November 21, 2024
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Washington Correspondent, D.C. Diagnosis Writer

You made it to Thursday. It’s been a chaotic week in Washington. It’s not going to calm down for a while. Keep me up to speed with tips and news by emailing me at john.wilkerson@statnews.com

 

THE NEXT HHS

Itching for a fight

RFK Jr. hasn’t been confirmed, or even formally nominated, as HHS secretary, and he already seems to be picking a fight with the nation’s biggest doctor lobby, Rachel Cohrs Zhang scoops.

RFK Jr.’s team is considering a policy to take away the influence that the American Medical Association has over the billing codes that Medicare uses to pay doctors. 

The AMA doctor panel that makes the payment recommendations is powerful, and control of the billing codes is a source of revenue for the trade group. Get more on the scoop by Rachel here.


THE TRUMP TRANSITION

We’re not in Kansas anymore

Presidents can’t officially nominate political appointees until they’re in office, and those nominations typically follow a top-down pattern. Cabinet positions are filled before nominating the agency heads who report to them. 

But that hasn’t stopped President-elect Trump from making announcements about his plan to nominate RFK Jr. to HHS secretary and Mehmet Oz to the head of the HHS agency that runs Medicare and Medicaid.

Oz, a heart surgeon and celebrity, has oscillated between spouting scientific misinformation and taking evidence-based and nuanced stances that place him well outside the Republican mainstream. He also has suggested funding “Medicare Advantage For All” using an “affordable 20% payroll tax.” Read more from the great teamwork by Rachel Cohrs Zhang, Sarah Owermohle, Lev Facher, and Tara Bannow.


TRUMP CABINET

Make America Sick Again

RFK Jr. appears intent on remaking the FDA based on assumptions and conspiracy theories, my colleague Ed Silverman writes. Such an approach would likely turn the clock back toward a time when infectious disease spread quickly and cures remained out of reach.

The disruption could come up next year when industry and the FDA start negotiating the next round of industry user fees that fund the staff needed to review drugs, inspect manufacturing facilities, and ensure that clinical trials are designed appropriately.

RFK Jr. also has warned FDA employees that they should be ready to pack their bags. Ed covers a lot of ground. Get the details here.



FDA INSPECTIONS 

Records? What records?

As the incoming Trump administration weighs its approach to China and Congress considers an anti-China biotech bill, Ed implores us to consider the case of Tianjin Darentang Jingwanhong Pharmaceutical.  

The company refused to hand over records to FDA inspectors, provide access to key production areas, or allow photography of machinery during an inspection of its facilities last March, according to an Oct. 30 warning letter that was posted on the agency web site this week.

The U.S. drug supply relies heavily on Chinese made ingredients, and many lawmakers in both political parties worry that reliance has become a national security risk. Tianjin Darentang Jingwanhong Pharmaceutical may not be an ingredients supplier, but its conduct is an example of why the U.S. government is worried about the pharmaceutical supply chain. More from Ed here.


FDA REGULATION

In the dark

The FDA’s regulation of medical devices can leave patients unaware of hazards lurking in their bodies, and my colleague Lizzy Lawrence has an example

Data has surfaced on a blood-clot prevention device that shows it could break apart after being implanted and migrate to other parts of the body. The clinical trial required for getting the product on the market was designed in a way that might have caused researchers to miss adverse events. That aside, data from the trial wasn’t available to patients and their doctors anyway

“Especially in this current moment where there’s so much concern about trust, medicine, and FDA transparency, this is a tangible example of where that lack of transparency really does cause harm,” said Kushal Kadakia, an author of a paper on the incident.


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What we’re reading

  • A husband designs a prosthetic nipple for his wife’s breast reconstruction, STAT
  • Anti-abortion groups drop challenge to abortion pill as states seek to continue the case, Reuters
  • Dr. Oz’s “Heal America” slogan from years ago was a prototype of the MAHA movement. From the STAT archives
  • RFK Jr. ranks No. 4 on list of diciest Trump Cabinet picks, Washington Post

Thanks for reading! More next week,