Hey there, Colorado, and welcome to another edition of The Temperature, where this past week I was reminded why local journalism is so important.
I was reading a story in The Washington Post — fine, lovely publication, no shade — about “recycling myths.” Their top myth? That greasy pizza boxes aren’t recyclable. “Yes, they are,” The Post declared.
Is this true? I asked fellow Temperature-er Michael Booth. Denver’s recycling guidelines say no pizza boxes with grease showing on the outside. Longmont tells residents to rip the box in half and recycle only the nongreasy side. The primary compost-making company recently said greasy boxes were ruining the clean-compost stream, and discouraged it in the green bins.
“It varies,” Mike told me.
See, the problem with reading only national news is that the nation isn’t a homogenous place with the same rules and resources everywhere. What happens in your local community has an enormous impact on your life — so being informed about what’s happening close to home is vitally important.
You’re a Sun member, so you get this — and thank you for that! But in this season of our political discontents, maybe tell a friend, too?
And if you’re still scratching your head about recycling rules — I know I am — be sure to get your tickets for SunFest, where Mike will be hosting a panel discussing exactly this topic, wrapped in a fun game show format. It’s going to be such a kick that you may start thinking the box is the best part of the pizza order.
Now, onto the news.
Reporter
TEMP CHECK
HEALTH
2-year-old girl moves to Colorado for a new heart
Only the sickest of the sick among the heart patients at Children’s Hospital Colorado will get a transplant. That’s because — and this a good thing — there aren’t that many children’s hearts to offer as transplants for other children.
But it means the Aurora hospital’s doctors and nurses can spend months or even years using medications to keep a child with a defective heart alive until they receive a heart transplant. Some kids die while they wait.
More parents than not whose children die are willing to donate their organs, said Dr. Melanie Everitt, a pediatric cardiologist and director of Children’s heart transplant program.
“Most families would do it,” she said. “At any one time, we have about 20 patients waiting for transplants. If you had unlimited hearts, it’s quite possible that more children would be listed as well. Since you don’t, it really ends up being the sickest children who have no other option.”
Children’s does 15-20 heart transplants each year, totaling more than 500 since the hospital’s heart transplant program began in the 1980s. The program is now among the top 5 nationally in terms of patient volume. It requires a huge team, and every transplant requires two surgeons — one to remove the organ from the donor and fly with it back to Colorado, and another to place it in the child who needs it.
We recently met one of those children with a new heart, a gift she received after another family’s tragedy. The family of a 2-year-old boy who died in New Mexico gave his heart to a sweet-faced toddler named Willow. The girl whose own heart had been barely working last week was running around her back yard in a diaper trying to keep up with her brothers.
Read more about Willow’s transplant in an upcoming article in The Sun, including about how East Coast children’s hospitals said Willow was too sick to get a transplant and how her parents and brothers packed up and moved to Colorado “on a hope and a prayer” that she would get a new heart here.
Section by Jennifer Brown | Reporter
MORE HEALTH NEWS
CLIMATE
Livestock trade fires back on “factory farms” lawsuit
The Colorado Livestock Association is firing back at environmental groups over their portrayal of concentrated animal farms, saying a new lawsuit perpetuates false or misleading accusations about what gets regulated, and how things really look around the state.
Special interests, the cattle trade group says, are using their right to litigate and demands for “excessive” regulation to “impose their beliefs on others and force them into doing what they want,” says Zach Riley, CEO of the livestock group. The groups attacking Colorado’s large animal farm permit system, who have now added a lawsuit to their tactics, are out to get rid of all concentrated feeding operations, which they refer to as “factory farms,” Riley said.
The livestock association isn’t just a target of the criticism, it is also a key legal player. The influential agriculture group formally intervened to defend Colorado’s permitting system when Food and Water Watch and the Center for Biological Diversity challenged it in administrative law court. Now the groups have escalated the permit-writing fight into state district court based in Larimer County, as their next legal opportunity for further challenges.
The watchdog groups’ main contention, supported so far by the administrative law judge who ruled in their favor, is that Colorado is not requiring enough monitoring of fresh water sources near large animal farms. The tons of manure, urine and other runoff may taint water sources with destructive nitrogen and other chemicals, and the state will never know, they say.
Colorado writes some of the strictest requirements into its concentrated animal farm permits, Riley responds. Colorado feedlot and dairy operators already spend tens of thousands of dollars a year fulfilling their permit conditions. (Colorado has gone with a “general” permit that covers more than 100 operations, as part of its state enforcement of the federal Clean Water Act. Some states choose to let the EPA do the permitting.)
Farm operators do monitor their wells, Riley said. Requiring even one additional monitoring well could cost operators $30,000 or more.
The administrative law judge agreed with the environmental groups that Colorado’s permit should be rewritten to include more water monitoring by the farms. Colorado health department chief Jill Hunsaker Ryan then took her legal right to overrule the administrative court. That’s when the environmental groups escalated the fight to district court.
Colorado’s current permit requires manure holding ponds to be lined and periodically checked, Riley said. State health department specialists “conduct regular check-ins and inspections to ensure compliance, all the way down to the weeds growing near banks of lagoons to ensure that they are dealt with so as to never compromise the lagoon liner integrity,” he said.
The environmental groups like to point to similar cases they have won in other states, Riley noted. “Idaho had nothing like this in place and comparing that situation to Colorado is like comparing an apple to a hammer.”
The livestock association will continue to support state health department officials as they fight the permit lawsuit at the district court level, and if it reaches higher appellate levels, Riley said.
“Soliciting an emotional response is a tactic employed by groups like the plaintiffs who didn’t get their way the first time and didn’t bend the world to their will,” Riley said. “So, they venue-shop until they drain the resources and force animal agriculture out. These environmentalists are behaving like insolent children.”
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Section by Michael Booth | Reporter
MORE CLIMATE NEWS
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CHART OF THE WEEK
Colorado’s Prescription Drug Affordability Board meets this week to decide what to do with another high-cost medicine.
The drug in the spotlight this time is Stelara, which treats autoimmune conditions like plaque psoriasis and psoriatic arthritis. In this sense, it has company. Four of Colorado’s nine most expensive drugs are for autoimmune diseases.
The chart above shows the most expensive drugs in Colorado in 2021 in terms of the total amount spent on medical claims. You’ll notice one drug — Humira, which treats rheumatoid arthritis, another autoimmune condition — is on there twice. That’s because Humira, like many drugs, comes in multiple forms, in this case as an autoinjector pen or as a pre-filled syringe. Colorado patients and insurers spend a lot per year on both.
That fact provides insight into why drug affordability boards across the country have taken so much time in doing their work. (Lawmakers created the Colorado board in 2021, and it is still reviewing its first batch of drugs, though it is farther along in that work than any other state’s board.)
There are a lot of different ways for drugs to be unaffordable. The chart above looks at the total spending, regardless of how many patients take the drug. Slice the data a different way and the list changes.
A drug called Takhzyro, which treats angioedema, is the most expensive on a per-patient, per-year basis: an average of $394,235. But the total spending on it per year is only a little over $16 million because just a few dozen people in Colorado use it.
The anti-seizure drug Sabril is the most expensive if you look at what the state says patients have to pay out-of-pocket: an average of $23,313 per year. But, again, the number of patients is small and changes in insurance coverage or manufacturer financial assistance programs could affect each patient’s cost significantly.
Even Humira may arguably not be as expensive as it appears. The Prescription Drug Affordability Board, or PDAB, declined to include it in its first round of reviews — despite its enormous systemwide price tag — because there are similar drugs that may be available at lower prices.
This data all comes from the Center for Improving Value in Health Care, which analyzes millions of Colorado medical claims per year. But CIVHC doesn’t get ALL the medical claims, meaning its numbers are ultimately incomplete — though they are more complete than any other data source.
The state collects all this info on a big data dashboard that you can play around with to learn more about drug costs.
This week’s PDAB meeting, which is virtual, is on Friday at 10 a.m. The board may vote on whether to declare Stelara unaffordable, which would trigger a monthslong process of deciding whether the board should set a price cap on it.
Colorado’s PDAB became the first in the country to look at setting a price cap when it declared the drug Enbrel unaffordable earlier this year. That decision, though, is now the subject of a lawsuit.
You can register to watch Friday’s meeting on the PDAB website.
Section by John Ingold | Reporter
Thanks for reading to the end, and thank you, again, for supporting local journalism. We say this a lot, but please know that we sincerely mean it: We literally couldn’t do this without you.
So celebrate yourself today by ordering out for pizza. And once you’ve had the joy of recycling the box — or maybe not! — you might even want to grab a slice to eat.
Till next time, friends.
— John & Michael
Corrections & Clarifications
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