May 11, 2023
Reporter, D.C. Diagnosis Writer

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Drug pricing

Insulin hearing foreshadows PBM showdown

Wednesday’s three-hour hearing before the Senate health committee did little to clarify decades of rising insulin costs, but set up a potential showdown today on PBM reform legislation that would require pass-through rebates and ban spread pricing.

While HELP Chair Sen. Bernie Sanders (I-Vt.) characterized the bills as “modest” when he wrapped the hearing, several Republicans, including ranking member Sen. Bill Cassidy (R-La.), clearly disagreed, D.C.D. co-writer Sarah Owermohle reports. Cassidy and Sen. Rand Paul (R-Ky.) both defended spread pricing and asked PBM executives to explain how pass-throughs could be more expensive. Cassidy also seemed to nod to his stance on a trio of bills, two with bipartisan sponsorship, that would cap patients’ monthly insulin costs.

“You can mandate lower and lower copays, but you might actually get the opposite,” he said. “You might actually drive consumers towards something that's actually more expensive.”

long covid

Eshoo demands answers from NIH on long Covid research


Rep. Anna Eshoo (D-Calif.), who is the House Energy & Commerce health subcommittee’s top Democrat, is interrogating the NIH’s plans for long Covid research.

A letter she wrote to NIH Acting Director Lawrence Tabak on Tuesday highlights slow progress enrolling clinical trials, the lack of relief for patients, and the exclusion of long Covid from the White House’s Next Gen program to accelerate development of Covid-19 vaccines and treatments. The points were all reported in an investigation published by STAT and MuckRock into NIH’s research efforts that is cited in the letter.

“Congress entrusted NIH with significant funding to provide relief to our constituents suffering from this life-altering disease, but so far, it hasn’t delivered that relief,” Eshoo wrote. 

Eshoo is requesting information about the NIH’s remaining budget on long Covid, plans for future spending, specific dates when the RECOVER initiative will start enrolling patients in clinical trials, and how treatments were selected to be tested in clinical trials. She’s also asking for a firm timeline on when HHS’ Office of Long Covid Research and Practice will be established, as well as whether the NIH needs more resources to study the condition. 


AHA rallies the troops

Hospitals are worried enough about a possible markup next week in the House Energy & Commerce Committee that the group is urging  its members to reach out to lawmakers, a document I obtained shows. 

The AHA warns members that the full committee will be voting on legislation on May 17 (a markup hasn’t officially been announced yet) on site-neutral pay policy, 340B program transparency, and DSH cuts.

“With harmful legislation potentially set to be marked up next week, there remains a critical need to continue the ongoing education of lawmakers, especially those serving on the full Energy and Commerce Committee,” the AHA stressed.


Medicare under pressure to pay for Alzheimer’s drugs

With Alzheimer’s drugs looking more promising by the day, House Republicans increased pressure for broader Medicare coverage of the treatments at a House hearing Wednesday, my colleague John Wilkerson reports. 

Medicare only pays for accelerated approval Alzheimer’s drugs when taken by patients in clinical trials. The policy was put in place in reaction to concerns that Aduhelm, approved in 2021, doesn’t work and is dangerous, but it applies to all drugs in the same class. Since then, two more Alzheimer’s drugs have shown better results than Aduhelm, so now there is pressure on Medicare officials to change the policy – they’ve given no indication that they will do any such thing.

“The 6.7 million people living with Alzheimer’s don’t have time for [Medicare] to come to its senses,” House Ways and Means health subcommittee Chair Vern Buchanan (R-Fla.) said.

Republicans also called out CMS for taking two years to replace a Trump-era rule that would have granted four years of Medicare coverage to FDA-designated breakthrough devices. The agency was supposed to release a somewhat pared-down version, with the same goal of encouraging device innovation, in April. “It’s been more than two years and the Biden administration has not proposed a replacement rule for this,” said Rep. Brad Wenstrup (R-Ohio).  “If you didn’t like it and you canceled it, fine. But tell us why.”


White House split screen on unspent Covid funds

Here’s an interesting side-by-side for you as debt ceiling negotiations drag on. For context, Republicans have called for the government to rescind billions in unspent Covid-19 relief funds. 

President Biden said Tuesday that idea is “on the table” in debt ceiling and government spending conversations. “The answer is I’d take a hard look at it because … we don’t need it all but the question is what obligations were made, commitments made, the money not disbursed, etc.”

In contrast, White House Covid-19 Response Coordinator Ashish Jha had this to say when he was asked the same day by reporters about the possibility unspent relief funds could be clawed back: “Obviously we remain committed to making sure that Americans remain protected against Covid, and that requires resources. And so we will continue to need resources to do the things that are important.”

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  • Gilead defeats federal government in closely watched battle over patents for HIV prevention pills, STAT
  • RFK Jr.: Ron DeSantis invited me to breakfast, said he wanted to burn the NIH "to the ground," Semafor

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