Round and round the revolving door

House Speaker Mike Johnson's new policy director Dan Ziegler is coming straight from a gig as a pharma lobbyist for Amgen, Eli Lilly, Merck, Novo Nordisk, Pfizer, PhRMA, and Sanofi. In theory, that should be a good thing for the pharmaceutical industry.

It remains to be seen, however, whether Ziegler's approach will substantively be different from that of former speaker Kevin McCarthy's office. McCarthy's former head of health policy, Ryan Long, lobbied at BGR on behalf of pharma clients including Alkermes, Alnylam, Amgen, Celgene, Eisai, Eli Lilly, Genentech, Gilead, Merck, Pfizer, PhRMA, and Sanofi from 2013 to 2017 before he returned to Capitol Hill. And now, Long is back at BGR.

It's worth noting that it's still possible someone else will be specifically handling the health portfolio that could also influence Johnson's direction, so stay tuned for updates there.

It's perfectly legal for Ziegler to return to the Hill after a lobbying gig, but Public Citizen called the hire another example of a revolving door that prevents drug pricing reforms.

"This may be the greatest gift to Big Pharma since Rep. Billy Tauzin barred Medicare from negotiating drug prices — and then went on to head the industry trade association," said the group's president, Robert Weissman.

influence

Health care industry gets buddy buddy with Buddy

Rep. Buddy Carter (R-Ga.), who is a pharmacist on the House Energy & Commerce Committee, has long been known to go on rants about the PBM industry during hearings.

But as Congress debates PBM policy and the upper echelons of House GOP leadership turn over, the pharmaceutical industry decided to help fund Carter's re-election campaign last quarter, according to new federal disclosures. Carter received nearly $16,000 from Lundbeck, Viatris, Pfizer, Genentech, Eli Lilly CEO David Ricks, and PhRMA executives Lori Reilly, Scott LaGanga, and Jim Stansel.

And providers gearing up for a year-end lobbying fight chipped in too, including orthopedic surgeons, pathologists, surgeons, cardiologists, face surgeons, anesthesiologists, physical therapists, eye surgeons, and ENT specialists.

regulations

Ready, set, refresh your browsers

Medicare could release an avalanche of regulations in the next week, including payment and policy rules for physicians, outpatient services, and Medicare Advantage insurers.

One I'm paying attention to in particular is how Medicare decides to fix a 340B drug payment policy that was struck down by the Supreme Court. The regulation cleared White House budget review on Tuesday. Hospitals have been pressuring the administration not to claw back or reduce future payments to make up for the billions in underpayments to 340B providers. If they don't get their way, as my colleague Bob Herman reported last week, they could sue.

medical devices

What medical device makers are lobbying for

The biggest issue for device makers this quarter, according to lobbying records, is the fight over ethylene oxide — a carcinogenic gas used to sterilize devices that can't be exposed to steam. That includes pacemakers, catheters, and ventilators, STAT's medical device reporter Lizzy Lawrence writes.

The EPA is trying to tamp down on its use, and device manufacturers are not happy. AdvaMed, other small device lobbies, and major companies like Edwards and Boston Scientific spent hundreds of thousands on the issue. The industry is also lobbying for Medicare reimbursement of breakthrough devices and of lab tests.

Spending is on par with 2022, with AdvaMed reporting $680,000 this quarter and $660,000 for the third quarter of last year.

drug pricing

Republican Senators wade into the weeds

A bunch of high-profile senators on the Finance Committee delved deep into the weeds on health policy on Wednesday when they criticized the Biden administration's plan to revamp how drug companies pay rebates to the Medicaid program.

The policy would require drug makers to give Medicaid bigger discounts by bundling together all the discounts they give various entities in the supply chain, like pharmacies and wholesalers, and giving Medicaid the entire discount. This Avalere blog has a handy graphic to explain the policy.

Every other Finance Republican except Sens. Chuck Grassley (Iowa) and Bill Cassidy (La.) signed onto the letter, which argues that the Biden administration's approach "upends three decades of statutory understanding" and amounts to "rewriting the rules of the road" for Medicaid rebates. The senators argue that it would be hard to operationalize, and that it risks incentivizing smaller discounts.

enforcement

Karma: drug price edition

Speaking of Medicaid rebates, a pharma company and its CEO, who once defended Martin Shkreli's drug price hikes, is now on the hook for $50 million for purposely underpaying rebates to the safety-net program, my colleague Ed Silverman writes.

The Department of Justice went after Nostrum Laboratories and its founder Nirmal Mulye for underpaying rebates for an antibiotic used to treat bladder infections — after the company boosted the drug's price by 400%.

More around STAT

Check out more exclusive coverage with a STAT+ subscription

Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

Opinion: How the government can help lower the price — not just the cost — of cutting-edge gene therapies, STAT
Pregnant farmworkers in California are eligible for paid time off — but many don't know it exists, The 19th
Venture capitalists want to own hospitals. Can they do better than private equity?, STAT
States are getting $50 billion in opioid cash. And it's an issue in governors' races, KFF Health News