HEALTH CARE BRIEFING: Trump Drug Plan Gives Grassley Time to Act

By Zachary Sherwood and Alex Ruoff

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President Donald Trump gave the drug industry until Aug. 24 to find a suitable alternative to one of his drug pricing plans, time Sen. Chuck Grassley (R-Iowa) indicated he plans to use to build support for his own prescription drug package, Alex Ruoff reports.

“For those who don’t like these executive actions, there’s time to get to the table and back a legislative solution,” Grassley said in a statement. “I will continue the fight in Congress until significant prescription drug pricing legislation becomes law. The next coronavirus relief bill presents the perfect opportunity for Congress to meet the moment.”

Trump unveiled a series of drug pricing initiatives Friday, the most wide-sweeping of which will go into effect unless the pharmaceutical companies come up with a better idea, the White House said. That order would tie the price of some medicines in the U.S. to their cost in countries that have successfully negotiated for better prices.

Grassley’s proposal (S. 2543) has long been seen as the most likely major drug pricing legislation to reach Trump’s desk. However, conservative groups dislike the bill’s cap on drug pricing increases and the legislation’s main Democratic sponsor, Sen. Ron Wyden (D-Ore.), recently withdrew from negotiations on the package.

That leaves Grassley with a ticking clock to build enough support for his proposal to get it through the Senate and to convince House leaders to take it up as well. House leadership has its own signature drug pricing measure (H.R. 3) that’s closer to Trump’s own order than Grassley’s bill.

The Grassley package would create a rebate system in Medicare Part B and Part D beginning in 2022 for brand-name drugs and biological products with prices that increase faster than inflation. Conservative groups and some Senate Republicans have opposed the rebate system for Part D, the prescription drug benefit program, but not for Part B, the outpatient services program.

Conservative groups like FreedomWorks were quick to condemn the Trump administration for trying to install pricing controls on medicine. These groups favor legislation such as one plan (H.R. 19) backed by Sen. Mike Crapo (R-Idaho) that would cap out-of-pocket costs in Medicare at $3,100 per year, the same as Grassley’s bill, but have no similar controls for the price of medicines.

Meeting With Drug Company Executives: Trump Friday said he plans to meet with drug company executives tomorrow to discuss how to lower out of pocket drug prices.

Latest on Stimulus Talks:

Happening on the Hill

HHS Appropriations: House lawmakers plan action later this week on a seven-bill fiscal 2021 appropriations package (H.R. 7617). It will include Labor-HHS-Education funding. The House Rules Committee is scheduled to meet tomorrow to narrow the list of amendments to the bill that will receive votes.

The House on Friday passed a four-bill fiscal 2021 spending package by a 224-189 vote, advancing its first annual funding measure of the year. The legislation (H.R. 7608) includes State and Foreign Operations, Agriculture-FDA, Interior-Environment, and Military Construction-VA funding, Jack Fitzpatrick reports.

Child Care Legislation: The House on Wednesday will vote on two child care measures:

  • Dependent care and payroll tax credits would be expanded to support caregivers and child care providers affected by the coronavirus pandemic under H.R. 7327. The bill would also provide $10 billion in emergency funding to the Child Care Development Fund for grants to enhance child care facility safety and infrastructure. The funding wouldn’t count against discretionary spending caps. The measure would also provide $10 billion annually through fiscal 2024 for general child care entitlement to states. The measure was referred to the House Appropriations, Budget, and Ways and Means committees, which haven’t acted. For more, see the BGOV Bill Summary by Naoreen Chowdhury.
  • A $50 billion stabilization fund would be created to support child care providers affected by the coronavirus pandemic under a modified version of H.R. 7027. The measure would provide the funding through the Child Care and Development Block Grant (CCDBG) program as an emergency appropriation. Funding would be used to provide grants to child care providers to sustain their operations during pandemic-related closures and as they reopen. The measure was referred to the House Appropriations and Budget committees, which haven’t acted. For more, see the BGOV Bill Summary by Danielle Parnass.

This Week’s Hearings:

  • Virus Containment: The House Select Subcommittee on the Coronavirus Crisis scheduled a hearing Friday on the need for a national plan to contain the Covid-19 pandemic.
  • Medical Supply Chain: The Senate Finance Committee meets for a hearing tomorrow on protecting the U.S. medical supply chain during Covid-19.
  • Public Health Programs: The House Energy and Commerce Health Subcommittee on Wednesday will discuss several bills to reauthorize public health programs.
  • Foreign Affairs Markup: The House Foreign Affairs Committee is scheduled to mark up eight bills on Wednesday including H.R. 6334, to authorize U.S. participation in the Coalition for Epidemic Preparedness Innovations.
  • VA Telehealth: The Senate Veterans’ Affairs Committee holds a hearing Wednesday on VA telehealth during Covid-19 and challenges in rural parts of the country.
  • Water Standards: The House Energy and Commerce Subcommittee on Environment and Climate Change holds a hearing tomorrow on updating national drinking water standards.

Trade Groups Draw Back Spending Amid Virus Pandemic: Industry groups and corporations pulled back their lobbying spending in the second quarter of 2020 compared to the first three months of the year as the pandemic complicated advocacy of Congress and federal agencies.

One of the top trade associations by revenue, the Pharmaceutical Research and Manufacturers of America, or PhRMA, spent $5.4 million on lobbying from April through June, a 40% drop from the preceding three months and a 14% decline from the second quarter in 2019. Pfizer, a PhRMA member, reported spending nearly $2.5 million in the second quarter of 2020, with identical drops over the previous quarter and year as its industry group. The company, however, added new issues including lobbying on “vaccine infrastructure.” Read more from Megan R. Wilson.

Meatpackers Not Consistently Social Distancing, Senators Say: Democratic Sens. Elizabeth Warren (Mass.) and Cory Booker (N.J.) said Tyson Foods, JBS USA, Cargill and Smithfield Foods aren’t consistently implementing CDC guidelines on 6-feet social distancing at their plants, even as the companies warn of shortages but continue exporting to China. “Their responses—or lack thereof—fail to sufficiently explain why they claimed there were pending domestic shortages only to go on and export record quantities of meat to China, which recent reports indicate they continue to do even as frozen supplies fall,” the lawmakers said, Vivek Shankar reports.

More Headlines:

Coronavirus Response

Lockdown Is Nuclear Option Despite Second Wave: Shuttering businesses, grounding airlines and ordering people to stay home was hard enough the first time. The thought of having to do it all over again is something world leaders don’t want to even contemplate. From Italy to New Zealand, irrespective of how well the virus was contained, governments acknowledge that fresh waves of the deadly coronavirus are likely and that the policy tools to mitigate the damage are limited. The hope is that localizing quarantines to towns, cities and regions will be enough to snuff out bouts of infections as they come.

It speaks to the great elephant in the room: while scientists warn it could take years to control a deadly virus that has killed more than 630,000 worldwide, there is no appetite to sustain the hiatus on travel, work and leisure that has upended everyone’s lives in 2020. Read more from Flavia Krause-Jackson.

VACCINE EFFORTS:

Draft Vaccine Plan On Tap for End of Summer: The public will get an early look at recommendations for who should be first in line for a Covid-19 vaccine by late August or early September, the president of the National Academy of Medicine said Friday. The new National Academies committee tasked with developing a framework for ensuring the fair distribution of virus vaccine doses held its first meeting late Friday afternoon. The directors of the National Institutes of Health and the Centers for Disease Control and Prevention had asked the scientific academies for a framework to inform the CDC’s immunization advisory panel.

The White House has thrown its weight behind several vaccine candidates from companies such as Moderna and AstraZeneca to make hundreds of millions of doses available by the end of the year. But it’s unlikely that the vaccine will be available for everyone right away. Read more from Jeannie Baumann.

Supply Chain Is Unprepared for a Vaccine: The industries that shepherd goods around the world on ships, planes and trucks acknowledge they aren’t ready to handle the challenges of shipping an eventual Covid-19 vaccine from drugmakers to billions of people. Already stretched thin by the pandemic, freight companies face problems ranging from shrinking capacity on container ships and cargo aircraft to a lack of visibility on when a vaccine will arrive. Shippers have struggled for years to reduce cumbersome paperwork and upgrade old technology that, unless addressed soon, will slow the relay race to transport fragile vials of medicine in unprecedented quantities. Read more from Brendan Murray and Riley Griffin.

More Headlines:

TESTING & TREATMENT:

Error Rates on Rapid Tests Put Nursing Homes on Edge: The new rapid Covid-19 antigen tests being sent to thousands of U.S. nursing homes in high-infection areas have a troubling flaw: They provide false negative results for about 15% of infected people.

As nursing home infections climb once again due to the resurgence of the coronavirus, a false negative test could prove dangerous and even fatal for facilities that don’t confirm the results and mistakenly provide access to an infected person, said Christopher Laxton, executive director of AMDA—The Society for Post-Acute and Long-Term Care Medicine. “If you’re putting people into an environment where they may in fact have the virus, it just hasn’t been caught, you’re putting a lot of people at risk. And that certainly is true of staff, but it’s especially true for residents,” said Laxton, whose organization represents more than 50,000 medical directors, doctors and other providers who work in nursing homes and other long-term care settings. Read more from Tony Pugh.

Postal Service Address Sorter for Contact Tracing: The post office’s method of sorting and standardizing addresses could be a powerful tool to track the spread of the coronavirus. The U.S. Postal Service’s address formatting database could help doctors and electronic health record vendors sort patients’ addresses in a uniform way through the agency’s free online address tool, now used to make sure that packages are more efficiently shipped to homes and businesses. Read more from Ayanna Alexander.

Elite Contact Tracers Show How to Beat Covid-19: The work of the Immediate Response Teams offers a look at how South Korea—once the second worst hit by the coronavirus—has succeeded in largely quelling its spread without the lockdowns that have derailed lives worldwide. At a time when cities from Los Angeles to Melbourne to Tokyo are grappling with resurgences, South Korea’s playbook offers one of the most successful blueprints yet for containing a disease that’s killed more than 600,000 worldwide. Read more from Heesu Lee.

More Headlines:

To contact the reporter on this story: Zachary Sherwood in Washington at zsherwood@bgov.com

To contact the editors responsible for this story: Giuseppe Macri at gmacri@bgov.com; Michaela Ross at mross@bgov.com

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