The pull of vaccine politics

The Trump administration is trying to shift focus away from controversial vaccine policies toward topics that are popular with voters, such as lowering drug prices and encouraging healthy diets. But vaccines keep coming up in the health care news cycle.

The latest example: Casey Means' nomination to be surgeon general has hit some rough waters because she would not commit to promoting vaccines during her nomination hearing last week.

The White House also is reportedly planning to nominate a new CDC director after Susan Monarez, the last Senate-confirmed director, was fired amid what she said was a disagreement over vaccine policy with health secretary Robert F. Kennedy Jr.

Ralph Abraham stepped down last week from his position as the CDC's No. 2 official. Abraham is a vaccine skeptic who made controversial comments about the measles outbreak.

Abraham is now serving as chair for Louisiana Rep. Julia Letlow's campaign to unseat Sen. Bill Cassidy (La.) in the upcoming Louisiana Republican primary. Trump endorsed Letlow over Cassidy, who last year cast the deciding vote to confirm Kennedy in return for promises on vaccine policy. Kennedy has since broken many of those promises.

Cassidy is the chair of the Senate health committee with jurisdiction over Means' nomination, as well as any CDC director nominee. Cassidy's office did not respond to questions about when he plans to schedule a vote on Means or where he stands on her nomination. Politico reported that Sens. Susan Collins (Maine) and Lisa Murkowski (Alaska), both Republican members of that committee, were left undecided following that hearing.

A single Republican no vote would result in a majority of committee members opposing her nomination, if all Democrats were to vote against it. However, there is the unusual option of sending her nomination to the full Senate without taking a position.

Meanwhile, the administration is supposed to nominate a new CDC director by March 25. The Wall Street Journal reported that nomination is coming soon. NIH Director Jay Bhattacharya has been the acting CDC director since Feb. 18, and the agency has only had a full-time director for four weeks in the current Trump administration.

acip

Another vaccine skeptic appointed to ACIP

Kennedy announced two new members for his panel of vaccine advisers on Friday, Chelsea Cirruzzo reports, ahead of a meeting rescheduled for March.

The new members of the Advisory Committee on Immunization Practices are Sean G. Downing, a primary care doctor licensed in Florida, and Angelina Farella, a pediatrician in Texas.

Farella has called the RSV vaccine an "utter FAILURE" and opposed COVID-19 vaccines.

Three years

That's how long Trump's deals with at least some drugmakers to lower prices will run, according to company filings with the Securities and Exchange Commission.

The administration gave drug companies a three-year reprieve from tariffs in return for striking so-called most-favored nation deals. Some companies have also said they're exempt from two proposed programs to lower Medicare drug prices to levels in peer countries. Those programs are proposed to run for five years.

The mismatched timelines made it difficult to guess at how long the deals would last, if they were time-limited at all, and the administration and drugmakers have mostly kept their agreements secret.

But the SEC requires public companies to disclose anything that could materially affect their bottom lines. Read more for insights from the SEC filings.

most-favored nation

The international reference pricing conundrum

Andrew Joseph reports on how European officials are dealing with Trump's demand that they pay higher prices for drugs.

While there's little evidence that drugmakers have yet to raise prices in Europe, countries are facing questions about whether companies will try to charge more and how strained health systems will respond. Companies also are threatening to withhold drugs from markets that won't meet their pricing demands now that the Trump administration is tying prices in those markets to prices in America.

But that begs the question: how much do drugs really cost anywhere? The prices that countries actually pay is usually secret. Read more.

medicare advantage

CMS halts Elevance MA enrollment

CMS is gearing up to ban Elevance Health from enrolling people into its Medicare Advantage plans because the company failed to submit required information to federal regulators over a seven-year period, Bob Herman reports.

CMS rarely issues sanctions this serious. It could financially crush Elevance if the company doesn't fix things by the start of Medicare's annual enrollment window in October.

What we're reading

Federal Medicaid audit finds massive overpayment for autism therapy in Colorado, STAT
States move to limit access to H.I.V. treatment, The New York Times
A titan of vaccine development sees his field's achievements slip away, STAT
Idaho considers an 'apocalyptic' choice for disabled people and families, The 19th