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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 Krista Mahr and Daniel Payne | | | With Carmen Paun and Daniel Lippman
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The Pentagon is testing weapon systems to determine what could cause Havana Syndrome’s symptoms. | Desmond Boylan/AP Photo | DOD KEEPS WORKING ON HAVANA SYNDROME — The Defense Department continues to research what the government calls “anomalous health incidents” — including what might have caused them and whether a weapon is responsible, POLITICO’s Lara Seligman and Erin Banco report. That’s despite an intelligence community assessment released last week that said no evidence supports the theory that the incidents were caused by a foreign adversary wielding a weapon. If you’re just catching up ... The mysterious ailment known as Havana Syndrome has affected more than 1,000 government employees over the past several years. It was first reported in late 2016 when a group of American diplomats at the U.S. embassy in Havana experienced severe headaches, temporary hearing loss, vertigo and other symptoms similar to those of traumatic brain injury. Hundreds more U.S. government personnel have reported similar incidents since then in locations worldwide, including China and Europe. Many victims and experts still believe they result from a directed-energy weapon. What the Pentagon is doing: A “cross-functional team” in the Pentagon “remains focused” on addressing the incidents, a DoD spokesperson said, established by the 2022 National Defense Authorization Act to address the national security challenges posed by the incidents and ensure the victims receive adequate care. DoD treats government employees who have suffered brain injuries, including some related to the Havana Syndrome incidents, at Walter Reed National Medical Center. The Pentagon’s research arm is testing weapon systems to determine what could cause the symptoms, and the agency is also working on developing “defenses” against the syndrome. WELCOME TO TUESDAY PULSE — Stranded at sea for 24 days, a man survived on a mix of filtered water, ketchup and Maggi seasoning. With access to water, doctors said it was enough to keep him alive. Send us your news and tips: kmahr@politico.com and dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Megan Messerly speaks with Alice Miranda Ollstein about what influenced Walgreens' decision not to sell abortion pills in 20 states — including several states that have no abortion restrictions — after threats of legal action.
| | | | | | | A message from PhRMA: Insurers and PBMs don’t pay full price for your medicines. So why do you? Insurers and PBMs get discounts on medicines. Surprised? These savings can reduce the cost of some brand medicines by 50% or more, but insurers and PBMs aren’t required to share these savings with you. What else don’t they want you to know? | | | | | | | 
Oklahoma’s booming weed industry faces a test in a March 7 referendum that would open marijuana sales to anyone at least 21 years old. | Miguel Rojo/AFP/Getty Images | THE ‘WILD WEST OF WEED’ — No state in the country has been as radically transformed by marijuana legalization as Oklahoma, POLITICO’s Paul Demko reports. Now the booming industry’s critics have their sights set on defeating a March 7 referendum that would open marijuana sales to anyone at least 21 years old. The stats: More than $3 billion worth of weed has been sold since Oklahoma’s program launched in late 2018 after voters backed a medical marijuana legalization referendum. There are roughly 12,000 licensed medical marijuana businesses in the state, including more than 7,000 grow operations and nearly 3,000 dispensaries. That’s nearly three times as many weed shops as in California — which has roughly 10 times the population. Nearly 400,000 Oklahomans are enrolled in the state's medical marijuana program, about 10 percent of the population and by far the highest level of participation per capita in the country. The backlash: There is one, of course. The country’s wildest weed market has found fierce critics in the staunchly conservative state, especially in rural areas inundated with marijuana farms. That’s been exacerbated by dozens of raids over the last two years on illegal grow operations, many run by Chinese nationals, with much of the product being funneled into the illicit market beyond the state’s borders. Narcotics agents have seized more than 600,000 pounds of illegal weed and made nearly 200 arrests.
| | | | DOWNLOAD THE POLITICO MOBILE APP: Stay up to speed with the newly updated POLITICO mobile app, featuring timely political news, insights and analysis from the best journalists in the business. The sleek and navigable design offers a convenient way to access POLITICO's scoops and groundbreaking reporting. Don’t miss out on the app you can rely on for the news you need, reimagined. DOWNLOAD FOR iOS– DOWNLOAD FOR ANDROID. | | | | | | | | INSIDE ELI LILLY’S MOVE ON INSULIN — Eli Lilly’s decision to lower the list price of its most popular insulin product by 70 percent in the final months of 2023 will save the company millions of dollars it would have paid in rebates to state Medicaid programs starting in 2024, POLITICO’s David Lim reports. State Medicaid programs would have generated about $150 in revenue for every vial of Humalog they purchased had Lilly not capped its prices — about $140 million in revenue nationally — based on calculations by Sean Dickson, a drug-pricing expert at the nonprofit West Health Policy Center. That number is a fraction of Lilly’s $28.5 billion in revenue last year and doesn’t amount to a large proportion of Medicaid funding. The Medicaid Drug Rebate Program, established in 1990 to help offset the cost of providing outpatient prescription drugs to low-income patients, requires drugmakers to pay a rebate to state and federal governments. The rebate has historically been capped at 100 percent of the average manufacturer price, but the cap will be eliminated in 2024 under a provision tucked into the 2021 American Rescue Plan. When that provision takes effect in January, manufacturers might be forced to pay rebates for drugs that are greater than what states pay to purchase them. What Lilly says: Lilly has worked for “a long time” toward its price-cut announcement and cap on out-of-pocket costs at $35 or less a month, said Antoinette Forbes, Lilly associate vice president of public affairs. “A variety of factors, including a changing marketplace and legislative environment, contributed to the decision and timing of reducing list prices,” Forbes said in a statement.
| | | COVID ORIGINS BACK ON THE HILL — The Select Subcommittee on the Coronavirus Pandemic in the House Oversight and Accountability committee will focus on Covid-19’s origins in a hearing Wednesday morning after both the Department of Energy and the FBI Director Christopher Wray recently backed the hypothesis of the virus originating from a lab leak in China. Two of the three people testifying — former CDC director Robert Redfield and Jamie Metzl, a former National Security Council official — have said they back the lab origin hypothesis. Science writer and editor Nicholas Wade, who has worked for The New York Times, Science and Nature, will also testify. Foregone conclusion? Many Republicans have long backed the hypothesis of a lab leak as the most likely origin of the coronavirus that sparked the pandemic. On Sunday, Republican staff published what they said was new evidence implicating Fauci and Jeremy Farrar, the World Health Organization’s chief scientist, in publishing a scientific article early in the pandemic trying to disprove the lab leak theory. HELP FOR CHRONIC DISEASE COVERAGE — Sens. Tom Carper (D-Del.) and John Thune (R-S.D.) reintroduced the Chronic Disease Management Act on Monday, a bill that aims to increase chronic disease coverage.s The bill proposes that high-deductible health plans (HDHPs) used with health savings accounts can cover care related to chronic disease management before an individual reaches their plan’s deductible. FLYING IN — The National Association of Community Health Centers is hosting its annual fly-in and policy forum this week, bringing thousands of doctors, nurses, pharmacists, patients and senior executives to Washington, D.C. The gathering will focus on advocating for issues such as addressing the provider workforce shortage, shielding the low-cost drug program known as 340B from changes and providing affordable health care.
| | | | A message from PhRMA:   | | | | | | FIRST IN PULSE: HEP C IS NOT GOING AWAY — Millions of Americans could be affected by hepatitis C, but the U.S. isn't on track to meet global goals to eliminate the virus, according to new research by risk firm Milliman. The research was published in a white paper and not peer-reviewed. In 2016, the WHO set a goal of eliminating hep C by 2030, defining elimination as an 80 percent reduction in new infections and a 65 percent reduction in death rates. The research — commissioned by Gilead, which makes hepatitis C medicines — suggests the U.S. won’t meet those goals for another 30 years at current testing and treatment rates and the country will have spent $47 billion on testing and treating in those decades at the same rates.
| | | Miles Lichtman is now Democratic staff director of the House Select Subcommittee on the Coronavirus Pandemic. He was previously Democratic health policy director for the House Oversight Committee.
| | | | STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today. | | | | | | | | More than a quarter of parents lied or didn’t follow recommended guidelines when their child got Covid-19, CIDRAP reports. The New York Times reports why the fall of Roe v. Wade turned North Carolina into an abortion destination. The New Yorker goes inside Biomilq, the startup trying to produce lab-grown breast milk.
| | | | A message from PhRMA: Insurers and their PBMs don’t want you to see that you could be paying more than they are for your medicines. Rebates and discounts can significantly lower what insurers and PBMs pay for medicines. These savings can reduce the cost of some brand medicines by 50% or more. But insurers and PBMs aren’t required to share those savings with you at the pharmacy counter.
They don’t want you to see that they use deductibles, coinsurance and other tactics to shift more costs on to you. Or that the three largest PBMs control 80% of the prescription drug market. Or that last year they blocked access to more than 1,150 medicines, including medicines that could have lowered costs for you at the pharmacy.
PBMs and insurance practices are shrouded in secrecy, they need to be held accountable. | | | | | | | Follow us on Twitter | | | | Follow us | | | | |  |
