| | | |   | Happy Thursday, D.C. Diagnosis readers! It’s going to be boom or bust for Congress on drug pricing reform over the next couple months. Consider this your save the date for a virtual event we’re hosting on July 20 to talk about all the action. It’s free and open to everyone — sign up here! In the meantime, pass along your best tips and questions to rachel.cohrs@statnews.com. | | | How much monkeypox medicine does the U.S. actually have?  (Chris Livingston/Getty Images) As global concern has grown about monkeypox, the Biden administration has tried to assure the public that the government has vaccines and treatments stockpiled – but officials have chosen to keep some information under wraps, too. The federal health department released some numbers about some vaccines this week, but they’re keeping secret what other products could be used to vaccinate the country if a much more deadly, contagious smallpox outbreak happens. And officials aren’t saying anything about how many treatments they have on hand for monkeypox. It’s a delicate situation, as there are only two countries with official stockpiles of smallpox virus — the United States and Russia. And negotiations are ongoing over what medicines the U.S. could share with the world. Read more details in my new story. | Hospitals’ quiet lobbying defeat Hospitals and doctors have had an impressive stretch of lobbying wins since the beginning of the pandemic, but this is the year that much of the pandemic padding to providers’ bottom lines has slowly faded away.
Congress acted several times in a highly unusual, bipartisan way to extend a pandemic-era, 2% boost to providers’ Medicare pay rate. But lawmakers quietly let the first phased pay cut go into effect at the end of March, and they’re on track to allow another pay reduction at the end of June.
There’s another big pay cut on the horizon at the end of the year, as Congress gave doctors an almost 4% pay bump this year to pacify them after the Trump administration tried to rebalance their rates. If Congress doesn’t act before the end of the year, that expires — adding up to a nearly 6% cut across the board. That’s not even accounting for the fact that the Provider Relief Fund, and related programs to pay for Covid-19 testing, treatment, and vaccination, have expired.
What to watch for next: Medicare is expected to release its doctor pay rule this summer, which will dictate exactly how the formulas will shake out for each specialty. Be ready for a lobbying bonanza. | Two months later, how’s NIH progressing on studying long Covid?  NATIONAL INSTITUTES OF HEALTH (RACHEL COHRS/STAT) It’s been more than two months since I investigated the National Institutes of Health’s billion-dollar project to study long Covid, and it’s about time for an update on the study’s progress.
Enrollment numbers: By March 18, NIH had only enrolled 1,366 patients, or 3.4% of its ultimate goal. As of Wednesday, enrollment has increased to 4,152 patients, or 10.4% of its goal, according to numbers provided by NIH.
Site locator: For months, the webpage for the study said a map of study sites was under construction. But now the map is up and running, and lists details for 91 study sites where participants can enroll. However, some of the sites are only collecting tissue from deceased people, and 12 of the sites listed aren’t actively enrolling new patients.
Letter response: Sens. Sheldon Whitehouse (D-R.I.) and Ed Markey (D-Mass.) wrote a letter to NIH on April 19 citing STAT’s reporting on the RECOVER initiative, and asked the agency to provide information about plans for clinical trials, project spending, and recruitment. They requested a response by May 15, but Whitehouse’s office told STAT it has not received a response to the letter. | Voters report delaying or skipping health care due to concern over out-of-pocket costs More Americans have health insurance than ever before, yet 72% of voters are concerned with the cost of getting care. New polling reveals consumer worries about the unpredictability and pressure caused by these costs, the prevalence of medical debt, and the lack of access to mental health care. Voters across party lines want elected officials to act and provide quality, affordable health care. Learn more. | User fee markup drama As my co-author Nick reported earlier this week, the Senate’s user fee markup has run into some trouble. It has now been postponed until Tuesday, June 14.
One outstanding issue is whether any measures on prescription drug importation could be included. I caught up with Sen. Bernie Sanders (I-Vt.) in the Capitol on Tuesday, who said he has filed an importation amendment. He said he really hopes it will be incorporated into the bill, and he didn’t really answer when I asked him whether he’ll ask for a vote on the amendment.
“Well, we're working it. Wait and see! Be patient, you're a young person,” he quipped.
If Sanders does push for a vote, it could get enough bipartisan support to be a genuine possibility, even if committee leadership doesn’t go along. In 2017 a floor vote on an importation amendment failed, but it got the support of eight sitting Republican senators. (The Trump administration also pushed importation hard, which might give GOP lawmakers more cover to move the idea forward.) | What we're reading -
FTC will investigate pharmacy benefit managers and their role in prescription drug costs, STAT -
White House shifts pandemic money to vaccines, cutting other programs, The Washington Post -
How the hard lessons of the AIDS crisis are shaping the response to the monkeypox outbreak, STAT - How many Covid deaths are acceptable? Some Biden officials tried to guess, POLITICO
| Thanks for reading! More next week,  | | | |
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