By SALLY HO

U.S. President Donald Trump announced Friday that nine drugmakers have agreed to lower the cost of their prescription drugs in the U.S.

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Pharmaceutical companies Amgen, Bristol Myers Squibb, Boehringer Ingelheim, Genentech, Gilead Sciences, GSK, Merck, Novartis and Sanofi will now rein in Medicaid drug prices to match what they charged in other developed countries.

As part of the deal, new drugs made by those companies will also be charged at the so-called “most-favored-nation” pricing across the country on any newly launched medications for all, including commercial and cash pay markets as well as Medicare and Medicaid.

Drug prices for patients in the U.S. can depend on a number of factors, including the competition a treatment faces and insurance coverage. Most people have coverage through work, the individual insurance market or government programs like Medicaid and Medicare, which shield them from much of the cost.

Patients in Medicaid, the state and federally funded program for people with low incomes, already pay a nominal co-payment of a few dollars to fill their prescriptions, but lower prices could help state budgets that fund the programs.

Lower drug prices also will help patients who have no insurance coverage and little leverage to negotiate better deals on what they pay. But even steep discounts of 50% found through the administration’s website could still leave patients paying hundreds of dollars a month for some prescriptions.

William Padula, a pharmaceutical and health economics professor at USC, said Medicaid already has the most favorable drug rates which in some cases will be close to what the “most-favored-nation” price is so it remains to be seen what other impacts it could have, such as more research and development.

“It can’t be bad. I don’t see much downside but it’s hard to judge what the upside is,” Padula said.

And while it is significant that Trump was able to get big drugmakers to the table to negotiate lower prices, it will take years to gage how effective this initiative is in terms of more people obtaining more of the medicines they need.

“It’s good for their stock and it’s good for their future” research and development, Padula said of the pharmaceutical companies. “It’s clearly influential but will all this add up to a major effect? Nothing really matters here unless our health gets better as a country.”

Trump administration officials said the drugmakers will also sell pharmacy-ready medicines on the TrumpRx platform, which is set to launch in January and will allow people to buy drugs directly from manufacturers.

Companies such as Merck, GSK and Bristol Myers Squibb also agreed to donate significant supplies of active pharmaceutical ingredients to a national reserve and to formulate and distribute them into medications such as antibiotics, rescue inhalers and blood thinners as needed in an emergency.

The New Jersey-based Bristol Myers Squibb further announced that it will be giving for free to the Medicaid program its signature blood thinner prescribed to reduce the risk of blood clots and stroke. Known as Eliquis, it is the company’s top prescribed drug as well as being one of Medicaid’s most widely-used medicines.

Padula said the donations — which encompass some of the world’s most critical medicines — are a significant step toward health equity and an acknowledgement that the drugmakers can afford to seek profits elsewhere in their operations. Eliquis already has been one of the most profitable drugs ever made.

“It’s a thoughtful health equity move that they can afford given that it’s been such a blockbuster,” Padula said of the Eliquis donation.

Other major drugmakers including Pfizer, AstraZeneca, EMD Serono, Novo Nordisk and Eli Lilly struck similar deals with the Trump administration earlier this year.

Though individual terms were not disclosed, the administration has now negotiated lower drug prices with 14 companies since Trump publicly sent letters to executives at 17 pharmaceutical companies about the issue, noting that U.S. prices for brand-name drugs can be up to three times higher than averages elsewhere.

Trump said he effectively threatened the pharmaceutical companies with 10% tariffs to get them to “do the right thing.”

ST. PAUL — Gov. Tim Walz and Minnesota Department of Human Services officials on Friday, Dec. 19, said the administration and agency don’t have evidence to suggest fraud could reach $9 billion.

On Thursday, the U.S. Attorney’s Office announced six new defendants in the latest wave of charges for Medicaid fraud in the state, also providing an update on its estimate of the scope of the state’s fraud — about $9 billion.

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First Assistant U.S. Attorney Joseph Thompson said that according to the federal Center for Medicaid and Medicare Services, an audit of 14 “high risk” state Medicaid programs found that the claims since 2018 of those 14 programs totaled out at $18 billion.

Thompson said based on what his office has investigated so far, he’d expect “about half or more” of the $18 billion in claims to be fraudulent. However, state officials said on Friday that they don’t have any information to suggest $9 billion, but they didn’t say it was incorrect.

“I wouldn’t say it’s wrong. I mean, we do the same thing at the Department of Human Services. We look at billing data, we look for red flags,” DHS Inspector General James Clark said Friday. “What I’m saying is I haven’t seen any evidence or information to suggest that there’s $9 billion worth of Medicaid fraud.”

Walz called the number “speculation,” and said they’re using that number without the proof behind it. He and DHS officials invited proof from the U.S. Attorney’s Office; Clark said he’s previously asked for proof of such figures and hasn’t received it.

“To extrapolate what that number is for sensationalism or to make statements about it, it doesn’t really help us,” Walz said Friday during an unrelated news conference at the Capitol. “It doesn’t get us to where we need. I just need their help to prosecute this. I need their help to help us get a realistic perception on this.”

John Connolly, deputy commissioner and Medicaid director at DHS, said the evidence he has indicates “tens of millions of dollars” in fraud. That estimate is specific to Medicaid fraud and does not include other state agencies, such as the Department of Education, which oversaw Feeding Our Future fraud estimated at $250 million.

“We don’t have evidence in hand to suggest that we have $9 billion in fraud and these benefits over the last seven years,” Connolly said. “And if there is evidence, we need it so that we can stop payment. That’s a very alarming number. And so if there is evidence, credible allegations of fraud. We need that information to take action now.”

Connolly also added a few pieces of context and noted that of the 18 billion, $6 billion ran through a managed care organization. $10 billion was subject to electronic visit verification.

“That basically means that a worker that goes to provide services in someone’s home is as basically indicating with a timestamp when they arrive, when they left, what service they provided who they are and who received the service,” Connolly said.

He added that $11 billion was authorized by a county case manager — which he said means care was authorized according to clinical need, “an assessment, a care plan,” with a dollar amount also being authorized by a case manager.

Walz said that while he is grateful for the U.S. attorney’s work in prosecuting, he called out the office for not mentioning on Thursday what the state has done.

“What they didn’t tell you yesterday is that June, I was given the authority to stop payments … The folks they were talking about on the housing stability stabilization grant, we stopped payment on them in July and turned the case over to law enforcement to prosecute,” Walz said. “They didn’t come in here and find that. They didn’t come in here and stop payments. They can’t do that. But what they didn’t tell you is, we’re partners in this.”

Throughout the fall and winter, the state has issued pauses on enrollees and licenses for new providers in some of the Medicaid programs on top of halting payments to programs with suspected fraudulent activity. Clark said yesterday he expects that effort from DHS to continue.

Walz also expressed concern about providers within the programs that are providing legitimate services.

“They just said the entire program. Well, that is not the case, and this becomes problematic because we’re already hearing it, and we’re very conscious to it, those programs that, the vast majority that provided incredible services, are now being put at a disadvantage because we’re not able to get them out,” he said.

The fight against fraud has taken a particularly partisan turn at the Capitol in recent weeks. During the session, lawmakers and Walz were previously able to find common ground on several proposals — including the bill that authorized the state to halt payments.

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On Wednesday, DFL members of the House Fraud Prevention and State Agency Oversight Policy Committee questioned Chair Kristin Robbins, R-Maple Grove, about sharing fraud tips received through a tip line the Republican-led committee set up.

“We have not because there is no trust, as you might understand,” Robbins said. “This fraud has been perpetuated on your watch, and the whistleblowers who reach out to us within the department are terrified, and they feel that they’ve been retaliated against already.”

Robbins said she has been forwarding information from the tip line to the U.S. Attorney’s Office, the FBI and the Office of Legislative Auditor, but hasn’t shared information with DFL colleagues or DHS. She said she’ll “consider it.”

“Nobody in the legislature on the Republican side is interested in solving this,” Walz said. “My God, it would be the worst thing in the world for them if this is solved like we’re doing it here early this year, because then what are they going to run on?”

In the days since beating St. John’s two weeks ago in a third-round game in the NCAA Division-III football playoffs, University of Wisconsin-River Falls coach Matt Walker identified a win over the Johnnies as “big in itself” given the proximity of the schools and their inherent recruiting battles.

Those bouts were Round 1 knockouts a decade ago. If St. John’s expressed interest in a player, that guy probably wasn’t going to River Falls.

“It sure felt that way at times,” said Walker, who has led the Falcons since 2011.

Gray-shirt freshman linebacker Noah Nusbaum attended St. Croix Central High School — where Walker is a frequent presence in recruiting efforts — in Hammond, Wis., just across I-94 from River Falls.

Nusbaum’s dad frequently brought him to Falcons games as a kid, and he fondly recalled throwing the ball around on the outskirts of the venue. Subsequently, River Falls was firmly on his radar when it came time to pick a school.

That story is a rare one.

“I’m the only person from my high school who committed here and stuck it out,” Nusbaum said.

Because the more common experience was that of senior defensive lineman Jack Olson, who grew up in Prescott, Wis. He knew of the Falcons, but not much beyond that. A teacher at his high school played for the Falcons in the 90s and spoke of their success decades ago.

But Olson came to a few games when he was in high school and …

“I just knew they struggled,” he said.

Mightily, with the Falcons recording zero seasons with winning records over from 2001 to 2021 — essentially the opposite of programs such as St. John’s, Wisconsin-Whitewater, Wisconsin-Oshkosh, Bethel and others in the region. Recruits had numerous options in the area, and little reason to pick up the Falcons’ phone calls.

Finally, in 2017, the university’s new, $63.5 million athletic complex opened. A door cracked open.

“More people would come to take a peek,” Walker said.

And once he had their ear, he had them.

“Even on my first visit here, talking to the coaches and seeing how they’re really heartfelt and care about you as a person, who you are and success for you is just a huge thing, and something you notice right away,” Olson said.

Falcons star quarterback Kaleb Blaha opened his collegiate career at Division II Winona State, the highest level at which he received an offer. But the moment he entered the transfer portal, he knew he was going to River Falls.

“They didn’t have a good team at the time, but that didn’t play a factor,” Blaha said. “I really liked Coach Walk and how he recruited me, how bad he wanted me.”

The Falcons won nine games in 2021, including a win in the first-ever Isthmus Bowl. a postseason contest created to feature the top Wisconsin Intercollegiate Athletic Conference and the College Conference of Illinois and Wisconsin teams that didn’t qualify for the NCAA bracket. They did so with a high-powered, lightning fast offense that now leads the country in plays per game and total offense.

All were major attractions to potential recruits.

“That tipped the horse and brought River Falls to the spotlight in the WIAC for football,” Olson said.

“It’s taken off since then,” Walker added.

And shows no signs of slowing down following this season’s playoff run into the national semifinals. The Falcons (12-1) play host to Johns Hopkins (12-1) Saturday at Smith Stadium. The winner advances to the Amos Alonzo Stagg Bowl, Division III’s national title game, Jan. 4 in Canton, Ohio.

Now, Walker said, “You’re in every fight you want to be in right now recruiting.”

Junior receiver Stephen Reifenberger, a Hastings native, said the Falcons football team has “the coolest culture I’ve been a part of in my sports career.”

“It’s so easy to come here every day and want to go to work,” Nusbaum said, “because you trust your brothers and you trust your coaches so much.”

That, Walker said, has always been a piece of River Falls’ “great story,” along with its small-town charm and history. He loves telling it. Now, everyone is listening.

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By KONSTANTIN TOROPIN, BEN FINLEY and AAMER MADHANI, Associated Press

WASHINGTON (AP) — Defense Secretary Pete Hegseth has announced the start of an operation to “eliminate ISIS fighters, infrastructure, and weapons sites” in Syria following the deaths of three U.S. citizens.

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“This is not the beginning of a war — it is a declaration of vengeance. The United States of America, under President Trump’s leadership, will never hesitate and never relent to defend our people,” he said Friday on social media.

Two Iowa National Guard members and a U.S. civilian interpreter were killed Dec. 13 in an attack in the Syrian desert that the Trump administration has blamed on the Islamic State group. The slain National Guard members were among hundreds of U.S. troops deployed in eastern Syria as part of a coalition fighting IS.

Soon after word of the deaths, President Donald Trump pledged “very serious retaliation” but stressed that Syria was fighting alongside U.S. troops. Trump has said Syrian President Ahmad al-Sharaa was “extremely angry and disturbed by this attack” and the shooting attack by a gunman came as the U.S. military is expanding its cooperation with Syrian security forces.

A U.S. official told The Associated Press that the attack was conducted using F-15 Eagle jets, A-10 Thuderbolt ground attack aircraft and AH-64 Apache helicopters. The official, who spoke on condition of anonymity to discuss sensitive operations, said more strikes should be expected.

When asked for further information, the Pentagon referred AP to Hegseth’s social media post.

White House officials noted that Trump had made clear that retaliation was coming.

“President Trump told the world that the United States would retaliate for the killing of our heroes by ISIS in Syria, and he is delivering on that promise,” White House deputy press secretary Anna Kelly said in a statement.

Trump this week met privately with the families of the slain Americans at Dover Air Force Base in Delaware before he joined top military officials and other dignitaries on the tarmac for the dignified transfer, a solemn and largely silent ritual honoring U.S. service members killed in action.

The guardsmen killed in Syria on Saturday were Sgt. Edgar Brian Torres-Tovar, 25, of Des Moines, and Sgt. William Nathaniel Howard, 29, of Marshalltown, according to the U.S. Army. Ayad Mansoor Sakat, of Macomb, Michigan, a U.S. civilian working as an interpreter, was also killed.