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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 Adam Cancryn and Sarah Owermohle | | | With Lauren Gardner and Joanne Kenen 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. | | | — President Joe Biden made a forceful case for the success of his pandemic response, insisting he’s still capable of getting Covid-19 under control. — Democrats’ $1.7 trillion social spending bill will need to be broken up and scaled down, Biden conceded. — A year into the vaccination campaign, the U.S. still has no comprehensive way to tell how many hospital workers are fully vaccinated. WELCOME TO THURSDAY PULSE — and save a thought for all the librarians in D.C. and elsewhere pressed into service during Omicron as de facto public health workers . Send tips and your favorite Dewey Decimal to acancryn@politico.com and sowermohle@politico.com. | | | | A message from PhRMA: Did you know more than half of every dollar spent on medicines goes to someone who doesn’t make them? There’s a long line of middlemen, like PBMs and insurers, collecting a significant portion of what you pay for medicine. The share of total spending for brand medicines received by the supply chain and other stakeholders increased from 33% in 2013 to 50.5% in 2020. Learn more. | | | | | | BIDEN VOWS PANDEMIC PROGRESS — It’s been a tough period for the White House’s coronavirus response. Omicron is sweeping the nation. The Supreme Court just blocked the administration’s vaccine mandate. Tests remain in short supply. And much of the country is either confused by the government’s Covid-19 guidance, or has just plain stopped listening. But to hear Joe Biden tell it, the U.S. is still only a few good weeks away from turning the corner. The president Wednesday touted his administration’s progress on Covid-19 and promised the best is yet to come — insisting that his first-year goal of eliminating the pandemic remained just as achievable at the outset of a second year marked by record caseloads. “Some people may call what’s happening now the new normal,” Biden said during a lengthy press conference. “I call it the job not yet finished. It will get better.” The confidence stood out among a spate of gloomy forecasts, even within the administration. Just last week, Biden’s own acting FDA commissioner conceded that “most people are going to get Covid.” Others have sought to prepare the public for a drawn-out fight with a virus still circulating and mutating largely uncontrolled. But Biden at times went as far as to demand credit for taking on “some of the biggest challenges that we’ve ever faced in this country,” making the case that Americans worn out by the pandemic should give him the benefit of the doubt — and maybe have a little faith that an administration spent its first year building a nationwide response is capable of finishing the job. Still: The caveats crept in. Even as he doubled down on ending the pandemic, Biden allowed that Covid isn’t going away. Instead, the hope is that soon it “won’t be a crisis.” He also conceded missteps in not ramping up testing faster and defended the CDC’s shifting guidance by arguing that “this is a brand new virus, a brand new phenomenon.” And in a bit of messaging notable for its forcefulness, Biden repeatedly blamed Republicans for doing little to help him end the pandemic — arguing that there’s nothing “they’re for” outside of opposing the White House’s various public health initiatives. Biden also offered no new ideas for reining in Covid. Asked what his version of “new normal” looks like, Biden said only that it wouldn’t have “30-some million people not vaccinated.” He also dodged a question on whether the administration would mandate vaccination for air travel. As for how to beat a virus that’s so far eluded his best efforts, Biden indicated the plan is to give all those best efforts another shot. “What is the trajectory of the country — is it moving in the right direction?” he said. “I don’t know how you can say that it’s not.” BUILD BACK BROKEN — During his presser, Biden admitted his $1.7 trillion social spending bill would need to be scaled back in response to opposition from Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.). The smaller package that could pass would likely include climate and early-education measures, he said, though even that could face difficulties getting past Democrats’ narrow margins in Congress, POLITICO’s Anthony Adragna notes. Not mentioned: Democrats’ compromise measure on drug pricing and the bill’s other health components, though those elements weren’t seen previously as stumbling blocks for Manchin or Sinema. | | | | JOIN NEXT FRIDAY TO HEAR FROM GOVERNORS ACROSS AMERICA : As we head into the third year of the pandemic, state governors are taking varying approaches to public health measures including vaccine and mask mandates. "The Fifty: America's Governors" is a series of live conversations featuring various governors on the unique challenges they face as they take the lead and command the national spotlight in historic ways. Learn what is working and what is not from the governors on the front lines, REGISTER HERE. | | | | | | | | IT’S A PANDEMIC. IS YOUR HEALTH WORKER VAXXED? — The Biden administration has no reliable way to know how many hospital employees are still unvaccinated, complicating efforts to manage the risks in facilities across the country, POLITICO’s Rachael Levy reports. The blind spot is a result of the nation’s fragmented data collection system and sluggish reporting by individual providers, with only 40 percent of U.S. hospitals having disclosed their vaccination rates so far. Among those that have sent their figures to the CDC, 77.6 percent of hospital workers are fully vaccinated and about four in five nursing home staffers have gotten the necessary shots. Yet, while nursing homes have had to submit weekly vaccination data since last May (where even then, 10 percent still fail to do so), hospitals won’t be required to do the same until May. “I suspect that many hospitals do not want to report their worker vaccination rates because they are very suboptimal, and it is embarrassing,” Amesh Adalja of Johns Hopkins Institute for Health Security said. Provider organizations say facilities are simply overwhelmed with requests, and haven’t been able to report immunization figures reliably. They also maintain that the CDC’s current data is likely representative of the situation overall. But the legal battle over mandates has slowed efforts to improve that accuracy. The Supreme Court only last week allowed the administration’s vaccine requirement for health workers to take effect. Yet even those rules don’t mandate that workers get boosters — and already, some red states have sought to further muddy the waters by prohibiting vaccine requirements or declaring they won’t enforce them. FIRST IN PULSE: GOP PRESSURES FDA OVER COVID DRUGS, BOOSTERS — House Oversight Committee Republicans are demanding details on the FDA’s emergency use authorization process and raising questions about why the agency hasn’t sped more Covid-19 treatments to market, POLITICO’s Lauren Gardner reports. In a letter to acting FDA Commissioner Janet Woodcock, the lawmakers requested information on how many EUA applications the FDA has received for such treatments, how many were rejected, and the expected approval dates for any still pending. They also accused the Biden administration of moving slower on Covid-19 drug development than during the Trump era, writing that it left the nation “with a very minimal supply of effective treatments at a time when we need them most.” In reality, the treatment shortage isn’t entirely on Biden’s FDA. The government has already purchased more than 11 million courses combined of antiviral pills produced by Pfizer and Merck and Ridgeback Biotherapeutics. Omicron’s apparent resistance to two existing antibody treatments also dealt an unexpected blow to the Covid-19 medicine cabinet. But the GOP letter previews a line of attack the party may pursue if it wins back the majority. The committee’s top Republican, Rep. James Comer (R-Ky.), also sent Woodcock a separate letter Wednesday asking about the FDA’s decision not to convene its outside advisory panel before making some decisions on vaccines, and whether those moves were politically influenced. | | | | A message from PhRMA:   | | | | | | HOW RACIAL PREJUDICE SHOWS UP IN MEDICAL RECORDS — A new Health Affairs study found that Black patients were more than twice as likely as white patients to be described with stigmatizing terms in their medical records, POLITICO’s Darius Tahir writes. The findings came out of an analysis of records of more than 18,000 patients tested for Covid-19 in a Chicago medical center, with a particular focus on the clinical notes describing their case histories. What the researchers found: Black patients were 2.54 times more likely to have negative descriptions such as “aggressive,” “hysterical” or “defensive” applied to them than white patients were. That disparity could become more urgent for providers as regulations that allow patients to see notes in their medical records are implemented. A study cited by the Health Affairs paper, reported that 10.5 percent of patients who viewed their clinical notes felt judged or came away offended. PUTTING THEIR MONEY WHERE THEIR SOCIAL DETERMINANT MOUTH IS — For the first time, the organization that weighs on the myriad metrics Medicare uses to pay providers has endorsed two measures addressing social determinants, POLITICO Contributing Editor Joanne Kenen writes. The recommendation approved by the National Quality Forum late Wednesday paves the way for CMS to work out the details and start the rulemaking process. It’s a wonky — but hugely significant move. Instead of just talking about social determinants of health and equity, this would start baking them into the system. “If we’re not screening our patients … we’re not going to get to the bottom of why they aren’t accessing care,” Joseph Valentie, an OB-GYN on the Texas Medical Association’s board, said during the meeting. The details: One measure requires patients to be screened for social needs like housing and food insecurity. The other one tracks how many patients “tested positive” for those social drivers of health. They’ll apply to both clinicians and hospitals. And while they won’t require providers to make or follow up on social service referrals, the screening and data collection will be the foundation for future measures, incentives or requirements. | | | | BECOME A GLOBAL INSIDER: The world is more connected than ever. It has never been more essential to identify, unpack and analyze important news, trends and decisions shaping our future — and we’ve got you covered! Every Monday, Wednesday and Friday, Global Insider author Ryan Heath navigates the global news maze and connects you to power players and events changing our world. Don’t miss out on this influential global community. Subscribe now. | | | | | | | | Venable snagged seven health care lobbyists from Faegre Drinker Biddle & Reath and its District Policy Group, POLITICO Influence reported. Those moving over are Jodie Curtis, Debbie Forrest, Laura Hanen, Julie Hyams, Jennifer Taylor McBride, Ilisa Halpern Paul and Jim Twaddell. Merck hired David Weinstock as its vice president of discovery oncology. Weinstock was previously the Lavine Family Chair for Preventative Cancer Therapies at the Dana-Farber Cancer Institute, as well as an associate physician at Brigham and Women’s Hospital and Harvard Medical School professor. | | | | A message from PhRMA: Did you know that PBMs, hospitals, the government, insurers, and others received a larger share of total spending on medicines than biopharmaceutical companies? That’s right, more than half of spending on brand medicines goes to someone who doesn’t make them. Let’s fix the system the right way and ensure more of the savings go to patients, not middlemen. Read the new report. | | | | | | Starbucks is among the major corporations no longer requiring employees to get vaccinated, after the Supreme Court rejected Biden’s vaccine-or-test rules, CNN’s Danielle Wiener-Bronner reports. ProPublica’s Maryam Jameel reports that the rate of illnesses caused by salmonella hasn’t fallen in 25 years in the U.S., leading to infections that result in thousands of hospitalizations a year. The rising demand for Covid-19 tests has prompted a rise in scams tied to phony testing websites and locations, The New York Times’ Amanda Holpuch reports. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
