay bringing its generic version of Lipitor to market. On June 17 the U.S. Supreme Court ruled that such pay-to-delay deals by drugmakers could violate antitrust laws.
2. Jack up the price of your drug before the patent expires. The price of Lipitor rose 9.3 percent in 2010, 17.5 percent in 2011 and 9.9 percent in 2012.
3. Offer consumer discounts. In 2011 Pfizer began to heavily promote a program that supplied Lipitor to privately insured patients for a $4 copayment, below the average copayment for other brand-name drugs and below the average copayment for generics in general. More than 750,000 people have signed up for the program, named Lipitor for You.
4. Once a generic version does come on the market, offer rebates to insurance plans and managers of prescription drug programs that will agree to reject claims for the generic version for a specified period.
5. “Authorize” a generic version of your drug. Pfizer reportedly authorized another drugmaker to market Lipitor as a generic in return for 70 percent of the profits.
6. Market the heck out of your product right through patent expiration. Pfizer did.

Did Pfizer’s tactics work? Though Lipitor sales dropped from $9.6 billion in 2011 to $3.9 billion in 2012, a 60 percent decrease, the company’s chief executive said its record-breaking drug was adding “hundreds of millions of dollars of profitability to the company.”

Related: Court — Pay-for-Delay Deals Between Drug Companies Can Be Illegal

But while Pfizer continued to reap profits, the AARP study concludes, its approach came at the expense of consumers, Medicare and Medicaid, employers that offer health plans, pharmacies and insurance companies.

“Strategies that hinder competition, like those reportedly employed by Pfizer, are harmful to consumers and all payers responsible for purchasing prescription drugs,” said Debra Whitman, AARP Executive Vice President for Policy, Strategy and International Affairs. “We’re hopeful these strategies are not a model for the future.”

Photo: Scott Camazine/Getty Images

Also of Interest

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“What we’ve said to the girls is, ‘If you guys ever decided you’re going to get a tattoo, then mommy and me will get the exact same tattoo in the same place. And we’ll go on YouTube and show it off as a family tattoo,” Obama told Savannah Guthrie in a taped interview. “And our thinking is that might dissuade them from thinking that somehow that’s a good way to rebel.”

The logic behind the Obama’s tattoo-prevention strategy sounds oddly familiar. A couple of years ago, as Democrats and Republicans struggled for a way to break their budget standoff, Obama proposed this: Let’s come up with a fiscal scheme so repugnant to everybody that a compromise budget deal is inescapable.

So they came up with the sequester, which went like this: If no budget compromise comes to pass, we’ll cut a ton of money from the military: Republicans will hate that. And we’ll cut a ton of money from domestic programs: Democrats will hate that.

What happened? Budget compromise, no. Sequester, yes.

If the president’s strategy for handling his daughters works as well as his strategy for handling Congress, one day you’ll see the Obamas show off their family tattoo on YouTube.

For a very different story about a family tattoo, watch the video below.

Click here to view the embedded video.

Photo: Bengt Nyman via Wikimedia

Also of Interest

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Rescuers evacuate rest home residents.

Maybe it’s because they’re often clustered in large groups. Maybe it’s because they’re less likely to be able to save themselves. And maybe in part it’s a numbers game: there’s simply more and more senior citizens.

We saw it in New Orleans during Katrina and in the Northeast during Superstorm Sandy. And we saw it again when a fertilizer plant exploded in the little town of West, Texas.

A nursing home stood near the fertilizer plant where fire had broken out. Alerted to pending disaster by firemen, nursing home workers had just begun to evacuate the facility’s 133 residents.

“All of a sudden it just blew, I mean, everything went flying everywhere, and once that happened I looked around and debris was just down,” nursing home worker Lola Millhollin told the Associated Press. “Everything fell down, the ceiling fell down and the windows blew out.”

Disaster can also bring out the best in people. By all accounts, Millhollin, her colleagues and skilled first responders rose to the occasion.

They went back into the damaged building and searched rooms for trapped residents. Many of them were panicked and in shock.

“I helped loosen debris so that we could wheel the ones that were out in the main part first,” Millhollin said. “We did the best we could with what we had, and we got them out safely. We were taking them out through broken windows, putting a mattress across the windows so we could get them out without getting them all cut up and stuff.”

The explosion killed up to 15 people. The residents of the West Rest Haven nursing home were not among them.

Click here to view the embedded video.

Also of Interest

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Credit: Rod Aydelotte/Waco Tribune Herald/AP Images

The other two are sharply divergent plans drafted by the lawmakers who chair the congressional budget committees: Rep. Paul Ryan (R-Wis.) and Sen. Patty Murray (D-Wash.). The Republican-controlled House passed the Ryan budget on March 21; the Democratic-controlled Senate passed the Murray budget two days later.

We surveyed news accounts and nonpartisan analyses to pull together the side-by-side summary of key provisions below. Keep in mind that because the competing budget proposals are built around different sets of economic assumptions (known in Washington-speak as “budget baselines”) and contain revenue and spending projections through 2023, you may very well see different numbers elsewhere. We aimed for “apples to apples” comparisons, relying on the budget baseline used by both the Center on Budget and Policy Priorities and the Committee for a Responsible Federal Budget.

Compare the three plans on the table. And we encourage you to enter your thoughts about the plans in the comments section below (“Tell Us What You Think”).

The Budget Plans at a Glance

SOURCES: House Budget Committee; Senate Budget Committee; White House; Center on Budget and Policy Priorities; National Council on Aging; National Association of Area Agencies on Aging

Also of Interest

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Here’s how Kagan described them: They’re both over 55 years old, apparently heterosexual and they want to get married. Oh, and she’s past her childbearing years, though he probably isn’t.

Kagan conjured the couple as the justices probed Cooper’s argument that “redefining marriage as a genderless institution” would undermine its foundation for having children and shift the emphasis to the needs of adults.

You can listen to their exchange here or read how it went below (with the transcript edited to eliminate some repetition and cross talk):

COOPER: The concern is that redefining marriage as a genderless institution will sever its abiding connection to its historic traditional procreative purposes, and it will refocus the purpose of marriage and the definition of marriage away from the raising of children and to the emotional needs and desires of adults, of adult couples.

JUSTICE KAGAN: Well, Mr. Cooper, suppose a state said that, “Because we think that the focus of marriage really should be on procreation, we are not going to give marriage licenses anymore to any couple where both people are over the age of 55.” Would that be constitutional?

COOPER: No, Your Honor, it would not be constitutional.

KAGAN: Because that’s the same state interest, I would think, you know: If you are over the age of 55, you don’t help us serve the government’s interest in regulating procreation through marriage. So why is that different?

COOPER: Your Honor, even with respect to couples over the age of 55, it is very rare that both parties to the couple are infertile, and —

KAGAN: No, really, because if the couple — I can just assure you, if both the woman and the man are over the age of 55, there are not a lot of children coming out of that marriage.

[Laughter.]

COOPER: Your Honor, society’s interest in responsible procreation isn’t just with respect to the procreative capacities of the couple itself. The marital norm, which imposes the obligations of fidelity and monogamy, Your Honor, advances the interests in responsible procreation by making it more likely that neither party, including the fertile party to that —

KAGAN: Actually, I’m not even —

JUSTICE ANTONIN SCALIA: I suppose we could have a questionnaire at the marriage desk when people come in to get the marriage [license], you know — Are you fertile or are you not fertile?

[Laughter.]

I suspect this Court would hold that to be an unconstitutional invasion of privacy, don’t you think?

KAGAN: Well, I just asked about age. I didn’t ask about anything else. We ask about people’s age all the time.

COOPER: Your Honor, and even asking about age, you would have to ask if both parties are infertile. Again —

SCALIA: Strom Thurmond was not the chairman of the Senate committee when Justice Kagan was confirmed. [Note: The Republican Senator from South Carolina was known on Capitol Hill as “Sperm Thurmond” for having fathered the first of four children with his beauty-queen wife when he was nearly 70.)

[Laughter.]

COOPER: Very few men outlive their own fertility. So I just —

KAGAN: A couple where both people are over the age of 55 —

COOPER: And Your Honor, again, the marital norm which imposes upon that couple the obligation of fidelity —

JUSTICE SONIA SOTOMAYOR: I’m sorry, where is this —

CHIEF JUSTICE JOHN ROBERTS: I’m sorry; maybe you can finish your answer to Justice Kagan.

SOTOMAYOR: I’m sorry.

COOPER: It’s designed, Your Honor, to make it less likely that either party to that marriage will engage in irresponsible procreative conduct outside of that marriage. That’s the marital norm. Society has an interest in seeing a 55-year-old couple that is — just as it has an interest of seeing any heterosexual couple that intends to engage in a prolonged period of cohabitation, to reserve that until they have made a marital commitment. So that, should that union produce any offspring, it would be more likely that that child or children will be raised by the mother and father who brought them into the world.

Photo: Steve Petteway/Collection of the Supreme Court of the United States

Also of Interest

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Republican and Democratic leaders from both chambers of Congress this week offered competing budget proposals that both look for savings in health care. KHN’s Mary Agnes Carey talks with Jackie Judd about what’s next for the proposals, and what President Obama could offer himself.

> > Listen to the audio or read a transcript below.

Jackie Judd: Good day, this is Health on the Hill. I’m Jackie Judd. Congressional budget leaders have now laid out their vision for federal spending over the next decade. House Budget Chair Republican Paul Ryan outlined a familiar budget yesterday, and Senate Budget Chair Democrat Patty Murray did the same today. Describing the distance between the two proposals, one journalist, said, “It is not even apples and oranges, it’s apples and bicycles.” Senior Correspondent for Kaiser Health News Mary Agnes Carey is here. How different are they?

Mary Agnes Carey: I think they’re extremely different. I really look at this as the tale of two conflicting budgets. Patty Murray talks about health care savings, but wants it in a way that doesn’t harm seniors or their families. [She] doesn’t want any changes to Medicare, nothing that would, in her words, “dismantle” or “voucherize” Medicare.

She would preserve the 2010 health care law. Paul Ryan, by contrast, the House Republican Budget chair, would repeal the health care law – keep the Medicare savings, but repeal the law itself. He would bring back his premium support plan that would change the way seniors currently get their health care.

They would get a set amount of money and they could buy a plan that costs more or costs less, it would be up to them. He would block-grant the Medicaid program. He would raise the Medicare eligibility age. So you have two very different visions.

Judd: Now, let’s introduce President Obama into this. He sends his budget up to Capitol Hill next month. He met with Senate Democrats this week. What hints did he give about, number one, what he expects of them, and number two, what his budget will look like?

Carey: He talked about entitlements, trying to make Democrats understand that if Republicans move on the revenue – and let’s be clear, they’ve said they don’t want to – but if the Republicans will move on revenue, Democrats have to be ready to move on entitlements.

And he got some immediate pushback. You mention his talk with the Senate Democrats. Tom Harkin of Iowa, Bernie Sanders of Vermont – some of the more liberal members of the Democratic caucus – pushed back and warned the president to move very carefully if he’s going to include Medicare as part of any grand bargain plan.

Judd: Big gulf here, as you’ve described. Do you, as a long time Capitol Hill reporter, see any nuance – any statement – that makes you think there may be room for future negotiation and compromise?

Carey:  I’ve been running that exact scenario past many of my sources. I usually get a shrug and an answer to the effect of: Who knows?

But everyone seems to look at some of these elements as potential movement. For example, we talked about Patty Murray trying to move a budget in the Senate. That hasn’t happened since 2009. She’s trying to move that process forward. As we know, it is moving forward in the House. You mentioned the president. He’s meeting on Capitol Hill in both chambers with both parties to try to get people to meet to the middle.

As we’ve noted, it cannot be underscored how far apart both sides seem now, but it’s March. People can change their minds. And if there’s any hope of a larger deal, it would really, I think, have to happen now. We’re a year past the presidential and congressional elections. We’ve got a mid-term election next year. So this would seem to be the year, if they’re going to move to any broader compromise on taxes, on entitlements and federal spending – it would have to happen now.

Judd:  And the consequences if there is not a deal?

Carey:  Life goes on. The implementation of the Affordable Care Act would continue, which – even though Republicans would like to stop that – it probably will continue anyway. Medicare spending continues on the same path, Medicaid on the same path. And Congress has to continue to pass some measures to fund the government, and they would have to raise the debt ceiling at some point.

So life goes on. There aren’t major things stopping if they don’t pass a budget. Nonetheless, there’s a lot of emphasis on it and attention to it this year.

Judd:  And, as you mentioned, implementation of the ACA, the health overhaul law, continues, becomes more entrenched into the system, despite Paul Ryan’s call for it to be repealed.

Carey:  We will see, whether it is on the debate on the budget, or, more immediately, the continuing resolution, this piece of legislation to fund the government beyond the end of March. You will see Republican amendments repeatedly to defund the ACA. And while previous efforts on this have failed — and as we know the Supreme Court upheld most of the provisions in the ACA – Republicans say they want to use every opportunity they have to tell the American public the flaws of that they think exists in the 2010 health care law and what they would do to replace it.

Judd:  Thank you, Mary Agnes Carey of Kaiser Health News. I’m Jackie Judd.

This article was produced by Kaiser Health News with support from The SCAN Foundation.

The daytime talk show “The Doctors” said Harper will appear Monday to talk with Travis Stork, Lisa Masterson and Andrew Ordon, as well as her own team of doctors.

The 1970s sitcom star has been diagnosed with a rare brain cancer and told she has as little as three months to live. She said her husband briefly withheld the diagnosis from her because it was so dire.

Harper, now 73, played Rhoda Morgenstern on television’s “The Mary Tyler Moore Show” and its spinoff, “Rhoda.”

She’s given the full hour of Monday’s talk show, and is surprised by former co-stars Ed Asner and Cloris Leachman.

Photo: Maggiejumps via Wikimedia

That’s one takeaway from a new poll by the Pew Research Center and USA Today on issues that are likely to dominate the political landscape this year.

By a 9 point margin (49 to 40 percent), those polled favored finding a way around the $85 billion in spending cuts scheduled for military and most domestic programs — known in Washington as the “sequester.” There was little difference between the response of those under age 50 and those 50 and older.

Asked how much they’ve heard about the sequester, 27 percent said “a lot”; 43 percent said “a little”; and 29 percent said “nothing at all.”

Here, though, there was a clear difference by age:

Those who have heard “a lot” about the sequester?

• Under age 50: 19 percent
• 50 and older: 37 percent.

Have heard “nothing at all”?

• Under age 50: 35 percent
• 50 and older: 21 percent.

The poll also asked how Congress and President Obama should reduce the budget deficit in the coming months.

• Spending cuts only: 19 percent
• Tax increases only: 3 percent
• A combination: 76 percent

There was no significant difference between those under 50 (less informed about the sequester) and 50 and older (more informed about the sequester) .

Common sense, I’m guessing, cuts across all age lines.

Eddie’s signature move? “The slam dunk,” says Jenny DeGroot, the zoo’s lead sea otter keeper.

“Eddie almost never misses,” DeGroot adds. “And if he does miss, he keeps going until he makes it.”

Have a look for yourself:

Click here to view the embedded video.