Did you have Obamacare on your GOP debate bingo card?

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GOP debate brings back Obamacare fight, albeit briefly

The second Republican presidential debate, still missing lead candidate Donald Trump, spanned drug prices, the opioid crisis, gender affirming care, and even the notion to resurrect Obamacare repeal attempts. No, really.

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Former Vice President Mike Pence suggested he’d be ready to peel back Affordable Care Act authorities in the name of states’ rights. “It’s my intention to make the federal government smaller by returning to the states those resources and programs that are rightfully theirs,” he told the California audience. “That means all Obamacare funding, all housing funding, all HHS funding, all of it goes back to the states.”

That said, Pence is currently polling leagues behind Trump and several of his rivals including Florida Gov. Ron DeSantis and former South Carolina Gov. Nikki Haley. Both of those candidates rallied against the fentanyl crisis while Haley also took shots at the entire health care sector, from hospitals to drugmakers and PBMs, for high costs. More here.

The price is right: vaccine edition

When I got the chance to ask HHS Secretary Xavier Becerra some questions after he got his Covid-19 vaccine last week, he told me the price that the CDC will pay for Covid-19 vaccines “will be similar to what we paid in the past for the vaccines.”

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But those prices are public, and it turns out that the government is paying triple the price this year for boosters compared with last year. For added context, Moderna is discussing selling vaccines to the European Union at one-third of the price that the U.S. is paying.

Read my full story for some reasons why — and what Senate health Chair Bernie Sanders (I-Vt.) thinks of how the whole situation has played out so far.

Drug shortage reform: the long and short of it

Republicans and Democrats alike want to stop drug shortages from happening. But how?

There are multiple legislative proposals floating about, but they don’t form a comprehensive whole, my colleague John Wilkerson writes in an overview of the options that the government has for stemming shortages of chemotherapies and other medicines. There also are existing programs scattered across several government agencies that could help.

Democrats say more forceful government regulation would fix the problem, and Republicans want some sort of incentives that encourage hospitals and generic drug makers to do the right thing. It’s also not clear what drug shortages actually mean. Read more.

FDA panel overwhelmingly rejects ALS treatment

After an impassioned, daylong meeting, the FDA’s expert advisers voted 17-1 with one abstention that the case for NurOwn, a treatment from BrainStorm Cell Therapeutics, was based too heavily on convoluted clinical trial results and compelling but unreliable anecdotal evidence, my colleague Damian Garde reports.

As Damian writes, “BrainStorm’s treatment has become the latest flashpoint in a societal debate over how to balance the needs of patients with grave diseases against the traditional standards of reviewing new medicines.” The FDA has been especially flexible with ALS treatments lately, approving two new drugs for the disease in the past year.

It’s not quite the end of the road for the embattled treatment: The FDA is not required to follow its advisers’ recommendations, though it often does. The agency has promised to make a final decision on BrainStorm’s medicine by Dec. 8. Read more.

Introducing retired Major General Paul Friedrichs

Major General Paul Friedrichs will be the inaugural leader of the White House’s new pandemic response office, and he sat down this week with former White House Covid-19 response official Tom Ingelsby to chat about next steps for the new office.

Friederichs said one of his biggest challenges will be to regain the public’s trust that officials are telling the truth. Given his history of military service, Friederichs will be more well-positioned than many to deliver that message to skeptical Republicans who have disavowed the traditional scientific establishment.

He also mentioned his office’s funding struggles. He said he’s been talking to congressional staff, and that he’ll need money to actually execute plans, saying that “policy in the absence of resources is just a good idea.” He acknowledged that’s going to be a tough ask given the chaos that is government funding policy on the Hill right now.

One bonus line I thought was telling, given reporting that the White House had trouble finding someone to take the job. He advised young people to take on challenging jobs: “That’s where you’ll fix the hardest problems and we need your help,” he said.

What we’re reading

  • Senate committee chair tries to spark negotiations to keep Medicare solvent, STAT
  • ARPA-H finally settles on its headquarters: hubs in Boston, Texas, and D.C., STAT
  • Biden plans $100 million drive to combat drug-resistant ‘superbugs,’ Reuters
  • Just how much money do drugmakers gain from patent extensions?, STAT
  • Safety-net providers bought a record $53.7B of discounted drugs, Axios

Correction: The initial edition of this newsletter misidentified former South Carolina Gov. Nikki Haley’s state affiliation.