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Congress’ ticking summer clock, the scientist under the GOP spotlight, & Grassley pushes party to move on PBMs

June 22, 2023
Reporter, D.C. Diagnosis Writer

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Congress

Time's running out for Congress 

We're just two days away from the Senate's July recess – plus a few weeks shy of the monthlong August break – and a lot of senators aren't happy about where they are on health care legislation. Democrats are still hammering out an insulin cap bill that several said they'd make top priority after the debt ceiling negotiation. Some proposed reforms to pharmacy benefit managers' businesses still haven't passed out of committee.

And now, Republicans are raising the pressure on a looming pile of reauthorizations. The Pandemic All Hazards and Preparedness Act expires at the end of September with the 2023 budget. Authorizations for community health centers, the National Health Services Corps and a web of opioid response resources through the SUPPORT Act also expire this year. Further, proposed funding hikes for those programs (like $20 billion in pandemic preparedness or a nearly $10 billion community health center increase) don't have budget offsets, HELP Ranking Member Bill Cassidy (R-La.) noted Wednesday. 

"If we're going to find offsets, we should have been working on this since January," he said during an unrelated markup of labor bills. "The likelihood of successfully vetting and operationalizing policies … [with] 16 days between now and what should be our deadline, which is the beginning of August recess is, shall I say, slim."


At the agencies

Who is Bernie Moss? 

Infectious disease scientist Bernard Moss has spent more than five decades in federal pox research. Now, he's at the center of Republican lawmakers' questions about controversial pathogen studies known as gain-of-function research that is under fresh scrutiny in the wake of the Covid-19 pandemic, STAT's Helen Branswell writes.

The longtime National Institutes of Allergy and Infectious Disease researcher caught House Republicans' interest when he described a plan to insert a fragment of a more lethal mpox strain into a less deadly one, during an interview last year. That study, pretty squarely in the gain-of-function camp, never happened. Republicans on the House E&C Committee are demanding to know why. 

But despite years of studies, published papers and pox innovations, Moss has never really been in the public eye. Colleagues and mentees describe him as a sharp and inquisitive scientist but also, at times, shy. HHS and NIH spokespeople told Helen they are working with the committee, but it's unclear whether he'll ever sit for an interview. Read more here.


congress

Grassley: Lead on PBM reform and the party will follow

Screen-Shot-2023-06-21-at-10.16.45-AM

Republican Sen. Chuck Grassley wants to see his party's leadership turn up the pressure on pharmacy benefit managers and worry less about splitting the caucus on a vote, he said during a STAT event Wednesday.

The longtime Iowa senator is one of several to introduce legislation that would bar the drug pricing middlemen from practices like spread pricing and hazy fees, but the clock is running out on getting legislation to votes, especially with summer recesses around the corner and a litany of leadership priorities, at least one of them a broad cap on monthly insulin prices.

Grassley told D.C.D. co-writer Rachel Cohrs that he most likes the proposed cap from Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) and wants it linked up with PBM provisions because an insulin cap – already a stated priority of Majority Leader Chuck Schumer – will be a "driving force" to advance the package. Read more from Rachel's interview here.

But while we await votes on PBM reforms: A House hearing Wednesday, ostensibly about health industry consolidation, homed in on PBMs too, with other witnesses happy to cast blame on the sector for high prices, STAT's John Wilkerson reports. Dive into the hearing here.



Drug pricing

PhRMA finally joins in on drug pricing lawsuits 

Merck's June 6 filing to stop Medicare's drug price negotiation plan kicked off a trend. Bristol Myers Squibb, the Chamber of Commerce, and now the industry's top lobby have followed suit (no pun intended). 

However PhRMA's Wednesday morning filing includes one new argument, Rachel notes: they say the excise tax (65% of a drug's prior year sales) for drugmakers who don't participate in the Medicare negotiation process constitutes an "excessive fine" under the 8th Amendment, and therefore the law is unconstitutional. The drug lobby is joined by the National Infusion Center Association and the Global Colon Cancer Association in the suit.

Why are these companies and organizations kicking off the court battles? A couple drugs used to treat colon cancer, including Merck's Keytruda and Bristol Myers Squibb's Opdivo, may be eligible for the negotiation program in its third year. While PhRMA's lawsuit was expected, the lobby has also had a tough year, with three companies leaving the organization in the past six months and its top federal lobbyist exiting this week, as Rachel scooped. More on the lobbyist departure here, and the lawsuit here.


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  • OB/GYN training programs try to adjust to post-Dobbs reality, Axios

Thanks for reading! More on Thursday,


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