with Alexandra Ellerbeck

Democrats and activists spent the last week begging the White House to include measures to lower drug prices in its next big spending proposal.

It didn't work. 

A summary of the plan President Biden will present to Congress tonight is devoid of drug pricing initiatives.

Biden will call for devoting hundreds of billions of dollars to child care, prekindergarten, and paid family and sick leave – along with making Obamacare subsidy expansions permanent – in the $1.8 trillion “American Families Plan” he'll lay out in his joint address to Congress at 9 p.m. 

“The White House’s new ‘American Families Plan’ provides Congress with details of the president’s domestic agenda, setting down markers for negotiations later this year,” Jeff Stein, Danielle Douglas-Gabriel, Laura Meckler and Caroline Kitchener write. “Biden’s plan proposes a suite of domestic policies that would collectively represent a marked change in how Americans interact with the federal government.”

But the White House decided to forgo controversial proposals to lower the high cost of prescription drugs. The plan won’t include any of the bold drug pricing proposals Democrats have been hoping to advance for the last 18 months — things such as allowing the federal government to directly negotiate for lower drug prices and capping drug costs for seniors. 

Even as Democrats have focused on how to further expand health coverage, lowering the high cost of brand-name prescription drugs in the United States has also emerged as a key goal for many progressives in recent years.

“It appears the White House may have made a decision to not include that in this package,” said Rep. Peter Welch (D-Vt.) in an phone interview.

But, he added, “I don’t take that in any way as a rejection of doing it separately or possibly including it as it goes through the legislative process.”

The White House decision is deeply frustrating to House Democrats.

At the end of 2019, they passed H.R. 3, which would do three primary things to lower drug costs and prices:

  • It would cap out-of-pocket drug costs for seniors in Medicare Part D plans at $2,000 per year.
  • It would require manufacturers of all drugs sold to Medicare and employer health plans to either reduce prices or pay rebates to the Treasury for drugs for which prices have grown more rapidly than inflation since 2016.
  • It would allow the health and human services secretary to directly negotiate the prices of between 50 and 250 branded drugs with the greatest cost to the health-care system. An international price index would be used as a target price ceiling.

Just two House Republicans voted for H.R 3. But anticipation had been growing around reports Biden would include elements of the bill in his spending plan, which Democrats could push through Congress using a special budget reconciliation process that allows them to exclude Republicans.

As Biden backs away from drug pricing, members of his party are leaning into it.

Next week, the House Energy and Commerce Committee will hold a hearing on H.R. 3, which members recently reintroduced. 

And House Speaker Nancy Pelosi (D-Calif.) issued a strong response to the news that drug pricing was being scrapped in the spending bill, saying  last week “lowering health costs and prescription drug prices will be a top priority for House Democrats to be included in the American Families Plan.”

But some fear the window for taking on the drug industry is closing quickly.

A torrent of health-care and patient advocates have turned up the dial, pleading with the administration to stay the course. 

“We must seize this opportunity to finally carry forward long-standing policy solutions thwarted by the pharmaceutical industry at the expense of consumers and patients struggling to make ends meet,” says a letter led by Families USA. “Anything short of Medicare drug negotiation will fail to meet this moment.”

But Democrats have only slim majorities in both chambers, and it’s not clear the measure has support from enough Democratic moderates.

“We’ve got a razor-thin margin in the House and 50-50 in the Senate, so I think they have to make some practical judgments,” Welch said, referring to the White House.

And it’s never easy to take on the pharmaceutical and medical products industry, which employs nearly three lobbyists for each member of Congress. It could get even harder next year, during the midterm election cycle.

“I’m very worried that if they don’t put health-care costs on the agenda, it is basically them saying they have no intention of doing anything before the midterms,” one health-care lobbyist wrote me.

Larry Levitt, senior vice president at the Kaiser Family Foundation:

There’s also feeling that the pandemic is a hard time to go after the pharmaceutical industry.

The industry is certainly focused on reminding Americans just how much they’re relying on vaccines developed by companies including Pfizer, Moderna and Johnson & Johnson. The Pharmaceutical Research and Manufacturers of America recently launched a series of ads highlighting just that.

Correction: An earlier version mistakenly said there is no GOP support for H.R. 3. Two House Republicans – Reps. Brian Fitzpatrick (R-Pa.) and Jaime Herrera Beutler (R-Wash.) – voted for it.

Ahh, oof and ouch

AHH: The CDC says fully vaccinated Americans still need to mask indoors.

Yesterday the agency relaxed its mask guidance, but only modestly. It said both vaccinated and unvaccinated Americans can forgo masks outdoors when walking, jogging or biking with household members, given that the coronavirus infrequently transmits outside.

“The guidelines address growing calls from infectious-disease and other public health experts to relax mask mandates for the outdoors because breezes disperse airborne virus particles, distancing is easier, and humidity and sunlight render the coronavirus less viable,” The Post’s Lena H. Sun reports.

The CDC also said the fully-vaccinated may dine outdoors at restaurants and attend small outdoor gatherings without masks. However, officials urged all Americans, regardless of vaccination status, to wear masks while inside and in crowded outdoor settings, such as live performances and parades.

“The examples today show that when you are fully vaccinated, you can return to many activities safely … and begin to get back to normal,” CDC Director Rochelle Walensky said.

The announcement sparked lots of reaction online – including from some who said the CDC guidance is still too conservative, given the potentially tiny risks of transmitting the virus after being vaccinated.

Former GOP House staffer Rory Cooper:

Former Baltimore health commissioner:

OOF: New rules make it easier for doctors to prescribe addiction medication.

The Biden administration announced that doctors, nurse practitioners, physician assistants and a range of other providers will be able to prescribe buprenorphine, an opioid addiction treatment, without first undergoing a separate training and applying for a waiver.

Buprenorphine is considered one of the most effective treatments for opioid addiction, but onerous requirements aimed at preventing misuse have meant that many patients cannot access the treatment. 

“For years, many addiction physicians and public health advocates have argued that the “X-waiver,” as the special buprenorphine license is known, poses a barrier to basic care for patients with opioid addiction. In particular, many have argued that if a doctor can prescribe potentially addictive prescription pain drugs, they should also be able to prescribe the medicine used to treat the addiction,” Stat News’s Lev Facher reports.

The move is similar to a proposal announced during the final days of the Trump administration but goes further by including more prescribers. The Biden administration put a hold on the Trump proposal soon after taking office to conduct a legal and policy review.

OUCH: India’s health system has been crushed by the coronavirus.

“In India’s devastating second wave of coronavirus infections, patients and their families are on their own, fighting to save their loved ones in an overwhelmed system where ambulances, hospital beds, oxygen, medicine and even cremation grounds are in short supply,” The Post’s Joanna Slater, Niha Masih and Shams Irfan report.

The country is reporting more than 300,000 cases of the virus and nearly 3,000 deaths a day, but experts say those numbers are undercounts.

Many who fall ill are unable to receive care. In Delhi on Tuesday, there were just nine intensive care beds available for covid patients in a city of more than 17 million. While countries around the world, including the United States, have promised to supply aid, it’s unclear how quickly it will arrive.

For some, the aid will arrive too late. Our colleagues recount the case of Rehmat Ahsan, who died of covid-19 in his home in New Delhi after struggling to breathe. In the days and hours leading up to his death, Ahsan's family embarked on a desperate search for an open bed in a covid-19 ward, only to find them all full. Ahsan’s older brother paid $350 for an oxygen cylinder, which lasted eight hours, but when he went to refill it, there were hundreds of people in line. 

The push to get everyone vaccinated

One hundred days into his presidency, Biden can claim progress in the fight against the coronavirus.

Death rates from the vaccine have plummeted, and more than half of American adults have received at least one dose of a vaccine. Polls show that most voters approve of Biden’s handling of the pandemic.

“But the hard part may be just beginning, as the mission switches from churning out vaccines to getting people to actually get them — especially the reluctant, the remote and the disadvantaged,” The Post’s Annie Linskey reports. “If the first challenge was logistical, the second is societal. It will require Biden to battle false information, challenge political divisions and overcome prejudices. How well he succeeds could determine the course of his presidency.”

School openings could also prove a challenge. Data suggests that Biden will meet his promise of having most K-8 public schools open for in-person learning within his first 100 days. But many classrooms remain empty, and experts say that schools may not be back to normal even by the start of the school year next fall.

Republican doctors in Congress are urging people to get vaccinated in a new ad.

The campaign comes as polls show that nearly half of unvaccinated Americans say that they do not want the vaccine, with younger Republicans being particularly vaccine-hesitant, the Hill's Peter Sullivan reports.

The lawmakers in the video include Sens. Roger Marshall (Kan.) and John Barrasso (Wyo.), both medical doctors; Sen. John Boozman (Ark.), a doctor of optometry; Reps. Greg Murphy (N.C.), Larry Bucshon (Ind.), John Joyce (Pa.) and Andy Harris (Md.), all of whom are doctors; Rep. Brian Babin (Tex.), a dentist; and Rep. Buddy Carter (Ga.), a registered pharmacist.

They stress that vaccinations will allow Americans to shed their masks and see family, point out that more than 90 percent of doctors have opted for a shot, and push back against the notion that the shots were rushed.

“They cut bureaucratic red tape, not corners,” says Burgess, speaking of the process of making and vetting the vaccines.

Some advisers to former president Donald Trump are also pushing for him to appear in a vaccine ad. Trump has told supporters that they should get a vaccine, but he did not publicize his own vaccination and has not appeared in any public health campaigns.

West Virginia is offering a $100 savings bond to every young person who gets vaccinated.

The state will give the money to every person between the ages of 16 to 35 — one of the demographics most resistant to vaccination — who gets the shot. The deal is also available retroactively to those who have already been vaccinated, The Post’s William Wan and Paulina Firozi report.

The plan is the brainchild of West Virginia Gov. Jim Justice (R), who has been looking for outside-the-box solutions to persuade residents in his state to get vaccinated. He calculated the total bill for the savings bonds at roughly $27.5 million. In the past year alone, the state has spent more than $75 million to test people for the virus.

“It would be such a drop in the bucket compared to the ungodly amount of money we’re spending right now,” Justice told The Post. He acknowledges that there are critics. “But if I’m able to pull this off and we are able to shut this down for the small price of $27.5 million … I would tell those critics to kiss my butt.”

Novavax is preparing to file for FDA authorization soon.

Novavax’s vaccine proved just as effective as the mRNA shots from Pfizer-BioNTech and Moderna in a trial in the United Kingdom. If approved, the shot would become the fourth vaccination to be used in the United States.

But the tiny U.S. drugmaker, which has never brought a product to market, got off to a rocky start and faces a momentous task in ramping up production. After initially struggling to scrape together the tens of thousands of doses needed for its clinical trial, the company has enlisted production partners worldwide, Politico’s Sarah Owermohle and Carmen Paun report. It has committed 100 million doses of its shot to the U.S. by the end of this year and plans to send 1.1 billion doses to low- and middle-income countries.

Sugar rush

@washingtonpost

The U.S. will share up to 60 million doses of the AstraZeneca vaccine with other countries. It will ship out once it clears federal safety reviews.

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