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What's next for pharma challenges to Medicare drug price negotiation

January 11, 2024
Reporter, D.C. Diagnosis Writer

Good morning and happy Thursday, D.C. Diagnosis readers! In not serious news, the Selena Gomez-Taylor Swift Golden Globes gossip meme may be dead, because HHS has used it on its official Twitter/X feed. Read on for serious news, and pass any tips on to rachel.cohrs@statnews.com.

in the courts

Crunch time is coming for Medicare negotiation challenges

Several of the pharmaceutical industry's challenges to Medicare's new drug price negotiation powers will read out soon, which could come in the thick of election season, I write in a new analysis out today

Both sides in the lawsuits from Merck, Bristol Myers Squibb, Johnson & Johnson, and AstraZeneca have finished submitting their briefings, which means rulings could, in theory, start coming anytime. Only one case has oral arguments scheduled so far: AstraZeneca's suit on Jan. 31. 

I talked to several experts following the cases to explore the path forward — and whether any of these rulings could actually affect the negotiation process as it marches onward. Read more. 


covid-19

What's next after Fauci's Covid grilling

AP24008577005813-1600x900SCOTT APPLEWHITE/AP

After 14 hours of closed-door questioning with former infectious disease official Anthony Fauci, Republicans on the House Select Subcommittee on the Coronavirus Pandemic say they aren't much closer to answers on the virus' origins or federal research safeguards — but they are interested in tighter lab regulation

"We need to make it clear that we need to do a better job monitoring our grants," said Rep. Morgan Griffiths (R-Va.), who as chair of the Energy & Commerce committee's oversight and investigations panel, has jurisdiction over these issues. "As the representative of the group that actually gets the policy down the road, Energy and Commerce, I'm listening for things that we can do better."

A probe into lab oversight could be the latest in a list of coronavirus-focused hearings spearheaded by House Republicans since taking leadership in 2022. Democrats, meanwhile, blasted the GOP's characterizations of Fauci's answers and urged leadership to release a full transcript of the two-day testimony as soon as possible. Read more from Sarah Owermohle.


business

The reappearance of Dan Mendelson

Longtime D.C. health policy veteran Dan Mendelson is seeking out reporters to argue that Morgan Health is still relevant, my colleague Tara Bannow reports from J.P. Morgan's health conference in San Francisco. For those who don't remember the blitz at its start, Morgan Health is the bank's effort to fix health care's many entrenched issues. 

After years of silence, he's ready to share more about the fund's progress. He said it's invested in six portfolio companies and will soon announce a seventh.

The goal? Decrease the amount that J.P. Morgan spends on health benefits for its employees — an attractive aim for many businesses fed up with health care eating into their bottom lines. Read more about Morgan Health's progress here.



 

patient voices

A Medicaid tragedy in the making

An Afghan couple that fled during the Taliban's takeover of the country is struggling to get Medicaid to pay for a potentially curative gene therapy treatment that could save their son's life, my colleague Megan Molteni writes

There's a potential cure, a company offering it free of charge, and a team of doctors in Minnesota ready to administer it. But the Medicaid program in Texas has said it won't cover the hospital stay and other associated costs because the therapy isn't yet approved in the United States.

The child's life likely hangs in the balance of a coverage appeal, as the genetic disorder is a terminal illness. Read more about the real-world consequences of payment policy for cutting-edge treatment.


INFLUENCE

AHA weighs in on heated lawsuit

The nation's largest hospital lobby waded into a legal fight between not-for-profit AdventHealth and MultiPlan over out-of-network payments to hospitals, my colleague Bob Herman writes

AHA came in as backup for its member, AdventHealth, arguing that the hospital industry is in a bleak financial position. 

It's a clash of health care giants, given Multiplan's clients include major insurance companies, too. Bob has the full update — and a newsletter every Monday that's worth signing up for!


More around STAT
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What we're reading

  • FDA's Peter Marks seems inclined to grant full approval to Sarepta's Duchenne gene therapy, STAT
  • Trump is coming for Obamacare again, The Atlantic
  • First Opinion: Sen. Maggie Hassan on what Congress must do next to fight the opioid crisis, STAT
  • White House weighs menthol ban amid dueling health, political pressures, Washington Post

Thanks for reading! More on Thursday,


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