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Presented by Better Medicare Alliance: Delivered daily by 10 a.m., Pulse examines the latest news in health care politics and policy. | | | | |  | | By Krista Mahr and Daniel Payne | | | With Megan R. Wilson and Ruth Reader
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President Joe Biden has chosen sanctions and diplomacy over military action in the fentanyl fight. | Drug Enforcement Administration via AP | THE OTHER BORDER CRISIS — Political pressure has been piling on President Joe Biden to stop the illicit flow of fentanyl across the U.S. border, but the president won’t entertain GOP ideas to designate Mexican drug cartels terrorist groups or threaten military action, POLITICO’s Carmen Paun reports. Last week, Sen. Lindsey Graham (R-S.C.) said he and Sen. John Kennedy (R-La.) planned to introduce legislation that would label Mexican drug cartels as foreign terrorist organizations so the U.S. would have more power to prosecute them and the Chinese companies supplying raw materials for fentanyl production. Both Graham and Rep. Dan Crenshaw (R-Texas) have also said they want to authorize military force against the cartels. Biden’s solution? Sanctions … A National Security Council spokesperson told POLITICO the U.S. already has “powerful sanction authorities specifically designed to combat narcotics trafficking organizations and the individuals and entities that enable them.” Since February, the Treasury Department has sanctioned a Mexican arms trafficker for supplying weapons to the Cartel de Jalisco Nueva Generación and eight Mexican companies linked to timeshare fraud for the cartel, which traffics fentanyl and other drugs. … and diplomacy: The White House and Mexican President Andrés Manuel López Obrador released a joint statement on Friday pledging cooperation to combat fentanyl trafficking. The two sides discussed a program to improve U.S. and Mexican interagency coordination and bilateral sharing of criminal intelligence to target key nodes in the drug supply chain, the statement said. Mexican and U.S. officials will meet in two months in Washington, D.C., “to further review and analyze the effectiveness of the enhanced policies and improve intelligence and information-sharing on transnational criminal organizations,” the statement said On Monday, Semafor reported that the Biden administration plans to also ask China for help combatting the fentanyl crisis. China is the primary source of chemicals used to make the deadly synthetic versions of the drug. WELCOME TO TUESDAY PULSE — Already starting to forget what the first year of the pandemic felt like? You’re not alone. Send us the one thing you want to make sure you remember, along with news and tips, to kmahr@politico.com and dpayne@politico.com. TODAY ON OUR PULSE CHECK PODCAST, host Ruth Reader talks with Michael Yang, a managing partner with OMERS Ventures, a global early-stage technology venture firm, about how the failure of Silicon Valley Bank — which had many health care and biotech startups among its client base — could hurt emerging health companies.
| | | | | A message from Better Medicare Alliance: Leading organizations representing physicians, nurses and patients have raised concerns about CMS rushing through major changes to risk adjustment in Medicare Advantage before the proposal has been properly analyzed and the impact on seniors and those who care for them is fully understood. Tell the White House to slow down and protect the 30 million seniors who count on Medicare Advantage. | | | | | | CONFIDENTIAL: LAYOFFS AT AAM — The Association for Accessible Medicines, which represents generic medicine manufacturers, laid off three executives as part of an effort to cut millions from its budget, Megan reports. According to a confidential email seen by POLITICO that was sent to the group's board members on Monday by interim CEO David Gaugh, the group has eliminated the positions of Erik Komendant, its top lobbyist; Allen Goldberg, the top person in its comms shop; and Jonathan Kimball, the vice president of trade, international and strategic initiative. Gaugh took over the association after its previous CEO, Dan Leonard, resigned in December. The association has been trying to cut costs. It ultimately needs to shed more than $4 million from its budget, said two people familiar with the matter who were given anonymity to speak freely about a sensitive topic. The layoffs are part of those cuts, they said. Last month, AAM agreed to give discounts on annual dues to keep some members from leaving, which only worsened the budget woes. “We greatly value the contributions of our staff, so it is never an easy decision to eliminate positions. However, like the members we represent, we run a business and need to ensure its financial stability," Gaugh said in an emailed statement to POLITICO on Monday night. “The generics industry, and AAM, are at an inflection point with continued pressures facing our industry. But we are up to the challenge and more committed than ever to advancing our industry’s mission to providing safe, effective, and more affordable medicines to American patients.” Komendant did not respond to a request for comment, and the other laid-off executives could not be reached for comment.
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Sens. Maggie Hassan (D-N.H.) and Rand Paul (R-Ky.) want generic drugs to be easier to obtain. | Sarah Silbiger/Getty Images | FIRST IN PULSE — Sens. Maggie Hassan (D-N.H.) and Rand Paul (R-Ky.) will reintroduce legislation today aimed at improving access to more affordable generic medications. The "Increasing Transparency in Generic Drug Applications Act," which passed the House and Senate HELP committees last year with bipartisan support, would help get generic drugs on the market faster by requiring the FDA to make it easier for generic manufacturers to match a name-brand drug’s ingredient formulation when seeking approval. “Expanding access to generic medications is a commonsense way to help families save money,” Hassan said. “Our bipartisan bill will cut unnecessary red tape to help get low-cost generic medications onto the market and into the hands of patients more quickly.”
| | | | A message from Better Medicare Alliance:   | | | | | | BIRD FLU WATCH — As Europe experiences its largest-ever avian flu outbreak, researchers are scrambling to have vaccines on standby. But the final recipes for the vaccine — and the production — won’t kick in until a pandemic hits, POLITICO Europe’s Sarah Taisser Bencharif writes. How does that work, exactly? Bird flu viruses are classified according to two proteins on the virus’ surface, which correspond to the “H” and the “N” of their names. The currently circulating H5N1 strain is part of the broader H5 grouping of avian influenza. Worldwide, nearly 20 vaccines that target an H5 strain of bird flu are licensed for pandemic use. The WHO maintains a curated bank of candidate vaccine viruses based on strains they suspect might cause trouble so vaccines that closely match a circulating pandemic strain can be made quickly. Those candidate vaccine viruses can be plugged into the existing vaccine technology to confer protection until a more specific jab is ready. At the end of February, a panel of experts organized by the WHO recommended updating the bank to include the culprit behind the worldwide outbreak in birds. The European Commission has two joint procurement contracts to purchase influenza vaccines in the event of a pandemic, one with GSK and the other with Seqirus UK, a spokesperson told POLITICO. The earliest deliveries would be expected within eight weeks of the vaccine-maker receiving the pandemic seed strain targeting the specific variant causing the pandemic.
| | | | 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. | | | | | | | | VA TO COVER ALZHEIMER’S DRUG — The Veterans Health Administration will cover Leqembi, a new Alzheimer’s drug from Eisai and Biogen that appears to slow the disease’s progression, POLITICO’s Katherine Ellen Foley reports. The decision, announced Monday, follows the FDA’s move to grant Leqembi accelerated approval in January and comes after CMS decided not to cover Leqembi for its patients. Out of pocket, Leqembi costs roughly $26,500 annually. Previously, the VA refused to cover Aduhelm, an earlier-approved Alzheimer's drug from Biogen. What’s next: Eisai has asked the FDA to approve Leqembi under a traditional pathway based on new data published late last year. If the agency grants Leqembi that approval later this year, CMS would cover the drug for patients enrolled in a registry that would track patients’ health over time. A BUMP FOR ARPA-H — Biden’s fiscal 2024 budget proposal calls for a major funding increase for the Advanced Research Projects Agency for Health, POLITICO’s Ben Leonard reports. Biden would allot $2.5 billion for ARPA-H, which Congress created in 2021 to fund research projects considered too risky by the private sector, up from $1.5 billion this fiscal year.
| | A message from Better Medicare Alliance: If proposed changes to risk adjustment in Medicare Advantage are rushed through, 30 million seniors could see unintended consequences. Low-income and chronically ill seniors could be disproportionally impacted, especially those with conditions such as diabetes and depression. Tell the White House to slow down and protect the 30 million seniors who count on Medicare Advantage. | | | | | | A SHOCK TO NEWSOM’S INNER CIRCLE — Gov. Gavin Newsom’s aides were recently surprised to learn that his former chief of staff Ann O’Leary represents Walgreens in a standoff between the California governor and the pharmacy chain over abortion pill access, POLITICO’s Christopher Cadelago reports. In a recent phone call, O’Leary, a national authority on expanding abortion access, tried to convince Newsom’s top aides to soften their approach on behalf of Walgreens. How we got here: After the company said it would scale back access to abortion pills in states where Republican attorneys general were objecting to them, Newsom said California would sever ties with the company. In an interview with POLITICO on Wednesday, he explained why the state wouldn’t renew a $54 million contract with Walgreens. What Newsomland is saying: “It didn’t sit particularly well with the governor that he had a former top aide of his administration now trying to push back on the policy he’s making,” said one of the people briefed on the calls. Meanwhile … California lawmakers are pursuing a new raft of bills designed to protect abortion patients’ privacy and increase access to abortion pills.
| | | Hogan Lovells, which made major news for defeating the DOJ’s attempt to block UnitedHealth’s acquisition of Change Health, is hiring Kenneth W. Field as a new antitrust lawyer. He was previously at Jones Day, where he helped hospitals through mergers and acquisitions.
| | | The Wall Street Journal writes about why candidates are backing away from the top job at NIH. STAT reports on how SVB’s collapse rattled the biotech industry. | | | | Follow us on Twitter | | | | Follow us | | | | |  |
