Overnight Healthcare

Overnight Health Care: Conservatives buck Trump over fears of 'socialist' drug pricing | White House planning September health policy push | Embattled Juul seeks allies in Washington

Welcome to the Wednesday recess edition of Overnight Health Care. 

Congress is out of town but there is plenty of health care news on tap. Novartis is defending its decision to hide faulty data from the FDA during its drug approval process, conservatives are lining up against Trump's drug pricing moves, and Kellyanne Conway says Trump will unveil another health initiative in a speech next month. 

We'll start with drug pricing...


Conservatives buck Trump over worries of 'socialist' drug pricing 

Conservatives are growing increasingly uneasy with the Trump administration's drug pricing moves. 

President Trump is desperately seeking an elusive political win in his efforts to lower prescription drug costs, but he faces a hard sell to conservative groups and GOP lawmakers as he touts ideas traditionally favored by Democrats.

In a rare break with Trump, conservatives are finding themselves on the same side as drug companies, as they push back against key administration policies and accuse the president of supporting what they call Sanders-style socialism. 

What don't they like? The president has embraced importing drugs from Canada, as well as an international pricing policy that would bar Medicare from paying more than other countries for prescription drugs.

Drug importation and the international pricing caps proposal are the only remaining policies that the White House can use to make a splash heading into 2020. Trump is personally invested in the ideas, and he has been rolling them out over the objections of White House advisers. 

Who is fighting this? Aside from the usual suspects like pharmaceutical companies, the opponents include groups like FreedomWorks, which ran Facebook ads this year urging people to tell Health and Human Services Secretary Alex Azar to oppose "socialist-style price controls." Another ad warned the administration against "importing socialist European drug prices in America."

Separately, a website sponsored by the American Conservative Union rails against the administration's pricing index, calling it an experiment "directly out of the Bernie Sanders and Hillary Clinton government health care takeover playbook."

Will conservative opposition matter? Not likely. With Trump looking for a win on drug pricing, political analysts and health experts argue he doesn't necessarily care about gaining the support of conservatives. Trump also doesn't need to actually lower drug prices, he just needs to convince the public he is trying. 

Read more on the conservative pushback here.


White House planning September health policy push

President Trump is planning a speech in the next month to roll out a major health care initiative, White House advisor Kellyanne Conway told reporters Wednesday. 

It's unclear if the speech will be to announce Trump's long-awaited alternative to the Affordable Care Act, but Conway hinted it could be. The administration last month argued in federal court that the entire health care law is unconstitutional and needs to be struck down; however, they have yet to publicly say what it would be replaced with.

According to the Wall Street Journal, the administration is considering provisions that would expand health savings accounts, link the transparency of health providers' prices to quality metrics, and allow the sale of insurance across state lines. But those ideas were all parts of the failed ObamaCare repeal plan promoted by congressional Republicans two years ago.

The president is scrambling for some sort of political health-care victory, as he shifts his rhetoric to focus on health costs and highlights actions he says will lower prices and challenge special interests.

Trump was originally scheduled to travel to Florida on Wednesday and deliver a speech on Medicare, but that was postponed in the wake of the mass shootings in El Paso and Dayton.

Conway said she could not give specifics about the president's health plan, but she noted that House Republicans have been briefed about the plan. Conway also said Trump is working on a drug pricing proposal. The administration's proposal to bar Medicare from paying more than other countries for prescription drugs was initially proposed in October 2018, and Trump has made numerous references to it in recent speeches. 


Embattled Juul seeks allies in Washington 

Juul Labs is spending big on campaign donations and a massive lobbying blitz as the e-cigarette maker faces growing threats from lawmakers and regulators, and with few allies in Washington.

The company spent $1.95 million on lobbying in the first two quarters of 2019, surpassing its 2018 total of $1.64 million. And Juul's PAC has given nearly $100,000 to lawmakers this year, a pace that will blow past the $225,000 the company spent in the entire 2018 cycle. 

Those moves have rattled Juul's critics, who fear the efforts could slow momentum to combat teen vaping, and question if the company is serious about addressing the problem.

"Juul's increased spending on lobbying and political donations is the latest example that the company says one thing and does another," said Vince Willmore, vice president of communications at the Campaign for Tobacco-Free Kids. 

Why it matters: Juul is trying to evade regulation from the FDA that would crack down on the sales of flavored pods. Democrats and public health officials say flavored pods are too appealing to children and has fueled an epidemic of youth vaping. 

Read more here.


Novartis CEO says organization can 'stand proud' after hiding data from FDA

Drug company Novartis is defending its decision to withhold information from the Food and Drug Administration (FDA) about partially faulty data in its application for approval of a $2.1 million drug. 

Novartis said it didn't tell the FDA about the faulty data until after the agency approved Zolgensma, used to treat spinal muscular atrophy in infants, because it was completing its own internal investigation. 

"Typically what we did in this case is exactly what we do in every case: informing the agency once we actually understand the information we have in hand," said Rob Kowalski, Novartis head of regulatory affairs, said in a conference call Wednesday.

The FDA said Tuesday the company that makes the drug, AveXis, a unit of Novartis, learned the data was incorrect before the drug was approved, but waited until after approval to tell the FDA. 

Novartis CEO Vas Narasimhan said the organization can "stand proud that we tried to do the right things in this instance." 

What's next: The FDA said it is considering civil or criminal action against Novartis. But both Novartis and the FDA says the drug is still safe to use and buy. 

Read more here.


Judge maintains block on Arkansas abortion laws

A federal judge Tuesday maintained a block on three Arkansas abortion laws that would have restricted access to the procedure.

The new preliminary injunction against the laws supplements a court-issued 14-day temporary restraining order implemented last month that was set to expire Tuesday.

The American Civil Liberties Union (ACLU) and Planned Parenthood, among others, filed the suit in June against state laws that would ban abortions after 18 weeks of pregnancy, only allow certified obstetrician-gynecologists to perform the procedure and that outlaw abortion targeting fetuses believed to have down syndrome. The groups say the restrictions violate the 14th Amendment's due process clause. 

"These extreme bans and restrictions would have decimated abortion access in Arkansas, so we're relieved the court has again blocked them from taking effect," said Holly Dickson, legal director and interim executive director of the ACLU of Arkansas. 

Why it matters: The ACLU says if the restrictions are allowed to go into effect, it would force the state's only surgical abortion clinic to shut down. 

Read more about the legal fight here.


What we're reading: 

Factcheck: Doctors argue plans to remedy surprise medical bills will 'shred' the safety net (Kaiser Health News)

For every 69 high-dose opioid prescriptions, U.S. pharmacies dispensed only one overdose-reversal drug (Stat News)

Short-term health plans spend little on medical care (Modern Healthcare)

Are Trump's top Medicaid regulators ignoring major problems? Insurance giant's tense meeting with a senator adds to growing concern. (Propublica and The Dallas Morning News)


State by state: 

Coordinating care of mind and body might help Medicaid save money and lives (Nashville Public Radio)

Minnesota insurer to cap monthly out-of-pocket insulin costs (Star Tribune)

In the opioid litigation, it's now states v. cities (The Wall Street Journal


From The Hill's opinion page: 

If we don't act fast, Hepatitis A will become a national epidemic

Mental trauma from mass shootings -- how do we cope?