| |   | Happy Thursday, D.C. Diagnosis readers! STAT is seeking nominations for early-career researchers (including in health policy) for our Wunderkinds program. I’ve met some of the prior honorees at STAT events, and it’s always an impressive cohort. The deadline is coming up on July 29, so get those applications in! And send your tips to rachel.cohrs@statnews.com. | | | Alzheimer’s Association breaks its lobbying record  Chart: Rachel Cohrs/STAT • Source: Federal Dislcosures As Medicare debated how to pay for a pricey, controversial new Alzheimer’s drug earlier this year, the Alzheimer’s Association dropped a major $1.3 million on lobbying between April and June this year — nearly triple what it spent in the spring of 2021. The group’s previous highest spend was $871,000, in the second quarter of 2019. The Association said the number for this year’s second quarter was significantly higher than in 2021 in part because the group held its first in-person advocacy forum after returning from virtual events during the pandemic.
But Medicare also took a restrictive coverage approach to coverage of Aduhelm in January, and finalized that decision at the beginning of the second quarter, on April 7. The decision had implications beyond just that one drug, as it also applies to other future drugs that work in similar ways. Their laundry list of lobbying priorities on their disclosure includes an item titled: “Other matters related to Monoclonal Antibodies Directed Against Amyloid for the Treatment of Alzheimer’s Disease.” | Whipping the insulin bill into shape As Democrats careen toward a potential vote on legislation to let Medicare negotiate drug prices, the political odds for a separate, bipartisan bill crafted by Sens. Jeanne Shaheen and Susan Collins remains clear as mud. Sen. Shaheen sounded pretty confident when I spoke with her on Tuesday: “In terms of support, we think we have the senators that we’re going to need in order to get over the 60-vote threshold.” However, behind the scenes, Democratic congressional aides haven’t heard much about whether the bill has enough support to move.
Sen. Kevin Cramer (R-N.D.) said he’s working with Shaheen and Collins to see if he can get to “yes,” and he sounds pretty optimistic about it — “They’re two people I trust a lot.” But his enthusiasm isn’t shared by all Republicans. Sen. Roy Blunt (R-Mo.) confirmed he’s a no, and Senate Minority Whip John Thune (R-S.D.) said he and his team haven’t whipped the bill so he doesn’t have a firm grasp on the numbers. And Thune added that Democrats’ decision to move forward with drug pricing in a partisan reconciliation process makes it harder to build support for the standalone insulin measure. | Will Medicare’s carrots be enough to change rural hospitals’ minds? The federal government has dreamed up a new type of hospital, and they’re offering perks — including $3 million-plus annual payments — to try to convince rural hospitals to sign on. But my colleague Tara Bannow reports that hospitals aren’t quite sold on the idea. The goal is to make running rural hospitals less of a money-loser. The new type of hospital would allow facilities to run emergency rooms without the rest of inpatient care. To qualify, they’d need to offer emergency rooms staffed 24/7 by either a physician, nurse practitioner, physician assistant, or clinical nurse specialist with training or experience in emergency care.
Tara expertly breaks down the decisionmaking process for hospitals weighing whether it’s worth the switch if they have to change how their cost structure works or demolish an inpatient wing. Read her report. | July 26 | A conversation with Admiral Rachel Levine Admiral Levine has used her position to prioritize the challenges that members of the LGBTQ+ community face when trying to access health care. Join her as she takes the virtual stage to share her story, and more about what she hopes to achieve, as part of our STATUS List Spotlight series. Register now. | A peek into the post-reconciliation future for drug pricing Sen. Ron Wyden and I covered quite a bit of ground yesterday during our fireside chat on drug pricing (a recording is here if you missed it), and he hinted that even if Democrats pass their major drug pricing reform package this Congress, there may still be more to be done. Wyden repeatedly praised Democrats’ current bill as “groundbreaking” and a “huge landmark,” but he also made it clear he wants to change the business model of drug middlemen, including DIR reform, a policy of ensuring certain fees charged by middlemen are reflected in the price of a drug when it’s picked up at the pharmacy counter.
My colleague Nicholas Florko reports on Wyden’s wishlist, here. | What we're reading -
There aren't nearly enough Native American physicians. A crash course in medicine seeks to change that, STAT -
Officials reorganize HHS to boost pandemic response, Washington Post -
At a 988 call center, volunteers embrace a new number while providing familiar hope, STAT -
How to fly safely if you hate wearing masks: Put your face in airplane mode, The Atlantic - Biogen agrees to pay $900 million to settle whistleblower case alleging kickbacks and sham speaking events, STAT
| Thanks for reading! More next week,  | | | |
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