Friday, November 15, 2024

RFK Jr. pick sparks FDA concerns

Presented by 340B Health: Delivered every Tuesday and Friday by 12 p.m., Prescription Pulse examines the latest pharmaceutical news and policy.
Nov 15, 2024 View in browser
 
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By Lauren Gardner and David Lim

Presented by 340B Health

With Sophie Gardner and Carmen Paun

Driving the Day

Robert F. Kennedy Jr. speaks at a microphone.

The nomination for Robert F. Kennedy Jr. for HHS secretary raises questions about who will be chosen to fill the top spot in the FDA. | Carlos Osorio/AP

THE RFK JR. DOMINO EFFECT — Robert F. Kennedy Jr.’s selection Thursday as President-elect Donald Trump’s Health and Human Services secretary nominee sent shockwaves through Washington, seemingly raising the odds that one of his “Make America Healthy Again” acolytes will be tapped to run the FDA, the CDC and other health agencies.

Medical experts decried the pick as a danger to U.S. public health, given Kennedy’s skeptical view of vaccines and growing public distrust of immunization recommendations.

Shortly after the election, we compiled a list of possible FDA and health agency candidates, which also included veterans of Trump’s first term who could still emerge.

Taking temperatures: The POLITICO health team fanned out across Capitol Hill this week to ask lawmakers what they thought about Kennedy’s influence over the transition team, whether they’d be willing to confirm him or his associates to executive branch positions and — for some Republicans — whether they’d entertain an FDA job offer.

Retiring Rep. Larry Bucshon , a heart surgeon whose name has been floated as a possible FDA commissioner pick, told Lauren on Wednesday he hadn’t heard from the transition team, adding that “the health care people have my resume — they know who I am.”

But the Indiana Republican said he didn’t think Kennedy should have an official role in the next administration despite being “a potentially valuable asset.”

The “best thing would be [putting him in] an advisory role on health care issues. And the reason I say that is because his views on, particularly, vaccinations are not mainstream and have not been,” he said.

But another retiring GOP doctor, Texas Rep. Michael Burgess, told Lauren that Kennedy has “some good suggestions.”

“The FDA has just been a bureaucratic quagmire for so long, and it’s tough — they had so many opportunities, both before and after the pandemic, and there were just opportunities lost,” he said. “So I’m glad someone might be looking at that with a fresh set of eyes.”

The incoming Senate HELP Committee chair, Louisiana Republican Bill Cassidy , said in a statement that he looks forward to learning more about Kennedy’s positions beyond healthy foods and public health “transparency … and how they will support a conservative, pro-American agenda.” While the Finance Committee has jurisdiction over the HHS secretary nominee, Cassidy will lead the review process for Trump’s other HHS agency picks — including the FDA commissioner.

View from the agencies: CDC Director Mandy Cohen said before Kennedy’s announcement that she was concerned about what putting him in a place of authority could mean for public trust in vaccines.

“I don’t want to go backwards and see children or adults suffer or lose their lives to remind us that vaccines work,” she said.

FDA Commissioner Robert Califf and his press office didn’t respond to requests for comment.

IT’S FRIDAY. WELCOME BACK TO PRESCRIPTION PULSE. Are you talking to the transition team about a job at the FDA? We want to hear from you! We can keep a secret.

Send tips to David Lim (dlim@politico.com or @davidalim) and Lauren Gardner (lgardner@politico.com or @Gardner_LM).

 

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Pharma’s rebate schemes dodge their obligation to provide 340B hospitals with upfront discounts. By delaying rebates, drug companies would force 340B hospitals to purchase 340B drugs at full price and wait for drugmakers to decide when — and whether — to rebate the difference. Lawmakers must protect 340B by blocking this harmful tactic. Let’s hold drug companies accountable and ensure 340B hospitals can continue serving our most vulnerable populations without financial strain. Learn more.

 
In Congress

The U.S. Patent and Trademark Office is pictured.

Two patent reform bills are on hold as senators work to address drug price concerns. | AP

PATENT BILLS HELD OVER — The Senate Judiciary Committee again held over two patent bills Thursday that have drawn opposition from patient advocacy groups focused on lowering drug costs.

The bills were initially scheduled to be marked up in September, but the panel delayed action for a week — a common practice for the committee. Lawmakers then left town early before the October recess to beat Hurricane Helene, which hit the Gulf Coast.

The legislation: One measure would overhaul the patent review process at the Patent Trial and Appeal Board to require petitioners to have standing — namely, to have been sued or charged with patent infringement before filing for a review.

The second would expand the processes eligible for patents to include “a use, application, or method of manufacture of a known or naturally-occurring process.” Both bills are led by Sens. Chris Coons (D-Del.) and Thom Tillis (R-N.C.).

The pair said they’re making progress on winning over support from committee members but need more time to address concerns raised by some colleagues. Each senator suggested that outside groups are misrepresenting what the bills would do.

“It’s going to get marked up, so those who may be trying to undermine progress of either [bill] … need to get at the table before they get on the table,” Tillis said.

Coming attractions: Coons said he’s drafted a manager’s amendment to the PTAB bill to incorporate provisions to address concerns from three Democrats — Sens. Richard Blumenthal (D-Conn.), Amy Klobuchar (D-Minn.) and Peter Welch (D-Vt.) — that the measure’s standing requirement would preclude generic drugmakers and patient advocates from challenging patents at the agency.

Lobbying groups for both interests have said the bills would make it easier for big drug companies to use the patent system to their advantage.

Two Republicans — Sens. Ted Cruz (R-Texas) and Marsha Blackburn (R-Tenn.) — asked Coons to delay a vote on the bill so they could continue negotiating potential amendments, the Delaware Democrat said, adding he hopes to advance it at the panel’s next markup.

PANDEMIC LESSONS LEARNED — Top officials from the CDC, the FDA and the NIH told lawmakers Thursday the lessons they learned during the pandemic response and how they’ll apply them in the future, at the final hearing of the House Select Subcommittee on the Coronavirus Pandemic.

Dr. Henry Walke, the CDC’s Office of Readiness and Response Director, said his institution released guidance that was too technical for the public to understand during Covid and the agency has since improved its communication. It’s done the same for its test development process, which famously failed in the pandemic’s early days. Now, the CDC is trying to work with other partners to develop tests for avian influenza and oropouche, a viral tropical infection reported in parts of Central and South America and the Caribbean.

Dr. Hillary Marston, the FDA’s chief medical officer, said the agency has found ways to better mitigate supply disruptions leading to drug and medical device shortages, which were also prominent in the pandemic’s early days.

Lawrence Tabak, NIH’s principal deputy director, said the agency has improved its oversight system for awarded grants. That came after documents the select subcommittee released showed one grantee, the EcoHealth Alliance, did not fully comply with reporting requirements over its NIH-funded work with a virology lab in Wuhan, China, the city where the pandemic started. The lab has been at the center of a theory that the virus that caused the pandemic came from a lab accident, not an infected animal.

Why it matters: While the hearing aimed to showcase how to be better prepared for the next pandemic, the steps agencies took to address their shortcomings while responding to Covid might not matter as a new Trump administration prepares to take over in January.

Kennedy said this weekend he would replace 600 people at the NIH, ABC reported. He also wants to fire the FDA’s nutrition workforce, which he believes has failed at regulating food to keep Americans healthy.

Industry Intel

AVIAN FLU RAPID TEST IN THE WORKS — Alveo Technologies has reached an agreement with the CDC to develop a rapid test for avian flu in humans, the company said today.

The test will be able to differentiate between H5 bird flu and other strains of influenza. Results should be available in 30-45 minutes, according to a company spokesperson.

“We are proud to work with CDC to be a part of a national preparedness effort by enabling timely detection and response where it matters most — at the front lines of care,” Shaun Holt, CEO of Alveo, said in a statement.

Key context: Currently, the CDC produces the only FDA-authorized avian flu test. In June, the agency initiated an open call to industry for “innovative solutions” to meet the agency’s avian-flu testing needs.

Last week, the CDC released a study that suggested H5N1 cases in many dairy workers go undetected and broadened its testing guidance.

 

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Pharma Worldwide

BIOGEN GETS A WIN FROM EU — A European Medicines Agency advisory committee recommended approval of Eisai and Biogen’s early Alzheimer’s disease treatment lecanemab for a subset of patients, reversing a negative opinion from July. The FDA approved the drug in 2023.

Document Drawer

The FDA published draft guidance outlining recommendations for companies conducting nonclinical safety evaluations of oligonucleotide-based therapeutics — treatments that affect gene expression.

WHAT WE'RE READING

A drop in global measles vaccination during the Covid-19 pandemic contributed to a 20 percent increase in measles cases in 2023 compared with 2022, STAT's Helen Branswell reports.

More older adults have gotten the Covid-19 vaccine this year compared with the same time last year, per CDC survey data, CBS News’ Alexander Tin reports.

 

A message from 340B Health:

Pharma’s rebate schemes are a deliberate dodge, sidestepping their obligations to provide upfront discounts that 340B safety-net hospitals rely on. By replacing immediate discounts with delayed rebates, drug companies force disproportionate share (DSH) hospitals to pay full price for medications and endure months-long waits for refunds. This dodge tactic drains hospital resources and disrupts access to critical care for low-income, rural, and underserved communities. When 340B hospitals are forced to operate under these rebate schemes, the victims are the patients and communities they serve.

340B hospitals provide 77% of Medicaid hospital care and 67% of uncompensated care in the U.S. Without vital 340B savings, many hospitals will be forced to scale back or eliminate programs, leaving patients and communities without access to affordable care. Lawmakers must act now to end this rebate dodge and hold drug companies accountable to the program’s original intent. Learn more.

 
 

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