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Presented by PhRMA: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | | |  | | By Sarah Owermohle and Adam Cancryn | | | With Alice Miranda Ollstein and Carmen Paun Editor’s Note: POLITICO Pulse is a free version of POLITICO Pro Health Care's morning newsletter, which is delivered to our s each morning at 6 a.m. The POLITICO Pro platform combines the news you need with tools you can use to take action on the day’s biggest stories. Act on the news with POLITICO Pro. | | | — Biden and top Democrats are assuring lawmakers they don’t need to rush as the party splits over legislative priorities. — Manchin’s Medicare demands are causing another rift between caucus members. — Merck’s antiviral sparks hope for a new weapon in the Covid fight. WELCOME TO MONDAY PULSE — It’s a hard time to be a teen, but possibly a slightly better time to be the parent of one? Send tips to sowermohle@politico.com and acancryn@politico.com. | | | | A message from PhRMA: Some in Congress are considering a plan that would tie medicine prices in Medicare to those in the U.S. Department of Veterans Affairs. This misguided approach is just the latest in a series of government price-setting proposals that threaten patients’ access to medicines and future innovation. Read the five reasons tying Medicare Part D prices to the VA misses the mark. | | | | | | BIDEN’S AGENDA IN LIMBO — No one on Pennsylvania Avenue knows when, or if, President Joe Biden’s legislative priorities will get key votes that could send them to his desk. The new strategy: They’ll happen when they happen. “ We don’t have a time frame on it,” White House senior adviser Cedric Richmond said on “Fox News Sunday,” referring to both the stalled infrastructure bill and the $3.5 trillion social spending package backed by progressives. “We’re not using an artificial timeline, and we’re not concerned with process. We’re concerned about delivering.” The bills are caught up in Democratic infighting, with House progressives demanding that they reach Biden’s desk in tandem and moderates — a handful of whom oppose key provisions in the $3.5 trillion package — insisting the infrastructure bill gets a vote ASAP … even if progressives aren’t on board. Biden himself sought to rally the caucus and strike a compromise with Friday’s visit to the Capitol, where he warned progressives they need to slash the social spending price tag but told moderates they didn’t need to rush an infrastructure vote: “We’re going to get it done.” Senate Budget Chair Bernie Sanders (I-Vt.) took a similar tone on NBC’s “Meet the Press” Sunday: “It doesn’t matter whether it’s next week or three weeks from now. What matters is that we finally address the problems facing working families” he said of the social spending bill. What does matter: At least a trillion dollars in social spending priorities that Democrats may need to lop off to save the broader package. And while Congress averted the most urgent crisis, funding the government, the timeline does matter to many lawmakers who promised to deliver health care reforms and assistance to voters on the campaign trail. | | | | Registration is OPEN for Breakthrough Summit 2021, the most important rare disease conference of the year! On Oct. 18 and 19, the National Organization for Rare Disorders will host the virtual Rare Disease and Orphan Products Breakthrough Summit. The Summit brings together the rare disease community from across the globe, including experts from patient advocacy, government, industry, media and academia, to discuss the current and critical topics in rare diseases. For access to two days of networking and dynamic programming on topics including drug pricing, genetic testing, Covid-19, equity and inclusivity, REGISTER NOW. | | | | | ANOTHER RIFT: MANCHIN’S MEDICARE DEMANDS — Sen. Joe Manchin’s (D-W.Va.) demand to cut the reconciliation package from $3.5 trillion to 1.5 isn’t the only thing roiling Capitol Hill. His push for means testing all of the new safety net programs in the bill, including the expansion of Medicare benefits to cover dental, vision and hearing, is also splitting Democrats who are struggling to find a path forward for their health care agenda, Alice Miranda Ollstein reports. Who’s for it? Manchin, House Democratic centrists like Reps. Kurt Schrader and Stephanie Murphy, and industry groups like the American Dental Association (whose members would lose money if millions of seniors became eligible for Medicare benefits since it pays less than private insurance). What’s their argument? Limiting the new benefits to only the poorest Americans would slash the projected cost by as much as half, freeing up money for expanding Medicaid, extending Obamacare subsidies and other top party priorities. Who’s against it? Progressive lawmakers like Rep. Rosa DeLauro and advocacy groups like Families USA and AARP. What’s their argument? Medicare is popular because it’s universal, and applying a means test limits who is invested in protecting the program and makes it more vulnerable to future cuts. Verifying seniors’ fluctuating incomes would also be a “bureaucratic nightmare” that risks allowing some eligible people to fall through the cracks. MERCK ANTIVIRAL SPARKS HOPE — The company and its partner Ridgeback Biotherapeutics say they will file “as soon as possible” for use of their experimental antiviral after promising results released Friday, potentially adding a key early treatment option for Covid-19 to the country’s arsenal. “It’s extremely important,” Biden’s chief medical adviser Anthony Fauci told CNN’s “State of the Union” — emphasizing that the drug, molnupiravir, can be taken by mouth as a pill. “It decreases the likelihood of getting hospitalization or dying in people who early in the course of their infection take this particular medication,” Fauci said of the drug. At the same time, Fauci also discouraged vaccine-hesitant Americans from counting on being able to take the drug instead of getting their Covid-19 shot, echoing concerns from public health experts and doctors on the back of Friday’s news. | | | |   | | | | | | FIRST IN PULSE: 15 SENATORS PUSH BIDEN FOR ALZHEIMER'S STRATEGY — A bipartisan coalition of 15 senators wrote to Biden and HHS Secretary Xavier Becerra over the weekend demanding the White House come up with a plan to tackle Alzheimer’s disease and “related dementias,” citing the economic toll of the conditions on Medicare and Medicaid among the pressing reasons to act. The letter pushes the Biden administration in particular on creating government incentives for providers to do more screening and early intervention, Alice writes. The senators cite studies estimating that 40 percent of dementia cases are potentially preventable through treating other factors like diabetes, hypertension, poor nutrition and smoking. SENATORS INTRO SUPPLY CHAIN BILL — Sens. Jacky Rosen (D-N.V.) and Bill Cassidy (R-La.) this morning introduced a bill aimed at bolstering the domestic supply chain for medical products. The Strategic Planning for Emergency Medical Manufacturing Act would direct HHS to keep a list of domestic manufacturers that could voluntarily produce medical supplies during shortages. | | | HOW DESANTIS PICKED HIS SURGEON GENERAL — Public health experts and some Florida lawmakers are questioning Gov. Ron DeSantis’ choice for the state’s next surgeon general. Joseph Ladapo has a medical degree from Harvard and a résumé of impressive teaching gigs. But he’s also questioned the safety of Covid-19 vaccines and the effectiveness of lockdowns and mask mandates, plus has little public health experience, POLITICO’s Arek Sarkissian reports. DeSantis’ pick gives the Republican governor a health adviser who agrees with his approach to the pandemic. DeSantis staunchly opposes mandates on face masks — especially in schools — and had promoted the use of monoclonal antibody therapies in treating the virus while deemphasizing the need for vaccines. Ladapo also signed the Great Barrington Declaration, which called for the pandemic to be addressed with “Focused Protection” of the elderly and medically vulnerable — similar to the course taken by DeSantis. He’s already experiencing a backlash. For his de facto first day on the job, Ladapo on Sept. 23 signed an emergency rule that repealed required quarantines for schoolchildren who were exposed to Covid-19. The UCLA David Geffen School of Medicine, where Ladapo had a professorship, has since removed his name and bio from its website. WEST VA GOVERNOR DEFENDS COVID RESPONSE — Republican Gov. Jim Justice on Sunday defended his state’s handling of the recent Covid-19 surge in a contentious interview on CBS’ “Face the Nation.” “We’re a long ways from being in crisis in West Virginia,” Justice said after host Margert Brennan described the state as “in crisis” because of the Delta variant. Their arguments continued through discussions of federal policies, vaccine rates and possible vaccine mandates for children, David Cohen writes, with Justice repeatedly using the phrase “for crying out loud” to express his exasperation. “No chance,” Justice said in response to Brennan’s questions about why his administration would not consider following California’s lead in mandating vaccinations for children ages 12 to 17. Brennan continued to push him on the subject, noting that other vaccines are mandated: “Why don't you want to protect those children by mandating it?“ “To think that I don't want to protect the children is ridiculous,” Justice countered, saying the decision should be in the hands of the parents: “For crying out loud, you know, that's who should be making these decisions is the parents.” SCHOOLS PRESS ATHLETES TO GET VACCINATED — Major U.S. school systems are beginning to require teen athletes, band members and even after-school program participants to get vaccinated, Juan Perez Jr. writes. “This is the beginning of a movement,” Fairfax County Public Schools Superintendent Scott Brabrand said. “I am convinced that more districts, more states and governors are going to realize that to preserve American public education in person, and to preserve the American athletic experience, we must have vaccinations for our students and our athletes.” Forty-five percent of 12- to 17-year-olds were fully vaccinated against Covid-19 by Sept. 29, according to an analysis of federal data from the American Academy of Pediatrics. | | | | TELL US WHAT YOU THINK: Do you listen to POLITICO podcasts? We want to hear from you! Tell us what you like, what you could do without, and what you want to see in the future from the POLITICO Audio team! Your responses will help us improve our offerings and tailor our podcast content to better fit your needs. Find the survey here. | | | | | | | | U.S., OTHERS EXPECT “FUNDAMENTAL REFORM” AT WHO OVER SEXUAL ABUSE — The United States and other countries said Friday they expect fundamental reform at the World Health Organization after an independent commission confirmed scores of cases of sexual exploitation and abuse by the organization’s staff during a recent Ebola response. “As WHO member states, we urge the WHO to initiate an immediate, thorough, and detailed assessment of the institutional policies, operational processes, leadership culture, and circumstances at WHO that allowed this to happen including for cases to go unreported to WHO’s leadership and Member States,” said the U.S., Australia, Canada, European Union countries, New Zealand, Norway and the U.K. Scores of women were promised and given local WHO jobs in exchange for sex during the 2018-2020 outbreak in the Democratic Republic of the Congo, according to a report by an independent commission released Tuesday. | | | Alaska’s Covid-19 crisis has put doctors in a dire position of choosing who can receive limited resources to save their lives, The New York Times’ Mike Baker reports. A practice of ‘race-norming ,’ or judging cognitive tests on a curve based on race kept Black NFL players and their families from dementia diagnoses and support, The Washington Post’s Will Hobson writes. James Watson and Francis Crick ripped off Rosalind Franklin’s research in their discovery that DNA was a double-helix structure, William Brangham writes in a new book, “The Secret of Life,” previewed on PBS News Hour. | | | | A message from PhRMA: Some in Congress are considering a plan that would tie medicine prices in Medicare to those in the U.S. Department of Veterans Affairs. This misguided approach is just the latest in a series of government price-setting proposals that threaten patients’ access to medicines and future innovation.
Here are five reasons why the VA is a wrong model for Medicare:
1. Unlike Medicare Part D, the VA uses a one-size-fits-all system that restricts access to medicines.
2. The majority of VA beneficiaries rely on other sources to help supplement their drug coverage, including Medicare Part D.
3. The VA relies on quality-adjusted life year (QALY)-based assessments to set prices for medicines.
4. Imposing the VA system on Medicare is wildly unpopular with seniors.
5. Comparisons between Medicare Part D and the VA fail to acknowledge inherent structural distinctions between the two programs.
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