Friday, December 4, 2020

Marks: Quick vaccine authorization possible after ad comms — Slaoui says 100M could be vaccinated by end of Feb. — Over-the-counter Covid test on horizon?

Presented by CVS Health: Delivered every Tuesday and Friday by 12 p.m., Prescription Pulse examines the latest pharmaceutical news and policy.
Dec 04, 2020 View in browser
 
POLITICO's Prescription Pulse newsletter logo

By David Lim

Presented by CVS Health

With Zachary Brennan and Emily Martin.

On Tap

— FDA's top vaccine regulator predicts emergency authorization could come quickly after an advisory committee meets.

— Operation Warp Speed chief says 100 million in U.S. could be vaccinated by the end of February.

Over-the-counter coronavirus tests may be on the horizon, FDA diagnostics regulator hints.

A message from CVS Health:

Since the start of the pandemic we've used our unique capabilities and unmatched local presence to help respond to the spread of the virus. We've opened 4,000 COVID-19 test sites since March, and administered nearly seven million tests. We're helping businesses and universities safely reopen, and look forward to playing a critical role in the vaccine distribution process. None of this would be possible without the tireless efforts of our 300,000 employees. Learn more.

 

It's Friday, welcome back to Prescription Pulse. Your substitute author is granting this week's best dressed award to FDA's Jeff Shuren for the color block sweater he rocked on a webinar Thursday. As always, send tips to dlim@politico.com or @davidalim. Reach Zachary Brennan at zbrennan@politico.com or @ZacharyBrennan and Sarah Owermohle at sowermohle@politico.com or @owermohle.

Coronavirus

MARKS: VACCINE EUAs WILL COME 'WITHIN A WEEK' OF AD COMMS FDA will likely authorize Pfizer and Moderna's coronavirus vaccines "within about a week" after the agency's vaccine advisory committee reviews each shot, FDA's top vaccine expert Peter Marks said Thursday.

"It will depend on the discussion at the advisory committees," he said during an event hosted by the American Medical Association. The panel will review Pfizer's shot on Dec. 10 and Moderna's on Dec. 17. Both vaccines have proven more than 90 percent effective, and Marks noted that FDA is "not compromising on safety."

"We're getting there as fast as we can because we understand people are losing their lives to this virus, but we also understand that the only way we can save more lives is to get a large proportion of the population to take the vaccine," he added.

FAUCI: UK 'REALLY RUSHED' PFIZER VACCINE APPROVAL Anthony Fauci, the government's top infectious disease expert, criticized the British government's decision to greenlight a coronavirus vaccine as overly hasty on Thursday — contending that the country's approval process relied too heavily on drugmaker data and lacked sufficient scrutiny.

Fauci lamented that Americans are already too skeptical of a potential vaccine, and said that if the U.S. "had jumped up over the hurdle here quickly and inappropriately to gain an extra week or a week-and-a-half" in the vaccine race, "I think that the credibility of our regulatory process would have been damaged."

While the FDA takes time to review raw data from drugmakers and run its own analysis of trial results, the U.K. regulatory agency relies to a much greater extent on reports submitted by pharmaceutical companies.

WARP SPEED CHIEF PREDICTS 100M VACCINATED BY END OF FEBRUARY The United States could vaccinate 100 million people against the coronavirus by the end of February, Moncef Slaoui, chief scientific adviser to Operation Warp Speed, told reporters on Wednesday.

Slaoui's estimate is based on 20 million people receiving the Moderna or Pfizer vaccine this month, with another 30 million people in January and 50 million more in February. The first shipment of the Pfizer vaccine, about 6.4 million doses, will be sent out around Dec. 15 if the vaccine is authorized by then, OWS chief operating officer Gustave Perna said Wednesday. The government is also preparing to send out 12.5 million doses of Moderna's vaccine once it is authorized.

SMALL STUDY SHOWS MODERNA VAX MAY PROVIDE LASTING PROTECTION People who received the Moderna coronavirus shot had higher levels of antibodies three months after vaccination than people who had recovered from Covid-19 infections, according to a report published Thursday in the New England Journal of Medicine.

"We don't yet know what levels of antibodies or types of immune cells will be required to protect against Covid infection," said the study's lead author, Alicia Widge, a vaccine researcher at the National Institutes of Health. "But it's a positive sign how high these levels are and how stable they are over time."

The peer-reviewed finding is based on a comparison of 34 people who got the vaccine as part of a Phase I trial and 41 people who had recovered from confirmed coronavirus infections.

PENCE HEADS TO CDC — Vice President Mike Pence is set to travel to the CDC today to visit employees at the agency's Emergency Operations Center. He is scheduled to hold a round table at noon to discuss Covid-19 vaccines and the planning for their distribution.

PFIZER EXPLAINS WHY IT CUT VACCINE SUPPLY PROJECTIONS Pfizer in early November quietly halved its estimate of how many doses of its coronavirus vaccine would be available this year — from 100 million to 50 million. Now we know why.

Scaling up the raw material supply chain "took longer than expected," a company spokesperson said, confirming a report published Thursday by the Wall Street Journal. "It is important to highlight that the outcome of the clinical trial was somewhat later than the initial projection, requiring us to focus additional efforts on clinical trial production."

Modifications to Pfizer's full-scale production lines in the U.S. and Europe are now complete and doses are being made at a rapid pace, the spokesperson said. Pfizer still expects to produce up to 1.3 billion doses in 2021.

A spokesperson for HHS confirmed that the U.S. supply of about 20 million Pfizer vaccine doses by the end of the year remains accurate and takes into account Pfizer's supply chain issues.

U.S. BUYS 650,000 MORE DOSES OF LILLY ANTIBODY The U.S. government purchased 650,000 additional doses of Eli Lilly's antibody drug for about $813 million, it announced late Wednesday — though widespread shortages of the treatment are still expected.

The government now has bought 950,000 doses of the drug, bamlanivimab, and will continue to distribute it to state health departments for free. But the need will continue to outstrip supply, as states are collectively seeing about 150,000 Covid-19 cases per day.

ELLUME SEEKS AUTHORIZATION FOR OTC COVID TEST — Australia-based Ellume is asking FDA to grant emergency use authorization for its over-the-counter Covid-19 antigen test, CEO Sean Parsons told POLITICO.

The test, which will cost about $30, is designed to be used at home and provides results in 15 minutes. Ellume says it compares favorably to lab-based PCR tests — correctly identifying 100 percent of negative samples and 96 percent of positive samples from people with symptoms. In people without symptoms, it identified 91 percent of positive samples and 96 percent of negative samples.

"The noises coming out of the FDA from our perspective are positive," Parsons said. "They're discussing some of the finer points of labeling and packaging and the sorts of things that are talked about when they're satisfied with the data."

Parsons said Ellume will be able to manufacture 100,000 tests a day in January before ramping up to around 1 million per day by the middle of 2021.

FDA last month granted the first EUA for an at-home test, made by Lucira Health — but it's only available by prescription and costs around $50. The agency's diagnostics director Tim Stenzel hinted Wednesday an over-the-counter authorization is coming soon. "We're absolutely open to OTC and I would anticipate in the not too distant future we're going to start making some OTC determinations," he said.

GIROIR BRIEFS BIDEN TEAM ON TESTING — A "number of senior recognizable individuals" on the Biden team attended a 90-minute virtual meeting Wednesday to be briefed on the policy and technical principles behind the Trump administration's decisions on coronavirus testing, said HHS testing czar Brett Giroir.

"It's important for them to understand the issues around some of the pathways that we took so they get that insight," Giroir said. "My job is not to tell them what to do, but to explain to them, from my perspective, why we made the decisions we did and what I perceive as some of the drawbacks or advantages of different routes."

 

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Eye on FDA

GOTTLIEB SAYS INCREASED HHS GUIDANCE OVERSIGHT WILL HINDER FDA — Former FDA Commissioner Scott Gottlieb warned Thursday that an effort by HHS and the White House to increase oversight of how health agencies use guidance documents will "slow public health work" on the Covid-19 pandemic and future crises.

"HHS and [Office of Information and Regulatory Affairs] should reconsider," Gottlieb tweeted. "The policy constrains FDA's ability to provide important scientific advice."

The department's final rule, released Thursday, requires "significant guidance documents" to undergo a public notice-and-comment period before being issued. It also requires documents to be posted on a searchable HHS website.

"For too long, federal agencies have succumbed to the temptation to create law without notice and comment or public participation," HHS chief of staff Brian Harrison said in a press release.

SHUREN TALKS DEVICE CENTER PRIORITIES Releasing FDA's over-the-counter hearing aid proposed rule is a "high priority" for the agency, medical device director Jeff Shuren told the Alliance for a Stronger FDA on Thursday.

Another goal in 2021 is to issue regulations that bring the U.S. into alignment with ISO 13485, an international standard on quality systems for medical devices.

The device chief also discussed FDA's regulation of Covid-19 tests early in the pandemic, saying the agency's March 16 policy that allowed a flood of antibody tests to be marketed without review was a mistake.

"The policy in hindsight was flawed, I'll be honest," Shuren said. "One of the lessons learned is 'Here's the importance of you've got to review tests going out onto the marketplace.'"

FDA UPDATES COVID TESTING REVIEW GUIDELINES — The FDA on Wednesday revised a frequently asked question outlining what Covid-19 tests will receive priority review, weeks after HHS directed the agency to resume reviewing EUA requests for laboratory-developed tests.

The new version of the question does not mention the tests specifically, instead stating the agency will take into account the "public health need for the product and the availability of the product." It is unclear how many LDTs — which are developed and used in an individual lab — fall under that categorization.

 

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In Congress

Richard Burr IN TALKS TO CHAIR HELP COMMITTEE The North Carolina Republican is in talks with Senate Majority Leader Mitch McConnell about taking over the HELP Committee chairmanship next Congress, he confirmed to Susannah Luthi. But when asked directly if he would take the post, Burr demurred.

"Listen, that's up to what the makeup of Congress is," Burr said, referring to the twin runoffs in Georgia that will determine the Senate majority. "We've got to wait until Jan. 5 for that."

Burr is next in line for the top GOP slot on the powerful committee. But with the FBI probing stock trades he made after an early intelligence briefing on the pandemic, there's been speculation that libertarian firebrand Sen. Rand Paul could get the post instead.

Burr and FDA : Burr has been active in the committee's oversight of the FDA and understands the agency's processes. He's also familiar with the user fee legislation that the next Congress will have to authorize.

Those fees from industry make up more than 60 percent of the FDA's budget on pharmaceutical work.

A former FDA official said Burr has been a friend to the agency on pandemic and hazardous preparedness issues, but he's also been skeptical of some of the FDA-industry user fee agreements and challenged them in the past. Whether he would tinker with the agreements becomes a bigger question if he assumes the chair, the former official said.

Kurt Karst, a Washington lawyer specializing in FDA regulations, said he thought Burr would be the more likely choice for the committee chair. He said Paul's libertarian positions aren't likely to be helpful for the FDA.

PALLONE AND McMORRIS RODGERS TO LEAD E&C New Jersey Rep. Frank Pallone will remain atop the House Energy and Commerce Committee, as the House Democratic Caucus unanimously reelected him as chair on Thursday.

House Republicans on Wednesday tapped Rep. Cathy McMorris Rodgers (R-Wash.) to lead the party on the committee, making her the first woman to hold a leadership role on the panel.

The two leaders have not seen eye to eye on drug pricing measures. Whereas Pallone has called to empower the federal government to negotiate lower drug prices, McMorris Rodgers has called for faster generic drug approvals, lower out-of-pocket spending and price transparency.

A message from CVS Health:

Our mission of helping people on their path to better health has never been more relevant, as the nation faces the grim realities of a pandemic. As an essential business our doors have remained open, and our frontline employees have helped millions of customers and patients safely fulfill their health care needs, from filling a prescription to seeing a MinuteClinic practitioner. Our Coram nurses have helped create hospital bed capacity by transitioning eligible IV-therapy patients to home-based nursing care. Use of our telehealth offerings has increased dramatically as more people discover this convenient option. We're not just your corner drugstore – we're a diversified health services company transforming health by meeting people where they are and making health care more accessible, affordable and simply better. Learn more.

 
Pharma Moves

Johnson & Johnson announced Thursday it is adding former U.S. Army Surgeon General Nadja West to its Board of Directors.

Quick Hits

France's Prime Minister Jean Castex announced a budget of 1.5 billions euros to ensure free Covid-19 vaccines to those in its social security system, Reuters reported.

Vanity Fair confirmed the account of an anonymous informant at a Merck plant in Durham, North Carolina, that detailed a biohazard nightmare involving workers unable to take bathroom breaks after an FDA investigator was sent to inspect the sprawling facility.

The New York Times reported that Facebook said it would remove posts that contain claims about Covid-19 vaccines that have been debunked by public health experts.

French drugmaker Sanofi will announce the price of the Covid-19 vaccine it is developing after it has released Phase I/II results, Reuters reported.

 

NEXT WEEK - DON'T MISS THE MILKEN INSTITUTE FUTURE OF HEALTH SUMMIT 2020: POLITICO will feature a special edition Future Pulse newsletter at the Milken Institute Future of Health Summit. The newsletter takes readers inside one of the most influential gatherings of global health industry leaders and innovators determined to confront and conquer the most significant health challenges. Covid-19 has exposed weaknesses across our health systems, particularly in the treatment of our most vulnerable communities, driving the focus of the 2020 conference on the converging crises of public health, economic insecurity, and social justice. Sign up today to receive exclusive coverage from December 7–9.

 
 
Document Drawer

The FDA and Federal Trade Commission issued a warning letter Wednesday to Rat's Army for selling products that fraudulently claim to treat Covid-19.

FDA on Wednesday updated its reference panel for Covid-19 diagnostic tests to improve its ability to compare the performance of assays.

A federal judge on Thursday sentenced Jeffrey Pearlman, an Insys Therapeutics district sales manager, to three years' probation for engaging in a kickback scheme related to fentanyl spray prescriptions.

 

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