Health Brief: Grassley Pushes to Include Drug Pricing Measures in CHIP Reauthorization


Government Brief

  • Sen. Chuck Grassley (R-Iowa), a senior member on the Senate Finance Committee, is making a bid to include two measures targeting pharmaceutical companies as potential offsets in a critical bill to fund the Children’s Health Insurance Program. Grassley staff members have had discussions with the Finance Committee staff and with Senate GOP leadership about attaching the bills — which have some bipartisan support but opposed by the drug industry — to the CHIP reauthorization ahead of committee markups in both chambers today. (Morning Consult)
  • Several Republican senators emerged from a closed-door meeting doubtful that bipartisan negotiations to stabilize the Affordable Care Act exchanges will yield an agreement. Sen. Lamar Alexander (R-Tenn.), who is the lead GOP negotiator, said during the weekly meeting that disagreements persist among Republicans and Democrats on the extent to which states should be allowed to waive Obamacare regulations. (Washington Examiner)
  • Food and Drug Administration Commissioner Scott Gottlieb has emerged as a frontrunner to succeed former Health and Human Services Secretary Tom Price, who resigned last week amid criticism of his travel-related expenses. If nominated, Gottlieb could have a relatively smooth path toward confirmation, given that he has won praise from some of President Donald Trump’s staunchest critics for seeking to speed the approval of generic drugs, asserting that the FDA has a role in curbing the opioid epidemic and outlining actions to tighten tobacco restrictions. (Stat News)

Business Brief

  • Health insurers across the country are increasing insurance premiums for 2018, in some cases by more than 50 percent. In approving the increases, state regulators appear to be trying to keep insurers from fleeing Obamacare amid instability on the exchanges and ongoing uncertainty in Congress over the future of the ACA. (The New York Times)
  • Some ardent Obamacare supporters are spearheading a campaign called Get America Covered to encourage Americans to buy health insurance, part of an effort to make up for at least some of the Trump administration’s funding cuts to enrollment outreach. The group, which is launching with a six-figure budget, will focus on partnering with employers and community organizations, and it will also run some digital ads. (Axios)
  • Not-for-profit and public hospitals are reducing spending to contend with rising drug costs and the Trump administration’s proposed cuts to the 340B Drug Discount Program, after the gap in growth between not-for-profit and public providers’ revenue and supply costs widened between 2015 and 2016, according to a report from Moody’s Investors Service. (Modern Healthcare)

Chart Review

Events Calendar (All Times Local)

Wednesday
S&P Global Ratings event on health care 8 a.m.
Senate Finance Committee marks up CHIP reauthorization 9:30 a.m.
Brookings Institution event on 21st century medicine 10 a.m.
Thursday
Senate HELP Committee hearing on the opioid crisis 10 a.m.
Friday
No events scheduled
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For those impacted by the devastation and flooding caused by Hurricanes Harvey, Irma and Maria, resources are available for patients to access medicines. America’s biopharmaceutical companies are coordinating with local and federal agencies to meet medical needs in the areas impacted by the hurricanes.

General

Scott Gottlieb rocketed to the top of FDA. He may keep rising
Ike Swetlitz, Stat News

When President Trump nominated Scott Gottlieb as the head of the Food and Drug Administration, he was quickly pegged by many as a conservative businessman who was cozy with the pharmaceutical industry. Seven months later, he is attracting praise from some of President Trump’s staunchest critics — including former Obama administration officials.

House passes ban on abortion after 20 weeks of pregnancy
Sophie Tatum, CNN

The House of Representatives passed legislation Tuesday that would criminalize abortions after 20 weeks of pregnancy, with exceptions for instances where the life of the mother is at risk and in cases involving rape or incest. The bill passed the House by a vote of 237 for and 189 against, largely on party lines.

Rep. Tim Murphy, popular with pro-life movement, urged abortion in affair, texts suggest
Paula Reed Ward, Pittsburgh Post-Gazette

A text message sent in January to U.S. Rep. Tim Murphy by a woman with whom he had an extra-marital relationship took him to task for an anti-abortion statement posted on Facebook from his office’s public account. “And you have zero issue posting your pro-life stance all over the place when you had no issue asking me to abort our unborn child just last week when we thought that was one of the options,” Shannon Edwards, a forensic psychologist in Pittsburgh with whom the congressman admitted last month to having a relationship, wrote to Mr. Murphy on Jan. 25, in the midst of an unfounded pregnancy scare.

Health experts urge NIH to renew gun research funding after Las Vegas shooting
Max Blau, Stat News

In the wake of the Las Vegas concert shooting, the deadliest mass shooting in recent American history, health experts are urging the National Institutes of Health to renew funding for gun violence research that expired earlier this year. Following the Sandy Hook Elementary School shooting in 2012, President Obama directed health agencies to fund research into firearms — leading the NIH, which has an annual budget of $34 billion, to award a total of $18 million for nearly two dozen different research projects.

FDA Hints It May Look Into Marijuana Health Claims
Michelle Cortez, Bloomberg

The U.S. Food and Drug Administration may start cracking down on claims that marijuana has health benefits that haven’t been proven, the agency’s commissioner said Tuesday. “I see people who are developing products who are making claims that marijuana has antitumor effects in the setting of cancer,” FDA Commissioner Scott Gottlieb said at a hearing before Congress on a separate matter.

Big Tobacco to Spend Millions on Self-Critical Ads in U.S.
Jennifer Maloney, The Wall Street Journal

Broadcast television networks and metro newspapers are about to get a boost from an unexpected but familiar source: Big Tobacco. It’s an old media buy to resolve an old fight. Starting as soon as next month, Altria Group Inc. and British American Tobacco PLC will begin running court-mandated ads to put to rest a lawsuit brought nearly two decades ago by the U.S. Department of Justice over misleading statements the industry had made about cigarettes and their health effects.

Ryan asked White House to reconsider ousting Price
Josh Dawsey and Rachael Bade, Politico

Speaker Paul Ryan last week urged the White House to reconsider ousting Health and Human Services Secretary Tom Price, his longtime friend who had come under fire for often using a taxpayer-funded private jet for travel, according to two people with knowledge of the call. John Kelly, the White House chief of staff, called the Wisconsin Republican minutes before the departure was announced Friday afternoon.

Dollar Weakens; Spanish Stocks and Bonds Slump: Markets Wrap
Cormac Mullen, Bloomberg

The dollar fell and global stocks were mixed as investors digested the shortlist of candidates said to be in the running for the leadership of the Federal Reserve. Spanish securities declined as concerns about the crisis in Catalonia grew.

Payers

Republicans pessimistic on Obamacare fix
Robert King, Washington Examiner

Several Republican senators left a closed-door luncheon Tuesday pessimistic about the chances of reaching a bipartisan deal to stabilize Obamacare’s markets. Democratic and Republican negotiators are trying to find consensus on how much flexibility to give states in exchange for insurer subsidy payments.

With Affordable Care Act’s Future Cloudy, Costs for Many Seem Sure to Soar
Reed Abelson, The New York Times

Health insurers are aggressively increasing prices next year for individual policies sold under the federal health care law, with some raising premiums by more than 50 percent. By approving such steep increases for 2018 in recent weeks, regulators in many states appeared to be coaxing companies to hang in there, despite turmoil in the market and continuing uncertainty in Congress about the future of the law, the Affordable Care Act.

How ACA supporters will try to sign people up themselves
Sam Baker, Axios

Supporters of the Affordable Care Act are ready to roll out a new campaign encouraging people to buy insurance — an effort they hope will make up for at least some of the cuts the Trump administration has made to enrollment outreach. Why it matters: The ACA only works if people sign up, and the Trump administration has canceled or rolled back almost every effort to get people enrolled.

States search for stopgaps as Congress misses CHIP deadline
Virgil Dickson, Modern Healthcare

Now that the federal funding deadline for the Children’s Health Insurance Program has lapsed, Minnesota officials have found themselves in an uncomfortable waiting game. The state had expected to run out of money for CHIP in the coming days, but the CMS said it would provide a last-minute reprieve.

Medicare officially kills controversial drug payment model
Bob Herman, Axios

The Centers for Medicare and Medicaid Services has officially withdrawn the Obama administration’s proposed rule that would have reduced Medicare payments for drugs administered in outpatient offices. The so-called Part B demonstration has effectively been dead for a while after the health care industry rallied against it, which led to political scorn from both sides of the aisle.

Cleveland Clinic, Humana launch co-branded Medicare Advantage plans
Lydia Coutré, Crain’s Cleveland Business

Cleveland Clinic and Humana Inc. (NYSE: HUM) are creating two $0 premium Medicare Advantage health plans for seniors in Cuyahoga County, according to a news release. The Humana Cleveland Clinic Preferred Medicare Plans will be offered during this year’s Medicare Advantage and Prescription Drug Plan enrollment period, which runs from Oct. 15 to Dec. 7, with plan coverage beginning Jan. 1, 2018.

Providers

Providers pinched by rising drug costs, looming policy changes
Alex Kacik, Modern Healthcare

Not-for-profit and public hospitals are reining in their spending as they cope with rising drug prices and proposed cuts to the 340B program that threaten to batter their margins. The gap between growth in not-for-profit and public providers’ revenue and supply costs widened between 2015 and 2016, according to a report from Moody’s Investors Service.

House panel proposes delay in cuts to uncompensated-care funding
Virgil Dickson, Modern Healthcare

House lawmakers have made a move to postpone a multibillion-dollar cut to federal funds to offset hospitals’ uncompensated-care costs. The House Energy and Commerce Committee added language that would delay the disproportionate-share hospital funding cuts to its Children’s Health Insurance Program reauthorization bill.

Hartford HealthCare OKs Aetna Contract As Anthem Deal Stalls
Stephen Singer, Hartford Courant

Hartford HealthCare announced on Tuesday a new three-year agreement with Aetna as contract negotiations with another larger insurer, Anthem, remained stalled. Hospitals included in the agreement are Hartford Hospital, The Hospital of Central Connecticut, MidState Medical Center and Backus and Windham hospitals.

As the wounded kept coming, hospitals dealt with injuries rarely seen in the U.S.
Tim Craig et al., The Washington Post

As trauma nurse Renae Huening rushed into Sunrise Hospital and Medical Center on Sunday night, she “followed a trail of blood indoors.” Dozens of patients already were crammed into the waiting area, hallways and rooms of the hospital’s emergency department.

Rural Hospitals Are Dying and Pregnant Women Are Paying the Price
Lisa Rab, Politico

Three years ago, Lucia Parker gave birth to her first child surrounded by people she loved. Her mother, sister, and husband were by her side at Blue Ridge Regional Hospital, and the nurses attending her were family friends.

Pharma, Biotech and Devices

Grassley Pressing to Include Drug Pricing Measures in CHIP Reauthorization
Jon Reid, Morning Consult 

Sen. Chuck Grassley, a senior member and former chairman of the powerful Senate Finance Committee, is pressing GOP leaders to tackle high drug prices in a critical bill to renew funding for the Children’s Health Insurance Program. Grassley (R-Iowa), who has tried for years to advance legislation targeting rising prescription drug costs to little avail, is pushing two bills as potential offsets for CHIP funding.

ACLU sues to challenge FDA limits on access to abortion pill
David Crary, The Associated Press

The American Civil Liberties Union sued Tuesday in a challenge to federal restrictions that limit many women’s access to the so-called abortion pill. The lawsuit, filed in U.S. District Court in Hawaii, targets long-standing restrictions imposed by the Food and Drug Administration that say the pill, marketed in the U.S. as Mifeprex, can be dispensed only in clinics, hospitals and doctors’ offices.

Health IT

CDC eyes blockchain for public health surveillance
Evan Sweeney, Fierce Healthcare

The Centers for Disease Control and Prevention is exploring the use of blockchain to simplify information sharing about public health events between the agency and state and local health departments. The encrypted ledger technology used by Bitcoin has generated significant interest from the healthcare industry, but few practical applications have surfaced so far.

A Message from PhRMA:

Getting medicines to those affected by hurricanes. America’s biopharmaceutical companies are partnering with disaster response organizations to address medical gaps in the areas impacted by the hurricanes.

Opinions, Editorials and Perspectives

Pay for College or Cancer Treatment? Let’s End That Awful Choice
Damon Reed, Morning Consult 

Roughly 72,000 Americans between the ages of 15-39 are diagnosed with cancer each year. That number is six times higher than cancers diagnosed at age 14 or younger.

The Health Reform That Hasn’t Been Tried
Scott Atlas, The Wall Street Journal

Republicans have now failed twice to repeal and replace ObamaCare. But their whole focus has been wrong.

Research Reports

Low-Cost, High-Volume Health Services Contribute The Most To Unnecessary Health Spending
John N. Mafi et al., Health Affairs

An analysis of data for 2014 about forty-four low-value health services in the Virginia All Payer Claims Database revealed more than $586 million in unnecessary costs. Among these low-value services, those that were low and very low cost ($538 or less per service) were delivered far more frequently than services that were high and very high cost ($539 or more).