Overnight Health Care: Senate panel advances drug pricing bill amid GOP blowback | House panel grills Juul executives | Trump gives boost to state drug import plans | Officials say new migrant kids' shelter to remain open but empty

Overnight Health Care: Senate panel advances drug pricing bill amid GOP blowback | House panel grills Juul executives | Trump gives boost to state drug import plans | Officials say new migrant kids' shelter to remain open but empty
© Greg Nash

Welcome to Thursday's Overnight Health Care.

A drug pricing bill took a step forward in the Senate, President TrumpDonald John TrumpChasten Buttigieg: 'I've been dealing with the likes of Rush Limbaugh my entire life' Lawmakers paint different pictures of Trump's 'opportunity zone' program We must not turn our heads from the effects of traumatic brain injuries MORE met with drug industry executives, and the new president of Planned Parenthood says the group is not political. 

We'll start with drug pricing...


Senate panel advances bipartisan bill to lower drug prices amid GOP blowback

The Senate Finance Committee's bipartisan drug pricing deal advanced out of committee on a 19-9 vote. But those were nine Republican no votes, a higher total than many expected. 

Why the vote matters: The large number of GOP defections doesn't bode well for the likelihood of Senate Majority Leader Mitch McConnellAddison (Mitch) Mitchell McConnellEverytown plans ad blitz on anniversary of House background check bill Kentucky state official says foreign adversaries 'routinely' scan election systems Don't let 'welfare for all' advocates derail administration's food stamp program reforms MORE (R-Ky.) bringing the bill up for a vote in the full Senate, at least not without substantial changes. McConnell is sure to be reluctant to bring up a bill that has such high GOP resistance. 


The key provision: The bill would impose a limit on drug price increases in Medicare's prescription drug program, called Part D, by forcing drug companies to pay money back if their prices rise faster than inflation. 

Many Republican senators opposed this provision as a price control that violates GOP free-market orthodoxy, and therefore opposed the larger package. 

That provision survived a GOP amendment to remove it on a tie vote of 14-14, a sign of the GOP opposition. 

Grassley's argument to Republicans: At least my bill is better than what Speaker Pelosi wants!

"You've got the president campaigning on doing away with the noninterference clause, who knows what he's going to do at the last minute," Grassley told reporters. "If he would join forces with Pelosi, look at what that would do to everything that we Republicans stand for in the United States Senate."

"It seems to me that the Grassley-Wyden approach is a very moderate approach to what could come out," he added. "There's got to be a realization on the part of Republicans about that and there ought to be a realization on the part of pharmaceutical companies where they would be if we had the noninterference clause go away."

The noninterference clause is law that says the government cannot have a role in negotiating Medicare drug prices.

Read more here


Speaking of PhRMA...


Trump meets with drug industry executives amid drug pricing push

The industry group got some face time with the President yesterday. Trump on Wednesday met with pharmaceutical executives at the White House as the industry fights mounting efforts to lower drug prices.

Steve Ubl, the CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA), as well as other drug company executives, used the meeting to voice their opposition to a White House-backed bill moving through the Senate Finance Committee that would lower drug prices.

House Minority Leader Kevin McCarthyKevin Owen McCarthyTrump officially makes Richard Grenell acting intelligence chief Overnight Energy: Trump signs order to divert water to California farmers | EPA proposes new rollback to Obama coal ash rules | Green group ranks Bloomberg, Klobuchar last in climate plans Trump signs order diverting water to California farmers against state wishes MORE (R-Calif.) and Rep. Mark MeadowsMark Randall MeadowsLawmakers grill Census Bureau officials after report on cybersecurity issues Conservative lawmakers warn Pelosi about 'rate-setting' surprise billing fix House GOP leader says reassignment of Vindman was appropriate MORE (R-N.C.), the chairman of the conservative House Freedom Caucus and a close Trump ally, also attended the meeting. 

The White House downplayed the implications of the meeting with drug company executives, saying Trump is not negotiating with them and that it was McCarthy who asked for the meeting.

"At leader McCarthy's request, the president hosted a meeting with PhRMA," the White House said. "The president does not intend to negotiate with PhRMA but listened respectfully."

Read more here.


Juul co-founder distances company from 'Big Tobacco'

During a contentious House hearing Thursday, Juul co-founder James Monsees told lawmakers he never wanted the product to be used by minors.

"We never wanted any non-nicotine user, and certainly nobody underage, to ever use Juul products," Monsees said, while acknowledging that the data show otherwise. "Our company has no higher priority than fighting it."

The House Oversight Subcommittee on Economic and Consumer Policy called Monsees and Ashley Gould, Juul's chief administrative officer, to testify in the second hearing over two days focused on the impact of Juul in creating the youth vaping epidemic. It marked the first time Juul executives testified in front of lawmakers. 

Monsees said that unlike tobacco companies, "we embrace appropriate regulation." Juul has been on the front lines of advocating to raise the age to purchase tobacco to 21. He emphasized that Juul is meant to be an alternative to adult smokers.

"Put simply, Juul Labs isn't Big Tobacco," Monsees said. 

When asked about why tobacco company Altria— the parent company of Philip Morris— would want to own a 35 percent stake in Juul, Monsees said it was an obvious business decision.

"We represent something of an inevitability," Monsees said. "The hope is we can accelerate the decline and alteration of their business to one that doesn't kill people anymore. That's a sustainable business."


Trump gives boost to state drug import plans

The Trump administration has softened its stance on drug importation, giving a boost to states that want to curb rising drug prices by importing medications from Canada.

Health and Human Services (HHS) Secretary Alex Azar said he and President Trump "are committed" to making importation work.

The development marks a significant break from the traditional GOP position, which is opposed to drug importation. Republicans often cite concerns over the safety of imported drugs.

Importation is not a new idea. States have technically had the authority since 2003, but the federal government needs to approve any plan, and certify that it's safe. 

What's causing the resurgence? High drug prices. Trish Riley, executive director of the National Academy for State Health Policy, said the massive spikes in prescription drug prices have put pressure on state officials to act.

"States are frustrated," Riley said. "It's a new phenomenon to see these arbitrary price spikes. It's reached a point where states are looking at everything they can do. Importation is one arrow in their quiver." 

Many, many challenges: White House support is the easy part. Importation could result in lower drug costs, but there are significant barriers. The pharmaceutical industry will lobby hard to kill any importation proposal at the state and federal level.

Canada is also opposed. Canadian officials are concerned that U.S. plans to import their drugs could result in high prices and potential shortages.

In addition, there are currently no wholesalers willing to partner with states, and there's no infrastructure in place to actually carry out the importation. 

Read more on drug importation here.


And check out more stories from The Hill's special report, Policy Prescriptions: Tackling drug prices in America.

Two senators from across the aisle are teaming up to improve transparency on drug pricing by requiring manufacturers to better justify cost increases.

"It is an absolutely opaque process," said Sen. Tammy BaldwinTammy Suzanne BaldwinOvernight Health Care: Appeals court strikes down Medicaid work requirements | Pelosi's staff huddles with aides on surprise billing | Senate Dems pressure Trump to drop ObamaCare lawsuit Senate Democrats pressure Trump to drop ObamaCare lawsuit Democratic senators press Amazon over injury rates MORE (D-Wis.) about how the industry selects prices for drugs, during an event titled "Policy Prescriptions: Lowering Drug Prices," hosted by The Hill and sponsored by AARP on Thursday. "It's actually been one of my missions to follow the dollar and no one can give me an answer."

More on how Baldwin and fellow Sen. Mike Braun (R-Ind.) intend to address the issue here, from The Hill's Josh Aaron Siegel.


President Trump has long highlighted Europe's drug market, arguing that Americans in comparison pay far too much for prescription drugs. And he's now pushing an ambitious proposal that would tie certain Medicare drug prices to lower prices in other countries. The Hill's Peter Sullivan looks at how Trump wants to make U.S. drug prices more like Europe's.


Drug companies are facing increasing pressure to make birth control pills available for over-the-counter sale, but that situation is still years away from reality. The Hill's Jessie Hellmann looks at the tough path advocates for OTC birth control face in the U.S.


Potential breakthroughs in medical treatment for serious diseases are turning what was once "the stuff of science fiction" into "real life science," in the words of former FDA Commissioner Scott Gottlieb. But the worry is that these new breakthroughs will also have enormous price tags. One new gene therapy this year became the world's most expensive drug, with a cost of $2.1 million. Peter takes a look at the worries over high costs for breakthrough medical treatments.


New migrant children's shelter to remain open but empty, officials say

The Trump administration's expensive new facility for holding unaccompanied migrant children in Carrizo Springs, Texas, will remain open, but empty of any children, the Department of Health and Human Services (HHS) said Thursday.

HHS spokeswoman Evelyn Stauffer said that as of Thursday, the last group of children will be discharged to an "appropriate sponsor or transferred from the Carrizo Springs temporary facility to other state licensed programs in HHS' network of care providers."

Stauffer said the agency will "retain access to the Carrizo Springs site for temporary influx as HHS considers options regarding its future use." 

Carrizo Springs is run by the nonprofit firm BCFS, which HHS will pay $50 million for its first 60 days of operation. The contract runs through January 2020, at a cost of up to $300 million, but it's not clear how long HHS will keep the facility open.

Read more here


Judiciary Committee examines family separations

Documents obtained by House Judiciary Committee Democrats showed 850 incidents of family separations between January 2018 and June 2018 that were referred to the Department of Homeland Security's Office of Civil Rights and Civil Liberties, mostly from the HHS refugee office.

During a hearing Thursday, Judiciary Committee Chairman Jerrold NadlerJerrold (Jerry) Lewis NadlerTrump adviser presses House investigators to make Bezos testify Nadler demands answers from Barr on 'new channel' for receiving Ukraine info from Giuliani Trump predicts Ocasio-Cortez will launch primary bid against Schumer MORE (D-N.Y.) said the committee found 12 children who were 1-year-old or younger who were allegedly separated between December 2017 and May 2018.

"These documents are startling," Nadler said. "Even more surprising, the 12 children under the age of 1, nine of those separations occurred before the Trump administration enacted the zero tolerance policy. In many cases, family separation happened without warning and without giving the children the chance to say goodbye to their families. Many were not told where their families were being taken," Nadler said.


New Planned Parenthood president says organization is not political 

Alexis McGill Johnson, acting president and chief executive of Planned Parenthood, penned an op-ed in The Washington Post Thursday arguing the organization isn't political, but has been "politicized" by abortion foes. 

"We are a health-care provider, plain and simple. But as I begin my tenure as acting head of Planned Parenthood, some are dismissing or mischaracterizing the organization's mission as "political," offering a false choice between advocating for women's health and offering health care," McGill Johnson wrote. 

"The sexual and reproductive health care our organization provides is not "political"; it has been politicized — and not by us."

McGill Johnson appears to be pushing back against Leana Wen, who wrote a New York Times op-ed last week claiming she was pushed out as Planned Parenthood's president because she wanted to "depoliticize" the organization. 

"The patients of Planned Parenthood don't have the luxury of pretending that politics can be ignored without experiencing a decline in the access and quality of sexual and reproductive health care. Nor do we," McGill Johnson wrote. 

Read the op-ed here


What we're reading

How drug middlemen like Express Scripts claw back money from pharmacists (Axios)

An AI expert's toughest project: writing code to save his son's life (STAT)

Juul targeted schools, camps and youth programs, House panel claims (The New York Times)

New protocol for HIV prevention drug reduces the number of pills required (CaliforniaHealthline)


State by state

Oklahoma group to begin collecting signatures for Medicaid expansion ballot measure (KFOR)

Arkansas abortion law could threaten Roe v. Wade (Vox.com


From The Hill's opinion page:

The cost of a 'right' to health care is liberty