Centrists throw a wrench in the House drug plan

From: POLITICO Pulse - Wednesday Sep 15,2021 02:06 pm

Sep 15, 2021

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Quick Fix

— Opposition to the drug price negotiation plan from at least three moderate Democrats is jeopardizing a fragile timeline for getting reconciliation through the House.

— The drug lobby fights back by underscoring Covid-19 innovations in a letter and a seven-figure ad buy launching this week.

— The Biden administration is limiting access to Covid-19 antibody treatments, after a handful of states ordered the bulk of the nation's supply.

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A message from PhRMA:

New CBO Report finds that even under its conservative assumptions at least 60 new treatments and cures will be sacrificed if H.R. 3 becomes reality. Instead, Congress should focus on commonsense, patient-centered solutions to address voters’ true concerns, like lowering out-of-pocket costs while protecting current and future access to medicines.

Driving the Day

CENTRISTS STALL THE DRUG PLAN — An intraparty fight over drug price controls threatens to derail House Democrats' sweeping ambitions for Medicare, Medicaid and other health reforms in their mammoth social spending package.

House Energy and Commerce Chair Frank Pallone (D-N.J.) and his senior aides were racing as of Tuesday evening to shore up support for language that would allow direct government negotiations over the prices of hundreds of drugs, penalize manufacturers that raise prices faster than inflation and apply both policies to private insurance plans as well as Medicare, Alice Miranda Ollstein, Heather Caygle and Sarah Ferris report.

But what’s happening: The bill ran into opposition Tuesday from a cadre of moderates led by Rep. Scott Peters (D-Calif.), who put forward a narrower set of pricing policies and threatened to withhold their support unless they're adopted. The centrist group, which also includes Reps. Kathleen Rice (D-N.Y.) and Kurt Schrader (D-Ore.), would only allow negotiation for a small subset of drugs in Medicare Part B that have no competition.

The Peters-led plan is a non-starter for progressives, who argue that it lets the drug industry off easy and would generate far less savings to apply to other health priorities.

The standoff jeopardizes Speaker Nancy Pelosi ’s timeline for moving the social spending package through the House this month — with the expectation that various committees finish markup today. It also doesn’t bode well for the Senate, where Democrats are already at odds over the cost of the package.

FIRST IN PULSE: PhRMA LAUNCHES MASS OFFENSIVE — With major drug pricing reform still on the table, the industry isn’t taking chances. Drug lobby PhRMA this morning issued a letter signed by every member, arguing that their ability to innovate is “under attack” on the heels of record-breaking Covid-19 treatment and vaccine development.

The letter is paired with a seven-figure ad campaign, including TV commercials and ads in Politico, The Washington Post and The Hill.

“While large companies like Merck will survive, we will do significantly less research. We have looked at what this would be. We have modeled it, and our ability to fund R&D inside Merck will be reduced by almost half,” Merck Executive Chairman (and well-liked former CEO) Ken Frazier said in a statement about Democrats’ negotiation plan.

A message from PhRMA:

HHS THROTTLES COVID ANTIBODY SHIPMENTS — The department is placing new limits on states’ access to pricey monoclonal antibody drugs, weeks after a handful of GOP governors began leaning heavily on the treatment as a primary tool to combat the virus.

HHS will now control what percentage of the roughly 150,000 doses per week each state gets, with amounts doled out based on caseloads and how much of the treatment is being used.

The shift comes just a month after Biden officials encouraged states to order more of the antibody drugs to help deal with the Delta surge.

But seven southern states have accounted for a staggering 70 percent of orders this month, fueled by GOP governors who embraced the treatments as an alternative to mask mandates or other public health restrictions. That group includes Florida, as well as deep-red states like Texas, Mississippi and Alabama.

The jump in demand sparked worry that the rest of the nation could be left shorthanded, and frustration among health officials that the states hoovering up the federally funded treatments were also among those that have done the worst at vaccinating their populations.

Florida Gov. Ron DeSantis, for example, has opened a slew of locations for people to get the expensive Covid-19 treatment — yet vehemently opposed the idea that people should have to wear (comparatively cheap) masks to cut down on the virus’ spread in the first place.

Now, HHS is putting itself back in charge — a policy that state officials expect to continue at least through October as the administration builds up its reserves in preparation for a potential fall resurgence of the virus.

To wit: The government is buying 1.4 million doses of Regeneron’s antibody cocktail at a cost of $2,100 each, the company announced Tuesday. That $2.9 billion of drugs will be delivered by the end of January 2022.

SOUTH AFRICA PRESSES BIDEN FOR VACCINE WAIVERS — A South African official on Tuesday called on President Joe Biden to break a World Trade Organization deadlock over whether to waive intellectual property rights for coronavirus vaccines, Doug Palmer reports.

Zane Dangor, a special adviser to South Africa’s foreign minister, called on the U.S. to come up with a proposal as a starting point for contentious discussions about allowing other countries to manufacture the vaccines.

That would allow countries to “get to the business of actually ensuring that we get jabs in arms of those who need it most, and that we have equitable access,” Dangor said during a discussion hosted by Public Citizen, a policy advocacy group.

Background: South Africa and India requested a broad waiver of intellectual property rights on Covid-19 vaccines, therapeutics and diagnostics nearly a year ago. While the idea gained little traction with the Trump administration, Biden said in May that he’d back a waiver covering Covid-19 vaccines — over the objections of the U.S. pharmaceutical industry and many Republican members of Congress.

But there still isn’t an agreement about how to do that; now, it faces opposition from the European Union and Germany in particular. Critics argue waiving the patent rights would discourage innovation and wouldn’t make a meaningful impact on vaccine access because setting up safe vaccine plants takes so much time.

Up next: This is sure to be a big topic during a virtual global summit the U.S. is hosting on Sept. 22.

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PATIENT GROUPS CALL FOR OBESITY CARE IN RECONCILIATION — The Obesity Care Advocacy Network sent letters to Congress and the White House this morning pressing for measures to be included in budget reconciliation this month.

The cluster of letters to Senate and House committees and White House chief of staff Ron Klain urge lawmakers to include in the package the Treat and Reduce Obesity Act, which would expand Medicare coverage for things like intensive behavioral therapy to treat obesity.

It’s never been more critical, more than 100 groups argue in the letter, noting that obesity is a top risk factor for serious Covid-19 cases and there is urgency “especially as the rising Delta variant once again threatens some of our most vulnerable populations.”

MA LOBBY BACKS DEMS’ MEDICARE PLAN, ON ONE CONDITION — The chief advocacy organization for Medicare Advantage plans is supporting Democrats’ effort to add new benefits to traditional Medicare — as long as that expansion is factored into the formula used to determine how much private Medicare insurers get paid.

In a letter, the Better Medicare Alliance urges Democratic leaders to ensure the provisions “fully reflect the cost of adding dental, vision, and hearing to Medicare in the benchmark calculation.”

“If the cost of providing these benefits is not reflected in the benchmark, Medicare Advantage beneficiaries may see a loss in supplemental benefits,” the group wrote.

More than 45 health plans and other organizations signed onto the letter, which also praised Democrats for trying to expand access to dental, vision and hearing benefits to more older Americans.

A message from PhRMA:

Proponents of government price setting often misrepresent voter opinion on support for allowing the federal government to “negotiate” drug prices. While nine out of 10 Americans said in a recent Kaiser Family Foundation poll that they support drug price negotiation, opposition to the approach soared to 65% when respondents were told negotiation could limit people’s access to medicines or result in fewer new treatments and cures.

Non-partisan, independent public polls have repeatedly demonstrated that once Americans understand what government negotiation is, and what the tradeoffs are, support drops dramatically.

76% of Americans oppose H.R.3-style “negotiation” if it causes delays in access to new prescription drugs, and 72% oppose it if it results in fewer new medicines developed in the future.

62% agree we should keep the current law that prohibits government interference in Medicare plan negotiations because it protects seniors and people with disabilities from losing access to their medicines.

What We're Reading

In New York City, the black market for counterfeit vaccination cards is booming, New York magazine’s Paula Aceves reports.

One week into the season, the NFL is confronting the first test of its Covid-19 protocols after eight members of the New Orleans Saints tested positive, The Wall Street Journal’s Andrew Beaton writes.

Months before the country was overrun with infections, India’s top science agency tailored research and pressured scientists to support Prime Minister Narendra Modi’s optimistic view of the course of the pandemic, The New York Times’ Karan Deep Singh reports.

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