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The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Advocates seek other pathways to lower drug prices

Analysis by

with research by McKenzie Beard

February 18, 2022 at 8:02 a.m. EST
The Health 202

A newsletter briefing on the health-care policy debate in Washington.

Good morning — TGIF. A quick programming note: The Health 202 will be off for Presidents' Day. See you back in your inbox Tuesday.

Today's edition: The Biden administration will surge $250 million in vaccine support to 11 countries in sub-Saharan Africa. Meanwhile, President Biden will deliver his State of the Union address before a chamber full of lawmakers, but no guests. But first: 

Congress isn't lowering drug prices, so maybe the Biden administration can try to

Efforts to lower the sky-high costs of medicines have stalled along with President Biden’s sweeping economic plan. 

So what’s next for the drug pricing push?

Progressive advocates are ratcheting up pressure on the Biden administration to use its executive powers to reduce costs. A politically vulnerable senator introduced a popular bill to cap the price of insulin, which got a critical nod from Senate leadership last night. And other lawmakers are considering what else can be done.

The renewed efforts come as Biden’s sweeping economic package languishes in the Senate — and that’s left a key Democratic pledge to lower drug costs in limbo. 

  • “We’ve been working as hard as we can for a legislative victory … but the time is up on any sort of waiting,” said Alex Lawson, executive director of the liberal group Social Security Works.
Advocates say…

The latest: Seven progressive and grass-roots organizations launched a new campaign called “Make Meds Affordable.” They’re focusing on never-used — or little-used — tools they believe the Department of Health and Human Services has at its disposal. 

One idea: So-called march-in rights allow the government to step in and license patent rights to another manufacturer. They’ve never been used before for drugs, though some advocates argue such a move could lower costs.

Cancer patients have petitioned the National Institutes of Health to exercise march-in rights for a pricey prostate cancer drug Xtandi, though the agency denied another effort back in 2016.

A decision on whether to initiate the process “will be made in a deliberate and impartial manner,” Tara A. Schwetz, NIH’s acting principal deputy director, wrote in a Feb. 3 letter obtained by The Health 202. 

  • “We’re hoping that that is a starting point,” said Peter Maybarduk, the director of Public Citizen’s access to medicines and knowledge economy group. The campaign plans to push for the government to step in on other medicines, like coronavirus treatment and HIV drugs.
  • The view from the administration: Reducing drug costs is a priority, and HHS will “continue working to remove barriers to quality, affordable care,” Sarah Lovenheim, chief HHS spokesperson, said in a statement.
On the Hill

Democrats reached a drug pricing deal after a frenzy of negotiations last fall. The compromise was tucked into the broader economic package, which Sen. Joe Manchin (D-W.Va.) has repeatedly said he won’t support. 

Last month, Biden suggested passing Build Back Better (BBB) in smaller bites. That’s still a tall order, but advocates hope any such effort would include the drug pricing measures, given Manchin supports them. 

  • Per a senior Democratic aide: The plan remains to get lower drug prices signed into law through the reconciliation bill, the fast-track budget maneuver Democrats would use to pass the package without any GOP votes.

But that doesn’t mean lawmakers aren’t exploring other options.

  • This week, Sen. Raphael Warnock (D-Ga.) — who’s in a tight reelection race — introduced a $35 cap on the cost of insulin, mirroring one of the provisions in BBB. Schumer has long indicated a desire to force Republicans to vote on the measure. On the Senate floor last night, Schumer said the proposal will be a priority for Democrats “in the weeks ahead.”
  • The Congressional Progressive Caucus has been creating a vision of what executive actions the White House should pursue, which will likely include addressing health-care costs.

One vulnerable lawmaker, Rep. Susan Wild (D-Pa.), has been mulling over some kind of bipartisan bill. She was at first inclined to introduce an individual bill, like on insulin, but has since changed her mind. 

  • “I was all in on doing the insulin as a stand-alone bill until I started hearing from the advocacy groups who are really, really concerned about going that route because they're afraid that that would get so much public recognition that people would just take the position of, ‘oh we’ve done something on drug prices,’ ” Wild said.

Our take: The lack of action on the issue is emblematic of the broader struggle of delivering on campaign promises with a razor-thin majority. That will only get harder if Democrats lose control of Congress — and further turn up the heat on what Biden can do on his own. 

Craig Caplan, CSPAN

Coronavirus

Biden to boost global aid to prepare for the next wave

The Biden administration is gearing up to distribute more than $250 million across 11 countries in sub-Saharan Africa under the president’s new Global VAX initiative aimed at boosting vaccination rates across the developing world, The Post’s Dan Diamond and Emily Rauhala report. 

The White House is aiming to help end the pandemic and restore U.S. health leadership — efforts driven by national and humanitarian concerns. 

  • Countries to receive “intensive support” include Angola, Ivory Coast, Eswatini, Ghana, Lesotho, Nigeria, Senegal, South Africa, Tanzania, Uganda and Zambia — all of which have generally vaccinated less than 40 percent of residents.
  • Funds could go toward creating mobile centers to administer shots, freezers for effective vaccine storage, in-person staffing and technical assistance.

The initiative comes after the White House has faced increased pressure from Democrats to boost their global pandemic response efforts. Remaining dollars from the $510 million set aside for the program will be used to support vaccination efforts across dozens countries. 

Omicron slammed essential workers. The National Guard filled the void.

The National Guard has been on the front lines of fighting the coronavirus for nearly two years. They've been contact tracers, manned testing sites, answered unemployment hotlines, helped vaccinate millions of Americans.

And amid the omicron variant, they're also trying to fill gaps at health facilities as desperate hospitals say they need workers of all kind. National Guard members are deployed to help with laundry, wheeling patients and more. Our colleagues Hannah Knowles and Karoun Demirjian dive deeper on the Guard's largest domestic response in recent years. 

Masks, vaccines and more kept a majority of anime convention attendees healthy

A study by the Centers for Disease Control and Prevention released Thursday found vaccine requirements, enforcement of face coverings in indoor settings and air filtration systems were largely successful in preventing the spread of the coronavirus among the 53,000 people who attended an anime convention in Manhattan last November, our colleague Lenny Bernstein reports. 

The success of the convention could pave the way for future large-scale events to go on safely in a pandemic world. This came as the contagious omicron variant had just begun to spread.

  • Participants who subsequently tested positive for the virus reported visiting bars, restaurants and nightclubs outside of the convention center.

White House prescriptions

Capitol Hill preps for State of the Union

All members of Congress, but no guests, will be invited to watch as Biden delivers his first State of the Union address next month, our colleague Amy B Wang reports. 

Attendees must produce a negative PCR coronavirus test within one day of the event, observe social distancing guidelines and wear an approved KN95 or N95 mask while in the Capitol, according to a letter sent Thursday to lawmakers by House Sergeant-at-Arms William Walker.

  • The evening’s health guidelines come after numerous GOP lawmakers have racked up fines for defying masking policies in the House and Senate.
  • The speech, slated for March 1, will coincide with the expiration date for D.C.'s indoor mask mandate, but pandemic precautions will remain in place in the U.S. Capitol for the foreseeable future. 

On the Hill

Senate approves stopgap spending bill, axes GOP amendments

The Senate approved a short-term spending bill to stave off a government shutdown through March 11, our colleague Tony Romm reports. Now, Biden’s signature will buy lawmakers an extra three weeks to hammer out the details of an elusive long-term spending package.

The stopgap bill had been stalled in the Senate for several days after a group of Republican lawmakers insisted on voting on several amendments.

  • In the health space…lawmakers didn’t agree to an amendment by Sen. Mike Lee (R-Utah) that would prevent the White House from enforcing a vaccine mandate for federal workers and military service members. Same with a measure by Sen. Ted Cruz (R-Tex.) that would have cut off federal funds to schools and child-care centers that mandate vaccines.

In other health news

What we're watching: Senate Majority Leader Chuck Schumer moved to set up a vote on the Women’s Health Protection Act for when Congress comes back from a week-long recess. The measure is aimed at guaranteeing abortion access, but faces a tough climb in the chamber. Ten Republican votes are needed for the key Democratic priority to pass. 

Robert Califf is sworn in as FDA commissioner. In a series of tweets, he outlined his top priorities, such as cutting down on tobacco and e-cigarettes usage; boosting the country’s opioid crisis response; and fighting misinformation.

Robert Califf, FDA commissioner

A West Health and Gallup poll released this morning highlights the country's longstanding health disparities, which the pandemic has further exacerbated.

Here are the key findings: 

  • About 8 percent of Black Americans know someone who has died in the past year because they couldn’t pay for treatment, compared to 6 percent of Hispanic Americans and 4 percent of White Americans.
  • Black and Hispanic Americans are each more likely than White Americans to say they cannot afford quality health care.
  • Meanwhile, more than half of U.S. adults say the cost of health care causes them daily stress, and 70 percent say that paying for treatment is a financial burden.

Quote of the week

Sugar rush

Thanks for reading! See y'all Tuesday.