Long Covid research gets a big-time funding boost

NIH's biggest initiative to research long Covid just got a huge cash infusion, the agency announced this week. Congress had given the initiative $1.15 billion to research the disease and how to treat it, and the new funding will give NIH another $515 million through 2028. That's a nearly 50% budget increase.

I've written at length about how the initiative got off to a slow start, and how patients are concerned that it's focused more on observing patients than actually testing treatments. Some senators in a recent hearing questioned whether money might be better spent through other agencies.

The patient advocates and experts I spoke with were cautiously optimistic — glad to see the cause getting more investment, but concerned about the short-term nature of the project and curious about exactly what the money will be spent on. Read more about the agency's outline of where they plan to spend the money, and where it came from.

influence

An inside look at the whole picture of Washington lobbying

ALEX HOGAN/STAT

It's an accepted fact among Washington insiders that big business' efforts to lobby Congress go far beyond hiring professional lobbyists and cutting checks to politicians. But rarely are those lesser-known tactics – like paying think tanks for positive research and giving untraceable donations to so-called dark money groups – revealed publicly. Until now.

My colleague Nick Florko has been combing through 50,000 internal emails and documents from the e-cigarette company Juul. The documents show the lengths to which Juul went, at the height of the youth vaping crisis, to revamp its image and prevent both Congress and the FDA from taking action that could cost the company financially. The documents also reveal the vast network of organizations and well-connected politicos that were on the company's payroll.

Take the prominent conservative think tank and advocacy group FreedomWorks. A signed contract between the group and Juul reveals that FreedomWorks charged the company $15,000 to generate comments to FDA regulatory dockets, and another $25,000 just to send emails to the organization's membership about e-cigarettes.

As one advocate put it, Juul's documents affirm "there are companies out there doing the things that advocates have been warning of." To read more of Juul's secrets, check out Nick's story here.

oversight

Khan't stop, won't stop

Another drug sector dominated by a few middlemen is in the crosshairs of the Federal Trade Commission, my colleagues John Wilkerson and Ed Silverman report.

The FTC and HHS are looking into whether the organizations that hospitals and physicians use to buy drugs are contributing to shortages of cancer treatments and other injectable generic drugs. Those organizations are known as group purchasing organizations.

John attended the American Medical Association event at which FTC Chair Lina Khan announced the probe. The commission and HHS are jointly soliciting feedback on whether GPOs and drug wholesalers are in part behind drug shortages. Three group purchasing organizations buy about 90% of the drugs used by hospitals, and Khan worries that dominance might be distorting the market.

"When you have markets with outsized intermediaries that have dominant power, that gatekeeper role can create a whole set of problems," Khan said.

hospitals

Define the relationship (safety-net hospital edition)

For years, health policy experts have urged Congress to better target billions of dollars in federal funding meant for safety net hospitals. These limited pools of money are set to get even smaller this year, my colleague Tara Bannow writes.

A new bipartisan bill in Congress that will be introduced today by Rep. Lori Trahan, D-Mass., and Rep. David Valadao, R-Calif., seeks to solve that problem by creating a new federal designation: "essential health system." The bill's crafters said the measure would be given to the more than 1,000 hospitals nationwide that deliver five times more uncompensated care on average than their peers, but are historically underfunded.

Once the "essential health systems" are identified, Trahan and Valadao said lawmakers could more easily send more funding their way. Trahan said in a statement that the measure will "provide federal lawmakers with the avenues necessary to target funding and resources to these critical facilities – just as we've done with other types of hospitals that serve specific populations or regions."

capitol hill

A doc fix checkup

Lawmakers have agreed that they'd ideally like to give doctors some kind of Medicare pay boost after physicians saw a nearly 3.4% cut take effect Jan. 1 — but fully bringing payment levels back to 2023 isn't going to happen, I scooped this week.

It's possible that there's some kind of partial increase to ease the pain of the full cut, but that number hasn't been decided yet. And it's also possible that the policy would only apply to forthcoming payments, rather than applying retroactively. But any increase would be an improvement from doctors' whiffed attempt to get more funding in a short-term government funding extension earlier this year.

A disclaimer: Talks are very much up in the air, it's unclear whether a deal will come together at all, and we don't know how much money is available from offsets. But here's where we're at now.

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