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Rob Califf is on his way to being the FDA commissioner … just barely

The Senate voted Monday evening to advance Robert Califf’s long stalled nomination to lead the FDA. The procedural vote was close – very very close – but it was the clearest sign yet that Califf has the votes to (narrowly) be confirmed as FDA commissioner.


Five Republican senators ultimately voted to save Califf’s floundering nomination: Richard Burr (N.C.), Lisa Murkowski (Alaska), Roy Blunt (Mo.), Susan Collins (Maine) and Mitt Romney (Utah), after five Democrats voted against him.

In the end, he squeaked through with a 49-45 vote. The Senate is expected to hold a full vote on Califf’s nomination later this week.


For more on the late-night nailbiter vote, check out my story with my colleague Rachel Cohrs, here.

Hospital staffing shortages have translated into big profits for private equity

Private equity firms have been rapidly buying up nursing staffing agencies, my colleague Rachel reveals in a new story for STAT. At least ten private equity firms have bought at least seven staffing agencies since the start of 2021, she reports.

So why is private equity suddenly so interested in nursing? The staffing firms are making boatloads of money providing so-called travel nurses to hospitals facing staffing shortages caused by the Covid-19 pandemic.

Already, the trend has got Congress’ attention. Nearly 200 lawmakers asked for an investigation into the nurse staffing industry in January.

For more, check out Rachel’s story here.

Washington may not be able to address drug prices, but …

Most state legislatures are officially back in session after a long winter holiday and they’re getting right back to actually legislating on the issue of high drug prices.

Here’s what’s currently peaking our interest:

The Maine legislature will hold a hearing today on a bill that would peg how much Mainers pay for certain prescriptions to how much is charged in a number of Canadian provinces. A number of other states, including Rhode Island, Hawaii and North Dakota have also introduced similar legislation, which was developed by the National Academy for State Health Policy.

The Washington legislature will hold a hearing Thursday on two proposals that would create a prescription drug affordability board and cap how much state residents could pay for insulin at $35 a month. Both proposals passed the state Senate last week. If the affordability board is signed into law, Washington would join a number of states, including Maryland and Colorado, that have stood up similar boards.

The Massachusetts Senate passed a bill last week 39-1 that would cap monthly insulin costs at $25, set up its own type of drug price review board, and subject drug middlemen to a slew of new oversight. That bill still has to be passed by the Massachusetts House to become law.

One state legislature is also having a different type of health care debate. Over 100 organizations have joined campaign urging the Maryland Senate to continue allowing witnesses at hearings to testify virtually after the Senate’s Democratic president declared that it would resume in-person committee hearings, which were moved online due to Covid-19.

A new lightning rod in the fight over high drug prices

With the BBB Act on the ropes, some drug pricing advocacy organizations are turning their attention to a far more wonky topic: A petition calling on the NIH to use so-called march-in rights to lower the price of the prostate cancer drug Xtandi.

Social Security Works drummed up nearly 16,000 signatures on a petition to the Biden administration on the topic, and they’ve sent in another 1,500 letters directly to the National Institutes of Health, according to the group’s executive director Alex Lawson. House Democrats also called for HHS to grant the petition.

The petition, and the growing swell of advocacy around it, has got drug makers and their allies worried — despite the fact the NIH denied an almost identical petition in 2016.

They have reasons to be worried: The Biden administration already scrapped a Trump administration proposal to limit the use of march-in rights, supported efforts to waive patent protections for Covid-19 vaccines, and HHS Secretary Xavier Becerra vocally supported march-in rights in his previous role as attorney general of California.

“I’m … concerned because you’ve got a full court press on [this] now. This is all over the place…There’s a huge effort now to influence the Biden administration politically,” said Joe Allen, the executive director of the Bayh-Dole Coalition, which does not directly lobby Congress but includes drug makers PhRMA and BIO. Allen described the activists’ efforts as an effort to “intimidate the Biden administration.”

Representatives for the Chamber of Commerce and PhRMA also criticized the petition, but largely did not outline the specific tactics they are using to influence the Biden administration’s deliberations.

“It was always and continues to be inappropriate for the government to consider the use of march-in rights as a price control measure,” said Patrick Kilbride, senior vice president of the Chamber of Commerce’s Global Innovation Policy Center, who added that the group has primarily engaged in the march-in rights debate through the Bayh-Dole Coalition.

STAT stories you may have missed

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Biogen made a counteroffer to Medicare officials trying to limit prescribing of Aduhelm.

One European country is getting serious about cracking down on companies who don’t disclose trial results.

Opinion: A former FDA official makes the case for greater use of Covid-19 therapeutics.

The Federal Trade Commission will formally vote on whether to probe drug middlemen.

A new study shows that rheumatologists who took money from drug makers were more likely to prescribe their drugs.

Pfizer and FDA backed off a controversial plan to charge forward with authorizing Covid-19 vaccines for young children.