Congress
Dueling health markups this week
The August break (...for lawmakers) is right around the corner, and there's a stack of bills they're trying to push through or tee up for September. This week's headliner is a Wednesday's double header of markups in the House Ways & Means Committee and the Senate Finance Committee.
Rachel scooped the details of the new Ways & Means package, which focuses on health care transparency and includes a provision that would ensure that Medicare patients pay for medicines they pick up at the pharmacy counter based on the discounted price that insurers negotiate with drugmakers, instead of higher sticker prices.
Finance, meanwhile, is taking on PBMs. Based on the chairman's marks and summary, all the major provisions laid out by STAT's Rachel Cohrs are still on the table. That includes a key reform that would bar PBMs from making money from outside service fees and prohibit them from charging those fees based on drugs' prices. Lobbying to stop or soften the measures has shot up in recent months.
Elsewhere, though, the agenda is on hold. HELP Committee Chair Bernie Sanders was planning a mark up Wednesday for a bill that would put $20 million towards boosting and training the health care workforce – and pay for it "by cutting a fraction of the enormous waste and abuse in our health care system and reduce what Americans pay for some of the most expensive prescription drugs on the market."
Unsurprisingly, not everyone is a fan of that payment plan. Provisions include capping physician fees, cutting down on prior authorizations, and requiring all biosimilars be automatically interchangeable with their pricier biologics. And it seems Sanders doesn't have the support he wants just yet: "Senator Marshall, I, and other HELP committee members have been having very productive conversations about addressing these crises in a bipartisan way and intend to have a major piece of bipartisan legislation ready by the first week of September," he said in a statement.
white house
Biden proposes mental health coverage requirements
The White House early Tuesday announced a plan to force health insurers to cover mental health and addiction care as comprehensively as they cover treatment for physical health conditions. If enacted, it could help end decades of whack-a-mole between government regulators and insurance companies, Lev Facher reports.
For instance, White House aides said in a call with reporters that people with health insurance are more than twice as likely to seek out-of-network care for mental health conditions as for physical health conditions.
The new rule would force insurers to evaluate their own networks to measure not just whether they're offering adequate mental health and addiction coverage, but also whether patients are truly accessing it. It'd also close a loophole that lets state and local health plans opt out of pay parity requirements. More from Lev.
drug pricing
Companies save lobbying cash post-PhRMA
Turns out leaving the club can do wonders for the budget: The three companies that recently exited PhRMA all spent less on lobbying after their departures, my D.C. Diagnosis co-writer Rachel Cohrs reports.
AbbVie, Teva, and AstraZeneca all left in the drug lobby in the months after Congress passed itsa the hotly contested Medicare price negotiation bill. AbbVie – which has complained about PhRMA fees in the past – saw its lobbying costs more than halve in the first six months of the year. Teva's spending dropped 42% in the same period, while AstraZeneca, which only left this May, saved 35% in the second quarter. Interestingly, none of the three companies have picked up new lobbying firms this year either.
As Rachel notes, both AbbVie and AstraZeneca make profitable drugs that could be first targets for Medicare price negotiations. Teva, meanwhile, has taken a more active leadership role in the generic drug lobby since it exited PhRMA. Dive into the figures.
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